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<1>
Accession Number
2023101193
Title
A Randomized Trial of an Exclusive Human Milk Diet in Neonates with Single
Ventricle Physiology.
Source
Journal of Pediatrics. 256 (pp 105-112.e4), 2023. Date of Publication: May
2023.
Author
Blanco C.L.; Hair A.; Justice L.B.; Roddy D.; Bonagurio K.; Williams P.K.;
Machado D.; Marino B.S.; Chi A.; Takao C.; Gordon E.E.; Ashrafi A.; Cacho
N.; Pruetz J.D.; Costello J.M.; Cooper D.S.
Institution
(Blanco, Bonagurio) Division of Neonatology, Department of Pediatrics,
University of Texas Health Science Center and University Health, San
Antonio, TX, United States
(Hair) Division of Neonatology, Department of Pediatrics, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
(Justice) Department of Cardiology, The Heart Institute, Cincinnati
Children's Hospital Medical Center, Cincinnati, OH, United States
(Roddy) Division of Pediatric Critical Care, Department of Pediatrics,
Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United
States
(Williams) Division of Neonatal Perinatal Medicine, Department of
Pediatrics, Oklahoma Children's Hospital, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Machado) Pediatric Cardiac ICU, Congenital Heart Center, Shands Hospital
University of Florida, Gainesville, FL, United States
(Marino, Costello) Department of Pediatrics, Ann & Robert H. Lurie
Children's Hospital of Chicago, Chicago, IL, United States
(Marino) Department of Pediatric Cardiology, Cleveland Clinic Children's,
Cleveland, OH, United States
(Chi) Division of Neonatology, Cook Children's Medical Center, Fort Worth,
TX, United States
(Takao, Pruetz) Division of Cardiology, Department of Pediatrics,
Children's Hospital of Los Angeles, University of Southern California, Los
Angeles, CA, United States
(Gordon) Division of Critical Care, Department of Pediatrics, University
of Texas Southwestern., Dallas, TX, United States
(Ashrafi) Department of Pediatrics, Children's Hospital of Orange County,
Orange, CA, United States
(Cacho) Division of Neonatology, Congenital Heart Center, Department of
Pediatrics, Shands Hospital University of Florida, Gainesville, FL, United
States
(Costello) Pediatric Cardiology, Department of Pediatrics, Shawn Jenkins
Children's Hospital, Medical University of South Carolina, Charleston, SC,
United States
(Cooper) The Heart Institute, Cincinnati Children's Hospital Medical
Center, Department of Pediatrics, University of Cincinnati College of
Medicine, Cincinnati, OH, United States
Publisher
Elsevier Inc.
Abstract
Objective: To determine whether weight gain velocity (g/kg/day) 30 days
after the initiation of feeds after cardiac surgery and other clinical
outcomes improve in infants with single ventricle physiology fed an
exclusive human milk diet compared with a mixed human and bovine diet.
Study design: In this multicenter, randomized, single blinded, controlled
trial, term neonates 7 days of age or younger with single ventricle
physiology and anticipated cardiac surgical palliation within 30 days of
birth were enrolled at 10 US centers. Both groups received human milk if
fed preoperatively. During the 30 days after feeds were started
postoperatively, infants in the intervention group received human milk
fortified once enteral intake reached 60 mL/kg/day with a human milk-based
fortifier designed for term neonates. The control group received standard
fortification with formula once enteral intake reached 100 mL/kg/day.
Perioperative feeding and parenteral nutrition study algorithms were
followed. <br/>Result(s): We enrolled 107 neonates (exclusive human milk =
55, control = 52). Baseline demographics and characteristics were similar
between the groups. The median weight gain velocity at study completion
was higher in exclusive human milk vs control group (12 g/day [IQR, 5-18
g/day] vs 8 g/day [IQR, 0.4-14 g/day], respectively; P = .03). Other
growth measures were similar between groups. Necrotizing enterocolitis of
all Bell stages was higher in the control group (15.4 % vs 3.6%,
respectively; P = .04). The incidence of other major morbidities, surgical
complications, length of hospital stay, and hospital mortality were
similar between the groups. <br/>Conclusion(s): Neonates with single
ventricle physiology have improved short-term growth and decreased risk of
NEC when receiving an exclusive human milk diet after stage 1 surgical
palliation. Trial Registration: This trial is registered with
ClinicalTrials.gov (www.clinicaltrials.gov, Trial ID:
NCT02860702).<br/>Copyright &#xa9; 2022 Elsevier Inc.

<2>
Accession Number
2023079816
Title
Understanding post-surgical decline in left ventricular function in
primary mitral regurgitation using regression and machine learning models.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1112797. Date of Publication: 2023.
Author
Zheng J.; Li Y.; Billor N.; Ahmed M.I.; Fang Y.-H.D.; Pat B.; Denney T.S.;
Dell'Italia L.J.
Institution
(Zheng, Li, Billor) Department of Mathematics and Statistics, Auburn
University, Auburn, AL, United States
(Ahmed, Pat, Dell'Italia) Division of Cardiovascular Disease, University
of Alabama at Birmingham, Birmingham, AL, United States
(Fang) Department of Radiology, University of Alabama at Birmingham,
Birmingham, AL, United States
(Pat, Dell'Italia) Birmingham Veterans Affairs Health Care System,
Birmingham, AL, United States
(Denney) Department of Electrical and Computer Engineering, Samuel Ginn
College of Engineering, Auburn University, Auburn, AL, United States
Publisher
Frontiers Media S.A.
Abstract
Background: Class I echocardiographic guidelines in primary mitral
regurgitation (PMR) risks left ventricular ejection fraction (LVEF) < 50%
after mitral valve surgery even with pre-surgical LVEF > 60%. There are no
models predicting LVEF < 50% after surgery in the complex interplay of
increased preload and facilitated ejection in PMR using cardiac magnetic
resonance (CMR). <br/>Objective(s): Use regression and machine learning
models to identify a combination of CMR LV remodeling and function
parameters that predict LVEF < 50% after mitral valve surgery.
<br/>Method(s): CMR with tissue tagging was performed in 51 pre-surgery
PMR patients (median CMR LVEF 64%), 49 asymptomatic (median CMR LVEF 63%),
and age-matched controls (median CMR LVEF 64%). To predict post-surgery
LVEF < 50%, least absolute shrinkage and selection operator (LASSO),
random forest (RF), extreme gradient boosting (XGBoost), and support
vector machine (SVM) were developed and validated in pre-surgery PMR
patients. Recursive feature elimination and LASSO reduced the number of
features and model complexity. Data was split and tested 100 times and
models were evaluated via stratified cross validation to avoid
overfitting. The final RF model was tested in asymptomatic PMR patients to
predict post-surgical LVEF < 50% if they had gone to mitral valve surgery.
<br/>Result(s): Thirteen pre-surgery PMR had LVEF < 50% after mitral valve
surgery. In addition to LVEF (P = 0.005) and LVESD (P = 0.13), LV
sphericity index (P = 0.047) and LV mid systolic circumferential strain
rate (P = 0.024) were predictors of post-surgery LVEF < 50%. Using these
four parameters, logistic regression achieved 77.92% classification
accuracy while RF improved the accuracy to 86.17%. This final RF model was
applied to asymptomatic PMR and predicted 14 (28.57%) out of 49 would have
post-surgery LVEF < 50% if they had mitral valve surgery.
<br/>Conclusion(s): These preliminary findings call for a longitudinal
study to determine whether LV sphericity index and circumferential strain
rate, or other combination of parameters, accurately predict post-surgical
LVEF in PMR.<br/>Copyright 2023 Zheng, Li, Billor, Ahmed, Fang, Pat,
Denney and Dell'Italia.

<3>
Accession Number
2022267283
Title
Appropriateness of Percutaneous Coronary Interventions: A Systematic
Review and Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 10(3) (no pagination),
2023. Article Number: 93. Date of Publication: March 2023.
Author
Chen Y.; Chang Z.; Han Y.; Tang S.; Zhao Y.; Fu J.; Liu Y.; Fan Z.
Institution
(Liu, Chen, Han, Tang, Zhao, Fu, Liu, Fan) Department of Cardiology,
Peking Union Medical College Hospital, Peking Union Medical College and
Chinese Academy of Medical Sciences, Beijing 100730, China
(Chang) Department of Respiratory, Civil Aviation General Hospital,
Beijing 100123, China
Publisher
MDPI
Abstract
Background: Since the foundation of appropriate use criteria (AUC) for
coronary revascularization, the proportion of inappropriate (later revised
as "rarely inappropriate") percutaneous coronary interventions (PCIs)
varied in different populations. However, the pooled inappropriate PCI
rate remains unknown. <br/>Method(s): We searched the PubMed, Cochrane,
Embase, and Sinomed databases for studies related to AUC and PCIs. Studies
that reported inappropriate/rarely appropriate PCI rates were included. A
random effects model was employed in the meta-analysis because of the high
statistical heterogeneity. <br/>Result(s): Thirty-seven studies were
included in our study, of which eight studies reported the appropriateness
of acute PCIs or PCIs in acute coronary syndrome (ACS) patients, 25
studies reported the appropriateness of non-acute/elective PCIs or PCIs in
non-ACS/stable ischemic heart disease (SIHD) patients, and 15 studies
reported both acute and non-acute PCIs or did not distinguish the urgency
of PCI. The pooled inappropriate PCI rate was 4.3% (95% CI: 2.6-6.4%) in
acute scenarios, 8.9% (95% CI: 6.7-11.0%) in non-acute scenarios, and 6.1%
(95% CI: 4.9-7.3%) overall. The inappropriate/rarely appropriate PCI rate
was significantly higher in non-acute than acute scenarios. No difference
in the inappropriate PCI rate was detected based on the study location,
the country's level of development, or the presence of chronic total
occlusion (CTO). <br/>Conclusion(s): The worldwide inappropriate PCI rate
is generally identical but comparatively high, especially under non-acute
scenarios.<br/>Copyright &#xa9; 2023 by the authors.

<4>
Accession Number
2023189246
Title
Constrictive pericarditis following cardiac transplantation: a report of
two cases and a literature review.
Source
Acta Cardiologica. (no pagination), 2023. Date of Publication: 2023.
Author
Tchana-Sato V.; Ancion A.; Ansart F.; Lardinois M.-J.; Dulgheru R.; Somja
J.; Delvenne P.; Defraigne J.O.
Institution
(Tchana-Sato, Ansart, Lardinois, Defraigne) Department of Cardiovascular
Surgery, CHU Liege, Liege, Belgium
(Ancion, Dulgheru) Department of Cardiology, CHU Liege, Liege, Belgium
(Somja, Delvenne) Department of Pathology, CHU Liege, Liege, Belgium
Publisher
Taylor and Francis Ltd.
Abstract
The data on constrictive pericarditis following heart transplantation are
scarce. Herein, the authors present 2 patients who developed a
constrictive pericarditis 19, and 55 months after heart transplantation.
They underwent several diagnostic procedures and successfully recovered
after a radical pericardiectomy. In addition, the authors review the
literature and report the incidence, aetiology, diagnostic features, and
management of this rare and challenging condition.<br/>Copyright &#xa9;
2023 Belgian Society of Cardiology.

<5>
Accession Number
2023174570
Title
Mild aortic insufficiency following transcatheter aortic valve
replacement: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Hameed I.; Ahmed A.; Kumar A.; Li E.; Candelario K.; Khan S.; Kannan A.;
Latif N.; Amabile A.; Geirsson A.; Williams M.L.
Institution
(Hameed, Ahmed, Li, Candelario, Khan, Kannan, Latif, Amabile, Geirsson,
Williams) Section of Cardiac Surgery, Department of Surgery, Yale School
of Medicine, New Haven, CT, United States
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Post-procedural aortic insufficiency (AI) continues to be
prevalent following transcatheter aortic valve replacement (TAVR). While
several studies have assessed the outcomes of moderate-severe AI following
TAVR, the incidence, predictors, and outcomes of mild AI remain unclear.
<br/>Method(s): A systematic literature review was performed to identify
studies reporting on mild AI following TAVR. The primary outcome was
pooled incidence of post-TAVR mild AI. Secondary outcomes included pooled
incidence of mild AI at 30 days and long term. The pooled incidence of
midterm mortality in patients with post-TAVR mild AI was also evaluated.
The random effect generalized linear mixed-effects model with
logit-transformed proportions and Hartung-Knapp adjustment was used to
calculate pooled incidence rates. Meta-regression was performed to
identify predictors of mild AI. <br/>Result(s): The pooled analysis
included 19,241 patients undergoing TAVR across 50 studies. The mean age
of patients ranged from 73 to 85 years, and female patients ranged from
20.0% to 83.3%. The overall pooled incidence of post-TAVR mild AI was
56.1% (95% confidence interval [CI] 0.31-0.64). The pooled incidence of
mild AI at 30 days was 33.7% (95% CI 0.12-0.37). At mean follow-up of 1.15
years, the pooled incidence of mild AI was 37.0% (95% CI 0.16-0.45). The
overall pooled incidence of Midterm mortality (mean follow-up 1.22 years)
in patients with mild AI was 14.8% (95% CI 0.10-0.25). At meta-regression,
none of the explored variables correlated with a difference in mild AI
incidence. <br/>Conclusion(s): In published studies to date, 50% of
patients undergoing TAVR develop mild AI postoperatively. In 37% of
patients, this persists in long term. Though the incidence of AI is likely
improving with newer generation TAVR valves, the prevalence and outcomes
of mild AI should be closely monitored as TAVR volume and indications
expand to younger patients with long life expectancy. The long-term
outcomes of mild AI remain unclear. Further dedicated studies on post-TAVR
mild AI are needed.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<6>
Accession Number
2024533123
Title
CLINICAL OUTCOMES OF MITRAL VALVE SURGERY IN PATIENTS WITH MITRAL VALVE
PROLAPSE WITH VENTRICULAR ARRHYTHMIAS.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S663-S664), 2023. Date of Publication: May 2023.
Author
Kewcharoen J.; Basharat S.; Shah K.B.; Mandapati R.; Bhardwaj R.; Turagam
M.K.; Contractor T.; Lakkireddy D.R.; Garg J.
Publisher
Elsevier B.V.
Abstract
Background: Malignant ventricular arrhythmias (VA) and ventricular ectopy
(VE) are common in patients with mitral valve prolapse (MVP). Data on
whether mitral valve (MV) surgery reduces arrhythmias burden in patients
with MVP and VA is limited. <br/>Objective(s): We aimed to assess the
clinical outcomes of MV surgery in MVP patients with VA Methods: A
systematic search, without language restriction, using PubMed, EMBASE,
SCOPUS, Google Scholar, and ClinicalTrials.gov was performed. The
meta-analysis was performed using a meta-package for R version 4.0/RStudio
version 1.2. We used the Logit method to establish the variance of raw
proportions and then used the random effects model (DerSimonian and Laird
method) to combine the transformed proportions. The data of the pooled
analysis was plotted on forest plots. Higgins's I-squared (I2) statistic
was used to assess the test of heterogeneity. Outcomes measured included
1) Malignant VA or ICD shock after surgery, 2) Reduction in VA burden, and
3) Mortality. <br/>Result(s): This systematic review of four studies (two
from the United States, one from Australia, and one from Iran)
incorporated a total of 40 MVP patients with VA undergoing MV surgery
(mean age 62.1+/-12.2 years, mean LVEF 57.5+/-2.5%, 55% women, 17.5% with
prior hemodynamically significant VA and 17.5% with pre-existing ICD).
65.5% of patients had bi-leaflet mitral prolapse, and 95% had severe
mitral regurgitation. During the surgery, 90% of patients had MV repair,
and 15% of patients also had concomitant intra-op cryoablation of the
papillary muscle. There were no surgical-related complications or post-op
mortality. During the mean follow-up period of 3.7+/-3 years, 69.5% (95%
CI 40.2-88.5%) of patients had a significant reduction in VA. There were
no deaths or malignant ventricular arrhythmias or ICD therapies during the
follow-up period. <br/>Conclusion(s): The results of our pooled analysis
demonstrated that MV surgery in patients with MVP could reduce ventricular
ectopy and malignant VA. Surgical cryoablation of papillary muscles could
be performed as an adjunct to mitral valve surgery in patients with MVP
who suffer from malignant ventricular arrhythmias, aborted SCD, or
frequent ventricular ectopy. French language not detected for EMBFRA
articles source xml<br/>Copyright &#xa9; 2023

<7>
Accession Number
2024533052
Title
LEFT ATRIAL APPENDAGE OCCLUSION VERSUS STANDARD OF CARE IN PATIENTS WITH
ATRIAL FIBRILLATION AND A PRIOR THROMBO-EMBOLIC EVENT DESPITE ORAL
ANTICOAGULANT THERAPY: A PROPENSITY SCORE MATCHED COMPARISON.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S383), 2023. Date of Publication: May 2023.
Author
Maarse M.; Seiffge D.; Aarnink E.; Fierro N.; Mazzone P.; Beneduce A.;
Gasperetti A.; Tondo C.; Pracon R.; Demkow M.; Zielinski K.; de Backer O.;
Korsholm K.; Nielsen-Kudsk J.E.; Estevez-Loureiro R.; Benito-Gonzalez T.;
Nombela-Franco L.; Simard T.; Alkhouli M.; Holmes D.R.; Romeo M.R.; Berti
S.; Millan X.; Arzamendi D.; Alla V.M.; Paitazoglou C.; Eitel I.;
Freixa-Rofastes X.; Badejoko S.; Chothia R.A.; Kilic O.; Bergmann M.;
Spoon D.; Ram P.; El-Chami M.F.; Branca L.; Adamo M.; Danley K.; Suradi
H.; Swaans M.; Werring D.; Boersma L.V.
Publisher
Elsevier B.V.
Abstract
Background: Patients with atrial fibrillation (AF) that suffer from
ischemic stroke despite oral anticoagulant (OAC) therapy have a very high
risk of recurrent stroke and better prevention strategies are needed. Left
atrial appendage occlusion (LAAO) is a promising secondary prevention
strategy that may provide mechanical protection. However, evidence showing
effectiveness of LAAO in this population is scarce and the current
international guidelines only consider LAAO in patients with a
contra-indication for OAC. <br/>Objective(s): To compare percutaneous LAAO
to standard-of-care including continuing/switching OAC therapy for
secondary stroke prevention in patients with AF and a prior
thrombo-embolic event and/or LAA thrombus under OAC therapy.
<br/>Method(s): The STR-OAC LAAO cohort is an international collaboration
of multiple LAAO registries (21 participating centers). All patients that
underwent percutaneous LAAO because of a thrombo-embolic event and/or LAA
thrombus on OAC were included. Propensity score matching with a previously
published multi-center dataset of patients continuing/switching OAC
therapy after a thrombo-embolic event was performed to compare the
occurence of ischemic stroke between groups.Time-to-event analysis was
performed with Kaplan-Meier curves and Cox-proportional-hazard regression
analyses. <br/>Result(s): A total of 425 patients underwent LAAO between
2010-2021 and were included in the STR-OAC LAAO cohort. Mean age was
72+/-9 years; 45% was female and mean CHA2DS2-VASc and HAS-BLED score were
4.8+/-1.5 and 2.8+/-1.2, respectively. Oral anticoagulation was
discontinued after LAAO at discharge or after confirmation of adequate LAA
closure at 1-3 months follow-up in most patients, the remaining 30% of
patients continued OAC after LAAO as an adjunctive strategy. All LAAO
patients were propensity-score matched and included in the primary outcome
analysis. During follow up including 1450 patient-years a total of 59
patients experienced ischemic stroke: 1.9% per patient-year in LAAO group
versus 9.2% per patient-year in the control group. LAAO was associated
with a significantly lower risk of ischemic stroke (HR 0.3, 95%CI
[0.2-0.5], p<0.001) compared to standard-of-care. <br/>Conclusion(s): In
this propensity-score matched study, LAAO was associated with a lower risk
of ischemic stroke compared to standard-of-care in patients with a
thrombo-embolic event and/or LAA thrombus despite OAC treatment.
Randomized controlled trial data may further confirm the effectiveness of
LAAO in this very high-risk population. [Formula presented]<br/>Copyright
&#xa9; 2023

<8>
Accession Number
2024532776
Title
POST-PROCEDURE ANTICOAGULATION IN PATIENTS RECEIVING PULMONARY VEIN
ISOLATION WITH LEFT ATRIAL APPENDAGE OCCLUSION DEVICES: A SINGLE CENTER
RETROSPECTIVE COHORT STUDY.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S173), 2023. Date of Publication: May 2023.
Author
Dye C.; Skeete J.R.; Planek M.I.; du Fay de Lavallaz J.M.; Larsen T.R.;
Sharma P.S.; Huang H.D.
Publisher
Elsevier B.V.
Abstract
Background: Embolic events are a major complication of atrial fibrillation
(AF). To prevent these events systemic anticoagulation is given based on
an individual's calculated risk using validated scoring systems (e.g.,
CHA2DS2-VASC score). In individuals for whom long-term oral
anticoagulation (OAC) is not possible, placement of left atrial appendage
occlusion (LAAO) devices is a reasonable alternative. Occasionally,
individuals with prior LAAO device implantation undergo pulmonary vein
isolation (PVI) for rhythm control, which typically warrants a short-term
period of at least 6 weeks of systemic OAC post-PVI. It is not clear,
however, whether prior placement of a LAAO device negates the need for 6
weeks of OAC. <br/>Objective(s): To determine the impact of truncated OAC
duration the first 6 weeks post-PVI compared to those completing 6 weeks
of OAC in individuals with high bleeding risk and prior placement of a
LAAO device. <br/>Method(s): We retrospectively examined patients 665
patients from Rush University Medical Center that received pulmonary vein
isolation from March 2017 to December 2021. Of these patients, 18 had
successful implantation of a LAAO device prior to PVI. Nine patients
completed a 6-week course of OAC and 9 patients completed < 6 weeks of OAC
after ablation. The primary clinical outcome was the incidence of
thromboembolic events during the peri-and post-procedural period.
Secondary outcome was the incidence of major or minor bleeding events
while on OAC using standard definitions. <br/>Result(s): The median age
was 65 years. Fifty-five percent of patients in each arm were diagnosed
with persistent atrial fibrillation. Mean CHA2DS2-VASc was 3 and mean
HAS-BLED score was 2.8. Reasons for shorter course of OAC in the truncated
group were variable and based on shared decision making between the
provider and the patient. There were no thromboembolic events post-PVI in
either group. Two patients (29%) who received 6 weeks of OAC had bleeding
events with no bleeding events in the group who received truncated
duration of OAC post-PVI. <br/>Conclusion(s): In this small proof of
concept study, patients with prior LAAO device placement who underwent
subsequent PVI and received < 6 weeks of OAC during the post-PVI period
did not have an increased rate of thromboembolic events compared to those
who received 6 weeks of OAC. Conversely, bleeding events occurred more
frequently in LAAO patients who received the full 6 weeks of OAC post-PVI.
Larger prospective or randomized clinical trials are needed to validate
these findings. [Formula presented] [Formula presented]<br/>Copyright
&#xa9; 2023

<9>
Accession Number
2024532757
Title
EPICARDIAL PULSED-FIELD ABLATION OF THE CARDIAC GANGLIONATED PLEXI:
IMPACTS ON THE AUTONOMIC NERVOUS SYSTEM.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S199), 2023. Date of Publication: May 2023.
Author
Musikantow D.R.; de Groot J.R.; Neuzil P.; Skalsky I.; Shaburishvili T.;
van Zyl M.; O'Brien B.; Coffey K.; Reilly J.; Reddy V.Y.
Publisher
Elsevier B.V.
Abstract
Background: The autonomic nervous system (ANS) has been shown to play a
role in the initiation and maintenance of atrial fibrillation (AF). While
incidental ablation of the Ganglionated Plexi (GP) during AF ablation
changes the ANS in a manner which correlates with procedural success,
targeted ablation of GP has met with mixed results. In pre-clinical
models, pulsed field (PF) energy delivered epicardially has demonstrated
the capability to ablate GP without damage to surrounding myocardium.
<br/>Objective(s): This is a first in human analysis to investigate the
feasibility and safety of epicardial PF ablation (PFA) during cardiac
surgery. <br/>Method(s): In a single arm, prospective analysis, patients
with or without a history of AF underwent epicardial PFA (OCED,
AtriAN[RV1] Inc, Dublin) during planned coronary artery bypass grafting
(CABG; see Figure). ANS tone was assessed via intraoperative pacing
maneuvers to assess atrial effective refractoriness (AERP) and with
Holter-assessment of heart rate variability (HRV) at baseline and 3 months
post procedure. <br/>Result(s): Most enrolled patients (23 of 24) received
the full ablation protocol with no device-related adverse effects. Pacing
demonstrated a 20.7+/-19.9% extension in AERP (P<0.001). Holter monitoring
demonstrated an increase in mean heart rate (74.0+/-8.7 vs 80.6+/-12.3
BPM, P=0.01). While there was a trend towards a decrease in SDNN (188+/-31
vs 104+/-40, P=0.20), there were no significant changes in HRV.
Post-operative AF (POAF) was noted in 7 (29%) of patients.
<br/>Conclusion(s): This study demonstrates the safety and feasibility of
epicardial PFA of the cardiac GP aimed at modulating the ANS during CABG.
While changes in AERP suggest acute efficacy, assessment of the long-term
effects and impact on the incidence of POAF is limited by the small sample
size and single-arm nature of this analysis. Larger, randomized studies
are needed to determine the long-term impact of epicardial PFA and its
ability to mitigate POAF. [Formula presented]<br/>Copyright &#xa9; 2023

<10>
Accession Number
2024532162
Title
LONG-TERM CLINICAL OUTCOMES OF PERI-DEVICE LEAK IN PATIENTS UNDERGOING
LEFT ATRIAL APPENDAGE OCCLUSION IN THE AMULET IDE TRIAL.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S396), 2023. Date of Publication: May 2023.
Author
Ellis C.R.; Lakkireddy D.R.; Windecker S.; Thaler D.; Gupta N.; Gambhir
A.; Nielsen-Kudsk J.E.
Publisher
Elsevier B.V.
Abstract
Background: The Amulet IDE trial is a global, randomized (1:1) trial of
the AmplatzerTM AmuletTM LAA occluder (Abbott) versus the WatchmanTM
device (Boston Scientific) in patients with non-valvular AF. Patients with
a peri-device leak (PDL) > 3mm have shown to be at increased risk for
stroke or systemic embolism (SSE) at 18 months. However, longer-term
clinical implications from PDL are unclear. <br/>Objective(s): Investigate
the 3-year clinical outcomes of PDL in patients in the Amulet IDE trial.
<br/>Method(s): Patients in the trial had minimum
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of >=3. Protocol mandated TEE was
performed at 45 days and 12 months post-LAAO. An independent echo core lab
analyzed TEE images for evidence of PDL. PDL was graded as the single
largest jet visualized around the device. Clinical outcomes at 3 years
were analyzed based on PDL >=3mm at 12 months (chronic PDL).
<br/>Result(s): A total of 1788 patients were successfully implanted as
randomized with an Amulet^TM occluder (N=903) or
Watchman^TM device (N=885). A total of 1291 (72%) patients had
an evaluable TEE at 12 months (673 Amulet occluder and 618 Watchman
device) resulting in 198 patients with PDL >=3mm (15.3% of patients
assessed: 64 Amulet occluder and 134 Watchman device). Controls were 1093
subjects with PDL <3mm (609 Amulet occluder and 484 Watchman device).
Patients with >=3mm PDL at 12 months were more likely in persistent or
permanent atrial fibrillation versus those without PDL (53.5% vs. 42.9%,
p=0.02). Patients with a PDL at 12 months trended to have more SSE at 3
years (4.4% vs. 2.4%, hazard ratio (HR): 1.85 [95% confidence interval
(CI), 0.83-4.11]) although not significant (p=0.13) (Figure 1). The
composite of stroke, systemic embolism, or cardiovascular death was
similar between patients with and without chronic PDL (7.0% vs. 7.3%, HR:
0.96 [95% CI, 0.54-1.74], p=1.00) with a trend to higher major bleeding
with >=3mm PDL (8.0% vs. 4.9%, HR: 1.68 [95% CI, 0.92-3.05], p=0.09).
Higher use of anti-coagulation in patients with larger leaks, and the
impact of coil or plug embolization procedures for PDL closure after the
12-month TEE may reduce the rate of SSE following 18 months. PDL closures
were performed at physician discretion, and not protocol driven.
<br/>Conclusion(s): Patients with persistent or permanent atrial
fibrillation were more likely to have >=3mm PDL at 12 months associated
with a numerically higher incidence of SSE long term. Management
strategies (PDL closure versus anti-coagulation) should be areas of future
investigation. [Formula presented]<br/>Copyright &#xa9; 2023

<11>
Accession Number
2024532140
Title
VENTRICULAR TACHYCARDIA PREDICTS ALL-CAUSE MORTALITY AND NON-SUDDEN
CARDIAC DEATH IN NON-ISCHAEMIC CARDIOMYOPATHY.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S28), 2023. Date of Publication: May 2023.
Author
Omara S.; Godsk T.S.; Kober L.; Thune J.J.; Pehrson S.; Tedrow U.B.;
Hindricks G.; Ebert M.; Carbucicchio C.; Berruezo A.; Vaseghi M.;
Shivkumar K.; Deneke T.; Wijnmaalen A.P.; Stevenson W.G.; Nielsen J.C.;
Zeppenfeld K.
Publisher
Elsevier B.V.
Abstract
Background: Endstage heart failure, ventricular tachycardia (VT) and
sudden cardiac death (SCD) are sequels of non-ischemic cardiomyopathies
(NICM). Implantable cardioverter defibrillators (ICDs) can terminate VT
and prevent SCD but mortality benefit has been limited in recent trials
suggesting that VT may also be associated with non-sudden cardiovascular
death (NSCVD). <br/>Objective(s): To assess the effect of VT on all-cause
mortality and NSCVD in NICM patients with ICDs. <br/>Method(s): Two
multicentre cohorts of NICM patients were merged for analysis: (1)
patients randomized to ICD in the DANISH trial, which included patients
with NICM, LVEF <=35% and no prior VT and (2) the DCM-VT study cohort,
which included consecutive NICM patients with any LVEF referred for
ablation of sustained VT. Predictors for the primary composite outcome of
all-cause death and heart transplant (death/HTx) and for the secondary
outcome of NSCVD were assessed. In addition, propensity score matching was
performed using the parameters age, gender, LVEF and eGFR. Finally,
survival following VT occurrence was compared between DANISH and DCM-VT
patients. <br/>Result(s): A total of 828 patients (556 DANISH, 272 DCM-VT)
were followed for a median of 3.9 years (2.1 - 5.8). DANISH patients had a
median LVEF of 25% (20 - 30) and DCM-VT patients 35% (27 - 43). A total of
148 patients (DANISH 16.4%, DCM-VT 21.0%) experienced death/HTx and NSCVD
occurred in 78 patients (7.7%, 12.9%, respectively). In multivariable
analysis history of VT at inclusion was a significant predictor of the
primary outcome with an adjusted hazard ratio (HR<inf>a</inf>) of 3.81
(95% CI 2.33 - 6.24) as were age [HR<inf>a</inf> 1.02 per year (1.01 -
1.04)], LVEF [HR<inf>a</inf> 0.96 per 1% increase (0.94 - 0.98)] and
reduced eGFR [HR<inf>a</inf> 1.71 (1.15 - 2.53)]. History of VT predicted
NSCVD with an HR<inf>a</inf> of 7.54 (3.97 - 14.33). After matching,
history of VT still predicted death/HTx [HR 4.12 (2.48 - 6.82)] and NSCVD
[HR 6.92 (3.30 - 14.52)]. Risk of death/HTx, as well as NSCVD, for DANISH
patients was similar to DCM-VT patients after they experienced their first
VT event [HR<inf>a</inf> 0.90 (0.48 - 1.69) and HR<inf>a</inf> 1.07 (0.56
- 2.06) resp.]. <br/>Conclusion(s): VT occurrence appears to be an
important predictor of non-sudden CV death as well as all-cause death in
NICM patients independent of other markers of heart failure severity. VT
may be a marker of progressive disease and remodelling that could be
incorporated into risk-stratification to help predict deterioration and
need for HTx. [Formula presented] [Formula presented]<br/>Copyright &#xa9;
2023

<12>
Accession Number
2024531395
Title
EFFICACY OF BOTULINUM TOXIN TYPE A (AGN-151607) FOR THE PREVENTION OF
POSTOPERATIVE ATRIAL FIBRILLATION IN CARDIAC SURGERY PATIENTS: ATRIAL
FIBRILLATION AND ANTICOAGULATION RESULTS FROM THE PHASE 2 NOVA STUDY.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S177-S178), 2023. Date of Publication: May 2023.
Author
Waldron N.; OSullivan A.; Piccini J.P.; Romano M.; Voisine P.; Titanji W.;
Leaback R.; Ferguson W.; Steinberg J.S.
Publisher
Elsevier B.V.
Abstract
Background: Oral anticoagulation reduces the risk of stroke but also
increases the risk of bleeding. Prevention of post-operative atrial
fibrillation (POAF) could result in a lower burden of oral anticoagulation
and bleeding events. AGN-151607 has been proposed to prevent POAF and its
safety/efficacy was tested in a multicenter randomized trial.
<br/>Objective(s): (1) Assess proportion of NOVA study patients free from
AF and anticoagulation and (2) assess time to anticoagulation post cardiac
surgery. <br/>Method(s): NeurOtoxin for the preVention of post-operative
Atrial fibrillation (NOVA; NCT03779841) was a randomized, multicenter,
placebo-controlled, double-blind trial that assessed safety and efficacy
of 5 epicardial injections of AGN-151607 125U and 250U vs placebo for
prevention of POAF after CABG and/or valve surgery. Patients underwent
continuous ECG monitoring for 30 days after surgery. Primary endpoint was
proportion of patients with continuous AF >=30 seconds by mITT (received
treatment and ECG patch). Prespecified anticoagulation endpoints included
proportion of patients free from AF >=30 seconds and anticoagulant
medication at any point up to 12-month follow-up (or early
discontinuation) and time to anticoagulation. <br/>Result(s): The mITT
population included 312 patients (placebo n=102, 125U n=104, and 250U
n=106). Primary endpoint occurred in 46.1% of placebo, 36.5% of 125U
(relative risk [RR] 0.80 [95% CI 0.58, 1.10]; P=0.16), and 47.2% of 250U
groups (RR 1.04 [95% CI 0.79, 1.37]; P=0.78). In CABG patients >=65 years,
125U demonstrated a reduction in the primary endpoint (RR 0.49 [95% CI
0.27, 0.87; P=0.0096). Of 213 completed patients at the time of primary
analysis (placebo n=71, 125U n=70, 250U n=72), the AF-free and
anticoagulation-free endpoint was met in 45.1% of placebo, 62.9% of 125U
(RR 1.38 [95% CI 1.02, 1.88]; P=0.0336), and 47.2% of 250U groups (RR 1.06
[95% CI 0.77, 1.47]; P=0.7115) (Table). The KM plot demonstrates that
numerically fewer patients in the 125U group received anticoagulation due
to AF and had a longer time to anticoagulation compared to placebo
(HR=0.676 [95% CI 0.328, 1.393]; P=0.3025) (Figure). <br/>Conclusion(s):
In completed patients, a higher proportion receiving 125U AGN-151607 were
free from AF and anticoagulation vs placebo (nominal P=0.03).
Additionally, there was a trend of less anticoagulation with 125U vs
placebo and, among those anticoagulated, it was administered later in
recovery compared to placebo (P=0.30). [Formula presented] [Formula
presented]<br/>Copyright &#xa9; 2023

<13>
Accession Number
2024531368
Title
IMPACT OF INTRACARDIAC VS. TRANSESOPHAGEAL ECHOCARDIOGRAPHY GUIDED LEFT
APPENDAGE CLOSURE ON PROCEDURAL CHARACTERISTICS AND LAB EFFICIENCY: A META
ANALYSIS.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S34), 2023. Date of Publication: May 2023.
Author
Diaz J.C.; Bastidas O.; Marin J.; Aristizabal J.M.; Nino C.; Duque M.;
Hoyos C.; Sauer W.H.; Matos C.; Patino C.; Rivera E.; Alviz I.; Krishnan
S.; Dave K.; Romero J.
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage occlusion (LAAO) is frequently performed
under transesophageal echocardiography (TEE) guidance, but intracardiac
echocardiography (ICE) is increasingly being used given its ease of use
and the possibility to perform the procedure under light sedation (as
opposed to general anesthesia). The impact of ICE vs. TEE guidance on
procedural characteristics and lab efficiency is yet to be determined.
<br/>Objective(s): To evaluate the impact of ICE vs. TEE guidance during
LAAO on procedural efficacy and safety; fluoroscopy procedural and in room
time; and the presence of peridevice leaks and residual septal defects
during follow-up. <br/>Method(s): Pubmed, Embase and Cochrane were
searched using the term "left atrial appendage" AND (closure OR occlusion)
AND "intracardiac echocardiography". No language restriction was applied.
Single arm studies, review articles, abstracts, letters to the editor and
studies using database claims were excluded. All articles were evaluated
by 3 independent reviewers (JCD, OB, JR) and the risk of bias established
using the Newcastle-Ottawa scale with a score >6 considered a high-quality
study; differences were solved by consensus. Statistical analysis was
performed using Revman 5.4 (Cochrane collaboration). <br/>Result(s):
Eleven observational studies (n=3034; 976 using ICE guided LAAO) were
included. Nine studies were considered high quality, with 2 studies having
a score of 6. There were no statistically significant differences in
procedural success (OR 1.38 95% CI 0.76-2.51, p=0.29) or procedure related
major adverse events (OR 0.77 95% CI 0.53-1.12) in ICE guided vs. TEE
guided LAAO. The use of ICE guidance resulted in a statistically
significant reduction in in-room time (mean difference -35.5 minutes; 95%
CI -44.9 to -26 min. p <0.0001). No significant differences were found in
procedural time or fluoroscopy time. During follow-up imaging, there were
no differences in peridevice leak (OR 0.9 95% CI 0.66-1.23). A trend
towards increased prevalence of residual interatrial septal defects was
observed with ICE guided vs. TEE guided LAAO (OR 1.43, 95% CI 0.99-2.07, p
=0.05). <br/>Conclusion(s): ICE guidance is associated with improved lab
efficiency (as established by a significant 35-minute reduction in in-room
time), without any significant differences in procedural success or
safety. During follow-up, there were no differences of the rate of
periprocedural leaks. A non-significant trend towards a higher prevalence
of residual interatrial septal defects was observed. [Formula
presented]<br/>Copyright &#xa9; 2023

