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<1>
Accession Number
2022947638
Title
Prognostic Value of Preprocedural LV Global Longitudinal Strain for
Post-TAVR-Related Morbidity and Mortality: A Meta-Analysis.
Source
JACC: Cardiovascular Imaging. 16(3) (pp 332-341), 2023. Date of
Publication: March 2023.
Author
Stens N.A.; van Iersel O.; Rooijakkers M.J.P.; van Wely M.H.; Nijveldt R.;
Bakker E.A.; Rodwell L.; Pedersen A.L.D.; Poulsen S.H.; Kjonas D.; Stassen
J.; Bax J.J.; Tanner F.C.; Lerakis S.; Shimoni S.; Poulin F.; Ferreira V.;
Reskovic Luksic V.; van Royen N.; Thijssen D.H.J.
Institution
(Stens, Rooijakkers, van Wely, Nijveldt, van Royen) Department of
Cardiology, Radboud Institute for Health Sciences, Radboud University
Medical Center, Nijmegen, Netherlands
(Stens, van Iersel, Bakker, Thijssen) Department of Physiology, Radboud
Institute for Health Sciences, Radboud University Medical Center,
Nijmegen, Netherlands
(Rodwell) Department of Health Evidence, section of Biostatistics, Radboud
Institute for Health Sciences, Radboud University Medical Center,
Nijmegen, Netherlands
(Pedersen, Poulsen) Department of Cardiology, Aarhus University Hospital,
Aarhus N, Denmark
(Kjonas) Department of General and Gastrointestinal Surgery, University
Hospital of North Norway, Tromso, Norway
(Stassen, Bax) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Bax) Turku Heart Center, University of Turku and Turku University
Hospital, Turku, Finland
(Tanner) Department of Cardiology, University Heart Center Zurich, Zurich,
Switzerland
(Lerakis) Department of Cardiology, Mount Sinai Heart, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Shimoni) The Heart Center, Kaplan Medical Center, Rehovot, Israel
(Poulin) Division of Cardiology, Hopital du Sacre-Coeur de Montreal,
Montreal, Canada
(Ferreira) Department of Cardiology, Hospital de Santa Marta, Centro
Hospitalar Universitario de Lisboa Central Lisbon, Lisbon, Portugal
(Reskovic Luksic) Department of Cardiovascular Diseases, University of
Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb,
Croatia
(Thijssen) Research Institute for Sport and Exercise Sciences, Liverpool
John Moores University, Liverpool, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Left ventricular ejection fraction (LVEF) demonstrates limited
prognostic value for post-transcatheter aortic valve replacement (TAVR)
outcomes. Evidence regarding the potential role of left ventricular global
longitudinal strain (LV-GLS) in this setting is inconsistent.
<br/>Objective(s): The aim of this systematic review and meta-analysis of
aggregated data was to evaluate the prognostic value of preprocedural
LV-GLS for post-TAVR-related morbidity and mortality. <br/>Method(s): The
authors searched PubMed, Embase, and Web of Science for studies
investigating the association between preprocedural 2-dimensional
speckle-tracking-derived LV-GLS and post-TAVR clinical outcomes. An
inversely weighted random effects meta-analysis was adopted to investigate
the association between LV-GLS vs primary (ie, all-cause mortality) and
secondary (ie, major cardiovascular events [MACE]) post-TAVR outcomes.
<br/>Result(s): Of the 1,130 identified records, 12 were eligible, all of
which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On
average, 2,049 patients demonstrated preserved LVEF (52.6% +/- 1.7%), but
impaired LV-GLS (-13.6% +/- 0.6%). Patients with a lower LV-GLS had a
higher all-cause mortality (pooled HR: 2.01; 95% CI: 1.59-2.55) and MACE
(pooled odds ratio [OR]: 1.26; 95% CI: 1.08-1.47) risk compared with
patients with higher LV-GLS. In addition, each percentage point decrease
of LV-GLS (ie, toward 0%) was associated with an increased mortality (HR:
1.06; 95% CI: 1.04-1.08) and MACE risk (OR: 1.08; 95% CI: 1.01-1.15).
<br/>Conclusion(s): Preprocedural LV-GLS was significantly associated with
post-TAVR morbidity and mortality. This suggests a potential clinically
important role of pre-TAVR evaluation of LV-GLS for risk stratification of
patients with severe aortic stenosis. (Prognostic value of left
ventricular global longitudinal strain in patients with aortic stenosis
undergoing Transcatheter Aortic Valve Implantation: a meta-analysis;
CRD42021289626)<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<2>
Accession Number
2021747789
Title
The cisterna chyli: a systematic review of definition, prevalence, and
anatomy.
Source
American Journal of Physiology - Heart and Circulatory Physiology. 323(5)
(pp H1010-H1018), 2022. Date of Publication: November 2022.
Author
Moazzam S.; O'Hagan L.A.; Clarke A.R.; Itkin M.; Phillips A.R.J.; Windsor
J.A.; Mirjalili S.A.
Institution
(Moazzam, O'Hagan) School of Medicine, The University of Auckland,
Auckland, New Zealand
(Clarke) Auckland Bioengineering Institute, The University of Auckland,
Auckland, New Zealand
(Itkin) Department of Radiology, Perelman School of Medicine, University
of Pennsylvania, Philadelphia, PA, United States
(Phillips) Applied Surgery and Metabolism Laboratory, School of Biological
Sciences, The University of Auckland, Auckland, New Zealand
(Windsor) Surgical and Translational Research Centre, Faculty of Medical
and Health Sciences, The University of Auckland, Auckland, New Zealand
(Mirjalili) Department of Anatomy and Medical Imaging, The University of
Auckland, Auckland, New Zealand
Publisher
American Physiological Society
Abstract
The cisterna chyli is a lymphatic structure found at the caudal end of the
thoracic duct that receives lymph draining from the abdominal and pelvic
viscera and lower limbs. In addition to being an important landmark in
retroperitoneal surgery, it is the key gateway for interventional
radiology procedures targeting the thoracic duct. A detailed understanding
of its anatomy is required to facilitate more accurate intervention, but
an exhaustive summary is lacking. A systematic review was conducted, and
49 published human studies met the inclusion criteria. Studies included
both healthy volunteers and patients and were not restricted by language
or date. The detectability of the cisterna chyli is highly variable,
ranging from 1.7 to 98%, depending on the study method and criteria used.
Its anatomy is variable in terms of location (vertebral level of T10 to
L3), size (ranging 2-32 mm in maximum diameter and 13-80 mm in maximum
length), morphology, and tributaries. The size of the cisterna chyli
increases in some disease states, though its utility as a marker of
disease is uncertain. The anatomy of the cisterna chyli is highly
variable, and it appears to increase in size in some disease states. The
lack of well-defined criteria for the structure and the wide variation in
reported detection rates prevent accurate estimation of its natural
prevalence in humans.<br/>Copyright &#xa9; 2022 the American Physiological
Society.

<3>
Accession Number
2020505872
Title
Effect of Soybean Isoflavones on Proliferation and Related Gene Expression
of Sow Mammary Gland Cells In Vitro.
Source
Animals. 12(23) (no pagination), 2022. Article Number: 3241. Date of
Publication: December 2022.
Author
Ma X.; Cui Y.; Tian Z.; Yu M.
Institution
(Ma, Cui, Tian, Yu) Institute of Animal Science, Guangdong Academy of
Agricultural Sciences, Key Laboratory of Animal Nutrition and Feed Science
in South China, Ministry of Agriculture, State Key Laboratory of Livestock
and Poultry Breeding, Guangzhou, China
(Ma, Cui, Tian, Yu) Guangdong Public Laboratory of Animal Breeding and
Nutrition, Guangzhou, China
(Ma, Cui, Tian, Yu) Guangdong Engineering Technology Research Center of
Animal Meat Quality and Safety Control and Evaluation, Guangzhou 510640,
China
Publisher
MDPI
Abstract
The present study was conducted to investigate the effects of synthetic
soybean isoflavones (ISO) on the proliferation and related gene expression
of sow mammary gland cells. Cells were cultured with 0 (control), 10, 20,
or 30 muM of ISO under incubation conditions. After a 48 h incubation,
these ISO-incubated cells proliferated more (p < 0.05) than the control
cells. Cyclin E expression was higher (p < 0.05) in the 10 muM ISO and 20
muM ISO treatment groups than in the control group. Cyclin D1 and p21
expressions decreased (p < 0.05) with the 10 muM ISO treatment for 48 h.
The relative mRNA abundances of the cells' IG-1R (Insulin-like growth
factor-1R), EGFR (Epidermal growth factor receptor), STAT3 (Signal
transducer and activator of transcription 3) and AKT (protein kinase B)
were enhanced (p < 0.05) by the 20 muM ISO treatment for 24 h and 48 h in
the medium. The relative mRNA abundances of kappa-casein at 48 h of
incubation and beta-casein at 24 h and 48 h of incubation were increased
(p < 0.05) by 10 muM of ISO supplementation. It was concluded that ISO
improved the proliferation of sow mammary gland cells, possibly by
regulating cyclins and function genes expression in the cell proliferation
signaling pathway.<br/>Copyright &#xa9; 2022 by the authors.

<4>
Accession Number
640991596
Title
The effects of differing anticoagulant regimes on blood quality after cell
salvage in coronary artery bypass grafting (CABG): a pilot study.
Source
Journal of cardiothoracic surgery. 18(1) (pp 116), 2023. Date of
Publication: 08 Apr 2023.
Author
Boer W.; van Tornout M.; Brusseleers M.; Strauven M.; de Vooght P.; Vander
Laenen M.; Hoste E.; Jorens P.G.
Institution
(Boer) Department of Anesthesiology, Intensive Care Medicine, Emergency
Medicine and Pain Medicine, Ziekenhuis Oost Limburg ZOL, Genk, Belgium
(van Tornout) Department of Anesthesiology and Intensive Care Medicine, AZ
Sint-Jan Brugge-Oostende AV, Brugge, Belgium
(Brusseleers, Strauven, de Vooght, Vander Laenen) Department of
Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain
Medicine, Ziekenhuis Oost Limburg ZOL, Genk, Belgium
(Hoste) Intensive Care Unit, Department of Internal Medicine and
Pediatrics, Ghent University Hospital, Ghent University, Ghent, Belgium
(Hoste) Research Foundation Flanders (FWO), Brussels, Belgium
(Jorens) Department of Critical Care Medicine, Antwerp University
Hospital, University of Antwerp, Edegem, Belgium
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cell salvage reduces allogenic blood transfusion requirements
in surgery. We present a pilot study exploring the impact of anticoagulant
choice, citrate or heparin, on the quality of cell salvaged blood in
adults undergoing coronary artery bypass grafting (CABG). MATERIALS AND
METHODS: Elective on pump CABG patients were randomly allocated to citrate
or heparin anticoagulation. We measured red blood cell characteristics and
inflammation in both the blood collection reservoir and the washed red
blood cell concentrate. Postoperatively, the level of biomarkers and the
coagulation profile in the peripheral blood as well as the transfusion
requirements of allogenic blood products were studied. <br/>RESULT(S):
Thirty eight patients were included, 19 in the citrate group and 19 in the
heparin group. Baseline characteristics were similar. In the washed red
blood cell concentrate, Mean Hb (g/dl) and Ht (%) were lower in the
citrate group [Hb: 18.1 g/dL (SD 1.3) vs. 21.1 (1.6), p<0.001; Ht: 59.9%
(54.7-60.9) vs. 63.7% (62.3-64.8); p<0.001]; Mean corpuscular volume (MCV,
mum 3) was higher [99.1fL (9.4) vs. 88 (4.2), p<0.001] and mean
corpuscular hemoglobin concentration (MCHC, g/dl) lower in the citrate
group [31.9 g/dl (29.6-32.4) vs. 33.6 (33.1-34.0) p<0.001]. Thrombocyte
count (1000/mul) was higher in the citrate group [31.0 (26.0-77.0) vs.
13.0 (10.0-39.0); p=0.006]. There were no differences in the requirement
for allogenic blood products' transfusion (intraoperatively and
postoperatively) or in the coagulation parameters after washed red blood
cell concentrate infusion. Higher IL-10 was found in the citrate group in
the blood collection reservoir, higher neutrophil-derived myeloperoxidase
(MPO) in the heparin group after washed red blood cell concentrate
infusion. <br/>CONCLUSION(S): Though red blood cells in washed red blood
cell concentrate were more swollen and diluted in the citrate group with
more residual thrombocytes, published quality guidelines were met in both
groups. Our pilot study suggests that differences in inflammatory markers
in the blood collection reservoir and after infusion of washed red blood
cell concentrate indicate a possible pro-inflammatory effect of heparin
compared to citrate. A larger study is warranted to confirm these results
and their possible clinical consequences. Trial registration
ClinicalTrials.gov : NCT02674906. Registered 5 February
2016.<br/>Copyright &#xa9; 2023. The Author(s).

<5>
Accession Number
640989235
Title
The 100 most cited papers on thymoma: a bibliometric analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 107), 2023. Date of
Publication: 07 Apr 2023.
Author
Liu L.; Zhang J.; Wang G.; Zhao K.; Guo C.; Huang C.; Li S.; Chen Y.
Institution
(Liu, Zhang, Wang, Zhao, Guo, Huang, Li, Chen) Department of Thoracic
Surgery, Peking Union Medical College Hospital, Shuaifuyuan No. 1
,Wangfujing Street, Dongcheng District, Beijing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The aim of this bibliometric analysis was twofold: to identify
the 100 most cited research articles on thymoma and to highlight future
research opportunities in light of past and current research efforts.
<br/>METHOD(S): The Web of Science database was queried to identify the
100 most cited articles on thymoma. Imformations relevant to scientific
research were extracted and analyzed: first author, journal, impact
factor, type of article, year of publication, country, organization and
keywords. <br/>RESULT(S): The publication year of the top 100 most cited
articles ranged from 1981 to 2018, and the number of citations ranged from
97 to 1182. Most of the included articles are original (75/100) and are
mainly retrospective studies (52/75). The United States has the most
published articles and citations, and the Annals of Thoracic Surgery is
the most sourced journal (n=16). Through VOSviewer analysis, high-density
keywords mainly come from thymic carcinoma/invasive thymoma management,
immune-related diseases, and laboratory research. <br/>CONCLUSION(S): To
our knowledge, this is the first bibliometric study on thymoma. We found
most of the top 100 most cited articles are original and retrospective
research. The United States has the published and cited works. Presently,
the hot keywords for thymoma research has gradually tilted towards
immune-related diseases and laboratory research.<br/>Copyright &#xa9;
2023. The Author(s).

<6>
Accession Number
640984839
Title
Pleural abrasion versus apical pleurectomy for primary spontaneous
pneumothorax: a systematic review and Meta-analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 105), 2023. Date of
Publication: 06 Apr 2023.
Author
Chang J.; Ratnaraj V.; Fu V.; Jiang M.; Peri V.; Nguyenhuy M.; Antippa P.
Institution
(Chang) St George Hospital, Kogarah, Sydney, NSW, 2217, Australia
(Ratnaraj, Antippa) The Royal Melbourne Hospital, Parkville, Melbourne,
VIC, 3050, Australia
(Fu) The University of Melbourne, Parkville, Melbourne, VIC, 3050,
Australia
(Jiang, Peri) Austin Hospital, 3084, Heidelberg, Melbourne, VIC, Australia
(Nguyenhuy) Western Health, 3011, Footscray, Melbourne, VIC, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Surgical approach is the most effective treatment for primary
spontaneous pneumothorax. The two most widely adopted surgical methods are
mechanical abrasion and apical pleurectomy, in addition to bullectomy. We
performed a systematic review and meta-analysis to examine which technique
is superior in treating primary spontaneous pneumothorax. <br/>METHOD(S):
PubMed, MEDLINE and EMBASE databases were searched for studies published
between January 2000 to September 2022 comparing mechanical abrasion and
apical pleurectomy for treatment of primary spontaneous pneumothorax. The
primary outcome was pneumothorax recurrence. Secondary outcomes included
post-operative chest tube duration, hospital length of stay, operative
time and intra-operative of blood loss. <br/>RESULT(S): Eight studies were
eligible for inclusion involving 1,613 patients. There was no difference
in the rate of pneumothorax recurrence between pleural abrasion and
pleurectomy (RR: 1.34; 95% CI: 0.94 to 1.92). However, pleural abrasion
led to shorter hospital length of stay (MD: -0.25; 95% CI: -0.51 to 0.00),
post-operative chest tube duration (MD: -0.30; 95% CI: -0.56 to -0.03),
operative time (MD: -13.00; 95% CI -15.07 to 10.92) and less surgical
blood loss (MD: -17.77; 95% CI: -24.36 to -11.18). <br/>CONCLUSION(S):
Pleural abrasion leads to less perioperative patient burden and shorter
hospital length of stay without compromising the rate of pneumothorax
recurrence when compared to pleurectomy. Thus, pleural abrasion is a
reasonable first choice surgical procedure for management of primary
spontaneous pneumothorax.<br/>Copyright &#xa9; 2023. The Author(s).

<7>
Accession Number
640494798
Title
Within and beyond 12-month efficacy and safety of antithrombotic
strategies in patients with established coronary artery disease: two
companion network meta-analyses of the 2022 joint clinical consensus
statement of the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), European Association for Acute CardioVascular Care
(ACVC), and European Association of Preventive Cardiology (EAPC).
Source
European heart journal. Cardiovascular pharmacotherapy. 9(3) (pp 271-290),
2023. Date of Publication: 10 Apr 2023.
Author
Navarese E.P.; Landi A.; Oliva A.; Piccolo R.; Aboyans V.; Angiolillo D.;
Atar D.; Capodanno D.; Fox K.A.A.; Halvorsen S.; James S.; Juni P.;
Kunadian V.; Leonardi S.; Mehran R.; Montalescot G.; Niebauer J.; Price
S.; Storey R.F.; Voller H.; Vranckx P.; Windecker S.; Valgimigli M.
Institution
(Navarese) Department of Cardiology and Internal Medicine, Nicolaus
Copernicus University, Bydgoszcz, Poland
(Navarese) SIRIO MEDICINE Research Network, Poland
(Landi, Valgimigli) Division of Cardiology, Cardiocentro Ticino Institute,
Ente Ospedaliero Cantonale, Via Tesserete 48, Lugano 6900, Switzerland
(Oliva) Department of Biomedical Sciences, Humanitas University, 20090
Pieve Emanuele, Milan, Italy
(Piccolo) Department of Advanced Biomedical Sciences, Division of
Cardiology, University of Naples Federico II, Naples, Italy
(Aboyans) Department of Cardiology, Dupuytren University Hospital,
University of Limoges, Martin Luther King ave, Limoges 87042, France
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine-Jacksonville, FL 32209, 655 West 8th Street, Jacksonville, United
States
(Atar) Oslo University Hospital Ulleval, Department of Cardiology,
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
(Capodanno) Division of Cardiology, Azienda Ospedaliero Universitaria
Policlinico 'G. Rodolico-San Marco', University of Catania, Via Santa
Sofia, Catania 95123, Italy
(Fox) Centre for Cardiovascular Science, University of Edinburgh Division
of Clinical and Surgical Sciences, United Kingdom
(Halvorsen) Institute of Clinical Medicine, University of Oslo, Blindern
,P.O. Box 1078, Oslo N-0316, Norway
(Halvorsen) Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(James) Department of Medical Sciences, Uppsala Clinical Research Center,
Uppsala University, Uppsala 75185, Sweden
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute of
St Michael's Hospital, Department of Medicine and Institute of Health
Policy, Management and Evaluation, University of Toronto, Canada
(Kunadian) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne
Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
(Leonardi) University of Pavia and Coronary Care Unit, Fondazione IRCCS
Policlinico San Matteo, Pavia, Italy
(Mehran) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
(Montalescot) ACTION Group, INSERM UMRS 1166, Institut de Cardiologie,
Hopital Pitie-Salpetriere, Sorbonne Universite, Assistance
Publique-Hopitaux de Paris, Paris, France
(Niebauer) Institute of Sports Medicine, Prevention and Rehabilitation,
Paracelsus Medical University Salzburg, Salzburg 5020, Austria
(Price) Royal Brompton Hospital, National Heart and Lung Institute,
Imperial College, London, United Kingdom
(Storey) Cardiovascular Research Unit, Department of Infection, Immunity &
Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
(Voller) Department of Rehabilitation Medicine, Faculty of Health Science
Brandenburg, University of Potsdam, Potsdam, Germany
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, Hasselt University,
Hasselt, Belgium
(Windecker) Department of Cardiology, Inselspital, University of Bern,
Bern, Switzerland
Publisher
NLM (Medline)
Abstract
AIMS: To appraise all available antithrombotic treatments within or after
12 months following coronary revascularization and/or acute coronary
syndrome in two network meta-analyses. METHODS AND RESULTS: Forty-three (N
= 189 261 patients) trials within 12 months and 19 (N = 139 086 patients)
trials beyond 12 months were included for efficacy/safety endpoints
appraisal. Within 12 months, ticagrelor 90 mg bis in die (b.i.d.) [hazard
ratio (HR), 0.66; 95% confidence interval (CI), 0.49-0.88], aspirin and
ticagrelor 90 mg (HR, 0.85; 95% CI, 0.76-0.95), or aspirin, clopidogrel
and rivaroxaban 2.5 mg b.i.d. (HR, 0.66; 95% CI, 0.51-0.86) were the only
treatments associated with lower cardiovascular mortality, compared with
aspirin and clopidogrel, without or with greater bleeding risk for the
first and the other treatment options, respectively. Beyond 12 months, no
strategy lowered mortality; compared with aspirin; the greatest reductions
of myocardial infarction (MI) were found with aspirin and clopidogrel (HR,
0.68; 95% CI, 0.55-0.85) or P2Y12 inhibitor monotherapy (HR, 0.76; 95% CI:
0.61-0.95), especially ticagrelor 90 mg (HR, 0.54; 95% CI, 0.32-0.92), and
of stroke with VKA (HR, 0.56; 95% CI, 0.44-0.76) or aspirin and
rivaroxaban 2.5 mg (HR, 0.58; 95% CI, 0.44-0.76). All treatments increased
bleeding except P2Y12 monotherapy, compared with aspirin.
<br/>CONCLUSION(S): Within 12 months, ticagrelor 90 mg monotherapy was the
only treatment associated with lower mortality, without bleeding risk
trade-off compared with aspirin and clopidogrel. Beyond 12 months, P2Y12
monotherapy, especially ticagrelor 90 mg, was associated with lower MI
without bleeding trade-off; aspirin and rivaroxaban 2.5 mg most
effectively reduced stroke, with a more acceptable bleeding risk than VKA,
compared with aspirin.Registration URL:
https://www.crd.york.ac.uk/PROSPERO/; Unique identifiers: CRD42021243985
and CRD42021252398.<br/>Copyright &#xa9; The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<8>
Accession Number
640029767
Title
Antithrombotic therapy and cardiovascular outcomes after transcatheter
aortic valve implantation in patients without indications for chronic oral
anticoagulation: a systematic review and network meta-analysis of
randomized controlled trials.
Source
European heart journal. Cardiovascular pharmacotherapy. 9(3) (pp 251-261),
2023. Date of Publication: 10 Apr 2023.
Author
Guedeney P.; Roule V.; Mesnier J.; Chapelle C.; Portal J.-J.; Laporte S.;
Ollier E.; Zeitouni M.; Kerneis M.; Procopi N.; Barthelemy O.; Sorrentino
S.; Mihalovic M.; Silvain J.; Vicaut E.; Montalescot G.; Collet J.-P.
Institution
(Guedeney, Zeitouni, Kerneis, Procopi, Barthelemy, Silvain, Montalescot,
Collet) Sorbonne Universite, ACTION Study Group, Institut de Cardiologie,
Centre Hospitalier Universitaire, Pitie-Salpetriere, 47 Boulevard de
l'Hopital, Paris 75013, France
(Roule) Service de Cardiologie, Centre Hospitalier Universitaire (CHU) de
Caen Normandie, Normandie Univ, Caen, France
(Mesnier) French Alliance for Cardiovascular Trials (FACT), Universite de
Paris, Hopital Bichat, Assistance Publique-Hopitaux de Paris, Paris,
France
(Chapelle, Laporte, Ollier) Unite de Recherche Clinique, Innovation et
Pharmacologie, Saint-Etienne, CHU de Saint-Etienne, France
(Portal, Vicaut) Unite de Recherche Clinique, Lariboisiere Hospital
(AP-HP), ACTION Study Group, Paris, France
(Sorrentino) Division of Cardiology, Department of Medical and Surgical
Science, Magna Graecia University, Catanzaro, Italy
(Mihalovic) Cardiocenter, Third Faculty of Medicine, Charles University,
University Hospital Kralovske Vinohrady, Prague, Czechia
Publisher
NLM (Medline)
Abstract
AIMS: As the antithrombotic regimen that may best prevent ischaemic
complications along with the lowest bleeding risk offset following
transcatheter aortic valve implantation (TAVI) remains unclear, we aimed
to compare the safety and efficacy of antithrombotic regimens in patients
without having an indication for chronic oral anticoagulation. METHODS AND
RESULTS: We conducted a PROSPERO-registered (CRD42021247924) systematic
review and network meta-analysis of randomized controlled trials
evaluating post-TAVI antithrombotic regimens up to April 2022. We
estimated the relative risk (RR) and 95% confidence intervals (95% CIs)
using a random-effects model in a frequentist pairwise and network
metanalytic approach. We included seven studies comprising 4006 patients
with a mean weighted follow-up of 12.9 months. Risk of all-cause death was
significantly reduced with dual antiplatelet therapy (DAPT) compared with
low-dose rivaroxaban + 3-month single antiplatelet therapy (SAPT) (RR
0.60, 95% CI 0.41-0.88), while no significant reduction was observed with
SAPT vs. DAPT (RR 1.02, 95% CI 0.67-1.58) and SAPT and DAPT compared with
apixaban or edoxaban (RR 0.60, 95% CI 0.32-1.14 and RR 0.59, 95% CI
0.34-1.02, respectively). SAPT was associated with a significant reduction
of life-threatening, disabling, or major bleeding compared with DAPT (RR
0.45, 95% CI 0.29-0.70), apixaban or edoxaban alone (RR 0.45, 95% CI
0.25-0.79), and low-dose rivaroxaban + 3-month SAPT (RR 0.30, 95% CI
0.16-0.57). There were no differences between the various regimens with
respect to myocardial infarction, stroke, or systemic embolism.
<br/>CONCLUSION(S): Following TAVI in patients without an indication for
chronic oral anticoagulant, SAPT more than halved the risk of bleeding
compared with DAPT and direct oral anticoagulant-based regimens without
significant ischaemic offset.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<9>
Accession Number
2020930749
Title
Assessing the impact of publications: A bibliometric analysis of the
top-cited articles from The Journal of Thoracic and Cardiovascular
Surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(5) (pp 1901-1916),
2023. Date of Publication: May 2023.
Author
Castro-Varela A.; Schaff H.V.
Institution
(Castro-Varela, Schaff) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minn, United States
Publisher
Elsevier Inc.
Abstract
Objective: After 90 years, The Journal of Thoracic and Cardiovascular
Surgery (JTCVS) remains one of the most influential and widely read
journals in our specialty. This study analyzes the characteristics of its
top-cited articles over the past 6 decades. <br/>Method(s): Using
Elsevier's Scopus database, we identified all papers published in JTCVS
since 1959. After exclusion of expert consensus guidelines, articles were
grouped by decade and ranked by the total number of citations. We included
the field-weighted citation impact (FWCI) when available. We analyzed the
characteristics of the 10 most cited documents overall and per decade.
<br/>Result(s): The Journal published a total of 32,335 papers, of which
14,052 were published between 2010 and 2021. The order of the top-cited
articles differs when ranked by citations versus FWCI. During the last 6
decades, the 10 most cited articles per decade have a mean number of 604
citations (range, 240-1670) and a mean FWCI of 13.1 (range, 4.3-24.7).
There is no overlap in positions when articles are ranked by citations
versus FWCI. The majority of the 60 top 10 cited articles over the past 6
decades were presented at a major meeting (n = 38, 63%), most commonly the
Annual Meeting of the American Association for Thoracic Surgery. Topics in
adult cardiac surgery and general thoracic surgery predominated among the
most-cited papers, which originated most often from the United States
followed by Japan, Canada, France, England, and Germany.
<br/>Conclusion(s): JTCVS continues to provide a global platform to share
impactful knowledge related to surgery for thoracic diseases. The use of
citations to determine an article's impact has limitations and
nontraditional metrics may prove to be an excellent complementary tool for
more equitable evaluations.<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<10>
Accession Number
2023824018
Title
Comparison of the hemodynamic effects of opioid-based versus
lidocaine-based induction of anesthesia with propofol in older adults: a
randomized controlled trial.
Source
Anaesthesia Critical Care and Pain Medicine. 42(4) (no pagination), 2023.
Article Number: 101225. Date of Publication: August 2023.
Author
Amin S.M.; Hasanin A.; ElSayed O.S.; Mostafa M.; Khaled D.; Arafa A.S.;
Hassan A.
Institution
(Amin, Hasanin, ElSayed, Mostafa, Khaled, Arafa, Hassan) Department of
Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
Publisher
Elsevier Masson s.r.l.
Abstract
Background: The present study aims to compare the hemodynamic profile of
lidocaine and fentanyl during propofol induction of general anesthesia.
<br/>Method(s): This randomized controlled trial included patients aged
above 60 years undergoing elective non-cardiac surgery. The included
patients received either 1 mg/kg lidocaine (n = 50) or 1 mcg/kg fentanyl
(n = 50) based on total body weight with propofol induction of anesthesia.
Patient's hemodynamics were recorded every minute for the first 5 min then
every 2 min until 15 min after induction of anesthesia. Hypotension (mean
arterial pressure [MAP] <65 mmHg or >30% reduction from baseline) was
treated by intravenous 4 mcg bolus of norepinephrine. Outcomes included
norepinephrine requirements (primary), the incidence of postinduction
hypotension, MAP, heart rate, intubation condition, and postoperative
delirium via the cognitive assessment method. <br/>Result(s): Forty-seven
patients in the lidocaine group and 46 patients in the fentanyl group were
analyzed. None in the lidocaine group experienced hypotension, while 28/46
(61%) of patients in the fentanyl group developed at least one episode of
hypotension requiring a median (25th and 75th quartiles) norepinephrine
dose of 4 (0,5) mcg, p-value <0.001 for both outcomes. The average MAP was
lower in the fentanyl group than in the lidocaine group at all time points
after anesthesia induction. The average heart rate was comparable between
the two groups nearly at all time points after anesthesia induction. The
overall intubation condition was comparable between the two groups. None
of the included patients developed postoperative delirium.
<br/>Conclusion(s): Lidocaine-based regimen for induction of anesthesia
reduced the risk of postinduction hypotension in older patients compared
to the fentanyl-based regimen.<br/>Copyright &#xa9; 2023 Societe francaise
d'anesthesie et de reanimation (Sfar)

<11>
Accession Number
2021649405
Title
A randomised controlled trial of dexmedetomidine for delirium in adults
undergoing heart valve surgery.
Source
Anaesthesia. 78(5) (pp 571-576), 2023. Date of Publication: May 2023.
Author
Wang H.-B.; Jia Y.; Zhang C.-B.; Zhang L.; Li Y.-N.; Ding J.; Wu X.; Zhang
Z.; Wang J.-H.; Wang Y.; Yan F.-X.; Yuan S.; Sessler D.I.
Institution
(Wang, Jia, Li, Ding, Wu, Zhang, Wang, Yan, Yuan) Department of
Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Zhang) Department of Anaesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Shenzhen (Sun Yat-sen Cardiovascular Hospital,
Shenzhen), Shenzhen, China
(Zhang) Department of Anaesthesiology, Chongqing Hospital of Traditional
Chinese Medicine, Chongqing, China
(Wang) Department of Medical Research & Biometrics Centre, Fuwai Hospital,
National Centre for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Dexmedetomidine might reduce delirium after cardiac surgery. We allocated
326 participants to an infusion of dexmedetomidine at a rate of 0.6 mug
kg^-1 for 10 min and then at 0.4
mug.kg^-1.h^-1 until the end of surgery; 326 control
participants received comparable volumes of saline. We detected delirium
in 98/652 (15%) participants during the first seven postoperative days:
47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted
relative risk (95%CI) 0.86 (0.56-1.33), p = 0.51. Postoperative renal
impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3)
was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7
and 4 control participants, p = 0.040. Intra-operative dexmedetomidine
infusion did not reduce the incidence of delirium after cardiac valve
surgery but might impair renal function.<br/>Copyright &#xa9; 2023
Association of Anaesthetists.

