EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 96

Results Generated From:
Embase <1980 to 2023 Week 21>
Embase (updates since 2023-05-19)
Embase <1980 to 2023 Week 21>
Embase Weekly Updates (updates since 2023-05-19)

<1>
Accession Number
2019702988
Title
The effect of topical airway anesthesia on hemodynamic profiles during the
induction period in patients undergoing cardiac surgery: Study protocol
for a randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 992534. Date of Publication: 10 Oct 2022.
Author
Du W.; Lv M.; Chen T.; Sun X.; Wang J.; Zhang H.; Wei C.; Liu Y.; Qiao C.;
Wang Y.
Institution
(Du, Chen, Sun) Shandong First Medical University, Taian, China
(Lv, Wang, Zhang, Wei, Liu, Qiao, Wang) Department of Anesthesiology and
Perioperative Medicine, The First Affiliated Hospital of Shandong First
Medical University, Jinan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Patients scheduled for cardiac surgery are often accompanied
by cardiac dysfunction and hemodynamic instability. However, the
conventional induction strategy for anesthesia using high-dose intravenous
anesthetics is often associated with persistent and recurrent hypotension
after tracheal intubation. The purpose of this study is to investigate the
effects of topical airway anesthesia on the hemodynamic profile of
patients undergoing cardiac surgery during the induction period.
<br/>Method(s): This is a superiority, single-blind, randomized controlled
study with two parallel groups. Participants scheduled to undergo elective
cardiac surgery will be allocated into two blocks according to the New
York Heart Association (NYHA) classification and then randomly assigned to
the following two groups at a 1:1 ratio: the conventional induction group
and the combined topical airway anesthesia induction group. The combined
topical airway anesthesia induction strategy includes aerosol inhalation
airway anesthesia, subglottic airway anesthesia, and general anesthesia
induction using low-dose intravenous anesthetics. The primary outcome is
the area under the curve (AUC) of blood pressure below baseline mean
arterial pressure (MAP) from 3 to 15 min after endotracheal intubation.
Secondary outcomes include the AUC above baseline MAP and below baseline
MAP at other time points, the highest and lowest arterial blood pressure
values during the induction period, type and dose of vasoactive drugs,
incidence of arrhythmias, cardiac function, and the incidence of
postoperative hoarseness and sore throat. <br/>Discussion(s): The study
will explore whether aerosol inhalation airway anesthesia and subglottic
airway anesthesia could reduce the incidence and duration of hypotension
during the induction period in patients undergoing cardiac surgery.
Clinical Trial Registration: This trial was registered on
www.ClinicalTrials.gov (NCT05323786).<br/>Copyright &#xa9; 2022 Du, Lv,
Chen, Sun, Wang, Zhang, Wei, Liu, Qiao and Wang.

<2>
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.

<3>
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.

<4>
Accession Number
2023813317
Title
Efficacy and Safety of Pemafibrate Versus Bezafibrate to Treat Patients
with Hypertriglyceridemia: A Randomized Crossover Study.
Source
Journal of Atherosclerosis and Thrombosis. 30(5) (pp 443-454), 2023. Date
of Publication: 2023.
Author
Nakamura A.; Kagaya Y.; Saito H.; Kanazawa M.; Sato K.; Miura M.; Kondo
M.; Endo H.
Institution
(Nakamura, Kagaya, Saito, Kanazawa, Sato, Miura, Kondo, Endo) Department
of Cardiology, Iwate Prefectural Central Hospital, Morioka, Japan
Publisher
Japan Atherosclerosis Society
Abstract
Aim: Pemafibrate is a highly selective agonist for peroxisome
proliferator-activated receptor (PPAR)-alpha, a key regulator of lipid and
glucose metabolism. We compared the efficacy and safety of pemafibrate
with those of bezafibrate, a nonselective PPAR-alpha agonist.
<br/>Method(s): In this randomized crossover study, 60 patients with
hypertriglyceridemia (fasting triglyceride [TG] >= 150 mg/dL) were treated
with pemafibrate of 0.2 mg/day or bezafibrate of 400 mg/day for 24 weeks.
The primary endpoint was percent change (%Change) from baseline in TG
levels, while the secondary endpoints were %Change in high-density
lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (Apo A-I) levels.
<br/>Result(s): The %Change in TG and Apo A-I levels was significantly
greater with pemafibrate than with bezafibrate (-46.1% vs. -34.7%, p0.001;
9.2% vs. 5.7%, p=0.018, respectively). %Change in HDL-C levels was not
significantly different between the two treatments. %Change in liver
enzyme levels was markedly decreased with pemafibrate than with
bezafibrate. Creatinine levels significantly increased in both treatments;
however, its %Change was significantly lower with pemafibrate than with
bezafibrate (5.72% vs. 15.5%, p 0.001). The incidence of adverse events
(AEs) or serious AEs did not differ between the two treatments; however,
the number of patients with elevated creatinine levels (>= 0.5 mg/dL
and/or 25% from baseline) was significantly lower in the bezafibrate group
than in the pemafibrate group (16/60 vs. 3/60, p=0.004).
<br/>Conclusion(s): Compared with bezafibrate, pemafibrate is more
effective in decreasing TG levels and increasing Apo A-I levels and is
safer regarding liver and renal function.<br/>Copyright &#xa9; 2023 Japan
Atherosclerosis Society.

<5>
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.

<6>
Accession Number
2024108730
Title
Nephrotic syndrome and acute coronary syndrome in children, teenagers and
young adults: Systematic literature review.
Source
Archives of Cardiovascular Diseases. 116(5) (pp 282-290), 2023. Date of
Publication: May 2023.
Author
Wolf O.; Didier R.; Chague F.; Bichat F.; Rochette L.; Zeller M.; Fauchier
L.; Bonnotte B.; Cottin Y.
Institution
(Wolf, Didier, Chague, Bichat, Zeller, Cottin) Department of Cardiology,
University Teaching Hospital of Dijon Bourgogne, Dijon 21000, France
(Rochette, Zeller) PEC2, EA 7460, University of Burgundy, Dijon 21000,
France
(Fauchier) Department of Cardiology, Francois-Rabelais University,
University Teaching Hospital of Trousseau, Tours 37044, France
(Bonnotte) Department of Internal Medicine, University Teaching Hospital
of Dijon Bourgogne, Dijon 21000, France
Publisher
Elsevier Masson s.r.l.
Abstract
Myocardial infarction is rare in children, teenagers and young adults
(aged < 20 years). The most common aetiologies identified include Kawasaki
disease, familial hypercholesterolaemia, collagen vascular disease-induced
coronary arteritis, substance abuse (cocaine, glue sniffing), trauma,
complications of congenital heart disease surgery, genetic disorders (such
as progeria), coronary artery embolism, occult malignancy and several
other rare conditions. Nephrotic syndrome is a very rare cause of
myocardial infarction, but it is probably underestimated. The purpose of
this review was to determine the current state of knowledge on acute
coronary syndrome related to nephrotic syndrome. We thus performed a
comprehensive structured literature search of the Medline database for
articles published between January 1st, 1969 and December 31st, 2021.
Myocardial infarction in young adults can be broadly divided into two
groups: cases of angiographically normal coronary arteries; and cases of
coronary artery disease of varying aetiology. There are several possible
mechanisms underlying the association between acute coronary syndrome and
nephrotic syndrome: (1) coronary thrombosis related to hypercoagulability
and/or platelet hyperactivity; (2) atherosclerosis related to
hyperlipidaemia; and (3) drug treatment. All of these mechanisms must be
evaluated systematically in the acute phase of disease because they evolve
rapidly with the treatment of nephrotic syndrome. In this review, we
propose a decision algorithm for the management of acute coronary syndrome
in the context of nephrotic syndrome. The final part of the review
presents the short- and medium-term therapeutic strategies available.
Thromboembolism related to nephrotic syndrome is a rare
non-atherosclerotic cause of acute coronary syndrome, and prospective
studies are needed to evaluate a systematic approach with personalized
therapeutic strategies.<br/>Copyright &#xa9; 2023 Elsevier Masson SAS

<7>
Accession Number
2023313674
Title
Percutaneous treatment of left circumflex coronary artery injury related
to mitral valve surgery: Case series and systematic review of the
literature.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Benedetti A.; Castaldi G.; Poletti E.; Moroni A.; Scott B.; Convens C.;
Verheye S.; Vermeersch P.; Agostoni P.; Zivelonghi C.
Institution
(Benedetti, Castaldi, Poletti, Moroni, Scott, Convens, Verheye,
Vermeersch, Agostoni, Zivelonghi) HartCentrum, Ziekenhuis Netwerk
Antwerpen (ZNA) Middelheim, Antwerp, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Left circumflex coronary artery (LCx) injury related to mitral valve
surgery is a rare complication. The best treatment option is not defined,
and percutaneous coronary intervention (PCI) may represent an effective
treatment to avoid prolonged myocardial ischemia. To evaluate feasibility
and efficacy of PCI treatment, all records of LCx injury related to mitral
valve surgery and treated with PCI were included after a systematic PubMed
searching. Moreover, we retrospectively analyzed our single-center PCI
database and patients fulfilling the inclusion criteria were included.
Patients undergoing transcatheter mitral valve intervention, non-mitral
valve surgery, conservatively or surgically treated after LCx injury were
excluded. Data about patient characteristics, procedural details, PCI
success, and in-hospital mortality were collected. Fifty-six patients were
included, 58.9% were male (n = 33) and the median age was 60.5 years (IQR
= 21.75). The majority had left dominant or codominant coronary system
(62.2%, n = 28 and 15.6%, n = 7, respectively). Clinical manifestations
ranged from hemodynamic stability (21.1%, n = 8) to hemodynamic
instability (42.1%, n = 16) and cardiac arrest (18.4%, n = 7). On ECG,
23.5% of patients (n = 12) presented ST-segment depression, 58.8% (n = 30)
ST-segment elevation, 7.8% (n = 4) atrioventricular block, and 29.4% (n =
15) ventricular arrhythmias. Left ventricle dysfunction was present in
52.3% (n = 22) of patients and wall motion abnormalities in 71.4% (n =
30). PCI success rate was 82.1% (n = 46) and in-hospital mortality 4.5% (n
= 2). LCx injury related to mitral surgery is a rare complication
characterized by an increased risk of mortality. PCI seems a feasible
treatment option, still burdened by suboptimal results, probably related
to the technical challenges posed by the surgical failure.<br/>Copyright
&#xa9; 2023 Wiley Periodicals LLC.

<8>
Accession Number
641372000
Title
Review on risk factors, classification, and treatment of sternal wound
infection.
Source
Journal of cardiothoracic surgery. 18(1) (pp 184), 2023. Date of
Publication: 19 May 2023.
Author
Song Y.; Chu W.; Sun J.; Liu X.; Zhu H.; Yu H.; Shen C.
Institution
(Song, Chu, Sun, Liu, Zhu, Yu, Shen) Senior Department of Burns and
Plastic Surgery, Fourth Medical Center of Chinese PLA General Hospital,
No. 51, Fucheng Road, Beijing 100048, China
Publisher
NLM (Medline)
Abstract
Sternal wound infection (SWI) is the most common complication of the
median sternal incision. The treatment time is long, and the
reconstruction is difficult, which causes challenges for surgeons. Plastic
surgeons were often involved too late in such clinical scenarios when
previous empirical treatments failed and the wound damage was relatively
serious. Accurate diagnosis and risk factors against sternal wound
infection need to be in focus. Classification of different types of
sternotomy complications post-cardiac surgery is important for specific
categorization and management. Not familiar with this kind of special and
complex wound, objectively increasing the difficulty of wound
reconstruction. The purpose of this comprehensive review is to review the
literature, introduce various SWI risk factors related to wound nonunion,
various classification characteristics, advantages and disadvantages of
various wound reconstruction strategies, to help clinicians understand the
pathophysiological characteristics of the disease and choose a better
treatment method.<br/>Copyright &#xa9; 2023. The Author(s).

<9>
Accession Number
641364036
Title
Effect of multicomponent rehabilitation on independence and functioning in
elderly patients with common age-associated diseases: protocol for a
scoping review (REHOLD).
Source
BMJ open. 13(5) (pp e068722), 2023. Date of Publication: 18 May 2023.
Author
Baritello O.; Stein H.; Wolff L.L.; Hamann M.; Voller H.; Salzwedel A.
Institution
(Baritello, Stein, Wolff, Hamann, Voller, Salzwedel) Rehabilitation
Medicine, University of Potsdam, Potsdam, Germany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Elderly patients after hospitalisation for acute events on
account of age-related diseases (eg, joint or heart valve replacement
surgery) are often characterised by a remarkably reduced functional
health. Multicomponent rehabilitation (MR) is considered an appropriate
approach to restore the functioning of these patients. However, its
efficacy in improving functioning-related outcomes such as care
dependency, activities of daily living (ADL), physical function and
health-related quality of life (HRQL) remains unclarified. We outline the
research framework of a scoping review designed to map the available
evidence of the effects of MR on the independence and functional capacity
of elderly patients hospitalised for age-related diseases in four main
medical specialties beyond geriatrics. METHODS AND ANALYSIS: The
biomedical databases (PubMed, Cochrane Library, ICTRP Search Platform,
ClinicalTrials) and additionally Google Scholar will be systematically
searched for studies comparing centre-based MR with usual care in patients
>=75 years of age, hospitalised for common acute events due to age-related
diseases (eg, joint replacement, stroke) in one of the specialties of
orthopaedics, oncology, cardiology or neurology. MR is defined as exercise
training and at least one additional component (eg, nutritional
counselling), starting within 3months after hospital discharge. Randomised
controlled trials as well as prospective and retrospective controlled
cohort studies will be included from inception and without language
restriction. Studies investigating patients <75 years, other specialties
(eg, geriatrics), rehabilitation definition or differently designed will
be excluded. Care dependency after at least a 6-month follow-up is set as
the primary outcome. Physical function, HRQL, ADL, rehospitalisation and
mortality will be additionally considered. Data for each outcome will be
summarised, stratified by specialty, study design and type of assessment.
Furthermore, quality assessment of the included studies will be performed.
ETHICS AND DISSEMINATION: Ethical approval is not required. Findings will
be published in a peer-reviewed journal and presented at national and/or
international congresses. TRIAL REGISTRATION NUMBER:
https://doi.org/10.17605/OSF.IO/GFK5C.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<10>
Accession Number
640435956
Title
The Rise and Fall of Antithrombin Supplementation in Cardiac Surgery.
Source
Anesthesia and analgesia. 136(6) (pp 1043-1051), 2023. Date of
Publication: 01 Jun 2023.
Author
Ranucci M.; Baryshnikova E.; Pistuddi V.; Di Dedda U.
Institution
(Ranucci) From the Department of Cardiothoracic and Vascular Anesthesia
and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
Publisher
NLM (Medline)
Abstract
Various cohort studies, both retrospective and prospective, showed that
low antithrombin levels after cardiac surgery (at the arrival in the
intensive care unit and during the next days) were associated with a
number of adverse outcomes, including surgical reexploration and
thromboembolic events, eventually leading to prolonged stay in the
intensive care. Values lower than 58% to 64% of antithrombin activity were
indicative of this higher morbidity with good sensitivity and specificity.
The scenario generated the hypothesis that low antithrombin levels needed
to be corrected by supplementation to improve postoperative outcome.
However, randomized controlled studies run to test this idea failed to
demonstrate any benefit of antithrombin supplementation, showing no
effects on outcome, neither as preemptive preoperative strategy nor for
treating postoperative low antithrombin values. In addition, randomized
trials highlighted that those patients who received antithrombin
experienced significantly higher incidence of acute kidney injury with a
pooled odds ratio of 4.41 (95% CI, 1.90-10.23; P = .001). A strongly
decreased thrombin activity after antithrombin correction may eventually
affect the efficiency of the glomerular filtration and cause the
deterioration of kidney function, but underlying biological mechanisms
remain unclear. In conclusion, low levels of antithrombin activity after
cardiac surgery should be considered as a marker of greater severity of
the patient's conditions and/or of the complexity of the surgical
procedure. There are no indications for antithrombin supplementation in
cardiac surgery unless for correcting heparin resistance.<br/>Copyright
&#xa9; 2022 International Anesthesia Research Society.