<14>
Accession Number
2024531170
Title
THE EFFECT OF LOW-LEVEL TRANSCUTANEOUS VAGUS NERVE STIMULATION ON
AUTONOMIC REMODELING OF GANGLIONATED PLEXI (GP) IN HUMANS.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S134), 2023. Date of Publication: May 2023.
Author
Farhat K.; Niewiadomska M.; Elkholey K.; Morries L.; Harville L.;
Stavrakis S.
Publisher
Elsevier B.V.
Abstract
Background: The intrinsic cardiac autonomic nervous system (CANS), which
is formed by interconnected clusters of autonomic ganglia called
ganglionated plexi (GP), has been found to play a key role in the onset
and maintenance of atrial fibrillation (AF). The ability of GP neurons to
change parasympathetic activity suggests that synaptic plasticity occurs
at synapses generated on and by GP neurons. Such changes could be a source
of maladaptive plasticity and fine-tuning autonomic innervation of the
heart during AF Objective: Low-level tragus stimulation (LLTS), which has
antiarrhythmic and anti-inflammatory properties, has been shown to benefit
patients with paroxysmal AF. The purpose of this study was to determine
the effect of LLTS on the synaptic plasticity of GP in patients undergoing
open heart surgery by examining changes in protein levels of neural
markers. Furthermore, the effect of LLTS on inflammatory markers in GP has
been determined. <br/>Method(s): Patients undergoing cardiac surgery
(including patients with paroxysmal AF, persistent AF, or no history of
AF) were randomized to active LLTS (20Hz, 30mA) for 1 hour or no
stimulation. A 2-3 mm biopsy of the GP tissue was taken immediately after
stimulation, and immunohistochemistry was used to stain for neural
(choline acetyltransferase (ChAT), synaptophysin, S100B, PGP9.5, nNOS, and
GFAP) and inflammatory markers (CD3, CD68). <br/>Result(s): Twenty five
patients were included. Patients' clinical and echocardiographic
characteristics were distributed evenly across groups (LLTS, n=12, 75%
male, age 65+/-9 years vs. sham, n=13, 92% male, age 63+/-11 years). In
comparison to sham, LLTS significantly decreased the protein expression
level of S100B, nNOS, GFAP, PGP9.5, and choline acetyltransferase (ChAT)
in GP tissue (Figure 1). The expression of synaptophysin in both groups
was not significantly different. Following stimulation, the expression of
the inflammatory marker CD3 was significantly reduced. There was no
statistically significant difference in CD68 expression between the LLTS
and sham groups. <br/>Conclusion(s): Significant changes in neural markers
within the GP occurred following LLTS, consistent with acute autonomic
remodeling. Further studies are warranted to understand the clinical
significance of this finding. [Formula presented]<br/>Copyright &#xa9;
2023

<15>
Accession Number
2024531033
Title
DURING CARDIAC ELECTROPHYSIOLOGY PROCEDURES ULTRASOUND GUIDANCE OF VENOUS
PUNCTURE REDUCES MAJOR AND TOTAL VASCULAR COMPLICATIONS - A META-ANALYSIS.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(5 Supplement) (pp S65-S66), 2023. Date of Publication: May 2023.
Author
Vamosi P.; Komlosi F.; Toth P.; Meszaros H.; Merkely B.; Geller L.; Nagy
K.V.
Publisher
Elsevier B.V.
Abstract
Background: Puncture site vascular complications (VCs) are the most common
complications of invasive electrophysiology (EP) procedures. The use of
vascular ultrasound during puncture is already included in the guidelines
of other medical fields, e.g. intensive care, and also widely used in EP
labs around the world, but not yet standard practice in all of them.
<br/>Objective(s): Our aim was to conduct a meta-analysis which compares
anatomical guidance to the use of ultrasound during the femoral venous
puncture in conjunction with electrophysiology procedures. In contrast to
the previous meta-analyses, we aimed to use a uniform endpoint and to
involve new publications to improve patients numbers. <br/>Method(s): In
order to find articles which report, both with and without ultrasound
guidance, the rate of vascular complications during EP procedures, a
systematic search was performed in the relevant electronic databases.
Major VCs (MVCs), as defined in the 2017 HRS/EHRA/ECAS/APHRS/SOLAECE
expert consensus) were the primary endpoint. AV-fistula, pseudoanerurysm
and major bleeding (each separately), minor VCs, total VCs and inadvertent
arterial punctures were defined as secondary endpoints, For statistical
analysis we used a random effects model with the Mantel-Haenszel method.
<br/>Result(s): Data on 23605 patients was reported by the 14 articles
matching our selection criteria. The primary outcome was reported on 13050
of them (in 10 articles), with 200 (156 %) reaching the primary endpoint
of an MVC. The occurrence of MVCs was significantly reduced by the routine
use of ultrasound during the puncture (29/4542 vs. 171/8508, OR 0.22
[0.10-0.50], p<0.001). Moreover, the incidence of several secondary
endpoints was also significantly lower: total vascular complications - OR
0.27 [0.13-0.53] (p<0.001), minor vascular complications: OR 0.25
[0.16-0.74], accidental artery puncture - OR was 0.20 [0.09-0.41]
(p<0.001). There was insufficient data reported regarding AV-fistula,
pseudoanerurysm and major bleeding specifically. <br/>Conclusion(s): While
using a more uniform MVC definition compared to previous meta-analyses and
covering more than 1.5 times as many patients, we demonstrated that
ultrasound guidance for femoral venous puncture during EP procedures is
significantly beneficial. Above all, the rate of MVCs and total VCs is
reduced by this technique. These results show that its routine use should
be considered in every EP lab and this could bring important improvements
in patient safety. [Formula presented] Forest plot. Major vascular
complications (MVCs)<br/>Copyright &#xa9; 2023

<16>
Accession Number
2023180193
Title
The Uncomfortable Truth: Open Thoracotomy versus Minimally Invasive
Surgery in Lung Cancer: A Systematic Review and Meta-Analysis.
Source
Cancers. 15(9) (no pagination), 2023. Article Number: 2630. Date of
Publication: May 2023.
Author
Kim D.; Woo W.; Shin J.I.; Lee S.
Institution
(Kim) Department of Thoracic and Cardiovascular Surgery, College of
Medicine, Chungbuk National University Hospital, Chungbuk National
University, Cheongju 28644, South Korea
(Woo, Lee) Department of Thoracic and Cardiovascular Surgery, Gangnam
Severance Hospital, Yonsei University College of Medicine, Seoul 03722,
South Korea
(Shin) Department of Pediatrics, Yonsei University College of Medicine, 50
Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
Publisher
MDPI
Abstract
For decades, lung surgery in thoracic cancer has evolved in two ways:
saving more parenchyma and being minimally invasive. Saving parenchyma is
a fundamental principle of surgery. However, minimally invasive surgery
(MIS) is a matter of approach, so it has to do with advances in surgical
techniques and tools. For example, MIS has become possible with the
introduction of VATS (video-assisted thoracic surgery), and the
development of tools has extended the indication of MIS. Especially, RATS
(robot-assisted thoracic surgery) improved the quality of life for
patients and the ergonomics of doctors. However, the dichotomous idea that
the MIS is new and right but the open thoracotomy is old and useless may
be inappropriate. In fact, MIS is exactly the same as a classic
thoracotomy in that it removes the mass/parenchyma containing cancer and
mediastinal lymph nodes. Therefore, in this study, we compare
randomized-controlled trials about open thoracotomy and MIS to find out
which surgical method is more helpful.<br/>Copyright &#xa9; 2023 by the
authors.

<17>
Accession Number
2023164001
Title
A randomised controlled, feasibility study to establish the acceptability
of early outpatient review and early cardiac rehabilitation compared to
standard practice after cardiac surgery and viability of a future
large-scale trial (FARSTER).
Source
Pilot and Feasibility Studies. 9(1) (no pagination), 2023. Article Number:
79. Date of Publication: December 2023.
Author
Ngaage D.L.; Mitchell N.; Dean A.; Mitchell A.; Hinde S.; Akowuah E.;
Doherty P.; Nichols S.; Fairhurst C.; Flemming K.; Hewitt C.; Ingle L.;
Watson J.
Institution
(Ngaage) Castle Hill Hospital, Hull University Teaching Hospitals NHS
Trust, Castle Road Cottingham, Hull, United Kingdom
(Mitchell, Dean, Mitchell, Doherty, Fairhurst, Flemming, Hewitt, Watson)
Department of Health Sciences, University of York, ARRC Building, York,
United Kingdom
(Hinde) Centre for Health Economics, Alcuin A Block, University of York,
York, United Kingdom
(Akowuah) James Cook Hospital, South Tees Hospitals NHS Foundation Trust,
Marton Road, Middlesbrough, United Kingdom
(Nichols) Sport and Physical Activity Research Centre, Sheffield Hallam
University, Collegiate Campus, Sheffield, United Kingdom
(Ingle) Department of Sport, Health and Exercise Science, University of
Hull, Hull, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Objective: To determine the acceptability and feasibility of delivering
early outpatient review following cardiac surgery and early cardiac
rehabilitation (CR), compared to standard practice to establish if a
future large-scale trial is achievable. <br/>Method(s): A randomised
controlled, feasibility trial with embedded health economic evaluation and
qualitative interviews, recruited patients aged 18-80 years from two UK
cardiac centres who had undergone elective or urgent cardiac surgery via a
median sternotomy. Eligible, consenting participants were randomised 1:1
by a remote, centralised randomisation service to postoperative outpatient
review 6 weeks after hospital discharge, followed by CR commencement from
8 weeks (control), or postoperative outpatient review 3 weeks after
hospital discharge, followed by commencement of CR from 4 weeks
(intervention). The primary outcome measures related to trial feasibility
including recruitment, retention, CR adherence, and acceptability to
participants/staff. Secondary outcome measures included health-rated
quality of life using EQ-5D-5L, NHS resource-use, Incremental Shuttle Walk
Test (ISWT) distance, 30- and 90-day mortality, surgical site
complications and hospital readmission rates. <br/>Result(s): Fifty
participants were randomised (25 per group) and 92% declared fit for CR.
Participant retention at final follow-up was 74%; completion rates for
outcome data time points ranged from 28 to 92% for ISWT and 68 to 94% for
follow-up questionnaires. At each time point, the mean ISWT distance
walked was greater in the intervention group compared to the control. Mean
utility scores increased from baseline to final follow-up by 0.202 for the
intervention (0.188 control). Total costs were 1519 for the intervention
(2043 control). Fifteen participants and a research nurse were
interviewed. Many control participants felt their outpatient review and CR
could have happened sooner; intervention participants felt the timing was
right. The research nurse found obtaining consent for willing patients
challenging due to discharge timings. <br/>Conclusion(s): Recruitment and
retention rates showed that it would be feasible to undertake a full-scale
trial subject to some modifications to maximise recruitment. Lower than
expected recruitment and issues with one of the clinical tests were
limitations of the study. Most study procedures proved feasible and
acceptable to participants, and professionals delivering early CR. Trial
registration: ISRCTN80441309 (prospectively registered on
24/01/2019).<br/>Copyright &#xa9; 2023, Crown.

<18>
Accession Number
2024498397
Title
The First Dedicated Comprehensive Heart Failure Program in the United
States: The Division of Circulatory Physiology at Columbia Presbyterian
(1992-2004).
Source
Journal of Cardiac Failure. (no pagination), 2023. Date of Publication:
2023.
Author
PACKER M.
Institution
(PACKER) From the Baylor Heart and Vascular Institute, Baylor University
Medical Center, Dallas, Texas, and Imperial College, London, United
Kingdom
Publisher
Elsevier B.V.
Abstract
The first dedicated multidisciplinary heart failure program in the United
States was founded as the Division of Circulatory Physiology at the
Columbia University College of Physicians & Surgeons in 1992. The Division
was administratively and financially independent of the Division of
Cardiology and grew to 24 faculty members at its peak. Its administrative
innovations included (1) a comprehensive full-integrated service line,
with 2 differentiated clinical teams, one devoted to drug therapy and the
other to heart transplantation and ventricular assist devices; (2) a nurse
specialist/physician assistant-led clinical service; and (3) a financial
structure independent of (and not supported by) other cardiovascular
medical or surgical services. The division had 3 overarching missions: (1)
to promote a unique career development path for each faculty member to be
linked to recognition in a specific area of heart failure expertise; (2)
to change the trajectory and enhance the richness of intellectual
discourse in the discipline of heart failure, so as to foster an
understanding of fundamental mechanisms and to develop new therapeutics;
and (3) to provide optimal medical care to patients and to promote the
ability of other physicians to provide optimal care. The major research
achievements of the division included (1) the development of beta-blockers
for heart failure, from initial hemodynamic assessments to
proof-of-concept studies to large-scale international trials; (2) the
development and definitive assessment of flosequinan, amlodipine, and
endothelin antagonists; (3) initial clinical trials and concerns with
nesiritide; (4) large-scale trials evaluating dosing of angiotensin
converting-enzyme inhibitors and the efficacy and safety of neprilysin
inhibition; (5) identification of key mechanisms in heart failure,
including neurohormonal activation, microcirculatory endothelial
dysfunction, deficiencies in peripheral vasodilator pathways, noncardiac
factors in driving dyspnea, and the first identification of subphenotypes
of heart failure and a preserved ejection fraction; (6) the development of
a volumetric approach to the assessment of myocardial shortening; (7)
conceptualization and early studies of cardiac contractility modulation as
a treatment for heart failure; (8) novel approaches to the identification
of cardiac allograft rejection and new therapeutics to prevent allograft
vasculopathy; and (9) demonstration of the effect of left ventricular
assist devices to induce reverse remodeling, and the first randomized
trial showing a survival benefit with ventricular assist devices. Above
all, the division served as an exceptional incubator for a generation of
leaders in the field of heart failure.<br/>Copyright &#xa9; 2023 The
Author(s)

<19>
Accession Number
2023208702
Title
Immediate flap increases patient safety for deep sternal wound infection:
A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Qiu X.; Sun X.; Huang G.
Institution
(Qiu, Sun) Affiliated Hospital of Weifang Medical University, School of
Clinical Medicine, Weifang Medical University, Weifang, China
(Qiu, Huang) Department of Burns and Plastic Surgery, Jinan Central
Hospital, Jinan, China
(Huang) Department of Burns and Plastic Surgery, Central Hospital
Affiliated to Shandong First Medical University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
Deep sternal wound infection is a severe complication after cardiac
surgery. We performed a meta-analysis evaluating the impact of immediate
flap and NPWT on mortality and length of hospital stay. The meta-analysis
was registered (CRD42022351755). A systematic literature search was
conducted from inception to January, 2023, including PubMed, EMBASE,
Cochrane Library, ClinicalTrials.gov and EU Clinical Trials Register. The
main outcome were in-hospital mortality and late mortality. And additional
outcomes were length of stay and ICU stay time. A total of 438 patients
(Immediate flap: 229; NPWT: 209) from four studies were included in this
study. Immediate flap was associated with lower in-hospital mortality (OR
0.33, 95% CI 0.13-0.81, P =.02) and length of stay (SMD -13.24, 95% CI
-20.53 to -5.94, P =.0004). Moreover, pooled analysis demonstrated no
significant difference was found in two groups in terms of late mortality
(OR 0.64, 95% CI 0.35-1.16, P =.14) and ICU stay time (SMD -1.65, 95% CI
-4.13 to 0.83, P =.19). Immediate flap could reduce in-hospital mortality
and length of stay for patients with deep sternal wound infection. Flap
transplantation as soon as possible may be advised.<br/>Copyright &#xa9;
2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<20>
Accession Number
641308020
Title
Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve
Replacement in Chronic Kidney Disease: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Trends in cardiovascular medicine. (no pagination), 2023. Date of
Publication: 09 May 2023.
Author
Jacquemyn X.; Van den Eynde J.; Iwens Q.; Billiau J.; Jabagi H.;
Serna-Gallegos D.; Chu D.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium; Faculty of Medicine, KU Leuven, Leuven, Belgium
(Iwens, Billiau) Faculty of Medicine, KU Leuven, Leuven, Belgium
(Jabagi) Department of Cardiothoracic Surgery, Valley Heart and Vascular
Institute, Ridgewood, NJ, United States
(Serna-Gallegos, Chu, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, Pennsylvania; Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh,
Pennsylvania
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with advanced chronic kidney disease (CKD) are a
challenging and understudied population. Specifically, the late outcomes
following surgical aortic valve replacement (SAVR) or transcatheter aortic
valve implantation (TAVI) in patients with CKD remains uncertain.
<br/>OBJECTIVE(S): To compare overall mortality risk in patients with
moderate-to-severe CKD following TAVI versus SAVR. <br/>METHOD(S):
Study-level meta-analysis of reconstructed time-to-event data from
Kaplan-Meier curves of studies published by August 2022. <br/>RESULT(S):
Nine studies met our inclusion criteria. Patients who underwent TAVI had a
higher 5-year mortality compared with patients undergoing SAVR in the
overall population (HR 1.56, 95% CI 1.44-1.69, P<0.001) and in populations
with similar risk scores (HR 1.15, 95% CI 1.01-1.31, P=0.035). The
landmark analysis revealed a lower risk of 30-day mortality with TAVI (HR
0.62, 95% CI 0.41-0.94, P=0.023), followed by similar risk until 7.5
months (HR 1, 95% CI 0.78-1.27, P=0.978). In contrast, the landmark
analysis beyond 7.5 months yielded a reversal of the HR in favor of SAVR
(TAVI with HR 1.27, 95% CI 1.08-1.49 P=0.003). <br/>CONCLUSION(S): In
patients with CKD, TAVI provides an initial survival benefit over SAVR.
However, in the long run, a significant survival benefit of SAVR over TAVI
was observed. Our findings highlight the need for randomized controlled
trials to investigate outcomes in this special population.<br/>Copyright
&#xa9; 2023. Published by Elsevier Inc.

<21>
Accession Number
2024178985
Title
Sex Differences in Outcomes After Transcatheter Aortic Valve Replacement:
A POPular TAVI Subanalysis.
Source
JACC: Cardiovascular Interventions. 16(9) (pp 1095-1102), 2023. Date of
Publication: 08 May 2023.
Author
van Bergeijk K.H.; van Ginkel D.-J.; Brouwer J.; Nijenhuis V.J.; van der
Werf H.W.; van den Heuvel A.F.M.; Voors A.A.; Wykrzykowska J.J.; ten Berg
J.M.
Institution
(van Bergeijk, van der Werf, van den Heuvel, Voors, Wykrzykowska)
Department of Cardiology, University Medical Center Groningen, University
of Groningen, Groningen, Netherlands
(van Ginkel, Brouwer, Nijenhuis, ten Berg) Department of Cardiology, St.
Antonius Hospital, Nieuwegein, Netherlands
(ten Berg) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Stroke and bleeding are complications after transcatheter
aortic valve replacement (TAVR). A higher incidence of bleeding and stroke
has been reported in women, but the role of antithrombotic management pre-
and post-TAVR has not been studied. <br/>Objective(s): The study sought to
compare bleeding and ischemic complications after TAVR between women and
men stratified by antiplatelet and oral anticoagulant (OAC) regimen.
<br/>Method(s): The POPular TAVI (Antiplatelet Therapy for Patients
Undergoing Transcatheter Aortic Valve Implantation) trial was a randomized
clinical trial to test the hypothesis that monotherapy with aspirin or OAC
after TAVR is safer than the addition of clopidogrel. The primary
endpoints of interest of this post hoc subanalysis were: 1) all bleeding;
and 2) a composite of ischemic events consisting of stroke and myocardial
infarction. Secondary endpoints were: 1) nonprocedural bleeding; 2) major
or life-threatening bleeding; 3) minor bleeding; 4) stroke; 5) myocardial
infarction; and 6) all-cause death. <br/>Result(s): A total of 978
patients (466 [47.6%] women) were included in this study. All bleeding and
the composite of myocardial infarction and stroke rates were similar
between sexes (all bleeding: 106 [22.8%] women vs 121 [23.6%] men; P =
0.815; ischemic events: 26 [5.6%] vs 36 [7.0%]; P = 0.429). However, major
or life-threatening bleeding occurred more often in women (58 [12.5%]) vs
men (38 [7.4%]) (P = 0.011), most of which were access site bleedings. The
use of aspirin pre- and post-TAVR increased major or life-threatening
bleeding in women but not in men. <br/>Conclusion(s): After TAVR, overall
bleeding and ischemic outcomes were similar between women and men.
However, women had more major or life-threatening bleedings, especially
those receiving aspirin pre- and post-TAVR.<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<22>
[Use Link to view the full text]
Accession Number
2018713662
Title
Effect of intrathecal morphine plus patient-controlled analgesia with
morphine versus patient-controlled analgesia with morphine alone on total
morphine dose 24 hours post-surgery: A systematic review.
Source
JBI Evidence Synthesis. 18(8) (pp 1611-1640), 2020. Date of Publication:
28 Aug 2020.
Author
Pitre L.; Garbee D.; Tipton J.; Schiavo J.; Pitt A.
Institution
(Pitre, Garbee, Tipton, Pitt) School of Nursing, Louisiana State
University Health Sciences Center, New Orleans, United States
(Pitre, Garbee, Tipton, Schiavo, Pitt) Louisiana Centre for Promotion of
Optimal Health Outcomes: A JBI Centre of Excellence
(Schiavo) School of Dentistry, Louisiana State University Health Sciences
Center, New Orleans, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective:The objective of this review was to evaluate the effects of
preoperative intrathecal morphine (ITM) in addition to patient-controlled
analgesia with morphine (PCAM) versus PCAM without preoperative ITM on
total morphine dose in the first 24 hours postoperatively in adult
patients undergoing abdominal or thoracic
surgery.Introduction:Postoperative pain is a significant problem for
patients undergoing major abdominal and thoracic surgery. Intrathecal
morphine can reduce postoperative pain and reduce intravenous (IV)
morphine requirements during the first 24 hours after surgery; however,
the amount of IV morphine dose reduction achieved has not been well
established. This knowledge could help anesthesia providers determine if
ITM is an appropriate analgesic option for patients.Inclusion
criteria:This review included studies with participants 18 years of age or
older receiving general anesthesia for abdominal or thoracic surgery.
Studies were included that used the intervention of preoperative ITM in
addition to PCAM versus PCAM without preoperative ITM. Total morphine dose
in milligrams during the first 24 hours after surgery was the outcome of
interest. <br/>Method(s):A search of PubMed and CINAHL was conducted for
studies published between January 1984 and October 2018 using the key
terms intrathecal, morphine, postoperative, pain, patient-controlled
analgesia and general anesthesia. Index terms and keywords from identified
articles were used to search CINAHL, Cochrane Central Register of
Controlled Trials (CENTRAL), Embase, ClinicalTrials.gov, Ovid MEDLINE,
ProQuest Dissertations and Theses/Nursing and Allied Health Databases, and
Scopus. The reference lists of articles that underwent critical appraisal
were searched for additional studies. Methodological quality was assessed
using the JBI Critical Appraisal Checklist for Randomized Controlled
Trials. Two independent reviewers assessed each selected article. Study
results were pooled in statistical meta-Analysis using the JBI System for
the Unified Management, Assessment and Review of Information, and two
studies were described in narrative form. Differences in IV morphine dose
between the ITM plus PCAM and PCAM alone groups were calculated to produce
the weighted mean difference (WMD) utilizing a 95% confidence interval
(CI). Heterogeneity was assessed using chi²and
I²values. Subgroup analysis was conducted on two studies that
included IV non-opioid analgesia in addition to ITM and PCAM for
postoperative analgesia. <br/>Result(s):Seven RCTs with a total sample
size of 352 patients were included in this review. Five studies that
evaluated postoperative total morphine dose in milligrams with and without
preoperative ITM were included for statistical meta-Analysis, with 277
participants from four countries. Total morphine dose was significantly
reduced in patients who received ITM (WMD =-24.44 mg, 95% CI-28.70
to-20.18 mg) compared to PCAM without ITM. Subgroup analysis of two
studies involving 112 participants using IV acetaminophen in addition to
ITM and PCAM indicated no additional benefit after ITM was already
administered (WMD =-25.93, 95% CI-32.05 to-19.80 mg). Two studies with 75
participants were described narratively because total morphine dose was
reported as median rather than mean values. <br/>Conclusion(s):In this
review, ITM provided a significant decrease in overall total morphine dose
during the first 24 hours after surgery in abdominal surgery patients. The
addition of IV non-opioids to the postoperative analgesia protocol showed
no additional reduction in postoperative IV morphine dose between
groups.Systematic review registration number:PROSPERO
CRD42018100613.<br/>Copyright &#xa9; 2021 Lippincott Williams and Wilkins.
All rights reserved.

<23>
[Use Link to view the full text]
Accession Number
2018164606
Title
Colchicine for Secondary Cardiovascular Prevention in Coronary Disease.
Source
Circulation. 142(20) (pp 1901-1904), 2020. Date of Publication: 17 Nov
2020.
Author
Roubille F.; Tardif J.-C.
Institution
(Roubille) PhyMedExp, Universite de Montpellier, INSERM, CNRS, Cardiology
Department, CHU de Montpellier, France
(Tardif) Montreal Heart Institute, Canada
(Tardif) Universite de Montreal, Canada
Publisher
Lippincott Williams and Wilkins

<24>
Accession Number
2015686180
Title
Reperfusion Strategies in Acute Myocardial Infarction: State of the Art.
Source
International Journal of Cardiovascular Sciences. 35(1) (pp 113-122),
2022. Date of Publication: 2022.
Author
Rangel F.O.D.
Institution
(Rangel) Hospital Pro-Cardiaco, RJ, Rio de Janeiro, Brazil
(Rangel) Instituto Nacional de Cardiologia, RJ, Rio de Janeiro, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
ST elevation myocardial infarction (STEMI) is a highly prevalent condition
worldwide. Reperfusion therapy is strongly associated with the prognosis
of STEMI and must be performed with a high standard of quality and without
delay. A systematic review of different reperfusion strategies for STEMI
was conducted, including randomized controlled trials that included major
cardiovascular events (MACE), and systematic reviews in the last 5 years
through the PRISMA (Preferred Reporting Items for Systematic Reviews and
Meta-Analysis) methodology. The research was done in the PubMed and
Cochrane Central Register of Controlled Trials databases, in addition to a
few manual searches. After the exclusion criteria were applied, 90
articles were selected for this review. Despite the reestablishment of IRA
patency in PCI for STEMI, microvascular lesions occur in a significant
proportion of these patients, which can compromise ventricular function
and clinical course. Several therapeutic strategies - intracoronary
administration of nicorandil, nitrates, melatonin, antioxidant drugs
(quercetin, glutathione), anti-inflammatory substances (tocilizumab [an
inhibitor of interleukin 6], inclacumab, P-selectin inhibitor ),
immunosuppressants (cyclosporine), erythropoietin and ischemic pre-and
post-conditioning and stem cell therapy - have been tested to reduce
reperfusion injury, ventricular remodeling and serious cardiovascular
events, with heterogeneous results: These therapies.<br/>Copyright &#xa9;
2022, Arquivos Brasileiros de Cardiologia. All rights reserved.

<25>
Accession Number
2023871814
Title
Serratus anterior and pectoralis plane blocks for robotically assisted
mitral valve repair: a randomised clinical trial.
Source
British Journal of Anaesthesia. 130(6) (pp 786-794), 2023. Date of
Publication: June 2023.
Author
Alfirevic A.; Marciniak D.; Duncan A.E.; Kelava M.; Yalcin E.K.;
Hamadnalla H.; Pu X.; Sessler D.I.; Bauer A.; Hargrave J.; Bustamante S.;
Gillinov M.; Wierup P.; Burns D.J.P.; Lam L.; Turan A.
Institution
(Alfirevic, Marciniak, Duncan, Kelava, Bauer, Hargrave, Bustamante)
Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland,
OH, United States
(Duncan, Yalcin, Pu, Sessler, Turan) Department of Outcomes Research,
Cleveland Clinic, Cleveland, OH, United States
(Yalcin, Turan) Department of General Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Hamadnalla) Department of Anesthesiology, Pain Management and
Perioperative Medicine, Henry Ford Health System, Detroit, MI, United
States
(Pu) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Gillinov, Burns) Department of Thoracic and Cardiovascular Surgery and
Cleveland Clinic, Cleveland, OH, United States
(Wierup) Department of Cardiothoracic Surgery, Lund University, Lund,
Sweden
(Lam) Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Elsevier Ltd
Abstract
Background: Minimally invasive cardiac surgery provokes substantial pain
and therefore analgesic consumption. The effect of fascial plane blocks on
analgesic efficacy and overall patient satisfaction remains unclear. We
therefore tested the primary hypothesis that fascial plane blocks improve
overall benefit analgesia score (OBAS) during the initial 3 days after
robotically assisted mitral valve repair. Secondarily, we tested the
hypotheses that blocks reduce opioid consumption and improve respiratory
mechanics. <br/>Method(s): Adults scheduled for robotically assisted
mitral valve repairs were randomised to combined pectoralis II and
serratus anterior plane blocks or to routine analgesia. The blocks were
ultrasound-guided and used a mixture of plain and liposomal bupivacaine.
OBAS was measured daily on postoperative Days 1-3 and were analysed with
linear mixed effects modelling. Opioid consumption was assessed with a
simple linear regression model and respiratory mechanics with a linear
mixed model. <br/>Result(s): As planned, we enrolled 194 patients, with 98
assigned to blocks and 96 to routine analgesic management. There was
neither time-by-treatment interaction (P=0.67) nor treatment effect on
total OBAS over postoperative Days 1-3 with a median difference of 0.08
(95% confidence interval [CI]: -0.50 to 0.67; P=0.69) and an estimated
ratio of geometric means of 0.98 (95% CI: 0.85-1.13; P=0.75). There was no
evidence of a treatment effect on cumulative opioid consumption or
respiratory mechanics. Average pain scores on each postoperative day were
similarly low in both groups. <br/>Conclusion(s): Serratus anterior and
pectoralis plane blocks did not improve postoperative analgesia,
cumulative opioid consumption, or respiratory mechanics during the initial
3 days after robotically assisted mitral valve repair. Clinical trial
registration: NCT03743194.<br/>Copyright &#xa9; 2023 British Journal of
Anaesthesia

<26>
Accession Number
2023155071
Title
Wound complications frequency in heart transplant recipients on mammalian
target of rapamycin inhibitors: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Zhu S.; Yu W.; Gao J.; Xiong J.
Institution
(Zhu) Department of Thoracic Surgery, First Affiliated Hospital of Gannan
Medical University, Ganzhou, China
(Zhu) Ganzhou Key Lab of Brain Injury & Brain Protection, Ganzhou, China
(Yu, Gao) The First Clinical Medical College, Gannan Medical University,
Ganzhou, China
(Xiong) Department of Cardiovascular Surgery, First Affiliated Hospital of
Gannan Medical University, Ganzhou, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation was executed to measure the wound
complications (WCs) frequency in heart transplant (HT) recipients on
mammalian target of rapamycin inhibitors (MTRIs). A comprehensive
literature investigation till February 2023 was applied and 978
interrelated investigations were reviewed. The 10 chosen investigations
enclosed 2173 individuals with HT were in the chosen investigations'
starting point, 1164 of them were utilising MTRIs, and 1009 were utilising
control. Odds ratio (OR) in addition to 95% confidence intervals (CIs)
were utilised to compute the value of the WCs frequency in HT recipients
on MTRIs by the dichotomous approaches and a fixed or random model. MTRIs
had significantly higher WCs (OR, 1.53; 95% CI, 1.19-1.98, P =.001)
compared with those with control in individuals with HT. MTRIs had
significantly higher WCs compared with those with control in individuals
with HT. However, care must be exercised when dealing with its values
because of the low number of the nominated investigations and the low
sample size of some of the nominated investigations for the
meta-analysis.<br/>Copyright &#xa9; 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<27>
Accession Number
2023133051
Title
Comparison of milrinone with dobutamine in patients undergoing cardiac
surgery: a systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Alkadri J.; Hu R.; Jeffers M.S.; Ross J.; McIsaac D.I.; McDonald B.
Institution
(Alkadri, McIsaac, McDonald) Department of Anesthesiology and Pain
Medicine, University of Ottawa, Ottawa, ON, Canada
(Hu) Department of Surgery, Division of General Surgery, University of
Ottawa, Ottawa, ON, Canada
(Jeffers) School of Epidemiology and Public Health, University of Ottawa,
Ottawa, ON, Canada
(Jeffers) Clinical Epidemiology Program, The Ottawa Hospital Research
Institute, Ottawa, ON, Canada
(Ross) Department of Surgery, Division of Urology, University of Ottawa,
Ottawa, ON, Canada
(McDonald) Division of Cardiac Anesthesiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
Publisher
Springer

<28>
Accession Number
2023132741
Title
Transcatheter edge-to-edge mitral valve repair for post-myocardial
infarction papillary muscle rupture and acute heart failure: A systematic
review.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Cali F.; Pagnesi M.; Pezzola E.; Montisci A.; Metra M.; Adamo M.
Institution
(Cali, Pagnesi, Pezzola, Metra, Adamo) Department of Medical and Surgical
Specialties, Radiological Sciences, and Public Health, Division of
Cardiology, ASST Spedali Civili di Brescia, University of Brescia,
Brescia, Italy
(Montisci) Division of Cardiothoracic Intensive Care, ASST Spedali Civili
di Brescia, Brescia, Italy
Publisher
John Wiley and Sons Inc
Abstract
Papillary muscle rupture (PMR) is a rare complication of acute myocardial
infarction (AMI) associated with high mortality and morbidity. Surgery is
the gold-standard treatment for these patients, but it is burdened by a
high perioperative risk due to hemodynamic instability. Mitral
transcatheter edge-to-edge repair (M-TEER) was reported to be safe and
effective in unstable patients with significant mitral regurgitation.
However, data in patients with post-AMI PMR are limited to a few case
reports. In this review, we summarized all data available regarding
percutaneous treatment of post-AMI PMR. These results show that M-TEER is
safe and effective in this setting with low in-hospital mortality and
complications and high rate of significant mitral regurgitation
reduction.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<29>
Accession Number
641285013
Title
Gastropericardial Fistula as a Complication of a Perforated Marginal Ulcer
in a Patient With Roux-en-Y Gastric Bypass Surgery.
Source
American Journal of Gastroenterology. Conference: Annual Scientific
Meeting of the American College of Gastroenterology, ACG 2022. Charlotte,
NC United States. 117(10 Supplement 2) (pp S2262-S2263), 2022. Date of
Publication: October 2022.
Author
Jariwala R.; Evans J.A.
Institution
(Jariwala) Ochsner Clinic Foundation, New Orleans, LA, United States
(Evans) Ochsner Medical Center, New Orleans, LA, United States
Publisher
Wolters Kluwer Health
Abstract
Introduction: Gastropericardial fistula is a rare occurrence. The most
common risk factor for non-traumatic pneumopericardium or
gastropericardial fistula is a gastroesophageal surgery such as a Nissen
Fundoplication; however, it is also seen with perforation of malignant or
benign gastric ulcers (1,2,3). Here we report a gastropericardial fistula
presenting with hydropneumopericardium in a patient with a perforation of
a marginal ulcer (MU) after laparoscopic Roux en Y gastric bypass (LRYGB)
in the setting of excessive NSAID use. Case Description/Methods: A
48-year-old gentleman 13 years out from an uncomplicated LRYGB had an EGD
for abdominal pain after chronic NSAID use and anemia. He was found to
have a gastrojejunal (GJ) anastomosis ulcer. Random stomach biopsies were
negative for H pylori. Care was taken to avoid biopsy of the ulcer. The
patient was prescribed high dose, twice daily PPI with plans for repeat
EGD in 8 weeks. 10 days later, he presented to the ED with shortness of
breath and chest pain. Vital signs upon arrival were notable for heart
rate in the 110s but otherwise unremarkable. Labs were remarkable for
leukocytosis 18,000 cells per liter, hemoglobin 10 g/dl, BNP 500 ng/l, and
normal troponin. Initial CT chest without contrast demonstrated
pericardial effusion with associated pneumomediastinum. The subsequent CT
chest with oral contrast had findings of a hydropneumopericardium and
large amount of oral contrast within the dependent portion of the
pericardial sac. A fistula from the pericardial sac to the GJ anastomosis
was seen. An echocardiogram demonstrated a very echodense large
circumferential pericardial effusion suspicious for food. The patient went
to the operating room and underwent pericardiectomy and reconstruction of
the prior gastrojejunostomy. (Figure) Discussion: This case demonstrates a
rare development of gastropericardial fistula in a LRYGB patient taking
NSAIDs causing a MU and subsequent perforation. The mainstays of
conservative therapy for MU in RYGB patients include twice daily high dose
PPI or H2 antagonist and sucralfate as well as avoidance of NSAIDs (4). A
systematic review by Coblijn et al discusses that of 67.9% of patients
(N=801) presenting with MU (including those with perforation) after RYGB
utilized conservative therapy as mentioned above (5). Alternative options
include revisional surgery or radiology assisted drainage, which is
typically reserved for recalcitrant ulcers, perforation, fistula
development, or dilated pouch (6).