<12>
Accession Number
2022365812
Title
Atrial natriuretic peptide in the prevention of acute renal dysfunction
after heart transplantation-a randomized placebo-controlled double-blind
trial.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2023. Date of
Publication: 2023.
Author
Tholen M.; Kolsrud O.; Dellgren G.; Karason K.; Lannemyr L.; Ricksten
S.-E.
Institution
(Tholen, Lannemyr, Ricksten) Department of Anesthesiology and Intensive
Care Medicine, Institute of Clinical Sciences, University of Gothenburg,
Gothenburg, Sweden
(Kolsrud, Dellgren) Department of Cardiothoracic Surgery, Institute of
Medicine, University of Gothenburg, Gothenburg, Sweden
(Dellgren, Karason) Deparment of Transplantation Surgery, Institute of
Transplantation, University of Gothenburg, Gothenburg, Sweden
(Karason) Department of Cardiology, Institute of Medicine, University of
Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Acute kidney injury (AKI) and renal dysfunction after heart
transplantation are common and serious complications. Atrial natriuretic
peptide (ANP) has been shown to increase glomerular filtration rate (GFR)
and exert renoprotective effects when used for the prevention/treatment of
AKI in cardiac surgery. We tested the hypothesis that intraoperative and
postoperative administration of ANP could prevent a postoperative decrease
in renal function early after heart transplantation. <br/>Method(s):
Seventy patients were randomized to receive either ANP (50 ng/kg/min) (n =
33) or placebo (n = 37) starting after induction of anesthesia and
continued for 4 days after heart transplantation or until treatment with
dialysis was started. The primary end-point of the present study was
measured GFR (mGFR) at day 4, assessed by plasma clearance of a renal
filtration marker. Also, the incidence of postoperative AKI and dialysis
were assessed. <br/>Result(s): Median (IQR) mGFR at day 4 postoperatively
was 60.0 (57.0) and 50.1 (36.3) ml/min/1.72 m² for the placebo
and ANP groups, respectively (p =.705). During ongoing ANP infusion, the
need for dialysis was 21.6% and 9.1% for the placebo and ANP groups,
respectively (p =.197). The incidences of AKI for the placebo and the ANP
groups were 76.5% and 63.6%, respectively (p =.616). The incidences of AKI
stage 1 were 32.4% and 21.2% for the placebo and ANP groups, respectively
(p =.420) and for AKI stage 2 or 3, 37.8% and 42.4%, respectively (p
=.808). <br/>Conclusion(s): The study failed to detect that ANP infusion
attenuates renal dysfunction or decreases the incidence of AKI after heart
transplantation.<br/>Copyright &#xa9; 2023 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<13>
Accession Number
640992311
Title
Impact of coronary artery disease on clinical outcomes after TAVR:
Insights from the BRAVO-3 randomized trial.
Source
Catheterization and cardiovascular interventions : official journal of the
Society for Cardiac Angiography & Interventions. (no pagination), 2023.
Date of Publication: 10 Apr 2023.
Author
Feldman D.; Cao D.; Sartori S.; Zhang Z.; Hengstenberg C.; Tron C.;
Anthopoulos P.; Widder J.D.; Meneveau N.; Stella P.R.; Ferrari M.; Jeger
R.; Violini R.; Dumonteil N.; Chen S.; Yan R.; Nicolas J.; Razuk V.;
Spirito A.; Vogel B.; Mehran R.; Dangas G.
Institution
(Feldman, Cao, Sartori, Zhang, Chen, Yan, Nicolas, Razuk, Spirito, Vogel,
Mehran, Dangas) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, NY, United States
(Feldman, Razuk) Department of Medicine, Icahn School of Medicine at Mount
Sinai, NY, United States
(Cao) Department of Biomedical Sciences, Humanitas University, Milan,
Italy
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Tron) Division of Cardiology, Rouen University Hospital, Rouen, France
(Anthopoulos) European Medical, Arena Pharmaceuticals Inc, Zurich,
Switzerland
(Widder) Department of Medicine, Cardiology and Angiology, Municipial
Hospital Karlsruhe, Karlsruhe, Germany
(Meneveau) Department of Cardiology, University Hospital Jean Minjoz,
Besancon, France
(Stella) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Ferrari) Division of Interventional Cardiology, Helios Dr. Horst Schmidt
Kliniken Wiesbaden, Wiesbaden, Germany
(Jeger) Department of Cardiology, Triemli Hospital, Zurich, Switzerland
(Jeger) Department of Cardiology, University Hospital Basel, Basel,
Switzerland
(Violini) Department of Interventional Cardiology, Rome, Italy
(Dumonteil) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To determine the prognostic impact of coronary artery disease
(CAD) in patients randomized to bivalirudin or unfractionated heparin
(UFH) during transcatheter aortic valve replacement (TAVR). BACKGROUND:
CAD is a common comorbidity among patients undergoing TAVR and studies
provide conflicting data on its prognostic impact. <br/>METHOD(S): The
Bivalirudin on Aortic Valve Intervention Outcomes-3 (BRAVO-3) randomized
trial compared the use of bivalirudin versus UFH in 802 high-surgical risk
patients undergoing transfemoral TAVR for severe symptomatic aortic
stenosis. Patients were stratified according to the presence or absence of
history of CAD as well as periprocedural anticoagulation. The coprimary
endpoints were net adverse cardiac events (NACE; a composite of all-cause
mortality, myocardial infarction, stroke, or major bleeding) and major
Bleeding Academic Research Consortium (BARC) bleeding >=3b at 30 days
postprocedure. <br/>RESULT(S): Among 801 patients, 437 (54.6%) had history
of CAD of whom 223 (51.0%) received bivalirudin. There were no significant
differences in NACE (adjusted odds ratio [OR]: 1.04; 95% confidence
interval [CI]: 0.69-1.58) or BARC>=3b bleeding (adjusted OR: 0.84; 95% CI:
0.51-1.39) in patients with vs without CAD at 30 days. Among CAD patients,
periprocedural use of bivalirudin was associated with similar NACE (OR:
0.80; 95% CI: 0.47-1.35) and BARC>=3b bleeding (OR: 0.64; 95% CI:
0.33-1.25) compared with UFH, irrespective of history of CAD
(p-interaction=0.959 for NACE; p-interaction=0.479 for major bleeding).
<br/>CONCLUSION(S): CAD was not associated with a higher short-term risk
of NACE or major bleeding after TAVR. Periprocedural anticoagulation with
bivalirudin did not show any advantage over UFH in patients with and
without CAD.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<14>
Accession Number
640988279
Title
Angiographic quantification of aortic regurgitation following myval
octacor implantation; independent core lab adjudication.
Source
International journal of cardiology. (no pagination), 2023. Date of
Publication: 05 Apr 2023.
Author
Elkoumy A.; Jose J.; Gunasekaran S.; Kumar A.; Srinivas B.C.; Manjunath
C.N.; Ravindranath K.S.; Parekh M.; Chandra P.; Kapoor R.; Abdelshafy M.;
Seth A.; Agrawal P.; Mathur A.; Rao R.S.; Elzomor H.; Sadanada K.S.;
Arsang-Jang S.; Mehrotra S.; Raghuraman B.; Khanolkar U.; Premchand R.K.;
Chopra M.; Krishna P.; Mehta H.; Gupta R.; Kumar V.; Boopathy N.; Baumbach
A.; Serruys P.W.; Soliman O.
Institution
(Elkoumy) Discipline of Cardiology, Saolta Group, Galway University
Hospital, Health Service Executive and CORRIB Core Lab, University of
Galway, H91 V4AY Galway, Ireland; Islamic Center of Cardiology, Al-Azhar
University, Nasr City, Cairo 11651, Egypt
(Jose) Department of Cardiology, Christian Medical College & Hospital,
Vellore 632004, India
(Gunasekaran) Department of Cardiology, Apollo Main Hospital, Greams Road,
Chennai 600006, India
(Kumar) Department of Cardiology, Meitra Hospital, Calicut, Kerala 673005,
India
(Srinivas, Manjunath, Ravindranath) Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Jayanagar, Bengaluru 560041, India
(Parekh) Sir H. N. Reliance Foundation Hospital and Research Centre,
Mumbai, Maharashtra 400004, India
(Chandra, Kapoor) Medanta, Medicity Hospitals, Haryana 122001, India
(Abdelshafy, Elzomor) Discipline of Cardiology, Saolta Group, Galway
University Hospital, Health Service Executive and CORRIB Core Lab,
University of Galway, Ireland
(Seth, Agrawal, Mathur) Fortis Escorts Heart Institute, New Delhi 110025,
India
(Rao) Rajasthan Hospital Limited, Jaipur, Rajasthan 302018, India
(Sadanada) Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka 570016, India
(Kumar) Madras Medical Mission Hospital, Chennai, Tamil Nadu 600037, India
(Arsang-Jang, Serruys, Soliman) Discipline of Cardiology, Saolta Group,
Galway University Hospital, Health Service Executive and CORRIB Core Lab,
University of Galway, H91 V4AY Galway, Ireland; CURAM, SFI Research Centre
for Medical Devices, H91 W2TY Galway, Ireland
(Mehrotra, Raghuraman, Khanolkar) Narayana Institute of Cardiac Sciences,
Bengaluru, Karnataka 560099, India
(Premchand) Krishna Institute of Medical Sciences (KIMS), Hyderabad,
Telangana 500014, India
(Chopra) Narayana Hospital (NH), Ahmedabad, Gujarat 380023, India
(Krishna) S Govindaswami (PSG), Coimbatore 641004, India
(Mehta) S. L. Raheja Hospital - Fortis, Mumbai, Maharashtra 400016, India
(Gupta) Apollo Hospital, Navi Mumbai, Maharashtra 400614, India
(Kumar) Max Hospital, New Delhi, Delhi 110017, India
(Boopathy) Sri Ramachandra Hospital (SRMC), Chennai, Tamil Nadu 600116,
India
(Baumbach) William Harvey Research Institute, Queen Mary University of
London and Barts Heart Centre, London EC1M 6BQ, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: The balloon expandable Myval transcatheter heart valve (THV)
showed encouraging results regarding residual aortic regurgitation (AR)
from multiple observational studies. The newly designed Myval Octacor has
been introduced recently, aiming for a reduction in AR and improved
performance. <br/>OBJECTIVE(S): The focus of this study is to report the
incidence of AR using the validated quantitative Videodensitometry
angiography technology (qLVOT-AR%) in the first in human use of the Myval
Octacor THV system. METHODOLOGY: We report on the first in human use of
the Myval Octacor THV system in 125 patients in 18 Indian centres.
Independent retrospective analysis of the final aortograms following
implantation of the Myval Octacor was performed using the CAAS-A-Valve
software. AR is reported as a regurgitation fraction. The previously
validated cutoff values have been used to identify >=moderate AR (RF%
>17%), mild (6%<RF% <=17%), and none or trace AR (RF%<=6%).
<br/>RESULT(S): Final aortogram was analysable for 103 patients (84.4%)
among the 122 available aortograms. 64 (62%) patients, had tricuspid
aortic valve (TAV), 38 (37%) with bicuspid AV (BAV), and one with
unicuspid AV. The median absolute RF% was 2% [1, 6], moderate or more AR
incidence was 1.9%, mild AR in 20.4%, and none or trace AR in 77.7%. The
two cases with RF% >17% were in the BAV group. <br/>CONCLUSION(S): The
initial results of Myval Octacor using quantitative angiography-derived
regurgitation fraction demonstrated a favourable outcome regarding
residual AR, possibly due to improved device design. Results must be
confirmed in a larger randomised study, including other imaging
modalities.<br/>Copyright &#xa9; 2023. Published by Elsevier B.V.

<15>
Accession Number
2023577844
Title
Meta-Analysis on the Impact of Coronary Bypass Graft Markers on
Angiographic Procedural Outcomes.
Source
American Journal of Cardiology. 195 (pp 23-26), 2023. Date of Publication:
15 May 2023.
Author
Sattar Y.; DeCicco D.; Faisaluddin M.; Almas T.; Yasmin F.; Alharbi A.;
Gonuguntla K.; Khan M.Z.; Chobufo M.D.; Daggubati R.; Bianco C.
Institution
(Sattar, Alharbi, Gonuguntla, Khan, Chobufo, Daggubati, Bianco)
Departments of Cardiology, West Virginia University, Morgantown, West
Virginia, United States
(DeCicco) Departments of Medicine, West Virginia University, Morgantown,
West Virginia, United States
(Faisaluddin) Department of Internal Medicine, Rochester General Hospital,
Rochester, New York, United States
(Almas) Department of Internal Medicine, University Hospital Galway,
Galway, Ireland
(Yasmin) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Utilization of radio-opaque coronary artery bypass graft markers is known
to decrease the amount of contrast dye required to complete the procedure.
The practice of marking bypass grafts varies significantly among surgeons.
Limited data exist comparing the outcomes of percutaneous coronary
intervention with and without coronary artery bypass graft (CABG) markers.
We sought to explore the impact of proximal radio-opaque markers placed
during CABG in subsequent percutaneous coronary intervention procedural
risks. In our understanding of the current literature, this is the first
meta-analysis conducted to evaluate the association between procedural
angiographic metrics and CABG radio-opaque markers. We performed a query
of MEDLINE and Scopus databases through August 2022 to identify relevant
studies evaluating procedural metrics among patients with previous CABG
with and without radio-opaque markers who underwent angiography. The
primary outcomes of interest were fluoroscopy time, amount of contrast,
and duration of angiography. We identified a total of 4 studies with 2,046
patients with CABG (CABG with markers n = 688, CABG without markers n =
1,518).^2-5 Total fluoroscopy time was significantly reduced
among patients with CABG markers compared with those with no markers (odds
ratio [OR] -3.63, p <0.0001). The duration of angiography (OR -36.39, p
>0.10) was reduced, although the result was not statistically significant.
However, the amount of contrast utilization was significantly reduced (OR
-33.41, p <0.0001). In patients who underwent CABG with radio-opaque
markers, angiographic procedural metrics were improved, including reduced
fluoroscopic time and the amount of contrast agent required compared with
no markers.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<16>
Accession Number
2023516900
Title
Meta-Analysis of Long-Term (>1 Year) Cardiac Outcomes of Peripartum
Cardiomyopathy.
Source
American Journal of Cardiology. 194 (pp 71-77), 2023. Date of Publication:
01 May 2023.
Author
Koerber D.; Khan S.; Kirubarajan A.; Spivak A.; Wine R.; Matelski J.;
Sobel M.; Harris K.
Institution
(Koerber) Faculty of Medicine, University of Alberta, Edmonton, ON, Canada
(Koerber, Khan, Kirubarajan, Spivak, Wine, Sobel, Harris) Faculty of
Medicine, Canada
(Kirubarajan) Faculty of Medicine, McMaster University, Hamilton, ON,
Canada
(Matelski) Biostatistics Research Unit, University Health Network,
Toronto, ON, Canada
(Sobel) Department of Obstetrics & Gynecology, Mount Sinai Hospital,
Canada
(Harris) Division of Maternal Fetal Medicine, Department of Obstetrics &
Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Peripartum cardiomyopathy is the development of heart failure toward the
end of pregnancy or in the months after delivery in the absence of other
attributable causes, with left ventricular systolic dysfunction and a left
ventricular ejection fraction (LVEF) generally <45%. Given that patients
are relatively young at the time of diagnosis, this study was performed to
summarize current evidence surrounding the long-term cardiac outcomes.
MEDLINE, Embase, Cochrane CENTRAL, and CINAHL were searched for original
studies that reported long-term (>1 year) patient outcomes. Of the 3,144
total records identified, 62 studies involving 4,282 patients met the
selection criteria. The mean LVEF was 28% at diagnosis and 47% at the time
of the last follow-up. Approximately half of the patients achieved
myocardial recovery (47%), most commonly defined as an LVEF >50% (n = 21).
The prevalence of implantable cardioverter-defibrillator use, left
ventricular assist device implantation, and heart transplantation was 12%,
7%, and 11%, respectively. The overall all-cause mortality was 9%, and
despite having more cardiovascular risk factors, patients residing in
high-income countries had superior outcomes, including reduced rates of
mortality.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<17>
Accession Number
2020994377
Title
Meta-Analysis on the Association Between Nutritional Status and Outcomes
After Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 186 (pp 109-116), 2023. Date of
Publication: 01 Jan 2023.
Author
Kazemian S.; Tavolinejad H.; Rashedi S.; Yarahmadi P.; Farrokhpour H.;
Kolte D.
Institution
(Kazemian, Tavolinejad, Rashedi, Yarahmadi, Farrokhpour) Tehran Heart
Center, Cardiovascular Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Kazemian, Tavolinejad, Rashedi, Yarahmadi, Farrokhpour) Cardiac Primary
Prevention Research Center, Cardiovascular Diseases Research Institute,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tavolinejad) Non-Communicable Diseases Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kolte) Cardiology Division, Massachusetts General Hospital and Harvard
Medical School, Boston, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Malnutrition is a common co-morbidity among candidates for transcatheter
aortic valve implantation (TAVI). This study aimed to investigate the
association between nutritional status determined by objective nutritional
indices and outcomes of patients who underwent TAVI. We systematically
searched PubMed, Embase, Web of Science, Scopus, and Cochrane Library from
inception until April 18, 2022 to identify studies examining the
association of preprocedural nutritional status with post-TAVI outcomes.
Malnutrition was defined by objective nutritional indices-controlling
nutritional index, nutritional risk index, geriatric nutritional risk
index (GNRI), and prognostic nutritional index (PNI). The primary end
point was 1-year all-cause mortality. The review included 13 observational
studies and 6,785 patients who underwent TAVI. Malnutrition was associated
with a higher risk of 1-year all-cause mortality, as defined by either the
controlling nutritional index (hazard ratio [HR] 2.70, 95% confidence
interval [CI] 1.21 to 6.03, p = 0.015), GNRI (HR 1.79, 95% CI 1.09 to
2.93, p = 0.021), or PNI (HR 1.17, 95% CI 1.11 to 1.23, p <0.001). In the
meta-analysis of adjusted results, lower GNRI was independently associated
with higher 1-year mortality (HR 1.70, 95% CI 1.16 to 2.50, p = 0.006).
Lower GNRI was associated with increased risk of acute kidney injury
(relative risk [RR] 2.21, 95% CI 1.63 to 2.99, p <0.001) and 1-year
cardiovascular mortality (RR 2.50, 95% CI 1.66 to 3.78, p <0.001). Lower
PNI was associated with a higher risk of major vascular complications (RR
2.99, 95% CI 1.38 to 6.51, p = 0.006). In conclusion, baseline
malnutrition, as assessed by objective indices, is associated with worse
outcomes after TAVI. Future studies should focus on the value of
nutritional assessment and interventions to improve nutritional status in
patients who underwent TAVI.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<18>
Accession Number
2022448359
Title
Vericiguat in HFrEF: Insights From the GWTG-HF Registry.
Source
JACC: Heart Failure. 11(2) (pp 224-226), 2023. Date of Publication:
February 2023.
Author
Kittleson M.M.
Institution
(Kittleson) Department of Cardiology, Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles, CA, United States
Publisher
Elsevier Inc.

<19>
Accession Number
2022182675
Title
Research status and development trend of extracorporeal membrane
oxygenation based on bibliometrics.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1048903. Date of Publication: 2023.
Author
Guan C.; Shen H.; Dong S.; Zhan Y.; Yang J.; Zhang Q.; Wang R.
Institution
(Guan, Zhan, Yang, Zhang) Tsinghua University Library, Tsinghua
University, Beijing, China
(Shen, Wang) Department of Adult Cardiac Surgery, The Sixth Medical Centre
of PLA General Hospital, Beijing, China
(Dong) Department of Cardiovascular Surgery, The First Medical Centre of
PLA General Hospital, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Using bibliometric method to analyze the research status and
development trend of extracorporeal membrane oxygenation (ECMO), we aim to
provide clinicians, scientists, and stakeholders with the most up-to-date
and comprehensive overview of ECMO research. <br/>Material(s) and
Method(s): Using Excel and VOSviewer, the literature on ECMO was
systematically analyzed regarding publication trends, journal source,
foundation, countries, institutions, core authors, research hotspots, and
market distribution. <br/>Result(s): There were five important time nodes
in the research process of ECMO, including the success of the first ECMO
operation, the establishment of ELSO, and the outbreak of influenza A/H1N1
and COVID-19. The R&D centers of ECMO were the United States, Germany,
Japan, and Italy, and the attention to ECMO was gradually increasing in
China. The products most used in the literature were from Maquet,
Medtronic, and LivaNova. Medicine enterprises attached great importance to
the funding of ECMO research. In recent years, the literature has mainly
focused on the following aspects: the treatment of ARDS, the prevention of
coagulation system-related complications, the application in neonatal and
pediatric patients, mechanical circulatory support for cardiogenic shock,
and ECPR and ECMO during the COVID-19 pandemic. <br/>Conclusion(s): The
frequent epidemic occurrence of viral pneumonia and the technical
advancement of ECMO in recent years have caused an increase in clinical
applications. The hot spots of ECMO research are shown in the treatment of
ARDS, mechanical circulatory support for cardiogenic shock, and the
application during the COVID-19 pandemic.<br/>Copyright 2023 Guan, Shen,
Dong, Zhan, Yang, Zhang and Wang.

<20>
Accession Number
2020466836
Title
A Review of Biventricular Repair for the Congenital Cardiac
Anesthesiologist.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 27(1) (pp 51-63),
2023. Date of Publication: March 2023.
Author
Davies S.J.; DiNardo J.A.; Emani S.M.; Brown M.L.
Institution
(Davies, DiNardo, Emani, Brown) Department of Anesthesiology, Critical
Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United
States
Publisher
SAGE Publications Inc.
Abstract
The management of children with a borderline ventricle has been debated
for many years. The pursuit of a biventricular repair in these children
aims to avoid the long-term sequelae of single ventricle palliation. There
is a lack of anesthesia literature relating to the care of this complex
heterogenous patient population. Anesthesiologists caring for these
patients should have an understanding on the many different forms of
physiology and the impact on provision of anesthesia and hemodynamic
parameters, the goals of biventricular staging and completion as well as
the pre-operative, intra-operative, and post-operative considerations
relating to this high-risk group of patients.<br/>Copyright &#xa9; The
Author(s) 2022.

<21>
Accession Number
2021354240
Title
Thoracic paravertebral versus interpleural catheter for post-thoracotomy
pain control in minimally invasive cardiac surgery.
Source
Asian Cardiovascular and Thoracic Annals. 31(3) (pp 202-209), 2023. Date
of Publication: March 2023.
Author
Pujara J.; Singh G.; Prajapati M.; Ninama S.; Rajesh V.S.P.; Trivedi V.;
Pandya H.
Institution
(Pujara, Singh, Prajapati, Ninama, Rajesh, Trivedi) Department of Cardiac
Anesthesia, U. N. Mehta Institute of Cardiology and Research Centre,
Affiliated to B. J. Medical College Ahmedabad, Gujarat, Ahmedabad, India
(Pandya) Department of Research, U. N. Mehta Institute of Cardiology and
Research Centre, Affiliated to B. J. Medical College Ahmedabad, Gujarat,
Ahmedabad, India
Publisher
SAGE Publications Inc.
Abstract
Objective: The aim of this study was to compare efficacy and safety of
paravertebral block (PVB) and interpleural analgesia (IPA) after minimally
invasive cardiac surgery through thoracotomy in terms of quality of
analgesia, post-operative mechanical ventilation time, intensive care unit
(ICU) and hospital length of stay (LOS) and complications. <br/>Design(s):
A randomized, prospective study. <br/>Participant(s): A total of 50 adult
patients (18-50 years old) undergoing minimally invasive cardiac surgery
via thoracotomy. <br/>Intervention(s): Patients were randomized for group
A: paravertebral epidural catheter (n = 25), group B: interpleural
catheter (n = 25). All patients were given Inj. Bupivacaine 0.125%, 8 ml
and Inj. Tramadol 100 mg as an adjuvant, total volume 10 ml.
<br/>Result(s): After obtaining institutional review board approval, data
collected and analysed - visual analogue score (VAS) at rest and on
coughing, haemodynamic and respiratory parameters, time to extubation,
supplementary analgesia requirement, LOS and complications. VAS was
recorded at 0, 2, 3, 4, 8, 12 and 24 h post-extubation, while blood gases
at-after shifting, 4, 8, 12 and 24 h. There were no significant
differences in haemodynamic or respiratory parameters, VAS at rest and on
coughing, ventilation duration, ICU and hospital LOS between two groups.
The requirement of rescue analgesia was in one patient of mini coronary
artery bypass in group B, while one patient in group A required
reintubation due to respiratory acidosis and got successfully extubated on
next day morning. <br/>Conclusion(s): PVB and IPA both are safe and
effective techniques for minimally invasive cardiac surgery with
thoracotomy. It allows optimal pain control and safe ICU fast-track
post-operative course.<br/>Copyright &#xa9; The Author(s) 2023.

<22>
Accession Number
640973426
Title
Analgesia and adverse effects of intrathecal buprenorphine: a
meta-analysis.
Source
Anaesthesia and Intensive Care. Conference: 2022 Australian and New
Zealand College of Anaesthetists Annual Scientific Meeting. Virtual.
51(Supplement) (pp 9-10), 2023. Date of Publication: January 2023.
Author
Erskine R.; Mladenovic J.; Davis K.; Sartain I.; Reardon D.; Velli G.;
Bright M.; White L.
Institution
(Erskine, Mladenovic, Davis, Sartain, Reardon, White) Sunshine Coast
University Hospital, Department of Anaesthetics and Pain Medicine,
Birtinya, QLD, Australia
(Velli, Bright) Princess Alexandra Hospital, Woolloongabba, QLD, Australia
Publisher
SAGE Publications Inc.
Abstract
Buprenorphine has a long duration of action and an analgesic profile
equivalent to morphine, suggesting the potential for it to be a highly
efficacious adjunct to neuraxial anaesthesia. 1,2 As it was traditionally
viewed as having limited use in the context of acute pain there is little
evidence regarding the efficacy and adverse event profile of buprenorphine
when used for spinal anaesthesia. The aim of this systematic review and
meta-analysis is to evaluate the use of intrathecal buprenorphine in
patients undergoing spinal anaesthesia for elective non-cardiac surgery
and caesarean sections. <br/>Method(s): A systematic search of databases
including Medline, Embase and Central was performed. Primary research
studies examining the use of intrathecal buprenorphine against a control
were eligible for inclusion. Studies including epidural or combined
spinal-epidural techniques were excluded. The primary outcomes assessed
included time to rescue analgesia and composite outcome of adverse events.
Adverse events were defined as respiratory depression, sedation, nausea,
vomiting, hypotension, bradycardia, pruritus, shivering, headache and
urinary retention. Dichotomous data was analysed using an Odds Ratio (95%
CI), and The Mantel-Haenszel (M-H) random effects model was applied to
continuous outcomes. <br/>Result(s): The initial search yielded 584
publications, from which 33 articles met inclusion criteria. Compared to
placebo there was a significant increase in time to rescue analgesia by
302.56 minutes (95%CI=233.98 to 371.13 minutes; I2=100%; p<0.00001). For
the composite outcome of any adverse event, there was a significant
increase in adverse events (OR=2.64; 95%CI=1.53 to 4.55; I2=61%;
p=0.0005). Buprenorphine significantly increased the incidence of nausea
(OR=2.96; 95%CI=1.94 to 4.59; I2=0%; p<0.00001; n=1,280), vomiting
(OR=2.19; 95% CI=1.02 to 4.72; I2=0%; p=0.045; n=590) and sedation
(OR=5.23; 95%CI=1.96 to 13.93; I2=2%; p=0.001). <br/>Discussion(s):
Buprenorphine demonstrated increased time to rescue analgesia compared to
placebo. However, the prolonged time to rescue analgesia was associated
with an increased rate of adverse events when compared to placebo. Further
studies are needed to differentiate the clinical effect of buprenorphine
compared with other intrathecal additives, including morphine.

<23>
Accession Number
640973591
Title
PERCUTANEOUS CORONARY INTERVENTION VS CORONARY ARTERY BYPASS GRAFTING IN
LEFT MAIN CORONARY ARTERY DISEASE: A SYSTEMATIC REVIEW AND UPDATED
META-ANALYSIS.
Source
Heart. Conference: Irish Cardiac Society Annual Scientific Meeting and
AGM. Virtual. 107(Supplement 2) (pp A56), 2021. Date of Publication:
October 2021.
Author
Hennessy C.; Henry J.A.; Brameier D.T.; Kharbanda R.K.; Myerson S.G.
Institution
(Hennessy, Brameier) Medical School Offices, Medical Sciences Division,
University of Oxford, United Kingdom
(Henry) Oxford University Clinical Academic Graduate School, Oxford
University Hospitals Foundation Trust OX3 9DU, United Kingdom
(Kharbanda) Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford
University Hospitals, Oxford, United Kingdom
(Kharbanda, Myerson) Division of Cardiovascular Medicine, Radcliffe
Department of Medicine, University of Oxford, Oxford, United Kingdom
(Myerson) Department of Cardiology, Oxford University Hospitals NHS
Foundation Trust, Oxford, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Aim There is still no consensus whether percutaneous coronary intervention
(PCI) is as safe and effective as coronary artery bypass grafting (CABG)
for left main coronary artery (LMCA) disease. Until recently, European and
US guidelines recommended CABG as the standard of care for LMCA disease
management. However numerous recent studies suggest that PCI with drug
eluting stents (DES) has a low risk of mortality at medium and long-term
follow-up after left main stenting. This has resulted in European
guidelines suggesting that PCI may be effective in treating anatomically
simple LMCA disease, while CABG is still the gold standard for more
complex lesions. These changes have been largely informed by six RCTs
which have compared PCI vs CABG in LMCA disease. However, the results of
these studies have not been straightforward, with often conflicting
results. The continuing lack of consensus coupled with the recent
publication of 5- and 10-year data from some of these studies necessitated
an updated systematic review and meta-analysis. Methods A systematic
search was performed of the MEDLINE (via PubMed), EMBASE, Cochrane and
clinicaltrials.gov databases from inception to December 20th, 2020. Only
RCTs which compared PCI and CABG in LMCA disease were included. Studies
were required to have a minimum follow-up of one year and to report
all-cause mortality as an outcome at a minimum. Selected studies were
analysed using the random effects model. Outcomes measured included
all-cause mortality, MACCE, myocardial infarction (MI), stroke and
revascularization. Follow up points were 30 days, 1 year, 5 years and 10
years. Where MI was concerned, meta-analysis was performed twice using the
originally published EXCEL MI data as well as a second time using the
recently released MI data classified according to the third universal
definition of MI. Results Six RCTs with a total population of 4700 were
included in the analysis. For all-cause mortality PCI was noninferior to
CABG at all time points (30 days (OR 0.6), 1 year (OR 0.77), 5 years (OR
1.41), 10 years (OR 1.08). MACCE favoured PCI at 30 days (OR 0.83 P <
0.01), and CABG at 5 years (OR 1.45, P < 0.001). No difference was seen at
1 year (OR 1.20) and 10 years (1.01). There was no significant difference
in MI occurrence between the PCI and CABG groups at 30 days (OR 0.77), 1
year (1.10), or 10 years (OR 1.01). Using the original 5-year EXCEL trial
MI definition, 5- year MI rates were higher for PCI than CABG (OR 1.66, P
< 0.05). When the re-analysed EXCEL data (using the third universal
definition of MI) was included instead, the 5-year data further favoured
CABG, with 7.5% MI rates in the PCI group compared to 3.6% in the CABG
group (OR 2.19, P < 0.001). For stroke, PCI was favourable to CABG at 30
days (OR 0.40, P < 0.05) and 1 year (OR 0.63 P < 0.001), with no
difference at 5 years (OR 0.86) and 10 years (OR 0.78). Revascularisation
favoured CABG at 1 year (OR 2.03, P < 0.001), and 5 years (OR 1.81, P <
0.001), with no differences at the other time-points. Conclusions The
results of this meta-analysis show that PCI may be considered as an
alternative to CABG for uncomplicated LMCA disease. However, more complex
lesions may still benefit from CABG. CABG may be of benefit where future
revascularisation would rather be avoided, as lower rates of
revascularisation were observed in the CABG groups at 1 year and 5 years.
Further clinical trials examining this research question are needed.

<24>
Accession Number
2023793555
Title
Transcatheter Aortic Valve Implantation Outcomes and Challenges in Asia: A
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(3) (no pagination), 2023. Article
Number: A48. Date of Publication: March 2023.
Author
Rivera F.B.; De Luna D.V.; Ansay M.F.M.; Nguyen R.T.; Flores G.P.;
Magalong J.V.; Cha S.W.; Aparece J.P.; Gonzales J.S.T.; Salva W.F.C.;
Mangubat G.F.E.; Mahilum M.L.P.; Inohara T.; Vijayaraghavan K.; Collado
F.M.S.; Latib A.
Institution
(Rivera) Department of Medicine, Lincoln Medical Center, New York, NY
10451, United States
(De Luna) Department of Internal Medicine, Danbury Hospital, Danbury, CT
06810, United States
(Ansay) Ateneo de Manila School of Medicine and Public Health, Pasig 1604,
Philippines
(Nguyen) Department of Medicine, Houston Methodist, Houston, TX 77030,
United States
(Flores) King George Hospital, Ilford IG3 8YB, United Kingdom
(Magalong) Department of Medicine, San Beda University College of
Medicine, Manila 1005, Philippines
(Cha, Aparece, Gonzales, Salva) Cebu Institute of Medicine, Cebu 6000,
Philippines
(Mangubat, Mahilum) Southern Philippines Medical Center, Davao 8000,
Philippines
(Inohara) Department of Cardiology, Keio University School of Medicine,
Tokyo 160-8582, Japan
(Vijayaraghavan) University of Arizona, Tucson, AZ 85721, United States
(Collado) Department of Cardiology, Rush University Medical Center,
Chicago, IL 60612, United States
(Latib) Section of Interventional Cardiology-Structural Heart, Montefiore
Medical Center, Albert Einstein College of Medicine, New York, NY 10461,
United States
Publisher
IMR Press Limited
Abstract
Background: Aortic stenosis (AS) is the world's most prevalent heart valve
disease. Transcatheter aortic valve replacement (TAVR) or Implantation
(TAVI) is widely available yet adopting this procedure in Asia has been
slow due to high device cost, the need for specific training programs, and
the lack of specialized heart teams and dedicated infrastructures. The
limited number of randomized controlled trials describing TAVI outcomes
among the Asian population hampered the approval for medical
reimbursements as well as acceptance among surgeons and operators in some
Asian countries. <br/>Method(s): A comprehensive medical literature search
on TAVI and/or TAVR performed in Asian countries published between January
2015 and June 2022 was done through MEDLINE and manual searches of
bibliographies. The full text of eligible articles was obtained and
evaluated for final analysis. The event rates for key efficacy and safety
outcomes were calculated using the data from the registries and randomized
controlled trials. <br/>Result(s): A total of 15,297 patients were
included from 20 eligible studies. The mean patient age was 82.88 +/- 9.94
years, with over half being females (62.01%). All but one study reported
Society of Thoracic Surgeons (STS) scores averaging an intermediate risk
score of 6.28 +/- 1.06%. The mean logistic European Systems for Cardiac
Operations Risk Evaluation (EuroSCORE) was 14.85. The mean baseline
transaortic gradient and mean aortic valve area were 50.93 +/- 3.70 mmHg
and 0.64 +/- 0.07 cm2, respectively. The mean procedural success rate was
95.28 +/- 1.51%. The weighted mean 30-day and 1-year all-cause mortality
rate was 1.66 +/- 1.21% and 8.79 +/- 2.3%, respectively. The mean average
for stroke was 1.98 +/- 1.49%. The acute kidney injury (AKI) rate was 6.88
+/- 5.71%. The overall major vascular complication rate was 2.58 +/-
2.54%; the overall major bleeding rate was 3.88 +/- 3.74%. Paravalvular
aortic regurgitation rate was 15.07 +/- 9.58%. The overall rate of
pacemaker insertion was 7.76 +/- 4.6%. <br/>Conclusion(s): Compared to
Americans and Europeans, Asian patients who underwent TAVI had lower
all-cause mortality, bleeding, and vascular complications, however, had a
higher rate of postprocedural aortic regurgitation. More studies with
greater sample sizes are needed among Asian patients for a more robust
comparison.<br/>Copyright &#xa9; 2023 The Author(s).

<25>
Accession Number
2023793545
Title
Procedural Characteristics and Clinical Outcomes Associated with Chronic
Total Occlusion Percutaneous Coronary Intervention in Patients with a
History of Prior Coronary Artery Bypass Graft: A Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(3) (no pagination), 2023. Article
Number: A38. Date of Publication: March 2023.
Author
He S.; Li Y.; Cheng Z.; Shi Y.; Liu J.
Institution
(He, Li, Cheng, Shi, Liu) Center for Coronary Artery Disease (CCAD),
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of
Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Publisher
IMR Press Limited
Abstract
Background: Owing to advances in procedural techniques and the training of
interventional staff in catheterization labs, recent work has demonstrated
the safety of percutaneous coronary intervention (PCI) as a treatment for
patients suffering from chronic total occlusion (CTO). However, there has
been little research focused on systematic comparisons of PCI outcomes in
CTO patients that did or did not exhibit a history of previous coronary
artery bypass grafting (CABG). <br/>Method(s): Electronic databases were
systematically searched for all studies comparing CTO-PCI outcomes for
patients with and without a history of CABG, with event rates subsequently
being compared via random-effects models with forest plots and odds ratios
with 95% confidence intervals (CI), owing to the assumption of
between-studies heterogeneity. <br/>Result(s): In total, 8 observational
studies enrolling 13,509 CTO patients were identified, including 3389 and
10,120 patients with and without a history of prior CABG, respectively.
Patients were enrolled in these studies from 1999-2018. Pooled analyses
indicated that CABG history was not linked to a lower proportion of radial
access 24 (95% CI 0.52-1.03, p = 0.08), and a prior CABG history was
linked to a greater contrast volume (95% CI 0.12-0.44, p<0.001), higher
radiation dose (95% CI 0.27-0.40, p< 0.001), longer fluoroscopy time (95%
CI 0.42-0.61, p < 0.001), longer procedural time (95% CI 0.38-0.64, p <
0.001), a higher number of implanted stents (95% CI 0.41-0.60, p < 0.001),
longer total stent length (95% CI 0.21-0.60, p < 0.001), higher technical
failure rates (95% CI 1.46-1.85, p < 0.001), and higher rates of
procedural failure (95% CI 1.42-1.79, p < 0.001). The in-hospital
mortality (95% CI 1.50-4.03, p < 0.001) and periprocedural mortality (95%
CI 1.63-3.73, p < 0.001) of patients with a history of CABG were also
higher. While stroke incidence was comparable in both groups (95% CI
0.80-4.47, p = 0.15), periprocedural major adverse cardiovascular and
cerebrovascular events (MACCE) rates were significantly higher among
patients exhibiting a history of CABG (95% CI 1.66-2.94, p < 0.001).
<br/>Conclusion(s): These results suggest that CTO-PCI procedures may be
more challenging and associated with lower rates of success in CABG
patients relative to procedures performed in patients without any history
of CABG. Moreover, in-hospital outcomes including MACCE and mortality were
worse for patients that had undergone prior CABG.<br/>Copyright &#xa9;
2023 The Author(s).