<11>
Accession Number
640238770
Title
Postoperative Outcomes in Elderly Patients Undergoing Cardiac Surgery With
Preoperative Cognitive Impairment: A Systematic Review and Meta-Analysis.
Source
Anesthesia and analgesia. 136(6) (pp 1016-1028), 2023. Date of
Publication: 01 Jun 2023.
Author
Au E.; Thangathurai G.; Saripella A.; Yan E.; Englesakis M.; Nagappa M.;
Chung F.
Institution
(Au, Saripella, Yan, Chung) From the Department of Anesthesia and Pain
Management, Toronto Western Hospital ,University Health Network, Toronto,
ON, Canada
(Thangathurai) Department of Medicine, McGill University, Montreal, QC,
Canada
(Yan) Department of Medical Science, University of Toronto, Toronto, ON,
Canada
(Englesakis) Department of Library & Information Services, University
Health Network, Toronto, ON, Canada
(Nagappa) Department of Anesthesia and Perioperative Medicine, London
Health Sciences Centre and St Joseph Health Care, Schulich School of
Medicine and Dentistry, Western University, London, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Older patients with preoperative cognitive impairment are at
risk for increased postoperative complications after noncardiac surgery.
This systematic review and meta-analysis aimed to determine the
association between preoperative cognitive impairment and dementia and
postoperative outcomes in older surgical patients after cardiac surgery.
<br/>METHOD(S): Eight electronic databases were searched from inception to
January 4, 2022. Inclusion criteria were cardiac surgery patients >=60
years of age; preoperative cognitive impairment; >=1 postoperative
complication reported; comparator group with no preoperative cognitive
impairment; and written in English. Using a random-effects model, we
calculated effect sizes as odds ratio (OR) and standardized mean
differences (SMDs). Risk of random error was assessed by applying trial
sequential analysis. <br/>RESULT(S): Sixteen studies (62,179 patients)
were included. Preoperative cognitive impairment was associated with
increased risk of delirium in older patients after cardiac surgery (70.0%
vs 20.5%; OR, 8.35; 95% confidence interval [CI], 4.25-16.38; I 2 , 0%; P
< .00001). Cognitive impairment was associated with increased hospital
length of stay (LOS; SMD, 0.36; 95% CI, 0.20-0.51; I 2 , 22%; P < .00001)
and intensive care unit (ICU) LOS (SMD, 0.39; 95% CI, 0.09-0.68; I 2 ,
70%; P = .01). No significant association was seen for 30-day mortality
(1.7% vs 1.1%; OR, 2.58; 95% CI, 0.64-10.44; I 2 , 55%; P = .18).
<br/>CONCLUSION(S): In older patients undergoing cardiac surgery,
cognitive impairment was associated with an 8-fold increased risk of
delirium, a 5% increase in absolute risk of major postoperative bleeding,
and an increase in hospital and ICU LOS by approximately 0.4 days. Further
research on the feasibility of implementing routine neurocognitive testing
is warranted.<br/>Copyright &#xa9; 2023 International Anesthesia Research
Society.

<12>
Accession Number
641374596
Title
Difficult airway management and low Bispectral Index (BIS) in a patient
with left Bochdalek congenital diaphragmatic hernia (CDH).
Source
BMC anesthesiology. 23(1) (pp 172), 2023. Date of Publication: 20 May
2023.
Author
Dahaba A.A.
Institution
(Dahaba) Department of Anaesthesiology and Intensive Care Medicine, Suez
Canal University, Ismailia 41522, Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: Bochdalek congenital diaphragmatic hernia (CDH) is a
developmental defect in the posterolateral diaphragm, allowing herniation
of abdominal contents into the thorax causing mechanical compression of
the developing lung parenchyma and lung hypoplasia. We describe a case of
an adult patient with a Bochdalek hernia who underwent minimally invasive
right thoracotomy Perceval bioprosthetic aortic valve replacement (AVR)
requiring one-lung ventilation (OLV) on the side of the hernia. This is a
complex and challenging case that brings up numerous thought-provoking
anesthetic implications. To the best of our knowledge, a Pubmed search did
not reveal any publication to date of difficult airway management in an
adult patient with CDH. CASE PRESENTATION: The first major problem
encountered was patient's crus habitus anatomical condition (exceedingly
ventrally displaced trachea) Mallampati Class IV and Cormack-Lehane grade
IV extremely difficult endotracheal intubation. Neither glottis nor
epiglottis was visible on laryngoscopy; resulting in failed placement of
the double-lumen endobronchial tube (DLT) following numerous attempts. The
DLT was eventually placed via GlideScope videolaryngoscopy. Whereas the
endobroncheal right lung block for left OLV was successfully placed using
fiberopticscopy. The crus habitus encroached on OLV tidal volume by the
cranially displaced ascending colon and left kidney. Anesthesia was
maintained with remifentanil /sevoflurane; adjusted to maintain bispectral
index (BIS) at 40-60. Digitally recorded BIS was 38-62 except when BIS
precipitously declined to 14-38 (SR, suppression ratio<10) for 25 min
after termination of the cardiopulmonary bypass. <br/>CONCLUSION(S): We
report a case essentially dealing with an anatomically distorted difficult
airway in a patient with left Bochdalek CDH undergoing a complex AVR. We
describe anesthetic difficulties and unforeseen issues encountered; such
as an extremely difficult DLT placement.<br/>Copyright &#xa9; 2023. The
Author(s).

<13>
Accession Number
2024605063
Title
Anterolateral territory coronary artery bypass grafting strategies: a
non-inferiority randomized clinical trial: the AMI-PONT trial.
Source
European Journal of Cardio-thoracic Surgery. 63(4) (no pagination), 2023.
Article Number: ezad060. Date of Publication: 01 Apr 2023.
Author
Stevens L.-M.; Chartrand-Lefebvre C.; Mansour S.; Beland V.; Soulez G.;
Forcillo J.; Basile F.; Prieto I.; Noiseux N.
Institution
(Stevens, Forcillo, Basile, Prieto, Noiseux) Division of Cardiac Surgery,
Department of Surgery, Centre Hospitalier de l'Universite de Montreal,
Montreal, QC, Canada
(Stevens, Chartrand-Lefebvre, Mansour, Beland, Soulez, Forcillo, Noiseux)
CHUM Research Centre (CRCHUM), Montreal, QC, Canada
(Chartrand-Lefebvre, Soulez) Department of Radiology, Centre Hospitalier
de l'Universite de Montreal, Montreal, QC, Canada
(Mansour) Division of Cardiology, Department of Medicine, Centre
Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The main objective was to assess whether a composite coronary
artery bypass grafting strategy including a saphenous vein graft bridge to
distribute left internal mammary artery outflow provides non-inferior
patency rates compared to conventional grafting surgery with separated
left internal mammary artery to left anterior descending coronary graft
and aorto-coronary saphenous vein grafts to other anterolateral targets.
<br/>METHOD(S): All patients underwent isolated grafting surgery with
cardiopulmonary bypass and received >_2 grafts/patients on the
anterolateral territory. The graft patency (i.e. non-occluded) was
assessed using multislice spiral computed tomography at 1 year.
<br/>RESULT(S): From 2012 to 2021, 208 patients were randomized to a
bridge (n = 105) or conventional grafting strategy (n = 103). Patient
characteristics were comparable between groups. The anterolateral graft
patency was non-inferior in the composite bridge compared to conventional
grafting strategy at 1 year [risk difference 0.7% (90% confidence interval
-4.8 to 6.2%)]. The graft patency to the left anterior descending coronary
was no different between groups (P = 0.175). Intraoperatively, the bridge
group required shorter vein length for anterolateral targets (P < 0.001)
and exhibited greater Doppler flow in the mammary artery pedicle (P =
0.004). The composite outcome of death, myocardial infarction or target
vessel reintervention at 30 days was no different (P = 0.164).
<br/>CONCLUSION(S): Anterolateral graft patency of the composite bridge
grafting strategy is non-inferior to the conventional grafting strategy at
1 year. This novel grafting strategy is safe, efficient, associated with
several advantages including better mammary artery flow and shorter vein
requirement, and could be a valuable alternative to conventional grafting
strategies. Ten-year clinical follow-up is underway.<br/>Copyright &#xa9;
The Author(s) 2023. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<14>
[Use Link to view the full text]
Accession Number
2024624954
Title
Epicardial Adipose Tissue Assessed by Computed Tomography and
Echocardiography Are Associated with Adverse Cardiovascular Outcomes: A
Systematic Review and Meta-Analysis.
Source
Circulation: Cardiovascular Imaging. 16(5) (pp E015159), 2023. Date of
Publication: 01 May 2023.
Author
Chong B.; Jayabaskaran J.; Ruban J.; Goh R.; Chin Y.H.; Kong G.; Ng C.H.;
Lin C.; Loong S.; Muthiah M.D.; Khoo C.M.; Shariff E.; Chan M.Y.;
Lajeunesse-Trempe F.; Tchernof A.; Chevli P.; Mehta A.; Mamas M.A.;
Dimitriadis G.K.; Chew N.W.S.
Institution
(Chong, Jayabaskaran, Ruban, Goh, Chin, Kong, Ng, Lin, Loong, Muthiah,
Chan) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Muthiah) Division of Gastroenterology and Hepatology, Department of
Medicine, National University Hospital, Singapore, Singapore
(Khoo) Division of Endocrinology, Department of Medicine, National
University Hospital, Singapore, Singapore
(Muthiah) National University Centre for Organ Transplantation, National
University Health System, Singapore, Singapore
(Khoo, Chew) Department of Cardiology, National University Heart Centre,
National University Health System, Singapore, Singapore
(Shariff) Universiti Teknologi MARA, UiTM Sungai Buloh, Selangor, Malaysia
(Lajeunesse-Trempe, Tchernof) Quebec Heart and Lung Institute, Quebec
City, Canada
(Lajeunesse-Trempe) Department of Nutrition, Laval University, Quebec
City, Canada
(Lajeunesse-Trempe, Dimitriadis) Department of Endocrinology ASO/EASO COM,
King's College Hospital NHS Foundation Trust, Denmark Hill, London, United
Kingdom
(Chevli) Section on Hospital Medicine, Department of Internal Medicine,
Wake Forest School of Medicine, Winston-Salem, NC, United States
(Mehta) VCU, Health Pauley Heart Center, Division of Cardiology,
Department of Internal Medicine, Virginia Commonwealth University,
Richmond, United States
(Mamas) Institute of Population Health, University of Manchester, United
Kingdom
(Mamas) Keele Cardiac Research Group, Centre for Prognosis Research, Keele
University, Stoke-on-Trent, United Kingdom
(Dimitriadis) Obesity, Type 2 Diabetes and Immunometabolism Research
Group, Department of Diabetes, Faculty of Cardiovascular Medicine &
Sciences, School of Life Course Sciences, King's College London, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Epicardial adipose tissue (EAT) has garnered attention as a
prognostic and risk stratification factor for cardiovascular disease. This
study, via meta-analyses, evaluates the associations between EAT and
cardiovascular outcomes stratified across imaging modalities, ethnic
groups, and study protocols. <br/>Method(s): Medline and Embase databases
were searched without date restriction on May 2022 for articles that
examined EAT and cardiovascular outcomes. The inclusion criteria were (1)
studies measuring EAT of adult patients at baseline and (2) reporting
follow-up data on study outcomes of interest. The primary study outcome
was major adverse cardiovascular events. Secondary study outcomes included
cardiac death, myocardial infarction, coronary revascularization, and
atrial fibrillation. <br/>Result(s): Twenty-nine articles published
between 2012 and 2022, comprising 19 709 patients, were included in our
analysis. Increased EAT thickness and volume were associated with higher
risks of cardiac death (odds ratio, 2.53 [95% CI, 1.17-5.44]; P=0.020;
n=4), myocardial infarction (odds ratio, 2.63 [95% CI, 1.39-4.96];
P=0.003; n=5), coronary revascularization (odds ratio, 2.99 [95% CI,
1.64-5.44]; P<0.001; n=5), and atrial fibrillation (adjusted odds ratio,
4.04 [95% CI, 3.06-5.32]; P<0.001; n=3). For 1 unit increment in the
continuous measure of EAT, computed tomography volumetric quantification
(adjusted hazard ratio, 1.74 [95% CI, 1.42-2.13]; P<0.001) and
echocardiographic thickness quantification (adjusted hazard ratio, 1.20
[95% CI, 1.09-1.32]; P<0.001) conferred an increased risk of major adverse
cardiovascular events. <br/>Conclusion(s): The utility of EAT as an
imaging biomarker for predicting and prognosticating cardiovascular
disease is promising, with increased EAT thickness and volume being
identified as independent predictors of major adverse cardiovascular
events. Registration: URL: https://www.crd.york.ac.uk/prospero; Unique
identifier: CRD42022338075.<br/>Copyright &#xa9; 2023 Lippincott Williams
and Wilkins. All rights reserved.

<15>
Accession Number
2022112260
Title
Effect of Acupressure on Dental Anxiety in Children: a Pilot Study for a
Randomized Clinical Trial.
Source
JAMS Journal of Acupuncture and Meridian Studies. 15(5) (pp 307-313),
2022. Date of Publication: 2022.
Author
Soares M.E.C.; de Souza Araujo A.; Pinto I.C.L.; Barbosa L.S.A.; Borsatto
M.C.; Galo R.
Institution
(Soares, de Souza Araujo, Pinto, Barbosa) Department of Dentistry, School
of Biological and Health Sciences, Universidade Federal dos Vales do
Jequitinhonha e Mucuri, Diamantina, Brazil
(Borsatto) Clinical Pediatric Dentistry Department, Ribeirao Preto School
of Dentistry, Universidade de Sao Paulo, Ribeirao Preto, Brazil
(Galo) Department of Dental Materials and Prosthesis, Ribeirao Preto
School of Dentistry, Universidade de Sao Paulo, Ribeirao Preto, Brazil
Publisher
Medical Association of pharmacopuncture Institute
Abstract
Background: Anxiety is an important problem in children in dental clinics.
Acupressure may be a useful tool to assist in dental procedures in anxious
children. <br/>Objective(s): This pilot study was performed to examine the
effects of acupressure on dental anxiety in children undergoing
restorative procedures. <br/>Method(s): Fourteen children aged 7-10 years
and with at least one primary molar with caries on the dentine were
included in the study. The participants also needed to score at least one
point on the modified Venham Picture Test (VPTm) for the determination of
anxiety. The children were randomly allocated to two groups: group A -
non-documented points for the reduction of anxiety and induction of
relaxation; group B - documented points (EX-HN3, Shen Men of auricular
acupuncture). The anxiety scale was administered on three occasions: prior
to the application of acupressure; immediately after sitting in the dental
chair to undergo restorative treatment; and after removal of acupressure
at the end of the restorative procedure. Heart rate (HR) was measured when
each child sat in the dental chair, after the removal of carious tissue,
and after the removal of acupressure. <br/>Result(s): After the procedure,
HR (as an indicator of anxiety) was statistically significantly lower in
group B than group A (p = 0.02). However, there was no significant
difference between the groups regarding anxiety before and during the
restorative procedure (VPTm and HR: p > 0.05). <br/>Conclusion(s): The
children who received acupressure on documented points for the reduction
of anxiety had a significantly lower HR after the restorative procedure.
No significant between-group difference was found regarding anxiety
measured using a psychometric evaluation (VPTm).<br/>Copyright &#xa9;
Medical Association of Pharmacopuncture Institute (MAPI)

<16>
Accession Number
2023894276
Title
Safety and Perioperative Outcomes After Drainless Video Assisted
Thoracoscopic Surgery.
Source
NeuroQuantology. 20(19) (pp 3522-3536), 2022. Date of Publication: 2022.
Author
Ahmady I.
Institution
(Ahmady) Cardiothoracic surgery Department, Faculty of Medicine, Zagazig
University, Egypt
Publisher
Anka Publishers
Abstract
Background: Drainless minimally invasive Video-assisted thoracoscopic
surgery (VATS) has become a milestone approach for surgery in many
thoracic procedures with favorable results on perioperative outcomes.
<br/>Objective(s): to assess safety and perioperative outcomes of
drainless VATS among eligible selected patients Methods: This randomized
controlled clinical trial was carried out on 24 randomly selected eligible
patients, and fulfilling the inclusion and exclusion criteria for
drainless VATS, they were randomly assigned into two groups:
Group-I(drainless group): including 12 patients undergoing VATS with intra
operative omitting of chest tube drainage after an air leakage test,
Group-II (Drainage group): including 12 patients undergoing VATS with
conventional treatment using standard chest tube drainage. <br/>Result(s):
Patient among drainless VATS group-I had short operation time(116.0), less
total average post operative pain score per day(1.66) and also short
postoperative duration of hospital stay (1.0 days) compared to (139.0,
4.83 and also 3.5days among those in the drainage VATS group-II,
(P<0.05)respectively. Drainless Uniportal VATS procedure significantly
consumed the least operation time (85.0&5 minutes)in between studied
patient of both groups and within each separate group, (P<0.05)
respectively. <br/>Conclusion(s): Omitting chest tube drainage after VATS
is feasible in eligible selected patients and improve its efficacy, safety
and perioperative outcomes (postoperative pain, early ambulation, length
of hospital stay, and the risk of perioperative complications), and
drainless U-VATS should be considered the preferred approach in minimally
invasive surgery that opens up for the possibility of fast track chest
surgery.<br/>Copyright &#xa9; 2022, Anka Publishers. All rights reserved.