<30>
Accession Number
641281973
Title
2022 CAS Virtual Annual Meeting.
Source
Canadian Journal of Anesthesia. Conference: Canadian Anesthesiologists'
Society Annual Meeting, CAS 2022. Halifax, NS Canada. 69(Supplement 2) (no
pagination), 2022. Date of Publication: June 2022.
Author
Anonymous
Publisher
Springer
Abstract
The proceedings contain 63 papers. The topics discussed include: a
retrospective study to optimize post-anesthetic recovery time after
ambulatory lower limb orthopedic procedures at a tertiary care hospital in
Canada; a virtual airway evaluation as good as the real thing?; airway
management during in hospital cardiac arrest by a consultant led airway
management team during the COVID-19 pandemic: a prospective and
retrospective quality assurance project; prevention of cautery induced
airway fire using saline filled endotracheal tube cuffs: a study in a
trachea airway fire model; smart phone assisted retrograde illumination
versus conventional laryngoscope illumination for orotracheal intubation:
a prospective comparative trial; time to single lung isolation in massive
pulmonary hemorrhage simulation using a novel bronchial blocker and
traditional techniques; cannabinoid type 2 receptor activation ameliorates
acute lung injury induced systemic inflammation; bleeding in patients with
end-stage liver disease undergoing liver transplantation and fibrinogen
level: a cohort study; endovascular Vena Cavae occlusion in right anterior
mini-thoracoscopic approach for tricuspid valve in patients with previous
cardiac surgery; and mesenchymal stem cell extracellular vesicles as a
novel, regenerative nanotherapeutic for myocardial infarction: a
preclinical systematic review.

<31>
Accession Number
641281870
Title
Erector Spinae Block (ESP) as an Analgesic Technique for Video-Assisted
Thoracoscopy Surgery (VATS): A Randomized-Controlled Bicentric Study.
Source
Canadian Journal of Anesthesia. Conference: Canadian Anesthesiologists'
Society Annual Meeting, CAS 2022. Halifax, NS Canada. 69(Supplement 2) (pp
S258-S259), 2022. Date of Publication: June 2022.
Author
Caron-Goudreau M.; Clairoux A.; Moore A.; Soucy-Proulx M.; Tanoubi I.; You
An T.; Brulotte V.; Belanger M.-E.; Raft J.; Godin N.; Ruel M.; Desroches
J.; Idrissi M.; Fortier A.; Richebe P.
Institution
(Caron-Goudreau, Clairoux, Moore, Soucy-Proulx, Tanoubi, You An, Brulotte,
Belanger, Idrissi, Richebe) Department of Anesthesiology and Pain
Medicine, Universite de Montreal, Montreal, QC, Canada
(Clairoux, Tanoubi, Brulotte, Belanger, Raft, Godin, Idrissi, Richebe)
Department of Anesthesiology and Pain Medicine, Hopital
Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montreal (CEMTL),
Montreal, QC, Canada
(Moore, You An, Ruel, Desroches) Department of Anesthesiology, Centre
Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
(Fortier) Department of Statistics, Montreal Health Innovations
Coordinating Center (MHICC), Montreal, QC, Canada
Publisher
Springer
Abstract
Introduction: There is no gold standard for postoperative analgesia after
VATS at the moment. While VATS has significantly decreased tissue trauma
and recovery time compared to thoracotomy, postoperative pain is often
severe due to the presence of chest tubes and multiple injuries to the
ribs, intercostal nerves and pleura. Multiple techniques have been
proposed to fill the research gap on postoperative pain management after
VATS. The paravertebral block is often mentioned, but may present a
questionable benefit-risk ratio given its proximity to the neuraxis. There
is a sizeable niche for a minimally invasive analgesic technique that
could facilitate the advent of ambulatory thoracic surgery1. Our objective
was to determine the analgesic potential of a single-shot Erector Spinae
Block (ESP) for VATS2. The primary objective was the total consumption of
hydromorphone with patient-controlled analgesia (PCA) at 24 hours after
surgery. <br/>Method(s): A prospective, randomized, double-blind study was
conducted in patients scheduled for VATS wedge resection, segmentectomy or
lobectomy. Our study was approved by the local Scientific and Ethics
Committee and was registered under Clinicaltrial.gov. Non-inclusion
criteria included: chronic pain history, regular marijuana use, any
contraindication to a regional block or documented allergy to medications
described in the research protocol. A total of 52 patients were randomized
into 2 groups: single-shot ESP block using bupivacaine (Bupivacaine group
= B) or ESP block with normal saline (Placebo group = P). The sample size
calculation was based on a local preliminary study. ESP blocks were
performed in the lateral decubitus position after standardized induction
of general anesthesia by ESP experts (>= 20 ESP blocks completed) with 30
mL of bupivacaine 0.5 % with epinephrine 5 mcg.mL-1 or 30 mL of normal
saline. Quality of recovery (QoR-15) questionnaire was administered
preoperatively and 24h postoperatively. Postoperative pain was assessed
using a visual analog scale (VAS) at 1h, 6h, 12h, 18h and 24h at rest and
when coughing for the thorax area as well as for shoulder pain. Total
standardized intra-operative fentanyl, total postoperative hydromorphone
consumption (PCA; primary endpoint), and incidence of adverse effects were
evaluated. <br/>Result(s): Demographic data and surgical characteristics
were similar between the groups. There was no difference regarding the
primary objective, hydromorphone consumption over 24 hours (7.6 (4.4) mg
for group B versus 8.1 (4.2) mg for group P at H24; absolute difference:
-0.3 (-2.8 to 2.1 95% CI). Secondary objectives such as intra-operative
fentanyl administration, postoperative pain scores at rest and when
coughing, shoulder pain and QoR-15 scores were not different between the
two groups at any time point during the first 24 hours following surgery
(see figure). There was also no significant difference between the two
groups in all evaluated postoperative adverse events (PONV, pruritus,
sedation scores). <br/>Discussion(s): Our randomized-controlled bicentric
study found no advantage of a single-shot ESP block for VATS lung
resection regarding intra- and postoperative opioid consumption, pain
scores, and QoR-15 scores. Larger VATS incisions by some surgeons and
surgical variability might explain the unexpected negative results
reported in our study3. Further studies are warranted and ongoing in our
center to establish the benefits of using denser blocks such as
paravertebral blocks in association with an ESP block (single shot +
continuous infusion through a catheter), to provide a larger spread of
local anesthetics and likely a better quality of analgesia.

<32>
Accession Number
2024473149
Title
Influence of recombinant human B-type natriuretic peptide on improving
ventricular function in patients with ST elevation myocardial infarction.
Source
European Review for Medical and Pharmacological Sciences. 27(8) (pp
3420-3429), 2023. Date of Publication: 2023.
Author
Yao L.; Liu C.-J.; Zhang L.; Lin Y.; Hu Y.-M.
Institution
(Yao, Hu) Department of Cardiology, Cangzhou Central Hospital, Cangzhou,
China
(Liu) Medical Examination Center, Cangzhou Central Hospital, Cangzhou,
China
(Zhang) Department of Image Center, Cangzhou Central Hospital, Cangzhou,
China
(Lin) Department of Catheter Room, Cangzhou Central Hospital, Cangzhou,
China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: The aim of this study was to investigate the effect of
recombinant human B-type natriuretic peptide (rhBNP) on improving
ventricular function in patients with ST-elevation myocardial infarction
(STEMI). <br/>PATIENTS AND METHODS: In this retrospective study, 96
patients with STEMI admitted to Cangzhou Central Hospital from June 2017
to June 2019 were recruited and randomized to either a control group or an
experimental group, with 48 patients in each group. Patients in both
groups were given conventional pharmacological therapy, and an emergency
coronary intervention was performed within 12 hours. Patients in the
experimental group received rhBNP intravenously postoperatively, whereas
patients in the control group received an equal amount of 0.9% NaCl
solution through an intravenous drip. Postoperative recovery indicators
were compared between the two groups. <br/>RESULT(S): Patients treated
with rhBNP showed better postoperative respiratory frequency, heart rate,
blood oxygen saturation, pleural effusion, acute left heart remodeling
after surgery and central venous pressure at 1-3 days after surgery than
those without (p<0.05). Early diastolic blood flow velocity/early
diastolic motion velocity (E/Em) and wall-motion score indices (WMSI) of
patients in the experimental group were markedly lower compared to the
control group one week after surgery (p<0.05). Patients receiving rhBNP
had better left ventricular ejection fraction (LVEF) and WMSI six months
after surgery and higher left ventricular end diastolic volume (LVEDV) and
LVEF one week after surgery than the controls (p<0.05). Administration of
rhBNP for patients with ST-MI provided a higher treatment safety by
significantly reducing the incidence of left ventricular remodeling and
complication than conventional medication (p<0.05). <br/>CONCLUSION(S):
Intervention with rhBNP in STEMI patients could effectively inhibit
ventricular remodeling, alleviate symptoms, reduce adverse complications
and improve ventricular function.<br/>Copyright &#xa9; 2023 Verduci
Editore s.r.l. All rights reserved.

<33>
Accession Number
2024521559
Title
Ventricular Remodeling and Outcomes After Mitral Transcatheter
Edge-to-Edge Repair in Heart Failure: The COAPT Trial.
Source
JACC: Cardiovascular Interventions. 16(10) (pp 1160-1172), 2023. Date of
Publication: 22 May 2023.
Author
Lindman B.R.; Asch F.M.; Grayburn P.A.; Mack M.J.; Bax J.J.; Gonzales H.;
Goel K.; Barker C.M.; Zalawadiya S.K.; Zhou Z.; Alu M.C.; Weissman N.J.;
Abraham W.T.; Lindenfeld J.; Stone G.W.
Institution
(Lindman, Gonzales, Goel, Barker, Zalawadiya, Lindenfeld) Cardiovascular
Division, Vanderbilt University Medical Center, Nashville, TN, United
States
(Asch, Weissman) Cardiovascular Core Laboratories, MedStar Health Research
Institute, Washington, DC, United States
(Grayburn) Baylor University Medical Center, Baylor Heart and Vascular
Institute, Dallas, TX, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Zhou, Alu) Clinical Trials Center, Cardiovascular Research Foundation,
New York, NY, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The relationship between left ventricular (LV) remodeling and
clinical outcomes after treatment of severe mitral regurgitation (MR) in
heart failure (HF) has not been examined. <br/>Objective(s): The aim of
this study was to evaluate the association between LV reverse remodeling
and subsequent outcomes and assess whether transcatheter edge-to-edge
repair (TEER) and residual MR are associated with LV remodeling in the
COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous
Therapy for Heart Failure Patients With Functional Mitral Regurgitation)
trial. <br/>Method(s): Patients with HF and severe MR who remained
symptomatic on guideline-directed medical therapy (GDMT) were randomized
to TEER plus GDMT or GDMT alone. Baseline and 6-month core laboratory
measurements of LV end-diastolic volume index and LV end-systolic volume
index were examined. Change in LV volumes from baseline to 6 months and
clinical outcomes from 6 months to 2 years were evaluated using
multivariable regression. <br/>Result(s): The analytical cohort comprised
348 patients (190 treated with TEER, 158 treated with GDMT alone). A
decrease in LV end-diastolic volume index at 6 months was associated with
reduced cardiovascular death between 6 months and 2 years (adjusted HR:
0.90 per 10 mL/m² decrease; 95% CI: 0.81-1.00; P = 0.04), with
consistent results in both treatment groups (P<inf>interaction</inf> =
0.26). Directionally similar but nonsignificant relationships were present
for all-cause death and HF hospitalization and between reduced LV
end-systolic volume index and all outcomes. Neither treatment group nor MR
severity at 30 days was associated with LV remodeling at 6 or 12 months.
The treatment benefits of TEER were not significant regardless of the
degree of LV remodeling at 6 months. <br/>Conclusion(s): In patients with
HF and severe MR, LV reverse remodeling at 6 months was associated with
subsequently improved 2-year outcomes but was not affected by TEER or the
extent of residual MR. (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation [The COAPT Trial] and COAPT CAS [COAPT];
NCT01626079)<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<34>
Accession Number
2024506829
Title
Surgical management of spontaneous intracranial hypotension syndrome: a
literature review.
Source
Neurologia i Neurochirurgia Polska. 57(2) (pp 151-159), 2023. Date of
Publication: 2023.
Author
Sobczyk P.; Bojarski P.; Sobstyl M.
Institution
(Sobczyk, Bojarski, Sobstyl) Department of Neurosurgery, Institute of
Psychiatry and Neurology, Warsaw, Poland
Publisher
Via Medica
Abstract
Introduction. Spontaneous intracranial hypotension (SIH) is a highly
disabling but often misdiagnosed disorder. The optimal management options
for patients with SIH remain uncertain. The aim of this study was to
review studies reporting the management of SIH with a special emphasis on
the surgical treatment of SIH including clinical trials, case series and
case reports related to the issue of various neurosurgical procedures
performed for SIH treatment. Objective. The clinical outcomes of patients
diagnosed with SIH treated with either only surgery or with surgery as the
primary method of treatment were analysed. Material and methods. The
PubMed, Scopus and Google Scholar databases were searched according to the
established criteria. Results. The literature search revealed seven
clinical trials, five case series and eight case reports regarding
surgical treatment of patients diagnosed with SIH. Manuscripts reporting
at least five individuals treated surgically for SIH were considered as
case series. In most published articles, surgery provided clinical
benefit, resulting in a success rate of 82.6-100% for complete relief of
SIH symptoms. Conclusions. Our literature review has revealed that SIH can
be diagnosed reliably by MRI and cisternography. The identification of the
location of SIH is mandatory for its successful surgical treatment. The
clinical outcome is related to the location of SIH in the spinal canal.
Most often, cerebrospinal fluid leakage occurs in the thoracic region.
Surgical treatment is very effective and the obtained treatment results
are complete and permanent.<br/>Copyright &#xa9; 2023 Polish Neurological
Society.

<35>
Accession Number
2024505593
Title
Percutaneous Closure of Post-infarct Left Ventricular Pseudoaneurysm: A
Review of Literature.
Source
Current Problems in Cardiology. 48(8) (no pagination), 2023. Article
Number: 101743. Date of Publication: August 2023.
Author
Naguib M.; Elsayed M.; Khouzam R.N.; Iskander A.
Institution
(Naguib) Roayl College of Surgeons in Ireland & North Lincolnshire
(Elsayed) Roayl College of Surgeons in Ireland & Southport, Osmskirk
District Hospital
(Khouzam) Methodist Health Care
(Iskander) Department of Medicine, St. Joseph's Health Hospital
Publisher
Elsevier Inc.
Abstract
Left ventricular pseudoaneurysm is a well-known complication of myocardial
infarction and open-heart surgery and has recently been described as
succeeding transapical transcatheter aortic valve replacement. While
surgical intervention is the conventional therapeutic approach,
transcatheter closure can be considered in patients at high risk for
surgical procedures. In this article, we present a postmyocardial
infarction pseudoaneurysm for which closure was done via retrograde left
ventricular access using an Amplatzer Septal Occluder, and provide a
review of recent literature focusing on indications and outcomes of the
different percutaneous techniques and devices.<br/>Copyright &#xa9; 2023

<36>
Accession Number
2024500125
Title
Effect of Dexmedetomidine on Postoperative Renal Function in Patients
Undergoing Cardiac Valve Surgery Under Cardiopulmonary Bypass: A
Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Qiu Y.-Q.; Zhuang L.-P.; Wu P.-Y.; Zhong L.-Y.; Zhong X.-H.; Chen B.; Liu
Z.-K.; Luo H.-R.; Yang L.-P.
Institution
(Qiu) Department of Anesthesiology, the First Affiliated Hospital of
Fujian Medical University, Fuzhou, China
(Qiu) Anesthesiology Research Institute, the First Affiliated Hospital,
Fujian Medical University, Fuzhou, China
(Qiu) Department of Anesthesiology, National Regional Medical Center,
Binhai Campus of the First Affiliated Hospital, Fujian Medical University,
Fuzhou, China
(Zhuang) Fujian Key Laboratory of Molecular Neurology and Institute of
Neuroscience, Fujian Medical University, Fuzhou, China
(Wu) The Graduate School of Fujian Medical University, Fujian Medical
University, Fuzhou, China
(Zhong) Department of Clinical Medicine, Xiamen Medical College, Xiamen,
China
(Zhong) Key Laboratory of Sports Function Evaluation of General
Administration of Sports of the People's Republic of China, School of PE
and Sport Science, Fujian Normal University, Fuzhou, China
(Chen) Department of Colorectal Surgery, the First Affiliated Hospital of
Fujian Medical University, Fujian, China
(Liu) Sports Teaching and Research Department, Fujian Medical University,
Fuzhou, China
(Luo) Department of Anesthesiology, Fujian Medical University Union
Hospital, Fuzhou, China
(Yang) Department of Cardiovascular Surgery, Fujian Medical University
Union Hospital, Fuzhou, China
Publisher
W.B. Saunders
Abstract
Objective: The effect of dexmedetomidine on postoperative renal function
was investigated in patients undergoing cardiac valve surgery under
cardiopulmonary bypass (CPB). <br/>Design(s): A randomized controlled
trial. <br/>Setting(s): University teaching, grade A tertiary hospital.
<br/>Participant(s): A total of 70 patients scheduled to undergo cardiac
valve replacement or valvuloplasty under CPB were eligible and randomly
divided into groups D (n = 35) and C (n = 35) between January 2020 and
March 2021. <br/>Intervention(s): Patients in group D were administered
0.6 mug/kg/h of dexmedetomidine intravenously from 10 minutes before
anesthesia induction to 6 hours after surgery; normal saline was used
instead of dexmedetomidine in group C. <br/>Measurements and Main Results:
The primary outcome was the incidence of acute kidney injury (AKI). Acute
kidney injury was defined according to the Kidney Disease Improving Global
Outcomes (2012). It was 22.86% and 48.57% in groups D and C, respectively
(p = 0.025). The secondary outcomes were intraoperative hemodynamics and
various indices in serum. Ten minutes before CPB (T<inf>1</inf>), 10
minutes after CPB (T<inf>2</inf>), and 30 minutes after CPB
(T<inf>3</inf>), mean arterial pressure in group D was lower than that in
group C, with statistical significance (74.94 +/- 8.52 v 81.89 +/- 13.66
mmHg, p=0.013; 62.83 +/- 11.27 v 71.86 +/- 7.89 mmHg, p < 0.001; 72.26 +/-
8.75 v 78.57 +/- 8.83 mmHg, p = 0.004). At T<inf>1</inf>, the heart rate
in group D was significantly lower than in group C (80.89 +/- 14.04 v
95.54 +/- 12.53 bpm, p=0.022). The tumor necrosis factor alpha,
interleukin-6, C-reactive protein, and cystatin C levels in group D were
lower than those in group C after the surgery (T<inf>4</inf>) and 24 hours
after surgery (T<inf>5</inf>), with statistical significance. The duration
of mechanical ventilation, intensive-care-unit stay time, and hospital
stay time in group D were significantly shorter than in group C. The
incidences of tachycardia, hypertension, nausea, and vomiting in group D
were similar to those in group C. <br/>Conclusion(s): Dexmedetomidine may
be considered as a way to reduce the incidence and severity of
postoperative AKI in patients undergoing cardiac valve surgery under
cardiopulmonary bypass.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<37>
Accession Number
2024498135
Title
Coronary artery bypass grafting in dialysis-dependent patients - Key
peri-operative considerations.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Shell D.
Institution
(Shell) Department of Cardiothoracic Surgery, St Vincent's Hospital -
Melbourne, St Vincent's Health Australia, Melbourne, Australia
Publisher
Elsevier Inc.
Abstract
Cardiovascular disease represents the leading cause of mortality in
dialysis-dependent (DD) patients, with the great majority of these
patients afflicted by severe coronary artery disease. As rates of
end-stage renal disease increase worldwide, DD patients represent a
growing proportion of the coronary artery bypass grafting (CABG) cohort.
Yet, these patients are complex, with crucial changes in their
haemodynamic and physiologic profiles that complicate revascularisation
surgery. First, this comprehensive literature review explores the outcomes
and prognostic factors for DD patients undergoing CABG. We then summarise
the intricacies relating to important peri-operative decisions such as use
of cardio-pulmonary bypass and choice of conduit.<br/>Copyright &#xa9;
2023 Elsevier Inc.

<38>
Accession Number
641296179
Title
The role of cardiac surgery in radiation-associated heart disease: a
scoping review.
Source
General thoracic and cardiovascular surgery. (no pagination), 2023. Date
of Publication: 11 May 2023.
Author
Shell D.
Institution
(Shell) Department of Cardiothoracic Surgery, St Vincent's Hospital
Melbourne, St Vincent's Health Australia, Melbourne, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thoracic irradiation is an important tool in the treatment of
breast cancer, non-Hodgkin's lymphoma, and other cancers of the chest. The
heart is commonly involved in these radiation fields, and young patients
can present with severe cardiac pathologies requiring surgical
intervention. However, this population poses a high surgical risk due to
involvement of mediastinal tissues, and there are no consensus guidelines
on best practice management. AIM: This review aims to summarise the
current experience of surgical correction of radiation-associated heart
disease. We explore outcomes, technique modifications and alternative
therapies for the three primary procedures performed: coronary artery
bypass grafting, valvular intervention and pericardiectomy.
<br/>METHOD(S): OVID Medline and PubMed databases were comprehensively
searched to identify all studies involving surgery in patients with prior
chest radiotherapy. All relevant studies within the past 25 years have
been discussed. <br/>CONCLUSION(S): Irradiated patients have heightened
peri-operative risk, but other than redo surgery, these operations are not
as treacherous as once thought. Involvement of all layers of the heart,
especially the myocardium, is such that long-term mortality suffers
despite optimal surgical correction. The goal of surgery in this cohort
should be for a quick and safe operation, rather than a technically
difficult procedure aimed at longevity.<br/>Copyright &#xa9; 2023. The
Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery.

<39>
Accession Number
641293173
Title
Analysis of Repair Type and Hypogastric Artery Antegrade Perfusion and
Erectile Function Following Repair of Abdominal Aortic Aneurysms.
Source
Annals of vascular surgery. (no pagination), 2023. Date of Publication:
08 May 2023.
Author
Bennett K.M.; Hurley L.; Kyriakides T.C.; Matsumura J.S.
Institution
(Bennett, Matsumura) Department of Surgery, University of Wisconsin School
of Medicine and Public Health, Madison, WI; Middleton Veterans Affairs
Medical Center, Surgery Service, Madison, WI
(Hurley) Department of Veterans Affairs, Cooperative Studies Program
Coordinating Center, West, Haven, CT; Department of Biostatistics, School
of Public Health, Yale University, New Haven, CT
(Kyriakides) Department of Veterans Affairs, Cooperative Studies Program
Coordinating Center, West, Haven, CT
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Published reports suggest that exclusion of antegrade
hypogastric artery flow may have deleterious effects on erectile function
after abdominal aortic aneurysm repair. Off-label and open surgical hybrid
procedures and, more recently, purpose-built branched devices have been
developed to maintain antegrade pelvic perfusion in patients undergoing
endovascular repair. Maintaining antegrade perfusion may reduce a spectrum
of risks, including buttock claudication, colorectal ischemia, spinal cord
ischemia when patients undergo subsequent thoracic aortic procedures, as
well as erectile dysfunction. This project specifically focuses on
erectile function, and analyzes baseline associations and relationships of
hypogastric artery exclusion on changes in erectile function following
aneurysm repair. <br/>METHOD(S): Male patients in the Veterans Affairs
Open Versus Endovascular Repair (CSP#498; OVER) Trial had erectile
function assessed pre- and postoperatively by administration of the
International Index of Erectile Function-5 questionnaire. Bayesian
mixed-effects regression models were created with the outcome variable
(erectile function) treated as a latent variable. Primary effects of
differences in erectile function between groups with and without
preservation of bilateral antegrade hypogastric flow were compared.
<br/>RESULT(S): 876 men (442 randomized to endovascular repair) were
enrolled in the trial and included in the analysis comparing treatment
assignment. There is significant erectile dysfunction in elderly men with
aortic aneurysm at baseline. Over five years of follow up, there is modest
decrease in erectile function and the endovascular group has improved
function compared to open repair (0.082; 95% credible interval 0.008 and
0.155). A fifth of patients did not have bilateral preservation of
antegrade hypogastric artery perfusion, with no difference in erectile
function by univariate analysis. A more detailed regression analysis was
applied--and after adjustment for baseline score, age, beta blocker use,
diabetes, activity level, ejection fraction, preoperative ABIs and
time--preservation of both antegrade hypogastric arteries' perfusion
showed transient improvement in survey scores compared to occlusion of at
least one hypogastric artery at 6 months and 12 months after treatment,
although this was not sustained at 60 months (score change: 0.046; 95%
credible interval: -0.123, 0.215). Retesting this model in the cohort with
complete data as a sensitivity analysis did not meaningfully change the
conclusions. <br/>CONCLUSION(S): In this large prospective aneurysm
treatment trial with systematic measurement of erectile function with a
validated instrument, endovascular repair is associated with improved
erectile function. Preservation of antegrade hypogastric flow with any
repair is associated with early improved erectile function; however, it is
not a sustained benefit. There is limited benefit of maintaining bilateral
hypogastric artery perfusion for this specific indication in unselected
men undergoing AAA repair.<br/>Copyright &#xa9; 2023. Published by
Elsevier Inc.

<40>
Accession Number
641291234
Title
Comparisons of different new-generation transcatheter aortic valve
implantation devices for patients with severe aortic stenosis: A
systematic review and network meta-analysis.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 11 May 2023.
Author
Yang Y.-X.; Liu X.-M.; Fu Y.; Li C.; Wang H.-J.; Xu L.; Xia K.; Zhang
Z.-Y.; Zhong J.-C.; Chen M.-L.; Su P.-X.; Wang L.-F.
Institution
(Yang) Heart Center and Beijing Key Laboratory of Hypertension, Beijing
Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road,
Chaoyang District, Beijing 100020, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether there are differences among the new-generation
transcatheter aortic valve implantation (TAVI) devices for patients with
aortic stenosis (AS) remains unclear. The aim of the study was to compare
the efficiency and safety of different new-generation TAVI devices for
patients with AS. MATERIALS AND METHODS: A comprehensive search of PubMed,
Embase and Web of Science from their inception to February 1, 2022.
Randomized clinical trials (RCT) and observational studies that compared
two or more different TAVI devices were enrolled. Pairwise meta-analysis
and frequentist network meta-analysis were conducted to pool the outcome
estimates of interest. <br/>RESULT(S): A total of 79 studies were finally
included. According to the surface under the cumulative ranking, the top
two ranked valves for lower rates of events were as follows: DFM (4.6%)
and Lotus (48.8%) for lower rate of device success; Sapien 3 (16.8%) and
DFM (19.7%) for lower mortality; DFM (8.6%) and Sapien 3 (25.5%) for lower
rates of stroke; Evolut (27.6%) and DFM (35.8%) for lower rates of major
and life-threatening bleeding (MLTB); Portico (22.6%) and Sapien 3 (41.9%)
for lower rates of acute kidney injury (AKI); Acurate (8.6%) and DFM
(13.2%) for lower rates of permanent pacemaker implantation (PPI); Lotus
(0.3%) and Sapien 3 (22.7%) for lower rates of paravalvular leak (PVL);
Evolut (1.4%) and Portico (29.1%) for lower rates of mean aortic valve
gradients (MAVG). <br/>CONCLUSION(S): The findings of the present study
suggested that the device success rates were comparable among these
new-generation valves except for DFM. After excluding DFM, Sapien 3 might
be the best effective for decreased mortality and stroke; Lotus might be
the best effective for decreased PVL; Evolut might be the best effective
for decreased MLTB and MAVG; Acurate and Portico might be the best
effective for decreased PPI and AKI respectively.<br/>Copyright &#xa9;
2023 the Author(s). Published by Wolters Kluwer Health, Inc.

<41>
Accession Number
2022353412
Title
Effects of glucagon-like peptide-1 receptor agonists on major coronary
events in patients with type 2 diabetes.
Source
Diabetes, Obesity and Metabolism. 25(S1) (pp 53-63), 2023. Date of
Publication: April 2023.
Author
Guo X.; Sang C.; Tang R.; Jiang C.; Li S.; Liu N.; Long D.; Du X.; Dong
J.; Ma C.
Institution
(Guo, Sang, Tang, Jiang, Li, Liu, Long, Du, Dong, Ma) Department of
Cardiology, Beijing Anzhen Hospital, Capital Medical University, National
Clinical Research Center for Cardiovascular Diseases, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Aims: To perform a meta-analysis to assess the effects of glucagon-like
peptide-1 receptor agonists (GLP-1RAs) on major coronary events, including
myocardial infarction (MI), unstable angina and coronary
revascularization, in patients with type 2 diabetes mellitus (T2DM).
<br/>Material(s) and Method(s): We systematically searched the PubMed,
CENTRAL, EMBASE and clinicaltrial.gov databases to seek eligible studies
with a cardiovascular endpoint comparing GLP-1RAs with a placebo in T2DM
patients. Odds ratio (ORs) and 95% confidence intervals (CIs) were
calculated for the outcomes. <br/>Result(s): Nine studies, with a total of
64 236 patients, were included. GLP-1RA treatment reduced fatal and
nonfatal MI by 8% (OR 0.92, 95% CI 0.86-0.99; P = 0.02, I² =
39%). The reduction reached 15% in human-based GLP-1RA-treated patients.
Similarly, once-weekly GLP-1RA treatment reduced the risk of MI by 13%. In
contrast, GLP-1RA treatment did not reduce the risk of hospitalization for
unstable angina (OR 1.11, 95% CI 0.97-1.28; P = 0.13, I² =
21%). GLP-1RAs exhibited a tendency to lower the risk of coronary
revascularization (OR 0.95, 95% CI 0.89-1.02; P = 0.15, I² =
22%), but without statistical significance. Human-based GLP-1RAs decreased
the risk by 11%. <br/>Conclusion(s): In high-risk patients with T2DM,
GLP-1RAs were associated with a decrease in MI, especially the human-based
and once-weekly GLP-1RAs. No benefit was seen for hospitalization for
unstable angina or coronary revascularization. Further research is
urgently needed to ascertain improvements in coronary
events.<br/>Copyright &#xa9; 2023 John Wiley & Sons Ltd.

<42>
Accession Number
2021190937
Title
A Novel Reperfusion Strategy for Primary Percutaneous Coronary
Intervention in Patients with Acute ST-Segment Elevation Myocardial
Infarction: A Prospective Case Series.
Source
Journal of Clinical Medicine. 12(2) (no pagination), 2023. Article Number:
433. Date of Publication: January 2023.
Author
He J.-F.; Yang Y.-X.; Li J.-Y.; Liang L.; Xu L.; Liu Y.; Guo Z.-S.; Yang
Q.; Jiang T.; Lin X.-M.; Yang X.-C.; Chen M.-L.; Su P.-X.; Zhong J.-C.;
Wang L.-F.
Institution
(He, Yang, Li, Xu, Liu, Guo, Lin, Yang, Chen, Su, Zhong, Wang) Heart
Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang
Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang
District, Beijing 100020, China
(Liang, Yang, Jiang) Department of Radiology, Beijing Chaoyang Hospital,
Capital Medical University, No. 8, Gongti South Road, Chaoyang District,
Beijing 100020, China
Publisher
MDPI
Abstract
Background: Ischemia reperfusion injury (IRI) remains a major problem in
patients with acute ST-segment elevation myocardial infarction (STEMI)
undergoing primary percutaneous coronary intervention (PCI). We have
developed a novel reperfusion strategy for PCI and named it
"volume-controlled reperfusion (VCR)". The aim of the current study was to
assess the safety and feasibility of VCR in patients with STEMI.
<br/>Method(s): Consecutive patients admitted to Beijing Chaoyang Hospital
with STEMI were prospectively enrolled. The feasibility endpoint was
procedural success. The safety endpoints included death from all causes,
major vascular complications, and major adverse cardiac event (MACE),
i.e., a composite of cardiac death, myocardial reinfarction, target vessel
revascularization (TVR), and heart failure. <br/>Result(s): A total of 30
patients were finally included. Procedural success was achieved in 28
(93.3%) patients. No patients died during the study and no major vascular
complications or MACE occurred during hospitalization. With the exception
of one patient (3.3%) who underwent TVR three months after discharge, no
patient encountered death (0.0%), major vascular complications (0.0%), or
and other MACEs (0.0%) during the median follow-up of 16 months.
<br/>Conclusion(s): The findings of the pilot study suggest that VCR has
favorable feasibility and safety in patients with STEMI. Further larger
randomized trials are required to evaluate the effectiveness of VCR in
STEMI patients.<br/>Copyright &#xa9; 2023 by the authors.

<43>
Accession Number
2020967041
Title
Incidence and Associations of Acute Kidney Injury after General Thoracic
Surgery: A System Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(1) (no pagination), 2023. Article Number:
37. Date of Publication: January 2023.
Author
Yu Y.; Xu S.; Yan B.; Tang X.; Zhang H.; Pan C.; Zhu S.
Institution
(Yu, Xu, Tang, Zhang, Pan, Zhu) Department of Anesthesiology, The First
Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
310000, China
(Yan) Department of Anesthesiology, Haining People's Hospital, Haining
314499, China
Publisher
MDPI
Abstract
(1) Background: Acute kidney injury (AKI) is related to adverse outcomes
in critical illness and cardiovascular surgery. In this study, a
systematic literature review and meta-analysis was carried out to evaluate
the incidence and associations of AKI as a postoperative complication of
thoracic (including lung resection and esophageal) surgical procedures.
(2) Methods: Adopting a systematic strategy, the electronic reference
databases (PubMed, EMBASE, and Cochrane Library) were searched for
articles researching postoperative renal outcomes that were diagnosed
using RIFLE, AKIN or KDIGO consensus criteria in the context of a thoracic
operation. A random-effects model was applied to estimate the incidence of
AKI and, where reported, the pooled relative risk of mortality and
non-renal complications after AKI. The meta-analysis is registered in
PROSPERO under the number CRD42021274166. (3) Results: In total, 20
studies with information gathered from 34,826 patients after thoracic
surgery were covered. Comprehensively, the incidence of AKI was estimated
to be 8.8% (95% CI: 6.7-10.8%). A significant difference was found in the
mortality of patients with and without AKI (RR = 2.93, 95% CI: 1.79-4.79,
p < 0.001). Additionally, in patients experiencing AKI, cardiovascular and
respiratory complications were more common (p = 0.01 and p < 0.001,
respectively). (4) <br/>Conclusion(s): AKI is a common complication
associated with adverse outcomes following general thoracic surgery. An
important issue in perioperative care, AKI should be considered as a
highly significant prognostic indicator and an attractive target for
potential therapeutic interventions, especially in high-risk
populations.<br/>Copyright &#xa9; 2022 by the authors.

<44>
Accession Number
2019950825
Title
Early and mid-term outcomes of transcatheter tricuspid valve repair:
systematic review and meta-analysis of observational studies.
Source
Revista Espanola de Cardiologia. 76(5) (pp 322-332), 2023. Date of
Publication: May 2023.
Author
Alperi A.; Avanzas P.; Almendarez M.; Leon V.; Hernandez-Vaquero D.; Silva
I.; Fernandez del Valle D.; Fernandez F.; Diaz R.; Rodes-Cabau J.; Moris
C.; Pascual I.
Institution
(Alperi, Avanzas, Almendarez, Leon, Hernandez-Vaquero, Silva, Fernandez
del Valle, Fernandez, Diaz, Moris, Pascual) Area del Corazon, Hospital
Universitario Central de Asturias, Asturias, Oviedo, Spain
(Alperi, Avanzas, Almendarez, Hernandez-Vaquero, Diaz, Moris, Pascual)
Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA),
Asturias, Oviedo, Spain
(Avanzas, Hernandez-Vaquero, Moris, Pascual) Universidad de Oviedo,
Asturias, Oviedo, Spain
(Rodes-Cabau) Quebec's Heart and Lung Institute, Quebec, Canada
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Severe tricuspid regurgitation (TR) is
associated with poor prognosis when left untreated, and a growing number
of studies on transcatheter tricuspid valve repair (TTVr) have been
published over the last few months. <br/>Method(s): We performed a
comprehensive systematic review of published literature providing clinical
data on TTVr for patients with significant TR. Early and mid-term clinical
and echocardiographic outcomes were evaluated. Risk ratios (RR) or mean
differences (MD) were obtained when comparing pre- and postprocedural
data. A sensitivity analysis was also performed according to the main
approach for repair (edge-to-edge vs annuloplasty). <br/>Result(s): A
total of 19 studies (all observational or single-arm trials) and 991
patients who underwent isolated TTVr were included. Thirty-day mortality
and stroke rates were 2.8% and 0.2%, respectively. Pooled random-effects
resulted in a significant reduction of >= severe TR (RR, 0.33; 95%CI,
0.26-0.42; P <.001), vena contracta width (MD, 5.9 mm; 95%CI, 4-7.9; P
<.001), right ventricular end-diastolic diameter (MD, 3.5 mm; 95%CI,
2.5-4.5; P <.001), and New York Heart Association (NYHA) class III or IV
at last follow-up (RR, 0.32; 95%CI, 0.27-0.37; P <.001). Bleeding
complications and residual >= severe TR were numerically higher in the
annuloplasty-like group compared with edge-to-edge repair (13.3% vs 3.8%
for bleeding and 40.4% vs 27.9% for residual severe TR).
<br/>Conclusion(s): Among 991 patients comprising the early experience for
several TTVr devices, there was a statistically significant reduction in
>= severe TR, NYHA class III-IV, vena contracta width and right
ventricular end-diastolic diameter after TTVr. Thus far, the edge-to-edge
approach seems to be associated with a better safety
profile.<br/>Copyright &#xa9; 2022 Sociedad Espanola de Cardiologia

<45>
[Use Link to view the full text]
Accession Number
2018237793
Title
Optimal Gender-Specific Strategies for the Secondary Prevention of Heart
Disease in Women A SYSTEMATIC REVIEW.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 38(5) (pp
279-285), 2018. Date of Publication: 01 Sep 2018.
Author
Rao A.; Newton P.J.; DiGiacomo M.; Hickman L.D.; Hwang C.; Davidson P.M.
Institution
(Rao, DiGiacomo, Hickman, Davidson) Faculty of Health, University of
Technology Sydney, Sydney, Australia
(Newton) Western Sydney University, Sydney, Australia
(Hwang) St. Vincent's Hospital Sydney, Darlinghurst, Australia
(Davidson) School of Nursing, Johns Hopkins University, Baltimore, MD,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: There is a paucity of evidence on gender-specifi c,
individually tailored secondary prevention (cardiac rehabilitation [CR])
services for women with heart disease. Women participate less in CR
programs, thus increasing their risk of further cardiac events. This
review aims to (1) determine the effectiveness of gender-specifi c
interventions specifi cally designed for women with heart disease,
delivered in outpatient CR settings; and (2) classify key elements of
effective CR strategies/models for women with heart disease.
<br/>Method(s): Using the PRISMA guidelines, this is a systematic review
of CR models tailored to women to improve cardiovascular risk. Four
databases were searched for randomized controlled trials (RCTs) between
January 1974 and July 2017 published in peer-reviewed English language
journals. <br/>Result(s): Three RCTs comprising 725 women of
gender-specific CR strategies were identifi ed. Signifi cant improvements
were found in one-third (1 study) of the included multicomponent CR
strategies for outcomes including general health, social functioning,
vitality, mental health, depression, and quality of life.
<br/>Conclusion(s): Further large-scale RCTs are required to replicate
positive fi ndings and accurately assess the capacity for gender-specifi c
multicomponent CR programs that incorporate participant-driven
collaborative models to moderate psychological risk and improve functional
capacity and quality of life for women with heart disease.<br/>Copyright
&#xa9; 2018 Wolters Kluwer Health, Inc.