<26>
Accession Number
2023793527
Title
Long-Term Efficacy and Safety of Left Atrial Appendage Occlusion (LAAO) vs
Direct Oral Anticoagulation (DOAC) in Patients with Atrial Fibrillation: A
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(2) (no pagination), 2023. Article
Number: A20. Date of Publication: February 2023.
Author
Razzack A.A.; Lak H.M.; Erasani G.; Rahman S.; Hussain N.; Ali B.F.; Eapi
S.; Yasmin F.; Najeeb H.; Mustafa A.; Chawla S.; Munir M.B.; Barakat A.F.;
Saliba W.; Wazni O.; Hussein A.A.
Institution
(Razzack, Erasani) Department of Internal Medicine, Dr. N.T.R University
of Health Sciences, Vijayawada 520008, India
(Lak, Chawla) Department of Internal Medicine, Cleveland Clinic
Foundation, Cleveland OH 44195, United States
(Rahman) Department of Internal Medicine, Jalalabad Ragib Rabeya Medical
College and Hospital, Sylhet 3030, Bangladesh
(Hussain) Department of Medicine, Saba University School of Medicine,
JQG3+87 The Bottom JQG3+87, Netherlands
(Ali) Department of Medicine, Akhtar Saeed Medical and Dental College,
Lahore 54000, Pakistan
(Eapi) Department of Medicine, Hackensack University Medical Center,
Hackensack, NJ NJ 07601, United States
(Yasmin, Najeeb) Department of Internal Medicine, Dow University of Health
Sciences, Karachi 74200, Pakistan
(Mustafa) Department of Internal Medicine, Staten Island University
Hospital, Staten Island, United States
(Munir) Section of Electrophysiology, Department of Cardiovascular
Medicine, University of. California San Diego, San Diego CA 92111, United
States
(Barakat) Section of Electrophysiology, UPMC Heart and Vascular Institute,
University of Pittsburgh, Pittsburgh PA 15260, United States
(Saliba, Wazni, Hussein) Section of Cardiac Pacing and Electrophysiology,
Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell
and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland
Clinic, Cleveland OH 44195, United States
Publisher
IMR Press Limited
Abstract
Background: Prevention of stroke by anticoagulation is essential in
patients with Atrial fibrillation (AF); with direct oral anticoagulants
(DOACs) being preferred over warfarin in most patients. The Long-term
efficacy and safety of DOACs vs. Left Atrial Appendage Occlusion (LAAO)
remain unknown. <br/>Method(s): Electronic databases (PubMed, Embase,
Scopus) were searched from inception to February 10th, 2021. The primary
endpoint was cardiovascular mortality. Secondary outcomes included
incidence of ischemic stroke/transient ischemic attack (TIA) and
systemicembolism. The safety endpoint was clinically relevant bleeding (a
composite of major or minor clinically relevant bleeding). <br/>Result(s):
A total of three studies with 3039 participants (LAAO = 1465; DOACs =
1574) were included. Mean age was 74.2 and 75.3 years in the LAAO and DOAC
group respectively. Average follow-up period was 2 years. There was no
difference in terms of cardiac mortality (RR 0.90, 95% CI 0.40-2.03; p =
0.81), ischemic stroke/TIA (RR 1.15, 95% CI 0.80-1.65; p = 0.46; I2 = 0)
and clinically significant bleeding (RR 0.77, 95% CI 0.50-1.17; p = 0.22;
I2 = 69) between the groups. <br/>Conclusion(s): Among patients with AF,
LAAO was comparable to DOACs with similar efficacy and safety
profiles.<br/>Copyright &#xa9; 2022 The Author(s).

<27>
Accession Number
2023770858
Title
Congenital mitral valve defects in pediatric population: a narrative
review of surgical repair.
Source
Pediatric Medicine. 6 (no pagination), 2023. Article Number: 6. Date of
Publication: 28 Feb 2023.
Author
Chen W.; Li M.; Sheng W.; Jia B.; Huang G.
Institution
(Chen, Li, Sheng, Jia, Huang) Heart Center, Children's Hospital of Fudan
University, Shanghai, China
(Chen, Li, Sheng, Jia, Huang) Shanghai Key Laboratory of Birth Defects,
Shanghai, China
Publisher
AME Publishing Company
Abstract
Background and Objective: Congenital mitral valve malformations (CMVM) are
rare and heterogeneous. The functional classification includes mitral
regurgitation, stenosis, and combined lesions. Surgical strategies of CMVM
remain challenging in the pediatric population due to various
malformations, growth potential, the requirement of long-term
anticoagulation, and the necessity of avoiding or delaying valve
replacement. Surgical techniques for CMVM must be individually tailored
for patients to achieve a proper valve function rather than "normal"
anatomy. Compared with mitral repair, mitral valve replacement (MVR) is a
less common procedure in children due to high mortality and morbidity
rates. Options for cardiac valve replacement in children are limited to
prostheses sizes that do not accommodate somatic growth, especially for
neonates and infants. The need for lifelong anticoagulation may lead to
adverse long-term pregnancy outcomes for female patients, limiting the
application of MVR. This review aims to provide a comprehensive analysis
of the current surgical techniques and developments for treating mitral
valve (MV) regurgitation and stenosis and the outcome of various surgical
strategies. <br/>Method(s): We conducted a literature search using online
database PubMed, Web of Science, and Embase for English literatures up to
Sep, 2021. We also consulted standard textbooks. Both original research
and systematic reviews and meta-analysis were included. Key Content and
Findings: This review mainly introduced current surgical strategies of
CMVM regarding to different anatomical defects of mitral valve and
short-term and long-term outcomes of different surgical strategies.
According to the literature, using autologous pericardium, percutaneous
edge-to-edge MV repair using the MitraClip and artificial chordae
implantation showed satisfied effectiveness among patients with MV
regurgitation. Surgical repair for MV stenosis also showed satisfying
survival rate and freedom from reoperation rate. MVR are challenging for
infants especially neonates, the chimney technique and ROSS II strategies
were proved to be effective for severe cases. <br/>Conclusion(s): MV
repair is accomplishable in the majority of cases for both congenital MV
regurgitation and stenosis. With the development of modification and
implantation strategies, both short- and long-term outcomes of MVR in
children are encouraging.<br/>Copyright &#xa9; Pediatric Medicine. All
rights reserved.

<28>
Accession Number
2023770695
Title
Effect of combined use of cerebral oximetry and electroencephalogram
monitoring on the incidence of perioperative neurocognitive disorders in
adult cardiac and non-cardiac surgery: A systematic review of randomized
and non-randomized trials.
Source
Acta Anaesthesiologica Belgica. 73(4) (pp 221-234), 2022. Date of
Publication: December 2022.
Author
Souberbielle Q.; Sariyar A.J.; Momeni M.
Institution
(Souberbielle, Sariyar, Momeni) Department of Anesthesiology, Cliniques
Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain),
Institut de Recherche Experimentale et Clinique (IREC), Belgium
Publisher
BeSARPP
Abstract
Background: There is insufficient evidence to recommend using either
intraoperative cerebral oximetry or (processed) electroencephalogram (EEG)
alone for preventing perioperative neurocognitive disorders (PNDs).
<br/>Objective(s): : To evaluate the effectiveness of combined use of
cerebral oximetry and electroencephalogramguided anesthesia on the
incidence of PNDs in adult patients undergoing cardiac and non-cardiac
interventions. <br/>Method(s): A PICOS - based systematic review of
English articles using Pubmed and Embase (from inception to August 2022)
was performed. There were no exclusion criteria regarding the type of the
study. Abstract proceedings and new study protocols or ongoing studies
were not included. Review articles were analyzed in search of eligible
references. All possible terms that were illustrative of PNDs were used.
<br/>Result(s): Among the 63 full manuscripts that were analyzed in
detail, 15 met the inclusion criteria. We found 2 retrospective, 8
prospective observational and 5 randomized controlled trials of which 1
did not evaluate the use of neuromonitoring in the randomization process.
The definition and the methods used to diagnose PNDs were very
heterogeneous. Only 8 studies used an algorithm to avoid/treat cerebral
oxygen desaturation and/or to treat EEG abnormalities. Overall, there was
a tendency towards less PNDs in studies where such an algorithm was used.
<br/>Conclusion(s): Our results suggest that integrating information
obtained from cerebral oximetry and an EEG monitor may reduce the
incidence of PNDs whenever an adapted algorithm is used to improve brain
function.<br/>Copyright &#xa9; 2022 ARSMB-KVBMG. All rights reserved.

<29>
Accession Number
2023626260
Title
Collaborative Neonatal Network for the first European CPAM Trial
(CONNECT): a study protocol for a randomised controlled trial.
Source
BMJ Open. 13(3) (no pagination), 2023. Article Number: e071989. Date of
Publication: 17 Mar 2023.
Author
Kersten C.M.; Hermelijn S.M.; Dossche L.W.J.; Muthialu N.; Losty P.D.;
Schurink M.; Rietman A.B.; Poley M.J.; Van Rosmalen J.; van den Adel
T.P.L.Z.; Ciet P.; Von Der Thusen J.; Brosens E.; Ijsselstijn H.; Tiddens
H.A.W.M.; Wijnen R.M.H.; Schnater J.M.
Institution
(Kersten, Hermelijn, Dossche, Poley, Ijsselstijn, Wijnen, Schnater)
Paediatric Surgery, Erasmus MC Sophia Children's Hospital, Zuid-Holland,
Rotterdam, Netherlands
(Muthialu, Schnater) Tracheal Team, Department of Cardiothoracic Surgery,
Great Ormond Street Hospital for Children, London, United Kingdom
(Losty) Paediatric Surgery, Institute Of Life Course And Medical Sciences,
University of Liverpool, Liverpool, United Kingdom
(Losty) Paediatric Surgery, Ramathibodi Hospital Mahidol University,
Bangkok, Thailand
(Schurink) Paediatric Surgery, Radboud University Medical Centre Amalia
Children's Hospital, Nijmegen, the Netherlands, Nijmegen, Netherlands
(Rietman) Child and Adolescent Psychiatry, Erasmus MC Sophia Children
Hospital, Zuid-Holland, Rotterdam, Netherlands
(Poley) Institute for Medical Technology Assessment, Erasmus University
Rotterdam, Rotterdam, Netherlands
(Van Rosmalen) Biostatistics, Erasmus MC, Zuid-Holland, Rotterdam,
Netherlands
(Van Rosmalen) Epidemiology, Erasmus MC, Zuid-Holland, Rotterdam,
Netherlands
(van den Adel) Orthopaedics, Erasmus MC Sophia Children's Hospital,
Zuid-Holland, Rotterdam, Netherlands
(Ciet, Tiddens) Radiology and Nuclear Medicine, Erasmus MC Sophia
Children's Hospital, Zuid-Holland, Rotterdam, Netherlands
(Ciet, Tiddens) Paediatric Pulmonology, Erasmus MC Sophia Children's
Hospital, Zuid-Holland, Rotterdam, Netherlands
(Ciet) Radiology and Medical Sciences, University of Cagliari, Cagliari,
Italy
(Von Der Thusen) Pathology, Erasmus MC, Rotterdam, Netherlands
(Brosens) Clinical Genetics, Erasmus MC Sophia Children's Hospital,
Zuid-Holland, Rotterdam, Netherlands
(Brosens) Erasmus MC Cancer Centre, Zuid-Holland, Rotterdam, Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Consensus is lacking on the optimal management of
asymptomatic congenital pulmonary airway malformation (CPAM). For future
studies, the CONNECT consortium (the COllaborative Neonatal Network for
the first European CPAM Trial) - an international collaboration of
specialised caregivers - has established consensus on a core outcome set
of outcome parameters concerning respiratory insufficiency, surgical
complications, mass effect and multifocal disease. These outcome
parameters have been incorporated in the CONNECT trial, a randomised
controlled trial which, in order to develop evidence-based practice, aims
to compare conservative and surgical management of patients with an
asymptomatic CPAM. Methods and analysis Children are eligible for
inclusion after the CPAM diagnosis has been confirmed on postnatal chest
CT scan and they remain asymptomatic. On inclusion, children are
randomised to receive either conservative or surgical management.
Subsequently, children in both groups are enrolled into a standardised,
5-year follow-up programme with three visits, including a repeat chest CT
scan at 2.5 years and a standardised exercise tolerance test at 5 years.
The primary outcome is exercise tolerance at age 5 years, measured
according to the Bruce treadmill protocol. Secondary outcome measures are
molecular genetic diagnostics, validated questionnaires - on parental
anxiety, quality of life and healthcare consumption -, repeated imaging
and pulmonary morbidity during follow-up, as well as surgical
complications and histopathology. This trial aims to end the continuous
debate surrounding the optimal management of asymptomatic CPAM. Ethics and
dissemination This study is being conducted in accordance with the
Declaration of Helsinki. The Medical Ethics Review Board of Erasmus
University Medical Centre Rotterdam, The Netherlands, has approved this
protocol (MEC-2022-0441). Results will be disseminated through
peer-reviewed scientific journals and conference presentations. Trial
registration number NCT05701514.<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.

<30>
Accession Number
2023553199
Title
Long-term effects of lowering postprandial glucose level on cardiovascular
outcomes in early-stage diabetic patients with coronary artery disease:
10-year post-trial follow-up analysis of the DIANA study.
Source
Journal of Diabetes and its Complications. 37(5) (no pagination), 2023.
Article Number: 108469. Date of Publication: May 2023.
Author
Kataoka Y.; Yasuda S.; Asaumi Y.; Honda S.; Noguchi T.; Miyamoto Y.; Sase
K.; Iwahashi N.; Kawamura T.; Kosuge M.; Kimura K.; Takamisawa I.; Iwanaga
Y.; Miyazaki S.
Institution
(Kataoka, Asaumi, Honda, Noguchi) Department of Cardiovascular Medicine,
National Cerebral & Cardiovascular Centre, Osaka, Suita, Japan
(Yasuda) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Miyamoto) Open Innovation Center, National Cerebral and Cardiovascular
Center, Suita, Japan
(Sase) Department of Clinical Pharmacology, Juntendo University School of
Medicine, Tokyo, Japan
(Iwahashi, Kosuge) Division of Cardiology, Yokohama City University
Medical Center, Yokohama, Japan
(Kawamura) Department of Cardiovascular Medicine, Kindai University,
Faculty of Medicine, Osakasayama, Japan
(Kimura) Yokosuka City Hospital, Yokosuka, Japan
(Takamisawa) Department of Cardiology, Sakakibara Heart Institute, Tokyo,
Fuchu, Japan
(Iwanaga) Center for Cerebral and Cardiovascular Disease Information,
National Cerebral & Cardiovascular Center, Osaka, Japan
(Miyazaki) Saiseikai Tondabayashi Hospital, Osaka, Japan
Publisher
Elsevier Inc.
Abstract
Aims: To elucidate the long-term cardiovascular benefit of lowering
postprandial hyperglycemia (PPG) in early-stage T2DM patients.
<br/>Method(s): This 10-year post-trial follow-up study included 243
patients from the DIANA (DIAbetes and diffuse coronary Narrowing) study, a
multi-center randomized controlled trial which compared the efficacy of
one-year life-style and pharmacological (voglibose/nateglinide)
intervention lowering PPG on coronary atherosclerosis in 302 early-stage
T2DM subjects [impaired glucose tolerance (IGT) or newly-diagnosed T2DM]
(UMIN-CTRID#0000107). MACE (all-cause death, non-fatal MI or unplanned
coronary revascularization) were compared in (1) three assigned therapies
(life-style intervention/vogliose/nateglinide) and (2) patients with and
without improvement of PPG (reversion from IGT to NGT or from DM to
IGT/NGT on 75 g oral glucose tolerance test). <br/>Result(s): During the
10-year post-trial observational period, voglibose (HR = 1.07, 95%CI:
0.69-1.66, p = 0.74) or nateglinide (HR = 0.99, 95%CI: 0.64-1.55, p =
0.99) did not reduce MACE. Similarly, achieving the improvement of PPG was
not associated with a reduction of MACE (HR = 0.78, 95%CI: 0.51-1.18, p =
0.25). However, in IGT subjects (n = 143), this glycemic management
significantly reduced the occurrence of MACE (HR = 0.44, 95%CI: 0.23-0.86,
p = 0.01), especially unplanned coronary revascularization (HR = 0.46,
95%CI: 0.22-0.94, p = 0.03). <br/>Conclusion(s): The early improvement of
PPG significantly reduced MACE and unplanned coronary revascularization in
IGT subjects during the post-trial 10-year period.<br/>Copyright &#xa9;
2023 The Authors

<31>
Accession Number
640942895
Title
Remote ischemic preconditioning and clinical outcomes after pediatric
cardiac surgery: a systematic review and meta-analysis.
Source
BMC anesthesiology. 23(1) (pp 105), 2023. Date of Publication: 01 Apr
2023.
Author
Li J.; Wang X.; Liu W.; Wen S.; Li X.
Institution
(Li, Liu) Departments of Anesthesiology, DongGuan SongShan Lake Tungwah
Hospital, DongGuan, China
(Wang) Departments of Anesthesiology, First Affiliated Hospital, Sun
Yat-Sen University, Guangzhou, China
(Wen) Departments of Anesthesiology, First Affiliated Hospital, Sun
Yat-Sen University, Guangzhou, China
(Li) Departments of Anesthesiology, DongGuan SongShan Lake Tungwah
Hospital, DongGuan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The benefit of remote ischemia preconditioning (RIPreC) in
pediatric cardiac surgery is unclear. The objective of this systematic
review and meta-analysis was to examine the effectiveness of RIPreC in
reducing the duration of mechanical ventilation and intensive care unit
(ICU) length of stay after pediatric cardiac surgery. <br/>METHOD(S): We
searched PubMed, EMBASE and the Cochrane Library from inception to
December 31, 2022. Randomized controlled trials comparing RIPreC versus
control in children undergoing cardiac surgery were included. The risk of
bias of included studies was assessed using the Risk of Bias 2 (RoB 2)
tool. The outcomes of interest were postoperative duration of mechanical
ventilation and ICU length of stay. We conducted random-effects
meta-analysis to calculate weighted mean difference (WMD) with 95%
confidence interval (CI) for the outcomes of interest. We performed
sensitivity analysis to examine the influence of intraoperative propofol
use. <br/>RESULT(S): Thirteen trials enrolling 1,352 children were
included. Meta-analyses of all trials showed that RIPreC did not reduce
postoperative duration of mechanical ventilation (WMD -5.35 h, 95% CI
-12.12-1.42) but reduced postoperative ICU length of stay (WMD -11.48 h,
95% CI -20.96- -2.01). When only trials using propofol-free anesthesia
were included, both mechanical ventilation duration (WMD -2.16 h, 95% CI
-3.87- -0.45) and ICU length of stay (WMD -7.41 h, 95% CI -14.77- -0.05)
were reduced by RIPreC. The overall quality of evidence was moderate to
low. <br/>CONCLUSION(S): The effects of RIPreC on clinical outcomes after
pediatric cardiac surgery were inconsistent, but both postoperative
mechanical ventilation duration and ICU length of stay were reduced in the
subgroup of children not exposed to propofol. These results suggested a
possible interaction effect of propofol. More studies with adequate sample
size and without intraoperative propofol use are needed to define the role
of RIPreC in pediatric cardiac surgery.<br/>Copyright &#xa9; 2023. The
Author(s).

<32>
Accession Number
639801250
Title
The effects of milking and suction drain management methods in paediatric
patients after cardiac surgery.
Source
International journal of nursing practice. 29(2) (pp e13122), 2023. Date
of Publication: 01 Apr 2023.
Author
Gokgoz G.; Karabacak U.; Kan Onturk Z.
Institution
(Gokgoz) Istanbul Training and Research Hospital, TR. Ministry of Health,
Istanbul, Turkey
(Karabacak, Kan Onturk) Faculty of Health Sciences, Department of Nursing,
Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
AIM: The aim of this study is to determine the effects of milking and
suction methods on maintaining drain patency following cardiac surgery in
paediatric patients. <br/>METHOD(S): This was a randomized controlled
trial. The patients were assigned to three groups (suction method, milking
method, and control group) between July 2018 and December 2019.
<br/>RESULT(S): The most frequent medical diagnoses were tetralogy of
Fallot (34.4%, n =31) and ventricular septal defect (14.4%, n =13). Heart
rate may increase unless a method was chosen to maintain drain patency (F:
4.450, p =0.003); suction (F: 0.528 p =0.781) and milking (F: 2.281 p
=0.070) methods did not significantly increase the heart rate. The use of
a manipulation method for maintaining drain patency maintained stability
of the blood pressure values and did not affect haemodynamic stability,
oxygen saturation, and body temperature. There was no statistically
significant difference within and among the groups (p >0.05) in relation
to the volume of bleeding between admission until the sixth hour, although
there was greater bleeding with the milking method (2.67+/-15.30ml) and
less bleeding (-5.00+/-23.30) with the suction method. <br/>CONCLUSION(S):
The milking and suction methods used to maintain drain patency can be
employed and will assist with maintaining the stability of the patient
within the first critical 6h. Further studies need to be conducted in
order to clarify that the recommendations can be generalized to all
children with congenital heart disease.<br/>Copyright &#xa9; 2022 John
Wiley & Sons Australia, Ltd.

<33>
Accession Number
2021964765
Title
Effect of transverse thoracic muscle plane block on postoperative
cognitive dysfunction after open cardiac surgery: A randomized clinical
trial.
Source
Journal of Cellular and Molecular Medicine. 27(7) (pp 976-981), 2023. Date
of Publication: April 2023.
Author
Chen S.; Zhang H.; Zhang Y.
Institution
(Chen, Zhang) Department of Anesthesiology, First Affiliated Hospital of
Nanchang University, Nanchang, China
(Zhang) Department of Anesthesiology, Nanchang Hongdu Hospital of TCM,
Nanchang, China
Publisher
John Wiley and Sons Inc
Abstract
The transversus thoracis muscle plane (TTMP) block provides effective
analgesia in cardiac surgery patients. The aim of this study was to assess
whether bilateral TTMP blocks can reduce the incidence of postoperative
cognitive dysfunction (POCD) in patients undergoing cardiac valve
replacement. A group of 103 patients were randomly divided into the TTM
group (n = 52) and the PLA (placebo) group (n = 51). The primary endpoint
was the incidence of POCD at 1 week after surgery. Secondary outcome
measures included a reduction of intraoperative mean arterial pressure
(MAP) >20% from baseline, intraoperative and postoperative sufentanil
consumption, length of stay in the ICU, incidence of postoperative nausea
and vomiting (PONV), time to first faeces, postoperative pain at 24 h
after surgery, time to extubation and the length of hospital stay.
Interleukin (IL)-6, TNF-alpha, S-100beta, insulin, glucose and insulin
resistance were measured at before induction of anaesthesia, 1, 3and 7
days after surgery. The MoCA scores were significantly lower and the
incidence of POCD decreased significantly in TTM group compared with PLA
group at 7 days after surgery. Perioperative sufentanil consumption, the
incidence of PONV and intraoperative MAP reduction >20% from baseline,
length of stay in the ICU, postoperative pain at 24 h after surgery, time
to extubation and the length of hospital stay were significantly decreased
in the TTM group. Postoperatively, IL-6, TNF-alpha, S-100beta, HOMA-IR,
insulin, glucose levels increased and the TTM group had a lower degree
than the PLA group at 1, 3 and 7 days after surgery. In summary, bilateral
TTMP blocks could improve postoperative cognitive function in patients
undergoing cardiac valve replacement.<br/>Copyright &#xa9; 2023 The
Authors. Journal of Cellular and Molecular Medicine published by
Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.

<34>
Accession Number
2021931845
Title
Full-endoscopic discectomy for thoracic disc herniations: a single-arm
meta-analysis of safety and efficacy outcomes.
Source
European Spine Journal. 32(4) (pp 1254-1264), 2023. Date of Publication:
April 2023.
Author
Silva J.D.S.; Carelli L.E.; de Oliveira J.A.A.; de Araujo R.M.L.
Institution
(Silva) Division of Medicine, Department of Neurosurgery, Hospital of
Federal University of Piaui - UFPI, Piaui, Teresina, Brazil
(Carelli) Division of Traumatology and Orthopedics, Department of
Medicine, National Institute of Traumatology and Orthopedics - INTO, Rio
de Janeiro, Brazil
(de Oliveira) Division of Traumatology and Orthopedics, Department of
Medicine, Federal University of Ceara - UFC, Ceara, Fortaleza, Brazil
(de Araujo) Division of Neurosurgery, Department of Medicine, University
of Sao Paulo - USP, Sao Paulo, Brazil
(Silva) Division of Neurosurgery, University Hospital, Federal University
of Piaui, University Camp Petronio Portela Minister w/n. Ininga, Piaui,
Teresina 64049-550, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Surgical intervention is the treatment of choice in patients
with thoracic disc herniation with refractory symptoms and progressive
myelopathy. Due to high occurrence of complications from open surgery,
minimally invasive approaches are desirable. Nowadays, endoscopic
techniques have become increasingly popular and full-endoscopic surgery
can be performed in the thoracic spine with low complication rates.
<br/>Method(s): Cochrane Central, PubMed, and Embase databases were
systematically searched for studies that evaluated patients who underwent
full-endoscopic spine thoracic surgery. The outcomes of interest were
dural tear, myelopathy, epidural hematoma, recurrent disc herniation, and
dysesthesia. In the absence of comparative studies, a single-arm
meta-analysis was performed. <br/>Result(s): We included 13 studies with a
total of 285 patients. Follow-up ranged from 6 to 89 months, age from 17
to 82 years, with 56.5% male. The procedure was performed under local
anesthesia with sedation in 222 patients (77.9%). A transforaminal
approach was used in 88.1% of the cases. There were no cases of infection
or death reported. The data showed a pooled incidence of outcomes as
follows, with their respective 95% confidence intervals (CI)-dural tear
(1.3%; 95% CI 0-2.6%); dysesthesia (4.7%; 95% CI 2.0-7.3%); recurrent disc
herniation (2.9%; 95% CI 0.6-5.2%); myelopathy (2.1%; 95% CI 0.4-3.8%);
epidural hematoma (1.1%; 95% CI 0.2-2.5%); and reoperation (1.7%; 95% CI
0.1-3.4%). <br/>Conclusion(s): Full-endoscopic discectomy has a low
incidence of adverse outcomes in patients with thoracic disc herniations.
Controlled studies, ideally randomized, are warranted to establish the
comparative efficacy and safety of the endoscopic approach relative to
open surgery.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<35>
Accession Number
2023625875
Title
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting
in Non-ST-Elevation Coronary Syndromes and Multivessel Disease: A
Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 195 (pp 70-76), 2023. Date of Publication:
15 May 2023.
Author
Kakar H.; Groenland F.T.W.; Elscot J.J.; Rinaldi R.; Scoccia A.; Kardys
I.; Nuis R.J.; Wilschut J.; Dekker W.K.D.; Daemen J.; Zijlstra F.; Van
Mieghem N.M.; Diletti R.
Institution
(Kakar, Groenland, Elscot, Scoccia, Kardys, Nuis, Wilschut, Dekker,
Daemen, Zijlstra, Van Mieghem, Diletti) Department of Cardiology,
Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands
(Rinaldi) Department of Cardiovascular and Pulmonary Sciences, Catholic
University of the Sacred Heart, Rome, Italy
Publisher
Elsevier Inc.
Abstract
There is lack of evidence regarding the optimal revascularization strategy
in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and
multivessel disease (MVD). This systematic review and meta-analysis
compares the clinical impact of percutaneous coronary intervention (PCI)
with that of coronary artery bypass graft surgery (CABG) in this subset of
patients. EMBASE, MEDLINE, and Web of Knowledge were searched for studies
including patients with NSTE-ACS and MVD who underwent PCI or CABG up to
September 1, 2021. The primary end point of the meta-analysis was
all-cause mortality at 1 year. The secondary end points were myocardial
infarction (MI), stroke, or repeat revascularization at 1 year. The
analysis was conducted using the Mantel-Haenszel random-effects model to
calculate the odds ratio (OR) with 95% confidence interval (CI). Four
prospective observational studies met the inclusion criteria, including
1,542 patients who underwent CABG and 1,630 patients who underwent PCI. No
significant differences were found in terms of all-cause mortality (OR
0.91, 95% CI 0.68 to 1.21, p = 0.51), MI (OR 0.78, 95% CI 0.40 to 1.51, p
= 0.46), or stroke (OR 1.54, 95% CI 0.55 to 4.35, p = 0.42) between PCI
and CABG. Repeat revascularization was significantly lower in the CABG
group (OR 0.21, 95% CI 0.13 to 0.34, p <0.00001). In patients presenting
with NSTE-ACS and MVD, 1-year mortality, MI, and stroke were similar
between patients treated with either PCI or CABG, but the repeat
revascularization rate was higher after PCI.<br/>Copyright &#xa9; 2023

<36>
Accession Number
2023619718
Title
Network Meta-Analysis Comparing Transcatheter, Minimally Invasive, and
Conventional Surgical Aortic Valve Replacement.
Source
American Journal of Cardiology. 195 (pp 45-56), 2023. Date of Publication:
15 May 2023.
Author
Fong K.Y.; Yap J.J.L.; Chan Y.H.; Ewe S.H.; Chao V.T.T.; Amanullah M.R.;
Govindasamy S.P.; Aziz Z.A.; Tan V.H.; Ho K.W.
Institution
(Fong) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore, Singapore
(Yap, Ewe, Amanullah, Ho) Department of Cardiology
(Chao, Govindasamy, Aziz) Department of Cardiothoracic Surgery, National
Heart Center Singapore, Singapore
(Chan) Biostatistics Unit, Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
(Tan) Department of Cardiology, Changi General Hospital, Singapore
Publisher
Elsevier Inc.
Abstract
The landscape of aortic valve replacement (AVR) has evolved dramatically
over the years, but time-varying outcomes have yet to be comprehensively
explored. This study aimed to compare the all-cause mortality among 3 AVR
techniques: transcatheter (TAVI), minimally invasive (MIAVR), and
conventional AVR (CAVR). An electronic literature search was performed for
randomized controlled trials (RCTs) comparing TAVI with CAVR and RCTs or
propensity score-matched (PSM) studies comparing MIAVR with CAVR or MIAVR
to TAVI. Individual patient data for all-cause mortality were derived from
graphical reconstruction of Kaplan-Meier curves. Pairwise comparisons and
network meta-analysis were conducted. Sensitivity analyses were performed
in the TAVI arm for high risk and low/intermediate risk, as well as
patients who underwent transfemoral (TF) TAVI. A total of 27 studies with
16,554 patients were included. In the pairwise comparisons, TAVI showed
superior mortality to CAVR until 37.5 months, beyond which there was no
significant difference. When restricted to TF TAVI versus CAVR, a
consistent mortality benefit favoring TF TAVI was seen (shared frailty
hazard ratio [HR] = 0.86, 95% confidence interval [CI] = 0.76 to 0.98, p =
0.024). In the network meta-analysis involving majority PSM data, MIAVR
demonstrated significantly lower mortality than TAVI (HR = 0.70, 95% CI =
0.59 to 0.82) and CAVR (HR = 0.69, 95% CI = 0.59 to 0.80); this
association remained compared with TF TAVI but with a lower extent of
benefit (HR = 0.80, 95% CI = 0.65 to 0.99). In conclusion, the initial
short- to medium-term mortality benefit for TAVI over CAVR was attenuated
over the longer term. In the subset of patients who underwent TF TAVI, a
consistent benefit was found. Among majority PSM data, MIAVR showed
improved mortality compared with TAVI and CAVR but less than the TF TAVI
subset, which requires validation by robust RCTs.<br/>Copyright &#xa9;
2023 Elsevier Inc.

<37>
Accession Number
2020105208
Title
Autologous CD133 + Cells and Laser Revascularization in patients with
severe Ischemic Cardiomyopathy.
Source
Stem Cell Reviews and Reports. 19(3) (pp 817-822), 2023. Date of
Publication: April 2023.
Author
Abdel-Latif A.; Ahmed T.; Leung S.W.; Alnabelsi T.; Tarhuni W.; Sekela
M.E.
Institution
(Abdel-Latif, Ahmed, Leung, Alnabelsi) Department of Cardiovascular
Medicine, Division of Cardiology, University of Kentucky, Lexington, KY,
United States
(Abdel-Latif) Department of Cardiovascular Medicine, Division of
Cardiology, University of Michigan, Ann Arbor, MI, United States
(Tarhuni) Department of Internal Medicine, Division of Cardiology,
Canadian Cardiac Research Center, University of Saskatchewan, Saskatoon,
SK, Canada
(Sekela) Department of Cardiothoracic Surgery, University of Kentucky,
Lexington, KY, United States
(Sekela) Heart Transplant, Division of Cardiothoracic Surgery, University
of Kentucky, Lexington, KY, United States
Publisher
Springer
Abstract
Objective: We tested the hypothesis that targeted TMLR combined with
intramyocardial injection of autologous CD 133⁺ progenitor
cells is safe and feasible in patients with chronic ischemic
cardiomyopathy (ICM) and no revascularization options. <br/>Method(s):
Eight male patients (age 62 +/- 2.4 years) with multivessel severe
ischemic heart disease and no revascularization options were enrolled.
Autologous CD 133 + endothelial progenitor cells were derived and purified
from the bone marrow on the day of surgery using the clinical-grade closed
CliniMACS system. Using a lateral thoracotomy approach, TMLR was
performed, followed by transmyocardial transplantation of purified CD133 +
cells (mean number of transplanted cells: 12.5 x 10⁶) in the
region surrounding the TMLR sites. These sites were selected based on
ischemia on pre-procedure perfusion imaging. We performed clinical and
myocardial perfusion imaging pre-procedure and then at 6- and 12-month
follow-up. <br/>Result(s): No major complications or death occurred during
the procedure or during the peri-operative hospital stay. One patient died
of cardiac cause 6 months post-procedure. There was a reported short-term
improvement in anginal and heart failure symptoms and a modest reduction
in the ischemic score as assessed by perfusion imaging.
<br/>Conclusion(s): Our phase 1 clinical study examining the combination
therapy of targeted transmyocardial laser revascularization therapy and
autologous CD133 + endothelial progenitor cells in patients with chronic
ICM and no revascularization options demonstrates the feasibility and
short-term safety of this combined approach and warrants future larger
phase 2 randomized clinical studies.<br/>Copyright &#xa9; 2022, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<38>
Accession Number
637854838
Title
Cytoreductive surgery with hyperthermic intrathoracic chemotherapy for
malignant pleural mesothelioma: A systematic review.
Source
Thorax. 78(4) (pp 409-417), 2023. Date of Publication: 01 Apr 2023.
Author
Dawson A.G.; Kutywayo K.; Mohammed S.B.; Fennell D.A.; Nakas A.
Institution
(Dawson, Kutywayo, Nakas) Department of Thoracic Surgery, University
Hospitals of Leicester NHS Trust, Leicester, United Kingdom
(Dawson, Fennell) Department of Cancer Studies, University of Leicester,
Leicester, United Kingdom
(Mohammed) Department of Statistics, University of Leicester, Clinical
Trials Unit, Leicester, United Kingdom
(Fennell) Department of Medical Oncology, University Hospitals of
Leicester NHS Trust, Leicester, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Cytoreductive surgery has been used a part of multimodality
treatment in patients with malignant pleural mesothelioma (MPM). The
residual microscopic disease that remains will lead to disease progression
in the majority of patients. Delivery of hyperthermic intrathoracic
chemotherapy at the time of surgery has been used to address this
microscopic disease, however it's effect and place in the multimodality
treatment sphere is unknown. The aim of this systematic review was to
assess the effect of surgery and hyperthermic intrathoracic chemotherapy
in patients with MPM on overall survival and disease-free interval.
Methods Ovid MEDLINE, Embase, Web of Science and the Cochrane Database of
Systematic Reviews were searched from database inception through to June
2021. Studies reporting overall survival and/or disease-free interval in
patients with MPM undergoing cytoreductive surgery with hyperthermic
intrathoracic chemotherapy were considered. Study quality was assessed
using the Newcastle-Ottawa Scale. A narrative review was performed.
Results Fifteen studies were eligible for inclusion comprising 598
patients. Surgery with hyperthermic intrathoracic chemotherapy was
associated with a median overall survival and disease-free interval
ranging from 11 to 75 months and 7.2 to 57 months, respectively. These
appeared to be superior to patients not receiving hyperthermic
intrathoracic chemotherapy (overall survival: 5-36 months and disease-free
interval: 12.1-21 months). A higher dose of hyperthermic intrathoracic
chemotherapy was associated with an improvement in overall survival
compared with a lower dose: 18-31 months versus 6-18 months, respectively.
The most common morbidity was atrial fibrillation followed by renal
complications. Conclusion Surgery with hyperthermic intrathoracic
chemotherapy offers a safe and effective therapy with an improvement in
disease-free interval and overall survival, particularly when hyperthermic
intrathoracic chemotherapy is administered at a higher dose. PROSPERO
registration number CRD42019129002. <br/>Copyright &#xa9; 2023 BMJ
Publishing Group. All rights reserved.