<17>
Accession Number
641374724
Title
Use of Preoperative Natriuretic Peptide in Predicting Mortality After
Coronary Artery Bypass Grafting: A Systematic Review and Meta-analysis.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2023.
Date of Publication: 20 Apr 2023.
Author
Comanici M.; Nadarajah D.; Katumalla E.; Cyclewala S.; Raja S.G.
Institution
(Comanici, Nadarajah, Katumalla, Cyclewala, Raja) Department of Cardiac
Surgery, Harefield Hospital, London, United Kingdom
Publisher
NLM (Medline)
Abstract
The objective of this systematic review was to evaluate the current
evidence on the utility of preoperative B-type natriuretic peptide (BNP)
and N-terminal-pro B-type natriuretic peptide (NT-proBNP) in predicting
short-term and long-term mortality after coronary artery bypass grafting
(CABG). OVID MEDLINE, EMBASE, SCOPUS, and PUBMED were searched from 1946
to August 2022 using the following terms: "coronary artery bypass
grafting" and "BNP" and "outcomes." Eligible studies included
observational studies reporting the association between preoperative BNP
and NT-proBNP levels and short- and long-term mortality after CABG.
Articles were selected systematically, assessed for bias, and, when
possible, meta-analyzed using a random effect model. After retrieving 53
articles, 11 were included for qualitative synthesis and 4 for
quantitative meta-analysis. Studies included in this review showed that
elevated preoperative natriuretic peptide levels, despite variable
cut-offs, have been consistently shown to be associated with short- and
long-term mortality after CABG. The median BNP cut-off value was 145.5
pg/mL (25th-75th percentile 95-324.25 pg/mL), and the mean NT-proBNP value
was 765 +/- 372 pg/mL. Compared to patients with normal natriuretic
peptide levels, patients with elevated BNP and NT-proBNP presented higher
mortality rates after CABG (odds ratio 3.96, 95% confidence interval
2.41-6.52; p < 0.00001). Preoperative BNP level is a powerful predictor of
mortality in patients undergoing CABG. The measurement of BNP can add
significant value to these patients' risk stratification and therapeutic
decision-making.<br/>Copyright &#xa9; 2023 Elsevier Inc. All rights
reserved.

<18>
Accession Number
2018963843
Title
Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction
Patients in Department of Cardiology of a Tertiary Care Centre: A
Descriptive Cross-sectional Study.
Source
Journal of the Nepal Medical Association. 61(257) (pp 54-58), 2023. Date
of Publication: January 2023.
Author
Sharma M.; Khanal R.R.; Shah S.; Gajurel R.M.; Poudel C.M.; Adhikari S.;
Yadav V.; Devkota S.; Thapa S.
Institution
(Sharma, Khanal, Gajurel, Poudel, Adhikari, Yadav, Devkota) Department of
Cardiology, Manmohan Cardio Thoracic Vascular and Transplant Centre,
Institute of Medicine, Maharajgunj, Kathmandu, Nepal
(Shah) Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan
University, Maharajgunj, Kathmandu, Nepal
(Thapa) Department of Cardiology, Chitwan Medical College, Bharatpur,
Nepal
Publisher
Nepal Medical Association
Abstract
Introduction: Non-ST elevation myocardial infarction is frequently thought
to be caused by incomplete blockage of the culprit artery, whereas ST
elevation myocardial infarction is frequently thought to be caused by
total occlusion of the culprit artery. The objective of the study was to
find out the prevalence of occluded coronary arteries among non-ST
elevation myocardial infarction patients department of cardiology of a
tertiary care centre. <br/>Method(s): A descriptive cross-sectional study
was conducted among non-ST elevation myocardial infarction patients in a
tertiary care centre from 22 June 2020 to 21 June 2021 after taking
ethical approval from the Institutional Review Committee [Reference
number: 4271 (6-11) E2 076/077]. A total of 196 patients were included in
the study by simple randomized sampling. Data on the patient's clinical
profile, angiographic findings, and in-hospital complications were
recorded. Point estimate and 95% Confidence Interval were calculated.
<br/>Result(s): Among 126 non-ST elevation myocardial infarction patients
included in the study, the prevalence of occluded coronary artery was 41
(32.54%) (24.36-40.72, 95% Confidence Interval). <br/>Conclusion(s): The
prevalence of occluded coronary arteries was similar to the studies done
in similar settings.<br/>Copyright &#xa9; 2023, Nepal Medical Association.
All rights reserved.

<19>
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.

<20>
Accession Number
2023751681
Title
ERS International Congress 2022: highlights from the Thoracic Surgery and
Lung Transplantation Assembly.
Source
ERJ Open Research. 9(2) (no pagination), 2023. Article Number: 00671-2022.
Date of Publication: 2023.
Author
Magouliotis D.E.; Bos S.; Esendagli D.; Nardini M.; Migliore M.; Perch M.;
Cardillo G.; Meloni F.; Ricciardi S.; Hellemons M.
Institution
(Magouliotis) Department of Cardiothoracic Surgery, University of
Thessaly, Larissa, Greece
(Bos) Translational and Clinical Research Institute, Newcastle University,
Institute of Transplantation, Newcastle upon Tyne, Hospitals NHS Trust,
Newcastle upon Tyne, United Kingdom
(Esendagli) Faculty of Medicine, Chest Diseases Department, Baskent
University, Ankara, Turkey
(Nardini) Thoracic Surgery, St James's University Hospital, Leeds, United
Kingdom
(Migliore) Program of Minimally Invasive Thoracic Surgery and New
Technologies, University Hospital of Catania, Department of Surgery and
Medical Specialties, University of Catania, Catania, Italy
(Perch) Department of Cardiology, Section for Lung Transplantation and
Respiratory Medicine, Heart Center, Rigshospitalet, Copenhagen, Denmark
(Perch) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Cardillo, Ricciardi) Unit of Thoracic Surgery, San Camillo Forlanini
Hospital, Rome, Italy
(Cardillo) Unicamillus - Saint Camillus International University of Health
Sciences, Rome, Italy
(Meloni) Transplant Center, IRCCS Policlinico San Matteo Foundation,
Pavia, Italy
(Ricciardi) Alma Mater Studiorum, University of Bologna, Bologna, Italy
(Hellemons) Dept of Respiratory Diseases, Erasmus University Medical
Center, Rotterdam, Netherlands
(Hellemons) Erasmus Transplant Institute, Erasmus University Medical
Center, Rotterdam, Netherlands
Publisher
European Respiratory Society
Abstract
The thoracic surgery and lung transplantation assembly (Assembly 8) of the
European Respiratory Society (ERS) is delighted to present the highlights
from the 2022 ERS International Congress that took place in a hybrid
version in Barcelona, Spain. We have selected the four main sessions that
discussed recent advances across a wide range of topics including the
effects of coronavirus disease 2019 on thoracic surgery and the challenges
regarding lung transplantation in connective tissue diseases and common
variable immunodeficiency. The sessions are summarised by early career
members in close collaboration with the assembly faculty. We aim to
provide the reader with an update and enhanced insight into the highlights
of the conference in the fields of thoracic surgery and lung
transplantation.<br/>Copyright &#xa9; The authors 2023.

<21>
[Use Link to view the full text]
Accession Number
2021323023
Title
Efficacy of a Drug-Eluting Stent Versus Bare Metal Stents for Symptomatic
Femoropopliteal Peripheral Artery Disease: Primary Results of the EMINENT
Randomized Trial.
Source
Circulation. 146(21) (pp 1564-1576), 2022. Date of Publication: 22 Nov
2022.
Author
Goueffic Y.; Torsello G.; Zeller T.; Esposito G.; Vermassen F.; Hausegger
K.A.; Tepe G.; Thieme M.; Gschwandtner M.; Kahlberg A.; Schindewolf M.;
Sapoval M.; Diaz-Cartelle J.; Stavroulakis K.
Institution
(Goueffic) Groupe Hospitalier Paris St. Joseph, Department of Vascular and
Endovascular Surgery, Paris, France
(Torsello) St. Franziskus-Hospital Munster, Munster, Germany
(Zeller) Universitats-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen,
Germany
(Esposito) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Italy
(Vermassen) Gent University Hospital, Belgium
(Hausegger) Klinikum Klagenfurt am Worthersee, Austria
(Tepe) Klinikum Rosenheim, Germany
(Thieme) REGIOMED Vascular Center, Sonneberg, Germany
(Thieme) Jena University Hospital, Clinic for Internal Medicine I, Germany
(Gschwandtner) Medizinische Universitat, Wien, Austria
(Kahlberg) Vita-Salute University, San Raffaele Scientific Institute,
Milan, Italy
(Schindewolf) Division of Angiology, Swiss Cardiovascular Center,
Inselspital, Bern, Switzerland
(Schindewolf) University Hospital, University of Bern, Switzerland
(Sapoval) Hopital Europeen Georges-Pompidou, Paris, France
(Diaz-Cartelle) Boston Scientific Corp, Marlborough, MA, United States
(Stavroulakis) Ludwig-Maximilian University, Munich, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: A clear patency benefit of a drug-eluting stent (DES) over
bare metal stents (BMSs) for treating peripheral artery disease of the
femoropopliteal segment has not been definitively demonstrated. The
EMINENT study (Trial Comparing Eluvia Versus Bare Metal Stent in Treatment
of Superficial Femoral and/or Proximal Popliteal Artery) was designed to
evaluate the patency of the Eluvia DES (Boston Scientific, Marlborough,
MA), a polymer-coated paclitaxel-eluting stent, compared with BMSs for the
treatment of femoropopliteal artery lesions. <br/>METHOD(S): EMINENT is a
prospective, randomized, controlled, multicenter European study with
blinded participants and outcome assessment. Patients with symptomatic
peripheral artery disease (Rutherford category 2, 3, or 4) of the native
superficial femoral artery or proximal popliteal artery with stenosis
>=70%, vessel diameter of 4 to 6 mm, and total lesion length of 30 to 210
mm were randomly assigned 2:1 to treatment with DES or BMS. The primary
effectiveness outcome was primary patency at 12 months, defined as
independent core laboratory-assessed duplex ultrasound peak systolic
velocity ratio <=2.4 in the absence of clinically driven target lesion
revascularization or surgical bypass of the target lesion. Primary
sustained clinical improvement was a secondary outcome defined as a
decrease in Rutherford classification of >=1 categories compared with
baseline without a repeat target lesion revascularization. Health-related
quality of life and walking function were assessed. <br/>RESULT(S): A
total of 775 patients were randomly assigned to treatment with DES (n=508)
or commercially available BMSs (n=267). Baseline clinical, demographic,
and lesion characteristics were similar between the study groups. Mean
lesion length was 75.6+/-50.3 and 72.2+/-47.0 mm in the DES and BMS
groups, respectively. The 12-month incidence of primary patency for DES
treatment (83.2% [337 of 405]) was significantly greater than for BMS
(74.3% [165 of 222]; P<0.01). Incidence of primary sustained clinical
improvement was greater among patients treated with the DES than among
those who received a BMS (83.0% versus 76.6%; P=0.045). The health-related
quality of life dimensions of mobility and pain/ discomfort improved for
the majority of patients in both groups (for 66.4% and 53.6% of
DES-treated and for 64.2% and 58.1% of BMS-treated patients, respectively)
but did not differ significantly. At 12 months, no statistical difference
was observed in all-cause mortality between patients treated with the DES
or BMS (2.7% [13 of 474] versus 1.1% [3 of 263]; relative risk, 2.4 [95%
CI, 0.69-8.36]; P=0.15). <br/>CONCLUSION(S): By demonstrating superior
1-year primary patency, the results of the EMINENT randomized study
support the benefit of using a polymer-based paclitaxel-eluting stent as a
first-line stent-based intervention for patients with symptomatic
peripheral artery disease attributable to femoropopliteal lesions.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT02921230.<br/>Copyright &#xa9; 2022 The Authors.

<22>
[Use Link to view the full text]
Accession Number
2019652662
Title
Efpeglenatide and Clinical Outcomes With and Without Concomitant
Sodium-Glucose Cotransporter-2 Inhibition Use in Type 2 Diabetes:
Exploratory Analysis of the AMPLITUDE-O Trial.
Source
Circulation. 145(8) (pp 565-574), 2022. Date of Publication: 22 Feb 2022.
Author
Lam C.S.P.; Ramasundarahettige C.; Branch K.R.H.; Sattar N.; Rosenstock
J.; Pratley R.; Del Prato S.; Lopes R.D.; Niemoeller E.; Khurmi N.S.; Baek
S.; Gerstein H.C.
Institution
(Lam) National Heart Centre Singapore and Duke-National University of
Singapore, 5 Hospital Dr 169609, Singapore
(Branch) Division of Cardiology, University of Washington, Seattle, United
States
(Sattar) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, United Kingdom
(Rosenstock) Dallas Diabetes Research Center at Medical City, TX, United
States
(Pratley) AdventHealth Translational Research Institute, Orlando, FL,
United States
(Del Prato) Department of Clinical and Experimental Medicine, Section of
Metabolic Diseases and Diabetes, University of Pisa, Italy
(Lopes) Duke Clinical Research Institute, Duke University Medical Center,
Durham, NC, United States
(Niemoeller) Sanofi, Frankfurt, Germany
(Khurmi) Sanofi, Bridgewater, NJ, United States
(Baek) Hanmi Pharmaceutical, Seoul, South Korea
(Ramasundarahettige, Gerstein) Population Health Research Institute,
Hamilton Health Sciences, ON, Canada
(Gerstein) McMaster University, Hamilton, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Both sodium-glucose cotransporter-2 (SGLT2) inhibitors and
glucagon-like peptide-1 receptor agonists reduce cardiovascular events
among patients with type 2 diabetes. However, no cardiovascular outcome
trial has evaluated the long-term effects of their combined use. The
AMPLITUDE-O trial (Effect of Efpeglenatide on Cardiovascular Outcomes)
reported that once-weekly injections of the glucagon-like peptide-1
receptor agonists efpeglenatide (versus placebo) reduced major adverse
cardiovascular events (MACEs); MACEs, coronary revascularization, or
unstable angina hospitalization (expanded MACEs); a renal composite
outcome; and MACEs or death in people with type 2 diabetes and
cardiovascular or renal disease. The trial uniquely stratified
randomization by baseline or anticipated use of SGLT2 inhibitors and
included the highest prevalence at baseline (N=618, 15.2%) of SGLT2
inhibitor use among glucagon-like peptide-1 receptor agonist
cardiovascular outcome trials to date. Its results were analyzed to
estimate the combined effect of SGLT2 inhibitors and efpeglenatide on
clinical outcomes. <br/>Method(s): Cardiovascular and renal outcomes were
analyzed with Cox proportional hazards models adjusted for region, SGLT2
inhibitor randomization strata, and the SGLT2 inhibitor-by-treatment
interaction. Continuous variables were analyzed with a mixed-effects
models for repeated measures that also included an interaction term.
<br/>Result(s): The effect (hazard ratio [95% CI]) of efpeglenatide versus
placebo in the absence and presence of baseline SGLT2 inhibitors on MACEs
(0.74 [0.58-0.94] and 0.70 [0.37-1.30], respectively), expanded MACEs
(0.77 [0.62-0.96] and 0.87 [0.51-1.48]), renal composite (0.70 [0.59-0.83]
and 0.52 [0.33-0.83]), and MACEs or death (0.74 [0.59-0.93] and 0.65
[0.36-1.19]) did not differ by baseline SGLT2 inhibitor use (P for all
interactions >0.2). The reduction of blood pressure, body weight,
low-density lipoprotein cholesterol, and urinary albumin-to-creatinine
ratio by efpeglenatide also appeared to be independent of concurrent SGLT2
inhibitor use (all interaction P>=0.08). Last, adverse events did not
differ by baseline SGLT2 inhibitor use. <br/>Conclusion(s): The efficacy
and safety of efpeglenatide appear to be independent of concurrent SGLT2
inhibitor use. These data support combined SGLT2 inhibitor and
glucagon-like peptide-1 receptor agonist therapy in type 2 diabetes.
Registration: URL: https://www.clinicaltrials.gov. Unique identifier:
NCT03496298.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<23>
Accession Number
2024564686
Title
Aortic Thrombosis in Patients on Mechanical Circulatory Support: A
Systematic Literature Review.
Source
Heart Lung and Circulation. (no pagination), 2023. Date of Publication:
2023.
Author
Guglin M.; Rao R.A.
Institution
(Guglin, Rao) Indiana University School of Medicine, Division of
Cardiovascular Disease, Krannert Institute of Cardiology, Indianapolis,
IN, United States
Publisher
Elsevier Ltd
Abstract
Background: Aortic valve (AV) thrombosis is an uncommon but ominous
complication in patients managed with mechanical circulatory support (MCS)
devices. In this systematic review, we summarised the data on clinical
presentations and outcomes in such patients. <br/>Method(s): We searched
articles on PubMed and Google Scholar, reporting at least one adult
patient with aortic thrombosis on MCS support and where the individual
patient data could be extracted. We grouped the patients by the type of
MCS (temporary or durable), and the type of the AV (prosthetic, surgically
modified, or native) Results: We identified reports on six patients with
aortic thrombus on short-term MCS, and on 41 patients on durable left
ventricular assist devices (LVADs). On temporary MCS, AV thrombus
typically causes no symptoms and is found incidentally pre- or
intra-operatively. For those with durable MCS, the occurrence of aortic
thrombus forming on prosthetic or surgically modified valves appears to be
more related to the intervention on the valve, rather than from the
presence of LVAD. The mortality in this group was 18%. In patients with
native AV on durable LVAD support, 60% of patients presented with acute
myocardial infarction, acute stroke, or acute heart failure, and mortality
in this cohort was 45%. In terms of management, heart transplantation was
most successful. <br/>Conclusion(s): While the outcomes of aortic
thrombosis were good in patients where temporary MCS was used in the
setting of aortic valve surgery, patients with native AV who develop this
complication on durable LVAD have high morbidity and mortality. Cardiac
transplantation should be strongly considered in eligible candidates
because other therapies provide inconsistent results.<br/>Copyright &#xa9;
2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<24>
Accession Number
2024543853
Title
The efficacy of various Enoxaparin dosing regimens in general surgery
patients: A systematic review.
Source
Surgery (United States). (no pagination), 2023. Date of Publication:
2023.
Author
Al Tannir A.H.; Biesboer E.A.; Pokrzywa C.J.; Figueroa J.; Harding E.; de
Moya M.A.; Morris R.S.; Murphy P.B.
Institution
(Al Tannir, Biesboer, Pokrzywa, Figueroa, Harding, de Moya, Morris,
Murphy) Division of Trauma and Acute Care Surgery, Department of Surgery,
Medical College of Wisconsin, Milwaukee, WI, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients undergoing surgical procedures are at an increased
risk of venous thromboembolism events. A fixed Enoxaparin dosing regimen
is the standard of care for chemoprophylaxis in most institutions;
however, breakthrough venous thromboembolism events are still reported. We
aimed to systematically review the literature to determine the ability of
various Enoxaparin dosing regimens to achieve adequate prophylactic
anti-Xa levels for venous thromboembolism prevention in hospitalized
general surgery patients. Additionally, we aimed to assess the correlation
between subprophylactic anti-Xa levels and the development of clinically
significant venous thromboembolism events. <br/>Method(s): A systematic
review was conducted using major databases from January 1, 1993, to
February 17, 2023. Two independent researchers screened titles and
abstracts, followed by a full-text review. Articles were included if
Enoxaparin dosing regimens were evaluated by anti-Xa levels. Exclusion
criteria included systematic reviews, pediatric population, nongeneral
surgery (defined as trauma, orthopedics, plastics, and neurosurgery), and
non-Enoxaparin chemoprophylaxis. The primary outcome was peak Anti-Xa
level measured at steady state concentration. The risk of bias was
assessed using the Risk of Bias in Nonrandomized studies-of Intervention
tool. <br/>Result(s): A total of 6,760 articles were extracted, of which
19 were included in the scoping review. Nine studies included bariatric
patients, whereas 5 studies explored abdominal surgical oncology patients.
Three studies assessed thoracic surgery patients, and 2 studies included
patients undergoing "general surgery" procedures. A total of 1,502
patients were included. The mean age was 47 years, and 38% were males. The
percentages of patients reaching adequate prophylactic anti-Xa levels were
39%, 61%, 15%, 50%, and 78% across the 40 mg daily, 40 mg twice daily, 30
mg twice daily, and weight-tiered, and body mass index-based groups,
respectively. The overall risk of bias was low to moderate.
<br/>Conclusion(s): Fixed Enoxaparin dosing regimens are not correlated
with adequate anti-Xa levels in general surgery patients. Additional
research is warranted to assess the efficacy of dosing regimens based on
novel physiologic parameters (such as estimated blood
volume).<br/>Copyright &#xa9; 2023 Elsevier Inc.