<46>
[Use Link to view the full text]
Accession Number
2017834773
Title
A systematic review and meta-analysis examining the impact of sleep
disturbance on postoperative delirium.
Source
Critical Care Medicine. 46(12) (pp E1204-E1212), 2018. Date of
Publication: December 2018.
Author
Fadayomi A.B.; Ibala R.; Bilotta F.; Westover M.B.; Akeju O.
Institution
(Fadayomi) Division of Epidemiology, Department of Obstetrics and
Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Ibala, Akeju) Department of Anesthesia, Critical Care, and Pain Medicine,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Bilotta) Department of Anesthesia and Critical Care Medicine, Sapienza
University, Rome, Italy
(Westover) Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: Basic science and clinical studies suggest that sleep
disturbance may be a modifiable risk factor for postoperative delirium. We
aimed to assess the association between preoperative sleep disturbance and
postoperative delirium. <br/>Data Sources: We searched PubMed, Embase,
CINAHL, Web of Science, and Cochrane from inception until May 31, 2017.
Study Selection: We performed a systematic search of the literature for
all studies that reported on sleep disruption and postoperative delirium
excluding cross-sectional studies, case reports, and studies not reported
in English language. <br/>Data Extraction: Two authors independently
performed study selection and data extraction. We calculated pooled
effects estimates with a random-effects model constructed in Stata and
evaluated the risk of bias by formal testing (Stata Corp V.14, College
Station, TX), Data Synthesis: We included 12 studies, from 1,238 citations
that met our inclusion criteria. The pooled odds ratio for the association
between sleep disturbance and postoperative delirium was 5.24 (95% CI,
3.61-7.60; p < 0.001 and I² = 0.0%; p = 0.76). The pooled risk
ratio for the association between sleep disturbance and postoperative
delirium in prospective studies (n = 6) was 2.90 (95% CI, 2.28-3.69; p <
0.001 and I² = 0.0%; p = 0.89). The odds ratio associated with
obstructive sleep apnea and unspecified types of sleep disorder were 4.75
(95% CI, 2.65-8.54; p < 0.001 and I² = 0.0%; p = 0.85) and 5.60
(95% CI, 3.46-9.07; p < 0.001 and I² = 0.0%; p = 0.41),
respectively. We performed Begg's and Egger's tests for publication bias
and confirmed a null result for publication bias (p = 0.371 and 0.103,
respectively). <br/>Conclusion(s): Preexisting sleep disturbances are
likely associated with postoperative delirium. Whether system-level
initiatives targeting patients with preoperative sleep disturbance may
help reduce the prevalence, morbidity, and healthcare costs associated
with postoperative delirium remains to be determined.<br/>Copyright &#xa9;
2018 by the Society of Critical Care Medicine and Wolters Kluwer Health,
Inc. All Rights Reserved.

<47>
Accession Number
2017824136
Title
Propensity score matched comparison of subcutaneous and transvenous
implantable cardioverter-defibrillator therapy in the SIMPLE and
EFFORTLESS studies.
Source
Europace. 20(FI2) (pp F240-F248), 2018. Date of Publication: 01 Sep 2018.
Author
Brouwer T.F.; Knops R.E.; Kutyifa V.; Barr C.; Mondesert B.; Boersma
L.V.A.; Lambiase P.D.; Wold N.; Jones P.W.; Healey J.S.
Institution
(Brouwer, Knops) Department of Clinical and Experimental Cardiology, Heart
Center, Academic Medical Center, University of Amsterdam, PO Box 22700,
Amsterdam 1100 DE, Netherlands
(Kutyifa) Division of Cardiology, University of Rochester, Rochester, NY,
United States
(Barr) Department of Cardiology, Russells Hall Hospital, Dudley, United
Kingdom
(Mondesert) Montreal Heart Institute, Universite de Montreal, Montreal,
QC, Canada
(Boersma) Department of Cardiology, St Antonius Ziekenhuis, Nieuwegein,
Netherlands
(Lambiase) Institute of Cardiovascular Science, The Heart Hospital,
University College London, London, United Kingdom
(Wold, Jones) Boston Scientific Corporation, Minneapolis, MN, United
States
(Healey) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
Publisher
Oxford University Press
Abstract
Aims Comparison of outcomes between subcutaneous and transvenous
implantable cardioverter-defibrillator (S-ICD and TV-ICD) therapy is
hampered by varying patient characteristics and complication definitions.
The aim of this analysis is to compare clinical outcomes of S-ICD and
TV-ICD therapy in a matched cohort. Methods Patients implanted with de
novo implantable cardioverter-defibrillators without need for pacing were
selected from two and results studies: SIMPLE (n = 1091 single and n = 553
dual chamber TV-ICDs) and EFFORTLESS (n = 798 S-ICDs). Subcutaneous
implantable cardioverter-defibrillator patients were 1:1 matched on
propensity score to TV-ICD patients. Propensity scores were calculated
using 15 baseline characteristics including diagnosis. The Kaplan-Meier
estimates for complications requiring invasive intervention, appropriate
shocks, and inappropriate shocks were calculated at 3 years follow-up. The
primary analysis yielded 391 patients pairs with balanced baseline
characteristics, with mean age 55 +/- 14 years, 49% ischaemic
cardiomyopathy, mean left ventricular ejection fraction 40%, 71% primary
prevention, and 89% of TV-ICDs were single chamber. Follow-up was mean 2.9
years in the S-ICD arm vs. 3.3 in the TV-ICD arm. All-cause complications
occurred in 9.0% of S-ICD vs. 6.5% of TV-ICD patients, P = 0.29.
Appropriate shocks occurred in 9.9% of S-ICD vs. 13.8% in TV-ICD patients,
P = 0.03 and inappropriate shocks in 11.9% in S-ICD vs. 8.9% in TV-ICD
patients (P = 0.07). Total shock burden (20 vs. 31, P = 0.05) and
appropriate shock burden per 100 patients years (9 vs. 18, P = 0.02) were
lower for S-ICD patients, while inappropriate shock burden was equal (11
vs. 13, P = 0.56). Conclusion The earliest experience of the S-ICD
demonstrates similar outcomes as contemporary TV-ICD therapy in a matched
comparison with predominately single-chamber devices at 3 years
follow-up.<br/>Copyright &#xa9; The Author(s) 2018.

<48>
Accession Number
2024353861
Title
Calcification in Pulmonary Heart Valve Tissue Engineering: A Systematic
Review and Meta-Analysis of Large-Animal Studies.
Source
JACC: Basic to Translational Science. 8(5) (pp 572-591), 2023. Date of
Publication: May 2023.
Author
van der Valk D.C.; Fomina A.; Uiterwijk M.; Hooijmans C.R.; Akiva A.;
Kluin J.; Bouten C.V.C.; Smits A.I.P.M.
Institution
(van der Valk, Fomina, Bouten, Smits) Department of Biomedical
Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
(van der Valk, Bouten, Smits) Institute for Complex Molecular Systems,
Eindhoven University of Technology, Eindhoven, Netherlands
(Uiterwijk, Kluin) Heart Center, Amsterdam University Medical Center,
Amsterdam, Netherlands
(Fomina) Graduate School of Life Sciences, Utrecht University, Utrecht,
Netherlands
(Hooijmans) Department for Health Evidence (Unit SYstematic Review Centre
for Laboratory animal Experimentation [SYRCLE]), Radboud University
Medical Center, Nijmegen, Netherlands
(Hooijmans) Department of Anesthesiology, Pain and Palliative Care,
Radboud University Medical Center, Nijmegen, Netherlands
(Akiva) Department of Biochemistry, Radboud University Medical Center,
Institute for Molecular Life Sciences, Nijmegen, Netherlands
Publisher
Elsevier Inc.
Abstract
Tissue-engineered heart valves (TEHVs) are emerging alternatives to
current valve prostheses and prospectively a lifelong replacement.
Calcification, a pathological complication for biological protheses, has
been reported in preclinical TEHV studies. Systematic analysis of its
occurrence is missing. This review aims to: 1) systematically review
reported calcification of pulmonary TEHVs in large-animal studies; and 2)
analyze the influence of engineering methodology (choice of scaffold
material, cell preseeding) and animal model (animal species and age) on
calcification. Baseline analysis included 80 studies, of which 41 studies
containing 108 experimental groups were included in meta-analysis.
Inclusion was low because only 55% of studies reported on calcification.
Meta-analysis showed an overall average calcification event rate of 35%
(95% CI: 28%-43%). Calcification was more prominent (P = 0.023) in the
arterial conduit region (34%; 95% CI: 26%-43%) than in the valve leaflets
(21%; 95% CI: 17%-27%), and was mostly (42% in leaflets, 60% in conduits)
present in a mild form. Time-analysis showed an initial surge within 1
month after implantation, decreased calcification between 1 and 3 months,
and then progression over time. There were no significant differences in
degree of calcification between TEHV strategy nor animal models. Much
variability between individual studies was observed in degree of
calcification as well as quality of analysis and reporting thereof,
hampering adequate comparisons between studies. These findings underline
the need for improved analysis and better reporting standards of
calcification in TEHVs. It also necessitates control-based research to
further enlighten the risk of calcification for tissue-engineered
transplants compared to current options. This can bring the field of heart
valve tissue engineering forward toward safe clinical use.<br/>Copyright
&#xa9; 2023 The Authors

<49>
Accession Number
2024291530
Title
Multimodality therapy for lung cancer invading the chest wall: A study of
the French EPITHOR database.
Source
Lung Cancer. 181 (no pagination), 2023. Article Number: 107224. Date of
Publication: July 2023.
Author
Tricard J.; Filaire M.; Verge R.; Pages P.-B.; Brichon P.-Y.; Loundou A.;
Boyer L.; Thomas P.A.
Institution
(Tricard, Filaire, Verge, Pages, Brichon, Thomas) EPITHOR Group, French
Society of Thoracic and Cardiovascular Surgery, 56 Bd Vincent Auriol,
Paris 75013, France
(Tricard) Department of Cardio-Thoracic Surgery, University Hospital of
Limoges, 16 Rue Bernard Descottes, Limoges 87042, France
(Filaire) Department of Thoracic and Endocrinological Surgery, Center Jean
Perrin, 58 Rue Montalembert, Clermont-Ferrand 63011, France
(Verge) Department of Thoracic Surgery, University Hospital of Toulouse,
24 Chem. de Pouvourville, Toulouse 31400, France
(Pages) Department of Thoracic and Cardiovascular Surgery, University
Hospital of Dijon, 14 Rue Paul Gaffarel, Dijon 21000, France
(Brichon) Department of Thoracic Surgery, University Hospital of Grenoble,
Av. des Maquis du Gresivaudan, La Tronche 38700, France
(Loundou, Boyer) Department of Medical Information, Assistance Publique -
Hopitaux Marseille & Centre d'Etudes et de Recherches sur les Services de
Sante et qualite de vie, CEReSS/EA 3279, 27 Bd Jean Moulin, Marseille
13385, France
(Thomas) Department of Thoracic Surgery, North Hospital, Assistance
Publique - Hopitaux Marseille, & Predictive Oncology Laboratory, CRCM,
Inserm UMR 1068, CNRS, UMR 7258, Aix-Marseille University UM105, Chem. des
Bourrely, Marseille 13015, France
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: According to a nation-based study, we intend to report the
data of the patients operated on for lung cancer invading the chest wall,
taking into consideration the completion of induction chemotherapy
(Ind_CT), induction radiochemotherapy (Ind_RCT) or no induction therapy
(0_Ind). <br/>Material(s) and Method(s): All patients with a primary lung
cancer invading the chest wall who underwent radical resection from 2004
to 2019 were included. Superior sulcus tumors were excluded.
<br/>Result(s): Overall, 688 patients were included: 522 operated without
induction therapy, 101 with Ind_CT and 65 with Ind_RCT. Postoperative
90-day mortality was 10.7% in the 0_Ind group, 5.0% in the Ind_CT group,
7.7% in the Ind_RCT group (p = 0.17). Incomplete resection rate was 14.0%
in the 0_Ind group, 6.9% in the Ind_CT group, 6.2% in the Ind_RCT group (p
= 0.04). In the 0_Ind group, 70% of the patients received adjuvant
therapies. Overall survival (OS) analysis disclosed the best long-term
outcomes in the Ind_RCT group (5-year OS probability: 56.5% versus 40.0%
and 40.5% for 0_Ind and Ind_CT groups, respectively; p = 0.035). At
multivariable analysis, Ind_RCT (HR = 0.571; p = 0.008), age > 60 years
old (HR = 1,373; p = 0.005), male sex (HR = 1.710; p < 0.001),
pneumonectomy (HR = 1.368; p = 0.025), pN2 status (HR = 1.981; p < 0.001),
>=3 resected ribs (HR = 1.329; p = 0.019), incomplete resection (HR =
2.284; p < 0.001) and lack of adjuvant therapy (HR = 1.959; p < 0.001)
were associated with OS. Ind_CT was not associated with survival (HR =
0.848; p = 0.257). <br/>Conclusion(s): Induction chemoradiation therapy
seems to improve survival. Therefore, the present results should be
confirmed by a prospective randomized trial testing the benefit of
induction radiochemotherapy for NSCLC invading the chest
wall.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<50>
Accession Number
2023805485
Title
Angiographic quantification of aortic regurgitation following myval
octacor implantation; independent core lab adjudication.
Source
International Journal of Cardiology. 382 (pp 68-75), 2023. Date of
Publication: 01 Jul 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.; Senguttuvan N.B.;
Baumbach A.; Serruys P.W.; Soliman O.
Institution
(Elkoumy, Abdelshafy, Elzomor, Arsang-Jang, Serruys, Soliman) Discipline
of Cardiology, Saolta Group, Galway University Hospital, Health Service
Executive and CORRIB Core Lab, University of Galway, Galway H91 V4AY,
Ireland
(Elkoumy) 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, Kerala, Calicut 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,
Girgaon, Maharashtra, Mumbai 400004, India
(Chandra, Kapoor) Medanta, The Medicity Hospitals, Haryana 122001, India
(Seth, Agrawal, Mathur) Fortis Escorts Heart Institute, New Delhi 110025,
India
(Rao) Rajasthan Hospital Limited, Rajasthan, Jaipur 302018, India
(Sadanada) Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka, Mysuru 570016, India
(Kumar) Madras Medical Mission Hospital, Tamil Nadu, Chennai 600037, India
(Arsang-Jang, Serruys, Soliman) CURAM, SFI Research Centre for Medical
Devices, Galway H91 W2TY, Ireland
(Mehrotra, Raghuraman, Khanolkar) Narayana Institute of Cardiac Sciences,
Karnataka, Bengaluru 560099, India
(Premchand) Krishna Institute of Medical Sciences (KIMS), Telangana,
Hyderabad 500014, India
(Chopra) Narayana Hospital (NH), Gujarat, Ahmedabad 380023, India
(Krishna) P S Govindaswami (PSG), Coimbatore 641004, India
(Mehta) S. L. Raheja Hospital - Fortis, Maharashtra, Mumbai 400016, India
(Gupta) Apollo Hospital, Maharashtra, Navi Mumbai 400614, India
(Kumar) Max Hospital, Saket, Delhi, New Delhi 110017, India
(Senguttuvan) Sri Ramachandra Hospital (SRMC), Tamil Nadu, Chennai 600116,
India
(Baumbach) William Harvey Research Institute, Queen Mary University of
London and Barts Heart Centre, London EC1M 6BQ, United Kingdom
Publisher
Elsevier Ireland Ltd
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 The Author(s)

<51>
Accession Number
2023127789
Title
An investigation on the respiratory mechanics of mechanically ventilated
patients during spontaneous breathing trials with enhanced low-level
pressure support ventilation.
Source
Clinical Respiratory Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Zhang B.; Zhang Z.; Qin H.; Jiang Z.; Deng Q.; Sun Q.; Wang Y.; Zhou J.;
Lin Z.; He W.; Hua D.; Xu Y.
Institution
(Zhang, Jiang, Deng, Sun, Wang, Zhou, Lin, He, Xu) Department of Critical
Care Medicine, The First Affiliated Hospital of Guangzhou Medical
University, Guangzhou, China
(Zhang) Guangzhou Respiratory Health Research Institute, The First
Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
(Qin) Department of Pulmonary and Critical Care Medicine, The Second
People's Hospital of Fengkai, Zhaoqing, China
(Hua) Department of General Medicine, Bunbury Regional Hospital, Bunbury,
WA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Low-level pressure support ventilation (PSV) is most
commonly adopted in spontaneous breathing trials (SBTs), and some have
proposed setting the positive end-expiratory pressure (PEEP) to 0
cmH<inf>2</inf>O in order to shorten the observation time of SBTs. This
study aims to investigate the effects of two PSV protocols on the
patients' respiratory mechanics. <br/>Material(s) and Method(s): A
prospective randomized self-controlled crossover design was adopted in
this study, which involved enrolling 30 difficult-to-wean patients who
were admitted to the intensive care unit of the First Affiliated Hospital
of Guangzhou Medical University between July 2019 and September 2021.
Patients were subjected to the S group (pressure support: 8
cmH<inf>2</inf>O, PEEP: 5 cmH<inf>2</inf>O) and S1 group (PS: 8
cmH<inf>2</inf>O, PEEP: 0 cmH<inf>2</inf>O) for 30 min in a random order,
and respiratory mechanics indices were dynamically monitored via a
four-lumen multi-functional catheter with an integrated gastric tube.
Among the 30 enrolled patients, 27 were successfully weaned.
<br/>Result(s): The S group showed higher airway pressure (Paw),
intragastric pressure (Pga) and airway pressure-time product (PTP) than
the S1 group. The S group also showed a shorter inspiratory trigger delay,
(93.80 +/- 47.85) versus (137.33 +/- 85.66) ms (P = 0.004); and fewer
abnormal triggers, (0.97 +/- 2.65) versus (2.67 +/- 4.48) (P = 0.042)
compared with the S1 group. Stratification based on the causes of
mechanical ventilation revealed that under the S1 protocol, patients with
chronic obstructive pulmonary disease (COPD) had a longer inspiratory
trigger delay compared to both post-thoracic surgery (PTS) patients and
patients with acute respiratory distress syndrome. Despite providing
greater respiratory support, S group led to significant reductions in
inspiratory trigger delay and less abnormal triggers compared to S1 group,
especially among patients with chronic obstructive pulmonary disease.
<br/>Conclusion(s): These findings suggest that the zero PEEP group was
more likely to induce a higher number of patient-ventilator asynchronies
in difficult-to-wean patients.<br/>Copyright &#xa9; 2023 The Authors. The
Clinical Respiratory Journal published by John Wiley & Sons Ltd.

<52>
Accession Number
2023127528
Title
Pharmacological options for Candida albicans Endocarditis at the roadblock
with irrecoverable prosthetics and drug interactions: a case report and
review of literature.
Source
BMC Infectious Diseases. 23(1) (no pagination), 2023. Article Number: 304.
Date of Publication: December 2023.
Author
Sahra S.; Javed A.; Jahangir A.; Thind S.K.
Institution
(Sahra, Thind) Department of Infectious Diseases, Veterans Affairs Medical
Center, Oklahoma City, OK 73104, United States
(Sahra, Thind) Department of Infectious Diseases, The University of
Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, United
States
(Javed) Department of Internal Medicine, Staten Island University
Hospital, Staten Island, NY 10305, United States
(Jahangir) Department of Critical Care, Veterans Affairs Medical Center,
Oklahoma City, OK 73104, United States
Publisher
BioMed Central Ltd
Abstract
Background: Candidemia is the fourth most common nosocomial bloodstream
infection. Endocarditis from candidemia is a rare but possibly fatal
complication. The efficacy of amphotericin and echinocandins for induction
and azoles for suppression has been well studied. Source control of
infection, including removal of foreign bodies, remains the cornerstone
for the success of any antifungal therapy. Case Presentation: We are
describing a case of a 63-years old patient with multiple comorbidities
who developed candidemia secondary to Candida albicans. The prospect of
curing the fungemia was made difficult by prosthetic devices, including
prosthetic heart valves, intracardiac defibrillator, and inferior vena
filter, which could not be extracted due to poor cardiovascular status and
higher postoperative mortality risk. Combination therapy with amphotericin
and 5-Flucytosine (5FC) was used with the first recurrence. Suppression
with fluconazole was contraindicated due to prolonged corrected QT (QTc)
interval. Isavuconazole was employed for chronic lifelong suppression.
<br/>Conclusion(s): Retaining prosthetics in higher surgical risk patients
presents us with unique clinical and pharmacological challenges regarding
breakthrough infections, drug interaction, and side effects from prolonged
suppressive therapies.<br/>Copyright &#xa9; 2023, The Author(s).

<53>
Accession Number
2024439014
Title
REDEFINE: A Prospective Randomized Evaluation of the ControlRad System to
Reduce Radiation Exposure During Cardiac Implantable Device Procedures.
Source
JACC: Clinical Electrophysiology. 9(5) (pp 713-714), 2023. Date of
Publication: May 2023.
Author
Mehta N.K.; France J.; Shah K.; Kutinsky I.; Williamson B.; Goel A.; Dixon
S.; Haines D.E.
Publisher
Elsevier Inc.

<54>
Accession Number
2024423101
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: 01 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, INSERM
1094 & IRD, University of Limoges, 2, Martin Luther King ave, Limoges
87042, France
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine-Jacksonville, 655 West 8th Street, Jacksonville, FL 32209, 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, 78, 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, 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, United States
(Montalescot) ACTION Group, INSERM UMRS 1166, Institut de Cardiologie,
Hopital Pitie-Salpetriere, Assistance Publique-Hopitaux de Paris, Sorbonne
Universite, 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
Oxford University Press
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 P2Y<inf>12</inf> 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 P2Y<inf>12</inf> monotherapy, compared with
aspirin. Conclusion 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,
P2Y<inf>12</inf> 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.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved.

<55>
Accession Number
2024423099
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: 01 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, UMR_S 1166, Caen, France
(Mesnier) French Alliance for Cardiovascular Trials (FACT), Universite de
Paris, INSERM Unite-1148, Hopital Bichat, Assistance Publique-Hopitaux de
Paris, Paris, France
(Chapelle, Laporte, Ollier) Unite de Recherche Clinique, Innovation et
Pharmacologie, CHU de Saint-Etienne, 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
Oxford University Press
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. Conclusion
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.

<56>
Accession Number
2024422702
Title
Direct oral anticoagulants versus vitamin K antagonists in the first 3
months after bioprosthetic valve replacement: a systematic review and
meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 63(4) (no pagination), 2023.
Article Number: ezad110. Date of Publication: 01 Apr 2023.
Author
Eikelboom R.; Whitlock R.P.; Muzaffar R.; Lopes R.D.; Siegal D.; Schulman
S.; Belley-Cote E.P.
Institution
(Eikelboom, Whitlock) Population Health Research Institute, Hamilton, ON,
Canada
(Eikelboom, Muzaffar) Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Whitlock) Department of Surgery, Division of Cardiac Surgery, McMaster
University, Hamilton, ON, Canada
(Lopes) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Siegal) Department of Medicine, University of Ottawa, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Schulman) Department of Medicine, Division of Hematology, McMaster
University, Hamilton, ON, Canada
(Belley-Cote) Department of Medicine, Division of Cardiology, McMaster
University, Hamilton, ON, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: We conducted a systematic review and meta-analysis of
randomized controlled trials comparing direct oral anticoagulants (DOACs)
to vitamin K antagonists (VKAs) in the first 90 days after bioprosthetic
valve implantation. <br/>METHOD(S): We systematically searched Embase,
Medline and CENTRAL. We screened titles, abstracts and full texts,
extracted data and assessed the risk of bias in duplicate. We pooled data
using the Mantel-Haenzel method and random effects modelling. We conducted
subgroup analyses based on the type of valve (transcatheter versus
surgical) and timing of initiation of anticoagulation (<7 vs >7 days after
valve implantation). We assessed the certainty of evidence using the
Grading of Recommendations, Assessments, Development and Evaluation
approach. <br/>RESULT(S): We included 4 studies of 2284 patients with a
median follow-up of 12 months. Two studies examined transcatheter valves
(1877/2284 = 83%) and 2 examined surgical valves (407/2284 = 17%). We
found no statistically significant differences between DOACs and VKAs with
regard to thrombosis, bleeding, death or subclinical valve thrombosis.
However, there was a subgroup trend towards more bleeding with DOACs when
initiated within 7 days of valve implantation. <br/>CONCLUSION(S): In the
existing randomized literature on DOACs versus VKAs in the first 90 days
after bioprosthetic valve implantation, there appears to be no difference
with regard to thrombosis, bleeding or death. Interpretation of the data
is limited by small numbers of events and wide confidence intervals.
Future studies should focus on surgical valves and should include
long-term follow-up to assess any potential impact of randomized therapy
on valve durability.<br/>Copyright VC The Author(s) 2023. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<57>
Accession Number
2023772377
Title
Low Contrast and Low kV CTA Before Transcatheter Aortic Valve Replacement:
A Systematic Review.
Source
Journal of Cardiovascular Imaging. 31(2) (pp 108-115), 2023. Date of
Publication: April 2023.
Author
Lacy S.C.; Benjamin M.M.; Osman M.; Syed M.A.; Kinno M.
Institution
(Lacy) Department of Internal Medicine, Loyola University Medical Center,
Maywood, IL, United States
(Benjamin, Syed, Kinno) Division of Cardiovascular Medicine, Loyola
University Medical Center, Maywood, IL, United States
(Osman) Knight & Cardiovascular Institute, Oregon Health & Science
University, Portland, OR, United States
Publisher
Korean Society of Echocardiography
Abstract
BACKGROUND: Minimizing contrast dose and radiation exposure while
maintaining image quality during computed tomography angiography (CTA) for
transcatheter aortic valve replacement (TAVR) is desirable, but not well
established. This systematic review compares image quality for low
contrast and low kV CTA versus conventional CTA in patients with aortic
stenosis undergoing TAVR planning. <br/>METHOD(S): We performed a
systematic literature review to identify clinical studies comparing
imaging strategies for patients with aortic stenosis undergoing TAVR
planning. The primary outcomes of image quality as assessed by the
signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were
reported as random effects mean difference with 95% confidence interval
(CI). <br/>RESULT(S): We included 6 studies reporting on 353 patients.
There was no difference in cardiac SNR (mean difference, -1.42; 95% CI,
-5.71 to 2.88; p = 0.52), cardiac CNR (mean difference, -3.83; 95% CI,
-9.98 to 2.32; p = 0.22), aortic SNR (mean difference, -0.23; 95% CI,
-7.83 to 7.37; p = 0.95), aortic CNR (mean difference, -3.95; 95% CI,
-12.03 to 4.13; p = 0.34), and ileofemoral SNR (mean difference, -6.09;
95% CI, -13.80 to 1.62; p = 0.12) between the low dose and conventional
protocols. There was a difference in ileofemoral CNR between the low dose
and conventional protocols with a mean difference of -9.26 (95% CI, -15.06
to -3.46; p = 0.002). Overall, subjective image quality was similar
between the 2 protocols. <br/>CONCLUSION(S): This systematic review
suggests that low contrast and low kV CTA for TAVR planning provides
similar image quality to conventional CTA.<br/>Copyright &#xa9; 2023
Korean Society of Echocardiography.

<58>
Accession Number
2023135073
Title
Postoperative intermittent pneumatic compression for preventing venous
thromboembolism in Chinese lung cancer patients: a randomized clinical
trial.
Source
Thrombosis Journal. 21(1) (no pagination), 2023. Article Number: 56. Date
of Publication: December 2023.
Author
Li J.; Huang A.; Han Z.; Zhou Y.; Tang M.; Wu W.; Zhang S.; Liao K.; Xie
Y.; Chen Q.; Zou X.; Liu S.; Gao S.; Ren J.; Xu Q.; Liu X.; Liao Y.; Jing
T.; Tan W.F.; Qiu Y.; Wang H.
Institution
(Li, Huang, Han, Zhou, Tang, Wu, Zhang, Liao, Xie, Chen, Liu, Gao, Xu,
Liu, Liao, Tan, Qiu, Wang) Department of Thoracic Surgery, Southwest
Hospital, Army Medical University, (Third Military Medical University),
Chongqing 400038, China
(Zou, Jing) Department of Vasculocardiology, Southwest Hospital, Army
Medical University, (Third Military Medical University), Chongqing, China
(Ren) Department of Neck and Chest Surgery, Affiliated Hospital of
Sergeant School of Army Medical University, Shijiazhuang, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative lung cancer patients belong to the high-risk
group for venous thromboembolism (VTE). The standardized preventive
measures for perioperative VTE in lung cancer are not perfect, especially
for the prevention and treatment of catheter-related thrombosis (CRT)
caused by carried central venous catheters (CVCs) in lung cancer surgery.
<br/>Patients and Methods: This study included 460 patients with lung
cancer undergoing video-assisted thoracic surgery (VATS) in our center
from July 2020 to June 2021. Patients were randomized into two groups, and
intraoperatively-placed CVCs would be carried to discharge. During
hospitalization, the control group was treated with low-molecular-weight
heparin (LMWH), and the experimental group with LMWH + intermittent
pneumatic compression (IPC). Vascular ultrasound was performed at three
time points which included before surgery, before discharge, and one month
after discharge. The incidence of VTE between the two groups was studied
by the Log-binomial regression model. <br/>Result(s): CRT occurred in
71.7% of the experimental group and 79.7% of the control group. The
multivariate regression showed that the risk of developing CRT in the
experimental group was lower than in the control group (Adjusted RR =
0.889 [95%CI0.799-0.989], p = 0.031), with no heterogeneity in subgroups
(P for Interaction > 0.05). Moreover, the fibrinogen of patients in the
experimental group was lower than control group at follow-up (P = 0.019).
<br/>Conclusion(s): IPC reduced the incidence of CRT during
hospitalization in lung cancer patients after surgery. Trial registration:
No. ChiCTR2000034511.<br/>Copyright &#xa9; 2023, The Author(s).

<59>
Accession Number
2024175428
Title
Bilateral internal thoracic artery coronary grafting: risks and benefits
in elderly patients.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(8) (pp
861-870), 2022. Date of Publication: 01 Dec 2022.
Author
Zhou Z.; Fu G.; Huang S.; Chen S.; Liang M.; Wu Z.
Institution
(Zhou, Fu, Huang, Chen, Liang, Wu) Department of Cardiac Surgery, First
Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan II Road,
Guangzhou 510080, China
(Zhou, Fu, Huang, Chen, Liang, Wu) NHC Key Laboratory of Assisted
Circulation, Sun Yat-sen University, Guangzhou 510080, China
Publisher
Oxford University Press
Abstract
Aims Whether bilateral internal thoracic artery (BITA) grafting benefits
elderly patients in coronary artery bypass grafting (CABG) remains unclear
since they tend to have a limited life expectancy and severe
comorbidities. We aim to evaluate the outcomes of BITA vs. single internal
thoracic artery (SITA) grafting in elderly patients. Methods and results A
meta-analysis was performed by database searching until May 2021. Studies
comparing BITA and SITA grafting among elderly patients were included. One
randomized controlled trial, nine propensity score matching, and six
unmatched studies were identified, with a total of 18 146 patients (7422
received BITA grafting and 10 724 received SITA grafting). Compared with
SITA grafting, BITA grafting had a higher risk of deep sternal wound
infection (DSWI) [odds ratio: 1.67; 95% confidence interval (CI):
1.22-2.28], and this risk could not be significantly reduced by the
skeletonization technique. Meanwhile, BITA grafting was associated with a
higher long-term survival [hazard ratio: 0.83; 95% CI: 0.77-0.90], except
for the octogenarian subgroup. Reconstructed Kaplan-Meier survival curves
revealed 4-year, 8-year, and 12-year overall survival rates of 85.5%,
66.7%, and 45.3%, respectively, in the BITA group and 79.3%, 58.6%, and
34.9%, respectively, in the SITA group. No significant difference was
observed in early mortality, perioperative myocardial infarction,
perioperative cerebral vascular accidents, or re-exploration for bleeding.
Conclusion Compared with SITA grafting, BITA grafting could provide a
long-term survival benefit for elderly patients, although this benefit
remained uncertain in octogenarians. Meanwhile, elderly patients who
received BITA were associated with a higher risk of DSWI and such a risk
could not be eliminated by the skeletonization technique.<br/>Copyright
&#xa9; The Author(s) 2021. Published by Oxford University Press on behalf
of the European Society of Cardiology. All rights reserved.