<39>
Accession Number
640966098
Title
Up-to-date review of published clinical research on Sucrosomial Iron: What
we missed?.
Source
Blood Transfusion. Conference: 8th International Multidisciplinary course
on Iron Deficiency, IMCID 2022. Stresa Italy. 21(Supplement 1) (pp
s19-s20), 2023. Date of Publication: February 2023.
Author
Munoz M.; Gomez-Ramirez S.
Institution
(Munoz) Department of Surgical Specialties, Biochemistry and Immunology,
School of Medicine, Universtity of Malaga, Malaga, Spain
(Gomez-Ramirez) Internal Medicine Unit, University Hospital 'Virgen de la
Victoria', Malaga, Spain
Publisher
Edizioni SIMTI
Abstract
Background. Anemia affects up to one-third of the global population,
though prevalence varied widely across regions, and iron deficiency (ID)
accounts >=50% of anemia cases1. The main causes of ID are increased
demands, reduced absorption and/or increased loss of iron2. Nevertheless,
the prevalence and consequences of ID may also vary depending on the
clinical setting considered3. In the Global Burden of Disease Study 2016,
iron-deficiency anemia (IDA) was the fourth leading cause of years lived
with disability, especially in women4. Thus, prophylaxis and management of
ID is a first order public issue. Iron deficiency is usually treated with
oral iron salts, especially ferrous sulfate, but up to 50% of patients
complain of gastrointestinal side effects, leading to reduced compliance
with treatment5. Intravenous (IV) iron formulations are increasingly safe,
but there is still a risk of infusion and hypersensitivity reactions and
the need for venous access and infusion monitoring6. Material and methods.
Literature review of studies involving the use of Sucrosomial Iron (SI)
for treating ID and IDA. Results. SI is an newer oral iron formulation in
which ferric pyrophosphate is protected by a phospholipid matrix plus a
sucrester matrix (sucrosome), which is absorbed through para-cellular and
trans-cellular routes (M cells)7,8. This confers SI's unique structural,
physicochemical and pharmacokinetic characteristics, together with its
high iron bioavailability and excellent gastrointestinal tolerance9. The
available evidence supports oral SI iron as a valid option for ID
treatment, being more efficacious and tolerable than oral iron salts9.
Newer evidence also demonstrates the effectiveness of SI, with fewer
side-effects, in patients usually receiving IV iron (e.g., inflammatory
bowel disease, cardiac failure, cardiac surgery, cancer, bleeding
pathology)10-16. Conclusion. Thus, oral SI emerges as a valuable first
option for treating ID, especially for subjects with intolerance to iron
salts or those for who iron salts are inefficacious. Moreover, SI could
also be considered as an alternative to IV iron for initial and/or
maintenance treatment in different patient populations.

<40>
Accession Number
640966016
Title
Implementation of a pre-operative optimization protocol with Sucrosomial
Iron in cardiac surgery.
Source
Blood Transfusion. Conference: 8th International Multidisciplinary course
on Iron Deficiency, IMCID 2022. Stresa Italy. 21(Supplement 1) (pp
s14-s15), 2023. Date of Publication: February 2023.
Author
Weltert L.P.
Institution
(Weltert) Cardiosurgery Division, European Hospital, Rome, Italy
(Weltert) Saint Camillus International, University of Health and Medical
Sciences (UniCamillus), Rome, Italy
Publisher
Edizioni SIMTI
Abstract
Background. The prevalence of low preoperative hemoglobin is high among
heart surgery patients which also show a systematic and significant
hemoglobin decrease between post-operative days 2 and 3, known as
hemoglobin drift. Overall this subset of patients receives conspicuous RBC
transfusions. As iron homeostasis is often impaired in these patients,
restoration of iron availability might override iron-restricted
erythropoiesis. However, reduced tolerance to oral iron salts has limited
this strategy to intravenous iron administration. This study was aimed at
assessing whether preoperative supplementation with oral Sucrosomial Iron
(SI), a new iron delivering technology with improved tolerance and
bioavailability, might be an effective strategy for this patient
population1. Material and methods. One-thousand consecutive patients were
randomized and received either a one-month course of SI (60 mg/day,
treatment group) or no treatment (control group) prior to elective heart
surgery at one high volume center (ClincalTrials.gov NCT03560687). Primary
end-points were hemoglobin concentration the day of hospital admittance
and blood transfusions. Secondary end-points were hemoglobin drift,
tolerance of treatment and cost-effectiveness of SI administration.
Results. Admission hemoglobin was higher by 0.67 g/dL in the treatment
group (p<0.001); transfusion rate in the treated group was 35,4 against
64.6% in the control group; and averaged transfused units were 0.95
U/patient in the treatment group against 2,03 U/patient in de control
group. In a pot hoc analysis (n=594), the improvements in these three
parameters appeared to be more prominent in the under 13 g/dL sub-cohort
receiving preoperative oral SI2. Hemoglobin drift was substantially
similar in the two groups. Treatment tolerability was excellent (98%).
Overall cost-effectiveness led to a 156 saving in the treatment group.
Conclusion. In elective heart surgery, routine preoperative SI
administration seems a safe, well tolerated and cost-effective strategy to
increase preoperative hemoglobin and reduce allogeneic blood transfusions,
with an expected benefit that becomes significantly higher in anemic
patients, as defined by a baseline Hb<13 g/dL for both genders.

<41>
Accession Number
2023687905
Title
Use of Induction Therapy Post Heart Transplantation - Clinical Practice
Recommendations Based on Systematic Review and Network Meta-Analysis of
Evidence.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S456-S457), 2023. Date of Publication: April
2023.
Author
Foroutan F.; Guyatt G.; Stehlik J.; Gustafsson F.; Greig D.; McDonald M.;
Bertolotti A.; Kugathasan L.; Rayner D.; Cook A.; Zlatanoski D.; Ram S.;
Demas-Clarke P.; Kozuszko S.; Alba A.
Institution
(Foroutan) Ted Rogers Centre for Heart Research, Toronto, ON, Canada
(Guyatt) Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, ON, Canada
(Stehlik) University of Utah, Salt Lake City, UT, United States
(Gustafsson) Rigshospitalet, Copenhagen, Denmark
(Greig) P. Universidad Catolica de Chile, RM, Chile
(McDonald, Kozuszko, Alba) Toronto General Hospital, Toronto, ON, Canada
(Bertolotti) Favaloro Foundation, Ciudad Autonoma Buenos Aires, Argentina
(Kugathasan) University Health Network, Toronto, ON, Canada
(Rayner) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Cook, Zlatanoski, Ram) None, Toronto, ON, Canada
(Demas-Clarke) Toronto General Hospital, Toront, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: In patients undergoing heart transplantation (HTx), induction
therapy (IT) provides early intense immunosuppression. Whether to use IT,
and the choice of optimal regimen remains controversial. We undertook a
systematic review and network meta-analysis to assess outcomes following
the use of IT agents, that informed a clinical practice guideline on the
utility of contemporary agents: Thymoglobulin and Basiliximab.
<br/>Method(s): We recruited an international, multidisciplinary panel,
inclusive of 3 patient partners, 5 cardiologists, 1 surgeon, 1 nurse
practitioner, 1 pharmacist, and 4 methodologists. We used the GRADE
framework summarize findings and develop recommendations. To develop
internationally applicable recommendations, our panel took a global
perspective. The panel considered balance between benefits and harms,
quality of evidence, and patient's values and preferences, to make
recommendations for or against the use of Thymoglobulin or Basiliximab.
The panel focused on the following outcomes: all-cause mortality, cellular
rejection (requiring treatment), infection, renal dysfunction, and
malignancy. <br/>Result(s): The review provided low- or, in most cases,
very low-quality evidence of either benefit or harm of the two agents,
leaving the effects of the interventions uncertain. The panel judged that
with low or very low-quality evidence providing no compelling suggestion
of benefit, the majority of patients would be reluctant to receive an
intervention with possible serious adverse effects. Therefore, our review
resulted in weak recommendations as follows: Recommendation #1: In adult
HTx recipients, we suggest against the routine use of Basiliximab, as
compared to no induction therapy. Recommendation #2: In adult HTx
recipients, we suggest against the routine use of Thymoglobulin, as
compared to no induction therapy. Recommendation #3: In adult HTx
recipients for whom induction therapy is deemed desirable, we suggest
using Thymoglobulin over Basiliximab. <br/>Conclusion(s): Our panel made
weak recommendations against the routine use of IT agents. In select
patients in whom shared decision-making leads to a decision to choose IT,
the panel favored the use of Thymoglobulin over Basiliximab. Additional
studies are needed to identify patient subgroups that may derive benefit
from IT.<br/>Copyright &#xa9; 2023

<42>
Accession Number
2023630525
Title
Utility of Intraoperative Cytokine Hemoadsorption Therapy During Cardiac
Transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S166-S167), 2023. Date of Publication: April
2023.
Author
Kamat N.A.; Gaur A.; Phadke A.; Waje N.; Bunage R.; Meeran T.; Sinha S.;
Chavan A.; Haji J.; Rathod A.; Mulay A.
Institution
(Kamat) Advanced Cardiac Surgery and Heart/Lung Transplant, Sir HN
Reliance Foundation Hospital & Research Center, Mumbai, India
(Gaur) Advanced Cardiac Surgery and Heart/Lung Transplant, Sir HN Reliance
Foundation Hospital and Research Center, Mumbai, India
(Phadke, Waje, Bunage, Meeran, Sinha, Chavan) Advanced Cardiac Surgery &
Heart/Lung Transplant, Sir HN Reliance Foundation Hospital and Research
Center, Mumbai, India
(Haji) Advanced Cardiac Surgery & Heart/Lung Transplant, Sir HN Reliance
Foundation Hospital and Reesearch Center, Mumbai, India
(Rathod) Advanced Cardiac Surgery & Heart/Lung Transplant, Sir HN Relaince
Foundation Hospital and Research Center, Mumbai, India
(Mulay) Advanced Cardiac Surgery & Heart/Lung Transplant, Sir HN Reliance
Foundation hospital and Research Center, Mumbai, India
Publisher
Elsevier Inc.
Abstract
Purpose: CYTOSORB is an approved extracorporeal hemadsorption (HA) device
that has shown beneficial effects in reducing the impact of cytokine storm
and other inflammatory mediators in patients undergoing complex cardiac
surgeries. However till date there is lack of randomised data to
demonstrate similar effects in patients undergoing cardiac
transplantation. We aimed to study the influence of Intraoperative
Cytokine HA therapy using CYTOSORB on perioperative inflammatory response,
vasoplegia, blood loss and overall morbidity and mortality during
orthotropic cardiac transplantation. <br/>Method(s): In this single-centre
randomised control trial, 19 patients undergoing Cardiac Transplantation
were included. In the Treatment arm (n=12), intra-operative CYTOSORB was
utilized as the cytokine HA filter on cardio pulmonary bypass (CPB). In
the Control arm (n=7), routine cardiac transplant surgery was performed
without CYTOSORB. Primary outcome was level of inflammatory response as
measured by procalcitonin (PCT), C-Reactive protein (CRP) and Interleukin
6 (IL-6) measured at the time of anaesthesia induction (0), 24, 48 & 72
hours post-CPB initiation. Secondary outcomes were peri-operative
inotropic & vasopressor demand, usage of mechanical circulatory support,
blood loss, rate of re-exploration and mortality. <br/>Result(s): PCT and
IL-6 levels were lower (33% & 27.5%) in the Treatment arm. There was no
significant difference in the CRP levels in both arms. An approximately
20% reduction in the surgical re-exploration rates was noted in in the
Treatment arm. Vasopressor demand was 50% lower in the Treatment arm.The
requirement for Mechanical Circulatory Support (MCS) was lower in the
Treatment arm (14% & 25%). No difference in inotrope demand was noted in
both the arms. There was also no difference in blood transfusions
requirement, ICU length of stay and peri-operative mortality in both the
arms. There were no increase in adverse events related to the use of
CYTOSORB therapy. <br/>Conclusion(s): Intra-operative HA therapy using
CYTOSORB during cardiac transplantation was associated with lower
peri-operative inflammatory mediators, lower vasoplegia and lower
requirement for MCS and surgical re-exploration. CYTSORB therapy was not
associated with any significant adverse events.<br/>Copyright &#xa9; 2023

<43>
Accession Number
2023630129
Title
Risk Factors for Primary Graft Dysfunction after Heart Transplantation - A
Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S147-S148), 2023. Date of Publication: April
2023.
Author
Vervoorn M.; Kaffka Genaamd Dengler S.; Kernkamp J.; Ballan E.; Mishra M.;
van der Kaaij N.
Institution
(Vervoorn, Kaffka Genaamd Dengler, Kernkamp, Ballan, Mishra, van der
Kaaij) UMC Utrecht, Utrecht, Netherlands
Publisher
Elsevier Inc.
Abstract
Purpose: Primary graft dysfunction (PGD) is an important contributor to
early mortality after heart transplantation (HTX). The International
Society for Heart and Lung Transplantation (ISHLT) published a consensus
definition of primary graft dysfunction in 2014. We conducted a systematic
review and meta-analysis of published literature aimed at identifying risk
factors for PGD according the ISHLT consensus definition. <br/>Method(s):
Studies were identified using Medline and Embase and were included if
published after the establishment of the consensus definition, the
population consisted of adults receiving isolated HTX and outcome was
specified as development of PGD according to the ISHLT consensus
definition. PRISMA-guidelines were applied. Only risk factors identified
with multivariate analysis were included and inserted into meta-analysis
if reported in >=2 studies. Pooled odds ratios (OR) and 95% confidence
intervals (CI) were calculated using the inverse variance method with a
DerSimonian and Laird random-effects model. <br/>Result(s): A total of 29
studies were included. Significant heterogeneity was noted regarding
severity of PGD and risk factor definition, limiting pooling of data for
meta-analysis. After meta-analysis, the only significant predictor for all
PGD was recipient mechanical circulatory support status prior to HTX (OR:
2.48; 95% CI: 1.38-44.6), while recipient amiodarone treatment (OR: 4.95;
95% CI: 2.48-9.86), female sex of the donor (OR: 2.08; 95% CI: 1.42-3.03)
and cold ischemic time per hour-increment (OR: 1.91; 95% CI: 1.74-2.11)
were significant predictors of severe PGD. No risk factors for right
ventricular PGD or PGD after cardiac donation after circulatory death
(DCD) could be identified. <br/>Conclusion(s): To our knowledge, this is
the first systematic review and meta-analysis specifically focused on risk
factors for PGD according to the ISHLT consensus definition. An important
observation was the significant heterogeneity among identified studies
regarding severity of PGD and risk factor definition, that restricted the
ability to reliably pool data for meta-analysis. Future studies should
take this into consideration to improve multi-center comparison,
reproducibility and statistical power of future meta-analysis.
Furthermore, focus should be aimed at identifying risk factors for right
ventricular PGD and PGD after cardiac DCD.<br/>Copyright &#xa9; 2023

<44>
Accession Number
2023629992
Title
Chasing the Dream (of Equipoise): Design and Execution Challenges of the
Multicenter TITRE Trial of Indication-Based Red Blood Cell Transfusion in
Pediatric ECMO.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S481), 2023. Date of Publication: April 2023.
Author
Sleeper L.A.; Alexander P.; Kelly D.P.; Bembea M.M.; Bellinger D.C.;
Sadhwani A.; Sun L.; Shrivastava M.; Klein G.L.; Newburger J.W.;
Thiagarajan R.R.
Institution
(Sleeper, Alexander, Sadhwani, Sun, Shrivastava, Klein, Newburger,
Thiagarajan) Cardiology, Boston Children's Hospital, Boston, MA, United
States
(Kelly) Medical Critical Care, Boston Children's Hospital, Boston, MA,
United States
(Bembea) Anesthesiology and Critical Care Medicine, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Bellinger) Neurology, Boston Children's Hospital, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Purpose: To describe the challenges in the design and execution of a
multicenter randomized clinical trial (RCT) of indication-based red blood
cell (RBC) transfusion for the pediatric ECMO population, in a landscape
characterized by heterogeneity in standard of care (SOC) and patient care
stakeholders from multiple disciplines and specialties. <br/>Method(s):
ECMO for critically ill children and adults has become more prevalent
since UNOS criteria were revised to support ECMO as a bridge to transplant
(BTT) for selected patients. RBC transfusion during ECMO can improve
oxygen delivery to tissues and manage bleeding; however, it is associated
with increased morbidity and mortality, and the hemoglobin (Hb) level
needed for optimal tissue oxygen delivery is unknown, thus exposing ECMO
patients to unnecessary RBC transfusions. The TITRE Trial aims to address
this knowledge gap. It is designed to determine whether indication-based
RBC transfusion based on reduced tissue oxygen delivery, compared with RBC
transfusion based on institutional-specific Hb thresholds, reduces organ
dysfunction by the time of decannulation, and improves 1-year
neurodevelopment in children receiving ECMO. <br/>Result(s): TITRE is
comprised of 18 North American sites with planned trial launch by April
2023. The trial is pragmatic, i.e., each site's SOC for RBC transfusion
will be the comparator to the indication-based RBC transfusion arm. We
identified important challenges of equipoise and secular changes in
practice. A reluctance to implement assigned treatment jeopardizes
protocol compliance and the power of ITT analysis. Rapid changes in SOC
towards an indication-based transfusion strategy and adoption of lower Hb
thresholds jeopardize the separation of treatments necessary to test
TITRE's hypothesis. The elusive nature of equipoise is further compounded
by the multiple ECMO delivery teams, i.e., cardiac, medical/surgical, and
neonatal intensive care programs. <br/>Conclusion(s): Execution of a
pragmatic multicenter RCT with SOC as the comparator in a
multidisciplinary care setting (ECMO) presents unique challenges that we
have successfully addressed to launch the TITRE Trial. TITRE will have
important implications for optimal management of those supported with ECMO
as BTT, as reduced RBC exposure during ECMO may improve post-transplant
outcomes.<br/>Copyright &#xa9; 2023

<45>
Accession Number
2023629959
Title
Cardiac Transplant in Southeast Asia: Challenges and Opportunities.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S460), 2023. Date of Publication: April 2023.
Author
Sulague R.; Cruz N.; Ricardo R.; Alfonso P.; Vervoort D.
Institution
(Sulague) Georgetown University School of Health, Washington, DC, United
States
(Cruz) Our Lady of Fatima University College of Medicine, Valenzuela City,
Philippines
(Ricardo) University of the Philippines-Philippine General Hospital,
Manila, Philippines
(Alfonso) University of the Philippines College of Medicine, Manila,
Philippines
(Vervoort) Institute of Health Policy, Management, and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Among the 18.6 million cardiovascular deaths worldwide, 33.5%
occurred in Southeast Asia, where cardiovascular diseases constitute 40.2%
of all causes of mortality and injury. There is higher prevalence of
symptomatic heart failure in Southeast Asian countries compared with the
rest of the world. While advances improved cardiac transplantation,
challenges remain to make it widely available. The study aims to discuss
its challenges and opportunities in Southeast Asia. <br/>Method(s): A
review of related literature was conducted on PubMed using combinations of
variations of key terms such as cardiac transplant, heart transplant,
Southeast Asia, and countries within the region. Ministries of health
websites in the region were reviewed for cardiac transplant-related
policies. The global burden of disease of heart failure-associated
conditions from 2000 to 2019 in disability-adjusted life-years were
assessed in the Southeast Asian region and other select geographical
region using the Institute for Health Metrics and Evaluation Global Burden
of Disease Results Tool. <br/>Result(s): Southeast Asia's burden of
disease is comparable to Western Europe but does not have the same high
volume of cardiac centers, health workforce, and robust network of organ
donors. Substantial financial risk protection remains limited for most of
the countries. Main barriers to organ donation include knowledge gaps,
sociocultural and religious restrictions, and lack of infrastructure. At
present, all countries follow an opting-in system based on informed
consent, except Singapore which follows an opting-out system based on
presumed consent. Association of Southeast Asian Nations may be optimized
to promote cooperation, physician mobility, improved training, and
policymaking. <br/>Conclusion(s): Southeast Asian countries may benefit
from considering opting-out scheme for donation, implementing a national
system for organ donation, forming a centralized body directing all
transplant activities, and improving public health education on
transplantation.<br/>Copyright &#xa9; 2023

<46>
Accession Number
2023629823
Title
Impact of a Prehabilitation Program on Lvad Implantation Surgical
Outcomes.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S472), 2023. Date of Publication: April 2023.
Author
Wu Y.; Fanous S.; Baudart S.; Jannesen A.; Strehlow A.; Abad A.J.;
Griswold K.; Mulcahy K.; Klein L.; Wieselthaler G.
Institution
(Wu, Baudart, Jannesen, Strehlow, Abad, Klein, Wieselthaler) Advanced
Heart Failure Comprehensive Care Center, University of California San
Francisco, San Francisco, CA, United States
(Fanous) Department of Pharmacy, University of California San Francisco,
San Francisco, CA, United States
(Griswold, Mulcahy) Department of Rehabilitation, University of California
San Francisco, San Francisco, CA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Left ventricular assist devices (LVAD) candidates often show
marked impairment in physical function, exercise capacity and nutritional
status which are all risk factors for poor surgical outcomes. No studies
have been undertaken to assess the efficacy of prehabilitation efforts in
patients undergoing cardiac surgery or LVAD implant. We developed and
implemented a prehabilitation program and assessed its impact on the
outcomes of patients undergoing LVAD implant. <br/>Method(s): We enrolled
patients in the prehabilitation program prior to their LVAD implant
between 10/1/2021 and 9/30/2022. The program consisted of physical
function, nutritional and cognitive function optimization. The historical
control group were LVAD patients implanted between 1/1/2020 and
12/31/2020. The primary outcomes included mean post-implant intensive care
unit (ICU) and total hospital (TH) length of stay (LOS). Secondary
outcomes included 30-days readmissions, INTERMACS adverse events (AEs) and
changes in 6-minute walk test (6MWT) before discharge. <br/>Result(s): We
enrolled 13 patients in the prehabilitation group (INTERMACS profile 1-2,
n=7; INTERMACS profile 3-4, n=6) and 11 patients in the control group
(INTERMACS profile 1-2, n=4; INTERMACS profile 3-4, n=7). The mean
prehabilitation duration was 11.8 days prior to the LVAD implant. The post
implant ICU LOS in the prehabilitation group was non-significantly higher
by an average of 2.1 days (p=0.44) and 2.6 days (p=0.35) after adjusting
for INTERMACS profile. The TH LOS was higher by 8.7 days (p=0.03) and 8.5
days (p=0.04) after adjusting for INTERMACS profile. There was no
significant difference in 6MWT and AEs. <br/>Conclusion(s): The short
duration of prehabilitation in this pilot study was not effective to
reduce post VAD implant LOS and AEs. A prospective randomized control
study of prehabilitation is needed in LVAD patients.<br/>Copyright &#xa9;
2023

<47>
Accession Number
2023629654
Title
Donor Simvastatin Treatment in Heart Transplantation: 5-Year Results of a
Randomized Clinical Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S467), 2023. Date of Publication: April 2023.
Author
Syrjala S.O.; Holmstrom E.; Dhaygude K.; Lommi J.; Nykanen A.; Lemstrom K.
Institution
(Syrjala) Helsinki University Hospital, Helsinki, Finland
(Holmstrom) Univ of Helsinki, Helsinki 18, Finland
(Dhaygude, Lemstrom) University of Helsinki, Helsinki 18, Finland
(Lommi) Helsinki Univ Hosp, Helsinki 18, Finland
(Nykanen) Helsinki University Hospital, Helsinki 18, Finland
Publisher
Elsevier Inc.
Abstract
Purpose: The prospective, single-center, double-blinded randomized
clinical trial (Donor Simvastatin Treatment in Heart Transplantation;
ClinicalTrials.gov number NCT01160978) investigates the effects of donor
simvastatin treatment on cardiac transplant recipient outcome. The primary
endpoint analysis demonstrates that donor treatment with a single-dose of
simvastatin before organ procurement reduces cardiac transplant
ischemia-reperfusion injury and the number of rejection treatments with
hemodynamic compromise within the first 30 days. In this secondary
endpoint analysis, we studied the 5-year follow-up data and the donor
plasma metabolic profile behind donor simvastatin treatment.
<br/>Method(s): The study population comprises of 84 cardiac allograft
donors, randomized to receive 80 mg of simvastatin or no simvastatin, and
the respective recipients. We analyzed the incidence of acute rejection,
malignancies, chronic allograft vasculopathy by coronary angiogram, and
patient survival as well as rejection-free survival during long-term
follow-up. Donor plasma metabolites were analyzed with UPLC mass
spectrometry and correlation analysis for long-term outcome was performed.
<br/>Result(s): At 5 years, 18 patients had died - 9 from each group. The
mean survival was 1515 days (95% CI: 1324-1705 days) in the control group
and 1553 days (95% CI: 1372-1730 days) in the donor simvastatin group. The
overall patient survival was similar in both groups at 5 years. No
statistically significant differences were observed in the number of
rejections, or in chronic allograft vasculopathy. Donor plasma arginine
levels showed significant correlation to recipient outcome. Interestingly,
2/3 of donors with high arginine level had better long-term outcome that
was further improved by simvastatin treatment. <br/>Conclusion(s): Donor
simvastatin showed to be safe in long-term follow-up but failed to show
improvements in patient outcome. In this heart transplant donor cohort,
the positive effect of simvastatin may be diluted by high arginine, a
substrate for nitric oxide.<br/>Copyright &#xa9; 2023

<48>
Accession Number
2023629553
Title
The Crossroads in VAD - To Wean or Not to Wean: A Meta-Analysis on
Predictors of Feasibility of Ventricular Assist Device Explantation with
Stable Myocardial Recovery in Chronic Non-Ischemic Dilative
Cardiomyopathy.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S464), 2023. Date of Publication: April 2023.
Author
Javier M.; Delmo E.J.; Dandel M.; Hetzer R.
Institution
(Javier) Cardiac Surgery, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Delmo) Charite Research Organisation, Charite -Universitatsmedizin
Berlin, Berlin, Germany
(Dandel) German Center for Cardiovascular Research (DZHK) Partner Site
Berlin, Berlin, Germany
(Hetzer) Charite Universitatsmedizin Berlin, Berlin, Germany
Publisher
Elsevier Inc.
Abstract
Purpose: Predicting sustained recovery after ventricular assist device
(VAD) explantation harbors potential to shape heart failure management.
This meta-analysis evaluates clinical and echocardiographic parameters
including Clenbuterol administration as potential predictors of stability
of myocardial recovery, to aid in determining the feasibility of VAD
explantation without orthotopic heart transplantation. <br/>Method(s):
Medline (PubMed) studies concerning patients with non-ischemic
cardiomyopathy weaned from VADs were searched. End points assessed were
myocardial recovery, heart failure (HF) recurrence and death.
<br/>Result(s): Ninety-eight (98) patients in 11 studies were included,
with data on age, gender, pre-explantation left ventricular (LV)
end-diastolic dimension/ejection fraction, exercise/dobutamine stress
tests and off-pump trials available in 83 patients (Group1) and HF
duration, pre-explant LV end-diastolic dimension stability, geometry (i.e.
sphericity index, relative wall thickness), ejection fraction and reduced
off-pump arterial diastolic pressure < 50 mmHg available in 51 patients
(Group 2). Age at implantation (hazard ratio 2.986,p=0.002), HF duration
(hazard ratio 1.438,p=0.001) and pre-explant instability of LV geometry
(hazard ratio 1.541,p=0.000) were identified as significant HF recurrence
predictors in Group 2 and pre-explantation LV end-diastolic dimension
(hazard ratio 1.126,p=0.031) and ejection fraction (hazard ratio
0.080,p=0.007) as stability of recovery predictors in Group 1. Overall
freedom from HF recurrence was 82%, 78%, 58% and 42% at 1, 5, 10 and 15
years and survival was 100%, 80%, 78% and 78% at 30-day, 5, 10 and 15
years follow-up after weaning, respectively. <br/>Conclusion(s): Gathered
data identified age <=45 years at implantation, non-spheric LV morphology
(sphericity index stability), high LV ejection fractions and low
end-diastolic dimensions during pump-reduction or off-pump trials as
significant predictors of successful weaning and sustained myocardial
recovery thereafter. In light of these results, myocardial recovery as a
therapeutic trajectory in VAD-supported patients is highly feasible and
elective VAD-weaning should be the primary goal in HF
management.<br/>Copyright &#xa9; 2023

<49>
Accession Number
2023629466
Title
Prevention of Driveline Infections with Cold Atmospheric Argon Plasma: A
Randomized Trial Comparing Two Surgical Techniques.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S129), 2023. Date of Publication: April 2023.
Author
Lauenroth V.; Lucke S.; Fox H.; Gunther S.P.; Morshuis M.; Schramm R.;
Gummert J.F.; Rojas S.V.
Institution
(Lauenroth, Lucke, Fox, Gunther) Cardiothoracic Surgery, Heart and
Diabetes Center NRW, Bad Oeynhausen, Germany
(Morshuis, Schramm, Gummert, Rojas) Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
Publisher
Elsevier Inc.
Abstract
Purpose: Despite important advances in left ventricular assist device
(VAD) therapy, driveline infections (DLI) remain a major unsolved drawback
with negative impact on quality of life, morbidity and overall outcomes.
It is conspicuous that prevention in the early phase of therapy might
currently be the best treatment option for driveline infections. In this
context, variation of the driveline velour position and preventive
treatment with cold argon plasma (CAP) at the exit site, seem to be
promising positive influencing factors. Therefore, our aim was to conduct
a randomized prospective study to verify their potential utility.
<br/>Method(s): Eighty consecutive VAD patients were enrolled at our
center and randomized to one of four groups. Group I had their driveline
diverted reaching the velour, whereas in Group II the driveline was
diverted at "full length", without intracorporal loop and extensive
external velour course. Both groups were divided into subgroups A and B,
with subgroup B receiving additional preventive CAP therapy during 30 days
after VAD implantation. Primary endpoint was defined as first positive
germ proof or clinical DLI according to DESTINE stage 2 criteria. Further
endpoints include mortality, heart transplantation, as well as VAD
weaning. Follow-up concluded at 365 days. <br/>Result(s): Preventive ACP
treatment was found to be superior over optimal standard of care after 180
days, reducing DLI occurrence (92 % freedom from DLI vs 65 %). Driveline
divert did not have a statistically significant impact on infection during
one year follow-up. Subgroup IA (non CAP, non diverted driveline)
illustrated an increased mortality compared to the other groups (75 %
survival in Group I versus 90 % in Group II (p=0.009)).
<br/>Conclusion(s): Preventive ACP treatment after VAD implantation
significantly reduced the incidence of DLI in the first 180 days.
Driveline placement with fully covered velour did not influence the
occurrence of DLI, but was associated with increased mortality. Further
trials are needed to abrogate confounding factors and to further improve
freedom from DLI, but also survival in VAD patients in the
future.<br/>Copyright &#xa9; 2023

<50>
Accession Number
2023597359
Title
THE USE OF IMMUNOMODULATORS, BIOLOGIC THERAPIES AND SMALL MOLECULES IN
PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND SOLID ORGAN TRANSPLANTS.
Source
Gastroenterology. Conference: Abstracts From the 2023 Crohn's & Colitis
Congress. Denver United States. 164(4 Supplement) (pp S3-S4), 2023. Date
of Publication: April 2023.
Author
Ghusn W.; Francis F.; Farraye F.; Hashash J.G.
Publisher
W.B. Saunders
Abstract
INTRODUCTION: Over the past 20 years, the number of solid organ
transplants (SOT) for a variety of indications has been on the rise.
Consequently, more patients with inflammatory bowel diseases (IBD) are
also receiving SOT. Although SOT related immunosuppression may at times
control IBD related inflammation, many patients still require additional
immunosuppressive medications for control of their IBD. With the growing
therapeutic armamentarium for IBD, physicians are in search for guidance
on the safety of using additional immunosuppressive medications in
patients who are already receiving transplant related immunosuppressive
medications. <br/>METHOD(S): We performed a review of published literature
that addressed the use of immunomodulators, biologic agents, and small
molecules in patients with IBD who also had a SOT. We searched PubMed,
Scopus, MEDLINE, and Google Scholar databases for studies published on the
topic in English between January 1st, 1910, and August 1st, 2022. We have
included data from systematic reviews, meta-analyses, case reports and
case series to assess the safety, effectiveness, and side effects of
immunomodulators, biologic therapies and small molecules in patients with
liver, renal and/or heart transplantations. <br/>RESULT(S): We identified
25 publications on liver transplants, 6 on renal transplants, and 1 on
heart transplants in patients with IBD. Among liver transplant patients,
the most common immunosuppressive medications used were tacrolimus,
mycophenolate mofetil, cyclosporine and steroids. In patients with IBD,
anti-TNF agents (infliximab and adalimumab) were used in SOT with no major
adverse safety concerns. The most common adverse events included
infections (Clostridioides difficile and CMV) and malignancies (colon
cancer). As for anti-integrin agents (vedolizumab and natalizumab) and
ustekinumab, their efficacy and safety were mainly reported in patients
with liver transplant on tacrolimus with no major adverse events reported.
For patients with renal transplant, the main immunosuppression used were
cyclosporine and tacrolimus. The combination of these immunosuppressive
drugs with either anti-TNF therapy or ustekinumab had a good safety
profile with rare malignancy occurrence. In one case report with heart
transplant in a patient with IBD and on tacrolimus, no complications were
reported. <br/>CONCLUSION(S): SOT has become the mainstay for treating
several common diseases. As such, gastroenterologists will care for more
patients with IBD who have had a SOT. From this extensive review, the use
of anti-TNF, anti-integrin agents and ustekinumab seem to be safe in
patients with SOT, regardless of their transplant related
immunosuppression which is usually comprised of tacrolimus, cyclosporine,
and prednisone. More studies are needed in patients with renal and heart
transplant and in patients treated with small molecules for their
IBD.<br/>Copyright &#xa9; 2023

<51>
Accession Number
640965276
Title
THE EFFECT OF REMOTE ISCHEMIC CONDITIONING AND GLYCERYL TRINITRATE ON
PERIOPERATIVE MYOCARDIAL INJURY IN CARDIAC BYPASS SURGERY PATIENTS: THE
ERIC-GTN STUDY.
Source
Heart. Conference: Irish Cardiac Society Annual Scientific Meeting and
AGM. Londonderry United Kingdom. 103(Supplement 6) (pp A34), 2017. Date of
Publication: October 2017.
Author
Hamarneh A.; Hardman E.; Wicks P.; Shanahan H.; Bulluck H.; Ramlall M.;
Chung R.; Bell R.; Cordery R.; Yellon D.; Hausenloy D.
Institution
(Hamarneh, Bulluck, Ramlall, Chung, Bell, Yellon, Hausenloy) Hatter
Cardiovascular Institute, University College London, United Kingdom
(Hardman, Wicks, Shanahan, Cordery, Hausenloy) Bart's Heart Centre. Health
NHS Trust, United Kingdom
(Hausenloy) National Heart Research Institute Singapore, National Heart
Centre Singapore, Singapore, Singapore
(Hausenloy) Cardiovascular and Metabolic Disorders Program, Duke-National
University of Singapore, Singapore, Singapore
Publisher
BMJ Publishing Group
Abstract
Introduction Remote Ischaemic Conditioning (RIC) using transient limb
ischemia/reperfusion has been reported to reduce perioperative myocardial
injury (PMI) in patients undergoing coronary artery bypass grafting (CABG)
and/or valve surgery. The role of intravenous Glyceryl Trinitrate (GTN)
therapy administered during cardiac surgery as a cardioprotective agent
and whether it interferes with RIC cardioprotection is not clear and is
investigated in the ERIC-GTN trial (Clinicaltrial.govidentifier:
NCT01864252). Aims The ERIC-GTN trial has been designed to determine
whether intraoperatively administered IV GTN is cardioprotective during
cardiac surgery and to investigate the interaction between RIC and IV GTN
in their cardioprotective effects. Hypothesis 1: Intra-operative
intravenous GTN will reduce PMI in patients undergoing CABG and/or valve
surgery. Hypothesis 2: RIC will reduce PMI in the absence of GTN in
patients undergoing CABG and/or valve surgery. Hypothesis 3: RIC will not
reduce PMI in the presence of GTN in patients undergoing CABG and/or valve
surgery. Design The ERIC-GTN trial is a single site, double-blind,
randomised placebo-controlled study. Consenting adult patients (>18 years)
undergoing elective CABG +/-valve surgery with blood cardioplegia will be
eligible for inclusion. 260 patients will be randomised to one of four
treatment groups following aesthetic induction: (1) RIC alone: RIC
protocol comprising three 5-minutes cycles of simultaneous upper arm and
thigh cuff inflation/deflation followed by an intravenous (IV) placebo
infusion; (2) GTN alone: A simulated sham RIC protocol will be applied
followed by an IV GTN infusion; (3) RIC+GTN: RIC protocol followed by IV
GTN infusion; and (4) Neither RIC or GTN: Sham RIC protocol followed by IV
placebo infusion. The primary endpoint will be peri-operative myocardial
injury as quantified by the 72 hour area-under-the-curve (AUC) serum high
sensitive Troponin-T. Implication The ERIC-GTN trial will determine
whether intraoperative GTN therapy is cardioprotective during cardiac
surgery, and whether it affects RIC cardioprotection. We recruited 180 out
of 260 patients so far and are currently undertaking a pre-specified
interim analysis. (Figure Presented).