<25>
Accession Number
2023311175
Title
Exploring the link between poor oral hygiene and mesh infection after
hernia repair: a systematic review and proposed best practices.
Source
Hernia. (no pagination), 2023. Date of Publication: 2023.
Author
East B.; Podda M.; Beznoskova-Seydlova M.; de Beaux A.C.
Institution
(East) 3rd Department of Surgery of 1st Faculty of Medicine at Charles
University, Motol University Hospital, Prague, Czechia
(Podda) Department of Surgical Science, Emergency Surgery Unit, University
of Cagliari, Cagliari, Italy
(Beznoskova-Seydlova) Private dentist, Prague, Czechia
(de Beaux) Spire Murrayfield Hospital, Edinburgh and The University of
Edinburgh, Edinburgh, United Kingdom
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Background: There is a reasonable body of evidence around oral/dental
health and implant infection in orthopaedic and cardiovascular surgery.
Another large area of surgical practice associated with a permanent
implant is mesh hernia repair. This study aimed to review the evidence
around oral/dental health and mesh infection. <br/>Method(s): The research
protocol was registered in PROSPERO (CRD42022334530). A systematic review
of the literature was undertaken according to the PRISMA 2020 statement.
The initial search identified 582 publications. A further four papers were
identified from references. After a review by title and abstract, 40
papers were read in full text. Fourteen publications were included in the
final review, and a total of 47,486 patients were included.
<br/>Result(s): There is no published evidence investigating the state of
oral hygiene/health and the risk of mesh infection or other infections in
hernia surgery. Improvement in oral hygiene/health can reduce surgical
site infection and implant infection in colorectal, gastric, liver,
orthopaedic and cardiovascular surgery. Poor oral hygiene/health is
associated with a large increase in oral bacteria and bacteraemia in
everyday activities such as when chewing or brushing teeth. Antibiotic
prophylaxis does not appear to be necessary before invasive dental care in
patients with an implant. <br/>Conclusion(s): Good oral hygiene and oral
health is a strong public health message. The effect of poor oral hygiene
on mesh infection and other complications of mesh hernia repair is
unknown. While research is clearly needed in this area, extrapolating from
evidence in other areas of surgery where implants are used, good oral
hygiene/health should be encouraged amongst hernia patients both prior to
and after their surgery.<br/>Copyright &#xa9; 2023, The Author(s).

<26>
Accession Number
2023036056
Title
Same-day discharge for left atrial appendage occlusion procedure: A
systematic review and meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. 34(5) (pp 1196-1205), 2023.
Date of Publication: May 2023.
Author
Khan J.A.; Parmar M.; Bhamare A.; Agarwal S.; Khosla J.; Liu B.; Abraham
R.; Khan T.; Clifton S.; Munir M.B.; DeSimone C.V.; Deshmukh A.; Po S.;
Stavrakis S.; Asad Z.U.A.
Institution
(Khan, Parmar, Bhamare, Agarwal, Khosla, Khan, Po, Stavrakis, Asad)
Department of Medicine, University of Oklahoma Health Sciences Center,
Oklahoma City, OK, United States
(Liu, Abraham) College of Medicine, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(Clifton) Robert M Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Munir) Section of Electrophysiology, Division of Cardiology, University
of California Davis, Davis, CA, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Most patients undergoing a left atrial appendage occlusion
(LAAO) procedure are admitted for overnight observation. A same-day
discharge strategy offers the opportunity to improve resource utilization
without compromising patient safety. We compared the patient safety
outcomes and post-discharge complications between same-day discharge
versus hospital admission (HA) (>1 day) in patients undergoing LAAO
procedure. <br/>Method(s): A systematic search of MEDLINE and Embase was
conducted. Outcomes of interest included peri-procedural complications,
re-admissions, discharge complications including major bleeding and
vascular complications, ischemic stroke, all-cause mortality, and
peri-device leak >5 mm. Mantel-Haenszel risk ratios (RRs) with 95% CIs
were calculated. <br/>Result(s): A total of seven observational studies
met the inclusion criteria. There was no statistically significant
difference between same-day discharge versus HA regarding readmission (RR:
0.61; 95% confidence interval [CI]: [0.29-1.31]; p =.21), ischemic stroke
after discharge (RR: 1.16; 95% CI: [0.49-2.73]), peri-device leak >5 mm
(RR: 1.27; 95% CI: [0.42-3.85], and all-cause mortality (RR: 0.60; 95% CI:
[0.36-1.02]). The same-day discharge study group had significantly lower
major bleeding or vascular complications (RR: 0.71; 95% CI: [0.54-0.94]).
<br/>Conclusion(s): This meta-analysis of seven observational studies
showed no significant difference in patient safety outcomes and
post-discharge complications between same-day discharge versus HA. These
findings provide a solid basis to perform a randomized control trial to
eliminate any potential confounders.<br/>Copyright &#xa9; 2023 Wiley
Periodicals LLC.

<27>
Accession Number
641350154
Title
Comments on "Effect of Continuous Infusion of Intravenous Nefopam on
Postoperative Opioid Consumption After Video-assisted Thoracic Surgery: A
Double-blind Randomized Controlled Trial".
Source
Pain physician. 26(3) (pp E234-E235), 2023. Date of Publication: 01 May
2023.
Author
Du Y.-T.; Xue F.-S.; Li C.-W.
Institution
(Du) Department of Anesthesiology, Beijing Friendship Hospital, Capital
Medical University, Beijing, China
(Xue, Li) Department of Anesthesiology, Beijing Friendship Hospital,
Capital Medical University, Beijing, China
Publisher
NLM (Medline)

<28>
Accession Number
640510536
Title
Transcatheter Repair for Patients with Tricuspid Regurgitation.
Source
The New England journal of medicine. 388(20) (pp 1833-1842), 2023. Date of
Publication: 18 May 2023.
Author
Sorajja P.; Whisenant B.; Hamid N.; Naik H.; Makkar R.; Tadros P.; Price
M.J.; Singh G.; Fam N.; Kar S.; Schwartz J.G.; Mehta S.; Bae R.; Sekaran
N.; Warner T.; Makar M.; Zorn G.; Spinner E.M.; Trusty P.M.; Benza R.;
Jorde U.; McCarthy P.; Thourani V.; Tang G.H.L.; Hahn R.T.; Adams D.H.
Institution
(Sorajja, Whisenant, Hamid, Naik, Makkar, Tadros, Price, Singh, Fam, Kar,
Schwartz, Mehta, Bae, Sekaran, Warner, Makar, Zorn, Spinner, Trusty,
Benza, Jorde, McCarthy, Thourani, Tang, Hahn, Adams) From Allina Health
Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis
(P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W.,
N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ
(H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.),
Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center,
Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks
(S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in
California; Kansas University Medical Center, Kansas City (P.T., G.Z.);
St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton,
ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC
(J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical
Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and
New York-Presbyterian Columbia University Medical Center (R.T.H.), New
York - all in New York; Northwestern University, Chicago (P.M.); and
Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Severe tricuspid regurgitation is a debilitating condition
that is associated with substantial morbidity and often with poor quality
of life. Decreasing tricuspid regurgitation may reduce symptoms and
improve clinical outcomes in patients with this disease. <br/>METHOD(S):
We conducted a prospective randomized trial of percutaneous tricuspid
transcatheter edge-to-edge repair (TEER) for severe tricuspid
regurgitation. Patients with symptomatic severe tricuspid regurgitation
were enrolled at 65 centers in the United States, Canada, and Europe and
were randomly assigned in a 1:1 ratio to receive either TEER or medical
therapy (control). The primary end point was a hierarchical composite that
included death from any cause or tricuspid-valve surgery; hospitalization
for heart failure; and an improvement in quality of life as measured with
the Kansas City Cardiomyopathy Questionnaire (KCCQ), with an improvement
defined as an increase of at least 15 points in the KCCQ score (range, 0
to 100, with higher scores indicating better quality of life) at the
1-year follow-up. The severity of tricuspid regurgitation and safety were
also assessed. <br/>RESULT(S): A total of 350 patients were enrolled; 175
were assigned to each group. The mean age of the patients was 78 years,
and 54.9% were women. The results for the primary end point favored the
TEER group (win ratio, 1.48; 95% confidence interval, 1.06 to 2.13;
P=0.02). The incidence of death or tricuspid-valve surgery and the rate of
hospitalization for heart failure did not appear to differ between the
groups. The KCCQ quality-of-life score changed by a mean (+/-SD) of
12.3+/-1.8 points in the TEER group, as compared with 0.6+/-1.8 points in
the control group (P<0.001). At 30 days, 87.0% of the patients in the TEER
group and 4.8% of those in the control group had tricuspid regurgitation
of no greater than moderate severity (P<0.001). TEER was found to be safe;
98.3% of the patients who underwent the procedure were free from major
adverse events at 30 days. <br/>CONCLUSION(S): Tricuspid TEER was safe for
patients with severe tricuspid regurgitation, reduced the severity of
tricuspid regurgitation, and was associated with an improvement in quality
of life. (Funded by Abbott; TRILUMINATE Pivotal ClinicalTrials.gov number,
NCT03904147.).<br/>Copyright &#xa9; 2023 Massachusetts Medical Society.

<29>
Accession Number
641357585
Title
The use of surgical pleth index in guiding anesthesia in
gastroenterological surgery.
Source
Acta Anaesthesiologica Scandinavica. Conference: 2022 Scandinavian Society
of Anesthesiology and Intensive Care Medicine Congress, SSAI 2022. Oslo
Norway. 67(4) (pp 506-507), 2023. Date of Publication: April 2023.
Author
Bergman T.; Kalliomaki M.-L.; Sarkela M.; Yli-Hankala A.; Harju J.
Institution
(Bergman, Kalliomaki, Harju) Tampere University Hospital, Tampere, Finland
(Sarkela) GE Healthcare, Helsinki, Finland
(Yli-Hankala) Tampere University, Tampere, Finland
Publisher
John Wiley and Sons Inc
Abstract
Background: The measurement and optimization of intraoperative
antinociceptive medication using Surgical Pleth Index (SPI) could
potentially improve the conduct of anesthesia especially in the elderly
people.¹ <br/>Material(s) and Method(s): Eighty patients (mean
age 69.2 +/- 8.9 years, body mass index 25.9 +/- 3.6, median Charlson
Comorbidity Index 5 [3-6]) were randomized and divided into two groups.
The inclusion criteria were age over 50, ASA classification 1-3, and major
abdominal surgery. Patients with heart rate irregularities were excluded.
Both groups were treated using target controlled infusions of propofol and
remifentanil and monitored with standard monitoring. In the treatment
group, SPI was used to guide remifentanil administration. The time
percentage of hypotension, hypertension, hemodynamic instability
score² and use of anesthetics was compared. <br/>Result(s): The
main findings are described in Table 1. <br/>Conclusion(s): Here the use
of SPI-guided remifentanil administration reduced hypotensive time in
invasively monitored patients, in spite of higher remifentanil
consumption. It may be that right timed control of antinociceptive
medication may balance the conduct of anesthesia thus enhancing the
quality. SPI-guided opioid administration might help for right dosing at
right time, but further research is needed.

<30>
Accession Number
641357421
Title
Abstracts for the 2022 Scandinavian Society of Anesthesiology and
Intensive Care Medicine Congress.
Source
Acta Anaesthesiologica Scandinavica. Conference: 2022 Scandinavian Society
of Anesthesiology and Intensive Care Medicine Congress, SSAI 2022. Oslo
Norway. 67(4) (no pagination), 2023. Date of Publication: April 2023.
Author
Anonymous
Publisher
John Wiley and Sons Inc
Abstract
The proceedings contain 119 papers. The topics discussed include: cerebral
circulatory ultrasound assessment of patients undergoing robotic surgery
in Trendelenburg position (CURT) - results from a pilot study on
intraoperative transcranial doppler monitoring; clear fluid fasting in
pediatric anesthesia - room for improvement!; is general anesthesia for
peripheral vascular surgery correlated with impaired outcome in patients
with cardiovascular comorbidity? a closer look into the nationwide Danish
cohort; preparing for obstetric anesthesia - an educational randomized
controlled trial comparing e-learning to written course material; local
anesthesia in new-borns: concentrations of alpha-1-acid glycoprotein
increase as a response to major surgery; presence of the partner in the
operating room during acute cesarean section. a scoping review;
premedication in pediatric anesthesia in Scandinavian countries; more
efficient handling of elective cesarean sections; and magnesium in
cardiopulmonary bypass priming solution: impact after cardiac surgery.