<60>
Accession Number
2024160566
Title
Aortic valve repair versus mechanical valve replacement for root aneurysm:
The CAVIAAR multicentric study.
Source
European Journal of Cardio-thoracic Surgery. 62(2) (no pagination), 2022.
Article Number: ezac283. Date of Publication: 01 Aug 2022.
Author
Lansac E.; Centa I.D.; Danial P.; Bouchot O.; Arnaud-Crozat E.; Hacini R.;
Doguet F.; Demaria R.; Verhoye J.P.; Jouan J.; Chatel D.; Lopez S.;
Folliguet T.; Leprince P.; Langanay T.; Latremouille C.; Fayad G.; Fleury
J.P.; Monin J.L.; Mankoubi L.; Noghin M.; Berrebi A.; Pousset S.;
Laubriet-Jazayeri A.; Lafourcade A.; Marcault E.; Kindo M.; Payot L.;
Bergoend E.; Hoffart C.J.; Debauchez M.; Tubach F.
Institution
(Lansac, Danial, Leprince, Debauchez) Department of Cardiac Surgery, CHU
Pitie Salpetriere, Paris, France
(Centa) Department of Vascular Surgery, Hopital Foch, Suresnes, France
(Bouchot, Laubriet-Jazayeri) Department of Cardiac Surgery, CHU Le Bocage,
Dijon, France
(Arnaud-Crozat, Hacini) Department of Cardiac Surgery, CHU A. Michallon,
La Tronche, France
(Doguet) Department of Cardiac Surgery, C.H.U Charles Nicolle, Rouen,
France
(Demaria) Department of Cardiac Surgery, CHU A. De Villeneuve,
Montpellier, France
(Verhoye, Langanay) Department of Cardiac Surgery, CHU Pontchaillou,
Rennes, France
(Jouan) Department of Cardiac Surgery, CHU Limoges, France
(Chatel) Department of Cardiac Surgery, Clinique Saint Gatien, Tours,
France
(Lopez) Department of Cardiac Surgery, Institut Arnault Tzanck, Saint
Laurent Du Var, France
(Folliguet, Bergoend) Department of Cardiac Surgery, CHU Mondor, Creteil,
France
(Latremouille) Department of Cardiac Surgery, CHU Hopital Europeen Georges
Pompidou, Paris, France
(Fayad) Department of Cardiac Surgery, Centre Hospitalier Regional
Universitaire de Lille, Lille, France
(Fleury) Department of Cardiac Surgery, Clinique Belledone, Saint Martin
d'Heres, France
(Monin, Mankoubi, Noghin, Berrebi, Pousset) Department of Cardiac Surgery,
Institut Mutualiste Montouris, Paris, France
(Lafourcade) AP-HP.Sorbonne Universite, Hopital Pitie Salpetriere, Centre
de Pharmacoepidemiologie (Cephepi), INSERM, Paris CIC-1422, France
(Marcault) APHP, Hopital Bichat, Departement d'Epidemiologie et Recherche
Clinique, Paris INSERM CIC-EC 1425, Paris F-75018, France
(Kindo) Department of Cardiac Surgery, CHU de Strasbourg, Strasbourg,
France
(Payot) Cardiology, Saint Brieuc Hospital, Saint Brieuc, France
(Hoffart) APHP, Departement de la Recherche Clinique et du Developpement
(DRCD), Groupement Interregional de Recherche Clinique et d'Innovation,
GIRCI Ile-de-France Hopital, Saint Louis, France
(Tubach) Sorbonne Universite, INSERM, Institut Pierre Louis
d'Epidemiologie et de Sante Publique, AP-HP.Sorbonne Universite, Hopital
Pitie Salpetriere, Departement de Sante Publique, Centre de
Pharmacoepidemiologie (Cephepi), Paris CIC-1422, France
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Despite growing evidence that aortic valve repair improves
long-term patient outcomes and quality of life, aortic valves are mostly
replaced. We evaluate the effect of aortic valve repair versus replacement
in patients with dystrophic aortic root aneurysm up to 4 years.
<br/>METHOD(S): The multicentric CAVIAAR (Conservation Aortique Valvulaire
dans les Insuffisances Aortiques et les Anevrismes de la Racine aortique)
prospective cohort study enrolled 261 patients: 130 underwent standardized
aortic valve repair (REPAIR) consisting of remodelling root repair with
expansible aortic ring annuloplasty, and 131 received mechanical composite
valve and graft replacement (REPLACE). Primary outcome was a composite
criterion of mortality, reoperation, thromboembolic or major bleeding
events, endocarditis or operating site infections, pacemaker implantation
and heart failure, analysed with propensity score-weighted Cox model
analysis. Secondary outcomes included major adverse valve-related events
and components of primary outcome. <br/>RESULT(S): The mean age was 56.1
years, and valve was bicuspid in 115 patients (44.7%). Up to 4 years,
REPAIR did not significantly differ from REPLACE in terms of primary
outcome [Hazard Ratio (HR) 0.66 (0.39; 1.12)] but showed significantly
less valve-related deaths (HR 0.09 [0.02; 0.34]) and major bleeding events
(HR 0.37 [0.16; 0.85]) without an increased risk of valve-related
reoperation (HR 2.10 [0.64; 6.96]). When accounting for the occurrence of
multiple events in a single patient, the REPAIR group had half the
occurrence of major adverse valve-related events (HR 0.51 [0.31; 0.86]).
<br/>CONCLUSION(S): Although the primary outcome did not significantly
differ between the REPAIR and REPLACE groups, the trend is in favour of
REPAIR by a significant reduction of valve-related deaths and major
bleeding events. Long-term follow-up beyond 4 years is needed to confirm
these findings.<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<61>
Accession Number
2024040767
Title
Associations of time-dependent changes in phosphorus levels with
cardiovascular diseases in patients undergoing hemodialysis: results from
the Japan Dialysis Active Vitamin D (J-DAVID) randomized clinical trial.
Source
Clinical Kidney Journal. 15(12) (pp 2281-2291), 2022. Date of Publication:
01 Dec 2022.
Author
Koshi-Ito E.; Inaguma D.; Ishii H.; Yuzawa Y.; Kabata D.; Shintani A.;
Inaba M.; Emoto M.; Mori K.; Morioka T.; Nakatani S.; Shoji T.
Institution
(Koshi-Ito, Inaguma, Yuzawa) Fujita Health University School of Medicine,
Aichi, Toyoake, Japan
(Koshi-Ito) Department of Nephrology, Internal Medicine, Nagoya University
Graduate School of Medicine, Japan
(Inaguma, Inaba, Emoto, Shoji) J-DAVID Investigators, Japan
(Inaguma) Department of Internal Medicine, Fujita Health University
Bantane Hospital, Aichi, Japan
(Ishii, Kabata, Shintani) Department of Medical Statistics, Osaka City
University Graduate School of Medicine, Osaka, Japan
(Shoji) Department of Vascular Medicine, Osaka City University Graduate
School of Medicine, Osaka, Japan
(Inaba, Emoto, Shoji) Vascular Science Centre for Translational Research,
Osaka City University Graduate School of Medicine, Osaka, Japan
(Inaba, Emoto, Morioka, Nakatani) Department of Metabolism, Endocrinology
and Molecular Medicine, Osaka City University Graduate School of Medicine,
Osaka, Japan
(Inaba, Emoto, Mori) Department of Nephrology, Osaka City University
Graduate School of Medicine, Osaka, Japan
Publisher
Oxford University Press
Abstract
Background: While the risk of exceeding the standard range of phosphorus
levels has been investigated, the impact of the degree of fluctuations has
not been investigated. <br/>Method(s): Data were derived from the Japan
Dialysis Active Vitamin D trial, a 4-year prospective, randomized study
involving 976 patients without secondary hyperparathyroidism undergoing
hemodialysis in Japan. Laboratory data were collected every 6 months and
the primary outcome was the time to the occurrence of cardiovascular
events. The effect of time-dependent changes in phosphorus levels was
assessed using a time-varying Cox proportional hazards regression model.
<br/>Result(s): The median serum phosphorus levels at baseline and at the
final observation were 4.70 mg/dl [interquartile range (IQR) 3.90-5.30]
and 5.00 mg/dl (IQR 4.20-5.80), respectively. Over each 6-month period,
phosphorus changes ranged from -7.1 to +6.7 mg/dl, with a median value of
-0.1 to +0.3 mg/dl. During follow-up, composite cardiovascular events
occurred in 103 of 964 patients. Although the P-value for the interaction
between serum phosphorus level fluctuations and baseline phosphorus levels
was insignificant, the following trends were observed. First, patients
with relatively high initial phosphorus levels over a 6-month period
showed a trend towards a higher hazard, with greater changes in the
phosphorus level over the 6-month period. Second, it was suggested that
oral vitamin D receptor activators could contribute to the relationship
between fluctuating phosphorus levels and cardiovascular events.
<br/>Conclusion(s): Our results suggest the importance of maintaining
stable phosphorus levels, not only in the normal range, but also without
fluctuations, in the risk of cardiovascular events among patients without
secondary hyperparathyroidism undergoing maintenance
hemodialysis.<br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford
University Press on behalf of the ERA.

<62>
Accession Number
2023726241
Title
Colchicine - From rheumatology to the new kid on the block: Coronary
syndromes and COVID-19.
Source
Cardiology Journal. 30(2) (pp 297-311), 2023. Date of Publication: 2023.
Author
Surma S.; Basiak M.; Romanczyk M.; Filipiak K.J.; Okopien B.
Institution
(Surma, Basiak, Romanczyk, Okopien) Department of Internal Medicine and
Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
(Filipiak) Department of Clinical Sciences, Maria Sklodowska-Curie Medical
Academy, Warsaw, Poland
Publisher
Via Medica
Abstract
Colchicine is an effective anti-inflammatory agent used to treat gout,
coronary artery disease, viral pericarditis, and familial Mediterranean
fever. It has been found to act by preventing the polymerization of the
protein called tubulin, thus inhibiting inflammasome activation,
proinflammatory chemokines, and cellular adhesion molecules. Accumulating
evidence suggests that some patients with coronavirus disease 2019
(COVID-19) suffer from "cytokine storm" syndrome. The ideal
anti-inflammatory in this setting would be one that is readily available,
cheap, orally administered, with a good safety profile, well--tolerated,
and that prevents or modulates inflammasome activation. The researchers
selected colchicine for their study. This paper is a review of the
literature describing the effects of colchicine, which is a drug that is
being increasingly used, especially when standard therapy fails.
Colchicine was shown to reduce inflammatory lung injury and respiratory
failure by interfering with leukocyte activation and recruit-ment. In this
publication, we try to systematically review the current data on new
therapeutic options for colchicine. The article focuses on new data from
clinical trials in COVID-19, rheumatic, cardiovascular, and other
treatment such as familial Mediterranean fever, chronic urticaria, and
PFAPA syndrome (periodic fever, aphthous, stomatitis, pharyngitis, and
cervical adenitis). We also summarize new reports on the side effects,
drug interactions, and safety of colchicine.<br/>Copyright &#xa9; 2023 Via
Medica.

<63>
Accession Number
2022161412
Title
Comparison of Haemodynamic Changes of Dexmedetomidine with That of Saline
Infusion for Spine Surgery in Prone Position under General Anaesthesia.
Source
European Journal of Molecular and Clinical Medicine. 9(7) (pp 8784-8792),
2022. Date of Publication: June 2022.
Author
Helawar S.; Shree S.P.; Prakash K.S.; Faiaz A.F.
Institution
(Helawar, Shree, Prakash, Faiaz) Department of Anaesthesia, Kanachur
Institute of Medical Sciences, Karnataka, Mangalore, India
Publisher
EJMCM, International House
Abstract
Background: In this study, we wanted to compare hemodynamic changes in
patients receiving dexmedetomidine with those of patients receiving
placebo. <br/>Material(s) and Method(s): This was a hospital based
randomized prospective comparative study conducted among 60 patients who
presented to the Department of General Anaesthesia in Seth G S Medical
College, KEM Hospital Mumbai from 2013 to 2014 after obtaining clearance
from Institutional Ethics Committee and written informed consent from the
study participants. <br/>Result(s): The mean pre-operative heart rate in
Group D was 79.83 +/- 8.92 beats per minute (bpm) and in group C it was
76.97 +/- 8.97 bpm and the difference was not statistically significant (p
= 0.208). Immediately after turning the patient prone, the mean heart rate
in group D was 79.83 +/- 6.28 bpm and that in group C was 90. 25 +/- 12.32
bpm and the difference was not statistically significant (p value = 0
784). The mean heart rate was significantly lower in group D compared to
group C during rest of the intra operative period. At the time of
reversal, the mean heart rate was 88.73 +/- 6.24 bpm and 94.31 +/- 6.21
bpm in group D and group C respectively. There is significant difference
in the mean heart rate with p value 0.001. The pre-operative mean SBP in
group D was 123.33 +/- 14.15 and that in group C was 125.94 +/- 11.45; the
difference was not statistically significant with p value 0.244. In
comparison of diastolic blood pressure (DBP) at various intervals between
Group D and Group C, all the p values were statistically significant.
Whereas the pre-operative mean DBP was 82.10 +/- 2.11 mm of Hg and 82.63
+/- 3.86 mm of Hg in Group D and Group C respectively. The difference was
not statistically significant (p value 0.513). In Comparison of MAP at
various intervals between Group D and Group C, all the p values were
statistically significant. Whereas the pre-operative mean arterial
pressure (MAP) in group D patients was 95.73 +/- 2.60 mm of Hg and that in
group C patients was 97 50 +/- 6.53 mm of Hg there is no significant
difference in mean MAP between two groups p value 0.172.
<br/>Conclusion(s): Dexmedetomidine provides good intra-operative
hemodynamic stability in spine surgeries. The incidence of bradycardia and
hypotension were less with the dexmedetomidine in prone
position.<br/>Copyright &#xa9; 2022 Ubiquity Press. All rights reserved.

<64>
Accession Number
2021978337
Title
Association between serum albumin and outcomes in heart failure and
secondary mitral regurgitation: the COAPT trial.
Source
European Journal of Heart Failure. 25(4) (pp 553-561), 2023. Date of
Publication: April 2023.
Author
Feng K.Y.; Ambrosy A.P.; Zhou Z.; Li D.; Kong J.; Zaroff J.G.; Mishell
J.M.; Ku I.A.; Scotti A.; Coisne A.; Redfors B.; Mack M.J.; Abraham W.T.;
Lindenfeld J.; Stone G.W.
Institution
(Feng, Ambrosy, Kong, Zaroff, Mishell, Ku) Department of Cardiology,
Kaiser Permanente San Francisco Medical Center, San Francisco, CA, United
States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Zhou, Li, Scotti, Coisne, Redfors) Clinical Trials Center, Cardiovascular
Research Foundation, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) NewYork-Presbyterian Hospital/Columbia University Medical
Center, New York, NY, United States
(Mack) Department of Cardiothoracic Surgery, Baylor Scott & White Health,
Plano, TX, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University
Medical Center, Columbus, OH, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Low serum albumin levels are associated with poor prognosis in
numerous chronic disease states but the relationship between albumin and
outcomes in patients with heart failure (HF) and secondary mitral
regurgitation (SMR) has not been described. <br/>Methods and Results: The
randomized COAPT trial evaluated the safety and effectiveness of
transcatheter edge-to-edge repair (TEER) with the MitraClip^TM
plus guideline-directed medical therapy (GDMT) versus GDMT alone in
patients with symptomatic HF and moderate-to-severe or severe SMR.
Baseline serum albumin levels were measured at enrolment. Among 614
patients enrolled in COAPT, 559 (91.0%) had available baseline serum
albumin levels (median 4.0 g/dl, interquartile range 3.7-4.2 g/dl).
Patients with albumin <4.0 g/dl compared with >=4.0 g/dl were older and
more likely to have ischaemic cardiomyopathy and a hospitalization within
the year prior to enrolment. After multivariable adjustment, patients with
albumin <4.0 g/dl had higher 4-year rates of all-cause death (63.7% vs.
47.6%; adjusted hazard ratio 1.34, 95% confidence interval 1.02-1.74; p =
0.032), but there were no significant differences in HF hospitalizations
(HFH) or all-cause hospitalizations according to baseline serum albumin
level. The relative effectiveness of TEER plus GDMT versus GDMT alone was
consistent in patients with low and high albumin levels
(p<inf>interaction</inf> = 0.19 and 0.35 for death and HFH, respectively).
<br/>Conclusion(s): Low baseline serum albumin levels were independently
associated with reduced 4-year survival in patients with HF and severe SMR
enrolled in the COAPT trial, but not with HFH. Patients treated with TEER
derived similarly robust reductions in both death and HFH regardless of
baseline albumin level.<br/>Copyright &#xa9; 2023 European Society of
Cardiology.

<65>
Accession Number
2019114474
Title
Chronic Coronary Syndrome: Medical Therapy or Myocardial
Revascularization?.
Source
International Journal of Cardiovascular Sciences. 36 (no pagination),
2023. Article Number: e20210223. Date of Publication: 2023.
Author
da Rocha A.S.C.; da Silva P.R.D.
Institution
(da Rocha, da Silva) Hospital Pro-Cardiaco, RJ, Rio de Janeiro, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
The best therapeutic strategy for chronic coronary syndrome (CCS) is still
controversial. The lack of contemporanei ty of medi cal treatment i n many
randomized clinical trials prior to the large-scale use of statins,
antiplatelet agents, anti-diabetic drugs with cardiovascular protection,
and changes in life habits with well-established goals limits the
applicability of such studies in current clinical practice. Medical
treatment is the only therapeutic option capable of reducing
atherosclerotic damage and, therefore, of acting effectively in preventing
the progression of this disease. The purpose of this brief review is to
critically analyze the main contemporary studies that confront medical
treatment with myocardial revascularization in CCS.<br/>Copyright &#xa9;
2023, Sociedade Brasileira de Cardiologia. All rights reserved.

<66>
[Use Link to view the full text]
Accession Number
2017499976
Title
Regional Analgesia Added to General Anesthesia Compared With General
Anesthesia Plus Systemic Analgesia for Cardiac Surgery in Children: A
Systematic Review and Meta-analysis of Randomized Clinical Trials.
Source
Anesthesia and Analgesia. 128(1) (pp 130-136), 2019. Date of Publication:
January 2019.
Author
Monahan A.; Guay J.; Hajduk J.; Suresh S.
Institution
(Monahan, Hajduk, Suresh) Department of Pediatric Anesthesiology, Ann &
Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
(Guay) Department of Anesthesiology and Critical Care, Faculty of
Medicine, Laval University, Quebec City, QC, Canada
(Guay) Department of Anesthesiology, Faculty of Medicine, University of
Sherbrooke, Quebec, Canada
(Guay) Teaching and Research Unit, Health Sciences, University of Quebec
in AbitibiTemiscamingue, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The aim of this systematic review was to compare the effects
of regional analgesic (RA) techniques with systemic analgesia on
postoperative pain, nausea and vomiting, resources utilization,
reoperation, death, and complications of the analgesic techniques in
children undergoing cardiac surgery. <br/>METHOD(S): A search was done in
May 2018 in PubMed, Embase, and the Cochrane Central Register of
Controlled Trials for randomized controlled trials comparing RA techniques
with systemic analgesia. Risks of bias of included trials were judged with
the Cochrane tool. Data were analyzed with fixed- (I² < 25%) or
random-effects models (I² >= 25%). The quality of evidence was
graded according to the Grading of Recommendations Assessment,
Development, and Evaluation working group scale. <br/>RESULT(S): We
included 14 randomized controlled trials with 605 participants (312 to RA
and 293 to the comparator). RA reduces pain up to 24 hours after surgery.
At 6-8 hours after surgery, the standardized mean difference was -0.81
(95% confidence interval [CI], -1.22 to -0.40; low-quality evidence). We
did not find a difference for nausea and vomiting (risk ratio [RR], 0.89;
95% CI, 0.61-1.31; very low-quality evidence), duration of tracheal
intubation (standardized mean difference, -0.18; 95% CI, -0.40 to 0.05;
low-quality evidence), intensive care unit length of stay (mean
difference, -0.10 hours; 95% CI, -1.31 to 1.12 hours; low-quality
evidence), hospital length of stay (mean difference, -0.02 days; 95% CI,
-1.16 to 1.12 days; low-quality evidence), reoperation (RR, 0.76; 95% CI,
0.17-3.28; low-quality evidence), death (RR, 0.50; 95% CI, 0.05-4.94;
low-quality evidence), and respiratory depression (RR, 2.06; 95% CI,
0.20-21.68; very low-quality evidence). No trial reported signs of local
anesthetic toxicity or lasting neurological or infectious complications
related to the RA techniques. One trial reported 1 transient ipsilateral
episode of diaphragmatic paralysis with intrapleural analgesia that
resolved with cessation of local anesthetic administration.
<br/>CONCLUSION(S): Compared to systemic analgesia, RA techniques reduce
postoperative pain up to 24 hours in children undergoing cardiac surgery.
Currently, there is no evidence that RA for pediatric cardiac surgery has
any impact on major morbidity and mortality. These results should be
interpreted cautiously because they represent a meta-analysis of small and
heterogeneous studies. Further studies are needed.<br/>Copyright &#xa9;
2018 International Anesthesia Research Society

<67>
Accession Number
2017409150
Title
Cell-Mediated Immune Responses After Influenza Vaccination of Solid Organ
Transplant Recipients: Secondary Outcomes Analyses of a Randomized
Controlled Trial.
Source
Journal of Infectious Diseases. 221(1) (pp 53-62), 2020. Date of
Publication: 01 Jan 2020.
Author
L'Huillier A.G.; Ferreira V.H.; Hirzel C.; Natori Y.; Slomovic J.; Ku T.;
Hoschler K.; Ierullo M.; Selzner N.; Schiff J.; Singer L.G.; Humar A.;
Kumar D.
Institution
(L'Huillier, Ferreira, Hirzel, Slomovic, Ku, Ierullo, Selzner, Schiff,
Singer, Humar, Kumar) Multi-Organ Transplant Program, University Health
Network, Toronto, Canada
(Natori) Division of Infectious Disease, Department of Medicine,
University of Miami Miller School of Medicine and Miami Transplant
Institute, Miami, FL, United States
(Hoschler) Public Health England, London, United Kingdom
Publisher
Oxford University Press
Abstract
Background. Despite annual immunization, solid organ transplant (SOT)
patients remain at increased risk for severe influenza infection because
of suboptimal vaccine immunogenicity. We aimed to compare the
CD4⁺and CD8⁺T-cell responses of the highdose (HD)
and the standard-dose (SD) trivalent inactivated vaccine. Methods. We
collected peripheral blood mononuclear cells pre- and postimmunization
from 60 patients enrolled in a randomized trial of HD versus SD vaccine
(30 HD; 30 SD) during the 2016-2017 influenza season. Results. The HD
vaccine elicited significantly greater monofunctional and polyfunctional
CD4⁺and CD8⁺T-cell responses against influenza
A/H1N1, A/H3N2, and B. For example, median vaccine-elicited
influenza-specific polyfunctional CD4⁺T cells were higher in
recipients of the HD than SD vaccine after stimulation with influenza
A/H1N1 (1193 vs 0 per 106 CD4⁺T cells; P = .003), A/H3N2 (1154
vs 51; P = .008), and B (1102 vs 0; P = .001). Likewise, vaccine-elicited
influenza-specific polyfunctional CD8⁺T cells were higher in
recipients of the HD than SD vaccine after stimulation with influenza B
(367 vs 0; P = .002). Conclusions. Our study provides novel evidence that
HD vaccine elicits greater cellular responses compared with the SD vaccine
in SOT recipients, which provides support to preferentially consider use
of HD vaccination in the SOT setting.<br/>Copyright &#xa9; 2020 Oxford
University Press. All rights reserved.

<68>
Accession Number
2017409011
Title
Lipid-Lowering Agents in Older Individuals: A Systematic Review and
Meta-Analysis of Randomized Clinical Trials.
Source
Journal of Clinical Endocrinology and Metabolism. 104(5) (pp 1585-1594),
2019. Date of Publication: 01 May 2019.
Author
Ponce O.J.; Larrea-Mantilla L.; Hemmingsen B.; Serrano V.;
Rodriguez-Gutierrez R.; Spencer-Bonilla G.; Alvarez-Villalobos N.;
Benkhadra K.; Haddad A.; Gionfriddo M.R.; Prokop L.J.; Brito J.P.; Murad
M.H.
Institution
(Ponce, Larrea-Mantilla, Prokop, Murad) Evidence-Based Practice Center,
Mayo Clinic, Rochester, MN 55905, United States
(Ponce) Unidad de Conocimiento y Evidencia (CONEVID), Universidad Peruana
Cayetano Heredia, Lima 15102, Peru
(Ponce, Larrea-Mantilla, Serrano, Rodriguez-Gutierrez, Spencer-Bonilla,
Alvarez-Villalobos, Brito) Knowledge and Evaluation Research Unit,
Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department
of Medicine, Mayo Clinic, Rochester, MN 55905, United States
(Hemmingsen) Department of Internal Medicine, Herlev University Hospital,
Herlev Ringvej 75, Herlev DK-2730, Denmark
(Serrano) Department of Nutrition, Diabetes and Metabolism, Escuela de
Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
(Rodriguez-Gutierrez, Alvarez-Villalobos) Universidad Autonoma de Nuevo
Leon, Hospital Universitario "Dr. Jose E. Gonzalez," Plataforma INVEST-KER
Mexico, Nuevo Leon, Monterrey, Mexico
(Spencer-Bonilla) University of Puerto Rico Medical Sciences Campus, San
Juan 00921, Puerto Rico
(Benkhadra) Department of Internal Medicine, School of Medicine, Wayne
State University, Detroit, MI 48202, United States
(Haddad) Department of Medicine, Saint Clair Memorial Hospital,
Pittsburgh, PA 15243, United States
(Gionfriddo) Center for Pharmacy Innovation and Outcomes, Geisinger,
Danville, PA 17822, United States
Publisher
Endocrine Society
Abstract
Background: The efficacy of lipid-lowering agents on patient-important
outcomes in older individuals is unclear. <br/>Method(s): We included
randomized trials that enrolled individuals aged 65 years or older and
that included at least 1 year of follow-up. Pairs of reviewers selected
and appraised the trials. <br/>Result(s): We included 23 trials that
enrolled 60,194 elderly patients. For primary prevention, statins reduced
the risk of coronary artery disease [CAD; relative risk (RR): 0.79, 95%
CI: 0.68 to 0.91] and myocardial infarction (MI; RR: 0.45, 95% CI: 0.31 to
0.66) but not all-cause or cardiovascularmortality or stroke. These
effects were imprecise in patients with diabetes, but there was no
significant interaction between diabetes status and the intervention
effect. For secondary prevention, statins reduced allcausemortality (RR:
0.80, 95% CI: 0.73 to 0.89), cardiovascularmortality (RR: 0.68, 95%CI:
0.58 to 0.79), CAD (RR: 0.68, 95% CI: 0.61 to 0.77),MI (RR: 0.68, 95% CI:
0.59 to 0.79), and revascularization (RR: 0.68, 95% CI: 0.61 to 0.77).
Intensive (vs less-intensive) statin therapy reduced the risk of CAD and
heart failure.Niacin did not reduce the risk of revascularization, and
fibrates did not reduce the risk of stroke, cardiovascular mortality, or
CAD. <br/>Conclusion(s): High-certainty evidence supports statin use for
secondary prevention in older individuals. Evidence for primary prevention
is less certain. Data in older individuals with diabetes are limited;
however, no empirical evidence has shown a significant difference based on
diabetes status.<br/>Copyright &#xa9; 2019 Endocrine Society. All rights
reserved.

<69>
[Use Link to view the full text]
Accession Number
2017344750
Title
Extracorporeal Circulatory Support in Acute Coronary Syndromes: A
Systematic Review and Meta-Analysis.
Source
Critical Care Medicine. 45(11) (pp E1173-E1183), 2017. Date of
Publication: 01 Nov 2017.
Author
Pavasini R.; Cirillo C.; Campo G.; Menezes M.N.; Biscaglia S.; Tonet E.;
Ferrari R.; Patel B.V.; Price S.
Institution
(Pavasini, Campo, Biscaglia, Tonet, Ferrari) Cardiology Unit, Azienda
Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
(Cirillo) Dipartimento di Scienze Cardiotoraciche, II universita degli
Studi di Napoli, Neaples, Italy
(Menezes) Hospital Universitario de Santa Maria, CHLN, CAML, CCUL,
Facultade de Medicina, Universitade de Lisboa, Lisbon, Portugal
(Ferrari) Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA),
Italy
(Patel) Anaesthetics, Pain Medicine & Intensive Care, Department of
Surgery and Cancer, Faculty of Medicine, Imperial College, London, United
Kingdom
(Patel, Price) Adult Intensive Care Unit, Royal Brompton Hospital, London,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: Extracorporeal circulatory support is a life-saving technique,
and its use is increasing in acute coronary syndromes. A meta-analysis on
pooled event rate of short-term mortality and complications of acute
coronary syndrome patients treated with extracorporeal circulatory support
was performed. <br/>Data Sources: Articles were searched in MEDLINE,
Cochrane Library, Google Scholar, and Biomed Central. Study Selection:
Inclusion criteria were observational studies on acute coronary syndrome
patients treated with extracorporeal circulatory support. Primary outcome
was short-term mortality. Secondary outcomes were extracorporeal
circulatory support-related complications, causes of death, long-term
mortality, and bridge therapy. <br/>Data Extraction: Sixteen articles were
selected. Data about clinical characteristics, acute coronary syndrome
diagnosis and treatment, extracorporeal circulatory support setting,
outcome definitions, and event rate were retrieved from the articles.
Random effect meta-analytic pooling was performed reporting results as a
summary point estimate and 95% CI. <br/>Data Synthesis: A total of 739
patients were included (mean age, 59.8 +/- 2.9). The event rate of
short-term mortality was 58% (95% CI, 51-64%), 6-month mortality was
affecting 24% (95% CI, 5-63%) of 1-month survivors, and 1-year mortality
17% (95% CI, 6-40%) of 6-month survivors. The event rates of
extracorporeal circulatory support-related complications were acute renal
failure 41%, bleeding 25%, neurologic damage in survivors 21%,
sepsis/infections 21%, and leg ischemia 12%. Between causes of death,
multiple organ failure and brain death affected respectively 40% and 27%
of patients. Bridge to ventricular assistance device was offered to 14% of
patients, and 7% received a transplant. <br/>Conclusion(s): There is still
a high rate of short-term mortality and complications in acute coronary
syndrome patients treated with extracorporeal circulatory support. New
studies are needed to optimize and standardize extracorporeal circulatory
support.<br/>Copyright &#xa9; 2017 by the Society of Critical Care
Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

<70>
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. 382 (pp 12-19), 2023. Date of
Publication: 01 Jul 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.

<71>
Accession Number
2023649346
Title
The outcomes of fetal aortic valvuloplasty in critical aortic stenosis: A
systematic review and meta-analysis.
Source
International Journal of Cardiology. 382 (pp 106-111), 2023. Date of
Publication: 01 Jul 2023.
Author
Mendel B.; Kohar K.; Amirah S.; Vidya A.P.; Utama K.E.; Prakoso R.;
Siagian S.N.
Institution
(Mendel, Prakoso, Siagian) Division of Pediatric Cardiology and Congenital
Heart Disease, Department of Cardiology and Vascular Medicine, National
Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta,
Indonesia
(Mendel) Department of Cardiology and Vascular Medicine, Sultan Sulaiman
Government Hospital, Serdang Bedagai, North Sumatera, Indonesia
(Kohar, Amirah, Vidya, Utama) Faculty of Medicine, Universitas Indonesia,
Jakarta, Indonesia
Publisher
Elsevier Ireland Ltd
Abstract
Background: Critical aortic stenosis that appears in mid-gestation tends
to develop to growth retardation of left ventricle, known as hypoplastic
left heart syndrome (HLHS). Despite better clinical management of HLHS,
the morbidity and mortality rates of univentricular circulation patients
remain high. In this paper, we sought to perform a systematic review and
meta-analysis to know the outcomes of fetal aortic valvuloplasty in
critical aortic stenosis patients. <br/>Method(s): This systematic review
and meta-analysis was conducted according to the Preferred Reporting Items
for Systematic Review and Meta-Analyses (PRISMA) statement. A systematic
search on fetal aortic valvuloplasty procedure for critical aortic
stenosis was performed through PubMed, Scopus, EBSCOhost, ProQuest, and
Google Scholar. The primary endpoint of each group was overall mortality.
We used R software (version 4.1.3) to estimate the overall proportion of
each outcome using random-effects model of proportional meta-analysis.
<br/>Result(s): A total of 389 fetal subjects from 10 cohort studies were
included in this systematic review and meta-analysis. Fetal aortic
valvuloplasty (FAV) was successfully performed in 84% of patients. It
revealed a successful conversion to biventricular circulation rate of 33%
with a mortality rate of 20%. Bradycardia and pleural effusion requiring
treatment were two most common fetal complications, whereas maternal
complication reported was only placental abruption in one patient.
<br/>Conclusion(s): FAV has a high technical success rate with the ability
to achieve biventricular circulation and a low rate of procedure-related
mortality if carried out by experienced operators.<br/>Copyright &#xa9;
2023 Elsevier B.V.

<72>
Accession Number
2023184274
Title
Left Atrial Appendage Occlusion in the Elderly: Insights From PROTECT-AF,
PREVAIL, and Continuous Access Registries.
Source
JACC: Clinical Electrophysiology. 9(5) (pp 669-676), 2023. Date of
Publication: May 2023.
Author
Sulaiman S.; Roy K.; Wang H.; de Backer O.; Alloco D.; Reddy V.Y.; Holmes
D.R.; Alkhouli M.
Institution
(Sulaiman, Holmes, Alkhouli) Department of Cardiovascular Disease, Mayo
Clinic, Rochester, MN, United States
(Roy, Wang, Alloco) Boston Scientific Corporation, Marlborough, MA, United
States
(de Backer) Department of Cardiology, The Heart Center, Copenhagen
University Hospital, Copenhagen, Rigshospitalet, Denmark
(Reddy) Helmsley Electrophysiology Center, Department of Cardiology, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Data on the safety and efficacy of left atrial appendage
occlusion (LAAO) in elderly patients are limited. <br/>Objective(s): This
study aimed to compare the outcomes of LAAO between patients >=80 and <80
years of age. <br/>Method(s): We included patients enrolled in randomized
trials and nonrandomized registries of the Watchman 2.5 device. The
primary efficacy endpoint was a composite of cardiovascular/unknown death,
stroke, or systemic embolism at 5 years. Secondary endpoints included
cardiovascular/unknown death, stroke, systemic embolism, and major and
nonprocedural bleeding. Survival analyses were performed using the
Kaplan-Meier, Cox proportional hazards, and competing risk analysis
methods. Interaction terms were used to compare the 2 age groups. We also
estimated the average treatment effect of the device with the use of
inverse probability weighting. <br/>Result(s): We studied 2,258 patients,
of whom 570 (25.2%) were >=80 years old, and 1,688 (74.8%) were <80 years
old. Procedural complications at 7 days were similar in both age groups.
The primary endpoint occurred in 12.0% in the device group vs 13.8% in the
control group (HR: 0.9; 95% CI: 0.6-1.4) among patients <80 years of age
and in 25.3% vs 21.7%, respectively (HR: 1.2; 95% CI: 0.7-2.0) among
patients >=80 (interaction P = 0.48). There was no interaction between age
and treatment effect for any of the secondary outcomes. The average
treatment effects of LAAO (compared with warfarin) were similar in the
elderly population (compared with younger patients). <br/>Conclusion(s):
Despite the higher event rates, octogenarians derive similar benefits from
LAAO as their younger counterparts. Age alone should not preclude LAAO in
otherwise suitable candidates.<br/>Copyright &#xa9; 2023 American College
of Cardiology Foundation

<73>
Accession Number
2023113456
Title
Impact of repeat revascularization within 5 years on 10-year mortality
after percutaneous or surgical revascularization.
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Wang R.; Lunardi M.; Hara H.; Gao C.; Ono M.; Davierwala P.M.; Holmes
D.R.; Mohr F.W.; Curzen N.; Burzotta F.; van Geuns R.-J.; Kappetein A.P.;
Head S.J.; Thuijs D.J.F.M.; Tao L.; Garg S.; Onuma Y.; Wijns W.; Serruys
P.W.
Institution
(Wang, Gao, Tao) Department of Cardiology, Xijing Hospital, The Fourth
Military Medical University, Xi'an, China
(Wang, Hara, Gao, Ono, Onuma, Serruys) Department of Cardiology, CORRIB
Research Center for Advanced Imaging and Core Laboratory, National
University of Ireland, Galway (NUIG), University Road, Galway H91 TK33,
Ireland
(Wang, Gao, van Geuns) Department of Cardiology, Radboud University
Medical Center, Radboud Institute for Health Sciences, Nijmegen,
Netherlands
(Lunardi, Wijns) The Smart Sensors Laboratory at the Lambe Institute for
Translational Medicine and CURAM, University of Galway, Galway, Ireland
(Lunardi) Department of Cardiology, University Hospital of Verona, Verona,
Italy
(Hara, Ono) Department of Clinical and Experimental Cardiology, Amsterdam
UMC, University of Amsterdam, Heart Center, Amsterdam Cardiovascular
Sciences, Amsterdam, Netherlands
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, University Health Network, Toronto,
Canada
(Holmes) Mayo Clinic, Rochester, MN, United States
(Mohr) Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig,
Germany
(Curzen) Faculty of Medicine, University of Southampton and Cardiology
Department, University Hospital Southampton, Southampton, United Kingdom
(Burzotta) Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Kappetein, Head, Thuijs) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Rotterdam, Netherlands
(Garg) East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United
Kingdom
(Serruys) NHLI, Imperial College London, London, United Kingdom
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The SYNTAX trial demonstrated negative impact of repeat
revascularization (RR) on 5-year outcomes following PCI/CABG in patients
with three-vessel(3VD) and/or left main coronary artery disease(LMCAD). We
aimed to investigate the impact of RR within 5 years, on 10-year mortality
in patients with 3VD and/or LMCAD after PCI/CABG. <br/>Method(s): The
SYNTAXES study evaluated the vital status out to 10 years of patients with
3VD and/or LMCAD. Patients were stratified by RR within 5 years and
randomized treatment. The association between RR within 5 years and
10-year mortality was assessed. <br/>Result(s): A total of 330 out of 1800
patients (18.3%) underwent RR within 5 years. RR occurred more frequently
after initial PCI than after initial CABG (25.9% vs. 13.7%, p < 0.001).
Overall, 10-year mortality was comparable between patients undergoing RR
and those not (28.2% vs. 26.1%, adjusted HR: 1.17, 95%CI 0.93-1.48, p =
0.187). In the PCI arm, RR was associated with a trend toward higher
10-year mortality (adjusted HR: 1.29, 95%CI 0.97-1.72, p = 0.075), while
in the CABG arm, the trend was opposite (adjusted HR: 0.74, 95%CI
0.46-1.20, p = 0.219). Among patients requiring RR, those who underwent
PCI as initial revascularization had a higher risk of 10-year mortality
compared to initial CABG (33.5% vs. 17.6%, adjusted HR: 2.09, 95%CI
1.21-3.61, p = 0.008). <br/>Conclusion(s): In the SYNTAXES study, RR
within 5 years had no impact on 10-year all-cause death in the population
overall. Among patients requiring any repeat procedures, 10-year mortality
was higher after initial treatment with PCI than after CABG. These
exploratory findings should be investigated with larger populations in
future studies. Trial registration: URL: https://www.clinicaltrials.gov ;
SYNTAXES Unique identifier: NCT03417050. URL:
https://www.clinicaltrials.gov ; SYNTAX Unique identifier: NCT00114972.
Graphical abstract: [Figure not available: see fulltext.].<br/>Copyright
&#xa9; 2023, The Author(s).

<74>
Accession Number
2022466783
Title
Impact of coronary artery disease on clinical outcomes after TAVR:
Insights from the BRAVO-3 randomized trial.
Source
Catheterization and Cardiovascular Interventions. 101(6) (pp 1134-1143),
2023. Date of Publication: 01 May 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) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Feldman, Razuk) Department of Medicine, Icahn School of Medicine at Mount
Sinai, New York, 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, Azienda Ospedaliera
S.Camillo Forlanini, Rome, Italy
(Dumonteil) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
Publisher
John Wiley and Sons Inc
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).
<br/>Background(s): 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.