<52>
Accession Number
640965680
Title
MITRAL VALVE REPAIR - A SINGLE CENTRE 10 YEARS EXPERIENCE.
Source
Heart. Conference: Irish Cardiac Society Annual Scientific Meeting and
AGM. Londonderry United Kingdom. 103(Supplement 6) (pp A26-A27), 2017.
Date of Publication: October 2017.
Author
Keita L.; Weedle R.; Veerasingham D.
Institution
(Keita, Weedle, Veerasingham) Galway University Hospital, Galway, Ireland
Publisher
BMJ Publishing Group
Abstract
Introduction Mitral valve repair surgery is the procedure of choice for
degenerative mitral valve disease in symptomatic patients. There is a
paucity of national records in mitral valve repair rates and outcomes in
Ireland. Aim We set out to review our mitral valve repair rates for
degenerative disease as proposed by the local Heart Team / Joint
Cardiology-Cardiac meeting recommendation. Method A non-randomised
retrospective observational study of prospectively collected data from an
electronic patient database was conducted over a 10 year period. Results
There were a total of 53 mitral valve repair procedures (39 males/14
females; age 64.7+/- 12.3 years) carried out within a total number of 117
mitral surgical procedures in our unit from 2007 to 2017. Exclusion
criteria included mitral stenosis, mitral regurgitation due to ischaemic
heart disease, rheumatic valve disease and complex repair procedures
involving extensive anterior leaflet pathology or annular calcification.
Repair techniques included annuloplasty (96.2%), leaflet ressection
(60.3%), neochords implantation (15.1%) and sliding plasty (9.4%).
Concommittant procedures included tricuspid valve repair (15%), atrial
fibrillation ablation (17%), CABG (5.6%) and AVR (7.5%). There were 2
intraoperative conversions resulting in mitral valve replacement which
equates to a 96.2% repair rate among patients considered for mitral valve
repair based on heart team recommendations. Clinical and echocardiographic
follow-up was achieved in 94.3% of patients. During a median follow up of
63 months there were 2 cardiac deaths. Freedom from mitral regurgitation
and reoperation rate were respectively 88.7% and 5.6%. Conclusion Mitral
valve repair can be carried out with satisfactory short and long-term
results in centres with a dedicated interest.

<53>
Accession Number
640965661
Title
COMPARING OUTCOMES IN PATIENTS UNDERGOING TAVI: GENERAL ANAESTHETIC VERSUS
CONSCIOUS SEDATION.
Source
Heart. Conference: Irish Cardiac Society Annual Scientific Meeting and
AGM. Londonderry United Kingdom. 103(Supplement 6) (pp A25-A26), 2017.
Date of Publication: October 2017.
Author
Lee C.; Casserly I.; Fahy E.
Institution
(Lee, Casserly, Fahy) Mater Misericordiae Hospital, Dublin, Ireland
Publisher
BMJ Publishing Group
Abstract
Introduction The Transcatheter Aortic Valve Insertion (TAVI) experience
has been evolving globally for over a decade and a half. The first ever
in-human TAVI was carried out in 2002 and was performed under mild
sedation and local anaesthesia (1). As TAVI has progressed from a novel
therapy to a mainstream treatment it has been adopted worldwide as the
standard treatment for severe aortic stenosis in symptomatic patients who
have contraindications or other considerations that are prohibitive to
surgical aortic valve replacement (SAVR). Despite growing data on TAVI,
consensus on best anaesthetic approach is yet to be reached. The recent
WRITTEN survey of over 70,000 TAVI procedures worldwide reveals that
general anaesthesia (GA) remains the preference in 60% of centres (2).
Despite GA remaining the favored approach, a number of studies have
demonstrated a trend towards conscious sedation (non-GA) (3 4). The
advantages of conscious sedation over GA are thought to include improved
recovery time and reduced reliance on anaesthetic staff. The impact of
anaesthesia type on patient outcome was analysed using data from the
recent CoreValve ADVANCE study. Using propensity score-matching analysis,
the characteristics and outcomes of patients who underwent TAVI with
either GA or non-GA were compared. The study demonstrated no statistical
difference between GA and non-GA groups in all-cause mortality,
cardiovascular mortality, or stroke through 2-year follow- up. Length of
hospital stay was similar between the two groups (5). Methods Using data
from the newly formed Mater Hospital TAVI database we compared key patient
outcomes against anaesthesia type. Patients were divided into general
anaesthetic group (TAVI-GA), conscious sedation directed by anaesthesia
staff (TAVI-SA) and conscious sedation directed by cardiology staff
(TAVI-SC). Measured outcomes included procedure time, length of ICU stay,
need for vasopressor support and over all length of hospital stay.
Conclusions The statistical analysis for this study is ongoing with
results expected May 2017. Overall this study aims to add to the growing
body of international data regarding anaesthesia choice in TAVI. It will
also compare Mater Hospital data against similar studies. Looking to the
future a randomised control trial would likely be the design of choice to
help better reach an international consensus. Planning and implementing
such a trial would be difficult given the clinical complexity of typical
TAVI candidates by their nature.

<54>
Accession Number
2023798274
Title
Meta-analysis assessing the sensitivity and specificity of
¹⁸F-FDG PET/CT for the diagnosis of prosthetic valve
endocarditis (PVE) using individual patient data (IPD).
Source
American Heart Journal. 261 (pp 21-34), 2023. Date of Publication: July
2023.
Author
O'Gorman P.; Nair L.; Kisiel N.; Hughes I.; Huang K.; Hsu C.C.-T.; Fagman
E.; Heying R.; Pizzi M.N.; Roque A.; Singh K.
Institution
(O'Gorman, Huang, Hsu) Medical Imaging Department, Gold Coast University
Hospital (Queensland Health), Southport, Australia
(Nair) Department of Cardiothoracic Surgery, The Prince Charles Hospital
(Queensland Health), Brisbane, Australia
(Kisiel) Department of Nuclear Medicine, Royal Brisbane and Women's
Hospital (Queensland Health), Brisbane, Australia
(Hughes) Office for Research Governance and Development (Biostatistics),
Gold Coast University Hospital (Queensland Health), Southport, Australia
(Hughes) School of Medicine, The University of Queensland, Brisbane,
Australia
(Fagman) Department of Radiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Fagman) Department of Radiology, Institute of Clinical Sciences,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Heying) Pediatric Cardiology, University Hospitals Leuven, Belgium
(Pizzi) Department of Cardiology, Hospital Universitari Vall d'Hebron,
Barcelona, Spain
(Pizzi, Roque) Universitat Autonoma de Barcelona, Barcelona, Spain
(Pizzi, Roque) Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
(Roque) Institut de Diagnostic per la Imatge (IDI), Barcelona, Spain
(Roque) Department of Radiology, Hospital Universitari Vall d'Hebron,
Barcelona, Spain
(Singh) Cardiology Department, Gold Coast University Hospital (Queensland
Health), Southport, Australia
Publisher
Elsevier Inc.
Abstract
Importance: The use of ¹⁸F-FDG PET/CT in diagnostic algorithms
for PVE has increased since publication of studies and guidelines
advocating its use. The assessment of test accuracy has been limited by
small study sizes. We undertook a systematic review using individual
patient data (IPD) meta-analysis techniques. <br/>Objective(s): To
estimate the summary sensitivity and specificity of ¹⁸F-FDG
PET/CT in diagnosing PVE. We also assessed the effect of patient factors
on test accuracy as defined by changes in the odds ratios associated with
each factor. The effect of the PET/CT study on the final diagnosis was
also assessed when compared to the preliminary Duke classification to
determine in which patient group ¹⁸F-FDG PET/CT had the
greatest utility. Study Selection: Studies were included if PET/CT was
performed for suspicion of PVE and IPD of both the PET/CT result and final
diagnosis defined by a gold-standard assessment was available. There were
3 possible final diagnoses ("definite PVE," "possible PVE," and "rejected
PVE"). <br/>Result(s): Seventeen studies were included with IPD available
for 537 patients (from 538 scans). The summary sensitivity and specificity
were 85% (95% CI 74.2%-91.8%) and 86.5% (95% CI 75.8%-92.9%) respectively
when patients with final diagnosis of "possible PVE" were classified as
positive for PVE. When this group was classified as negative for PVE,
sensitivity was 87.4% (95% CI 80.4%-92.1%) and specificity was 84.9% (95%
CI 71.5%-92.6%). Patients with a known pathogen (especially coagulase
negative staphylococcal species), elevated CRP, a biological or aortic
valve infection appeared more likely to have an accurate PET/CT diagnosis.
Those with a mechanical valve, prior antibiotic treatment or a
transcatheter aortic valve replacement valve were less likely to have an
accurate test. Time since valve implantation and the presence of surgical
adhesive did not appear to affect test accuracy. Of the patients with a
preliminary Duke classification of "possible PVE," 84% received a more
conclusive final diagnosis of "definite" or "rejected" PVE after the
PET/CT study. <br/>Conclusions and Relevance: ¹⁸F-FDG PET/CT
has high sensitivity and specificity in diagnosing PVE and the diagnostic
utility is greatest in patients with a preliminary Duke classification of
"possible PVE." Some patient factors appear to affect test accuracy,
though these results should be interpreted with caution given low patient
numbers for subgroup analyses.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<55>
Accession Number
2023779419
Title
Lodderomyces elongisporus fungemia in a patient with previous cardiac
surgery: Case report and review of literature.
Source
Medical Mycology Case Reports. 40 (pp 40-43), 2023. Date of Publication:
June 2023.
Author
Gourav S.; Xess I.; Xess A.B.; Yadav R.K.; Ramakrishnan S.; Singh G.
Institution
(Gourav, Xess, Xess, Yadav, Singh) Department of Microbiology, All India
Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
(Ramakrishnan) Department of Cardiology, All India Institute of Medical
Sciences, Ansari Nagar, New Delhi 110029, India
Publisher
Elsevier B.V.
Abstract
Lodderomyces elongisporus is a rare cause of invasive fungal infections.
Most phenotypic tests that are routinely used for identification of yeasts
fail to identify this organism. However, chromogenic media for yeasts,
MALDI-TOF MS and DNA sequencing can be used for correct identification. We
report a case of fungemia complicated by infective endocarditis and
intracerebral bleeding in a pediatric patient with previous cardiac
surgery.<br/>Copyright &#xa9; 2023 The Authors

<56>
Accession Number
2023771164
Title
Perioperative individualized hemodynamic optimization according to
baseline mean arterial pressure in cardiac surgery patients: Rationale and
design of the OPTIPAM randomized trial.
Source
American Heart Journal. 261 (pp 10-20), 2023. Date of Publication: July
2023.
Author
Descamps R.; Amour J.; Besnier E.; Bougle A.; Charbonneau H.; Charvin M.;
Cholley B.; Desebbe O.; Fellahi J.-L.; Frasca D.; Labaste F.; Lena D.;
Mahjoub Y.; Mertes P.-M.; Molliex S.; Moury P.-H.; Moussa M.D.; Oilleau
J.-F.; Ouattara A.; Provenchere S.; Rozec B.; Parienti J.-J.; Fischer
M.-O.
Institution
(Descamps) Department of Anesthesiology and Critical Care Medicine, Caen
University Hospital, Caen, France
(Amour) Institute of Perfusion, Critical Care Medicine and Anesthesiology
in Cardiac Surgery (IPRA), Hopital Prive Jacques Cartier, Massy, France
(Besnier) Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, Department of
Anesthesiology and Critical Care, Rouen, France
(Bougle) Sorbonne Universite, GRC 29, Assistance Publique - Hopitaux de
Paris, DMU DREAM, Departement d'Anesthesie et Reanimation, Institut de
Cardiologie, Hopital La Pitie-Salpetriere, Paris, France
(Charbonneau) Department of Anesthesiology and Intensive Care Unit,
Clinique Pasteur, France
(Charvin) CHU Clermont-Ferrand, Medecine Peri-Operatoire (MC, FL, PJ,
A-LC, EF), Universite Clermont-Auvergne (EF), France
(Cholley) AP-HP, Hopital Europeen Georges Pompidou, Paris, France
(Desebbe) Department of Anesthesiology and Intensive Care, Ramsay Sante
Sauvegarde Clinic, Lyon, France
(Fellahi) Service d'anesthesie-Reanimation, Hopital Louis Pradel, Bron
Cedex, Boulevard Pinel, France
(Frasca) Department of Anaesthesia and Intensive Care, University Hospital
of Poitiers, France
(Labaste) Anesthesiology and Intensive Care Department, University
Hospital of Toulouse, Toulouse, France
(Lena) Institut Arnault Tzanck, Cardiologie Medico-chirurgicale, Saint
Laurent du Var, France
(Mahjoub) Anesthesia and Critical Care Medicine Department, Amiens
University Medical Center, Amiens, France
(Mertes) Service d'Anesthesie-Reanimation, Nouvel Hopital Civil, Hopitaux
Universitaires de Strasbourg, Strasbourg, France
(Molliex) Department of Anaesthesiology and Critical Care Medicine,
Hopital Nord, Saint Etienne, France
(Moury) Pole Anesthesie-Reanimation, CHU Grenoble Alpes, Grenoble, France
(Moussa) CHU Lille, Pole d'Anesthesie-Reanimation, Lille, France
(Oilleau) Department of Anaesthesia and Critical Care, Brest University
Hospital, Brest, France
(Ouattara) CHU Bordeaux, Department of Anaesthesia and Critical Care,
Magellan Medical Surgical Centre, Bordeaux, France
(Provenchere) Anesthesiology and surgical critical care department, DMU
PARABOL, AP-HP, Bichat Hospital, Paris, France
(Rozec) Service d'Anesthesie-Reanimation, Hopital Laennec, Centre
Hospitalier Universitaire, Nantes, France
(Parienti) Department of Biostatistics and Clinical Research, Caen
University Hospital, Caen, France
(Fischer) Clinique Saint Augustin, Institut Aquitain du Coeur, Bordeaux
Cedex, France
Publisher
Elsevier Inc.
Abstract
Background: Postoperative morbidity and mortality after cardiac surgery
with cardiopulmonary bypass (CPB) remain high despite recent advances in
both anesthesia and perioperative management. Among modifiable risk
factors for postoperative complications, optimal arterial pressure during
and after surgery has been under debate for years. Recent data suggest
that optimizing arterial pressure to the baseline of the patient may
improve outcomes. We hypothesize that optimizing the mean arterial
pressure (MAP) to the baseline MAP of the patient during cardiac surgery
with CPB and during the first 24 hours postoperatively may improve
outcomes. Study design: The OPTIPAM trial (NCT05403697) will be a
multicenter, randomized, open-label controlled trial testing the
superiority of optimized MAP management as compared with a MAP of 65 mm Hg
or more during both the intraoperative and postoperative periods in 1,100
patients scheduled for cardiac surgery with CPB. The primary composite end
point is the occurrence of acute kidney injury, neurological complications
including stroke or postoperative delirium, and death. The secondary end
points are hospital and intensive care unit lengths of stay, Day 7 and Day
90 mortality, postoperative cognitive dysfunction on Day 7 and Day 90, and
quality of life at Day 7 and Day 90. Two interim analyses will assess the
safety of the intervention. <br/>Conclusion(s): The OPTIPAM trial will
assess the effectiveness of an individualized target of mean arterial
pressure in cardiac surgery with CPB in reducing postoperative morbidity.
Clinical trial registration: NCT05403697<br/>Copyright &#xa9; 2023
Elsevier Inc.

<57>
Accession Number
2023771273
Title
Long-term outcomes of valve-sparing root versus composite valve graft
replacement for acute type A aortic dissection: Meta-analysis of
reconstructed time-to-event data.
Source
International Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Sa M.P.; Tasoudis P.; Jacquemyn X.; Van den Eynde J.; Rad A.A.; Weymann
A.; Ruhparwar A.; Caranasos T.G.; Ikonomidis J.S.; Chu D.; Serna-Gallegos
D.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Tasoudis, Caranasos, Ikonomidis) Department of Surgery, Division of
Cardiothoracic Surgery, University of North Carolina, Chapel Hill, NC,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Rad) Oxford University Clinical Academic Graduate School, University of
Oxford, Oxford, United Kingdom
(Weymann, Ruhparwar) Department of Cardiothoracic, Transplantation and
Vascular Surgery, Hannover Medical School, Medizinische Hochschule
Hannover (MHH), Hannover, Germany
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: To evaluate the long-term outcomes of valve-sparing aortic
root replacement (VSARR) versus composite aortic valve graft replacement
(CAVGR) in the treatment of acute type A aortic dissections (ATAAD).
<br/>Method(s): We performed a pooled meta-analysis of
Kaplan-Meier-derived time-to-event data from studies with longer follow-up
beyond the immediate postoperative period. <br/>Result(s): Seven studies
met our eligibility criteria, comprising a total of 858 patients (367
patients in the VSARR groups and 491 patients in the CAVGR group). We
found no statistically significant differences in the overall survival
between the groups over time (HR 0.83, 95%CI 0.63-1.10, P = 0.192), but we
observed a higher risk of reoperation in the VSARR group when compared
with the CAVGR group (HR 9.99, 95% CI 2.23-44.73, P = 0.003). The
meta-regression revealed statistically significant positive coefficients
for age (P < 0.001) in the analysis of survival, which means that this
covariate has a modulating effect on this outcome. The higher the mean
age, the higher the HR for overall mortality was found to be with VSARR as
compared with CAVGR. Other covariates such as female sex, hypertension,
diabetes, connective tissue disorders, bicuspid aortic valve, hemiarch
and/or total arch replacement, concomitant coronary bypass surgery did not
seem to have any effect on the outcomes. <br/>Conclusion(s): VSARR did not
confer a better (or worse) survival over time in patients with ATAAD, but
it was associated with higher risk of reoperations in the long
run.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<58>
Accession Number
2023751246
Title
An Updated Meta-Analysis on Cerebral Embolic Protection in Patients
Undergoing Transcatheter Aortic Valve Intervention Stratified by Baseline
Surgical Risk and Device Type.
Source
Structural Heart. (no pagination), 2023. Article Number: 100178. Date of
Publication: 2023.
Author
Khan S.U.; Zahid S.; Alkhouli M.A.; Akbar U.A.; Zaid S.; Arshad H.B.;
Little S.H.; Reardon M.J.; Kleiman N.S.; Goel S.S.
Institution
(Khan, Zaid, Arshad, Little, Kleiman, Goel) Department of Cardiology,
Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United
States
(Zahid) Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, United States
(Alkhouli) Division of Interventional Cardiology, Mayo Clinic, Rochester,
MN, United States
(Akbar) Department of Medicine, North Shore University Hospital, New York,
NY, United States
(Reardon) Department of Cardiovascular Surgery, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Transcatheter aortic valve intervention (TAVI) can lead to the
embolization of debris. Capturing the debris by cerebral embolic
protection (CEP) devices may reduce the risk of stroke. New evidence has
allowed us to examine the effects of CEP in patients undergoing TAVI. We
aimed to assess the effects of CEP overall and stratified by the device
used (SENTINEL or TriGuard) and the surgical risk of the patients.
<br/>Method(s): We selected randomized controlled trials using electronic
databases through September 17, 2022. We estimated random-effects risk
ratios (RR) with (95% confidence interval) and calculated absolute risk
differences at 30 days across baseline surgical risks derived from the
TAVI trials for any stroke (disabling and nondisabling) and all-cause
mortality. <br/>Result(s): Among 6 trials (n = 3921), CEP vs. control did
not reduce any stroke [RR: 0.95 (0.50-1.81)], disabling [RR: 0.75
(0.18-3.16)] or nondisabling [RR: 0.99 (0.65-1.49)] strokes, or all-cause
mortality [RR: 1.23 (0.55-2.77)]. However, when analyzed by device,
SENTINEL reduced disabling stroke [RR: 0.46 (0.22-0.95)], translating into
6 fewer per 1000 in high-risk, 3 fewer per 1000 in intermediate-risk, and
1 fewer per 1000 in low surgical-risk patients. CEP vs. control did not
reduce the risk of any bleeding [RR: 1.03 (0.44-2.40)], major vascular
complications [RR: 1.41 (0.57-3.48)], or acute kidney injury [RR: 1.36
(0.57-3.28)]. <br/>Conclusion(s): This updated meta-analysis showed that
SENTINEL CEP might reduce disabling stroke in patients undergoing TAVI.
Patients with high and intermediate surgical risks were most likely to
derive benefits.<br/>Copyright &#xa9; 2023 The Authors

<59>
[Use Link to view the full text]
Accession Number
2022080804
Title
Survival after Invasive or Conservative Management of Stable Coronary
Disease.
Source
Circulation. 147(1) (pp 8-19), 2023. Date of Publication: 03 Jan 2023.
Author
O'Brien S.M.; Rosenberg Y.; Kirby R.; Newman J.D.; Berger J.S.; Sidhu
M.S.; White H.D.; Harrington R.A.; Boden W.E.; Stone G.W.; Mark D.B.;
Spertus J.A.; Hochman J.S.; Maron D.J.; Reynolds H.R.; Bangalore S.;
Mavromichalis S.; Chang M.; Contreras A.; Esquenazi-Karonika S.; Gilsenan
M.; Gwiszcz E.; Mathews P.; Mohamed S.; Naumova A.; Roberts A.; Vanloo K.;
Anthopolos R.; Xu Y.; Troxel A.B.; Lu Y.; Huang Z.; Broderick S.;
Selvanayagam J.; Lopes R.D.; Goodman S.G.; Steg G.; Juliard J.-M.; Doerr
R.; Keltai M.; Bhargava B.; Thomas B.; Sharir T.; Nikolsky E.; Maggioni
A.P.; Kohsaka S.; Escobedo J.; Pracon R.; Bockeria O.; Senior R.; Banfield
A.; Shaw L.J.; Phillips L.; Berman D.; Kwong R.Y.; Picard M.H.; Chaitman
B.R.; Ali Z.; Min J.; Mancini G.B.J.; Leipsic J.; Guzman L.; Hillis G.;
Thambar S.; Joseph M.; Selvnayagam J.; Beltrame J.; Lang I.; Schuchlenz
H.; Huber K.; Goetschalckx K.; Hueb W.; Caramori P.R.; De Quadros A.;
Smanio P.; Mesquita C.; Lopas R.D.; Vitola J.; Marin-Neto J.; Da Silva
E.R.; Tumelero R.; Andrade M.; Alves A.R.; Dall'Orto F.; Polanczyk C.;
Figueiredo E.; Howarth A.; Gosselin G.; Cheema A.; Bainey K.; Phaneuf D.;
Diaz A.; Garg P.; Mehta S.; Wong G.; Lam A.; Cha J.; Galiwango P.; Uxa A.;
Chow B.; Hameed A.; Udell J.; Chema A.; Hamid M.; Hauguel-Moreau M.;
Furber A.; Goube P.; Steg P.-G.; Barone-Rochette G.; Thuaire C.; Slama M.;
Doer R.; Nickenig G.; Bekeredjian R.; Schulze P.C.; Merkely B.; Fontos G.;
Vertes A.; Varga A.; Bhargva B.; Kumar A.; Nair R.G.; Grant P.; Manjunath
C.; Moorthy N.; Satheesh S.; Nath R.K.; Wander G.; Christopher J.; Dwivedi
S.; Oomman A.; Mathur A.; Gadkari M.; Naik S.; Punnoose E.; Kachru R.;
Christophar J.; Kaul U.; Sharer T.; Kerner A.; Tarantini G.; Perna G.P.;
Racca E.; Mortara A.; Monti L.; Briguori C.; Leone G.; Amati R.; Salvatori
M.; Di Chiara A.; Calabro P.; Galvani M.; Provasoli S.; Fukuda K.; Koshaka
S.; Nakano S.; Laucevicius A.; Kedev S.; Khairuddin A.; Escobdo J.;
Riezebos R.; Timmer J.; Heald S.; Stewart R.; Ramos W.M.; Demkow M.;
Mazurek T.; Drozdz J.; Szwed H.; Witkowski A.; Ferreira N.; Pinto F.;
Ramos R.; Popescu B.; Pop C.; Bockeria L.; Bockerya O.; Demchenko E.;
Romanov A.; Bershtein L.; Jizeeri A.; Stankovic G.; Apostolovic S.; Adjic
N.C.; Zdravkovic M.; Beleslin B.; Dekleva M.; Davidovic G.; Chua T.; Foo
D.; Poh K.K.; Ntsekhe M.; Sionis A.; Marin F.; Miro V.; Lopez-Sendon J.;
Blancas M.G.; Gonzalez-Juanatey J.; Fernandez-Aviles F.; Peteiro J.; Luena
J.E.C.; Held C.; Aspberg J.; Rossi M.; Kuanprasert S.; Yamwong S.;
Johnston N.; Donnelly P.; Moriarty A.; Roxy R.; Elghamaz A.; Gurunathan
S.; Karogiannis N.; Shah B.N.; Trimlett R.H.J.; Rubens M.B.; Nicol E.D.;
Mittal T.K.; Hampson R.; Gamma R.; De Belder M.; Nageh T.; Lindsay S.;
Mavromatis K.; Miller T.; Banerjee S.; Reynolds H.; Nour K.; Stone P.
Institution
(Hochman, Anthopolos, Reynolds, Bangalore, Xu, Mavromichalis, Chang,
Contreras, Newman, Berger, Troxel) NYU Grossman School of Medicine, New
York, NY, United States
(O'Brien, Lopes, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Rosenberg, Kirby) National Institutes of Health, Bethesda, MD, United
States
(Bhargava) All India Institute of Medical Sciences, New Delhi, India
(Senior, Banfield) Northwick Park Hospital, London, United Kingdom
(Senior) Imperial College London, Royal Brompton Hospital, United Kingdom
(Goodman) St Michael's Hospital, University of Toronto, Canada
(Pracon) Department of Coronary and Structural Heart Diseases, National
Institute of Cardiology, Warsaw, Poland
(Lopez-Sendon) IdiPaz Research Institute and Hospital, Universitario la
Paz, Madrid, Spain
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Sidhu) Albany Medical College, NY, United States
(White) Te Whatu Ora Health New Zealand, Te Toki Tumai, Green Lane
Cardiovascular Services, University of Auckland, New Zealand
(Harrington, Maron) Stanford University, Department of Medicine, CA,
United States
(Boden) Veterans Affairs New England Healthcare System, Boston University
School of Medicine, MA, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) compared an initial
invasive versus an initial conservative management strategy for patients
with chronic coronary disease and moderate or severe ischemia, with no
major difference in most outcomes during a median of 3.2 years. Extended
follow-up for mortality is ongoing. <br/>Method(s): ISCHEMIA participants
were randomized to an initial invasive strategy added to
guideline-directed medical therapy or a conservative strategy. Patients
with moderate or severe ischemia, ejection fraction >=35%, and no recent
acute coronary syndromes were included. Those with an unacceptable level
of angina were excluded. Extended follow-up for vital status is being
conducted by sites or through central death index search. Data obtained
through December 2021 are included in this interim report. We analyzed
all-cause, cardiovascular, and noncardiovascular mortality by randomized
strategy, using nonparametric cumulative incidence estimators, Cox
regression models, and Bayesian methods. Undetermined deaths were
classified as cardiovascular as prespecified in the trial protocol.
<br/>Result(s): Baseline characteristics for 5179 original ISCHEMIA trial
participants included median age 65 years, 23% women, 16% Hispanic, 4%
Black, 42% with diabetes, and median ejection fraction 0.60. A total of
557 deaths accrued during a median follow-up of 5.7 years, with 268 of
these added in the extended follow-up phase. This included a total of 343
cardiovascular deaths, 192 noncardiovascular deaths, and 22 unclassified
deaths. All-cause mortality was not different between randomized treatment
groups (7-year rate, 12.7% in invasive strategy, 13.4% in conservative
strategy; adjusted hazard ratio, 1.00 [95% CI, 0.85-1.18]). There was a
lower 7-year rate cardiovascular mortality (6.4% versus 8.6%; adjusted
hazard ratio, 0.78 [95% CI, 0.63-0.96]) with an initial invasive strategy
but a higher 7-year rate of noncardiovascular mortality (5.6% versus 4.4%;
adjusted hazard ratio, 1.44 [95% CI, 1.08-1.91]) compared with the
conservative strategy. No heterogeneity of treatment effect was evident in
prespecified subgroups, including multivessel coronary disease.
<br/>Conclusion(s): There was no difference in all-cause mortality with an
initial invasive strategy compared with an initial conservative strategy,
but there was lower risk of cardiovascular mortality and higher risk of
noncardiovascular mortality with an initial invasive strategy during a
median follow-up of 5.7 years. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04894877.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<60>
Accession Number
2023599380
Title
Rationale and design of the colchicine for the prevention of perioperative
atrial fibrillation in patients undergoing major noncardiac thoracic
surgery (COP-AF) trial.
Source
American Heart Journal. 259 (pp 87-96), 2023. Date of Publication: May
2023.
Author
Conen D.; Popova E.; Wang M.K.; Chan M.T.V.; Landoni G.; Reimer C.;
Srinathan S.K.; Cata J.P.; McLean S.R.; Trujillo Reyes J.C.; Grande A.M.;
Gonzalez Tallada A.; Sessler D.I.; Fleischmann E.; Maziak D.E.; Kabon B.;
Voltolini L.; Gutierrez-Soriano L.; Tandon V.; DuMerton D.; Kidane B.;
Rajaram R.; Shargall Y.; Neary J.D.; Wells J.R.; McIntyre W.F.; Blum S.;
Ofori S.N.; Vincent J.; Xu L.; Li Z.; Healey J.S.; Garg A.X.; Devereaux
P.J.
Institution
(Conen, Wang, Wells, McIntyre, Blum, Ofori, Vincent, Xu, Li, Healey, Garg,
Devereaux) Population Health Research Institute, Hamilton, ON, Canada
(Conen, Wang, Tandon, Neary, McIntyre, Ofori, Xu, Healey, Devereaux)
Department of Medicine, McMaster University, Hamilton, ON, Canada
(Conen, Wang, McIntyre, Healey, Garg, Devereaux) Department of Health
Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON,
Canada
(Popova) Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
(Popova) Iberoamerican Cochrane Centre, Barcelona, Spain
(Chan) The Chinese University of Hong Kong, Shatin, Hong Kong
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Reimer, DuMerton) Kingston Health Sciences Centre, Kingston, ON, Canada
(Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB,
Canada
(Cata) Department of Anesthesiology and Perioperative Medicine, The
University of Texas - MD Anderson Cancer Center, Houston, TX, United
States
(McLean) Department of Anesthesia, Vancouver Acute (Vancouver General
Hospital and UBC Hospital), The University of British Columbia, Vancouver,
BC, Canada
(McLean) Department of Anesthesia, Pharmacology and Therapeutics, The
University of British Columbia, Vancouver, BC, Canada
(Trujillo Reyes) Department of Thoracic Surgery, Hospital de la Santa Creu
i Sant Pau, Barcelona, Spain
(Grande) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Gonzalez Tallada) Department of Anesthesiology, Hospital Universitari
Vall d'Hebron, Barcelona, Spain
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Fleischmann, Kabon) Department of Anesthesia, Intensive Care Medicine and
Pain Medicine, Medical University of Vienna, Vienna, Austria
(Maziak) University of Ottawa, Ottawa, ON, Canada
(Voltolini) Thoracic Surgery Unit, Careggi University Hospital, Florence,
Italy
(Gutierrez-Soriano) Department of Anesthesiology, Fundacion CardioInfantil
- Instituto de Cardiologia, Bogota, Colombia
(Kidane) Departments of Surgery, Physiology and Pathophysiology,
University of Manitoba, Winnipeg, MB, Canada
(Rajaram) Department of Cardiothoracic Surgery, The University of Texas -
MD Anderson Cancer Center, Houston, TX, United States
(Shargall) Division of Thoracic Surgery, Department of Surgery, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
(Blum) Cardiovascular Research Institute Basel, University Hospital Basel,
Basel, Switzerland
(Ofori) University of Port Harcourt, Choba, Nigeria
(Garg) Departments of Medicine, Epidemiology and Biostatistics, Western
University, London, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Perioperative atrial fibrillation (AF) and myocardial injury
after noncardiac surgery (MINS) are common complications after noncardiac
surgery. Inflammation has been implicated in the pathogenesis of both
disorders. The COP-AF trial tests the hypothesis that colchicine reduces
the incidence of perioperative AF and MINS in patients undergoing major
noncardiac thoracic surgery. <br/>Methods and Results: The 'COlchicine for
the Prevention of Perioperative Atrial Fibrillation' (COP-AF) trial is an
international, blinded, randomized trial that compares colchicine to
placebo in patients aged at least 55 years and undergoing major noncardiac
thoracic surgery with general anesthesia. Exclusion criteria include a
history of AF and a contraindication to colchicine (eg, severe renal
dysfunction). Oral colchicine at a dose of 0.5 mg or matching placebo is
given within 4 hours before surgery. Thereafter, patients receive
colchicine 0.5 mg or placebo twice daily for a total of 10 days. The 2
independent co-primary outcomes are clinically important perioperative AF
(including atrial flutter) and MINS during 14 days of follow-up. The main
safety outcomes are sepsis or infection and non-infectious diarrhea. We
aim to enroll 3,200 patients from approximately 40 sites across 11
countries to have at least 80% power for the independent evaluation of the
2 co-primary outcomes. The COP-AF main results are expected in 2023.
<br/>Conclusion(s): COP-AF is a large randomized and blinded trial
designed to determine whether colchicine reduces the risk of perioperative
AF or MINS in patients who have major noncardiac thoracic
surgery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<61>
Accession Number
2015924781
Title
Conduction system pacing in prosthetic heart valves.
Source
Journal of Interventional Cardiac Electrophysiology. 66(3) (pp 561-566),
2023. Date of Publication: April 2023.
Author
Shah K.; Williamson B.D.; Kutinsky I.; Bhardwaj R.; Contractor T.; Turagam
M.K.; Mandapati R.; Lakkireddy D.; Garg J.
Institution
(Shah, Williamson, Kutinsky) Department of Cardiovascular Medicine,
Beaumont Hospital, Oakland University William Beaumont School of Medicine,
Royal Oak, MI, United States
(Bhardwaj, Contractor, Mandapati, Garg) Division of Cardiology, Cardiac
Arrhythmia Service, Loma Linda University Health, 11234 Anderson St, Loma
Linda, CA 92354, United States
(Turagam) Helmsley Electrophysiology Center, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Kansas City, KS, United States
Publisher
Springer
Abstract
Background: There has been increasing interest in physiologic pacing
techniques that directly activate the specialized conduction system. We
aimed to assess outcomes of conduction system pacing (CSP) in patients
with prosthetic heart valves. <br/>Method(s): This systematic review was
performed according to PRISMA guidelines. Freeman-Tukey double arcsine
transformation with the random-effect model was used to summarize the
data. Outcomes studied were 1) implant success (defined as ability to
recruit the His-Purkinje system or the distal Purkinje system); (2) lead
parameters at implant and follow-up; and (3) procedure-related
complications. <br/>Result(s): This systematic review of 7 studies
included 267 unique patients in whom CSP was attempted with either HBP or
LBBAP for pacing indications after a prosthetic valve. HBP was attempted
in 38% (n = 108), while LBBAP in 62% (n = 175) patients. The overall
success rate of CSP was 87%, while in patients post-TAVR, the overall
success rate was 83.2%. In the subgroup analysis, LBBAP had a significant
higher overall success rate compared to HBP (94.3% vs. 76.5%, p
<inf>interaction</inf> = 0.02) and post-TAVR patients (94.3 vs. 66.9%, p
<inf>interaction</inf> < 0.01), respectively. The LBBAP thresholds were
significantly lower compared to HBP both at implant (0.67 +/- 0.4 @ 0.44
ms vs. 1.35 +/- 1 @ 0.85 ms, p <inf>interaction</inf> < 0.01) and at a
mean follow-up of 12.4 +/- 8 months (0.73 +/- 0.1 @ 0.44 ms vs. 1.39 +/- 1
@ 0.85 ms, p <inf>interaction</inf> < 0.01), respectively.
<br/>Conclusion(s): CSP is safe and feasible in patients with a prosthetic
valve, with a significantly higher success rate and superior lead
parameters with LBBAP than HBP, especially in patients
post-TAVR.<br/>Copyright &#xa9; 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<62>
Accession Number
2016948571
Title
Triiodothyronine Supplementation in Infants Undergoing Cardiopulmonary
Bypass: A Randomized Controlled Trial.
Source
Seminars in Thoracic and Cardiovascular Surgery. 35(1) (pp 105-112), 2023.
Date of Publication: Spring 2023.
Author
Portman M.A.; Slee A.E.; Roth S.J.; Radman M.; Olson A.K.; Mainwaring
R.D.; Kamerkar A.; Nuri M.; Hastings L.
Institution
(Portman, Radman, Olson) Seattle Children's Research Institute and
Department of Pediatrics, University of Washington, Seattle, WA, United
States
(Slee) New Arch Consulting, Seattle, WA, United States
(Roth) Department of Cardiology and Critical Care, Lucile Packard
Children's Hospital, Palo Alto, California, United States
(Mainwaring) Department of Cardiothoracic Surgery, Lucile Packard
Children's Hospital, Palo Alto, California, United States
(Kamerkar) Department of Critical Care, Los Angeles Children's Hospital,
Los Angeles, California, United States
(Nuri) Division of Cardiothoracic Surgery at Children's Hospital of
Philadelphia, Philadelphia, Pennsylvania
(Hastings) Levine Children's Hospital, Scope Anesthesia, Charlotte, North
Carolina
Publisher
W.B. Saunders
Abstract
Cardiopulmonary bypass (CPB) profoundly suppresses circulating thyroid
hormone levels in infants. We performed a multicenter randomized placebo
controlled trial to determine if triiodothyronine (T3) supplementation
improves reduces time to extubation (TTE) in infants after CPB. Infants (n
= 220) undergoing cardiac surgery with CPB and stratified into 2 age
cohorts: <=30 days and >30 days to <152 days were randomization to receive
either intravenous triiodothyronine or placebo bolus followed by study
drug infusion until extubated or at 48 hours, whichever preceded. T3 did
not significantly alter the primary endpoint, TTE (hazard ratio for chance
of extubation (1.08, 95% CI: 0.82-1.43, P = 0.575) in the entire
randomized population with censoring at 21 days. T3 showed no significant
effect on TTE (HR 0.82, 95% CI:0.55-1.23, P = 0.341) in the younger
subgroup or in the older (HR 1.38, 95% CI:0.95-2.2, P = 0.095). T3 also
did not significantly impact TTE during the first 48 hours while T3 levels
were maintained (HR 1.371, 95% CI:0.942-1.95, P = 0.099) No significant
differences occurred for arrhythmias or other sentinel adverse events in
the entire cohort or in the subgroups. This trial showed no significant
benefit on TTE in the entire cohort. T3 supplementation appears safe as it
did not cause an increase in adverse events. The study implementation and
analysis were complicated by marked variability in surgical risk, although
risk categories were balanced between treatment groups.<br/>Copyright
&#xa9; 2022 Elsevier Inc.