<31>
Accession Number
641357120
Title
DCD in pediatric transplantation: Our multidisciplinary experience.
Source
Pediatric Transplantation. Conference: 12th Congress of the International
Pediatric Transplant Association, IPTA 2023. Austin, TX United States.
27(Supplement 2) (no pagination), 2023. Date of Publication: March 2023.
Author
Serradilla J.; Andres A.; Sanchez A.; Encinas J.L.; Polo L.; Rocafort A.;
Alcolea A.; Ramos E.; Martinez Urrutia M.J.; Oliveros F.H.
Institution
(Serradilla, Andres, Sanchez, Encinas, Oliveros) Pediatric Surgery,
Hospital Universitario la Paz, Madrid, Spain
(Polo, Rocafort) Cardiovascular Surgery, Hospital Universitario la Paz,
Madrid, Spain
(Alcolea, Ramos) Intestinal Rehabilitation and Transplantation, Hospital
Universitario la Paz, Madrid, Spain
(Martinez Urrutia) Pediatric Urology, Hospital Universitario la Paz,
Madrid, Spain
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Donation after circulatory death (DCD) is a currently
expanding donation modality. Recent improvements in its specific protocols
and the use of normothermic regional perfusion have improved clinical
outcomes in most organs used for DCD. Nevertheless, its application in the
field of pediatric transplantation has taken place progressively after its
acceptance in adults, following more exhaustive and conservative protocols
and conditions. For this reason, reported experiences with DCD in
pediatric transplantation are still very limited. Our aim was to review
our experience using DCD in pediatric transplantation from a
multidisciplinary point of view. <br/>Method(s): Our series of DCD
transplants for pediatric recipients was reviewed, identifying the
transplanted organ as liver, heart, kidney, or intestine. Demographic
variables of donors and recipients were studied, as well as technical and
clinical variables throughout their follow-up. <br/>Result(s): 10 DCD
transplants were performed between 2017 and 2022. We identified 2 cases of
liver transplantation (hepatocarcinoma, Alagille syndrome), 2 of heart
transplantation (dilated cardiomyopathy, transposition of great arteries
with biventricular obstruction), 5 kidneys (nephronophthisis,
nephrocalcinosis, focal segmental glomerulosclerosis, neonatal hypovolemic
shock, Kearnes-Sayre syndrome) and the world's first multivisceral DCD
transplant ((short bowel syndrome due to jejunal atresia and meconium
cyst). Recipients had a median age of 144 months (2-214) and 34.65 kg
(3.4-85.6), while donors had a median age and weight of 15 years (0-39)
and 38 kg (4-60). With a mean follow-up of 10 months (0-65), there have
been two deaths (liver transplant due to Alagille syndrome, heart
transplant due to dilated cardiomyopathy) for early clinical and technical
complications unrelated to the DCD donation modality. The rest of the
patients maintain their graft and function and have not presented any
clinical event of interest, except for mild self-limited cutaneous GVHD in
the case of multivisceral transplantation. <br/>Conclusion(s): DCD
represents a valid source of organs to increase the pool of donors in
pediatric transplantation. Although limited, preliminary data suggest that
its results are not inferior to those obtained from other donation
modalities. Larger series and meta-analyses are needed to establish the
most appropriate conditions for its use in pediatric recipients.

<32>
Accession Number
2024600498
Title
SHORT TERM EFFECTS OF CARDIOPULMONARY REHABILITATION AND NEUROMUSCULAR
ELECTRICAL STIMULATION ON FUNCTIONAL CAPACITY, MYOCARDIAL TISSUE DOPPLER
AFTER CORONARY ARTERY BYPASS GRAFT SURGERY.
Source
Turkish Journal of Physiotherapy and Rehabilitation. 33(2) (pp 32-44),
2022. Date of Publication: 20 Aug 2022.
Author
Ozuberk B.; Kunduracilar Z.; Aslan U.B.; Turan S.A.; Cakir M.O.; Tutun U.
Institution
(Ozuberk) Kirklareli University, Faculty of Health Sciences, Department of
Physiotherapy and Rehabilitation, Kirklareli, Turkey
(Kunduracilar) University of Health Sciences, Hamidiye Faculty of Health
Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
(Aslan) Pamukkale University, Faculty of Health Sciences, Department of
Physiotherapy and Rehabilitation, Denizli, Turkey
(Turan) Zonguldak Bulent Ecevit University, Faculty of Medicine,
Department of Cardiology, Zonguldak, Turkey
(Cakir, Tutun) Zonguldak Bulent Ecevit University, Faculty of Medicine,
Department of Cardiovascular Surgery, Zonguldak, Turkey
Publisher
Turkish Physiotherapy Association
Abstract
Purpose: Exercise capacity is associated with diastolic function. The aim
of our study is to investigate the short-term effects of cardiopulmonary
rehabilitation and NMES on functional capacity and myocardial tissue
doppler (MTD) after coronary artery surgery. <br/>Method(s): Forty
patients with coronary artery bypass graft were randomly divided into two
groups: CPR+NMES and CPR. Functional capacity were analyzed through 2
minutes walk test (2MWT) and sit to stand test (SST), left ventricular
(LV) diastolic functions were analyzed with MTD and thoracic expansion was
analyzed with chest wall measurement on the 2nd and 7th postoperative
days. <br/>Result(s): Statistically significant difference was identified
between the groups in 2MWT distance (CPR+NMES, Zt*p=0.000*), SST (CPR,
Zt*p=0.000*), E' (CPR+NMES, Zt*p=0.002*), E (CPR+NMES, Zt*p=0.025*), E/E'
(CPR+NMES, Zt*p=0.007*), A (CPR, Zt*p=0.006*) (p<0.05). Statistically
significant difference has been observed in group comparisons in E'
(CPR+NMES, G*p=0.000*) ve E/E'(CPR+NMES, G*p=0.007* postoperative 2nd day;
G*p=0.019* postoperative 7th day) (p<0.05). The temporal changes of 2MWT
distance, heart rate, blood pressures, respiratory frequency, saturation
and Borg dyspnea-fatigue measurements did not show a statistically
significant difference between groups (p>0.05), except for
E'(Zg*p=0.000*), E/E' (Zg*p=0.003*) parameters (p<0.05).
<br/>Conclusion(s): It was seen that NMES, which we applied in addition to
early cardiopulmonary rehabilitation, made a positive contribution to LV
filling pressure and LV filling rate in the CPR+NMES group. Additionally,
in the intergroup comparisons of the CPR+NMES group, it was observed that
there was a statistically significant increase in the 2 MWT distance on
the postoperative 7th day compared to the postoperative 2nd
day.<br/>Copyright &#xa9; 2022 Turkish Physiotherapy Association. All
rights reserved.

<33>
[Use Link to view the full text]
Accession Number
2024555691
Title
Efficacy and safety of aprotinin in paediatric cardiac surgery: A
systematic review and meta-analysis.
Source
European Journal of Anaesthesiology. 39(4) (pp 352-367), 2022. Date of
Publication: 01 Apr 2022.
Author
Atasever A.G.; Eerens M.; Van Den Eynde R.; Faraoni D.; Rex S.
Institution
(Atasever, Eerens, Van Den Eynde, Rex) Department of Anaesthesiology,
University Hospitals of the Ku Leuven, Herestraat, Leuven, Belgium
(Faraoni) Arthur S. Keats Division of Paediatric Cardiovascular
Anesthesia, Department of Anesthesiology, Peri-operative and Pain
Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston,
TX, United States
(Rex) Department of Cardiovascular Sciences, Ku Leuven, Herestraat,
Leuven, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The relicensing of aprotinin in Europe and Canada has
stimulated discussions on its usefulness in paediatric cardiac
surgery.OBJECTIVETo systematically evaluate the available evidence on the
efficacy and safety of aprotinin in paediatric cardiac
surgery.DESIGNSystematic review of all randomised and observational
studies comparing aprotinin with tranexamic acid, epsilon aminocaproic
acid, placebo or no drug in paediatric cardiac surgery. Meta-analyses were
performed on efficacy and safety outcomes.DATA SOURCESPubMed, Cochrane
Central Register of Controlled Trials, Web of Science and Embase were
searched from January 2000 to March 2021.ELIGIBILITY CRITERIAStudies that
enrolled children under 18 years undergoing cardiac surgery with
cardiopulmonary bypass.RESULTSThirty-two studies enrolling a total of 63
894 paediatric cardiac procedures were included. Aprotinin significantly
reduced total blood loss [mean difference -4.70 ml kg-1, 95% confidence
interval (CI), -7.88 to -1.53; P = 0.004], postoperative transfusion
requirements and the incidence of surgical re-exploration for bleeding
[odds ratio (OR) 0.74, 95% CI, 0.56 to 0.97; P = 0.03]. Aprotinin had no
effects on 30-day mortality (OR 1.02, 95% CI, 0.93 to 1.11; P = 0.73) and
on other safety outcomes, except for the incidence of renal replacement
therapy (RRT), which was significantly increased in patients given
aprotinin (OR 1.29, 95% CI, 1.08 to 1.54; P = 0.006). Findings from
observational and randomised controlled trials did not largely differ. A
sub-group analysis in neonates showed that aprotinin significantly reduced
packed red blood cell transfusions and the incidence of postoperative
surgical re-exploration for bleeding and/or tamponade. When compared with
lysine analogues, aprotinin was more effective at reducing bleeding and
transfusion without increasing the risk of side effects.CONCLUSIONThis
meta-analysis suggests that aprotinin is effective and well tolerated in
paediatric cardiac surgery. Given the large heterogeneity of the results
and the risk of selection bias in observational studies, large randomised
controlled trials are warranted. <br/>Copyright &#xa9; European Society of
Anaesthesiology and Intensive Care. Unauthorized reproduction of this
article is prohibited.

<34>
[Use Link to view the full text]
Accession Number
2024606435
Title
Comparison of the intraoperative analgesic efficacy between
ultrasound-guided deep and superficial serratus anterior plane block
during video-assisted thoracoscopic lobectomy: A prospective randomized
clinical trial.
Source
Medicine (United States). 99(47) (pp E23214), 2020. Date of Publication:
20 Nov 2020.
Author
Moon S.; Lee J.; Kim H.; Kim J.; Kim S.
Institution
(Moon, Kim) Department of Anesthesiology and Pain Medicine, School of
Medicine, Kyungpook National University, South Korea
(Lee, Kim, Kim) Department of Anesthesiology and Pain Medicine, Yeungnam
University College of Medicine, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Keimyung University
School of Medicine, Daegu, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background:The serratus anterior plane block (SAPB) is a novel method that
provides lateral chest wall analgesia. There are 2 methods of SAPB; deep
and superficial SAPB. Each of these methods has been demonstrated to
provide effective perioperative analgesia in thoracic surgery. The aim of
this study was to compare the intraoperative hemodynamic and analgesic
benefits of deep versus superficial SAPB during video-assisted thoracic
surgery (VATS) lobectomy. <br/>Method(s):We performed a prospective,
randomized, patient/assessor-blinded trial. We included patients who were
20 to 75 years of age and scheduled to undergo VATS lobectomy with
American Society of Anesthesiologists physical status 1 or 2. Patients
were randomly allocated to receive either ultrasound-guided deep SAPB
(Group D) or superficial SAPB (Group S). The primary outcome was
intraoperative remifentanil consumption. We also recorded intraoperative
systolic blood pressure (SBP), heart rate (HR), emergence time, and doses
of rescue drugs used to manage hemodynamic instability.
<br/>Result(s):Data for 50 patients undergoing 3-port VATS lobectomy were
analyzed. Intraoperative remifentanil consumption did not differ
significantly between Group D (n = 25, 715.62 +/- 320.36 mug) and group S
(n = 25, 721.08 +/- 294.48 mug) (P = .97). Additionally, there were no
significant differences between the 2 groups in SBP and HR at any time
point, emergence time, or amount of rescue drugs used.
<br/>Conclusion(s):Our study suggests that the intraoperative analgesic
efficacy is similar for deep and superficial SAPB during VATS lobectomy.
<br/>Copyright &#xa9; 2020 the Author(s). Published by Wolters Kluwer
Health, Inc.

<35>
Accession Number
2023310325
Title
Cost Effectiveness of Strategies to Manage Atrial Fibrillation in Middle-
and High-Income Countries: A Systematic Review.
Source
PharmacoEconomics. (no pagination), 2023. Date of Publication: 2023.
Author
Okafor C.; Byrnes J.; Stewart S.; Scuffham P.; Afoakwah C.
Institution
(Okafor, Byrnes, Scuffham, Afoakwah) Centre for Applied Health Economics,
School of Medicine and Dentistry, Griffith University, 170 Kessels Road,
Nathan, QLD 4111, Australia
(Okafor, Byrnes, Stewart, Scuffham, Afoakwah) Menzies Health Institute
Queensland, Griffith University, Southport, QLD, Australia
(Stewart) Institute for Health Research, University of Notre Dame
Australia, Freemantle, WA, Australia
Publisher
Adis
Abstract
Background: Atrial fibrillation (AF) remains the most common form of
cardiac arrhythmia. Management of AF aims to reduce the risk of stroke,
heart failure and premature mortality via rate or rhythm control. This
study aimed to review the literature on the cost effectiveness of
treatment strategies to manage AF among adults living in low-, middle- and
high-income countries. <br/>Method(s): We searched MEDLINE (OvidSp),
Embase, Web of Science, Cochrane Library, EconLit and Google Scholar for
relevant studies between September 2022 and November 2022. The search
strategy involved medical subject headings or related text words. Data
management and selection was performed using EndNote library. The titles
and abstracts were screened followed by eligibility assessment of full
texts. Selection, assessment of the risk of bias within the studies, and
data extraction were conducted by two independent reviewers. The
cost-effectiveness results were synthesised narratively. The analysis was
performed using Microsoft Excel 365. The incremental cost effectiveness
ratio for each study was adjusted to 2021 USD values. <br/>Result(s):
Fifty studies were included in the analysis after selection and risk of
bias assessment. In high-income countries, apixaban was predominantly cost
effective for stroke prevention in patients at low and moderate risk of
stroke, while left atrial appendage closure (LAAC) was cost effective in
patients at high risk of stroke. Propranolol was the cost-effective choice
for rate control, while catheter ablation and the convergent procedure
were cost-effective strategies in patients with paroxysmal and persistent
AF, respectively. Among the anti-arrhythmic drugs, sotalol was the
cost-effective strategy for rhythm control. In middle-income countries,
apixaban was the cost-effective choice for stroke prevention in patients
at low and moderate risk of stroke while high-dose edoxaban was cost
effective in patients at high risk of stroke. Radiofrequency catheter
ablation was the cost-effective option in rhythm control. No data were
available for low-income countries. <br/>Conclusion(s): This systematic
review has shown that there are several cost-effective strategies to
manage AF in different resource settings. However, the decision to use any
strategy should be guided by objective clinical and economic evidence
supported by sound clinical judgement. Registration:
CRD42022360590.<br/>Copyright &#xa9; 2023, The Author(s).

<36>
Accession Number
2023293965
Title
Whipple's disease-associated infective endocarditis: a systematic review.
Source
Infectious Diseases. (no pagination), 2023. Date of Publication: 2023.
Author
Ioannou P.; Kourtidis M.; Mytilinis D.-O.; Psyllaki A.; Baliou S.;
Kofteridis D.
Institution
(Ioannou, Kofteridis) School of Medicine, University of Crete, Heraklion,
Greece
(Ioannou, Kourtidis, Mytilinis, Psyllaki, Baliou, Kofteridis) Department
of Internal Medicine & Infectious Diseases, University Hospital of
Heraklion, Heraklion, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Whipple's disease is an uncommon chronic systemic disease caused by
Tropheryma whippelii. The most characteristic findings of late Whipple's
disease include diarrhoea, abdominal pain, weight loss, and arthralgias,
however, other clinical findings can occur, including lymphadenopathy,
fever, neurologic manifestations, myocarditis and endocarditis. The aim of
the present study was to systematically review all cases of Whipple's
disease-associated infective endocarditis (IE) in the literature. A
systematic review of PubMed, Scopus, and Cochrane Library (all published
studies up to 28 May 2022) for studies providing data on epidemiology,
clinical characteristics as well as data on treatment and outcomes of
Whipple's disease-associated IE was performed. A total of 72 studies,
containing data for 127 patients, were included. A prosthetic valve was
present in 8% of patients. The aortic valve was the most commonly involved
intracardiac site followed by the mitral valve. Heart failure, embolic
phenomena, and fever were the most common clinical presentations, however,
fever occurred in less than 30% of patients. Sepsis was rarely noted. The
diagnosis was most commonly performed through pathology through positive
PCR or histology in cardiac valves in 88.2% of patients. Trimethoprim with
sulfamethoxazole were the most commonly used antimicrobials followed by
cephalosporins and tetracyclines. Surgery was performed in 84.3% of
patients. Mortality was 9.4%. A multivariate logistic regression analysis
model identified presentation with sepsis or development of a paravalvular
abscess to be independently associated with increased mortality, while
treatment with the combination of trimethoprim with sulfamethoxazole was
independently associated with reduced mortality.<br/>Copyright &#xa9; 2023
Society for Scandinavian Journal of Infectious Diseases.