<75>
Accession Number
2021965281
Title
Three-year clinical outcomes of the novel sirolimus-eluting bioresorbable
scaffold for the treatment of de novo coronary artery disease: A
prospective patient-level pooled analysis of NeoVas trials.
Source
Catheterization and Cardiovascular Interventions. 101(6) (pp 967-972),
2023. Date of Publication: 01 May 2023.
Author
Wang X.; Li Y.; Fu G.; Xu B.; Zhou Y.; Su X.; Liu H.; Zhang Z.; Yu B.; Tao
L.; Zheng Q.; Li L.; Xu K.; Han Y.
Institution
(Wang, Li, Xu, Han) General Hospital of Northern Theater Command,
Liaoning, Shenyang, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, College of
Medicine, Zhejiang University, Zhejiang, Hangzhou, China
(Xu) State Key Laboratory of Cardiovascular Disease, Department of
Cardiology, Centre for Coronary Heart Disease, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Zhou) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Su) Department of Cardiology, Wuhan Asia Heart Hospital, Affiliated to
Wuhan University of Science and Technology, Hubei, Wuhan, China
(Liu) Beijing CAPF General Hospital, Beijing, China
(Zhang) Department of Cardiology, the First Hospital of Lanzhou
University, Gansu, Lanzhou, China
(Yu) The Key Laboratory of Myocardial Ischemia, Department of Cardiology,
2nd Affiliated Hospital of Harbin Medical University, Chinese Ministry of
Education, Harbin, China
(Tao) Department of Cardiology, Xijing Hospital, Air Force Medical
University, Shaanxi, Xi'an, China
(Zheng) Department of Cardiology, Halison International Peace Hospital,
Shijiazhuang, Hengshui, China
(Li) Department of Cardiology, the First Affiliated Hospital of Guangxi
Medical University, Guangxi, Nanning, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We aimed to evaluate the long-term outcomes of the novel
NeoVas sirolimus-eluting bioresorbable scaffold (BRS) for the treatment of
de novo coronary artery disease. <br/>Background(s): The long-term safety
and efficacy of the novel NeoVas BRS are still needed to be elucidated.
<br/>Method(s): A total of 1103 patients with de novo native coronary
lesions for coronary stenting were enrolled. The primary endpoint of
target lesion failure (TLF) was defined as a composite of cardiac death
(CD), target vessel myocardial infarction (TV-MI), or
ischemia-driven-target lesion revascularization (ID-TLR). <br/>Result(s):
A three-year clinical follow-up period was available for 1,091 (98.9%)
patients. The cumulative TLF rate was 7.2% with 0.8% for CD, 2.6% for
TV-MI, and 5.1% for ID-TLR. Additionally, 128 (11.8%) patient-oriented
composite endpoint and 11 definite/probable stent thromboses (1.0%) were
recorded. <br/>Conclusion(s): The extended outcomes of the NeoVas
objective performance criterion trial demonstrated a promising 3-year
efficacy and safety of the NeoVas BRS in low-risk patients with low
complexity in terms of lesions and comorbidities.<br/>Copyright &#xa9;
2022 Wiley Periodicals LLC.

<76>
Accession Number
2021904273
Title
A survey of solid organ transplant recipient attitudes and concerns
regarding contraception and pregnancy.
Source
Clinical Transplantation. 37(5) (no pagination), 2023. Article Number:
e14948. Date of Publication: May 2023.
Author
McIntosh T.; Puerzer P.; Li M.T.; Malat G.; Sammons C.; Norris M.; Fallah
T.; Trofe-Clark J.; DuBois J.M.; Iltis A.; Mohan S.; Sawinski D.
Institution
(McIntosh, DuBois) Bioethics Research Center, Department of Medicine,
Washington University School of Medicine, St. Louis, MO, United States
(Puerzer) School of Arts and Sciences, University of Pennsylvania,
Philadelphia, PA, United States
(Li, Mohan) Department of Medicine, Division of Nephrology, Columbia
University Vagelos College of Physicians and Surgeons, NY, United States
(Malat, Sammons, Norris, Fallah, Trofe-Clark) Department of Pharmacy,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Trofe-Clark) Renal, Electrolyte, and Hypertension Division, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, United
States
(Trofe-Clark) Department of Surgery, Division of Transplantation, Perelman
School of Medicine, University of Pennsylvania, PA, United States
(Iltis) Center for Bioethics, Health and Society, Wake Forest University,
Winston-Salem, NC, United States
(Sawinski) Weill Cornell Medical College, Department of Medicine, Division
of Nephrology and Transplantation, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Many women who are solid organ transplant (SOT) recipients
wish to have children after transplantation. Contraception is an important
component of post-transplant planning and care, given the increased risk
associated with post-transplant pregnancies. We sought to understand
patient attitudes and concerns about post-transplant contraception and
pregnancy. <br/>Method(s): Following a comprehensive literature review,
our team developed a survey that was administered to female SOT recipients
of childbearing age. We used descriptive and inferential statistics to
characterize participant views. <br/>Result(s): A total of 243 transplant
recipients completed the survey (80.7% response rate). The mean age of
respondents was 37.5 years (+/-8.1 years), 66.7% were kidney recipients,
and 40.7% were within the first year after transplant. The most common
concerns among respondents included fetal and maternal health
complications. Participants generally did not agree that transplant
recipients should be advised to avoid pregnancy. There was strong support
for shared decision-making about pregnancy after transplantation.
<br/>Conclusion(s): Understanding patient perspectives can help transplant
providers make better care recommendations and support patient autonomy in
reproductive decisions post-transplant. Given that there are some
differences in views by transplant type, individualized conversations
between patients and providers are needed.<br/>Copyright &#xa9; 2023 John
Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

<77>
Accession Number
2014136331
Title
Direct oral anticoagulants versus vitamin K antagonists in patients with
atrial fibrillation and bioprosthetic valves: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(6) (pp 2052-2059.e4),
2023. Date of Publication: June 2023.
Author
Yokoyama Y.; Briasoulis A.; Ueyama H.; Mori M.; Iwagami M.; Misumida N.;
Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, Pa, United States
(Briasoulis) Division of Cardiovascular Diseases, University of Iowa
Hospitals and Clinics, Iowa City, IA, United States
(Ueyama) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Mori) Division of Cardiac Surgery, Yale School of Medicine, New Haven,
Conn, United States
(Iwagami) Department of Health Services Research, University of Tsukuba,
Tsukuba, Japan
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, Ky, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal anticoagulation strategy for patients with
bioprosthetic valves and atrial fibrillation remains uncertain. We
conducted a meta-analysis using updated evidence comparing direct
anticoagulants (DOACs) and vitamin K antagonists (VKAs) in patients with
bioprosthetic valves and atrial fibrillation. <br/>Method(s): Medline and
Embase were searched through March 2021 to identify randomized controlled
trials (RCTs) and observational studies investigating the outcomes of DOAC
therapy and VKA therapy in patients with bioprosthetic valves and atrial
fibrillation. The outcomes of interest were all-cause death, major
bleeding, and stroke or systemic embolism. <br/>Result(s): Our analysis
included 4 RCTs and 6 observational studies enrolling a total of 6405
patients with bioprosthetic valves and atrial fibrillation assigned to a
DOAC group (n = 2142) or a VKA group (n = 4263). Pooled analysis
demonstrated the similar rates of all-cause death (hazard ratio [HR],
0.90; 95% confidence interval [CI], 0.77-1.05; P = .18; I² =
0%) in the DOAC and VKA groups. However, the rate of major bleeding was
significantly lower in the DOAC group (HR, 0.66; 95% CI, 0.48-0.89; P =
.006; I² = 0%), whereas the rate of stroke or systemic embolism
was similar in the 2 groups (HR, 0.72; 95% CI, 0.44-1.17; P = .18;
I² = 39%). <br/>Conclusion(s): DOAC might decrease the risk of
major bleeding without increasing the risk of stroke or systemic embolism
or all-cause death compared with VKA in patients with bioprosthetic valves
and atrial fibrillation.<br/>Copyright &#xa9; 2021 The American
Association for Thoracic Surgery

<78>
Accession Number
641212231
Title
Benefits of Using Smartphones and Other Digital Methods in Achieving
Better Cardiac Rehabilitation Goals: A Systematic Review and
Meta-Analysis.
Source
Medical science monitor : international medical journal of experimental
and clinical research. 29 (pp e939132), 2023. Date of Publication: 05 May
2023.
Author
Popovici M.; Ursoniu S.; Feier H.; Mocan M.; Tomulescu O.M.G.; Kundnani
N.R.; Valcovici M.; Dragan S.R.
Institution
(Popovici, Feier, Tomulescu, Kundnani, Valcovici, Dragan) Department VI
Cardiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara,
Romania
(Ursoniu) Department of Functional Sciences, Discipline of Public Health,
"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
(Ursoniu) Center for Translational Research and Systems Medicine, "Victor
Babes" University of Medicine and Pharmacy, Timisoara, Romania
(Feier, Kundnani, Valcovici, Dragan) Department of Cardiology, Institute
of Cardiovascular Diseases, Timisoara, Romania
(Mocan) Department of Internal Medicine, Iuliu Hatieganu University of
Medicine and Pharmacy, Cluj-Napoca, Romania
Publisher
NLM (Medline)
Abstract
BACKGROUND The importance of introducing digital technology as an
alternative to classical cardiac rehabilitation has been discussed in
several reviews. The purpose of this systematic review and meta-analysis
was to analyze the effectiveness of digital technology use in cardiac
rehabilitation to determine whether digital methods like use of
smartphones, compared to traditional rehabilitation methods, can improve
the overall quality of life and exercise capacity of cardiac patients.
MATERIAL AND METHODS PubMed, EMBASE, and ScienceDirect were systematically
searched in a randomized manner, resulting in 11 randomized controlled
trials (RCTs) that met all the inclusion criteria. The inclusion criteria
were patients with coronary heart disease, valvular surgery, or post-
myocardial revascularization that were in a technology-assisted cardiac
rehabilitation program vs traditional standard physical follow-up
protocol. RESULTS Seven eligible trials including a total of 802
participants examined the effect of interventions on VO2 peak. One of the
studies comprised 2-stage analysis for this parameter. We found that VO2
peak was significantly higher in the intervention group. Three studies
analyzed the 6-minute walk test (6MWT) results; significant differences
were reported, with better results in the interventional group.
CONCLUSIONS The results of our meta-analysis support conducting further
randomized trials, considering that the development of technology is on
the rise. In the past decade there has been an immense increase in the use
of smartphones, which can widely be used in healthcare, with promising
benefits in having efficient home-based monitoring of the patients and in
reducing financial burden.

<79>
Accession Number
631578938
Title
Prognostic Significance of Left Ventricular Noncompaction.
Source
Circulation: Cardiovascular Imaging. 13(1) (pp E009712), 2020. Date of
Publication: 01 Jan 2020.
Author
Aung N.; Doimo S.; Ricci F.; Sanghvi M.M.; Pedrosa C.; Woodbridge S.P.;
Al-Balah A.; Zemrak F.; Khanji M.Y.; Munroe P.B.; Naci H.; Petersen S.E.
Institution
(Aung, Sanghvi, Pedrosa, Woodbridge, Zemrak, Khanji, Munroe, Petersen)
William Harvey Research Institute, NIHR Cardiovascular Biomedical Research
Centre at Barts, Queen Mary University of London, Charterhouse Square,
United Kingdom
(Aung, Sanghvi, Zemrak, Khanji, Munroe, Petersen) Barts Heart Centre, St
Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London,
United Kingdom
(Doimo) Cardiovascular Department, University of Trieste, Azienda
Sanitaria Universitaria Integrata, Italy
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
Institute of Advanced Biomedical Technologies, G. D'Annunzio University,
Chieti, Italy
(Al-Balah) Imperial College London, Kensington, United Kingdom
(Munroe) Clinical Pharmacology, William Harvey Research Institute, Barts
and The London School of Medicine and Dentistry, Queen Mary University of
London, United Kingdom
(Naci) Department of Health Policy, London School of Economics and
Political Science, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Although left ventricular noncompaction (LVNC) has been
associated with an increased risk of adverse cardiovascular events, the
accurate incidence of cardiovascular morbidity and mortality is unknown.
We, therefore, aimed to assess the incidence rate of LVNCrelated
cardiovascular events. <br/>METHOD(S): We systematically searched
observational studies reporting the adverse outcomes related to LVNC. The
primary end point was cardiovascular mortality. <br/>RESULT(S): We
identified 28 eligible studies enrolling 2501 LVNC patients (mean age, 46
years; male/female ratio, 1.7). After a median follow-up of 2.9 years, the
pooled event rate for cardiovascular mortality was 1.92 (95% CI,
1.54-2.30) per 100 person-years. LVNC patients had a similar risk of
cardiovascular mortality compared with a dilated cardiomyopathy control
group (odds ratio, 1.10 [95% CI, 0.18-6.67]). The incidence rates of
all-cause mortality, stroke and systemic emboli, heart failure admission,
cardiac transplantation, ventricular arrhythmias, and cardiac device
implantation were 2.16, 1.54, 3.53, 1.24, 2.17, and 2.66, respectively,
per 100 person-years. Meta-regression and subgroup analyses revealed that
left ventricular ejection fraction, not the extent of left ventricular
trabeculation, had an important influence on the variability of incidence
rates. The risks of thromboembolism and ventricular arrhythmias in LVNC
patients were similar to dilated cardiomyopathy patients. However, LVNC
patients had a higher incidence of heart failure hospitalization than
dilated cardiomyopathy patients. <br/>CONCLUSION(S): Patients with LVNC
carry a similar cardiovascular risk when compared with dilated
cardiomyopathy patients. Left ventricular ejection fraction-a conventional
indicator of heart failure severity, not the extent of
trabeculation-appears to be an important determinant of adverse outcomes
in LVNC patients.<br/>Copyright &#xa9; 2020 Lippincott Williams and
Wilkins. All rights reserved.

<80>
Accession Number
2024471189
Title
The remote exercise SWEDEHEART study-Rationale and design of a multicenter
registry-based cluster randomized crossover clinical trial (RRCT).
Source
American Heart Journal. 262 (pp 110-118), 2023. Date of Publication:
August 2023.
Author
Back M.; Leosdottir M.; Ekstrom M.; Hambraeus K.; Ravn-Fischer A.; Oberg
B.; Ostlund O.; James S.
Institution
(Back) Department of Occupational Therapy and Physiotherapy, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Back, Ravn-Fischer) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Back, Oberg) Department of Medical and Health Sciences, Division of
Physiotherapy, Linkoping University, Linkoping, Sweden
(Leosdottir) Department of Cardiology, Skane University Hospital, Malmo,
Sweden
(Leosdottir) Department of Clinical Sciences Malmo, Lund University,
Malmo, Sweden
(Ekstrom) Division of Cardiovascular Medicine, Department of Clinical
Sciences, Danderyd Hospital, Stockholm, Sweden
(Hambraeus) Department of Cardiology, Falu Hospital, Falun, Sweden
(Ostlund, James) Uppsala Clinical Research Center, Uppsala University,
Uppsala, Sweden
(James) Department of Medical Sciences, Uppsala University, Uppsala,
Sweden
Publisher
Elsevier Inc.
Abstract
Background: Despite proven benefits of exercise-based cardiac
rehabilitation (EBCR), few patients with myocardial infarction (MI)
participate in and complete these programs. Study design and objectives:
The Remote Exercise SWEDEHEART study is a large multicenter registry-based
cluster randomized crossover clinical trial with a planned enrollment of
1500 patients with a recent MI. Patients at intervention centers will be
offered supervised EBCR, either delivered remotely, center-based or as a
combination of both modes, as self-preferred choice. At control centers,
patients will be offered supervised center-based EBCR, only. The duration
of each time period (intervention/control) for each center will be 15
months and then cross-over occurs. The primary aim is to evaluate if
remotely delivered EBCR, offered as an alternative to center-based EBCR,
can increase participation in EBCR sessions. The proportion completers in
each group will be presented in a supportive responder analysis. The key
secondary aim is to investigate if remote EBCR is as least as effective as
center-based EBCR, in terms of physical fitness and patient-reported
outcome measures. Follow-up of major adverse cardiovascular events
(cardiovascular- and all-cause mortality, recurrent hospitalization for
acute coronary syndrome, heart failure hospitalization, stroke, and
coronary revascularization) will be performed at 1 and 3 years. Safety
monitoring of serious adverse events will be registered, and a
cost-effectiveness analysis will be conducted to estimate the cost per
quality-adjusted life-year (QALY) associated with the intervention
compared with control. <br/>Conclusion(s): The cluster randomized
crossover clinical trial Remote Exercise SWEDEHEART study is evaluating if
participation in EBCR sessions can be increased, which may contribute to
health benefits both on a group level and for individual patients
including a more equal access to health care. Trial registration: The
study is registered at ClinicalTrials.gov (Identifier:
NCT04260958)<br/>Copyright &#xa9; 2023 Elsevier Inc.

<81>
Accession Number
2024466876
Title
A practical approach to pseudoexudative pleural effusions.
Source
Respiratory Medicine. 214 (no pagination), 2023. Article Number: 107279.
Date of Publication: August 2023.
Author
Mohan G.; Bhide P.; Agrawal A.; Kaul V.; Chaddha U.
Institution
(Mohan, Bhide) Department of Internal Medicine, Rutgers-Monmouth Medical
Center, Long Branch, NJ, United States
(Agrawal) Division of Pulmonary, Critical Care & Sleep Medicine, Zucker
School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States
(Kaul) Crouse Health/SUNY Upstate Medical University, Syracuse, NY, United
States
(Chaddha) Division of Pulmonary, Critical Care & Sleep Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
W.B. Saunders Ltd
Abstract
Light's criteria falsely label a significant number of effusions as
exudates. Such exudative effusions with transudative etiologies are
referred to as "pseduoexudates". In this review, we discuss a practical
approach to correctly classify an effusion that may be a pseudoexudate. A
PubMed search yielded 1996 manuscripts between 1990 and 2022. Abstracts
were screened and 29 relevant studies were included in this review
article. Common etiologies for pseudoexudates include diuretic therapy,
traumatic pleural taps, and coronary artery bypass grafting. Here, we
explore alternative diagnostic criteria. Concordant exudates (CE), defined
as effusions where proteins in pleural fluid/serum (PF/SPr) > 0.5 and
pleural fluid LDH level of >160 IU/L (>2/3 upper limit of normal) confer
higher predictive value to the Light's criteria. Serum-pleural effusion
albumin gradient (SPAG) > 1.2 g/dL and serum-pleural effusion protein
gradient (SPPG) > 3.1 g/dL together yielded a sensitivity of 100% in heart
failure and a sensitivity of 99% in hepatic hydrothorax whe n identifying
pseudoexudates (Bielsa et al., 2012) [5]. Pleural fluid N-Terminal Pro
Brain Natriuretic Peptide (NTPBNP) offered a specificity and sensitivity
of 99% in identifying pseudoexudates when using a cut-off of >1714 pg/mL
(Han et al., 2008) [24]. However, its utility remains questionable.
Additionally, we also looked at pleural fluid cholesterol and imaging
modalities such as ultrasound and CT scan to measure pleural thickness and
nodularity. Finally, the diagnostic algorithm we suggest involves using
SPAG >1.2 g/dL and SPPG >3.1 g/dL in effusions classified as exudates when
there is a strong clinical suspicion for pseudoexudates.<br/>Copyright
&#xa9; 2023 Elsevier Ltd

<82>
Accession Number
2024427381
Title
Randomized controlled trial to evaluate the effect of prophylactic
amiodarone versus dexmedetomidine on reducing the incidence of
postoperative junctional ectopic tachycardia after pediatric open heart
surgery.
Source
Annals of Pediatric Cardiology. 16(1) (pp 4-10), 2023. Date of
Publication: January 2023.
Author
Wadile S.; Sivakumar K.; Murmu U.C.; Ganesan S.; Dhandayuthapani G.G.;
Agarwal R.; Sheriff E.A.; Varghese R.
Institution
(Wadile, Sivakumar, Murmu, Ganesan, Dhandayuthapani, Agarwal, Sheriff,
Varghese) Department of Pediatric Cardiology, Institute of Cardio Vascular
Diseases, Madras Medical Mission, Tamil Nadu, Chennai, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Junctional ectopic tachycardia (JET) is the most common
arrhythmia after pediatric open-heart surgeries (OHS), causing high
morbidity and mortality. As diagnosis is often missed in patients with
minimal hemodynamic instability, its incidence depends on active
surveillance. A prospective randomized trial evaluated the efficacy and
safety of prophylactic amiodarone and dexmedetomidine to prevent and
control postoperative JET. <br/>Method(s): Consecutive patients aged under
12 years were randomized into amiodarone, dexmedetomidine (initiated
during anesthetic induction) and control groups. Outcome measures included
incidence of JET, inotropic score, ventilation, and intensive care unit
(ICU) duration and hospital stay, as well as adverse drug effects.
<br/>Result(s): Two hundred and twenty-five consecutive patients with a
median age of 9 months (range 2 days-144 months) and a median weight of
6.3 kg (range 1.8 kg-38 kg) were randomized with 70 patients each to
amiodarone and dexmedetomidine groups, and the rest were controls.
Ventricular septal defect and Fallot's tetralogy were the common defects.
The overall incidence of JET was 16.4%. Syndromic patients, hypokalemia,
hypomagnesemia, longer bypass, and cross-clamp duration were the risk
factors for JET. Patients with JET had significantly prolonged ventilation
(P = 0.043), longer ICU (P = 0.004), and hospital stay (P = 0.034) than
those without JET. JET was less frequent in amiodarone (8.5%) and
dexmedetomidine (14.2%) groups compared to controls (24.7%) (P = 0.022).
Patients receiving amiodarone and dexmedetomidine had significantly lower
inotropic requirements, lower ventilation duration (P = 0.008), ICU (P =
0.006), and hospital stay (P = 0.05). Adverse effects such as bradycardia
and hypotension after amiodarone and ventricular dysfunction after
dexmedetomidine were not significantly different from controls.
<br/>Conclusion(s): Prophylactic amiodarone or dexmedetomidine started
before OHS is effective and safe for the prevention of postoperative
JET.<br/>Copyright &#xa9; 2023 Wolters Kluwer Medknow Publications. All
rights reserved.

<83>
Accession Number
2023093068
Title
Impact of a comprehensive cardiac rehabilitation programme versus coronary
revascularisation in patients with stable angina pectoris: study protocol
for the PRO-FIT randomised controlled trial.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
238. Date of Publication: December 2023.
Author
Heutinck J.M.; De Koning I.A.; Vromen T.; Van Geuns R.-J.M.; Thijssen
D.H.J.; Kemps H.M.C.; Adang E.M.; Geleijnse J.M.; van Gorp P.; van 't Hof
A.W.J.; Janssen V.R.; Jorstad H.T.; Kraaijenhagen R.A.; Lammers J.; de Man
F.H.A.F.; Nollen G.J.; van Ofwegen-Hanekamp C.E.E.; Onkelinx S.; Oostveen
L.M.L.C.; Roes K.C.B.; Sunamara M.; Tonino P.A.L.
Institution
(Heutinck, Kemps) Department of Industrial Design, Eindhoven University of
Technology, Eindhoven, Netherlands
(Heutinck, De Koning, Thijssen) Department of Medical BioSciences, Radboud
University Medical Centre, Nijmegen, Netherlands
(Vromen, Kemps) Department of Cardiology, Maxima Medical Centre,
Eindhoven, Netherlands
(Van Geuns) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Thijssen) Research Institute for Sport and Exercise Sciences, Liverpool
John Moores University, Liverpool, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Currently, in the majority of patients with stable angina
pectoris (SAP) treatment consists of optimal medical treatment,
potentially followed by coronary angiography and subsequent coronary
revascularisation if necessary". Recent work questioned the effectiveness
of these invasive procedures in reducing re-events and improving
prognosis. The potential of exercise-based cardiac rehabilitation on
clinical outcomes in patients with coronary artery disease is well-known.
However, in the modern era, no studies compared the effects of cardiac
rehabilitation versus coronary revascularisation in patients with SAP.
<br/>Method(s): In this multicentre randomised controlled trial, 216
patients with stable angina pectoris and residual anginal complaints under
optimal medical treatment will be randomised to: 1) usual care (i.e.,
coronary revascularisation), or 2) a 12-month cardiac rehabilitation (CR)
programme. CR consists of a multidisciplinary intervention, including
education, exercise training, lifestyle coaching and a dietary
intervention with a stepped decline in supervision. The primary outcome
will be anginal complaints (Seattle Angina Questionnaire-7) following the
12-month intervention. Secondary outcomes include cost-effectiveness,
ischemic threshold during exercise, cardiovascular events, exercise
capacity, quality of life and psychosocial wellbeing. <br/>Discussion(s):
In this study, we will examine the hypothesis that multidisciplinary CR is
at least equally effective in reducing anginal complaints as the
contemporary invasive approach at 12-months follow-up for patients with
SAP. If proven successful, this study will have significant impact on the
treatment of patients with SAP as multidisciplinary CR is a less invasive
and potentially less costly and better sustainable treatment than coronary
revascularisations. Trial registration: Netherlands Trial Register,
NL9537. Registered 14 June 2021.<br/>Copyright &#xa9; 2023, The Author(s).

<84>
Accession Number
2023004448
Title
Comparison of revascularization with conservative medical treatment in
maintenance dialysis patient with coronary artery disease: a systemic
review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1143895. Date of Publication: 2023.
Author
Zheng L.; Wang X.; Zhong Y.-C.
Institution
(Zheng, Wang) Department of Cardiology, Union Hospital, Huazhong
University of Science and Technology, Wuhan, China
(Zhong) Department of Cardiovascular Surgery, Union Hospital, Huazhong
University of Science and Technology, Wuhan, China
Publisher
Frontiers Media S.A.
Abstract
Background: The primary cause of death among maintenance dialysis patients
is coronary artery disease (CAD). However, the best treatment plan has not
yet been identified. <br/>Method(s): The relevant articles were retrieved
from various online databases and references from their inception to
October 12, 2022. The studies that compared revascularization
[percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG)] with medical treatment (MT) among maintenance dialysis
patients with CAD were selected. The outcomes evaluated were long-term
(with a follow-up of at least 1 year) all-cause mortality, long-term
cardiac mortality, and the incidence rate of bleeding events. Bleeding
events are defined according to TIMI hemorrhage criteria: (1) major
hemorrhage, intracranial hemorrhage or clinically visible hemorrhage
(including imaging diagnosis) with decrease of hemoglobin concentration
>=5 g/dl; (2) minor hemorrhage, clinically visible bleeding (including
imaging diagnosis) with a drop in hemoglobin of 3-5 g/dl; (3) minimal
hemorrhage, clinically visible bleeding with hemoglobin drop <3 g/dl. In
addition, revascularization strategy, CAD type, and the number of diseased
vessels were considered in subgroup analyses. <br/>Result(s): A total of
eight studies with 1,685 patients were selected for this meta-analysis.
The current findings suggested that revascularization was associated with
low long-term all-cause mortality and long-term cardiac mortality but a
similar incidence rate of bleeding events compared to MT. However,
subgroup analyses indicated that PCI is linked to decreased long-term
all-cause mortality compared to MT but CABG did not significantly differ
from MT in terms of long-term all-cause mortality. Revascularization also
showed lower long-term all-cause mortality compared to MT among patients
with stable CAD, single-vessel disease, and multivessel disease but did
not reduce long-term all-cause mortality among patients with ACS.
<br/>Conclusion(s): Long-term all-cause mortality and long-term cardiac
mortality were reduced by revascularization in comparison to MT alone in
patients undergoing dialysis. Larger randomized studies are needed to
confirm the conclusion of this meta-analysis.<br/>Copyright 2023 Zheng,
Wang and Zhong.

<85>
Accession Number
2024439005
Title
Randomized Comparison of a Radiofrequency Wire Versus a Radiofrequency
Needle System for Transseptal Puncture.
Source
JACC: Clinical Electrophysiology. 9(5) (pp 611-619), 2023. Date of
Publication: May 2023.
Author
Dewland T.A.; Gerstenfeld E.P.; Moss J.D.; Lee A.C.; Vedantham V.; Lee
R.J.; Tseng Z.H.; Hsia H.H.; Lee B.K.; Wall G.C.; Chang K.R.; Yang M.H.;
Marcus G.M.
Institution
(Dewland, Gerstenfeld, Moss, Lee, Vedantham, Lee, Tseng, Hsia, Lee, Wall,
Chang, Yang, Marcus) Department of Medicine, Division of Cardiology,
Electrophysiology Section, University of California-San Francisco, San
Francisco, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transseptal puncture is a necessary component of many
electrophysiology and structural heart procedures. Improving this
technique has broad ramifications for the overall efficiency and safety of
these interventions. A new technology uses a specialized introducer wire
to cross the septum with radiofrequency (RF) energy, eliminating the need
for a transseptal needle and wire/needle exchanges. <br/>Objective(s):
This study sought to compare the efficacy and safety of an RF needle
versus RF wire approach for transseptal puncture. <br/>Method(s):
Individuals >=18 years of age undergoing double transseptal puncture for
atrial fibrillation or left atrial flutter ablation were randomized to a
transseptal approach with either an RF needle or RF wire. The primary
outcome was time to achieve first transseptal puncture. Secondary outcomes
included second and combined transseptal puncture time, fluoroscopy time,
number of equipment exchanges, and complications. <br/>Result(s): A total
of 75 participants were enrolled (36 RF needle, 39 RF wire). No crossovers
occurred. Randomization to the RF wire resulted in a significant reduction
in first transseptal time compared with the RF needle (median 9.2 [IQR:
5.7-11.2] minutes vs 6.9 [IQR: 5.2-8.4] minutes, P = 0.03). Second and
combined transseptal times, and number of equipment exchanges, were also
reduced with the RF wire. One participant in the RF needle group
experienced transient atrioventricular block due to mechanical trauma from
the sheath/dilator assembly. There were no complications in the RF wire
group. <br/>Conclusion(s): The RF wire technique resulted in faster time
to transseptal puncture and fewer equipment exchanges compared with an RF
needle with no difference in complications.<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<86>
Accession Number
2024422691
Title
Warm versus cold blood cardioplegia in paediatric congenital heart
surgery: a randomized trial.
Source
European Journal of Cardio-thoracic Surgery. 63(4) (no pagination), 2023.
Article Number: ezad041. Date of Publication: 01 Apr 2023.
Author
Stoica S.; Smartt H.J.M.; Heys R.; Sheehan K.; Walker-Smith T.; Parry A.;
Beringer R.; Ttofi I.; Evans R.; Dabner L.; Ghorbel M.T.; Lansdowne W.;
Reeves B.C.; Angelini G.D.; Rogers C.A.; Caputo M.
Institution
(Stoica, Sheehan, Parry, Beringer, Ttofi, Lansdowne, Caputo) Bristol Royal
Hospital for Children, University Hospitals Bristol, Weston NHS Foundation
Trust, Bristol, United Kingdom
(Smartt, Heys, Walker-Smith, Evans, Dabner, Reeves, Rogers) Bristol Trials
Centre, Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Smartt, Heys, Sheehan, Walker-Smith, Evans, Dabner, Reeves, Angelini,
Rogers) National Institute for Health Research, Bristol Biomedical
Research Centre, University Hospitals Bristol, Weston NHS Foundation
Trust, University of Bristol, Bristol, United Kingdom
(Ghorbel, Angelini, Caputo) Bristol Heart Institute, University of
Bristol, Bristol, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Intermittent cold blood cardioplegia is commonly used in
children, whereas intermittent warm blood cardioplegia is widely used in
adults. We aimed to compare clinical and biochemical outcomes with these 2
methods. <br/>METHOD(S): A single-centre, randomized controlled trial was
conducted to compare the effectiveness of warm (>_34^degreeC)
versus cold (4-6^degreeC) antegrade cardioplegia in children.
The primary outcome was cardiac troponin T over the 1st 48 postoperative
hours. Intensive care teams were blinded to group allocation. Outcomes
were compared by intention-to-treat using linear mixed-effects, logistic
or Cox regression. <br/>RESULT(S): 97 participants with median age of 1.2
years were randomized (49 to warm, 48 to cold cardioplegia); 59
participants (61%) had a risk-adjusted congenital heart surgery score of 3
or above. There were no deaths and 92 participants were followed to
3-months. Troponin release was similar in both groups [geometric mean
ratio 1.07; 95% confidence interval (CI) 0.79-1.44; P = 0.66], as were
other cardiac function measures (echocardiography, arterial and venous
blood gases, vasoactive-inotrope score, arrhythmias). Intensive care stay
was on average 14.6 h longer in the warm group (hazard ratio 0.52; 95% CI
0.34-0.79; P = 0.003), with a trend towards longer overall hospital stays
(hazard ratio 0.66; 95% CI 0.43-1.02; P = 0.060) compared with the cold
group. This could be related to more unplanned reoperations on bypass in
the warm group compared to cold group (3 vs 1). <br/>CONCLUSION(S): Warm
blood cardioplegia is a safe and reproducible technique but does not
provide superior myocardial protection in paediatric heart
surgery.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<87>
Accession Number
2024351850
Title
Effects of qCON and qNOX-guided general anaesthesia management on patient
opioid use and prognosis: a study protocol.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e069134. Date of
Publication: 02 May 2023.
Author
Kang J.; Fang C.; Yuan Y.; Niu K.; Zheng Y.; Yu Y.; Wang G.; Li Y.
Institution
(Kang, Fang, Li, Yuan, Zheng, Yu, Wang, Li) Department of Anesthesiology,
Tianjin Medical University General Hospital, Tianjin, China
(Kang, Fang, Li, Yuan, Zheng, Yu, Wang, Li) Tianjin Research Institute of
Anesthesiology, Tianjin, China
(Niu) Nutritional Epidemiology Institute, School of Public Health, Tianjin
Medical University, Tianjin, China
Publisher
BMJ Publishing Group
Abstract
Introduction The adverse effects of general anaesthetic drugs (especially
opioids) cannot be ignored. However, current nociceptive-monitoring
techniques still lack consistency in guiding the use of opioids. This
trial will study the demand for opioid use and patient prognosis in qCON
and qNOX-guided general anaesthesia management. Methods and analysis This
prospective, randomised, controlled trial will randomly recruit 124
patients undergoing general anaesthesia for non-cardiac surgery in equal
numbers to either the qCON or BIS group. The qCON group will adjust
intraoperative propofol and remifentanil dosage according to qCON and qNOX
values, while the BIS group will adjust according to BIS values and
haemodynamic fluctuations. The differences between the two groups will be
observed in remifentanil dosing and prognosis. The primary outcome will be
intraoperative remifentanil use. Secondary outcomes will include propofol
consumption; the predictive ability of BIS, qCON and qNOX on conscious
responses, noxious stimulus and body movements; and changes in cognitive
function at 90 days postoperatively. Ethics and dissemination This study
involves human participants and was approved by the Ethics Committee of
the Tianjin Medical University General Hospital (IRB2022-YX-075-01).
Participants gave informed consent to participate in the study before
taking part. The study results will be published in peer-reviewed journals
and presented at relevant academic conferences. Trial registration number
ChiCTR2200059877 <br/>Copyright &#xa9; 2023 BMJ Publishing Group. All
rights reserved.

<88>
Accession Number
2024351831
Title
Effect of the machine learning-derived Hypotension Prediction Index (HPI)
combined with diagnostic guidance versus standard care on depth and
duration of intraoperative and postoperative hypotension in elective
cardiac surgery patients: HYPE-2 - study protocol of a randomised clinical
trial.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e061832. Date of
Publication: 02 May 2023.
Author
Rellum S.R.; Schuurmans J.; Schenk J.; Van Der Ster B.J.P.; Van Der Ven
W.H.; Geerts B.F.; Hollmann M.W.; Cherpanath T.G.V.; Lagrand W.K.;
Wynandts P.; Paulus F.; Driessen A.H.G.; Terwindt L.E.; Eberl S.; Hermanns
H.; Veelo D.P.; Vlaar A.P.J.
Institution
(Rellum, Schuurmans, Schenk, Van Der Ster, Van Der Ven, Hollmann,
Wynandts, Terwindt, Eberl, Hermanns, Veelo) Department of Anesthesiology,
Amsterdam Umc Locatie Amc, Amsterdam, Netherlands
(Rellum, Schuurmans, Cherpanath, Lagrand, Wynandts, Paulus, Vlaar)
Department of Intensive Care, Amsterdam Umc Locatie Amc, Amsterdam,
Netherlands
(Schenk) Department of Epidemiology & Data Science, Amsterdam Umc Locatie
Amc, Amsterdam, Netherlands
(Geerts) Medical Affairs, Healthplus.ai B.V, Amsterdam, Netherlands
(Hollmann) Laboratory of Experimental Intensive Care and Anesthesiology,
Amsterdam Umc Locatie Amc, Amsterdam, Netherlands
(Driessen) Department of Cardiothoracic Surgery, Heart Centre, Amsterdam
Umc Locatie Amc, Amsterdam, Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Hypotension is common during cardiac surgery and often
persists postoperatively in the intensive care unit (ICU). Still,
treatment is mainly reactive, causing a delay in its management. The
Hypotension Prediction Index (HPI) can predict hypotension with high
accuracy. Using the HPI combined with a guidance protocol resulted in a
significant reduction in the severity of hypotension in four non-cardiac
surgery trials. This randomised trial aims to evaluate the effectiveness
of the HPI in combination with a diagnostic guidance protocol on reducing
the occurrence and severity of hypotension during coronary artery bypass
grafting (CABG) surgery and subsequent ICU admission. Methods and analysis
This is a single-centre, randomised clinical trial in adult patients
undergoing elective on-pump CABG surgery with a target mean arterial
pressure of 65 mm Hg. One hundred and thirty patients will be randomly
allocated in a 1:1 ratio to either the intervention or control group. In
both groups, a HemoSphere patient monitor with embedded HPI software will
be connected to the arterial line. In the intervention group, HPI values
of 75 or above will initiate the diagnostic guidance protocol, both
intraoperatively and postoperatively in the ICU during mechanical
ventilation. In the control group, the HemoSphere patient monitor will be
covered and silenced. The primary outcome is the time-weighted average of
hypotension during the combined study phases. Ethics and dissemination The
medical research ethics committee and the institutional review board of
the Amsterdam UMC, location AMC, the Netherlands, approved the trial
protocol (NL76236.018.21). No publication restrictions apply, and the
study results will be disseminated through a peer-reviewed journal. Trial
registration number The Netherlands Trial Register (NL9449),
ClinicalTrials.gov (NCT05821647). <br/>Copyright &#xa9; 2023 BMJ
Publishing Group. All rights reserved.