<63>
Accession Number
2019563370
Title
Heart failure and trimethylamine N-oxide: time to transform a 'gut
feeling' in a fact?.
Source
ESC Heart Failure. 10(1) (pp 1-7), 2023. Date of Publication: February
2023.
Author
Crisci G.; Israr M.Z.; Cittadini A.; Bossone E.; Suzuki T.; Salzano A.
Institution
(Crisci, Cittadini) Department of Translational Medical Sciences, Federico
II University, Via S Pansini 5, Naples 80131, Italy
(Crisci, Cittadini) Italian Clinical Outcome Research and Reporting
Program (I-CORRP), Naples 80131, Italy
(Israr, Suzuki) Department of Cardiovascular Sciences, University of
Leicester and NIHR Leicester Biomedical Research Centre, Groby road,
Leicester LE3 9QP, United Kingdom
(Bossone) Department of Public Health, Federico II University, Naples
80138, Italy
(Salzano) IRCCS Synlab SDN, Diagnostic and Nuclear Research Institute, Via
E Gianturco 113, Naples 80143, Italy
Publisher
John Wiley and Sons Inc

<64>
Accession Number
2023236978
Title
Cardiac Surgery for Treatment of COVID-19- Associated Infectious
Endocarditis.
Source
Texas Heart Institute Journal. 50(2) (no pagination), 2023. Article
Number: e227884. Date of Publication: March 2023.
Author
Taghizadeh-Waghefi A.; Petrov A.; Wilbring M.; Alexiou K.; Kappert U.;
Matschke K.; Tugtekin S.-M.
Institution
(Taghizadeh-Waghefi, Petrov, Wilbring, Alexiou, Kappert, Matschke,
Tugtekin) Department of Cardiac Surgery, University Heart Center Dresden,
Dresden, Germany
Publisher
Texas Heart Institute
Abstract
Background: Significant uncertainty exists about the optimal timing of
surgery for infectious endocarditis (IE) surgery in patients with active
SARS-CoV-2 infection. This case series and a systematic review of the
literature were carried out to evaluate the timing of surgery and
postsurgical outcomes for patients with COVID-19-associated IE.
<br/>Method(s): The PubMed database was searched for reports published
from June 20, 2020, to June 24, 2021, that contained the terms infective
endocarditis and COVID-19. A case series of 8 patients from the authors'
facility was also added. <br/>Result(s): A total of 12 cases were
included, including 4 case reports that met inclusion criteria in addition
to a case series of 8 patients from the authors' facility. Mean (SD)
patient age was 61.9 (17.1) years, and patients were predominantly male
(91.7%). Being overweight was the main comorbidity among patients studied
(7/8 [87.5%]). Among all patients evaluated in this study, dyspnea (n = 8
[66.7%]) was the leading symptom, followed by fever (n = 7 [58.3%]).
Enterococcus faecalis and Staphylococcus aureus caused 75.0% of COVID-19-
associated IE. The mean (SD) time to surgery was 14.5 (15.6) days (median,
13 days). In-hospital and 30-day mortality for all evaluated patients was
16.7% (n = 2). <br/>Conclusion(s): Clinicians must carefully assess
patients diagnosed with COVID-19 to prevent missing underlying diseases
such as IE. If IE is suspected, clinicians should avoid postponement of
crucial diagnostic and treatment steps.<br/>Copyright &#xa9; 2023 by The
Texas Heart Institute, Houston.

<65>
Accession Number
2023233741
Title
Influence of Anesthetics on Cardiac Index and Metabolic Outcomes in Mitral
and Aortic Valve Replacement in Adults: A Randomized Clinical Study.
Source
Anesthesiology and Pain Medicine. 13(2) (no pagination), 2023. Article
Number: e134119. Date of Publication: April 2023.
Author
Baiterek B.A.; Mustafin A.
Institution
(Baiterek) Astana Medical University, Nur-Sultan, Kazakhstan
(Baiterek) Departments of Anesthesiology, Resuscitation and Intensive Care
Unit Medical Centre, Hospital of President's Affairs Administration of the
Republic of Kazakhstan, Nur-Sultan, Kazakhstan
(Mustafin) Departments of Anesthesiology, Resuscitation and Intensive Care
Unit, City Multidisciplinary Hospital No. 2, Nur-Sultan, Kazakhstan
(Mustafin) Department of Anesthesiology and Intensive Care, Astana Medical
University, Nur-Sultan, Kazakhstan
Publisher
Brieflands
Abstract
Background: Cardiac index (CI) and metabolic response to surgery are
important indicators of the course of the intraoperative period.
<br/>Objective(s): This study aimed to determine the effect of
sevoflurane, isoflurane, and propofol on CI and metabolic outcomes during
aortic and mitral valve replacement in adults. <br/>Method(s): In this
single-center prospective randomized controlled clinical study, a total of
75 patients were randomly assigned into 3 groups according to the type of
anesthesia: the propofol group (n = 25), the sevoflurane group (n = 25),
and the isoflurane group (n = 25). Cardiac stroke volume (SV) was
determined by intraesophageal echocardiography (SV = end-diastolic volume
- end-systolic volume). Cardiac output (CO) and CI were calculated
according to the formulas. Oxygen consumption during surgery = CI x
arteri-ovenous difference. Indirect calorimetry was used to determine
energy expenditure during anesthesia using a spirometry device.
<br/>Result(s): The use of anesthetics did not change CI. Cardiac index
decreased from 3 to 2.9 L/min/m² in the propofol group,
increased from 3.1 to 3.2 L/min/m² in the sevoflurane group,
and decreased from 2.9 to 2.7 L/min/m² in the isoflurane group.
Compared to inhaled anesthetics, propofol significantly reduced
VO<inf>2</inf> from 179.1 to 135.7 mL/min/m² . Propofol reduced
energy expenditure from 1483.7 to 1333.5 kcal. <br/>Conclusion(s):
Volatile anesthetics, propofol has practically no effect on CI in an
uncomplicated surgery. Anesthesia with propofol is associated with lower
VO<inf>2</inf> and better oxygen delivery to tissues. Energy consumption
during propofol anesthesia decreases.<br/>Copyright &#xa9; 2023,
Author(s).

<66>
Accession Number
2023126547
Title
Effects of Remote Ischemic Preconditioning on Decreasing Troponin Release
in Patients Not Taking Sulfonylureas After Cardiac Surgery - A
Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 38(2) (pp 289-299), 2023.
Date of Publication: 2023.
Author
Wang X.; Xiao S.; Hu Y.; Guo M.; Liu A.; Huan C.; Xu T.; Yin J.; Pan D.;
Zhu H.
Institution
(Wang, Xiao, Hu, Guo, Liu, Huan, Xu, Pan, Zhu) Department of Cardiology,
The Affiliated Hospital of Xuzhou Medical University, Jiangsu, Xuzhou,
China
(Yin) Department of General Practice, The Affiliated Hospital of Xuzhou
Medical University, Jiangsu, Xuzhou, China
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Remote ischemic preconditioning (RIPC) is a new noninvasive
myocardial protection strategy that uses blood pressure cuff inflation to
simulate transient non-fatal ischemia to protect the myocardium and reduce
ischemia-reper-fusion injury. Sulfonylureas may mask the effects of RIPC
due to their cardioprotec-tive effect. This meta-analysis aimed to
evaluate whether RIPC, in the absence of sulfonylureas, reduces troponin
release in patients undergoing cardiac surgery. <br/>Method(s): We
conducted a meta-analysis of randomized controlled clinical trials to
determine whether RIPC can reduce postoperative troponin release in
cardiac surgery patients undergoing cardiopulmonary bypass without
treatment with sulfonylureas. The data were normalized to equivalent units
prior to the analysis. A random-effects model was used to provide more
conservative estimate of the effects in the presence of known or unknown
heterogeneity. <br/>Result(s): Six studies with a total of 570
participants were included. The analysis showed that troponin release was
lower in the RIPC group than in the control group at six hours (test of
standardized mean differences = 0, Z=3.64, P<0.001) and 48 hours (Z=2.72,
P=0.007) postoperatively. When the mean of cross-clamping time was > 60
minutes, RIPC reduced troponin release at six hours (Z=2.84, P=0.005), 24
hours (Z=2.64, P=0.008), and 48 hours (Z=2.87, P=0.004) postoperatively.
<br/>Conclusion(s): In cardiac surgery patients who are not taking
sulfonylureas, RIPC can reduce troponin release at six and 48 hours
postoperatively; hence, RIPC may serve significant benefits in certain
cardiac surgery patients.<br/>Copyright &#xa9; 2023, Sociedade Brasileira
de Cirurgia Cardiovascular. All rights reserved.

<67>
Accession Number
2023126544
Title
Albumin-Bilirubin Score: A Novel Mortality Predictor in Valvular Surgery.
Source
Brazilian Journal of Cardiovascular Surgery. 38(2) (pp 271-277), 2023.
Date of Publication: 2023.
Author
Duman Z.M.; Timur B.
Institution
(Duman) Department of Cardiovascular Surgery, Cizre State Hospital,
Sirnak, Turkey
(Timur) Department of Cardiovascular Surgery, Dr Siyami Ersek Thoracic and
Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The heart and liver are two organs that are closely related.
The Albumin-Bilirubin (ALBI) score is a developed scoring system for
assessing liver function. The aims of this study were to examine the
correlation between preoperative ALBI score and pulmonary artery pressure
and to investigate its ability to predict heart valve surgery mortality
outcomes. <br/>Method(s): The data of 872 patients who underwent isolated
and combined heart valve surgery from 2014 to 2021 were retrospectively
screened. In the preoperative period, 152 patients with laboratory tests
including albumin and total bilirubin were found and analyzed
retrospectively. Thirteen of these patients were excluded from the study.
The remaining 139 patients were included in the analysis. Baseline
demographic data, echocardiography data, performance status, laboratory
data, operative data, and postoperative status were collected. The optimal
cutoff value of preoperative ALBI score was calculated. <br/>Result(s):
The cutoff for ALBI scores was calculated as-2.44 to predict in-hospital
mortality (sensitivity = 75.0%, specificity = 70%). Based on the cutoff
value, 90 patients had a low ALBI score (<=-2.44, 64.7%) and 49 patients
had a high ALBI score (>-2.44, 35.3%). High ALBI score was associated with
an increased incidence of acute kidney injury and in-hospital mortality,
and a positive correlation was found between ALBI score and pulmonary
artery pressure. <br/>Conclusion(s): In patients with valvular surgery,
high ALBI score was an independent prognostic factor of in-hospital
mortality and acute kidney injury. It is easily measurable and a
cost-effective way to predict mortality.<br/>Copyright &#xa9; 2023,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<68>
Accession Number
2023126533
Title
DEX, Delirium and Dilemma.
Source
Brazilian Journal of Cardiovascular Surgery. 38(2) (pp 305-308), 2023.
Date of Publication: 2023.
Author
Magoon R.; Mahajan S.; Jose J.
Institution
(Magoon) Department of Cardiac Anaesthesia, Atal Bihari Vajpayee Institute
of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia Hospital, New
Delhi, India
(Mahajan) Department of Anaesthesia and Intensive Care, Post Graduate
Institute of Medical Education & Research (PGIMER), Chandigarh, India
(Jose) Department of Cardiac Anesthesiology, Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Jayanagar, Karnataka, Bengaluru,
India
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Dexmedetomidine has been subjected to an extensive evaluation for its'
role in the prevention of postoperative delirium following cardiac
surgery. In striking contrast to the preexisting meta-analysis supporting
postoperative delirium-reduction with dexmedetomidine, few recently
concluded multicentric large scale randomized controlled trials suggest
otherwise. This article aims to present a nuanced perspective of the
evolving controversy by attempting to decode the apparent incongruences in
the literature accumulating off-late, which is particularly pertinent
amidst an ever-escalating heterogeneity in the current research
ecosystem.<br/>Copyright &#xa9; 2023, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<69>
Accession Number
2023104993
Title
The impact of chronic obstructive pulmonary disease on the prognosis
outcomes of patients with percutaneous coronary intervention or coronary
artery bypass grafting: A meta-analysis.
Source
Heart and Lung. 60 (pp 8-14), 2023. Date of Publication: 01 Jul 2023.
Author
Li Y.; Zheng H.; Yan W.; Cao N.; Yan T.; Zhu H.; Bao H.
Institution
(Li, Zheng, Yan, Cao, Yan, Zhu, Bao) School of Public Health, Inner
Mongolia Medical University, Hohhot, China
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery disease (CAD) is one of the main types of
cardiovascular disease and is characterized by myocardial ischemia as a
result of narrowing of the coronary arteries. <br/>Objective(s): To
evaluate the impact of chronic obstructive pulmonary disease (COPD) on
outcomes in patients with CAD treated by percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG).
<br/>Method(s): We searched PubMed, Embase, Web of Science, and Cochrane
Library for observational studies and post-hoc analyses of randomized
controlled trials published before Jan 20, 2022, in English. Adjusted odds
ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) for short-term
outcomes (in-hospital and 30-day all-cause mortality) and long-term
outcomes (all-cause mortality, cardiac death, major adverse cardiac
events) were extracted or transformed. <br/>Result(s): Nineteen studies
were included. The risk of short-term all-cause mortality was
significantly higher in patients with COPD than in those without COPD (RR
1.42, 95% CI 1.05-1.93), as were the risks of long-term all-cause
mortality (RR 1.68, 95% CI 1.50-1.88) and long-term cardiac mortality (HR
1.84, 95% CI 1.41-2.41). There was no significant between-group difference
in the long-term revascularization rate (HR 1.01, 95% CI 0.99-1.04) or in
short-term and long-term stroke rates (OR 0.89, 95% CI 0.58-1.37 and HR
1.38, 95% CI 0.97-1.95). Operation significantly affected heterogeneity
and combined results for long-term mortality (CABG, HR 1.32, 95% CI
1.04-1.66; PCI, HR 1.84, 95% CI 1.58-2.13). <br/>Conclusion(s): COPD was
independently associated with poor outcomes after PCI or CABG after
adjustment for confounders.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<70>
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

<71>
Accession Number
2022937147
Title
Systematic Review of a Novel Approach to Prevent Pain After Chest Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(5) (pp 801-802),
2023. Date of Publication: May 2023.
Author
Anwar S.
Institution
(Anwar) Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
(Anwar) William Harvey Research Institute, NIHR Biomedical Research
Centre, London, United Kingdom
(Anwar) Cleveland Clinic London, London, United Kingdom
(Anwar) Outcomes Research Consortium, Cleveland, OH, United States
Publisher
W.B. Saunders

<72>
Accession Number
2022783628
Title
Failure of Guidelines and Consensus Statements to Recommend Follow-up for
Chronic Cardiovascular Conditions.
Source
Heart and Lung. 59 (pp 128-138), 2023. Date of Publication: 01 May 2023.
Author
Patel K.; Maestas C.M.; Petrechko O.; Boja H.; Blankenship J.C.
Institution
(Patel, Petrechko) Department of Internal Medicine, University of New
Mexico, Albuquerque, NM
(Maestas) University of Virginia Health Science Center, Charlottesville,
VA, United States
(Boja) Presbyterian Health System, Albuquerque, NM
(Blankenship) Division of Cardiology, University of New Mexico,
Albuquerque, NM
Publisher
Elsevier Inc.
Abstract
Background: Many cardiac conditions require long-term clinical follow-up
to monitor progression of disease and tolerance and adherence to
therapies. Providers are often unsure as to the frequency of clinical
follow-up and who should provide the follow-up. In the absence of formal
guidance, patients may be seen more frequently than necessary - thereby
limiting clinic space for other patients, or not frequently enough,
potentially leading to undetected progression of disease.
<br/>Objective(s): To determine the extent to which guidelines
(GL)/consensus statements (CS) provide guidance about appropriate
follow-up for common cardiovascular conditions. <br/>Method(s): We
identified 31 chronic cardiovascular disease conditions for which
long-term (beyond 1 year) follow-up is indicated and used PubMed and
professional society websites to identify all relevant GL/CS (n = 33)
regarding these chronic cardiac conditions. <br/>Result(s): Of the 31
cardiac conditions reviewed, GL/CS contained no recommendation or vague
recommendation for long-term follow-up for 7 of the conditions. Of the 24
conditions with recommendations for follow-up, 3 had recommendations for
imaging follow-up only without mention of clinical follow-up. Of the 33
GL/CS reviewed, 17 made any recommendations about long-term follow-up.
When recommendations were made regarding follow-up, they were often vague,
using terminology such as "as needed". <br/>Conclusion(s): Half of GL/CS
fail to provide recommendations for clinical follow-up of common
cardiovascular conditions. Writing groups for GL/CS should adopt a
standard of routinely including recommendations for follow-up including
specific advice about level of expertise needed (eg, primary care
physician, cardiologist), need for imaging or testing, and frequency of
follow-up.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<73>
Accession Number
2022085557
Title
Treatment Decision in Aortic Stenosis-Look at the Valve but Do Not Forget
the Ventricle.
Source
SN Comprehensive Clinical Medicine. 5(1) (no pagination), 2023. Article
Number: 101. Date of Publication: December 2023.
Author
Nuis R.-J.; Ribeiro J.M.; Lopez-Jimenez F.; Vahanian A.; de Jaegere P.P.T.
Institution
(Nuis, Ribeiro, de Jaegere) Department of Cardiology, Thoraxcenter,
Erasmus University Medical Center, Dr Molewaterplein 40, Rotterdam 3015
GD, Netherlands
(Ribeiro) Department of Cardiology, Centro Hospitalar de Entre o Douro e
Vouga, Santa Maria da Feira, Portugal
(Lopez-Jimenez) Department of Cardiology, Mayo Clinic, Rochester, United
States
(Vahanian) Departement de Cardiologie, UFR Medecine, Universite de Paris,
Paris, France
(Vahanian) LVTS INSERM U1148, GH Bichat, Paris, France
Publisher
Springer Nature
Abstract
In patients with aortic stenosis, current guidelines recommend valve
replacement therapy in case of severe valve narrowing in combination with
symptoms and/or left ventricular dysfunction (ejection fraction < 50%). It
is increasingly recognized that left ventricular ejection fraction offers
a crude interpretation of a complex disease entity that is in need of
refinement to optimize the timing of valve replacement therapy and patient
outcome. In this state-of-the-art review article, we discuss the
pathophysiological transition from left ventricular hypertrophy to other
types of cardiac remodeling and myocardial fibrosis in response to
progressive narrowing of the aortic valve, and how new imaging
developments and biomarkers may help identify patients with a dismal
outcome at earlier stages of disease. Also, the digital transformation of
health care and novel analytical methods such as artificial intelligence
that can help improve treatment decision is evaluated. This is in
combination with the increased use of minimally invasive treatment
modalities that may fulfill the goal of offering valve replacement in
patients with aortic stenosis at earlier stages of disease and prior to
the onset of symptoms but nevertheless at risk of left ventricular
deterioration.<br/>Copyright &#xa9; 2023, The Author(s).

<74>
Accession Number
2023415353
Title
Impact of Computational Modeling on Transcatheter Left Atrial Appendage
Closure Efficiency and Outcomes.
Source
JACC: Cardiovascular Interventions. 16(6) (pp 655-666), 2023. Date of
Publication: 27 Mar 2023.
Author
De Backer O.; Iriart X.; Kefer J.; Nielsen-Kudsk J.E.; Aminian A.; Rosseel
L.; Kofoed K.F.; Odenstedt J.; Berti S.; Saw J.; Sondergaard L.; Garot P.
Institution
(De Backer, Kofoed, Sondergaard) Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Iriart) Bordeaux University Hospital, Fondation Bordeaux Universite,
Bordeaux, France
(Kefer) Cliniques Universitaires Saint-Luc, Brussels, Belgium
(Nielsen-Kudsk) Aarhus University Hospital, Aarhus, Denmark
(Aminian) Centre Hospitalier Universitaire de Charleroi, Charleroi,
Belgium
(Rosseel) Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
(Odenstedt) Sahlgrenska University Hospital, Gothenburg, Sweden
(Berti) Fondazione CNR Regione Toscana, Massa, Italy
(Saw) Vancouver General Hospital, Vancouver, BC, Canada
(Garot) Hopital Jacques Cartier, Institut Cardiovasculaire Paris Sud,
Ramsay-Sante, Massy, France
Publisher
Elsevier Inc.
Abstract
Background: When performing transcatheter left atrial appendage (LAA)
closure, peridevice leaks and device-related thrombus (DRT) have been
associated with worse clinical outcomes-hence, their risk should be
mitigated. <br/>Objective(s): The authors sought to assess whether use of
preprocedural computational modeling impacts procedural efficiency and
outcomes of transcatheter LAA closure. <br/>Method(s): The PREDICT-LAA
trial (NCT04180605) is a prospective, multicenter, randomized trial in
which 200 patients were 1:1 randomized to standard planning vs cardiac
computed tomography (CT) simulation-based planning of LAA closure with
Amplatzer Amulet. The artificial intelligence-enabled CT-based anatomical
analyses and computer simulations were provided by FEops (Belgium).
<br/>Result(s): All patients had a preprocedural cardiac CT, 197 patients
underwent LAA closure, and 181 of these patients had a postprocedural CT
scan (standard, n = 91; CT + simulation, n = 90). The composite primary
endpoint, defined as contrast leakage distal of the Amulet lobe and/or
presence of DRT, was observed in 41.8% in the standard group vs 28.9% in
the CT + simulation group (relative risk [RR]: 0.69; 95% CI: 0.46-1.04; P
= 0.08). Complete LAA closure with no residual leak and no disc retraction
into the LAA was observed in 44.0% vs 61.1%, respectively (RR: 1.44; 95%
CI: 1.05-1.98; P = 0.03). In addition, use of computer simulations
resulted in improved procedural efficiency with use of fewer Amulet
devices (103 vs 118; P < 0.001) and fewer device repositionings (104 vs
195; P < 0.001) in the CT + simulation group. <br/>Conclusion(s): The
PREDICT-LAA trial demonstrates the possible added value of artificial
intelligence-enabled, CT-based computational modeling when planning for
transcatheter LAA closure, leading to improved procedural efficiency and a
trend toward better procedural outcomes.<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<75>
Accession Number
2022267285
Title
A Pilot Trial to Compare the Long-Term Efficacy of Pulmonary Vein
Isolation with High-Power Short-Duration Radiofrequency Versus Laser
Energy with Rapid Ablation Mode.
Source
Journal of Cardiovascular Development and Disease. 10(3) (no pagination),
2023. Article Number: 98. Date of Publication: March 2023.
Author
Schildt S.; Fredersdorf S.; Jungbauer C.G.; Hauck C.; Tarnowski D.; Debl
K.; Neef S.; Schach C.; Sossalla S.; Maier L.S.; Ucer E.
Institution
(Schildt, Fredersdorf, Jungbauer, Hauck, Tarnowski, Debl, Neef, Schach,
Sossalla, Maier, Ucer) Internal Medicine II, Cardiology, University
Hospital Regensburg, Regensburg 93053, Germany
Publisher
MDPI
Abstract
Background: Pulmonary vein (PV) reconnection is the major cause of atrial
fibrillation (AF) recurrence after pulmonary vein isolation (PVI). The
probability of reconnection is higher if the primary lesion is not
sufficiently effective, which can be unmasked with an adenosine
provocation test (APT). High-power short-duration radiofrequency energy
(HPSD) guided with ablation index (AI) and the third generation of the
visually guided laser balloon (VGLB) are new methods for PVI.
<br/>Method(s): A total of 70 participants (35 in each group) who
underwent a PVI with either AI-guided HPSD (50 W; AI 500 for the anterior
and 400 for the posterior wall, respectively) or VGLB ablation were
included in this observational pilot trial. Twenty minutes after each PVI,
an APT was performed. The primary endpoint was the event-free survival
from AF after three years. <br/>Result(s): A total of 137 (100%) PVs in
the HPSD arm and 131 PVs (98.5%) in the VGLB arm were initially
successfully isolated (p = 0.24). The overall procedure duration was
similar in both arms (155 +/- 39 in HPSD vs. 175 +/- 58 min in VGLB, p =
0.191). Fluoroscopy time, left atrial dwelling time and duration from the
first to the last ablation were longer in the VGLB arm (23 +/- 8 vs. 12
+/- 3 min, p < 0.001; 157 (111-185) vs. 134 (104-154) min, p = 0.049;
92(59-108) vs. 72 (43-85) min, p = 0.010). A total of 127 (93%) in the
HPSD arm and 126 (95%) PVs in the VGLB arm remained isolated after APT (p
= 0.34). The primary endpoint was met 1107 +/- 68 days after ablation in
71% vs. 66% in the VGLB and HPSD arms, respectively (p = 0.65).
<br/>Conclusion(s): HPSD and VGLB did not differ with respect to long-term
outcome of PVI. A large, randomized study should be conducted to compare
clinical outcomes with respect to these new ablation
techniques.<br/>Copyright &#xa9; 2023 by the authors.

<76>
Accession Number
2022267260
Title
Percutaneous Coronary Intervention Outcomes in Patients with Liver
Cirrhosis: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 10(3) (no pagination),
2023. Article Number: 92. Date of Publication: March 2023.
Author
Khandait H.; Jaiswal V.; Hanif M.; Shrestha A.B.; Iturburu A.; Shah M.;
Ishak A.; Garimella V.; Ang S.P.; Mathew M.
Institution
(Khandait, Mathew) Trinitas Regional Medical Center/RWJ Barnabas Health,
Elizabeth, NJ 07202, United States
(Jaiswal) Department of Research, JCCR Cardiology Research, Varanasi
221005, India
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY 13210, United States
(Shrestha) Department of Medicine, M Abdur Rahim Medical College, Dinajpur
5200, Bangladesh
(Iturburu) Department of Medicine, Universidad de Guayaquil, Guayas
090514, Ecuador
(Shah, Ishak) Department of Research and Academic Affairs, Larkin
Community Hospital, South Miami, FL 33143, United States
(Garimella) Department of Internal Medicine, University of Miami (Holy
Cross), Miami, FL 33136, United States
(Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, Toms River, NJ 08755, United States
Publisher
MDPI
Abstract
There is a paucity of data and minimal literature on outcomes of
percutaneous coronary intervention (PCI) among liver cirrhosis patients.
Therefore, we conducted a systematic review and meta-analysis to evaluate
the clinical outcomes among liver cirrhosis patients post-PCI. We
conducted a comprehensive literature search in the PubMed, Embase,
Cochrane, and Scopus databases for relevant studies. Effect sizes were
pooled using the DerSimonian and Laird random-effects model as an odds
ratio (OR) with 95% confidence intervals (CI). A total of 3 studies met
the inclusion criteria, providing data from 10,705,976 patients. A total
of 28,100 patients were in the PCI + Cirrhosis group and 10,677,876
patients were in the PCI-only group. The mean age of patients with PCI +
Cirrhosis and PCI alone was 63.45 and 64.35 years. The most common
comorbidity was hypertension among the PCI + Cirrhosis group compared with
PCI alone (68.15% vs. 73.6%). Cirrhosis patients post-PCI were had higher
rates of in-hospital mortality (OR, 4.78 (95%CI: 3.39-6.75), p < 0.001),
GI bleeding (OR, 1.91 (95%CI:1.83-1.99), p < 0.001, I² = 0%),
stroke (OR, 2.48 (95%CI:1.68-3.66), p < 0.001), AKI (OR, 3.66 (95%CI:
2.33-6.02), p < 0.001), and vascular complications (OR, 1.50 (95%CI:
1.13-1.98), p < 0.001) compared with the PCI group without cirrhosis.
Patients with cirrhosis are at a high risk for mortality and adverse
outcomes post-PCI procedure compared to the PCI-only group of
patients.<br/>Copyright &#xa9; 2023 by the authors.

<77>
Accession Number
2023187312
Title
Effectiveness of preoperative respiratory rehabilitation on ICU stay and
social pain in patients undergoing heart surgery.
Source
Journal of Pain Management. 15(3) (pp 207-214), 2022. Date of Publication:
2022.
Author
Niazi S.; Gisour B.B.; Tafti S.H.A.; Aliannejad R.; Khah A.S.; Shahi
M.H.P.
Institution
(Niazi, Tafti) Research Center for Advanced Technologies in Cardiovascular
Medicine, Cardiovascular Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Gisour) Department of Sport Psychology, Faculty of Physical Education and
Sport Sciences, University of Tehran, Tehran, Iran, Islamic Republic of
(Aliannejad) Division of Pulmonary and Critical Care, Shariati Hospital,
Tehran, Iran, Islamic Republic of
(Khah) Sepehr Heart Center, Baharloo Hospital, Tehran, Iran, Islamic
Republic of
(Shahi) Sports Medicine Research Center, Neuroscience Institute, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Nova Science Publishers, Inc.
Abstract
The purpose of the present study was to examine the influence of pre-heart
surgery pulmonary rehabilitation, including inspiratory muscle training
(IMT) and psychological intervention on ICU (Intensive Care Units) stay,
respiratory muscle strength, and social pain in patients on the list for
heart surgery. In this study, 60 patients on the list for heart surgery
were randomly divided into two groups of experimental and control. The
experimental group was undergoing pulmonary rehabilitation and
psychological interventions from the moment of admission to the day of
surgery. The strength of index of inspiration (Sindex), length of ICU
stays, and questionnaires were assessed before and after training. A total
of sixty patients with an age range of 52-68 years were included in the
study. Sindex was significantly improved in the experiment group (p <
0.005). In addition, the results showed that there are significant
reductions in the length of ICU stay, postoperative stress, depression,
and social pain were also reduced. The current study showed that pulmonary
rehabilitation and preoperative psychological interventions help wait for
heart surgery patients.<br/>Copyright &#xa9; Nova Science Publishers, Inc.

<78>
Accession Number
2021153255
Title
Determinants and long-term outcomes of largely uncovered struts in
thin-struts drug-eluting stents assessed by optical coherence tomography.
Source
Catheterization and Cardiovascular Interventions. 100(S1) (pp S25-S35),
2022. Date of Publication: 01 Nov 2022.
Author
Moretti F.; Bernelli C.; Pellegrini D.; Boccuzzi G.; Colombo F.; Sirbu V.;
Vassileva A.; Fiocca L.; Canova P.; Bezerra H.; Pereira G.T.R.; Cereda A.;
De Luca L.; Saia F.; Capodanno D.; Guagliumi G.
Institution
(Moretti, Pellegrini, Sirbu, Vassileva, Fiocca, Canova, Guagliumi)
Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy
(Moretti) Cardiology Unit, Department of Molecular Medicine, University of
Pavia, Pavia, Italy
(Bernelli) Division of Cardiology, Ospedale Santa Corona, Pietra Ligure,
Italy
(Boccuzzi, Colombo) Department of Cardiovascular, Ospedale San Giovanni
Bosco, Torino, Italy
(Sirbu) Interventional Cardiology, Jilin Heart Hospital, Jilin Province,
Changchun, China
(Bezerra, Pereira) Cardiovascular Imaging Core Laboratory, University
Hospital, Case Medical Centre, Cleveland, OH, United States
(Cereda) Division of Cardiology, ASST Santi Paolo e Carlo, Milan, Italy
(De Luca) Department of Cardiosciences, Azienda Ospedaliera San
Camillo-Forlanini, Roma, Italy
(Saia) Department of Cardiothoracic Vascular, University Hospital,
Bologna, Italy
(Capodanno) Department of Cardio-Thoracic-Vascular and Transplant, A.O.U.
Vittorio Emanuele-Policlinico, University of Catania, Catania, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Uncovered struts are a determinant of stent failure. The
impact of plaque composition and procedural factors on the occurrence,
evolution, and outcomes of uncovered struts in a high-risk setting has not
been investigated. <br/>Objective(s): To investigate the determinants and
long-term clinical impact of largely uncovered struts (LUS) in thin-struts
drug-eluting stents (DES) implanted in complex lesions by intracoronary
optical coherence tomography (OCT). <br/>Method(s): Ninety patients with
multivessel disease undergoing staged complete revascularization were
randomly assigned to bioabsorbable or durable polymer DES. OCT were
serially performed during the index procedure, at 3- and 18-month
follow-up, and analyzed by an independent core lab. Struts were defined
uncovered by OCT if no tissue was visible above the struts. LUS were
defined as >=30% of uncovered struts at 3-month follow-up. Clinical
outcomes were the occurrence of target vessel failure (TVF) and major
adverse cardiac and cerebrovascular events (MACCE) at 5-year follow-up.
<br/>Result(s): LUS occurred in 31 patients (34.4%) regardless of stent
platform. At 5 years, no differences were observed in the rate of TVF
(12.7% vs. 13.4%; p = 0.91) and MACCE (23.9% vs. 24.9%; p = 0.88) between
the two groups. At multivariate logistic regression, plaque rupture, mean
lumen diameter, proximal reference vessel area, and maximum stent
deployment pressure were independent predictors of LUS.
<br/>Conclusion(s): LUS are a frequent finding in complex coronary lesions
treated with thin-struts DES, especially in the presence of plaque
rupture. However, in this study, no significant safety signal related to
LUS emerged in long-term follow-up.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<79>
Accession Number
2020028055
Title
Human Immunodeficiency Virus Infection-Associated Cardiomyopathy and Heart
Failure.
Source
Journal of Personalized Medicine. 12(11) (no pagination), 2022. Article
Number: 1760. Date of Publication: November 2022.
Author
Papamanoli A.; Muncan B.; Yoo J.; Psevdos G.; Kalogeropoulos A.P.
Institution
(Papamanoli) Internal Medicine, Zucker School of Medicine, Northwell
Health at Mather Hospital, Port Jefferson, NY 11777, United States
(Muncan) Renaissance School of Medicine, Stony Brook University, Stony
Brook, NY 11794, United States
(Yoo) Division of Cardiology, Albany Medical Center, Albany, NY 12208,
United States
(Psevdos) Division of Infectious Diseases, Northport Veterans Affairs,
Northport, NY 11768, United States
(Kalogeropoulos) Division of Cardiology, Department of Medicine, Stony
Brook University Medical Center, 101 Nicolls Road, Health Science Center
T-16, Rm. 080, Stony Brook, NY 11794, United States
Publisher
MDPI
Abstract
The landscape of human immunodeficiency virus (HIV) epidemiology and
treatment is ever-changing, with the widespread and evolving use of
antiretroviral therapy (ART). With timely ART, people living with HIV
(PLWH) are nearing the life expectancies and the functionality of the
general population; nevertheless, the effects of HIV and ART on
cardiovascular health remain under investigation. The pathophysiology of
HIV-related cardiomyopathy and heart failure (HF) have historically been
attributed to systemic inflammation and changes in cardiometabolic
function and cardiovascular architecture. Importantly, newer evidence
suggests that ART also plays a role in modulating the process of
HIV-related cardiomyopathy and HF. In the short term, newer highly active
ART (HAART) seems to have cardioprotective effects; however, emerging data
on the long-term cardiovascular outcomes of certain HAART medications,
i.e., protease inhibitors, raise concerns about the potential adverse
effects of these drugs in the clinical course of HIV-related HF. As such,
the traditional phenotypes of dilated cardiomyopathy and left ventricular
systolic failure that are associated with HIV-related heart disease are
incrementally being replaced with increasing rates of diastolic
dysfunction and ischemic heart disease. Moreover, recent studies have
found important links between HIV-related HF and other clinical and
biochemical entities, including depression, which further complicate
cardiac care for PLWH. Considering these trends in the era of ART, the
traditional paradigms of HIV-related cardiomyopathy and HF are being
called into question, as is the therapeutic role of interventions such as
ventricular assist devices and heart transplantation. In all, the
mechanisms of HIV-related myocardial damage and the optimal approaches to
the prevention and the treatment of cardiomyopathy and HF in PLWH remain
under investigation.<br/>Copyright &#xa9; 2022 by the authors.