<37>
Accession Number
641364461
Title
Current Status of Simulation in Thoracic Surgical Training.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 16 May 2023.
Author
Whittaker G.; Ghita I.-A.; Taylor M.; Salmasi M.Y.; Granato F.; Athanasiou
T.
Institution
(Whittaker) Department of Surgery and Cancer, Imperial College London,
London, UK; Department of Cardiothoracic Surgery, Manchester University
NHS Foundation Trust, Manchester, UK
(Ghita) Faculty of Medicine, University of Medicine and Pharmacy of
Craiova, Craiova, Romania
(Taylor, Granato) Department of Cardiothoracic Surgery, Manchester
University NHS Foundation Trust, Manchester, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Simulation is playing an increasingly important role in
surgical training but is not yet a mandatory part of most surgical
curricula. A simulator must undergo rigorous validation to verify it as a
reliable tool. The aim of this study was to review the literature to
identify simulators that are currently available to augment thoracic
surgical training and analyse any evidence supporting or validating them.
<br/>METHOD(S): A literature search of the MEDLINE (1946 to November 2022)
and EMBASE (1947 to November 2022) databases was performed to identify
simulators for basic skills and procedures in thoracic surgery. A
selection of keywords were used to perform the literature search. After
identification of appropriate articles, data were extracted and analysed.
<br/>RESULT(S): Thirty-three simulators were found in thirty-one articles.
Simulators for basic skills (n=13) and thoracic lobectomy (n=13) were most
commonly described, followed by miscellaneous (n=7). The majority of
models were of a hybrid modality (n=18). Evidence of validity was
established in 48.5% (n=16) of simulators. In total, 15.2% (n=5) of
simulators had three or more elements of validity demonstrated and only
3.0% (n=1) accomplished full validation. <br/>CONCLUSION(S): Numerous
simulators of varying modality and fidelity exist for a variety of
thoracic surgical skills and procedures, although validation evidence is
frequently inadequate. Simulation models may be able to provide training
in basic surgical and procedural skills, however further assessment of
validity needs to be undertaken prior to consideration of their
integration into training programmes.<br/>Copyright &#xa9; 2023. Published
by Elsevier Inc.

<38>
Accession Number
2024418148
Title
Effectiveness of pulmonary artery catheter monitoring for patients with
cardiogenic shock of various causes: a systematic review and
meta-analysis.
Source
Journal of Thoracic Disease. 15(3) (pp 1115-1123), 2023. Date of
Publication: March 2023.
Author
Lee J.; Lee J.-B.; Kim A.-R.; Hyun J.; Lee S.-E.; Kim M.-S.
Institution
(Lee, Kim, Hyun, Lee, Kim) Division of Cardiology, Department of Internal
Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Lee) Department of Clinical Epidemiology and Biostatistics, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
Publisher
AME Publishing Company
Abstract
Background: Cardiogenic shock is associated with significant morbidity and
mortality. Invasive hemodynamic monitoring with pulmonary artery
catheterization (PAC) can be useful in the assessment of changes in
cardiac function and hemodynamic status; however, the benefits of PAC in
the management of cardiogenic shock are not known well. <br/>Method(s): We
performed a systematic review and meta-analysis of observational studies
and randomized controlled trials, comparing in-hospital mortality between
PAC and non-PAC groups of cardiogenic shock patients with various
underlying causes. Articles were obtained from MEDLINE, Embase, and
Cochrane CENTRAL. We reviewed titles, abstracts, and full articles and
evaluated the quality of evidence using the GRADE (Grading of
Recommendations, Assessment, Development, and Evaluations) framework. We
used a random-effects model to compare studies in terms of in-hospital
mortality findings. <br/>Result(s): We included twelve articles in our
meta-analysis. Mortality among patients with cardiogenic shock was not
significantly different between the PAC and the non-PAC groups [risk ratio
(RR) 0.86, 95% confidence interval (CI): 0.73-1.02, I²=100%,
P<0.01]. Two studies investigating cardiogenic shock caused by acute
decompensated heart failure determined lower in-hospital mortality in the
PAC group than in the non-PAC group (RR 0.49, 95% CI: 0.28-0.87,
I²=45%, P=0.18). Six studies investigating cardiogenic shock of
any cause determined lower in-hospital mortality in the PAC group than in
the non-PAC group (RR 0.84, 95% CI: 0.72-0.97, I²=99%, P<0.01).
There was no significant difference in in-hospital mortality between the
PAC and non-PAC groups of patients with cardiogenic shock secondary to
acute coronary syndrome (RR 1.01, 95% CI: 0.81-1.25, I²=99%,
P<0.01). <br/>Conclusion(s): Overall, our meta-analysis demonstrated no
significant association between PAC monitoring and in-hospital mortality
among patients managed for cardiogenic shock. The use of PAC in the
management of cardiogenic shock caused by acute decompensated heart
failure was associated with lower in-hospital mortality, but there was no
association between PAC monitoring and in-hospital mortality among
patients with cardiogenic shock caused by acute coronary
syndrome.<br/>Copyright &#xa9; Journal of Thoracic Disease. All rights
reserved.

<39>
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.

<40>
Accession Number
2024175293
Title
Randomized trial of cardiovascular prevention in Norway combining an
in-hospital lifestyle course with primary care follow-up: The Hjerteloftet
study.
Source
European Journal of Preventive Cardiology. 29(17) (pp 2252-2263), 2022.
Date of Publication: 01 Nov 2022.
Author
Bergum H.; Sandven I.; Abdelnoor M.; Anderssen S.A.; Grimsmo J.; Rivrud
D.E.; Myhr N.E.; Vold M.B.; Stenbakken C.; Lidfors B.; Dufseth L.;
Klemsdal T.O.
Institution
(Bergum, Grimsmo, Rivrud, Myhr, Vold, Stenbakken, Lidfors, Dufseth)
Department of Rehabilitation and Lifestyle Medicine, LHL-Hospital
Gardermoen, Postboks 103 Jessheimbyen, Jessheim 2051, Norway
(Bergum) University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway
(Sandven) Oslo Center for Biostatistics and Epidemiology (OCBE), Oslo
University Hospital, Postboks 4950 Nydalen, Oslo 0424, Norway
(Abdelnoor) Epidemiology and Biological Statistics, Independent Health
Research Unit, Nobels gate 5, Oslo 0273, Norway
(Anderssen) Department of Sports Medicine, the Norwegian School of Sports
Sciences, Sognsveien 220, Oslo 0806, Norway
(Klemsdal) Department of Preventive Cardiology, Oslo University Hospital,
Aker, Trondheimsveien 235, Oslo 0586, Norway
Publisher
Oxford University Press
Abstract
Aims Cardiovascular risk factor control is suboptimal in Europe, including
Norway. The present study examined the efficacy of a multimodal primary
prevention intervention programme based on the existing Norwegian health
care system. Methods and results In this open-label randomized controlled
trial, adult patients with elevated cardiovascular risk were randomly
assigned to an intervention programme including a hospital-based lifestyle
course and primary care follow-up or to a control group (CG). The
participants were recruited between 2011 and 2015. Primary outcome was
change in validated cardiovascular risk scores, national and international
(NORRISK, NORRISK 2, Framingham, PROCAM) between baseline and follow-up.
Secondary outcomes included major cardiovascular risk factors. After 36
months the NORRISK score was significantly improved in patients assigned
to the intervention group (IG) compared to patients assigned to the CG;
absolute difference in mean delta score in the IG (n = 305) compared to
mean delta score in the CG (n = 296): -0.92, 95% CI: -1.48 to -0.36, P =
0.001. The results for NORRISK 2, Framingham and PROCAM showed similar
significant effects. The secondary endpoints including total cholesterol
and blood pressure were only minimally, and non-significantly, reduced in
the IG, but the proportion of smokers (P = 0.0028) and with metabolic
syndrome (P < 0.0001) were significantly reduced. A limited number of
cardiovascular events were observed, IG (n = 9), CG (n = 16). Conclusion
In subjects with elevated cardiovascular risk, a newly developed
prevention programme, combining a hospital-based lifestyle course and
primary care follow-up, significantly reduced cardiovascular risk scores
after 36 months. This benefit appeared achievable primarily through
improvements in metabolic syndrome characteristics and smoking habits. The
study protocol was registered in ClinicalTrials.gov
(NCT01741428).<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<41>
Accession Number
2023726250
Title
Prognostic value of post-procedural muQFR for drug-coated balloons in the
treatment of in-stent restenosis.
Source
Cardiology Journal. 30(2) (pp 167-177), 2023. Date of Publication: 17 Apr
2023.
Author
Liu L.; Ding F.; Gutierrez-Chico J.L.; Zhu J.; Zhu Z.; Du R.; Yang Z.; Hu
J.; Tu S.; Zhang R.
Institution
(Liu, Ding, Gutierrez-Chico, Zhu, Zhu, Du, Yang, Hu, Zhang) Department of
Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University
School of Medicine, Shanghai, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
Publisher
Via Medica
Abstract
Background: Investigating the prognostic value of the Murray law-based
quantitative flow ratio (muQFR) on the clinical outcome after treatment of
in-stent restenosis (ISR) with a drug-coated balloon (DCB).
<br/>Method(s): Patients participating in a previous randomized clinical
trial for DCB-ISR were post-hoc analyzed. The primary endpoint was
vessel-oriented composite endpoint (VOCE), defined as cardiac death,
target vessel-related myocardial infarction, and ischemia-driven target
vessel revascularization. muQFRs at baseline and after DCB angioplasty was
calculated, and its prognostic value as a predictor of VOCE was explored
in Cox regression. <br/>Result(s): A total of 169 lesions in 169 patients
were analyzed. At 1-year follow-up, 20 VOCEs occurred in 20 patients.
Receiver-operating characteristic curve analysis identified a
post-procedural muQFR of <= 0.89 as the best cut-off to predict VOCE (area
under curve [AUC]: 0.74; 95% confidence interval [CI]: 0.67-0.80; p <
0.001), superior to post-procedural in-stent percent diameter stenosis,
which reported an AUC of 0.61 (95% CI: 0.53-0.68; p = 0.18).
Post-procedural muQFR was significantly lower in patients with VOCE
compared with those without (0.88 [interquartile range: 0.79-0.94] vs.
0.96 [interquartile range: 0.91-0.98], respectively; p < 0.001). After
correction for potential confounders, post-procedural muQFR <= 0.89 was
associated with a 6-fold higher risk of VOCE than lesions with muQFR >
0.89 (hazard ratio: 5.94; 95% CI: 2.33-15.09; p < 0.001).
<br/>Conclusion(s): Post-procedural muQFR may become a promising predictor
of clinical outcome after treat-ment of DES-ISR lesions by DCB
angioplasty.<br/>Copyright &#xa9; 2023 Via Medica.

<42>
Accession Number
2022325747
Title
Coaptation Length as Predictor of Recurrent Mitral Regurgitation After
Surgical Repair for Degenerative Mitral Valve Disease: Meta-Analysis of
Reconstructed Time-to-Event Data.
Source
Structural Heart. 7(3) (no pagination), 2023. Article Number: 100152. Date
of Publication: May 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Erten O.; Caldonazo T.; Doenst
T.; Marin-Cuartas M.; Borger M.A.; Clavel M.-A.; Pibarot P.; Rodriguez R.;
Ramlawi B.; Goldman S.
Institution
(Sa, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic Surgery,
Lankenau Heart Institute, Lankenau Medical Center, Main Line Health,
Wynnewood, PA, United States
(Sa, Erten, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena, Germany
(Marin-Cuartas, Borger) University Department of Cardiac Surgery, Leipzig
Heart Center, Leipzig, Germany
(Clavel, Pibarot) University Institute of Cardiology and Pulmonology of
Quebec - Laval University, Quebec City, Quebec, Canada
Publisher
Cardiovascular Research Foundation