<89>
Accession Number
2024351620
Title
Environmental impact of cardiovascular healthcare.
Source
Open Heart. 10(1) (no pagination), 2023. Article Number: e002279. Date of
Publication: 02 May 2023.
Author
Barratt A.L.; Li Y.; Gooroovadoo I.; Todd A.; Dou Y.; McAlister S.;
Semsarian C.
Institution
(Barratt, Li, Gooroovadoo, Todd, Dou, McAlister, Semsarian) Faculty of
Medicine and Health, The University of Sydney, Sydney, NSW, Australia
(Barratt, McAlister, Semsarian) Wiser Healthcare, The University of
Sydney, Sydney, NSW, Australia
(McAlister) Department of Critical Care, The University of Melbourne,
Melbourne, VIC, Australia
(Semsarian) Agnes Ginges Centre for Molecular Cardiology, Centenary
Institute, Sydney, NSW, Australia
(Semsarian) Department of Cardiology, Royal Prince Alfred Hospital,
Sydney, NSW, Australia
Publisher
BMJ Publishing Group
Abstract
Importance The healthcare sector is essential to human health and
well-being, yet its significant carbon footprint contributes to climate
change-related threats to health. Objective To review systematically
published studies on environmental impacts, including carbon dioxide
equivalent (CO 2 e) emissions, of contemporary cardiovascular healthcare
of all types, from prevention through to treatment. Evidence review We
followed the methods of systematic review and synthesis. We conducted
searches in Medline, EMBASE and Scopus for primary studies and systematic
reviews measuring environmental impacts of any type of cardiovascular
healthcare published in 2011 and onwards. Studies were screened, selected
and data were extracted by two independent reviewers. Studies were too
heterogeneous for pooling in meta-analysis and were narratively
synthesised with insights derived from content analysis. Findings A total
of 12 studies estimating environmental impacts, including carbon emissions
(8 studies), of cardiac imaging, pacemaker monitoring, pharmaceutical
prescribing and in-hospital care including cardiac surgery were found. Of
these, three studies used the gold-standard method of Life Cycle
Assessment. One of these found the environmental impact of
echocardiography was 1%-20% that of cardiac MR (CMR) imaging and Single
Photon Emission Tomography (SPECT) scanning. Many opportunities to reduce
environmental impacts were identified: carbon emissions can be reduced by
choosing echocardiography as the first cardiac test before considering CT
or CMR, remote monitoring of pacemaker devices and teleconsultations when
clinically appropriate to do so. Several interventions may be effective
for reducing waste, including rinsing bypass circuitry after cardiac
surgery. Cobenefits included reduced costs, health benefits such as cell
salvage blood available for perfusion, and social benefits such as reduced
time away from work for patients and carers. Content analysis revealed
concern about the environmental impact of cardiovascular healthcare,
particularly carbon emissions and a desire for change. Conclusions and
relevance Cardiac imaging, pharmaceutical prescribing and in-hospital care
including cardiac surgery have significant environmental impacts,
including CO 2 e emissions which contribute to climate-related threats to
human health. Importantly, many opportunities to effectively reduce
environmental impacts exist within cardiac care, and can provide economic,
health and social cobenefits. <br/>Copyright &#xa9; 2023 BMJ Publishing
Group. All rights reserved.

<90>
[Use Link to view the full text]
Accession Number
2024344167
Title
Implementation of the Kidney Disease Improving Global Outcomes guidelines
for the prevention of acute kidney injury after cardiac surgery: An
international cohort survey.
Source
European Journal of Anaesthesiology. 40(6) (pp 418-424), 2023. Date of
Publication: 01 Jun 2023.
Author
Massoth C.; Kullmar M.; Moncho A.P.; Suarez S.G.; Grigoryev E.; Ivkin A.;
Von Dossow V.; Ott S.; Rau N.; Meersch M.; Zarbock A.
Institution
(Massoth, Kullmar, Meersch, Zarbock) The Department of Anaesthesiology,
Intensive Care and Pain Medicine, University Hospital Munster, Germany
(Moncho) Department of Anaesthesiology, La Fe University and Polytechnic
Hospital Valencia, Spain
(Suarez) Department of Anaesthesiology, University Hospital Vall D Hebron
Barcelona, Spain
(Grigoryev, Ivkin) Scientific Research Institute for Complex Issues of
Cardiovascular Diseases, Kemerovo, Russian Federation
(Von Dossow) Institute of Anaesthesiology and Pain Therapy, Heart and
Diabetes Center Bad Oeynhausen, Ruhr-University, Germany
(Ott, Rau) Department of Cardiac Anaesthesiology and Intensive Care
Medicine, German Heart Center Berlin, Germany
(Ott) Department of Cardiac Anaesthesiology and Intensive Care Medicine,
Charite-Universitatsmedizin Berlin, Germany
(Ott) Department of Intensive Care Medicine, University Hospital Vall
d'Hebron Barcelona, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDIncreasing evidence from randomised controlled trials supports
the implementation of a six-measure care bundle proposed by the Kidney
Disease Improving Global Outcomes (KDIGO) guidelines in patients at high
risk for acute kidney injury (AKI) to reduce its incidence after cardiac
surgery.OBJECTIVETo assess compliance with the KDIGO bundle in clinical
practice.DESIGNProspective observational multinational study.SETTINGSix
international tertiary care centres, from February 2021 to November
2021.PATIENTSFive hundred and thirty-seven consecutive patients undergoing
cardiac surgery during a 1-month observational period.INTERVENTIONSAll
patients were assessed for the postoperative implementation of the
following measures: Avoidance of nephrotoxic medication and radiocontrast
agents whenever possible, strict glycaemic control, close monitoring of
renal function, optimisation of haemodynamic and volume status and
functional monitoring of haemodynamic status.MAIN OUTCOME MEASURESThe
primary endpoint was the proportion of patients receiving fully compliant
care. Secondary outcomes were occurrence of AKI and major adverse kidney
event rate at day 30.RESULTSThe full care bundle was applied to 0.4% of
patients. There was avoidance of nephrotoxic drugs in 15.6%, radiocontrast
agents in 95.3% and hyperglycaemia in 39.6%. Close monitoring of urine
output and serum creatinine was achieved in 6.3%, 57.4% underwent
optimisation of volume and haemodynamic status, and 43.9% received
functional haemodynamic monitoring. 27.2% developed AKI within 72h after
surgery. The average number of implemented measures was 2.6+/-1.0 and did
not differ between AKI or non-AKI patients (P=0.854).CONCLUSIONAdherence
with the KDIGO bundle was very low in cardiac surgery patients.
Initiatives to improve guideline compliance might provide a strategy to
mitigate the burden of AKI.TRIAL REGISTRATIONwww.drks.de
DRKS00024204.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<91>
Accession Number
2024379802
Title
Preoperative P-wave parameters and risk of atrial fibrillation after
cardiac surgery: a meta-analysis of 20 201 patients.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(4) (no pagination),
2022. Article Number: ivac220. Date of Publication: 01 Oct 2022.
Author
Kawczynski M.J.; Van De Walle S.; Maesen B.; Isaacs A.; Zeemering S.;
Hermans B.; Vernooy K.; Maessen J.G.; Schotten U.; Bidar E.
Institution
(Kawczynski, Van De Walle, Maesen, Maessen, Bidar) Department of
Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University
Medical Centre, Maastricht, Netherlands
(Kawczynski, Maesen, Isaacs, Zeemering, Hermans, Maessen, Schotten, Bidar)
Department of Physiology, Maastricht University, Maastricht, Netherlands
(Zeemering, Hermans, Vernooy) Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Vernooy) Department of Cardiology, Heart and Vascular Centre, Maastricht
University Medical Centre, Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: To evaluate the role of P-wave parameters, as defined on
preprocedural electrocardiography (ECG), in predicting atrial fibrillation
after cardiac surgery [postoperative atrial fibrillation (POAF)].
<br/>METHOD(S): PubMed, Cochrane library and Embase were searched for
studies reporting on P-wave parameters and risk of POAF. Meta-analysis of
P-wave parameters reported by at least 5 different publications was
performed. In case of receiver operator characteristics (ROC-curve)
analysis in the original publications, an ROC meta-analysis was performed
to summarize the sensitivity and specificity. <br/>RESULT(S): Thirty-two
publications, with a total of 20 201 patients, contributed to the
meta-analysis. Increased P-wave duration, measured on conventional 12-lead
ECG (22 studies, Cohen's d = 0.4, 95% confidence interval: 0.3-0.5, P <
0.0001) and signal-averaged ECG (12 studies, Cohen's d = 0.8, 95%
confidence interval: 0.5-1.2, P < 0.0001), was a predictor of POAF
independently from left atrial size. ROC meta-analysis for signal-averaged
ECG P-wave duration showed an overall sensitivity of 72% (95% confidence
interval: 65-78%) and specificity of 68% (95% confidence interval:
58-77%). Summary ROC curve had a moderate discriminative power with an
area under the curve of 0.76. There was substantial heterogeneity in the
meta-analyses for P-wave dispersion and PR-interval. <br/>CONCLUSION(S):
This meta-analysis shows that increased P-wave duration, measured on
conventional 12-lead ECG and signal-averaged ECG, predicted POAF in
patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<92>
Accession Number
2024379797
Title
Perioperative electroencephalography in cardiac surgery with hypothermic
circulatory arrest: a narrative review.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(4) (no pagination),
2022. Article Number: ivac198. Date of Publication: 01 Oct 2022.
Author
Mcdevitt W.M.; Gul T.; Jones T.J.; Scholefield B.R.; Seri S.; Drury N.E.
Institution
(Mcdevitt, Seri) Department of Neurophysiology, Birmingham Children's
Hospital, Birmingham, United Kingdom
(Gul) School of Biomedical Sciences, University of Birmingham, Birmingham,
United Kingdom
(Gul, Jones, Drury) Department of Paediatric Cardiac Surgery, Birmingham
Children's Hospital, Birmingham, United Kingdom
(Jones, Drury) Institute of Cardiovascular Sciences, University of
Birmingham, Birmingham, United Kingdom
(Scholefield) Institute of Inflammation and Ageing, University of
Birmingham, Birmingham, United Kingdom
(Scholefield) Paediatric Intensive Care Unit, Birmingham Children's
Hospital, Birmingham, United Kingdom
(Seri) College of Health and Life Sciences, Aston University, Birmingham,
United Kingdom
Publisher
Oxford University Press
Abstract
OBJECTIVES: Cardiac surgery with hypothermic circulatory arrest (HCA) is
associated with neurological morbidity of variable severity and
electroencephalography (EEG) is a sensitive proxy measure of brain injury.
We conducted a narrative review of the literature to evaluate the role of
perioperative EEG monitoring in cardiac surgery involving HCA.
<br/>METHOD(S): Medline, Embase, Central and LILACS databases were
searched to identify studies utilizing perioperative EEG during surgery
with HCA in all age groups, published since 1985 in any language. We aimed
to compare EEG use with no use but due to the lack of comparative studies,
we performed a narrative review of its utility. Two or more reviewers
independently screened studies for eligibility and extracted data.
<br/>RESULT(S): Fourty single-centre studies with a total of 3287 patients
undergoing surgery were identified. Most were observational cohort studies
(34, 85%) with only 1 directly comparing EEG use with no use. EEG
continuity (18, 45%), seizures (15, 38%) and electrocerebral inactivity
prior to circulatory arrest (15, 38%) were used to detect, monitor,
prevent and prognose neurological injury. Neurological dysfunction was
reported in almost all studies and occurred in 0-21% of patients. However,
the heterogeneity of reported clinical and EEG outcome measures prevented
meta-analysis. <br/>CONCLUSION(S): EEG is used to detect cortical
ischaemia and seizures and predict neurological abnormalities and may
guide intraoperative cerebral protection. However, there is a lack of
comparative data demonstrating the benefit of perioperative EEG
monitoring. Use of a standardized methodology for performing EEG and
reporting outcome metrics would facilitate the conduct of high-quality
clinical trials.<br/>Copyright &#xa9; 2022 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<93>
Accession Number
2024388532
Title
Vascular access for transcatheter aortic valve replacement: A network
meta-analysis.
Source
Journal of Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Yokoyama Y.; Sakata T.; Mikami T.; Misumida N.; Scotti A.; Takagi H.;
Sugiura T.; Kuno T.; Latib A.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Sakata) Cardiovascular Research Institute, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Mikami) Department of Neurology, Tufts Medical Center, Medford and
Somerville, MA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, United States
(Scotti, Kuno, Latib) Department of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shimizu, Shizuoka, Japan
(Sugiura) Department of Cardiothoracic & Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, New York,
United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: The choice of an alternative access for transcatheter aortic
valve replacement (TAVR) remains controversial when transfemoral (TF)
access is not feasible. <br/>Method(s): We conducted a network
meta-analysis to compare the outcomes of TAVR via various peripheral
vascular accesses. MEDLINE and EMBASE were searched through July 2022 to
identify studies that investigated outcomes in patients who underwent TAVR
via TF, trans-subclavian (Tsc), transcarotid (TC), or transcaval (Tcav)
access. A network meta-analysis was conducted via random-effects model.
Outcomes of interest were major or life-threatening bleeding, stroke,
major vascular complication, and 30-day mortality. <br/>Result(s): No
randomized trial was identified. Our analysis included 33 observational
studies that enrolled a total of 43,455 patients who underwent TAVR via TF
(n = 36,202), Tsc (n = 3869), TC (n = 3066), or Tcav (n = 318) access. The
risk of major or life-threatening bleeding was higher via Tsc compared
with TF [odds ratio (OR); 95 % confidence interval (CI) =1.51 (1.03-2.23),
p = 0.034]. The risk of stroke was higher via Tsc compared with TF and
Tcav [OR (95 % CI) =2.00 (1.14-3.52), p = 0.018, OR (95 % CI) =2.43
(1.03-5.74), p = 0.044, respectively]. The risk of major vascular
complications was lower via TC compared with Tsc, and Tcav and higher with
Tcav compared with TF and Tsc. 30-day mortality was higher via Tsc
compared with TF. Tsc was associated with higher risk of major or
life-threatening bleeding compared with TF, and higher risk of stroke
compared to TF and Tcav. Tcav had the highest risk of major vascular
complications. <br/>Conclusion(s): In patients who underwent TF, Tsc, TC,
or Tcav TAVR, Tsc had a higher rate of stroke compared to TF and Tcav, and
major or life-threatening bleeding compared to TF. The rate of major
vascular complications in Tcav was the highest among the four
approaches.<br/>Copyright &#xa9; 2023 Elsevier Ltd

<94>
Accession Number
2022861315
Title
Evaluating the value of progressive muscle relaxation therapy for patients
with lumbar disc herniation after surgery based on a
difference-in-differences model.
Source
Biotechnology and Genetic Engineering Reviews. (no pagination), 2023.
Date of Publication: 2023.
Author
Chen X.; Chen G.; Zhao Y.; Chen Q.; Huang J.; Hu G.
Institution
(Chen, Zhao, Chen, Huang, Hu) Ward of Nursing Department of the First
Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
(Chen) Department of Orthopedics, The First Affiliated Hospital of Wenzhou
Medical University, Zhejiang, China
Publisher
Taylor and Francis Ltd.
Abstract
We evaluate the value of progressive muscle relaxation (PMR) for patients
with lumbar disc herniation after surgery based on a
difference-in-differences model. A total of 128 patients with lumbar disc
herniation who underwent surgery were randomly assigned to undergo either
conventional intervention (conventional intervention group, n = 64) or
conventional intervention combined with PMR (PMR group, n = 64).
Perioperative anxiety level, stress level and lumbar function were
compared between the two groups and compared pain between the two groups
before and 1 week and 1 and 3 months after surgery. After 3 months, no one
was lost to follow-up. At 1 day before surgery and 3 days after surgery,
Self-rating Anxiety Scale score in the PMR group was significantly lower
than that in the conventional intervention group (P < 0.05). At 30 min
before surgery, heart rate and systolic blood pressure in the PMR group
were significantly lower than those in the conventional intervention group
(P < 0.05). After intervention, the scores of subjective symptoms,
clinical signs and restrictions on activities of daily living were
significantly higher in the PMR group than those in the conventional
intervention group (all P < 0.05). Visual Analogue Scale score in the PMR
group was significantly lower than that in the conventional intervention
group (all P < 0.05). The amplitude of change in VAS score in the PMR
group was greater than that in the conventional intervention group (P <
0.05). PMR can relieve perioperative anxiety and stress in patients with
lumbar disc herniation, reduce postoperative pain and improve lumbar
function.<br/>Copyright &#xa9; 2023 Informa UK Limited, trading as Taylor
& Francis Group.

<95>
Accession Number
2016891506
Title
European position paper on the management of patients with patent foramen
ovale. Part II - Decompression sickness, migraine, arterial deoxygenation
syndromes and select high-risk clinical conditions.
Source
European Heart Journal. 42(16) (pp 1545-1553), 2021. Date of Publication:
21 Apr 2021.
Author
Pristipino C.; Germonpre P.; Toni D.; Sievert H.; Meier B.; D'Ascenzo F.;
Berti S.; Onorato E.M.; Bedogni F.; Mas J.-L.; Scacciatella P.;
Hildick-Smith D.; Gaita F.; Kyrle P.A.; Thomson J.; Derumeaux G.; Sibbing
D.; Chessa M.; Hornung M.; Zamorano J.; Dudek D.; Omede P.; Ballocca F.;
Barbero U.; Giordana F.; Gili S.; Iannaccone M.; Akagi T.; Anzola G.;
Carroll J.; Dalvi B.; De Angelis C.; Junbo G.; Kasner S.E.; Michel-Behnke
I.; Musumeci G.; Sondergaard L.; Tarantini G.; Biondi-Zoccai G.G.L.;
Capodanno D.; Valgimigli M.; Byrne R.; Kunadian V.
Institution
(Pristipino) S. Filippo Neri Hospital ASL Roma 1, Rome, Italy
(Germonpre) Military Hospital, Brussels, Belgium
(Toni) Hospital Policlinico Umberto, Sapienza University, Rome, Italy
(Sievert, Hornung) CardioVascular Center Frankfurt (CVC Frankfurt),
Frankfurt, Germany
(Sievert) Anglia Ruskin University, Chelmsford, United Kingdom
(Sievert) University California San Francisco (UCSF), San Francisco, CA,
United States
(Meier, Valgimigli) University Hospital, Bern, Switzerland
(D'Ascenzo, D'Ascenzo, Gaita, Omede) Citta della Salute e della Scienza
Hospital, University of Turin, Turin, Italy
(Berti, Gili) Heart Hospital, Massa, Italy
(Onorato) Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Bedogni, Chessa) IRCCS Policlinico San Donato, San Donato Milanese,
Milan, Italy
(Mas) Hopital Sainte-Anne, Universite Paris Descartes, Paris, France
(Scacciatella) UParini Hospital, Aosta, Italy
(Hildick-Smith) Sussex Cardiac Centre, Brighton and Sussex University
Hospitals, Brighton, United Kingdom
(Kyrle) Medical University, Vienna, Austria
(Thomson) Leeds General Infirmary, Leeds, United Kingdom
(Derumeaux) Hopital Henri Mondor, Faculte de Medecine de Creteil, Creteil,
France
(Sibbing) Privatklinik Lauterbacher Muhle Am Ostersee, Iffeldorf and
Ludwig-Maximilians-Universitat (LMU) Munchen, Munich, Germany
(Zamorano) University Hospital Ramon y Cajal, Madrid, Spain
(Dudek) Jagiellonian University Medical College, Krakow, Poland
(Dudek) Maria Cecilia Hospital, GVM Care and Research, Cotignola (RA),
Italy
(Ballocca) Ospedale Maria Vittoria, Turin, Italy
(Barbero) Ospedale Civile SS. Annunziata, Savigliano, Italy
(Giordana) Ospedale Santa Croce e Carle, Cuneo, Italy
(Iannaccone) Ospedale San Giovanni Bosco, Turin, Italy
(Akagi) Okayama University Hospital, Okayama, Japan
(Anzola) Brescia University, Brescia, Italy
(Carroll) University of Colorado Hospital, Denver, CO, United States
(Dalvi) Glenmark Cardiac Centre, Mumbai, India
(De Angelis) Italian Air Force HQ, Rome, Italy
(Junbo) Shanghai Institute of Cardiovascular Disease, Shanghai, China
(Kasner) University of Pennsylvania, Philadelphia, PA, United States
(Michel-Behnke) University Hospital for Children and Adolescents, Medical
University Vienna, Vienna, Austria
(Musumeci) Mauriziano Hospital, Turin, Italy
(Sondergaard) Rigshospitalet, Copenhagen, Denmark
(Tarantini) Padua University Hospital, Padua, Italy
(Biondi-Zoccai) Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Naples, Italy
(Capodanno) Azienda Ospedaliero-Universitaria "policlinico-Vittorio
Emanuele", University of Catania, Catania, Italy
(Byrne) RCSI University of Medicine and Health Sciences, Dublin, Ireland
(Kunadian) Newcastle University and Freeman Hospital, Newcastle Upon Tyne
Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
Publisher
Oxford University Press
Abstract
Patent foramen ovale (PFO) is implicated in the pathogenesis of a number
of medical conditions but to date only one official position paper related
to left circulation thromboembolism has been published. This
interdisciplinary paper, prepared with the involvement of eight European
scientific societies, reviews the available evidence and proposes a
rationale for decision making for other PFO-related clinical conditions.
In order to guarantee a strict evidence-based process, we used a modified
grading of recommendations, assessment, development, and evaluation
(GRADE) methodology. A critical qualitative and quantitative evaluation of
diagnostic and therapeutic procedures was performed, including assessment
of the risk/benefit ratio. The level of evidence and the strength of the
position statements were weighed and graded according to predefined
scales. Despite being based on limited and observational or low-certainty
randomised data, a number of position statements were made to frame PFO
management in different clinical settings, along with suggestions for new
research avenues. This interdisciplinary position paper, recognising the
low or very low certainty of existing evidence, provides the first
approach to several PFO-related clinical scenarios beyond left circulation
thromboembolism and strongly stresses the need for fresh high-quality
evidence on these topics.<br/>Copyright &#xa9; The Author(s), 2021.

<96>
[Use Link to view the full text]
Accession Number
2024265607
Title
On-Site Computed Tomography-Derived Fractional Flow Reserve to Guide
Management of Patients with Stable Coronary Artery Disease: The TARGET
Randomized Trial.
Source
Circulation. 147(18) (pp 1369-1381), 2023. Date of Publication: 02 May
2023.
Author
Yang J.; Shan D.; Wang X.; Sun X.; Shao M.; Wang K.; Pan Y.; Wang Z.;
Schoepf U.J.; Savage R.H.; Zhang M.; Dong M.; Xu L.; Zhou Y.; Ma X.; Hu
X.; Xia L.; Zeng H.; Liu Z.; Chen Y.
Institution
(Yang, Shan, Wang, Liu, Chen) Department of Cardiology, Chinese People's
Liberation Army General Hospital, Beijing, China
(Sun, Zhang, Dong) Department of Cardiology, Qilu Hospital of Shandong
University, Jinan, China
(Shao, Ma) Department of Cardiology, First Affiliated Hospital of Xinjiang
Medical University, Urumchi, China
(Wang, Hu) Department of Cardiology, Second Affiliated Hospital, School of
Medicine, Zhejiang University, Hangzhou, China
(Pan, Xia) Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Zeng) Department of Cardiology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
(Wang, Zhou) Department of Cardiology, Anzhen Hospital, Capital Medical
University, Beijing, China
(Xu) Department of Radiology, Anzhen Hospital, Capital Medical University,
Beijing, China
(Schoepf, Savage) Department of Radiology and Radiological Science,
Medical University of South Carolina, Charleston, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Computed tomography-derived fractional flow reserve (CT-FFR)
using on-site machine learning enables identification of both the presence
of coronary artery disease and vessel-specific ischemia. However, it is
unclear whether on-site CT-FFR improves clinical or economic outcomes when
compared with the standard of care in patients with stable coronary artery
disease. <br/>Method(s): In total, 1216 patients with stable coronary
artery disease and an intermediate stenosis of 30% to 90% on coronary
computed tomographic angiography were randomized to an on-site CT-FFR care
pathway using machine learning or to standard care in 6 Chinese medical
centers. The primary end point was the proportion of patients undergoing
invasive coronary angiography without obstructive coronary artery disease
or with obstructive disease who did not undergo intervention within 90
days. Secondary end points included major adverse cardiovascular events,
quality of life, symptoms of angina, and medical expenditure at 1 year.
<br/>Result(s): Baseline characteristics were similar in both groups, with
72.4% (881/1216) having either typical or atypical anginal symptoms. A
total of 421 of 608 patients (69.2%) in the CT-FFR care group and 483 of
608 patients (79.4%) in the standard care group underwent invasive
coronary angiography. Compared with standard care, the proportion of
patients undergoing invasive coronary angiography without obstructive
coronary artery disease or with obstructive disease not undergoing
intervention was significantly reduced in the CT-FFR care group (28.3%
[119/421] versus 46.2% [223/483]; P<0.001). Overall, more patients
underwent revascularization in the CT-FFR care group than in the standard
care group (49.7% [302/608] versus 42.8% [260/608]; P=0.02), but major
adverse cardiovascular events at 1 year did not differ (hazard ratio, 0.88
[95% CI, 0.59-1.30]). Quality of life and symptoms improved similarly
during follow-up in both groups, and there was a trend towards lower costs
in the CT-FFR care group (difference, -4233 [95% CI, -8165 to 973];
P=0.07). <br/>Conclusion(s): On-site CT-FFR using machine learning reduced
the proportion of patients with stable coronary artery disease undergoing
invasive coronary angiography without obstructive disease or requiring
intervention within 90 days, but increased revascularization overall
without improving symptoms or quality of life, or reducing major adverse
cardiovascular events. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT03901326.<br/>Copyright &#xa9; 2023 Lippincott
Williams and Wilkins. All rights reserved.

<97>
Accession Number
2024198971
Title
Relationship between postoperative biomarkers of neuronal injury and
postoperative cognitive dysfunction: A metaanalysis.
Source
PLoS ONE. 18(4 April) (no pagination), 2023. Article Number: e0284728.
Date of Publication: April 2023.
Author
Wang X.; Chen X.; Wu F.; Liu Y.; Yang Y.; Chen W.; Pan Z.; Hu W.; Zheng
F.; He H.
Institution
(Wang, Chen, Wu, Liu, Yang, Chen, He) Department of Anesthesiology, The
Second Affiliated Hospital of Fujian Medical University, Fujian Province,
Quanzhou, China
(Pan, Hu, Zheng) Department of Neurosurgery, The Second Affiliated
Hospital of Fujian Medical University, Fujian Province, Quanzhou, China
Publisher
Public Library of Science
Abstract
Early biomarkers are needed to identify patients at risk of developing
postoperative cognitive dysfunction (POCD). Our objective was to determine
neuronal injury-related biomarkers with predictive values for this
condition. Six biomarkers (S100beta, neuron-specific enolase [NSE],
amyloid beta [Abeta], tau, neurofilament light chain, and glial fibrillary
acidic protein) were evaluated. According to the first postoperative
sampling time, observational studies showed that S100beta was
significantly higher in patients with POCD than in those without POCD
(standardized mean difference [SMD]: 6.92, 95% confidence interval [CI]:
4.44 -9.41). The randomized controlled trial (RCT) showed that S100beta
(SMD: 37.31, 95% CI: 30.97-43.64) and NSE (SMD: 3.50, 95% CI: 2.71-4.28)
in the POCD group were significantly higher than in the non-POCD group.
The pooled data of observational studies by postoperative sampling time
showed significantly higher levels of the following biomarkers in the POCD
groups than in the control groups: S100beta levels at 1 hour (SMD: 1.35,
95% CI: 0.07-2.64), 2 days (SMD: 27.97, 95% CI: 25.01-30.94), and 9 days
(SMD: 6.41, 95% CI: 5.64-7.19); NSE levels at 1 hour (SMD: 0.92, 95% CI:
0.25-1.60), 6 hours (SMD: 0.79, 95% CI: 0.12-1.45), and 24 hours (SMD:
0.84, 95% CI: 0.38-1.29); and Abeta levels at 24 hours (SMD: 2.30, 95% CI:
1.54-3.06), 2 days (SMD: 2.30, 95% CI: 1.83-2.78), and 9 days (SMD: 2.76,
95% CI: 2.25-3.26). The pooled data of the RCT showed that the following
biomarkers were significantly higher in POCD patients than in non-POCD
patients: S100beta levels at 2 days (SMD: 37.31, 95% CI: 30.97-43.64) and
9 days (SMD: 126.37, 95% CI: 104.97-147.76) and NSE levels at 2 days (SMD:
3.50, 95% CI: 2.71-4.28) and 9 days (SMD: 8.53, 95% CI: 7.00-10.06). High
postoperative levels of S100beta, NSE, and Abeta may predict POCD. The
relationship between these biomarkers and POCD may be affected by sampling
time.<br/>Copyright &#xa9; 2023 Wang et al.

<98>
Accession Number
2023666103
Title
A Systematic Review of Benefits and Risks of Fetal Surgery for Congenital
Cardiac Defects Such as Pulmonary Valve Stenosis and Critical Aortic
Stenosis.
Source
Brazilian Journal of Cardiovascular Surgery. 38(3) (pp 398-404), 2023.
Date of Publication: 2023.
Author
Diniz A.M.B.; Manso P.H.; Santos M.V.; Rodrigues A.J.; Sbragia L.
Institution
(Diniz, Sbragia) Division of Pediatric Surgery, Department of Surgery and
Anatomy, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao
Paulo, Sao Paulo, Ribeirao Preto, Brazil
(Manso) Division of Pediatric Cardiology, Department of Pediatrics,
Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Sao
Paulo, Ribeirao Preto, Brazil
(Santos) Division of Pediatric Neurosurgery, Department of Surgery and
Anatomy, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao
Paulo, Sao Paulo, Ribeirao Preto, Brazil
(Rodrigues) Division of Cardiothoracic Surgery, Faculdade de Medicina de
Ribeirao Preto, Universidade de Sao Paulo, Sao Paulo, Ribeirao Preto,
Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Congenital heart diseases (CHDs) constitute the most
prevalent congenital pathology, and they are a consequence of structural
and functional abnormalities during fetal development. The etiology of CHD
involves the interaction of genetic and environmental factors. Fetal
cardiac surgery aims at preventing natural pathways of CHD in utero,
mitigating progression to more complex abnormalities. The goal of this
review was to demonstrate the benefits and risks of fetal interventions in
the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with
an intact ventricular septum, but also critical aortic stenosis and
hypoplastic left heart syndrome. <br/>Method(s): Original and relevant
articles were selected by meta-aggregation to perform a qualitative
analysis of fetal cardiac interventions for pulmonary stenosis and
critical aortic stenosis. The Joanna Briggs Institute's Qualitative
Assessment and Review Instrument (or JBI-QARI) was used for data quality
appraisal. <br/>Result(s): Of 61 potential articles, 13 were selected, and
nine were finally included. <br/>Discussion(s): The present review
demonstrated that fetal cardiac surgery increases right ventricular growth
and hemodynamic flow in pulmonary stenosis, whereas in critical aortic
stenosis it enables growth of the left ventricle and increases left
ventricular pressure. However, it has a high complication rate, along with
considerable morbidity and mortality. <br/>Conclusion(s): The benefits of
fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis
are well-described in the literature; however, there is a significant risk
of complications which can be reduced by the surgeon's technical expertise
and well-structured hospital facilities.<br/>Copyright &#xa9; 2023,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<99>
Accession Number
2022185225
Title
Global variation in the incidence of new-onset postoperative atrial
fibrillation after cardiac and noncardiac surgery: a systematic review.
Source
Vessel Plus. 6 (no pagination), 2022. Article Number: 50. Date of
Publication: 2022.
Author
Pardo D.; Shroyer A.L.; Bilfinger T.V.
Institution
(Pardo) Renaissance School of Medicine, Stony Brook University, Stony
Brook, NY 11794-8434, United States
(Shroyer, Bilfinger) Department of Surgery, Stony Brook University
Renaissance School of Medicine, Stony Brook, NY 11794-8191, United States
Publisher
OAE Publishing Inc.
Abstract
Aim: In the US, postoperative atrial fibrillation (POAF) is the most
common complication after cardiac surgery and a frequent complication
after non-cardiac surgery, causing excess patient length of stay and
costs. After a comprehensive review looking for validated statistically
significant data sets, too few data, particularly from outside of the US
and Europe, could be found to perform a conclusive analysis, but there is
enough data for a well-informed, educated opinion. <br/>Method(s): A
systematic review analyzing 28 international and US studies of POAF
hospital length of stay were identified; from this excess and % excess
along with total patient length of stay were calculated, where excess
patient length of stay is defined as the difference in post-operative stay
between POAF and non-POAF patients in days. Geographic variabilities were
calculated using chi-square analyses for US regions and international
comparisons for a variety of surgical procedures with POAF.
<br/>Result(s): Geographic variability analyses when corrected for total
hospital stay showed a 325% longer excess patient length of stay (days) in
the US vs. Europe (3.4 days vs. 0.8 days) for coronary artery bypass
grafting (CABG). It also showed a 27.3% longer excess patient length of
stay (days) in the US vs. Europe (4.2 days vs. 3.3 days) for lung
resections. These were both statistically significant at P < 0.001.
<br/>Conclusion(s): There appear to be substantial variations in
POAF-related care practices worldwide. In all practice settings, POAF
causes increased patient length of stay. Europeans appear to do better
than the US in POAF patients' length of stay for CABG but not for lung
resections. POAF is a worldwide problem where international cooperation in
research and development of best practice guidelines would be particularly
fruitful.<br/>Copyright &#xa9; The Author(s) 2022.

<100>
Accession Number
2021119137
Title
Reduction of permanent pacemaker implantation by using the cusp overlap
technique in transcatheter aortic valve replacement: a meta-analysis.
Source
Clinical Research in Cardiology. 112(5) (pp 633-644), 2023. Date of
Publication: May 2023.
Author
Rawish E.; Macherey S.; Jurczyk D.; Patz T.; Jose J.; Stiermaier T.; Eitel
I.; Frerker C.; Schmidt T.
Institution
(Rawish, Jurczyk, Patz, Stiermaier, Eitel, Frerker, Schmidt) University
Hospital Schleswig-Holstein, Medical Clinic II, University Heart Center
Lubeck, Lubeck, Germany
(Rawish, Stiermaier, Eitel, Frerker, Schmidt) DZHK (German Centre for
Cardiovascular Research), Partner Site Hamburg/Kiel/Lubeck, Lubeck,
Germany
(Macherey) University of Cologne, Faculty of Medicine and University
Hospital Cologne, Clinic III for Internal Medicine, Cologne, Germany
(Jose) Cardiac Valve and Structural Heart Disease Clinic, Christian
Medical College Hospital, Vellore, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The need for permanent pacemaker (PPM) implantation is a
common complication after transcatheter aortic valve replacement (TAVR).
Deep implantation position is a risk factor for PPM implantation. Thus, in
the field of self-expandable (SE) transcatheter heart valves (THV) cusp
overlap projection (COP) technique was implemented to reduce parallax,
allowing a more precise guidance of implantation depth. <br/>Aim(s): This
meta-analysis aims to report the outcome of patients undergoing TAVR with
SE THV using COP versus conventional implantation technique (CIT).
<br/>Method(s): Systematical search in MEDLINE and EMBASE yielded five
observational controlled studies comparing both implantation techniques
for the SE Evolut prosthesis (Medtronic Intern. Ltd., CA, USA) and
fulfilling the inclusion criteria for meta-analysis. <br/>Result(s):
Totally, 1227 patients were included, comprising 641 who underwent COP and
586 CIT TAVR. Incidence of post-procedural need for PPM implantation was
significantly lower in COP group (9.8% vs 20.6%; OR = 0.43; p < 0.00001).
This was accompanied by significantly higher implantation position in COP
group (mean difference distance from distal end of the intraventricular
portion of the THV to the non-coronary cusp (NCC): - 1.03 mm; p =
0.00001). Incidence of new-onset left bundle branch block did not differ.
Regarding procedural and 30-day mortality, technical success,
post-procedural aortic regurgitation, and rates of multiple device
implantation, no difference between COP and CIT was found.
<br/>Conclusion(s): COP is an effective and safe implantation technique to
reduce the need for a permanent pacemaker implantation during TAVR with SE
Evolut prosthesis. Graphical abstract: [Figure not available: see
fulltext.].<br/>Copyright &#xa9; 2023, The Author(s).