<80>
Accession Number
2020749519
Title
Clinicopathological Features of Intrathoracic Liposarcoma-A Systematic
Review with an Illustrative Case.
Source
Journal of Clinical Medicine. 11(24) (no pagination), 2022. Article
Number: 7353. Date of Publication: December 2022.
Author
Kielbowski K.; Ruszel N.; Skrzyniarz S.A.; Wojtys M.E.; Becht R.;
Ptaszynski K.; Gajic D.; Wojcik J.
Institution
(Kielbowski, Wojtys, Gajic, Wojcik) Department of Thoracic Surgery and
Transplantation, Pomeranian Medical University in Szczecin, Alfreda
Sokolowskiego 11, Szczecin 70-891, Poland
(Ruszel) Department of Internal Medicine and Hypertension with
Subdepartment of Cardiology, Independent Public Provincial Hospital in
Szczecin, Alfreda Sokolowskiego 11, Szczecin 70-891, Poland
(Skrzyniarz) Dietrich-Bonhoeffer-Klinikum, Neubrandenburg 17036, Germany
(Becht) Department of Clinical Oncology, Chemotherapy and Cancer
Immunotherapy, Pomeranian Medical University in Szczecin, Unii Lubelskiej
1, Szczecin 71-252, Poland
(Ptaszynski) Department of Pathology, Faculty of Medicine, Collegium
Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn 10-561,
Poland
Publisher
MDPI
Abstract
Background: Liposarcoma (LPS) is one of the most common soft-tissue
sarcomas. However, intrathoracic LPS is rare, as only 1% of all LPS cases
are found in the thorax. <br/>Method(s): A systematic literature review
through PubMed and Embase databases was performed. Only eligible case
reports and case series reporting intrathoracic LPS in adult patients were
included. Kaplan-Meier curves were calculated to evaluate the survival
rate of included patients based on the histological subtype of LPS.
<br/>Result(s): 123 studies reporting 197 patients were included. We added
a case of a 69-year-old female patient with recurrent giant intrathoracic
LPS. The primary tumor measured 15.1cm x 22.9 cm x 21.9 cm and weighed
3100 g. Six months later, the patient was admitted to the hospital with
another intrathoracic tumor measuring 9.5 cm x 9 cmx 1.4 cm. The
immunohistochemical studies showed expression of murine double minute 2
(MDM2) antigen in both primary and recurrent tumor cells.
<br/>Conclusion(s): Dyspnea, chest pain, and cough were the most common
symptoms reported in included studies. Overall, the 5-year survival rate
was 62%. The highest survival was observed in well-differentiated LPS
patients (80%) and the lowest in myxoid LPS (31%).<br/>Copyright &#xa9;
2022 by the authors.

<81>
Accession Number
2023644601
Title
Outcomes of truncal valve replacement in neonates and infants: A
meta-analysis.
Source
Cardiology in the Young. 29 (no pagination), 2023. Date of Publication: 27
Mar 2023.
Author
Hardy W.A.; Kang L.; Turek J.W.; Rajab T.K.
Institution
(Hardy, Rajab) Section of Pediatric Cardiothoracic Surgery, Medical
University of South Carolina, Charleston, SC, United States
(Kang) Department of Surgery, Duke University Medical Center, Durham, NC,
United States
(Turek) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
Publisher
Cambridge University Press
Abstract
Background: Infants with truncus arteriosus typically undergo repair by
repurposing the truncal valve as the neo-aortic valve and using a valved
conduit homograft for the neo-pulmonary valve. In cases where the native
truncal valve is too insufficient for repair, it is replaced, but this is
a rare occurrence with a paucity of data, especially in the infant
population. Here, we conduct a meta-analysis to better understand the
outcomes of infant truncal valve replacement during the primary repair of
truncus arteriosus. <br/>Method(s): We systematically reviewed PubMed,
Scopus, and CINAHL for all studies reporting infant (<12 months) truncus
arteriosus outcomes between 1974 and 2021. Exclusion criteria were studies
which did not report truncal valve replacement outcomes separately. Data
extracted included valve replacement type, mortality, and reintervention.
Our primary outcome was early mortality, and our secondary outcomes were
late mortality and reintervention rates. <br/>Result(s): Sixteen studies
with 41 infants who underwent truncal valve replacement were included. The
truncal valve replacement types were homografts (68.8%), mechanical valves
(28.1%), and bioprosthetic valves (3.1%). Overall early mortality was
49.4% (95% CI: 28.4-70.5). The pooled late mortality rate was 15.3%/year
(95% CI: 5.8-40.7). The overall rate of truncal valve reintervention was
21.7%/year (95% CI: 8.4-55.7). <br/>Conclusion(s): Infant truncal valve
replacement has poor early and late mortality as well as high rates of
reintervention. Truncal valve replacement therefore remains an unsolved
problem in congenital cardiac surgery. Innovations in congenital cardiac
surgery, such as partial heart transplantation, are required to address
this. <br/>Copyright &#xa9; The Author(s), 2023. Published by Cambridge
University Press.

<82>
Accession Number
2023644562
Title
Exeporfinium chloride (XF-73) nasal gel dosed over 24 hours prior to
surgery significantly reduced Staphylococcus aureus nasal carriage in
cardiac surgery patients: Safety and efficacy results from a randomized
placebo-controlled phase 2 study.
Source
Infection Control and Hospital Epidemiology. 28 (no pagination), 2023.
Date of Publication: 23 Mar 2023.
Author
Mangino J.E.; Firstenberg M.S.; Milewski R.K.C.; Rhys-Williams W.; Lees
J.P.; Dane A.; Love W.G.; Gonzalez Moreno J.
Institution
(Mangino) Division of Infection Diseases, Department of Internal Medicine,
The Ohio State University, Columbus, OH, United States
(Firstenberg) William Novick Global Cardiac Alliance, Aurora, CO, United
States
(Milewski) Department of Surgery, Yale School of Medicine, New Haven, CT,
United States
(Rhys-Williams, Lees, Love, Gonzalez Moreno) Destiny Pharma, Brighton,
United Kingdom
(Dane) Danestat Consulting Ltd, Macclesfield, United Kingdom
Publisher
Cambridge University Press
Abstract
We studied 83 cardiac-surgery patients with nasal S. aureus carriage who
received 4 intranasal administrations of XF-73 nasal gel or placebo <24
hours before surgery. One hour before surgery, patients exhibited a S.
aureus nasal carriage reduction of 2.5 log10 with XF-73 compared to 0.4
log10 CFU/mL for those who received placebo (95% CI, -2.7 to -1.5; P
<.0001). <br/>Copyright &#xa9; Destiny Pharma plc, 2023. Published by
Cambridge University Press on behalf of The Society for Healthcare
Epidemiology of America.

<83>
Accession Number
2023698216
Title
Effects of Percutaneous Coronary Intervention and Coronary Artery Bypass
Grafting on Clinical Outcomes in Patients with Reduced Ejection Fraction
Heart Failure and Coronary Heart Disease: A Meta-Analysis.
Source
Heart Surgery Forum. 26(1) (pp E62-E73), 2023. Date of Publication: 2023.
Author
Yu Z.-X.; Yan J.; Wang M.-Y.; Chen R.; Luo J.-Y.; Li X.-M.; Xie X.; Ma
Y.-T.
Institution
(Yu, Yan, Wang, Chen, Luo, Li, Xie, Ma) Department of Cardiology, Heart
Center, The First Affiliated Hospital of Xinjiang Medical University,
Urumqi, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Objective: To clarify the effects of percutaneous coronary intervention
(PCI) and coronary artery bypass grafting (CABG) on the clinical outcomes
of patients with coronary heart disease (CHD) complicated with reduced
ejection fraction heart failure (HFrEF) through meta-analysis.
<br/>Method(s): Three major literature databases - PubMed, Web of Science,
and Cochrane - were searched by search terms and the literature retrieval
time was publications dating from January 2007 to December 2021. To search
for observational studies and randomized controlled trials (RCT) comparing
the efficacy of PCI and CABG in patients with CHD and HFrEF, the abstract
or full text of the literature was read and the final included literature
was determined, according to inclusion and exclusion criteria. The quality
of the included literature was evaluated using the Ottawa scale and data
extraction was further completed. Data analysis was made using RevMan5.4
and R4.1 software; relevant forest plots and funnel plots were made,
according to the extracted data. Egger's test was used to evaluate whether
the data had publication bias. Outcomes were the major adverse
cardiovascular events (MACE). <br/>Result(s): A total of 10 studies were
included and 11, 032 subjects were included, made up of 5, 521 cases of
PCI and 5, 511 cases of CABG. The results showed no significant difference
between the two groups in cardiac mortality (CM) (RR=1.13, 95% CI
0.98-1.30, P = 0.10) and in overall all-cause mortality (ACM) (RR=1.12,
95% CI 0.92-1.37, P = 0.25). In the subgroup analysis of ACM, in the
subgroups with left ventricular ejection fraction (LVEF) less than 35% and
exceeding 35% and less than 50% (RR=1.12, 95% CI 0.92-1.37, P = 0.25)
between the two groups, there was no statistical difference. However,
among other MACE, compared with the PCI group, the CABG group had a lower
risk of MACE (RR=1.58, 95%CI 1.49-1.70, P < 0.00001), myocardial
infarction (MI) (RR=1.99, 95% CI 1.02-3.88, P = 0.04), heart failure (HF)
(RR=1.29, 95% CI 1.17-1.43, P < 0.00001) and revascularization (RR=2.74,
95% CI 1.93-3.90, P < 0.00001). Finally in the CABG group, the risk of
stroke or transient ischemic attack (TIA) was higher (RR=0.71, 95% CI
0.58-0.86, P = 0.0006) than the PCI group. <br/>Conclusion(s): The
mortality rates of PCI and CABG were similar in patients with CHD
complicated with HFrEF. Compared with PCI, CABG had a lower incidence of
MACE, MI, HF, and revascularization, and a higher incidence of stroke or
TIA.<br/>Copyright &#xa9; 2022 Forum Multimedia Publishing, LLC.

<84>
Accession Number
2023698208
Title
Minimally Invasive Direct Coronary Artery Bypass Versus Percutaneous
Coronary Intervention for Isolated Left Anterior Descending Artery
Stenosis: An Updated Meta-Analysis.
Source
Heart Surgery Forum. 26(1) (pp E114-E125), 2023. Date of Publication:
2023.
Author
Zhang S.; Chen S.; Yang K.; Li Y.; Yun Y.; Zhang X.; Qi X.; Zhou X.; Zhang
H.; Zou C.; Ma X.
Institution
(Zhang, Chen, Li, Zhang, Zou, Ma) Department of Cardiovascular Surgery,
Shandong Provincial Hospital, Shandong University, Jinan, China
(Yang) Shandong First Medical University, Jinan, China
(Yun) Department of Radiology, Qilu Hospital of Shandong University,
Jinan, China
(Zhang, Zhang, Zou, Ma) Department of Cardiovascular Surgery, Shandong
Provincial Hospital, Shandong First Medical University, Jinan, China
(Qi) Key Laboratory for Experimental Teratology, The Ministry of
Education, Department of Medical Genetics, School of Basic Medical
Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
(Zhou) Department of Endocrinology, Shandong Provincial Hospital, Shandong
First Medical University, Jinan, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: The optimal revascularization strategy for isolated left
anterior descending (LAD) coronary artery lesion between minimally
invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary
intervention (PCI) remains controversial. This updated meta-analysis aims
to compare the long- and short-term outcomes of MIDCAB versus PCI for
patients with isolated LAD coronary artery lesions. <br/>Method(s): The
Pubmed, Web of Science, and Cochrane databases were searched for
retrieving potential publications from 2002 to 2022. The primary outcome
was long-term survival. Secondary outcomes were long-term target vessel
revascularization (TVR), long-term major adverse cardiovascular events
(MACEs), and short-term outcomes, including postoperative mortality,
myocardial infarction (MI), TVR, and MACEs of any cause in-hospital or 30
days after the revascularization. <br/>Result(s): Six randomized
controlled trials (RCTs) and eight observational studies were included in
this updated meta-analysis. In total, 1757 patients underwent MIDCAB and
15245 patients underwent PCI. No statistically significant difference was
found between the two groups in the rates of long-term survival. MIDCAB
had a lower long-term MACE rate compared with PCI. Besides, PCI resulted
in an augmented risk of TVR. Postoperative mortality, MI, TVR, and MACEs
were similar between the two groups. <br/>Conclusion(s): The updated
meta-analysis presents the evidence that MIDCAB has a reduced risk of
long-term TVR and MACEs, with no benefit in terms of long-term mortality
and short-term results, in comparison with PCI. Large multicenter RCTs,
including patients treated with newer techniques, are warranted in the
future.<br/>Copyright &#xa9; 2023 Forum Multimedia Publishing, LLC.

<85>
Accession Number
2023259904
Title
Myocardial Revascularization in Patients With Ischemic Cardiomyopathy: For
Whom and How.
Source
Journal of the American Heart Association. 12(6) (no pagination), 2023.
Article Number: e026943. Date of Publication: 21 Mar 2023.
Author
Liga R.; Colli A.; Taggart D.P.; Boden W.E.; De Caterina R.
Institution
(Liga, Colli, De Caterina) Cardiology Division, Pisa University Hospital,
University of Pisa, Italy
(Taggart) Nuffield Department of Surgical Sciences, Oxford University John
Radcliffe Hospital, Oxford, United Kingdom
(Boden) VA Boston Healthcare System, Boston University School of Medicine,
Boston, MA, United States
(De Caterina) Fondazione VillaSerena per la Ricerca, Citta Sant'Angelo,
Italy
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Myocardial revascularization has been advocated to improve
myocardial function and prognosis in ischemic cardiomyopathy (ICM). We
discuss the evidence for revascularization in patients with ICM and the
role of ischemia and viability detection in guiding treatment. METHODS AND
RESULTS: We searched for randomized controlled trials evaluating the
prognostic impact of revascularization in ICM and the value of viability
imaging for patient management. Out of 1397 publications, 4 randomized
controlled trials were included, enrolling 2480 patients. Three trials
(HEART [Heart Failure Revascularisation Trial], STICH [Surgical Treatment
for Ischemic Heart Failure], and REVIVED [REVascularization for Ischemic
VEntricular Dysfunction]-BCIS2) randomized patients to revascularization
or optimal medical therapy. HEART was stopped prematurely without showing
any significant difference between treatment strategies. STICH showed a
16% lower mortality with bypass surgery compared with optimal medical
therapy at a median follow-up of 9.8 years. However, neither the
presence/extent of left ventricle viability nor ischemia interacted with
treatment outcomes. REVIVED-BCIS2 showed no difference in the primary end
point between percutaneous revasculari-zation or optimal medical therapy.
PARR-2 (Positron Emission Tomography and Recovery Following
Revascularization) randomized patients to imaging-guided revascularization
versus standard care, with neutral results overall. Information regarding
the consistency of patient management with viability testing results was
available in =65% of patients (n=1623). No difference in survival was
revealed according to adherence or no adherence to viability imaging.
<br/>CONCLUSION(S): In ICM, the largest randomized controlled trial,
STICH, suggests that surgical revascularization improves pa-tients'
prognosis at long-term follow-up, whereas evidence supports no benefit of
percutaneous coronary intervention. Data from randomized controlled trials
do not support myocardial ischemia or viability testing for treatment
guidance. We propose an algorithm for the workup of patients with ICM
considering clinical presentation, imaging results, and surgical
risk.<br/>Copyright &#xa9; 2023 The Authors.

<86>
Accession Number
2023259833
Title
Novel Measures of Arterial Hemodynamics and Wave Reflections Associated
With Clinical Outcomes in Patients With Heart Failure.
Source
Journal of the American Heart Association. 12(6) (no pagination), 2023.
Article Number: e027666. Date of Publication: 21 Mar 2023.
Author
Steinberg R.S.; Udeshi E.; Dickert N.; Quyyumi A.; Chirinos J.A.; Morris
A.A.
Institution
(Steinberg, Udeshi, Dickert, Quyyumi, Morris) Division of Cardiology,
Emory University, Atlanta, GA, United States
(Chirinos) Division of Cardiology, University of Pennsylvania,
Philadelphia, PA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Arterial stiffness and earlier wave reflections can increase
afterload and impair cardiovascular function. Most prior studies have been
performed in patients with preserved left ventricular function. We
describe novel measures of pulsatile arterial hemodynamics and their
association with clinical outcomes in patients with heart failure with
reduced ejection fraction. METHODS AND RESULTS: Participants with heart
failure with reduced ejection fraction (n=137, median age 56 years, 49%
women, 58% Black) and age-matched healthy controls (n=124) underwent
measurements of large artery stiffness and pulsatile arterial
hemodynamics. Carotid-femoral pulse wave velocity and augmentation index
were assessed using radial applanation tonometry. Pressure-flow analyses
derived reflected wave transit time, the systolic pressure-time integral
imposed by proximal aortic characteristic impedance, and the pressure-time
integral from wave reflection (wasted pressure effort). Cox proportional
hazards models defined associations between hemodynamic measures and (1)
all-cause death and (2) a combined end point of left ventricular assist
device implant, heart transplant, and death, at 2 years adjusted for race,
BNP (B-type natriuretic peptide), and the Meta-Analysis Global Group in
Chronic Heart Failure Risk Score. Compared with controls, participants
with heart failure with reduced ejection fraction exhibited similar
carotid-femoral pulse wave velocity (6.8+/-1.6 versus 7.0+/-1.6 m/s,
P=0.40) but higher augmentation index normalized to a heart rate of 75 bpm
(13+/-2% versus 22+/-2%, P<0.001). Shorter reflected wave transit time
(ie, earlier wave reflection arrival to the proximal aorta) was associated
with an increased risk of death (adjusted hazard ratio [aHR] 1.67 [95% CI
1.03-1.63]) and the combined end point of death/left ventricular assist
device/heart transplant (aHR, 1.61 [95% CI, 1.06-2.44]) at 2 years. Wasted
pressure effort/proximal aortic characteristic impedance, representing the
proportion of systolic load from wave reflection versus aortic root
characteristic impedance, was univariately associated with death (hazard
ratio (HR), 1.44 [95% CI, 1.05-1.97]) and with death/left ventricular
assist device/heart transplant on univariate (HR, 1.42 [95% CI,
1.07-1.88]) and multivariable (aHR, 1.40 [95% CI, 1.02-1.93]) analysis.
<br/>CONCLUSION(S): Increased left ventricular systolic load from
premature wave reflections is associated with adverse clinical outcomes in
patients with heart failure with reduced ejection fraction.<br/>Copyright
&#xa9; 2023 The Authors. Published on behalf of the American Heart
Association, Inc., by Wiley.

<87>
Accession Number
2022389139
Title
Is a hyperosmolar pump prime for cardiopulmonary bypass a risk factor for
postoperative delirium? A double blinded randomised controlled trial.
Source
Scandinavian Cardiovascular Journal. 57(1) (no pagination), 2023. Article
Number: 2186326. Date of Publication: 2023.
Author
Claesson Lingehall H.; Gustafson Y.; Svenmarker S.; Appelblad M.;
Davidsson F.; Holmner F.; Wahba A.; Olofsson B.
Institution
(Claesson Lingehall, Svenmarker, Appelblad, Davidsson, Holmner, Wahba)
Department of Public Health and Clinical Medicine, Heart Centre, Umea
University, Umea, Sweden
(Claesson Lingehall, Olofsson) Department of Nursing, Umea University,
Umea, Sweden
(Gustafson) Department of Community Medicine and Rehabilitation, Geriatric
Medicine, Umea University, Umea, Sweden
(Wahba) Norwegian University of Circulation and Medical Imagining,
Trondheim, Norway
Publisher
Taylor and Francis Ltd.
Abstract
Objective: Postoperative delirium (POD) is common after cardiac surgery.
We have previously identified plasma sodium concentration and the volume
of infused fluids during surgery as possible risk factors. Both are linked
to the selection and composition of the pump prime used for
cardiopulmonary bypass (CPB). Present study aims to examine whether
hyperosmolality increases the risk for POD. <br/>Design(s): Patients >=65
years (n = 195) scheduled for cardiac surgery were prospectively enrolled
into this double blinded randomised clinical trial. Study group received a
pump prime containing mannitol and ringer-acetate (966 mOsmol) (n = 98)
vs. ringer-acetate (388 mOsmol) (n = 97) in the control group.
Postoperative delirium was defined according to DSM-5 criteria based on a
test-battery pre- and postoperatively (days 1-3). Plasma osmolality was
measured on five occasions and coordinated with the POD assessments. The
primary outcome was the POD incidence related to hyperosmolality as the
secondary outcome. <br/>Result(s): The incidence of POD was 36% in the
study group and 34% in the control group, without intergroup difference
(p=.59). The plasma osmolality was significantly higher in the study
group, both on days 1 and 3 and after CPB (p<.001). Post hoc analysis
indicated that high osmolality levels increased the risk for delirium on
day 1 by 9% (odds ratio (OR) 1.09, 95% CI 1.03-1.15) and by 10% on day 3
(OR 1.10, 95% CI 1.04-1.16). <br/>Conclusion(s): Use of a prime solution
with high osmolality did not increase the incidence of POD. However, the
influence of hyperosmolality as a risk factor for POD warrants further
investigation.<br/>Copyright &#xa9; 2023 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<88>
Accession Number
2023741734
Title
Sodium glucose co-transporter 2 inhibition with empagliflozin on
metabolic, cardiac and renal outcomes in recent cardiac transplant
recipients (EMPA-HTx): Protocol for a randomised controlled trial.
Source
BMJ Open. 13(3) (no pagination), 2023. Article Number: e069641. Date of
Publication: 29 Mar 2023.
Author
Raven L.M.; Muir C.A.; Kessler Iglesias C.; Bart N.K.; Muthiah K.; Kotlyar
E.; Macdonald P.; Hayward C.S.; Jabbour A.; Greenfield J.R.
Institution
(Raven, Muir, Greenfield) Department of Diabetes and Endocrinology, St
Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
(Raven, Greenfield) Clinical Diabetes, Appetite and Metabolism Laboratory,
Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
(Raven, Muir, Kessler Iglesias, Bart, Muthiah, Kotlyar, Macdonald,
Hayward, Jabbour, Greenfield) School of Clinical Medicine, St Vincent's
Campus, Faculty of Medicine and Health, University of New South Wales,
Sydney, NSW, Australia
(Kessler Iglesias, Bart, Muthiah, Kotlyar, Macdonald, Hayward, Jabbour)
Department of Heart and Lung Transplantation, St Vincent's Hospital
Sydney, Darlinghurst, NSW, Australia
(Kessler Iglesias, Bart, Muthiah, Kotlyar, Macdonald, Hayward, Jabbour)
Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiac transplantation (CTx) is a life-saving operation that
can improve the quality and length of a recipient's life.
Immunosuppression medication, required to prevent rejection, can result in
adverse metabolic and renal effects. Clinically significant complications
include metabolic effects such as diabetes and weight gain, renal
impairment, and cardiac disease such as allograft vasculopathy and
myocardial fibrosis. Sodium glucose co-transporter 2 (SGLT2) inhibitors
are a class of oral medication that increase urinary excretion of glucose.
In patients with type 2 diabetes, SGLT2 inhibitors improve cardiovascular,
metabolic and renal outcomes. Similar benefits have been shown in patients
with heart failure and reduced ejection fraction irrespective of diabetes
status. In patients with post-transplant diabetes mellitus, SGLT2
inhibitors improve metabolic parameters; however, their benefit and safety
have not been evaluated in randomised prospective studies. This study will
potentially provide a novel therapy to improve or prevent complications
(diabetes, kidney failure and heart fibrosis) that occur with
immunosuppressive medications. Methods The EMPA-HTx study is a randomised,
placebo-controlled trial of the SGLT2 inhibitor empagliflozin 10 mg daily
versus placebo in recent CTx recipients. One hundred participants will be
randomised 1:1 and commence the study medication within 6-8 weeks of
transplantation with treatment and follow-up until 12 months after
transplantation. Demographic information, anthropomorphic measurements,
pathology tests and cardiac magnetic resonance (CMR) scan will be recorded
at baseline and follow-up. Patients will be reviewed monthly during the
study until 12 months post-CTx and data will be collected for each patient
at each study visit. The overall aim of the study is to assess the safety
and efficacy of empagliflozin in CTx recipients. The primary outcome is
glycaemic improvement measured as change in glycated haemoglobin and/or
fructosamine. Key secondary outcomes are cardiac interstitial fibrosis
measured by CMR and renal function measured by estimated glomerular
filtration rate. Ethics and dissemination This study has been approved by
St Vincent's Hospital Human Research Ethics Committee (2021/ETH12184). The
findings will be presented at national and international scientific
meetings and published in peer-reviewed journals. Trial registration
number ACTRN12622000978763. <br/>Copyright &#xa9; 2023 BMJ Publishing
Group. All rights reserved.

<89>
Accession Number
2023698184
Title
Predictive Efficacy of the Index of Microcirculatory Resistance for Acute
Allograft Rejection and Cardiac Events After Heart Transplantation: A
Systematic Review and Meta-Analysis.
Source
Heart Surgery Forum. 25(5) (pp E784-E792), 2022. Date of Publication:
2022.
Author
Lu Z.; Song G.; Bai X.
Institution
(Lu, Song, Bai) Department of Cardiovascular Surgery, Qilu Hospital of
Shandong University, Jinan, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: In patients treated by heart transplantation, the index of
microcirculatory resistance (IMR) has been found to have predictive
potential for subsequent acute allograft rejection (AAR) and long-time
cardiac events. When consulting related literature, the studies mostly
were single-center with small sample sizes. The question of whether IMR
can be utilized as a predictive biomarker is becoming increasingly
contentious. To confirm the predictive efficacy of IMR, researchers did a
systematic review and meta-analysis. <br/>Method(s): From inception to
April 2022, PubMed, EMBASE, Cochrane Library, Web of Science, Ovid,
ProQuest, and Scopus systematically were searched. The results were
presented as pooled ratio rate (RR) with 95% confidence intervals (CI).
Assessment of the quality, heterogeneity analyses, and publication bias
analysis also were performed. <br/>Result(s): A total of 616 patients were
studied in five trials. There were significant differences in subsequent
AAR (RR = 4.08; 95% CI: 2.69~6.17; P = 0.000) or long-time cardiac events
(RR=2.14; 95% CI: 1.44~3.19; P = 0.000) between IMR-high and IMR-low
patients in the forest plots. Patients treated with heart transplantation
in the high IMR group had better predictive efficacy than the low IMR
group. <br/>Conclusion(s): High IMR could predict the events of subsequent
AAR and cardiac events after heart transplantation. This will help reduce
the occurrence of adverse events and personalize treatment for
patients.<br/>Copyright &#xa9; 2022 Forum Multimedia Publishing, LLC.

<90>
Accession Number
2023614573
Title
Prognostic impact of secondary prevention after coronary artery bypass
grafting - insights from the TiCAB trial.
Source
European Journal of Cardio-thoracic Surgery. 62(3) (no pagination), 2022.
Article Number: ezac048. Date of Publication: 01 Sep 2022.
Author
Heer T.; Von Scheidt M.; Boening A.; Heyken C.; Gusmini F.; De Waha A.;
Kuna C.; Fach A.; Grothusen C.; Oberhoffer M.; Knosalla C.; Walther T.;
Danner B.C.; Misfeld M.; Wimmer-Greinecker G.; Siepe M.; Grubitzsch H.;
Joost A.; Schaefer A.; Conradi L.; Cremer J.; Hamm C.; Lange R.; Radke
P.W.; Schulz R.; Laufer G.; Grieshaber P.; Attmann T.; Schmoeckel M.;
Meyer A.; Ziegelhoffer T.; Hambrecht R.; Sandner S.E.; Kastrati A.;
Schunkert H.; Zeymer U.
Institution
(Heer) Department of Cardiology, Munchen Klinik Neuperlach,
Oskar-Maria-Graf-Ring 51, Munich 81737, Germany
(Von Scheidt, Heyken, Gusmini, De Waha, Kuna, Kastrati, Schunkert)
Department of Cardiology, Deutsches Herzzentrum Munchen, Technische
Universitat Munchen, Munich, Germany
(Von Scheidt, Kastrati, Schunkert) DZHK (German Center for Cardiovascular
Research), Partner Site Munich Heart Alliance, Munich, Germany
(Boening) Department of Cardiovascular Surgery, Justus-Liebig University
Giesen, Giesen, Germany
(Fach, Hambrecht) Department of Cardiology and Angiology, Klinikum Links
der Weser, Bremen, Germany
(Grothusen, Cremer, Attmann) Department of Cardiac Surgery,
Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Oberhoffer) Department of Cardiac Surgery, Klinik und Poliklinik fur
Herz- und Gefaschirurgie, Universitatsmedizin der Johannes
Gutenberg-Universitat Mainz, Mainz, Germany
(Knosalla, Meyer) Department of Cardiothoracic and Vascular Surgery,
German Heart Institute Berlin, Berlin, Germany
(Knosalla, Meyer) DZHK (German Center for Cardiovascular Research),
Partner Site Berlin, Berlin, Germany
(Walther) Department of Cardiac Surgery, Universitatsklinikum Frankfurt,
Frankfurt am Main, Germany
(Danner) Department of Thoracic and Cardiovascular Surgery, University
Medical Center, Gottingen, Germany
(Misfeld) University Department of Cardiac Surgery, Leipzig Heart Center,
Leipzig, Germany
(Wimmer-Greinecker) Department for Cardiothoracic Surgery, Heart and
Vessel Center Bad Bevensen, Bad Bevensen, Germany
(Siepe) Department of Cardiovascular Surgery, Heart Centre Freiburg
University, University of Freiburg, Freiburg, Germany
(Grubitzsch) Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, Berlin, Germany
(Joost) Department of Cardiology Angiology and Intensive Care Medicine,
Medical Clinic II, University Hospital Schleswig-Holstein, Lubeck, Germany
(Schaefer, Conradi) Department of Cardiovascular Surgery, University Heart
Center Hamburg, Hamburg, Germany
(Hamm) Department of Cardiology, Justus-Liebig University Giesen,
Kerckhoff Campus, Giesen, Germany
(Hamm) DZHK (German Center for Cardiovascular Research), Partner Site
Rhein-Main, Rhine-Main, Germany
(Lange) Department of Cardiovascular Surgery, Deutsches Herzzentrum
Munchen, Technische Universitat Munchen, Munich, Germany
(Radke) Department of Internal Medicine-Cardiology, Schon Klinik Neustadt
SE & Co. KG, Neustadt, Germany
(Schulz) Institute of Physiology, Justus-Liebig University Giesen, Giesen,
Germany
(Laufer, Sandner) Division of Cardiac Surgery, Medical University Vienna,
Wien, Austria
(Grieshaber) Department of Cardiovascular Surgery, University of
Heidelberg, Heidelberg, Germany
(Schmoeckel) Department of Cardiac Surgery, Asklepios Klinik St. Georg,
Hamburg, Germany
(Ziegelhoffer) Department of Cardiac Surgery, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Zeymer) Klinikum Ludwigshafen and Institut fur Herzinfarktforschung
Ludwigshafen, Bremserstrase 79, Ludwigshafen 6706, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: There are disparities in the adherence to
guideline-recommended therapies after coronary artery bypass graft (CABG).
We therefore sought to evaluate the effect of guideline-adherent medical
secondary prevention on 1-year outcome after CABG. <br/>METHOD(S): Data
were taken from the randomized 'Ticagrelor in CABG' trial. From April 2013
until April 2017, patients who underwent CABG were included. For the
present analysis, we compared patients who were treated with optimal
medical secondary prevention with those where 1 or more of the recommended
medications were missing. <br/>RESULT(S): Follow-up data at 12 months were
available in 1807 patients. About half (54%) of them were treated with
optimal secondary prevention. All-cause mortality [0.5% vs 3.5%, hazard
ratio (HR) 0.14 (0.05-0.37), P < 0.01], cardiovascular mortality [0.1% vs
1.7%, HR 0.06 (0.01-0.46), P = 0.007] and major adverse events [6.5% vs
11.5%, HR 0.54 (0.39-0.74), P < 0.01] were significantly lower in the
group with optimal secondary prevention. The multivariable model for the
primary end point based on binary concordance to guideline recommended
therapy identified 3 independent factors: adherence to guideline
recommended therapy [HR 0.55 (0.39-0.78), P < 0.001]; normal renal
function [HR 0.99 (0.98-0.99), P = 0.040]; and off-pump surgery [HR 2.06
(1.02-4.18), P = 0.045]. <br/>CONCLUSION(S): Only every second patient
receives optimal secondary prevention after CABG. Guideline adherent
secondary prevention therapy is associated with lower mid-term mortality
and less adverse cardiovascular events after 12 months.<br/>Copyright
&#xa9; 2022 The Author(s). Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<91>
Accession Number
2023615028
Title
Management of mitral stenosis: a systematic review of clinical practice
guidelines and recommendations.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(6) (pp
602-618), 2022. Date of Publication: 01 Nov 2022.
Author
Galusko V.; Ionescu A.; Edwards A.; Sekar B.; Wong K.; Patel K.; Lloyd G.;
Ricci F.; Khanji M.Y.
Institution
(Galusko) Department of Cardiology, King's College Hospital, London SE5
9RS, United Kingdom
(Ionescu, Sekar) Morriston, UK Cardiac Regional Centre, Swansea Bay Health
Board, Swansea SA6 6NL, United Kingdom
(Edwards, Lloyd, Khanji) Department of Cardiology, Newham University
Hospital, Barts Health NHS Trust, Glen Road, London E13 8SL, United
Kingdom
(Wong, Patel, Lloyd, Khanji) Barts Heart Centre, Barts Health NHS Trust,
West Smithfield, London EC1A 7BE, United Kingdom
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
Institute of Advanced Biomedical Technologies, G.d'Annunzio University,
Chieti 66100, Italy
(Ricci) Department of Clinical Sciences, Lund University, Jan Waldenstroms
gata 35-205 02, Malmo SE-221 00, Sweden
(Ricci) Department of Cardiology, Casa di Cura Villa Serena, Citta
Sant'Angelo, Pescara 65013, Italy
(Khanji) NIHR Barts Biomedical Research Centre, William Harvey Research
Institute, Queen Mary University of London, London EC1A 7BE, United
Kingdom
Publisher
Oxford University Press
Abstract
A number of guidelines exist with recommendations for diagnosis and
management of mitral stenosis (MS). We systematically reviewed existing
guidelines for diagnosis and management of MS, highlighting their
similarities and differences, in order to guide clinical decision-making.
We searched national and international guidelines in MEDLINE and EMBASE
(5/4/2011-5/9/2021), the Guidelines International Network, Guideline
Library, National Guideline Clearinghouse, National Library for Health
Guidelines Finder, Canadian Medical Association Clinical Practice
Guidelines Infobase, and websites of relevant organizations. Two
independent reviewers screened titles and abstracts, and the full text of
potentially relevant articles where needed. Selected guidelines were
assessed for rigor of development; only guidelines with Appraisal of
Guidelines for Research and Evaluation II instrument score >50% were
included in the final analysis. Four guidelines were retained for
analysis. There was consensus for percutaneous mitral balloon
commissurotomy as first-line treatment of symptomatic severe rheumatic MS
with suitable anatomy. In patients with unfavourable anatomy, surgical
intervention should be considered. Exercise testing is indicated if
discrepancy exists between symptoms and echocardiographic measurements.
There was no clear divide between rheumatic MS and degenerative MS for
their respective diagnoses and management. Pregnancy in severe MS is
discouraged and the stenosis should be treated before conception.
Long-term antibiotic prophylaxis is recommended for patients with
rheumatic MS. Recommendations for the management of patients with mixed
valvular diseases are lacking.<br/>Copyright &#xa9; 2022 The Author(s).