<43>
[Use Link to view the full text]
Accession Number
2024544067
Title
Transcatheter Aortic Valve Replacement in Patients with Reduced Ejection
Fraction and Nonsevere Aortic Stenosis.
Source
Circulation: Cardiovascular Interventions. 16(5) (no pagination), 2023.
Article Number: e012768. Date of Publication: 01 May 2023.
Author
Ludwig S.; Schofer N.; Abdel-Wahab M.; Urena M.; Jean G.; Renker M.; Hamm
C.W.; Thiele H.; Iung B.; Ooms J.F.; Wiessman M.; Mogensen N.S.B.; Longere
B.; Perrin N.; Ben Ali W.; Coisne A.; Dahl J.S.; Van Mieghem N.M.;
Kornowski R.; Kim W.-K.; Clavel M.-A.
Institution
(Ludwig, Schofer) Department of Cardiology, University Heart and Vascular
Center, Hamburg, Germany
(Ludwig, Schofer) German Center for Cardiovascular Research, DZHK, Partner
Site Hamburg/Kiel/Lubeck, Germany
(Ludwig, Schofer) Cardiovascular Research Foundation, NY, United States
(Abdel-Wahab, Thiele) Heart Center Leipzig, University of Leipzig,
Department of Internal Medicine/Cardiology, Germany
(Urena, Longere) Department of Cardiology, Bichat-Claude Bernard Hospital,
Paris, France
(Jean, Clavel) Institut Universitaire de Cardiologie et de Pneumologie,
Universite Laval, Quebec, Canada
(Renker, Hamm, Kim) Department for Cardiology, Kerckhoff Heart Center, Bad
Nauheim, Germany
(Ooms, Van Mieghem) Department of Cardiology, Erasmus University Medical
Center, Rotterdam, Netherlands
(Wiessman, Kornowski) Department of Cardiology, Rabin Medical Center,
Tel-Aviv University, Israel
(Mogensen, Dahl) Department of Cardiology, Odense University Hospital,
Denmark
(Coisne) Universite Lille, Inserm, Centre Hospitalier Universitaire de
Lille, France
(Perrin, Ben Ali) Structural Valve Program, Montreal Heart Institute,
Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The potential benefit of transcatheter aortic valve
replacement (TAVR) in patients with nonsevere aortic stenosis (AS) and
heart failure is controversial. This study aimed to assess outcomes of
patients with nonsevere low-gradient AS (LGAS) and reduced left
ventricular ejection fraction undergoing TAVR or medical management.
<br/>Method(s): Patients undergoing TAVR for LGAS and reduced left
ventricular ejection fraction (<50%) were included in a multinational
registry. True-severe low-gradient AS (TS-LGAS) and pseudo-severe
low-gradient AS (PS-LGAS) were classified according to computed
tomography-derived aortic valve calcification thresholds. A medical
control group with reduced left ventricular ejection fraction and moderate
AS or PS-LGAS was used (Medical-Mod). Adjusted outcomes between all groups
were compared. Among patients with nonsevere AS (moderate or PS-LGAS),
outcomes after TAVR and medical therapy were compared using propensity
score-matching. <br/>Result(s): A total of 706 LGAS patients undergoing
TAVR (TS-LGAS, N=527; PS-LGAS, N=179) and 470 Medical-Mod patients were
included. After adjustment, both TAVR groups showed superior survival
compared with Medical-Mod patients (all P<0.001), while no difference was
found between TS-LGAS and PS-LGAS TAVR patients (P=0.96). After propensity
score-matching among patients with nonsevere AS, PS-LGAS TAVR patients
showed superior 2-year overall (65.4%) and cardiovascular survival (80.4%)
compared with Medical-Mod patients (48.8% and 58.5%, both P<=0.004). In a
multivariable analysis including all patients with nonsevere AS, TAVR was
an independent predictor of survival (hazard ratio, 0.39 [95% CI,
0.27-0.55]; P<0.0001). <br/>Conclusion(s): Among patients with nonsevere
AS and reduced left ventricular ejection fraction, TAVR represents a major
predictor of superior survival. These results reinforce the need for
randomized-controlled trials comparing TAVR versus medical management in
heart failure patients with nonsevere AS. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04914481.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<44>
Accession Number
641122790
Title
Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in
Noncardiac Surgery : An International Randomized Controlled Trial.
Source
Annals of internal medicine. 176(5) (pp 605-614), 2023. Date of
Publication: 01 May 2023.
Author
Marcucci M.; Painter T.W.; Conen D.; Lomivorotov V.; Sessler D.I.; Chan
M.T.V.; Borges F.K.; Leslie K.; Duceppe E.; Martinez-Zapata M.J.; Wang
C.Y.; Xavier D.; Ofori S.N.; Wang M.K.; Efremov S.; Landoni G.;
Kleinlugtenbelt Y.V.; Szczeklik W.; Schmartz D.; Garg A.X.; Short T.G.;
Wittmann M.; Meyhoff C.S.; Amir M.; Torres D.; Patel A.; Ruetzler K.;
Parlow J.L.; Tandon V.; Fleischmann E.; Polanczyk C.A.; Lamy A.; Jayaram
R.; Astrakov S.V.; Wu W.K.K.; Cheong C.C.; Ayad S.; Kirov M.; de Nadal M.;
Likhvantsev V.V.; Paniagua P.; Aguado H.J.; Maheshwari K.; Whitlock R.P.;
McGillion M.H.; Vincent J.; Copland I.; Balasubramanian K.; Biccard B.M.;
Srinathan S.; Ismoilov S.; Pettit S.; Stillo D.; Kurz A.; Belley-Cote
E.P.; Spence J.; McIntyre W.F.; Bangdiwala S.I.; Guyatt G.; Yusuf S.;
Devereaux P.J.
Institution
(Marcucci, Conen, Borges, Ofori, Wang, Lamy, Whitlock, McGillion, Vincent,
Copland, Balasubramanian, Pettit, Stillo, Belley-Cote, Spence, McIntyre,
Bangdiwala, Yusuf, Devereaux) Population Health Research Institute,
Hamilton, Ontario, Canada (M.M., D.C., F.K.B., S.N.O., M.K.W., A.L.,
R.P.W., M.H.M., J.V., I.C., K.B., S.P., D.S., E.P.B., J.S., W.F.M.,
S.I.B., S.Y., P.J.D.)
(Painter) Acute Care Medicine, University of Adelaide, Adelaide, SA,
Australia
(Lomivorotov, Ismoilov) Department of Anesthesiology and Intensive Care,
E. Meshalkin National Medical Research Centre, Novosibirsk, Russian
Federation
(Sessler, Ruetzler, Ayad, Maheshwari, Kurz) Anesthesiology Institute,
Department of Outcomes Research, Cleveland Clinic, K.M., Cleveland, S.A,
United States
(Chan, Wu) Chinese University of Hong Kong, Hong Kong Special
Administrative Region, China (M.T.V.C., China
(Leslie) Department of Critical Care Medicine, Melbourne Medical School,
University of Melbourne, Melbourne, VIC, United Kingdom
(Duceppe) Department of Medicine, Centre Hospitalier de l'Universite de
Montreal, Montreal, QC, Canada
(Martinez-Zapata) Iberoamerican Cochrane Centre, Public Health and
Clinical Epidemiology Service, IIB Sant Pau, CIBERESP, Barcelona,
Philippines
(Wang, Cheong) Department of Anesthesiology, Faculty of Medicine,
University of Malaya, Kuala Lumpur, Malaysia
(Xavier) St. John's Medical College, Bangalore
(Efremov) Saint Petersburg State University Hospital, Saint Petersburg,
United States
(Landoni) Department of Anesthesiology and Intensive Care, IRCCS San
Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan,
United States
(Kleinlugtenbelt) Department of Orthopedic and Trauma Surgery, Deventer
Ziekenhuis, Deventer, Netherlands
(Szczeklik) Centre for Intensive Care and Perioperative Medicine,
Jagiellonian University Medical College, Poland (W.S.), Krakow, Poland
(Schmartz) CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium
(Garg) Department of Medicine, Western University, London, ON, Canada
(Short) Department of Anaesthesia, Auckland City Hospital, Auckland, New
Zealand
(Wittmann) Department of Anesthesiology and Intensive Care Medicine,
University Hospital Bonn, Germany (M.W.), Bonn, Germany
(Meyhoff) Department of Anesthesia and Intensive Care, Copenhagen
University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Amir) Department of Surgery, Shifa International Hospital and Shifa
Tameer-e-Millat University, Islamabad, Pakistan
(Torres) Departamento de Epidemiologia y Estudios en Salud, Universidad de
Los Andes, Santiago, Dominican Republic
(Patel, Tandon) Department of Medicine, McMaster University, Hamilton,
Ontario, Canada (A.P., V.T.)
(Parlow) Department of Anesthesiology and Perioperative Medicine, Queen's
University, and Kingston Health Sciences Centre, Kingston, Ontario, Canada
(J.L.P.)
(Fleischmann) Department of Anesthesia, Intensive Care Medicine and Pain
Medicine, Medical University of Vienna, Vienna, Austria
(Polanczyk) UFRGS, Hospital de Clinicas de Porto Alegre, National
Institute for Health Technology Assessment, IATS; Hospital Moinhos de
Vento, Porto Alegre, Brazil (C.A.P.)
(Jayaram) Department of Anaesthetics, Clinical Neurosciences, University
of Oxford, Oxford University Hospitals NHS Trust, United Kingdom (R.J.),
Oxford, United Kingdom
(Astrakov) Department of Anesthesiology, Novosibirsk State University,
Novosibirsk, Russian Federation
(Kirov) Department of Anesthesiology and Intensive Care Medicine, Northern
State Medical University, Russian Federation
(de Nadal) Department of Anesthesiology and Intensive Care, Hospital Vall
d'Hebron, Universitat Autonoma de Barcelona, Spain (M. de N.), Barcelona,
Philippines
(Likhvantsev) V. Negovsky Reanimatology Research Institute, Moscow,
Russian Federation
(Paniagua) Anesthesiology Department, Santa Creu i Sant Pau University
Hospital, Barcelona, Philippines
(Aguado) Trauma & Orthopaedic Surgery Department, Hospital Clinico
Universitario de Valladolid, Valladolid, Mexico
(Biccard) Department of Anesthesia and Perioperative Medicine, Groote
Schuur Hospital, University of Cape Town, South Africa (B.M.B.), Cape
Town, South Africa
(Srinathan) Section of Thoracic Surgery, Department of Surgery, University
of Manitoba, Winnipeg, MB, Canada
(Guyatt) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada (G.G.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Among patients having noncardiac surgery, perioperative
hemodynamic abnormalities are associated with vascular complications.
Uncertainty remains about what intraoperative blood pressure to target and
how to manage long-term antihypertensive medications perioperatively.
<br/>OBJECTIVE(S): To compare the effects of a hypotension-avoidance and a
hypertension-avoidance strategy on major vascular complications after
noncardiac surgery. DESIGN: Partial factorial randomized trial of 2
perioperative blood pressure management strategies (reported here) and
tranexamic acid versus placebo. (ClinicalTrials.gov: NCT03505723).
SETTING: 110 hospitals in 22 countries. PATIENTS: 7490 patients having
noncardiac surgery who were at risk for vascular complications and were
receiving 1 or more long-term antihypertensive medications. INTERVENTION:
In the hypotension-avoidance strategy group, the intraoperative mean
arterial pressure target was 80mm Hg or greater; before and for 2days
after surgery, renin-angiotensin-aldosterone system inhibitors were
withheld and the other long-term antihypertensive medications were
administered only for systolic blood pressures 130mm Hg or greater,
following an algorithm. In the hypertension-avoidance strategy group, the
intraoperative mean arterial pressure target was 60mm Hg or greater; all
antihypertensive medications were continued before and after surgery.
MEASUREMENTS: The primary outcome was a composite of vascular death and
nonfatal myocardial injury after noncardiac surgery, stroke, and cardiac
arrest at 30days. Outcome adjudicators were masked to treatment
assignment. <br/>RESULT(S): The primary outcome occurred in 520 of 3742
patients (13.9%) in the hypotension-avoidance group and in 524 of 3748
patients (14.0%) in the hypertension-avoidance group (hazard ratio, 0.99
[95% CI, 0.88 to 1.12]; P =0.92). Results were consistent for patients who
used 1 or more than 1 antihypertensive medication in the long term.
LIMITATION: Adherence to the assigned strategies was suboptimal; however,
results were consistent across different adherence levels.
<br/>CONCLUSION(S): In patients having noncardiac surgery, our
hypotension-avoidance and hypertension-avoidance strategies resulted in a
similar incidence of major vascular complications. PRIMARY FUNDING SOURCE:
Canadian Institutes of Health Research, National Health and Medical
Research Council (Australia), and Research Grant Council of Hong Kong.

<45>
Accession Number
638090424
Title
Does Down syndrome influence the outcomes of congenital cardiac surgery? A
systematic review and meta-analysis.
Source
European heart journal. Quality of care & clinical outcomes. 9(3) (pp
240-248), 2023. Date of Publication: 26 Apr 2023.
Author
Wang B.; Verrocchi J.; Liew D.; Zentner D.
Institution
(Wang, Zentner) Cardiology Department, The Royal Melbourne Hospital, 300
Grattan St, Parkville, VIC 3050, Australia
(Verrocchi) Monash Medical Centre, Monash Health, Clayton, VIC 3168,
Australia
(Liew) Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, VIC 3004, Australia
(Zentner) Department of Medicine, University of Melbourne, Parkville, VIC
3010, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Congenital cardiac surgery for individuals with Down syndrome
(DS) has historically occurred at a reduced frequency. Little data are
available regarding long-term post-congenital cardiac surgical outcomes.
Limited sample sizes and clinical heterogeneity require a pooled analysis
approach. AIMS: To compare long-term outcomes post-congenital heart
surgery between adults with and without DS. <br/>METHOD(S): Databases
(Medline, Embase, and PubMed) were searched utilizing terms related to DS
and congenital heart disease.Studies that enrolled adults (>18 years) with
operated congenital heart disease and compared long-term outcomes with
respect to DS presence were included. All study designs were included, but
those with limited/peri-operative follow-up, non-English texts, case
studies, and literature reviews were excluded.Blinded screening, data
extraction, and quality assessment were independently conducted by two
reviewers. QUIPS criteria were used for risk of bias analysis. Both
random- and fixed-effects models were used for meta-analysis.
<br/>RESULT(S): A total of 23 studies (n = 10 466) were included. Risk of
bias was frequently high due to unblinded retrospective study designs and
analyses limited in adjustment for other prognostic factors.Meta-analysis
demonstrated no effect of DS on long-term mortality [hazard ratio (HR)
0.86, 95% confidence interval (95% CI) 0.6-1.23], to a maximum described
follow-up of 38 years. Lower cardiac reoperation risk (HR 0.6, 95% CI
0.46-0.78) for individuals with DS was found on pooled analysis.
Meta-analysis was limited by between-study variation. <br/>CONCLUSION(S):
DS does not affect post-congenital cardiac surgical survival in adulthood.
Reduced reoperation may reflect challenges in assessing functional and
symptomatic status and/or concerns regarding perceived reoperation
difficulties or likely benefits.<br/>Copyright &#xa9; The Author(s) 2022.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<46>
Accession Number
2023822362
Title
Safety and Perioperative Outcomes After Drainless Video Assisted
Thoracoscopic Surgery.
Source
NeuroQuantology. 21(5) (pp 1854-1868), 2023. Date of Publication: 2023.
Author
El-Sharawy M.; Shemais D.S.; Brik A.; Ahmady I.; Alanwar M.
Institution
(El-Sharawy, Shemais, Brik, Ahmady, Alanwar) Cardiothoracic surgery
Department, Faculty of Medicine, Zagazig University, Egypt
Publisher
Anka Publishers
Abstract
Background: Drainless minimally invasive Video-assisted thoracoscopic
surgery (VATS) has become a milestone approach for surgery in many
thoracic procedures with favorable results on perioperative outcomes.
<br/>Objective(s): to assess safety and perioperative outcomes of
drainless VATS among eligible selected patients Methods: This randomized
controlled clinical trial was carried out on 24 randomly selected eligible
patients, and fulfilling the inclusion and exclusion criteria for
drainless VATS, they were randomly assigned into two groups:
Group-I(drainless group): including 12 patients undergoing VATS with intra
operative omitting of chest tube drainage after an air leakage test,
Group-II (Drainage group): including 12 patients undergoing VATS with
conventional treatment using standard chest tube drainage. <br/>Result(s):
Patient among drainless VATS group-I had short operation time(116.0), less
total average post operative pain score per day(1.66) and also short
postoperative duration of hospital stay (1.0 days) compared to (139.0,
4.83 and also 3.5days among those in the drainage VATS group-II,
(P<0.05)respectively. Drainless Uniportal VATS procedure significantly
consumed the least operation time (85.0&5 minutes)in between studied
patient of both groups and within each separate group, (P<0.05)
respectively. <br/>Conclusion(s): Omitting chest tube drainage after VATS
is feasible in eligible selected patients and improve its efficacy, safety
and perioperative outcomes (postoperative pain, early ambulation, length
of hospital stay, and the risk of perioperative complications), and
drainless U-VATS should be considered the preferred approach in minimally
invasive surgery that opens up for the possibility of fast track chest
surgery.<br/>Copyright &#xa9; 2023, Anka Publishers. All rights reserved.

<47>
[Use Link to view the full text]
Accession Number
2024544257
Title
The Thresholds of Caprini Score Associated with Increased Risk of Venous
Thromboembolism Across Different Specialties: A Systematic Review.
Source
Annals of Surgery. 277(6) (pp 929-937), 2023. Date of Publication: 01 Jun
2023.
Author
Lobastov K.; Urbanek T.; Stepanov E.; Lal B.K.; Marangoni J.; Krauss E.S.;
Cronin M.; Dengler N.; Segal A.; Welch H.J.; Gianesini S.; Chen X.;
Caprini J.A.
Institution
(Lobastov, Stepanov) Pirogov Russian National Research Medical University,
Moscow, Russian Federation
(Urbanek) Medical University of Silesia, Katowice, Poland
(Lal) University of Maryland School of Medicine, Baltimore, MD, United
States
(Marangoni) Legacy Good Samaritan Medical Center, Portland, OR, United
States
(Krauss, Cronin, Dengler, Segal) Department of Orthopaedic Surgery,
Syosset Hospital, Northwell Health, Syosset, NY, United States
(Welch) Division of Vascular Surgery, Lahey Hospital and Medical Center,
Burlington, MA, United States
(Gianesini) University of Ferrara, Ferrara, Italy
(Chen) Department of Respiratory and Critical Care Medicine, Beijing
Shijitan Hospital, Capital Medical University, Beijing, China
(Caprini) Pritzker School of Medicine, Chicago, IL, United States
Publisher
Wolters Kluwer Health
Abstract
Objective: Estimation of the specific thresholds of the Caprini risk score
(CRS) that are associated with the increased incidence of venous
thromboembolism (VTE) across different specialties, including identifying
the highest level of risk. <br/>Background(s): Accurate risk assessment
remains an important but often challenging aspect of VTE prophylaxis. One
well-established risk assessment model is CRS, which has been validated in
thousands of patients from many different medical and surgical
specialties. <br/>Method(s): A search of MEDLINE and the Cochrane Library
was performed in March 2022. Manuscripts that reported on (1) patients
admitted to medical or surgical departments and (2) had their VTE risk
assessed by CRS and (3) reported on the correlation between the score and
VTE incidence, were included in the analysis. <br/>Result(s): A total of
4562 references were identified, and the full text of 202 papers was
assessed for eligibility. The correlation between CRS and VTE incidence
was reported in 68 studies that enrolled 4,207,895 patients. In all
specialties, a significant increase in VTE incidence was observed in
patients with a CRS of >=5. In most specialties thresholds of >=7, >=9,
and >=11 to 12 were associated with dramatically increased incidences of
VTE. In COVID-19, cancer, trauma, vascular, general, head and neck, and
thoracic surgery patients with >=9 and >=11 to 12 scores the VTE incidence
was extremely high (ranging from 13% to 47%). <br/>Conclusion(s): The
Caprini score is being used increasingly to predict VTE in many medical
and surgical specialties. In most cases, the VTE risk for individual
patients increases dramatically at a threshold CRS of 7 to
11.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All rights
reserved.

<48>
Accession Number
2024542467
Title
Effects of glargine on hyperglycemia in patients with diabetes mellitus
type II undergoing off-pump coronary artery bypass graft: A randomized,
controlled, double-blind clinical trial.
Source
Journal of Cardiovascular and Thoracic Research. 15(1) (pp 44-50), 2023.
Date of Publication: March 2023.
Author
Sheybani S.; Kahrom M.; Ganjali R.; Kalati S.M.; Zirak N.; Ghorani V.
Institution
(Sheybani, Zirak) Department of Anesthesiology, Faculty of Medicine,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Kahrom) Department of Cardiovascular Surgery, Faculty of Medicine,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Ganjali, Ghorani) Clinical Research Development Unit, Imam Reza Hospital,
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad,
Iran, Islamic Republic of
(Kalati) Department of Anesthesiology, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: In this trial, effects of glargine on hyperglycemia in
patients with diabetes mellitus type II who were undergoing off-pump
coronary artery bypass graft (CAGB), were examined. <br/>Method(s):
Seventy diabetic patients who were candidate for off-pump CABG were
randomly divided into the following two groups (1) Control group who were
treated with normal saline + regular insulin and (2) Glargine group who
received glargine + regular insulin. Normal saline and glargine were
administered subcutaneously 2 hours before surgery, and regular insulin
was injected before, during and after the surgery in the intensive care
unit (ICU) in both groups. Finally, levels of blood sugar before, 2 hours
after starting the surgery and at the end of the surgery, were recorded.
Blood sugar levels during ICU stay were also measured every 4 hours for 36
hours. <br/>Result(s): There were no significant differences in blood
sugar levels between the groups at the three time points (i.e. before, 2
hours after starting the surgery and at the end of the surgery). In
addition, during 36 hours of ICU stay, blood sugar levels did not show
significant variations between the groups; however, 20 hours after ICU
admission, blood sugar level was significantly higher in the glargine
group (P= 0.04). <br/>Conclusion(s): The results indicated that both
glargine and regular insulin effectively control the blood glucose in
diabetic patients undergoing CABG. However, the blood sugar fluctuation
was less in the glargine group than control group.<br/>Copyright &#xa9;
2023 The Author(s).