<101>
Accession Number
2018181730
Title
Effect of omega-3 fatty acids on cardiovascular events in high-risk
patients with hypertriglyceridemia in Japan: a 3-year post-marketing
surveillance study (OCEAN3 survey).
Source
Expert Opinion on Drug Safety. 22(1) (pp 81-90), 2023. Date of
Publication: 2023.
Author
Teramoto T.; Ogawa H.; Ueshima H.; Okada Y.; Haze K.; Matsui S.; Fujikawa
K.; Hashimoto T.; Sakui S.; Nishimura K.; Kajita M.; Horimoto A.;
Fernandez J.
Institution
(Teramoto) Teikyo Academic Research Center (TARC), Teikyo University,
Tokyo, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
(Ueshima) NCD Epidemiology Research Center, Shiga University of Medical
Science, Shiga, Japan
(Okada) Department of Cerebrovascular Medicine and Neurology, National
Hospital Organization Kyushu Medical Center, Fukuoka, Japan
(Haze) Department of Cardiology, Kashiwara Municipal Hospital, Kashiwara,
Japan
(Matsui) Department of Biostatistics, Nagoya University, Nagoya, Japan
(Fujikawa, Nishimura, Kajita, Fernandez) Japan Medical Office, Takeda
Pharmaceutical Company, Tokyo, Japan
(Hashimoto, Sakui) Statistical and Quantitative Sciences, Takeda
Pharmaceutical Company, Osaka, Japan
(Horimoto) Department of Biometrics, PRA Health Sciences, Osaka, Japan
Publisher
Taylor and Francis Ltd.
Abstract
Background: Studies on the efficacy of prescription omega-3
polyunsaturated fatty acids to reduce cardiovascular events have produced
conflicting results. Research design and methods: This 3-year prospective
post-marketing surveillance study evaluated the effect of omega-3-acid
ethyl esters (O3AEE; usual dosage 2 g/day) on cardiovascular events in
high-risk statin-treated Japanese patients with hypertriglyceridemia.
Statin-treated patients not receiving O3AEE were included as a reference
cohort. The composite primary endpoint was cardiovascular death,
myocardial infarction, stroke, angina requiring coronary
revascularization, or peripheral arterial disease requiring surgery or
peripheral arterial intervention. <br/>Result(s): At 3 years, Kaplan-Meier
estimated cumulative incidence of the primary endpoint was 2.5% (95%
confidence interval, 2.1%-2.9%) in O3AEE-treated patients (N = 6,580) and
2.7% (2.4%-3.1%) in non-O3AEE-treated patients (N = 7,784; hazard ratio,
0.99; 95% confidence interval, 0.79-1.23). Incidence of heart failure
requiring hospitalization was 0.4% with O3AEE versus 0.8% in
non-O3AEE-treated patients (hazard ratio, 0.47; 95% confidence interval,
0.28-0.78; P < 0.05). <br/>Conclusion(s): Among patients receiving
statins, cardiovascular event incidence did not differ significantly
between O3AEE-treated patients and non-O3AEE-treated patients. Further
studies are required before definitive conclusions can be drawn on the
effect of O3AEE on cardiovascular event incidence in high-risk patients
with hypertriglyceridemia. Trial registration: ClinicalTrials.gov,
NCT02285166.<br/>Copyright &#xa9; 2022 Takeda Pharmaceutical Company.
Published by Informa UK Limited, trading as Taylor & Francis Group.

<102>
[Use Link to view the full text]
Accession Number
2017347602
Title
Short- and long-term impact of remifentanil on thermal detection and pain
thresholds after cardiac surgery A randomised controlled trial.
Source
European Journal of Anaesthesiology. 36(1) (pp 32-39), 2019. Date of
Publication: 01 Jan 2019.
Author
de Hoogd S.; Valkenburg A.J.; van Dongen E.P.A.; Daeter E.J.; van Rosmalen
J.; Dahan A.; Tibboel D.; Knibbe C.A.J.
Institution
(de Hoogd, Knibbe) Department of Clinical Pharmacy, St. Antonius Hospital,
Nieuwegein, Netherlands
(Valkenburg, Tibboel, Knibbe) Intensive Care, Department of Paediatric
Surgery, Erasmus MC - Sophia Children's Hospital, Rotterdam, Netherlands
(van Dongen) Department of Anaesthesiology and Intensive Care, Denmark
(Daeter) Department of Cardiothoracic Surgery, St. Antonius Hospital,
Nieuwegein, Netherlands
(van Rosmalen) Department of Biostatistics, Erasmus MC, Rotterdam,
Netherlands
(Dahan) Department of Anaesthesiology, Leiden University Medical Centre,
Netherlands
(Knibbe) Division of Pharmacology, Leiden Academic Centre for Drug
Research, Leiden University, Leiden, Netherlands
(Knibbe) Department of Clinical Pharmacy, St. Antonius Hospital,
Koekoekslaan 1, Nieuwegein 3435 CM, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The clinical relevance of the suggested hyperalgesic effects of
remifentanil is still unclear, especially in the long term. OBJECTIVE The
current study evaluated the impact of remifentanil on thermal thresholds 3
days and 12 months after surgery, measured with Quantitative Sensory
Testing. DESIGN A single-blind, randomised controlled trial. SETTING A
tertiary care teaching hospital in The Netherlands, from 2014 to 2016.
PATIENTS A total of 126 patients aged between 18 and 85 years, undergoing
cardiothoracic surgery via sternotomy (coronary artery bypass grafts
and/or valve replacement) were included. Exclusion criteria were BMI above
35 kg m^-2, history of cardiac surgery, chronic pain conditions,
neurological conditions, allergy to opioids or paracetamol, language
barrier and pregnancy. INTERVENTIONS Patients were allocated randomly to
receive intra-operatively either a continuous remifentanil infusion or
intermittent intra-operative fentanyl as needed in addition to
standardised anaesthesia with propofol and intermittent intravenous
fentanyl at predetermined time points. MAIN OUTCOME MEASURES Warm and cold
detection and pain thresholds 3 days and 12 months after surgery. In
addition the use of remifentanil, presence of postoperative chronic pain,
age, opioid consumption and pre-operative quality of life were tested as a
predictor for altered pain sensitivity 12 months after surgery. RESULTS
Both warm and cold detection, and pain thresholds, were not significantly
different between the remifentanil and fentanyl groups 3 days and 12
months after surgery (P > 0.05). No significant predictors for altered
pain sensitivity were identified. CONCLUSION Earlier reports of increased
pain sensitivity 1 year after the use of remifentanil could not be
confirmed in this randomised study using Quantitative Sensory Testing.
This indicates that remifentanil plays a minor role in the development of
chronic thoracic pain. Still, the relatively high incidence of chronic
thoracic pain and its accompanying impact on quality of life remain
challenging problems.
Assistance with the study: the authors thank Richard Sandifort, BSc,
Department of Clinical Pharmacy, St Antonius Hospital, Nieuwegein, The
Netherlands for support in data entry and Ko Hagoort, MA, Department of
Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, the
Netherlands for text editing. Financial support and sponsorship: support
was provided solely from institutional and/or departmental sources.
Conflicts of interest: none. Presentation: none.<br/>Copyright s 2018 The
Author(s).

<103>
[Use Link to view the full text]
Accession Number
2017344822
Title
Effect of a Perioperative Intra-Aortic Balloon Pump in High-Risk Cardiac
Surgery Patients: A Randomized Clinical Trial.
Source
Critical Care Medicine. 46(8) (pp E742-E750), 2018. Date of Publication:
01 Aug 2018.
Author
Ferreira G.S.R.; De Almeida J.P.; Landoni G.; Vincent J.L.; Fominskiy E.;
Galas F.R.B.G.; Gaiotto F.A.; Dallan L.O.; Franco R.A.; Lisboa L.A.;
Dallan L.R.P.; Fukushima J.T.; Rizk S.I.; Park C.L.; Strabelli T.M.; Lage
S.H.G.; Camara L.; Zeferino S.; Jardim J.; Arita E.C.T.C.; Ribeiro J.C.;
Ayub-Ferreira S.M.; Auler J.O.C.; Filho R.K.; Jatene F.B.; Hajjar L.A.
Institution
(Ferreira, De Almeida, Galas, Franco, Fukushima, Rizk, Park, Camara,
Zeferino, Jardim, Arita, Ribeiro, Auler) Surgical Intensive Care Unit,
Department of Anesthesiology, Heart Institute (InCor), Hospital das
Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo,
Brazil
(Landoni, Fominskiy) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy
(Landoni) Faculty of Medicine and Surgery, Vita-Salute San Raffaele
University of Milan, Milan, Italy
(Vincent) Department of Intensive Care, Erasme Hospital, Universite Libre
de Bruxelles, Brussels, Belgium
(Gaiotto, Dallan, Lisboa, Dallan, Jatene) Department of Cardiovascular
Surgery, Heart Institute (InCor), Hospital das Clinicas, Faculdade de
Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Strabelli) Department of Infectious Diseases, Heart Institute (InCor),
Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo,
Sao Paulo, Brazil
(Lage, Ayub-Ferreira, Filho, Hajjar) Department of Cardiology, Heart
Institute (InCor), Hospital das Clinicas, Faculdade de Medicina,
Universidade de Sao Paulo, Sao Paulo, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: The aim of this study was to evaluate the efficacy of
perioperative intra-aortic balloon pump use in high-risk cardiac surgery
patients. <br/>Design(s): A single-center randomized controlled trial and
a metaanalysis of randomized controlled trials. <br/>Setting(s): Heart
Institute of Sao Paulo University. <br/>Patient(s): High-risk patients
undergoing elective coronary artery bypass surgery. <br/>Intervention(s):
Patients were randomized to receive preskin incision intra-aortic balloon
pump insertion after anesthesia induction versus no intra-aortic balloon
pump use. <br/>Measurements and Main Results: The primary outcome was a
composite endpoint of 30-day mortality and major morbidity (cardiogenic
shock, stroke, acute renal failure, mediastinitis, prolonged mechanical
ventilation, and a need for reoperation). A total of 181 patients (mean
[sd] age 65.4 [9.4] yr; 32% female) were randomized. The primary outcome
was observed in 43 patients (47.8%) in the intra-aortic balloon pump group
and 42 patients (46.2%) in the control group (p = 0.46). The median
duration of inotrope use (51hr [interquartile range, 32-94 hr] vs 39hr
[interquartile range, 25-66 hr]; p = 0.007) and the ICU length of stay (5
d [interquartile range, 3-8 d] vs 4 d [interquartile range, 3-6 d]; p =
0.035) were longer in the intra-aortic balloon pump group than in the
control group. A meta-analysis of 11 randomized controlled trials
confirmed a lack of survival improvement in high-risk cardiac surgery
patients with perioperative intra-aortic balloon pump use.
<br/>Conclusion(s): In high-risk patients undergoing cardiac surgery, the
perioperative use of an intra-aortic balloon pump did not reduce the
occurrence of a composite outcome of 30-day mortality and major
complications compared with usual care alone.<br/>Copyright &#xa9; 2018 by
the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All
Rights Reserved.

<104>
[Use Link to view the full text]
Accession Number
2017343133
Title
A meta-analysis of impact of low-flow/low-gradient aortic stenosis on
survival after transcatheter aortic valve implantation.
Source
Journal of Cardiovascular Medicine. 20(10) (pp 691-698), 2019. Date of
Publication: 01 Oct 2019.
Author
Takagi H.; Hari Y.; Kawai N.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Kawai) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari) Department of Cardiovascular Surgery, Kitasato University
School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, New
York, NY, United States
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Aims To determine whether low-flow/low-gradient (LF/LG) aortic stenosis
affects survival after transcatheter aortic valve implantation (TAVI), we
performed a meta-analysis of currently available studies. Methods MEDLINE
and EMBASE were searched through January 2019 using PubMed and OVID.
Observational studies comparing all-cause mortality after TAVI for
patients with classical LF/LG (C/LF/LG) aortic stenosis versus
normal-flow/high-gradient (NF/HG) aortic stenosis, paradoxical LF/LG
(P/LF/LG) aortic stenosis versus NF/HG aortic stenosis, and (3) C/LF/LG
aortic stenosis versus P/LF/LG aortic stenosis were included.
Study-specific estimates, risk and hazard ratios of mortality, were
combined in the random-effects model. Results Our search identified nine
eligible studies including a total of 5512 TAVI patients. Pooled analysis
demonstrated significantly higher early mortality in C/LF/LG aortic
stenosis than NF/HG aortic stenosis (risk ratio, 1.72; P U 0.02) and no
statistically significant difference in early mortality between P/LF/LG
aortic stenosis and NF/HG aortic stenosis (P U 0.67) and between C/LF/LG
aortic stenosis and P/LF/LG aortic stenosis (P U 0.51). Midterm mortality
in C/LF/LG (risk ratio/hazard ratio, 1.73; P U 0.0003) and P/LF/LG aortic
stenosis (risk ratio/hazard ratio, 1.48; P < 0.0001) was significantly
higher than that in NF/HG aortic stenosis. There was no statistically
significant difference in midterm mortality between C/LF/LG aortic
stenosis and P/LF/LG aortic stenosis (P U 0.63). Conclusion After TAVI,
C/LF/LG aortic stenosis is associated with increased early mortality
compared with NF/HG, and C/LF/LG and P/LF/LG aortic stenosis is associated
with increased midterm mortality compared with NF/HG aortic stenosis
despite no difference in early mortality between P/LF/LG aortic stenosis
and NF/HG aortic stenosis. There is no difference in early and midterm
mortality between C/LF/LG aortic stenosis and P/LF/LG aortic
stenosis.<br/>Copyright &#xa9; 2019 Italian Federation of Cardiology -
I.F.C.

<105>
Accession Number
2017334218
Title
Randomized Trial of Sternal Closure for Low Risk Patients: Rigid Fixation
versus Wire Closure.
Source
Heart Surgery Forum. 20(4) (pp E164-E169), 2017. Date of Publication:
2017.
Author
Peigh G.; Kumar J.; Unai S.; Diehl J.T.; Hirose H.
Institution
(Peigh, Kumar, Unai, Diehl, Hirose) Division of Cardiothoracic Surgery,
Thomas Jefferson University Hospital, Philadelphia, PA, United States
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: A previous retrospective analysis of our cardiac surgery
patients showed shortened ventilation time and hospital stay among
patients receiving rigid sternal fixation compared to sternal wire
fixation. We performed a prospective randomized study to further
investigate these outcomes and determine if rigid closure can provide
reduced pain after cardiac surgery. <br/>Method(s): Patients undergoing
cardiac surgery between July 2011 and May 2014 were prospectively
randomized into wire closure (Group C) or rigid fixation using sternal
plates (Group R) groups. Age above 80, emergency surgery, redo sternotomy,
and immunosuppression were among major exclusion criteria precluding
randomization. Intubation time was recorded for all patients. Pain scores
were determined daily from postoperative day 1 until day 5 at 6 a.m. using
a numeric rating scale. Narcotic pain medication requirements from day 1
to 5 were collected and converted into intravenous morphine equivalents.
<br/>Result(s): Of 80 patients, 39 patients were in Group R (average age
65 +/- 8; 31 male and 8 female) and 41 patients were in Group C (average
age 66 +/- 9; 34 male and 7 female). Group R patients had a higher body
mass index than patients in Group C (Group R: 31 +/- 5; Group C: 29 +/- 5;
P = .04). No significant differences in the end points of intubation time
and postoperative pain were observed. <br/>Conclusion(s): This randomized
study of cardiac surgery patients showed no significant benefits of rigid
fixation over conventional sternal wire closure with regard to intubation
time, postoperative pain, or length of hospital stay.<br/>Copyright &#xa9;
2017 Forum Multimedia Publishing LLC. All rights reserved.

<106>
Accession Number
2016850446
Title
The Effect of Fiberoptic Bronchoscopy-guided Technique for Placement of a
Left-sided Double-lumen Tube on the Intubation Performance Compared with
the Conventional Method Using a Macintosh Laryngoscope.
Source
Open Anesthesia Journal. 14 (pp 115-122), 2020. Date of Publication: 2020.
Author
Lim J.A.; Kim I.-Y.; Byun S.H.
Institution
(Lim, Kim, Byun) Department of Anesthesiology and Pain Medicine, Catholic
University of Daegu School of Medicine, 33, Duryugongwon-ro 17-gil,
Nam-gu, Daegu 42472, South Korea
Publisher
Bentham Science Publishers
Abstract
Background: The accurate placement of the double-lumen endotracheal tube
is imperative for effective one-lung ventilation in thoracic surgery.
Malpositioning and repositioning of a misplaced tube may cause excessive
trauma. <br/>Objective(s): We hypothesized that the fiberoptic
bronchoscope-guided method for double-lumen endotracheal tube placement
would reduce the incidence of malpositioning as compared to the
conventional method using the Macintosh laryngoscope. <br/>Method(s):
Fifty patients scheduled to undergo elective thoracic surgery were
recruited and randomly assigned to the fiberoptic bronchoscope-guided
[n=25; Group F] and conventional [n=25; Group C] method groups, according
to the method of double-lumen endotracheal tube placement. The primary
outcome was the incidence of double-lumen endotracheal tube malpositioning
observed under the fiberoptic bronchoscope after initial placement.
Secondary outcomes included the times for placement, confirmation, and
total procedure of double-lumen endotracheal tube intubation.
<br/>Result(s): The incidence of malpositioning after initial double-lumen
endotracheal tube placement was significantly lower in Group F than in
Group C (20.0% vs 68.0%). In addition, the time for placement was
significantly higher in Group F than in Group C, and that for confirmation
was significantly lower in Group F than in Group C. <br/>Conclusion(s):
The fiberoptic bronchoscope-guided method for double-lumen endotracheal
tube placement can reduce the incidence of malpositioning after initial
placement and expedite the intubation process with a double-lumen
endotracheal tube in thoracic surgery.<br/>Copyright &#xa9; 2020 Lim et
al.

<107>
Accession Number
2024278697
Title
Hydroxocobalamin for Vasodilatory Hypotension in Shock: A Systematic
Review With Meta-Analysis for Comparison to Methylene Blue.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Brokmeier H.M.; Seelhammer T.G.; Nei S.D.; Gerberi D.J.; Mara K.C.;
Wittwer E.D.; Wieruszewski P.M.
Institution
(Brokmeier, Nei, Wieruszewski) Department of Pharmacy, Mayo Clinic,
Rochester, MN, United States
(Seelhammer, Wittwer, Wieruszewski) Department of Anesthesiology, Mayo
Clinic, Rochester, MN, United States
(Gerberi) Mayo Medical Libraries, Mayo Clinic, Rochester, MN, United
States
(Mara) Department of Quantitative Health Sciences, Division of Clinical
Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Hydroxocobalamin inhibits nitric oxide-mediated vasodilation, and has been
used in settings of refractory shock. However, its effectiveness and role
in treating hypotension remain unclear. The authors systematically
searched Ovid Medline, Embase, EBM Reviews, Scopus, and Web of Science
Core Collection for clinical studies reporting on adult persons who
received hydroxocobalamin for vasodilatory shock. A meta-analysis was
performed with random-effects models comparing the hemodynamic effects of
hydroxocobalamin to methylene blue. The Risk of Bias in Nonrandomized
Studies of Interventions tool was used to assess the risk of bias. A total
of 24 studies were identified and comprised mainly of case reports (n =
12), case series (n = 9), and 3 cohort studies. Hydroxocobalamin was
applied mainly for cardiac surgery vasoplegia, but also was reported in
the settings of liver transplantation, septic shock, drug-induced
hypotension, and noncardiac postoperative vasoplegia. In the pooled
analysis, hydroxocobalamin was associated with a higher mean arterial
pressure (MAP) at 1 hour than methylene blue (mean difference 7.80, 95% CI
2.63-12.98). There were no significant differences in change in MAP (mean
difference -4.57, 95% CI -16.05 to 6.91) or vasopressor dosage (mean
difference -0.03, 95% CI -0.12 to 0.06) at 1 hour compared to baseline
between hydroxocobalamin and methylene blue. Mortality was also similar
(odds ratio 0.92, 95% CI 0.42-2.03). The evidence supporting the use of
hydroxocobalamin for shock is limited to anecdotal reports and a few
cohort studies. Hydroxocobalamin appears to positively affect hemodynamics
in shock, albeit similar to methylene blue.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<108>
Accession Number
2024264287
Title
The Influence of baseline glycemic status on the effects of intensive
blood pressure lowering: Results from the STEP randomized trial.
Source
European Journal of Internal Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Yang R.; Wang Y.; Tong A.; Yu J.; Zhao D.; Cai J.
Institution
(Yang, Wang, Cai) Hypertension Center, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, National Center for Cardiovascular
Diseases, Peking Union Medical College & Chinese Academy of Medical
Sciences, Beilishi Road 167, Xicheng District, Beijing 100037, China
(Tong) Department of Endocrinology, NHC key laboratory of Endocrinology,
Peking Union Medical College Hospital, Peking Union Medical College &
Chinese Academy of Medical Sciences, Beijing 100730, China
(Yu) Hypertension Center, Lanzhou University Second Hospital, No. 82
Cuiyingmen, Lanzhou 730030, China
(Zhao) Department of Cardiology, First Affiliated Hospital of Harbin
Medical University, No. 199 Dazhi Street, Harbin 150001, China
Publisher
Elsevier B.V.
Abstract
Background: Intensive systolic blood pressure (SBP) lowering showed
cardiovascular benefits in the Strategy of Blood Pressure Intervention in
the Elderly Hypertensive Patients (STEP) trial. We investigated whether
baseline glycemic status influences the effects of intensive SBP lowering
on cardiovascular outcomes. <br/>Method(s): In this post hoc analysis of
the STEP trial, participants were randomly assigned to receive intensive
(110 to <130 mmHg) or standard SBP treatment (130 to <150 mmHg) and
categorized by baseline glycemic status into three subgroups:
normoglycemia, prediabetes, and diabetes. The primary outcome was a
composite of stroke, acute coronary syndrome, acute decompensated heart
failure, coronary revascularization, atrial fibrillation, or death from
cardiovascular causes. A competing risk proportional hazards regression
model was used in the analysis. <br/>Result(s): Of the 8,318 participants,
3,275, 2,769, and 2,274 had normoglycemia, prediabetes, and diabetes,
respectively. Over a median follow-up of 3.33 years, intensive SBP
lowering significantly reduced the risk of the primary outcome (adjusted
hazard ratio 0.73, 95% confidence interval [CI] 0.59-0.91). The adjusted
hazard ratios for the primary outcome in the normoglycemia, prediabetes,
and diabetes subgroups were 0.72 (95% CI 0.49-1.04), 0.69 (95% CI
0.46-1.02), and 0.80 (95% CI 0.56-1.15), respectively. The intensive SBP
lowering strategy resulted in similar effects among participants in the
three subgroups (all interaction P >0.05). The sensitivity analyses showed
consistent results with the main analysis. <br/>Conclusion(s): The effects
of intensive SBP lowering on cardiovascular outcomes were consistent among
participants with normoglycemia, prediabetes, and diabetes.<br/>Copyright
&#xa9; 2023 European Federation of Internal Medicine

<109>
Accession Number
2023061741
Title
Rivaroxaban versus nadroparin for thromboprophylaxis following thoracic
surgery for lung cancer: A randomized, noninferiority trial.
Source
American Journal of Hematology. (no pagination), 2023. Date of
Publication: 2023.
Author
Zhao M.; Bao Y.; Jiang C.; Chen L.; Xu L.; Liu X.; Yang Y.; Jiang G.; Li
J.; She Y.; Chen Q.; Shen L.; Chen C.
Institution
(Zhao, Bao, Jiang, Chen, Liu, Li, Yang, Jiang, She, Chen, Shen, Chen)
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
(Xu) Department of Ultrasound, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
(Li) Clinical Research Center, Ruijin Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China
(Shen) Department of Infectious Diseases, Shanghai Key Laboratory of
Infectious Diseases and Biosafety Emergency Response, National Medical
Center for Infectious Diseases, Huashan Hospital, Fudan University,
Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
The benefit of rivaroxaban in thromboprophylaxis after oncologic lung
surgery remains unknown. To evaluate the efficacy and safety of
rivaroxaban, patients who underwent thoracic surgery for lung cancer were
enrolled, and randomly assigned to rivaroxaban or nadroparin groups in a
1:1 ratio; anticoagulants were initiated 12-24 h after surgery and
continued until discharge. Four hundred participants were required
according to a noninferiority margin of 2%, assuming venous
thromboembolism (VTE) occurrence rates of 6.0% and 12.6% for patients in
the rivaroxaban and nadroparin groups, respectively. The primary efficacy
outcome was any VTE during the treatment and 30-day follow-up periods. The
safety outcome was any on-treatment bleeding event. Finally, 403 patients
were randomized (intention-to-treat [ITT] population), with 381 included
in per-protocol (PP) population. The primary efficacy outcomes occurred in
12.5% (25/200) of the rivaroxaban group and 17.7% (36/203) of the
nadroparin group (absolute risk reduction, -5.2%; 95% confidence interval
[CI], [-12.2-1.7]), indicating the noninferiority of rivaroxaban in ITT
population. Sensitivity analysis was performed in the PP population and
yielded similar results, confirming the noninferiority of rivaroxaban. In
the safety analysis population, the incidence of any on-treatment bleeding
events did not differ significantly between the groups (12.2% for
rivaroxaban vs. 7.0% for nadroparin; relative risk [RR], 1.9; 95% CI,
[0.9-3.7]; p =.08), including major bleeding (9.7% vs. 6.5%; RR, 1.6 [95%
CI, 0.9-3.7]; p =.24), and nonmajor bleeding (2.6% vs. 0.5%; RR, 5.2 [95%
CI, 0.6-45.2]; p =.13). Rivaroxaban for thromboprophylaxis after oncologic
lung surgery was shown to be noninferior to nadroparin.<br/>Copyright
&#xa9; 2023 Wiley Periodicals LLC.

<110>
Accession Number
634785638
Title
A Multicenter, Open-Label, Randomized Controlled Trial of a Conservative
Fluid Management Strategy Compared With Usual Care in Participants After
Cardiac Surgery: The Fluids After Bypass Study.
Source
Critical Care Medicine. 49(3) (pp 449-461), 2021. Date of Publication: 01
Mar 2021.
Author
Parke R.L.; Gilder E.; Gillham M.J.; Walker L.J.C.; Bailey M.J.;
McGuinness S.P.
Institution
(Parke, Gilder, Gillham, Walker, McGuinness) Auckland City Hospital,
Cardiothoracic and Vascular ICU, Auckland, New Zealand
(Parke, Gilder) Faculty of Medical and Health Sciences, School of Nursing,
University of Auckland, Auckland, New Zealand
(Parke, McGuinness) Medical Research Institute of New Zealand, Wellington,
New Zealand
(Parke, Bailey, McGuinness) ANZIC-Research Centre, Department of
Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: There is little evidence to guide fluid administration to
patients admitted to the ICU following cardiac surgery. This study aimed
to determine if a protocolized strategy known to reduce fluid
administration when compared with usual care reduced ICU length of stay
following cardiac surgery. DESIGN: Prospective, multicenter,
parallel-group, randomized clinical trial. SETTING: Five cardiac surgical
centers in New Zealand conducted from November 2016 to December 2018 with
final follow-up completed in July 2019. PATIENTS: Seven-hundred fifteen
patients undergoing cardiac surgery; 358 intervention and 357 usual care.
INTERVENTIONS: Randomization to protocol-guided strategy utilizing stroke
volume variation to guide administration of bolus fluid or usual care
fluid administration until desedation or up to 24 hours. Primary outcome
was length of stay in ICU. Organ dysfunction, mortality, process of care
measures, patient-reported quality of life, and disability-free survival
were collected up to day 180. MEASUREMENTS AND MAIN RESULTS: Overall 666
of 715 (93.1%) received at least one fluid bolus. Patients in the
intervention group received less bolus fluid (median [interquartile
range], 1,000 mL [250-2,000 mL] vs 1,500 mL [500-2,500 mL]; p < 0.0001)
and had a lower overall fluid balance (median [interquartile range], 319
mL [-284 to 1,274 mL] vs 673 mL [38-1,641 mL]; p < 0.0001) in the
intervention period. There was no difference in ICU length of stay between
the two groups (27.9 hr [21.8-53.5 hr] vs 25.6 hr [21.9-64.6 hr]; p =
0.95). There were no differences seen in development of organ dysfunction,
quality of life, or disability-free survival at any time points. Hospital
mortality was higher in the intervention group (4% vs 1.4%; p = 0.04).
<br/>CONCLUSION(S): A protocol-guided strategy utilizing stroke volume
variation to guide administration of bolus fluid when compared with usual
care until desedation or up to 24 hours reduced the amount of fluid
administered but did not reduce the length of stay in ICU.<br/>Copyright
&#xa9; 2021 Lippincott Williams and Wilkins. All rights reserved.

<111>
Accession Number
631606219
Title
Sex-Specific Management in Patients With Acute Myocardial Infarction and
Cardiogenic Shock: A Substudy of the CULPRIT-SHOCK Trial.
Source
Circulation: Cardiovascular Interventions. 13(3) (pp E008537), 2020. Date
of Publication: 01 Mar 2020.
Author
Gimenez M.R.; Zeymer U.; Desch S.; De Waha-Thiele S.; Ouarrak T.; Poess
J.; Meyer-Saraei R.; Schneider S.; Fuernau G.; Stepinska J.; Huber K.;
Windecker S.; Montalescot G.; Savonitto S.; Jeger R.V.; Thiele H.
Institution
(Gimenez, Desch, Thiele) The Department of Internal Medicine/Cardiology,
Heart Center Leipzig, Germany
(Gimenez, Jeger) Cardiology Department, University Hospital Basel,
Switzerland
(Zeymer) Klinikum Ludwigshafen, Germany
(Meyer-Saraei, Fuernau) German Center for Cardiovascular Research, Berlin,
Germany
(De Waha-Thiele, Poess) Department of Internal
Medicine/Cardiology/Angiology/Intensive Care Medicine, University Heart
Center Lubeck, Germany
(Ouarrak, Schneider) Institut fur Herzinfarktforschung, Ludwigshafen,
Germany
(Stepinska) Institute of Cardiology, Warsaw, Poland
(Huber) 3rd Department of Internal Medicine, Cardiology and Intensive Care
Medicine, Wilhelminenhospital and Sigmund Freud University, Medical
School, Vienna, Austria
(Windecker) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern, Switzerland
(Montalescot) Department of Cardiology, Sorbonne Universite, Institut de
Cardiologie (AP-HP), Hopital Pitie Salpetriere, Paris, France
(Savonitto) Department of Cardiology, Manzoni Hospital, Lecco, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Women are more likely to suffer and die from cardiogenic shock
(CS) as the most severe complication of acute myocardial infarction. Data
concerning optimal management for women with CS are scarce. Aim of this
study was to better define characteristics of women experiencing CS and to
the influence of sex on different treatment strategies. <br/>Method(s): In
the CULPRIT-SHOCK trial (The Culprit Lesion Only PCI Versus Multivessel
PCI in Cardiogenic Shock), patients with CS complicating acute myocardial
infarction and multivessel coronary artery disease were randomly assigned
to one of the following revascularization strategies: either percutaneous
coronary intervention of the culprit-lesion-only or immediate multivessel
percutaneous coronary intervention. Primary end point was composite of
death from any cause or severe renal failure leading to renal replacement
therapy within 30 days. We investigated sex-specific differences in
general and according to the revascularization strategies. <br/>Result(s):
Among all 686 randomized patients included in the analysis, 24% were
women. Women were older and had more often diabetes mellitus and renal
insufficiency, whereas they had less often history of previous acute
myocardial infarction and smoking. After 30 days, the primary clinical end
point was not significantly different between groups (56% women versus 49%
men; odds ratio, 1.29 [95% CI, 0.91-1.84]; P=0.15). There was no
interaction between sex and coronary revascularization strategy regarding
mortality and renal failure (P<inf>interaction</inf>=0.11). The primary
end point occurred in 56% of women treated by the culprit-lesion-only
strategy versus 42% men, whereas 55% of women and 55% of men in the
multivessel percutaneous coronary intervention group. <br/>Conclusion(s):
Although women presented with a different risk profile, mortality and
renal replacement were similar to men. Sex did not influence mortality and
renal failure according to the different coronary revascularization
strategies. Based on these data, women and men presenting with CS
complicating acute myocardial infarction and multivessel coronary artery
disease should not be treated differently. However, further randomized
trials powered to address potential sex-specific differences in CS are
still necessary. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT01927549.<br/>Copyright &#xa9; 2020 Lippincott Williams and
Wilkins. All rights reserved.

<112>
Accession Number
2023693165
Title
Carotid Artery Stenting before CABG: A Better Alternative to Treat
Concomitant Coronary and Carotid Artery Disease.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 30(7) (pp
e199-e210), 2023. Date of Publication: 15 Apr 2023.
Author
Moawed M.M.; Attia K.; Sobh K.
Institution
(Moawed, Attia) Zl-azhar university, New Damietta, Egypt
(Sobh) Faculty of medicine, Al_azhar University alhusein hospital, Egypt
Publisher
Codon Publications
Abstract
Background: Atherosclerosis of the coronary and carotid arteries can be
fatal. Stroke is a serious complication of coronary artery bypass graft
surgery, and carotid artery dysfunction is a major risk factor for stroke
(CABG). <br/>Method(s): Patients who met the criteria for CABG were
included in this prospective cohort study of those with severe carotid
artery stenosis (>70%). Complications 30 days after stenting, neurological
complications during cardiac surgery, rates of myocardial infarction (MI),
and rates of death were among the outcome indicators evaluated.
<br/>Result(s): according to outcome the mean duration of follow-up was
31.23 (+/-18.27 SD) with range (1-60) months, according to early adverse
event there were 1 (0.5%) with cardiac death, 1 (0.5%) with major
Ipsilateral Nonfatal Strokes, 2 (1%) with minor strokes, there were 30
cases of cardiac death (15%), 2 cases of neurological death (1%), 4 cases
of death for other reasons (2%), 2 cases of major ipsilateral nonfatal
stroke (1%), 1 case of major contralateral nonfatal stroke (0.5%), 10
cases of minor ischemic stroke (5%), 12 cases of transient ischemic attack
(2%), and 2 cases of nonfatal myocardial infarction (1%).
<br/>Conclusion(s): Patients with concurrent carotid and coronary artery
disease may benefit from both hybrid revascularization by CAS-CAB and
phased revascularization by CAS-CAB, which are feasible, safe, and provide
good short-and long-term results. Our research suggests that CAS should be
considered as a feasible alternative to open heart surgery. An adequately
powered randomised experiment should compare the two
approaches.<br/>Copyright &#xa9; 2021 Muslim OT et al.

<113>
Accession Number
641214150
Title
A review and meta-analysis of conventional sternotomy versus minimally
invasive mitral valve surgery for degenerative mitral valve disease
focused on the last decade of evidence.
Source
Perfusion. (pp 2676591231174579), 2023. Date of Publication: 05 May 2023.
Author
Hussain S.; Swystun A.G.; Caputo M.; Angelini G.D.; Vohra H.A.
Institution
(Hussain) University of Bristol, Bristol, United Kingdom
(Swystun) University of Bradford, Bradford, United Kingdom
(Caputo, Angelini, Vohra) Department of Cardiac Surgery, Bristol Heart
Institute, Bristol, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Early meta-analyses comparing minimally invasive mitral valve
surgery (MIMVS) with conventional sternotomy (CS) have determined the
safety of MIMVS. We performed this review and meta-analysis based on
studies from 2014 onwards to examine the differences in outcomes between
MIMVS and CS. Specifically, some outcomes of interest included renal
failure, new onset atrial fibrillation, mortality, stroke, reoperation for
bleeding, blood transfusion and pulmonary infection. <br/>METHOD(S): A
systematic search was performed in six databases for studies comparing
MIMVS with CS. Although the initial search identified 821 papers in total,
nine studies were suitable for the final analysis. All studies included
compared CS with MIMVS. The Mantel - Haenszel statistical method was
chosen due the use of inverse variance and random effects. A meta-analysis
was performed on the data. <br/>RESULT(S): MIMVS had significantly lower
odds of renal failure (OR: 0.52; 95% CI 0.37 to 0.73, p < 0.001), new
onset atrial fibrillation (OR: 0.78; 95% CI 0.67 to 0.90, p < 0.001),
reduced prolonged intubation (OR: 0.50; 95% CI 0.29 to 0.87, p = 0.01) and
reduced mortality (OR: 0.58; 95% CI 0.38 to 0.87, p < 0.01). MIMVS had
shorter ICU stay (WMD: -0.42; 95% CI -0.59 to -0.24, p < 0.001) and
shorter time to discharge (WMD: -2.79; 95% CI -3.86 to -1.71, p < 0.001).
<br/>CONCLUSION(S): In the modern era, MIMVS for degenerative disease is
associated with improved short-term outcomes when compared to the CS.

<114>
Accession Number
641211155
Title
Evaluating YouTube as a Source of Education for Patients Undergoing
Surgery: A Systematic Review.
Source
Annals of surgery. (no pagination), 2023. Date of Publication: 05 May
2023.
Author
Javidan A.; Nelms M.W.; Li A.; Lee Y.; Zhou F.; Kayssi A.; Naji F.
Institution
(Javidan, Nelms, Kayssi) Division of Vascular Surgery, Department of
Surgery, University of Toronto, Toronto, ON, Canada
(Li) Ottawa Hospital Research Institute & Faculty of Medicine, University
of Ottawa, Ottawa, ON, Canada
(Lee, Zhou, Naji) Division of Vascular Surgery, Department of Surgery,
McMaster University, Hamilton, Ontario, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The objective of this systematic review is to characterize the
peer-reviewed literature investigating YouTube as a source of patient
education for patients undergoing surgery. SUMMARY BACKGROUND DATA:
YouTube is the largest online video sharing platform and has become a
substantial source of health information that patients are likely to
access before surgery, yet there has been no systematic assessment of
peer-reviewed studies. A comprehensive literature search was conducted
using EMBASE, MEDLINE, and Ovid HealthStar from inception through to
December of 2021. <br/>METHOD(S): All primary studies evaluating YouTube
as a source of patient education relating to surgical procedures (general,
cardiac, urology, otolaryngology, plastic, vascular) were included. Study
screening and data extraction occurred in duplicate with two reviewers.
Characteristics including video length, view count, upload source, overall
video educational quality, quality of individual studies. <br/>RESULT(S):
Among 6,453 citations, 56 studies were identified that examined 6,797
videos with 547 hours of content and 1.39 billion views. There were 49
studies that evaluated the educational quality of the videos, 43 quality
assessment tools were used, with each study using a mean of 1.88
assessment tools. Per the global rating for assessments, 34/49 studies
(69%) concluded that the overall quality of educational content was poor.
<br/>CONCLUSION(S): While the impact of non-peer-reviewed YouTube videos
on patient knowledge for surgery is unclear, the large amount of online
content suggests that they are in demand. The overall educational content
of these videos is poor, however, and there is substantial heterogeneity
in the quality assessment tools used in their evaluation. A peer-reviewed
and standardized approach to online education with video content is needed
to better support patients.<br/>Copyright &#xa9; 2023 Wolters Kluwer
Health, Inc. All rights reserved.