<92>
Accession Number
2021223634
Title
Efficacy and safety of concomitant use of proton pump inhibitors with
aspirin-clopidogrel dual antiplatelet therapy in coronary heart disease: A
systematic review and meta-analysis.
Source
Frontiers in Pharmacology. 13 (no pagination), 2023. Article Number:
1021584. Date of Publication: 10 Jan 2023.
Author
Luo X.; Hou M.; He S.; Yang X.; Zhang P.; Zhao Y.; Xing H.
Institution
(Luo, Hou, He, Yang, Zhang, Zhao, Xing) Department of Pharmacy, Daping
Hospital, Army Medical University, Chongqing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Proton pump inhibitors (PPIs) are usually prescribed to
prevent gastrointestinal (GI) complications in patients receiving dual
antiplatelet therapy (DAPT). This systematic review and meta-analysis
aimed to explore the efficacy and safety of the concomitant use of PPIs
with aspirin-clopidogrel DAPT in patients with Coronary heart disease
(CHD). <br/>Method(s): The PubMed, Embase, Cochrane Library, and Web of
Science databases were searched from inception to August 2022 for eligible
studies. The adjusted hazard ratios (HRs) and 95% confidence intervals
(CIs) were calculated to evaluate the clinical outcomes. Subgroup analysis
was conducted according to different PPI subtypes, populations, follow-up
times and study types. This study was registered on PROSPERO
(CRD42022332195). <br/>Result(s): A total of 173,508 patients from 18
studies [2 randomized controlled trials (RCTs), 3 post hoc analyses of
RCTs, and 13 cohort studies] were included in this study. Pooled data
revealed that coadministration of PPIs significantly increased the risk of
major adverse cardiovascular events (MACEs) (HR = 1.15, 95% CI =
1.06-1.26, p =.001) and reduced the risk of gastrointestinal (GI)
complications (HR = 0.44, 95% CI = 0.30-0.64, p <.0001). Subgroup analysis
results showed that the esomeprazole users and patients with coronary
stenting in the PPI group were associated with an increased risk of MACEs
compared with the non-PPI group. The occurrence of MACEs in PPI users was
more common than that in non-PPI users in long-term follow-up (>=12
months) studies and in the observational studies. There was no significant
differences in the incidences of net clinical adverse events (NACEs),
all-cause mortality, or cardiac death between the two groups.
<br/>Conclusion(s): In patients with CHD, the concomitant use of PPIs with
aspirin and clopidogrel was associated with a reduced risk of GI
complications but could increase the rates of MACEs (particularly in
patients receiving esomeprazole or with coronary stenting). There was no
clear evidence of an association between PPI use and NACEs, all-cause
mortality, or cardiac death. The results could have been affected by the
follow-up time and study type. Further large-scale RCTs with long-term
follow-up are needed.<br/>Copyright &#xa9; 2023 Luo, Hou, He, Yang, Zhang,
Zhao and Xing.

<93>
Accession Number
2020482810
Title
Drug-coated balloon for the treatment of small vessel disease: 9 months of
angiographic results and 12 months of clinical outcomes of the PEPCAD
China SVD study.
Source
Catheterization and Cardiovascular Interventions. 101(1) (pp 33-43), 2023.
Date of Publication: 01 Jan 2023.
Author
Qian J.; Wu Y.; Li C.; Yin J.; Fu G.; Wang J.; He Y.; Ma G.; Xia Y.; Li
L.; Ji F.; Zeng H.; Wei M.; Nie S.; Jin H.; He B.; Chen Y.; Liu F.; Wang
H.; Sun Y.; Xu B.; Ge J.
Institution
(Qian, Wu, Li, Yin, Ge) Department of Cardiology, Zhongshan Hospital Fudan
University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
(Qian, Wu, Li, Yin, Ge) National Clinical Research Center for
Interventional Medicine, Shanghai, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhenjiang
University School of Medicine, Hangzhou, China
(Wang) Department of Cardiology, The Second Affiliated Hospital Zhejiang
University School of Medicine, Hangzhou, China
(He) Department of Cardiology, West China Hospital of Sichuan University,
Chengdu, China
(Ma) Department of Cardiology, Zhongda Hospital Southeast University,
Nanjing, China
(Chen) Department of Cardiology, Chinese PLA General Hospital, Beijing,
China
(Xia) Department of Cardiology, The Affiliated Hospital of Xuzhou Medical
University, Xuzhou, China
(Li) Department of Cardiology, The First Affiliated Hospital of Guangxi
Medical University, Nanning, China
(Ji) Department of Cardiology, Beijing Hospital of the Ministry of Health,
Beijing, China
(Zeng) Department of Cardiology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
(Wei) Department of Cardiology, Shanghai Sixth People's Hospital
Affiliated to Shanghai Jiaotong University, Shanghai, China
(Nie) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Jin) Department of Cardiology, Central Hospital of Putuo District,
Shanghai, China
(He) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong
University, Shanghai, China
(Chen) Department of Cardiology, Qilu Hospital of Shandong University,
Ji'nan, China
(Liu) Department of Cardiology, The Second Hospital of Hebei Medical
University, Shijiazhuang, China
(Wang) Department of Cardiology, Jiangsu Province Hospital, The First
Affiliated Hospital with Nanjing Medical University, Nanjing, China
(Sun) Department of Cardiology, The First Hospital of China Medical
University, Shenyang, China
(Xu) Department of Cardiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Whether the drug-coated balloons (DCBs)-alone strategy was
superior to plain old balloon angioplasty (POBA) in treating SVD remains
unknown. <br/>Aim(s): We aimed to evaluate the efficacy and safety of DCBs
for the treatment of coronary de novo small vessel disease (SVD) and
provide further evidence for extending the clinical indications of DCBs.
(ChiCTR1800014966). <br/>Method(s): Eligible patients were randomized at a
2:1 ratio to receive DCB treatment or POBA in this prospective,
multicenter clinical trial. The reference vessel diameter of lesions was
visually assessed to be 2.0 to 2.75 mm. The primary endpoint of the study
was angiographic in-segment late luminal loss (LLL) at the 9-month
follow-up to demonstrate the superiority of DCB treatment to POBA in SVD.
The composite clinical endpoints included clinically driven target lesion
revascularization (CD-TLR), target lesion failure (TLF), major adverse
cardiac events (MACEs), and thrombosis at the 12-month follow-up.
<br/>Result(s): A total of 270 patients were enrolled (181 for DCB, 89 for
POBA) at 18 centers in China. The primary endpoint of 9-month in-segment
LLL in the intention-to-treat population was 0.10 +/- 0.33 mm with DCB and
0.25 +/- 0.38 mm with POBA (p = 0.0027). This difference indicated
significant superiority of DCB treatment (95% CI: -0.22, -0.04,
p<inf>superiority</inf> = 0.0068). The rates of the clinical
endpoints-CD-TLR, TLF, and MACEs-were comparable between groups. No
thrombosis events were reported. <br/>Conclusion(s): DCB treatment of de
novo SVD was superior to POBA with lower 9-month in-segment LLL. The rates
of clinical events were comparable between the two devices.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<94>
Accession Number
2020155279
Title
Risk Factors for Tube Feeding at Discharge in Infants Undergoing Neonatal
Surgery for Congenital Heart Disease: A Systematic Review.
Source
Pediatric Cardiology. 44(4) (pp 769-794), 2023. Date of Publication: April
2023.
Author
Elgersma K.M.; Trebilcock A.L.; Whipple M.O.; Tanner L.R.; Pilditch S.J.;
Shah K.M.; McKechnie A.C.
Institution
(Elgersma, Trebilcock, Whipple, Tanner, Pilditch, McKechnie) University of
Minnesota School of Nursing, Minneapolis, MN, United States
(Tanner) Children's Minnesota, Minneapolis, MN, United States
(Shah) Department of Pediatrics, M Health Fairview University of Minnesota
Masonic Children's Hospital, Minneapolis, MN, United States
Publisher
Springer
Abstract
Approximately 30-50% of infants undergoing neonatal surgery for congenital
heart disease (CHD) cannot meet oral feeding goals by discharge and
require feeding tube support at home. Feeding tubes are associated with
increased readmission rates and consequent hospital, payer, and family
costs, and are a burden for family caregivers. Identification of
modifiable risk factors for oral feeding problems could support targeted
care for at-risk infants. Therefore, the aim of this systematic review is
to determine risk factors for tube feeding at discharge in infants
undergoing neonatal surgery for CHD. Following Preferred Reporting Items
for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a search was
conducted using MEDLINE, CINAHL, and Cochrane Database of Systematic
Reviews. Studies published before 2010 were excluded. The search resulted
in 607 records, of which 18 were included. Studies were primarily
retrospective cohort designs and results were often inconsistent. Study
quality was assessed using the Joanna Briggs Critical Appraisal Tools. As
a group, the studies exhibited substantial risk for bias. Based on the
findings, infants who struggle with feeding preoperatively, experience
increased nil per os duration and/or low oral feeding volume
postoperatively, experience increased duration of mechanical ventilation,
or have vocal cord dysfunction may be at risk for tube feeding at hospital
discharge. Factors warranting further examination include cardiac
physiology (e.g., aortic arch obstruction) and the relationship between
neurodevelopment and oral feeding. Clinicians should use caution in
assuming risk for an individual and prioritize early implementation of
interventions that facilitate oral feeding development.<br/>Copyright
&#xa9; 2022, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<95>
Accession Number
2023630477
Title
Mapping a DSA-Negative ABMR-Like State in Lung Transplants That is Highly
Associated with NK Cells.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S53-S54), 2023. Date of Publication: April
2023.
Author
Gauthier P.T.; Mackova M.; Halloran K.; Halloran P.F.; Collaborators I.
Institution
(Gauthier, Mackova) Alberta Transplant Applied Genomics Centre, Edmonton,
AB, Canada
(Halloran, Halloran) University of Alberta, Edmonton, AB, Canada
(Collaborators) .,., AB, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: ABMR is now recognized as frequently DSA -ve in kidney (AJT
2022;22:1976) and heart (JHLT 2022: 41:334) transplants and has little
short-term impact on survival when TCMR is absent. We studied if lung
transplants also manifest a DSA -ve ABMR-like state. <br/>Method(s): We
studied 896 transbronchial biopsies (TBB) from 672 patients (INTERLUNG
ClinicalTrials.gov: NCT02812290) using genome-wide microarrays. Only 3%
were diagnosed as clinical ABMR by the centers. We developed new
rejection-associated transcript sets and studied their expression in TBB
using PCA and archetypal analysis. <br/>Result(s): We identified four
groups (fig 1a): R1 no rejection, n=493; R2 TCMR n=94; and R3 ABMR-like,
n=238; 71 R4 biopsies with low surfactant were removed from analysis.
ABMR-like biopsies were only 24% DSA +ve, similar to no rejection (26%);
TCMR was 42% DSA +ve. Negative PC2 was associated with graft loss,
reflecting TCMR (fig 1a). In genome-wide analysis, the top 20 genes
associated with the ABMR-like state were all highly expressed in NK cells
(table 2); IFNG-inducible transcripts were also increased in ABMR-like
biopsies and TCMR. The ABMR-like state was not associated with CLAD, and
had no effect on three-year graft survival (fig 1b). R2 TCMR was
associated with increased three-year graft loss (fig a,b), as was clinical
CLAD (fig 1c); TCMR was especially deleterious when associated with CLAD
(fig 1d). <br/>Conclusion(s): Lung transplants frequently manifest a DSA
-ve pure ABMR-like state, highly associated with NK cell transcripts and
IFNG-inducible transcripts, that has little impact on short term survival
(similar to DSA -ve ABMR in kidney and heart transplants).<br/>Copyright
&#xa9; 2023

<96>
Accession Number
2023630370
Title
Bridge to Transplant and Transplant Outcomes in Cardiac Amyloidosis: A
Systematic Review.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S248), 2023. Date of Publication: April 2023.
Author
Raftopulos N.; Gorrie N.; Bart N.
Institution
(Raftopulos) St Vincent's Hospital, Darlinghurst, Sydney, Australia
(Gorrie) St Vincent's Hospital Sydney, Darlinghurst, Australia
(Bart) St Vincent's Hospital, Sydney, Australia
Publisher
Elsevier Inc.
Abstract
Purpose: Amyloid cardiomyopathy (ACM) is a progressive and
life-threatening disease caused by abnormal protein deposits in cardiac
tissue. The most common causes of ACM are immunoglobulin light chains (AL)
and transthyretin (ATTR). Orthotopic heart transplantation (OHT) remains
the only definitive treatment for patients with end-stage heart failure.
Mechanical circulatory support (MCS) may be considered as bridge to
transplant but with typically relatively small left ventricular cavity
size and increased wall thickness, MCS in ACM is limited by anatomical
suitability. Studies have historically found ACM patients have performed
poorly with OHT. This study aimed to evaluate the outcomes of OHT and MCS
in ACM. <br/>Method(s): We systematically searched OVID, PubMed and
Cochrane Review following PRISMA guidelines. A total of 79 studies
examining 2535 patients with ACM were included; 91 had MCS (13 studies),
2444 had OHT (67 studies), 198 had combined heart/liver transplantation
(CHL) (21 studies) with 24 case studies. The results of 2535 patients were
pooled for analysis. <br/>Result(s): There were 2444 OHT patients [M=1197
(49%) F =438 (18%) Unspecified = 809 (33%)]. Sub-typing was limited with
313 AL and 246 TTR reported cases. For OHT cases, studies after 2012 for
1- and 5-year survival rates (%) ranged from 77 to 95 and 43 to 100
respectively, compared to before 2012 from 50 to 85 and 35 to 91,
respectively. The largest registry documented 1- and 5-year survival rates
(%) between 2016 and 2019 at 88 and 72. Common reported adverse events
were infection, acute graft rejection and disease recurrence. For MCS
types; 56 left ventricular assist devices, 8 biventricular assist devices
and 25 total artificial hearts were included. In MCS cases, 62% had ATTR,
42% AL, 68 were male and 13 were female. Bleeding and device-related
infection were the most common adverse effects, with minimal reported
embolic events. When compared with non-ACM patients who received MCS, ACM
patients had the highest rates of biventricular support and worst
survival. <br/>Conclusion(s): Current advancements have demonstrated
better outcomes for ACM patients. ACM patients have comparable transplant
outcomes to non-ACM. The use of MCS is still limited, with less than 4% of
OHT cases here undergoing MCS prior, compared to the general OHT
population where this is >40%. Outcomes in ACM are poorer with MCS; hence
ACM patients should be referred early for OHT.<br/>Copyright &#xa9; 2023

<97>
Accession Number
2023630270
Title
As Comfortable as a Pillow: The Superiority of the Sternasafe Device Over
the Standard of Care.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S249), 2023. Date of Publication: April 2023.
Author
Ochoa E.; Jain S.; Rodgers D.; de Matos S.N.; Uppalapati S.C.; Bangaru S.;
Johnson K.; Sudheendra K.; Ram K.; Hynes D.; Sorensen K.; Paluri S.N.;
Madhushankar A.; Jeevanandam V.
Institution
(Ochoa) Washington University in St. Louis School of Medicine, St. Louis,
MO, United States
(Jain, Rodgers, de Matos, Uppalapati) University of Chicago, Chicago, IL,
United States
(Bangaru, Johnson) Illinois Mathematics and Science Academy, Aurora, IL,
United States
(Sudheendra) Hinsdale Central High School, Hinsdale, IL, United States
(Ram) University of Michigan, Ann Arbor, MI, United States
(Hynes) Hamilton College, Clinton, NY, United States
(Sorensen) Dominican University, River Forest, IL, United States
(Paluri) Chicago College of Osteopathic Medicine, Midwestern University,
Chicago, IL, United States
(Madhushankar) Adlai E. Stevenson High School, Lincolnshire, IL, United
States
(Jeevanandam) University of Chicago Medical Center, Chicago, IL, United
States
Publisher
Elsevier Inc.
Abstract
Purpose: Median sternotomies (MS) are a treatment modality for advanced
heart failure. After MS, post operative care is essential, especially
during painful coughing and sneezing actions. The status quo sternal
support standard of care (SOC) is for patients to squeeze specialized bed
pillows to their chests while performing breathing intensive activities.
However, there are ease of use and complication reduction concerns for the
manually operated SOC. SternaSafe, an adjustable, worn, sternal supportive
device aims to enhance the SOC for post MS patients. <br/>Method(s): An
open-label, non-crossover, randomized trial that compared comfort and pain
management among PMS cardiac surgery patients who used the SOC bed pillow
versus patients who used SternaSafe. After a baseline, T=1, assessment,
patients were followed through postoperative days 7, 14, 21, and 30 to
assess comfort and pain. Pain was assessed using a scale of 0-10 with 0
being no pain and 10 being extreme pain. Comfort was measured with 0 being
uncomfortable/difficult to use and 10 being extreme comfort. A p-value
<0.05 was considered statistically significant. <br/>Result(s):
Twenty-five PMS SOC using patients and twenty-four SternaSafe using
patients met the inclusion criteria. We reviewed data of patients that
successfully completed the trial. There were no significant differences in
baseline characteristics. SternaSafe users reported an average device
comfort ranging from 7.4 to 8.4, demonstrating comfort and ease of use. At
30 days, a statistically significant p-value of 0.022 was observed for
pain. <br/>Conclusion(s): Although statistical significance wasn't
observed, there was a lower average number of morphine equivalents used
amongst men using SternaSafe: 226.4 versus 215.3 mg. At 30 days, a
statistically significant p-value of 0.022 was observed, exhibiting lower
pain with SternaSafe. A multicenter trial should be conducted to determine
SternaSafe's reduction in length of stay, QOL improvement, and reduction
of morphine equivalents in women.<br/>Copyright &#xa9; 2023

<98>
Accession Number
2023630208
Title
Mechanical Circulatory Support Using Impella 5.5 for Patients Presented
with Ischemic Heart Disease and Severely Impaired Left Ventricular
Function Undergoing Coronary Artery Bypass Surgery: A Three-Year Single
Centre Experience.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S406), 2023. Date of Publication: April 2023.
Author
Shehada S.; Jasarevic M.; Jarkas S.; Haddad A.; Al-Rashid F.; Thielmann
M.; Koch A.; Pizanis N.; Kamler M.; Ruhparwar A.; Schmack B.
Institution
(Shehada, Jasarevic, Jarkas, Thielmann, Koch, Pizanis, Kamler, Ruhparwar,
Schmack) Department of Thoracic and Cardiovascular Surgery, West German
Heart and Vascular Center, University Hospital Essen, Essen, Germany
(Haddad) Department of Anesthesiology and Intensive Care Medicine,
University Hospital Essen, Essen, Germany
(Al-Rashid) Department of Cardiology and Angiology, West German Heart and
Vascular Center, University Hospital Essen, Essen, Germany
Publisher
Elsevier Inc.
Abstract
Purpose: Management of patients presenting with severely impaired left
ventricular function (SI-LVF) due to ischemic heart disease (IHD) and
undergoing coronary artery bypass grafting (CABG) is complicated and
associated with high morbidities as well as poor early and late survival
outcomes. Mechanical circulatory support (MCS) using extracorporeal
membrane oxygenation is considered as the main bail out strategy for such
patients. Recently, the use of Impella 5.5 as minimal invasive MCS is
gaining more adoption. We are evaluating patients presented with SI-LVF
due to IHD, undergoing CABG surgery and supported with Impella 5.5.
<br/>Method(s): Between 08/2019 through 10/2022, 23 consecutive patients
presented with IHD and SILVF, undergoing CABG and supported with impella
5.5 in our department are retrospectively evaluated. Impella 5.5
implantation was preemptively within the initial procedure in 65.2%, hours
later within the operative day in 13% and later than 2 days in 21.8% of
the patients. Endpoints are early and late survival outcomes.
<br/>Result(s): Mean age was 64.8+/-10.5 years; most of the patients were
male (82.6%). Mean ejection fraction was 23.4+/-8.8%, logistic EuroScore
was 22.3+/-19.6% and STS-PROM was 4.1+/-4.0%. About 43.5% of the patients
presented with acute coronary syndrome and cardiogenic shock and underwent
urgent or emergent surgery.CABG was concomitant with other surgeries in
21.7% of patients. Early outcomes reported incidence of acute kidney
failure requiring dialysis in 30.4%, stroke in 13%, revision for bleeding
in 43.5% of patients. Successful weaning was reported in 52.2%, switch to
long-term assist device in 13% and 30-day mortality in 34.8% (stroke
related in 13%), of patients. During a mean follow-up time of 355+/-265
days, Impella related complications were reported in one patient and
one-year mortality was reported in 43.5% of patients. <br/>Conclusion(s):
In patients with IHD and severely impaired-LFV undergoing CABG surgery,
Impella 5.5 provides a good alternative MCS as a bridge to therapy or to
long-term assist device implantation. Impella related complications are so
far scanty observed. Prospective randomized studies with larger cohort are
warranted to prove these promising results.<br/>Copyright &#xa9; 2023

<99>
Accession Number
2023629862
Title
Relationship Between Absolute Quantification of Donor-Derived Cell-Free
DNA and Donor-Derived Cell-Free DNA Fraction for Detection of Allograft
Rejection in Heart Transplant Patients.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S428-S429), 2023. Date of Publication: April
2023.
Author
Patel S.; Uriel N.; Nguyen A.; Silvia B.; Wolf-Doty T.; Tian W.; Qu K.;
Pinney S.
Institution
(Patel) Montefiore-Einstein, Bronx, NY, United States
(Uriel) New York Presbyterian, New York, NY, United States
(Nguyen, Silvia, Wolf-Doty, Tian, Qu) CareDx, Brisbane, CA, United States
(Pinney) University of Chicago, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Percent donor-derived cell-free DNA (dd-cfDNA %) has been widely
used as a validated diagnostic tool for allograft rejection. There has
been interest in evaluating whether absolute copies (AbC) of dd-cfDNA
could improve the assessment of rejection. We aimed to compare the value
of AbC to dd-cfDNA % in heart transplant patients to discriminate
allograft rejection. <br/>Method(s): Blood samples were assessed within 7
days of, and prior to, endomyocardial biopsy (EMB) from a sub-set of
patients in the multi-center Surveillance HeartCare Outcomes Registry
(SHORE, ClinicalTrials.gov Identifier: NCT03695601) where dd-cfDNA %, AbC
of dd-cfDNA and EMB were able to be obtained. Dd-cfDNA % was performed
using AlloSure (CareDx, Inc) and total cfDNA was quantified using
Tapestation 4200. AbC was computed from dd-cfDNA % and total cfDNA,
accounting for process efficiencies. Rejections were defined as ACR (ISHLT
grade >=2R), AMR (ISHLT grade >=pAMR1) or mixed rejection. Receiver
Operator Curve (ROC) analysis was performed to compare the ability of
dd-cfDNA, AbC and their combination to discriminate rejection vs
non-rejection. <br/>Result(s): There were 299 blood samples from 226
patients in this cohort. This included 204 no rejection and 95 rejection
(46 ACR, 48 AMR, 1 mixed) cases. In a pairwise comparison, identification
of allograft rejection was not significantly different in dd-cfDNA % vs
AbC (p=0.44) or dd-cfDNA % vs combination (p=0.68). The AUCs for dd-cfDNA
%, AbC and the combination were 0.72, 0.69 and 0.71, respectively. (Figure
1) <br/>Conclusion(s): The performance of AbC and dd-cfDNA % in
discriminating rejection from no rejection was similar. AbC may not
provide additional value compared to quantifying the percentage of
dd-cfDNA. It is noted that the analytical accuracy of AbC has not yet been
established at very low dd-cfDNA levels, therefore future efforts are
needed to understand its diagnostic role.<br/>Copyright &#xa9; 2023

<100>
Accession Number
2023629692
Title
COVID-19 Vaccination Strategies in Solid Organ Transplant Recipients: A
Living Systematic Review and Network Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S13), 2023. Date of Publication: April 2023.
Author
Rayner D.G.; Nunes J.T.; Chu A.; Orchanian-Cheff A.; Foroutan F.; Rotstein
C.; Ross H.J.; Aleksova N.
Institution
(Rayner, Chu) McMaster University, Hamilton, ON, Canada
(Nunes, Orchanian-Cheff, Foroutan, Rotstein, Ross, Aleksova) Toronto
General Hospital, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: The optimal COVID-19 vaccination strategy in solid organ
transplant recipients (SOTRs) remains unclear. We conducted a living
systematic review and network meta-analysis (NMA) to explore COVID-19
vaccination strategies in SOTRs. <br/>Method(s): We conducted a search of
databases from inception to July 2022 for all studies comparing any
COVID-19 vaccination strategy in SOTRs. We performed a NMA to evaluate the
impact of various vaccination strategies on COVID-19 infection, and
COVID-related mortality. We used the GRADE approach for NMA to judge our
certainty in the evidence. <br/>Result(s): Of 2,534 publications
identified, 27 proved eligible (4 RCTs, 23 observational). Identified RCTs
were only subject to narrative summarization due to heterogeneity in their
research questions (Figure A). Nine observational studies (76,703 SOTRs,
6.3% heart transplant, 5.2% lung transplant) reported adjusted hazard
ratios (HRs) for COVID-19 infection and/or COVID-related mortality. The
NMA for the impact of various doses of vaccines on COVID-19 infection
suggested a dose-response relationship (Figure B). Compared to no
vaccination, three (HR 0.16, 95%CI 0.11-0.22, moderate certainty) or two
(HR 0.45, 95%CI 0.35-0.58, moderate certainty) doses of any COVID-19
vaccine showed a strong effect on reducing COVID-19 infection. One dose
showed a moderate effect (HR 0.73, 95%CI 0.49-1.07, low certainty) on
reducing COVID-19 infection. Two doses of any vaccine showed a moderate
effect on lowering risk of mortality in COVID-19 infected SOTRs (HR 0.74,
95%CI 0.63-0.89, low certainty). We did not identify sufficient data to
explore effect modification by organ group or immunosuppressant use.
<br/>Conclusion(s): Current evidence suggests that increasing the number
of COVID-19 vaccination doses may provide increasing protection against
COVID-19 infection in SOTRs (moderate to low certainty). Further studies
are needed to better understand the impact of COVID-19 vaccination on all
patient-important outcomes.<br/>Copyright &#xa9; 2023

<101>
Accession Number
2023629606
Title
Characteristics and Outcomes of Cardiac Amyloidosis after Heart
Transplantation: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S287), 2023. Date of Publication: April 2023.
Author
Yan V.; Ahmad D.; Im M.; Brailovsky Y.; Rajapreyar I.; Storozynsky E.;
Rame J.; Rajagopal K.; Entwistle J.W.; Massey H.; Tchantchaleishvili V.
Institution
(Yan, Ahmad, Im, Brailovsky, Rajapreyar, Storozynsky, Rame, Rajagopal,
Entwistle, Massey, Tchantchaleishvili) Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Amyloidosis patients with cardiac involvement infrequently
undergo heart transplantation (HTx) due to the associated poor outcomes.
Large databases do not provide sufficient granularity to allow for
differentiation between its major subtypes [light-chain (AL) and
transthyretin (ATTR) amyloidosis]. We sought to pool the existing data on
amyloidosis patients undergoing HTx, and perform stratified analysis based
on its major subtypes. <br/>Method(s): Electronic search identified adult
patients with amyloidosis undergoing HTx. Cohort-level data for 340
patients from 19 studies were extracted and analyzed. Patients were
categorized based on amyloid subtype into AL and ATTR groups.
<br/>Result(s): AL amyloidosis was diagnosed at an earlier age compared to
ATTR [53 (95% CI 48; 57) years vs. 63 (55; 71) years, p=0.03], with
greater incidence in the Caucasian population [75% (60; 87) vs. 39% (21;
59), p= <0.01]. Females comprised 33% (25; 41) of the patients with
greater preponderance in AL subgroup [41% (33; 48) vs. 21% (8; 36),
p=0.02]. AL patients also had higher involvement of >=2 organs [50% (29;
70) vs. 15% (3; 32), p=0.01]. GI amyloidosis [25% (6; 50) vs. 0% (0; 8),
p=0.02], and renal amyloidosis [20% (8; 34) vs. 0% (0; 2), p<0.01] were
virtually limited to AL, while ATTR patients had more Implantable
Cardioverter Defibrillator implanted [64% (34; 90) vs. 15% (6; 28),
p<0.01] and trended towards greater incidence of neuropathy [24% (9; 42)
vs. 9% (2; 19), p=0.07]. The AL group had a significantly higher incidence
of recurrent amyloidosis [16% (7; 27) vs. 0(0; 0), p= <0.01]. Pooled
Kaplan-Meier survival analysis (Figure) showed worse long-term survival in
the AL group (p=0.02). <br/>Conclusion(s): Patients with AL amyloidosis
showed more widespread systemic involvement and worse long-term survival
after HTx compared to patients with ATTR amyloidosis. Protocols for
mitigating the recurrence of AL amyloidosis are needed to improve survival
in this high-risk subtype.<br/>Copyright &#xa9; 2023

<102>
Accession Number
2023629556
Title
Changes in Pulse Pressure after 24 Hours of Initiation of Inotrope Therapy
in Cardiogenic Shock is Associated with Adverse Outcomes.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S197-S198), 2023. Date of Publication: April
2023.
Author
Han J.; Grinstein J.; Santo P.D.; Hibbert B.; Belkin M.
Institution
(Han, Grinstein, Belkin) University of Chicago Medical Center, Chicago,
IL, United States
(Santo, Hibbert) University of Ottawa Heart Institute, Ottawa, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiogenic shock (CS) is a leading cause of in-hospital
morbidity and mortality. We sought to determine the association between
serial changes in hemodynamics after initiation of inotrope therapy and
outcomes. <br/>Method(s): Data were obtained from the DOREMI randomized
clinical trial. A total of 155 participants with SCAI Stage C CS at a
single center from 9/2017 to 5/2020 were included. Participants received
either dobutamine or milrinone for CS. Serial measurements of pulse
pressure and percent change from baseline were measured at 4, 12, and 24
hours after initiation of inotropes. The primary outcome was a composite
of in-hospital death, resuscitated cardiac arrest, cardiac transplant or
mechanical support, non-fatal myocardial infarction, cerebrovascular event
or renal replacement therapy. The secondary outcome was in-hospital death.
<br/>Result(s): The cohort was predominantly male (62.6%), with a mean age
of 70.6+/-12.5 years. A total of 77 (49.7%) participants received
milrinone, and the remaining received dobutamine. At baseline, patients
with SCAI stage C CS had median pulse pressure of 45 (IQR: [34, 56]) mmHg.
Lower absolute change in pulse pressure at 24 hours was associated with
the primary outcome (median 2 with IQR: [-4, 10] vs. 9 with IQR [-4, 20]
mmHg, p=0.03) and secondary outcome (p=0.027). Participants who met the
primary outcome had reduced percent change in pulse pressure compared to
baseline (median 4.3% IQR: [-7.7%, 23.8%] vs. 16.5% IQR: [-9.6%, 52.9%],
p=0.05). Pulse pressure alone at each time point was not associated with
primary outcome (0 hours: p=0.46, 4 hours: p=0.85, 12 hours p=0.89, 24
hours p=0.10). <br/>Conclusion(s): In patients with SCAI Stage C CS,
reduced absolute or percent change in pulse pressure at 24 hours after
initiation of an inotrope is associated with adverse cardiovascular
outcomes. This dynamic change may be considered for decisions regarding
early escalation of therapy.<br/>Copyright &#xa9; 2023

<103>
Accession Number
2023629454
Title
Custodiol-N versus Custodiol: Results from a Prospective Randomised Single
Blind, Multicenter Phase Iii Trial in Patients Undergoing Heart
Transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 43rd Annual
Meeting and Scientific Sessions. Colorado Convention Center, Denver United
States. 42(4 Supplement) (pp S277), 2023. Date of Publication: April 2023.
Author
Aliabadi-Zuckermann A.; Osorio-Jaramillo E.; Knosalla C.; Gummert J.;
Szabo G.; Wittmann F.; Yeter R.; Schramm R.; Goekler J.; Hennig F.;
Morshuis M.; Zuckermann A.
Institution
(Aliabadi-Zuckermann) Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Osorio-Jaramillo) Medical University of Vienna, Vienna, Austria
(Knosalla, Hennig) Deutsches Herzzentrum Berlin, Berlin, Germany
(Gummert) Herz und Diabeteszentrum NRW, Bad Oeynhausen, Germany
(Szabo) Universitatsklinikum Halle, Halle, Germany
(Wittmann) Medical Univ of Vienna AKH Vienna, Wien, 9, Austria
(Yeter) German Heart Institute, BE, Berlin, Germany
(Schramm, Morshuis) Heart Center NRW, Bad Oeynhausen, Germany
(Goekler) Med Univ Vienna, Wien, Austria
(Zuckermann) Medical University of Vienna, Wien, Austria
Publisher
Elsevier Inc.
Abstract
Purpose: Custodiol solution (HTK) is a well-established preservation
solution in organ transplantation. Custodiol-N (HTK-N), is a novel
HTK-based solution, which includes iron chelators to reduce oxidative
injury, as well as L-arginine, to improve endothelial cell function.
Earlier results in coronary artery bypass surgery, showed good cardiac
protection without any safety concerns. The aim of this study was to
evaluate the safety and ability of Custodiol-N to preserve cardiac grafts
for heart transplantation Methods: This prospective randomised, single
blind multicenter non-inferiority trial was performed at 3 centers in
Austria and Germany. 105 patients were randomized to HTK N (n=53) or HTK
(n=52) as preservation solution for their donor hearts. The primary
endpoint was creatine kinase (CK-MB) peak value from 4-168 hours after
opening of cross clamp, with a 30% non-inferiority margin. Secondary
efficacy endpoints were patient survival, incidence of primary graft
failure, length of intensive care unit stay. The primary endpoint was
analysed in per-protocol (PP) population, whereas other endpoints were
analysed in both as treated and PP populations. <br/>Result(s): Median
donor age (41years (range:21-64) vs. 46 years (18-67);p=n.s.) and ischemic
times (212.5min (range:85-356) vs. 201.5 min.(range: 108-345); p=n.s.)
were comparable between HTK-N and HTK groups. For the PP data set, 19
patients (HTK-N n=12, HTK n=7) were excluded due to missing CK-MB values.
Average CK-MB peak values 178.17+/-202.41 U/L in the HTK group compared to
136.29+/-70,72 U/L in the HTK-N Group (p-value for non-inferiority of
HTK-N by 30% <.0001). Patient survival were comparable between groups at
30 days and 1-year post transplantation (HTK-N: 100%, 88,7%; HTK: 98.1%,
90,4%, p=0.83). The incidence of primary graft failure was 21.5% in the
HTK and 11.3% in HTK-N group (p=0.19). Median length of intensive care
unit stay was 8 days (25%-75%: 5-11 days) in the HTK-N group compared to
11 days in the HTK group (25%-75%: 6-19 days; p=0.13). Safety assessment
showed even distributed adverse events with only 7 (HTK:n=4, HTK-N:n=3)
possibly related to the preservation solutions. <br/>Conclusion(s): This
study shows that HTK-N is safe and provides similar cardiac protection as
the established HTK solution. Both solutions were safe to use in clinical
heart transplantation.<br/>Copyright &#xa9; 2023