<49>
Accession Number
2024487736
Title
Value of retrograde pulmonary vein perfusion combined with pulmonary
artery thrombectomy in acute pulmonary embolism: A protocol for a
systematic review and meta-Analysis.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e069685. Date of
Publication: 05 May 2023.
Author
Xiang J.; He L.; Peng T.; Liang W.; Wei S.
Institution
(Xiang, Peng, Liang, Wei) Department of Cardiovascular Surgery, Affiliated
Hospital of North Sichuan Medical College, Sichuan, Nanchong, China
(He) Department of Paediatrics, Affiliated Hospital of North Sichuan
Medical College, Sichuan, Nanchong, China
Publisher
BMJ Publishing Group
Abstract
Introduction Acute pulmonary embolism is a serious cardiovascular disease
with high mortality. Surgery is an important therapeutic means. The
traditional surgical method is pulmonary artery embolectomy with
cardiopulmonary bypass, but there is a certain recurrence rate after
surgery. Some scholars use retrograde pulmonary vein perfusion as an
adjunct to conventional pulmonary artery embolectomy. However, whether
this method can be used safely for acute pulmonary embolism and its
long-Term effects remains unclear. Therefore, we plan to conduct a
systematic review and meta-Analysis to investigate whether retrograde
pulmonary vein perfusion combined with pulmonary artery thrombectomy can
be safely used in acute pulmonary embolism. Methods and analysis We will
search key databases (Ovid MEDLINE, PubMed, Web of Science, Cochrane
Library, China Science and Technology Journals and Wanfang) for studies on
acute pulmonary embolism treated with retrograde pulmonary vein perfusion
from January 2002 to December 2022. The useful information will be
consolidated into a piloting spreadsheet. The Cochrane Risk of Bias Tool
will be used to assess the bias. Data will be synthesised and
heterogeneity will be evaluated. The dichotomous variables will be
determined by using risk ratio with 95% CI, and weighted mean differences
(with 95% CI) or standardised mean differences (95% CI) will be used for
continuous variables. S 2 test and I 2 test will be used to assess the
statistical heterogeneity. Meta-Analysis will be conducted when strong
homogeneous data are accessible. Ethics and dissemination Approval of the
ethics committee is not needed for this review. While results will be
disseminated electronically, effective dissemination will be done through
presentations and peer-reviewed publication. PROSPERO registration number
CRD42022345812; pre-results. <br/>Copyright &#xa9; 2023 BMJ Publishing
Group. All rights reserved.

<50>
Accession Number
2024487731
Title
Atorvastatin and the influence on postoperative atrial fibrillation after
surgical aortic valve replacement (STARC) in adults at Odense University
Hospital, Denmark: Study protocol for a randomised controlled trial.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e069595. Date of
Publication: 10 May 2023.
Author
Krasniqi L.; Brandes A.; Mortensen P.E.; Dahl J.S.; Gerke O.; Ali M.;
Riber L.P.S.
Institution
(Krasniqi, Mortensen, Riber) Department of Cardiac, Thoracic and Vascular
Surgery, Odense University Hospital, Odense, Denmark
(Krasniqi, Brandes, Dahl, Gerke, Ali, Riber) Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
(Brandes) Cardiology, University of Southern Denmark, Campus Esbjerg,
Esbjerg, Denmark
(Brandes, Dahl, Ali) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Gerke) Department of Nuclear Medicine, Odense University Hospital,
Odense, Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction Atrial fibrillation (AF) is the most common postoperative
complication after surgical aortic valve replacement (SAVR) and occurs in
up to 50% of the patients. Development of postoperative AF (POAF) is
associated with a 2-3 fold increased risk of adverse events, including
stroke, myocardial infarction and death. Several studies have implied that
prophylactic Atorvastatin therapy could prevent POAF in patients
undergoing coronary artery bypass graft. These studies suggest that
Atorvastatin has rapid and significant pleiotropic actions that reduce the
risk of POAF. However, prophylactic treatment with statins has yet to be
understood in SAVR. The aim of this study is to investigate whether
prophylactic administration of torvastatin reduces POAF in patients
undergoing SAVR. Methods and analysis In this investigator-initiated,
prospective, parallel-group, randomised, double-blind, placebo-controlled
single-centre trial, 266 patients undergoing elective solitary SAVR with
bioprosthetic valve, with no prior history of AF, and statin-naive will be
randomised (1:1) to treatment with Atorvastatin (80 mg once daily) or
matching placebo for 1-2 weeks prior to and 30 days after surgery. The
primary endpoint is POAF defined as an episode of irregular RR-intervals
without a traceable p-wave of at least 30 s duration. After discharge and
until day 30 after surgery, POAF will be documented by either rhythm strip
or 12-lead ECG. Ethics and dissemination Protocol approval has been
obtained from the Regional Scientific Ethical Committee for Southern
Denmark (S-20210159), The Danish Medicines Agency (2021103821) and the
Data Protection Agency (21/65621). The trial is conducted in accordance
with the Declaration of Helsinki, the ICH-GCP (International Conference on
Harmonisation Good Clinical Practice) guidelines and the legal regulations
of Denmark. Study findings will be shared via peer-reviewed journal
publication and conference presentations. Trial registration number
NCT05076019. <br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<51>
Accession Number
2023042370
Title
Comparison between levosimendan versus beta agonists in preservation of
renal function in cardiac surgery patients with low cardiac output
syndrome.
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 384-394), 2023. Date of
Publication: 2023.
Author
Elkhattab S.O.; Mustafa Z.A.; Kamal M.M.; Hassab G.S.A.
Institution
(Elkhattab, Mustafa, Kamal, Hassab) Department of Anesthesia, Intensive
Care and Pain Management, Faculty of Medicine, Ain Shams Universitc,
Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Post cardiac surgery acute kidney injury (AKI) secondary to
postoperative low cardiac output syndrome (LCOS), is a serious
complication. Positive inotropic agents are the main line of treatment for
LCOS with different degrees of improvement of cardiac function &
nephroprotective efficacy Levosimendan is a calcium sensitizer in cardiac
muscles, which has a comparable positive inotropic and nephroprotective
effects to that of classic beta2 agonists. <br/>Objective(s): To evaluate
the possible nephroprotective effect of levosimendan as compared to beta
agonists in cardiac surgery patients with LCOS. <br/>Patients and Methods:
It is a prospective, randomized and comparative study conducted at Ain
Shams University Hospitals over the period from December 2020 to May 2021.
A total of 60 patients with post cardiac surgery low cardiac output
syndrome were divided into two groups of 30 patients each. Group A
(control) received beta-agonists (dobutamine or adrenaline) and Group B
(study) received levosimendan. The incidence of AKI at the diagnosis of
LCOS & its progression to renal failure in both groups were assessed.
<br/>Result(s): The incidence of AKI at diagnosis of LCOS postoperative
was 30% (n = 9) in each group; 44% of them in the control group (n = 4)
developed renal failure at discharge from ICU and none of the study group
patients developed renal failure at discharge. At the time of discharge
from ICU, the incidence of renal failure in beta-agonist group was 13.3%,
while the incidence in the levosimendan group was 0% with statistically
significant P value of 0.038. <br/>Conclusion(s): In comparison to
beta-agonists, Levosimendan may have a better nephroprotective effect that
plays a role in decreasing the incidence of kidney failure in patients
with post cardiac surgery LCOS. A larger randomized, controlled trials are
recommended to prove such a beneficial nephroprotective effect and its
exact mechanism.<br/>Copyright &#xa9; 2023 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<52>
[Use Link to view the full text]
Accession Number
2024555624
Title
Virtual reality and hypnosis for anxiety and pain management in intensive
care units: A prospective randomised trial among cardiac surgery patients.
Source
European Journal of Anaesthesiology. 39(1) (pp 58-66), 2022. Date of
Publication: 01 Jan 2022.
Author
Rousseaux F.; Dardenne N.; Massion P.B.; Ledoux D.; Bicego A.; Donneau
A.-F.; Faymonville M.-E.; Nyssen A.-S.; Vanhaudenhuyse A.
Institution
(Rousseaux, Bicego, Nyssen) Laboratory of Cognitive Ergonomics and Work
Intervention, University of Liege, ULiege (B32) Quartier Agora - Place des
Orateurs, Belgium
(Faymonville, Vanhaudenhuyse) Algology Department, University Hospital of
Liege, Chu Sart Tilman, Domaine Universitaire du Sart Tilman, Belgium
(Rousseaux, Bicego, Faymonville, Nyssen, Vanhaudenhuyse) Sensation &
Perception Research Group, Giga Consciousness, University of Liege, Giga
(B34), Belgium
(Massion, Ledoux) Intensive Care Units, University Hospital of Liege
(B35), Belgium
(Dardenne, Donneau) Public Health Department, Biostatistics, University of
Liege, Chu (B35), Belgium
(Ledoux) Anesthesia & Intensive Care, Giga Consciousness, University of
Liege, Giga (B34), Quartier Hopital - Avenue de l'Hopital, Liege, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Virtual reality and hypnosis are little studied in complex
contexts, such as intensive care, where patients need significant physical
and psychological assistance.OBJECTIVESTo compare and combine hypnosis and
virtual reality benefits on anxiety and pain on patients before and after
cardiac surgery.DESIGNProspective randomised controlled clinical
trial.SETTINGThe study was conducted in the University Hospital of Liege
(Belgium) from October 2018 to January 2020.PATIENTSOne hundred patients
(66 +/- 11.5 years; 24 women, 76 men) were included. Participants were
adults undergoing cardiac surgery. Exclusion criteria: psychiatric
diseases, claustrophobia, acrophobia, hearing loss, visual impairment,
extreme fatigue, confusion surgery cancelled.INTERVENTIONSPatients were
randomly assigned to four arms (control; hypnosis; virtual reality;
virtual reality hypnosis) and had 20 min of one of the techniques the day
before and the day after surgery.MAIN OUTCOMES MEASURESAnxiety, pain,
fatigue, relaxation, physiological parameters, and opioid use were
evaluated before and after each session.RESULTSThe main results did not
show any significant differences between the groups. In all groups,
anxiety decreased and pain increased from baseline to the postoperative
day. Relaxation increased in all groups in the pre-operative (P < 0.0001)
and postoperative period (P = 0.03). There were no significant differences
for fatigue, physiological measures, or opioid use.CONCLUSIONAs there were
no significant differences between groups for the measured variables, we
cannot affirm that one technique is better than another. Additional
studies are required to compare and evaluate the cost-effectiveness of
these techniques for critical care patients and caregivers.<br/>Copyright
&#xa9; 2021 European Society of Anaesthesiology and Intensive Care.
Unauthorized reproduction of this article is prohibited.

<53>
[Use Link to view the full text]
Accession Number
2024555608
Title
Perioperative ADministration of Dexamethasone And blood Glucose
concentrations in patients undergoing elective non-cardiac surgery - the
randomised controlled PADDAG trial.
Source
European Journal of Anaesthesiology. 38(9) (pp 932-942), 2021. Date of
Publication: 01 Sep 2021.
Author
Corcoran T.B.; O'Loughlin E.; Chan M.T.V.; Ho K.M.
Institution
(Corcoran) Department of Anaesthesia and Pain Medicine, Royal Perth
Hospital, Australia
(Corcoran, O'Loughlin) School of Medicine and Pharmacology, University of
Western Australia, Perth, WA, Australia
(Corcoran) Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(Corcoran) Department of Anaesthesia and Pain Medicine, Fiona Stanley
Hospital, Perth, WA, Australia
(O'Loughlin) Department of Anaesthesia and Intensive Care, The Chinese
University of Hong Kong, Hong Kong Special Administrative Region New
Territories, Shatin, Hong Kong
(Chan) Department of Intensive Care Medicine, Royal Perth Hospital,
Australia
(Ho) Medical School, University of Western Australia, Australia
(Ho) School of Veterinary & Life Sciences, Murdoch University, Perth, WA,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The hyperglycaemic effect of dexamethasone in diabetic and
nondiabetic patients in the peri-operative period is unknown.OBJECTIVETo
assess the effect of a single dose of intra-operative dexamethasone on
peri-operative blood glucose.DESIGNMulticentre, stratified, randomised
trial.SETTINGUniversity hospitals in Australia and Hong Kong.PATIENTSA
total of 302 adults scheduled for elective, noncardiac and nonobstetric
surgical procedures under general anaesthesia, stratified by diabetes
mellitus status, were randomised to receive placebo, 4 or 8 mg
dexamethasone administered intravenously after induction of
anaesthesia.MAIN OUTCOME MEASURESMaximum blood glucose within 24 h of
surgery, and the interaction between glycated haemoglobin (HbA1c) and
dexamethasone were the primary and secondary outcomes.RESULTSThe median
[IQR] baseline blood glucose in the nondiabetes stratum in the placebo
(n=81), 4 mg (n=81) and 8 mg dexamethasone (n=77) trial arms were
respectively 5.3 [4.6 to 5.8], 5.0 [4.7 to 5.4] and 5.0 [4.2 to 5.9] mmol
l-1. In the diabetes stratum these values were 6.6 [6.0 to 8.3]; (n=22),
6.1 [5.5 to 10.4]; (n=22) and 6.7 [5.6 to 8.3]; (n=19) mmol l-1. The
median [IQR] maximum peri-operative blood glucose values in the
nondiabetes stratum were 6.0 [5.3 to 6.8], 6.3 [5.5 to 7.3] and 6.3 [5.8
to 7.4] mmol l-1 in the control, dexamethasone 4 mg and dexamethasone 8 mg
arms, respectively. In the diabetes stratum these values were 10.3 [8.1 to
12.4], 12.6 [10.3 to 18.3] and 13.6 [11.2 to 20.1] mmol l-1. There was a
significant interaction between pre-operative HbA1c value and 8 mg
dexamethasone: every 1% increment in HbA1c produced a 4.0 mmol l-1
elevation in maximal peri-operative glucose
concentration.CONCLUSIONDexamethasone 4 mg or 8 mg did not induce greater
hyperglycaemia compared with placebo for nondiabetic and well controlled
diabetic patients. Maximal peri-operative blood glucose concentrations in
patients with diabetes were related to baseline HbA1c values in a
concentration-dependent fashion after 8 mg of dexamethasone.<br/>Copyright
&#xa9; 2021 European Society of Anaesthesiology and Intensive Care.
Unauthorized reproduction of this article is prohibited.

<54>
[Use Link to view the full text]
Accession Number
2024555607
Title
Does a balanced colloid decrease perioperative blood loss in paediatric
cardiac surgery: A double-blinded randomized controlled trial?.
Source
European Journal of Anaesthesiology. 38(9) (pp 923-931), 2021. Date of
Publication: 01 Sep 2021.
Author
Willems A.; De Groote F.; Schmartz D.; Fils J.-F.; Van Der Linden P.
Institution
(Willems) Paediatric Intensive Care Unit, Department of Intensive Care,
Leiden University Medical Centre, Leiden, Netherlands
(De Groote, Schmartz, Van Der Linden) Department of Anaesthesiology,
University Hospital Brugmann, Queen Fabiola University Children's
Hospital, Brussels, Belgium
(Fils) Ars Statistica, Nivelles, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Unbalanced fluid solutions cause metabolic acidosis and could
be associated with impaired coagulation and increased blood
loss.OBJECTIVETo investigate whether the use of a balanced colloid
compared with a saline colloid for peri-operative fluid therapy in
children undergoing cardiac surgery is associated with decreased blood
loss and exposure to blood products.DESIGNDouble-blinded randomised
controlled trial.SETTINGTertiary children's hospital from 2013 to
2016.PATIENTSChildren older than 29 days and younger than 3 years admitted
for cardiac surgery with cardiopulmonary bypass (CPB). Exclusion criteria
were emergency cardiac surgery, moribund (American Society of
Anesthesiologists 5), Jehovah's witnesses, coagulopathy, renal failure,
liver injury, intracranial haemorrhage and electrolyte disturbances. From
the 128 patients eligible, 88 were included in the
study.INTERVENTIONRandom assignment of patients to either a saline colloid
(6% hydroxyethyl starch 130/0.4 in 0.9% NaCl) or a balanced-electrolyte
colloid (6% hydroxyethyl starch 130/0.4 in an isotonic solution) for CPB
priming and intra- and postoperative fluid therapy during the first
postoperative 48 h.MAIN OUTCOME MEASUREThe primary outcome measure was
calculated blood loss until the third postoperative day (POD3).RESULTSA
total of 44 patients were included in each study arm. Calculated blood
loss at POD3 was not significantly different between the groups (saline
colloid 19.9 [IQR 13.8 to 26.1] ml kg-1 versus balanced colloid 15.9 [IQR
9.0 to 25.3 ml kg-1], P = 0.409). Secondary outcomes related to bleeding,
exposure to blood products and coagulation were not different between
groups. There was also no difference in length of mechanical ventilation,
intensive care and hospital length of stay between groups.CONCLUSIONThe
use of a balanced colloid for peri-operative fluid therapy compared with a
saline one is not associated with decreased blood loss or exposure to
blood products.<br/>Copyright &#xa9; 2021 European Society of
Anaesthesiology and Intensive Care. Unauthorized reproduction of this
article is prohibited.

<55>
[Use Link to view the full text]
Accession Number
2024588434
Title
Impact of atrial fibrillation on outcomes of patients treated by
transcatheter mitral valve repair: A systematic review and meta-analysis.
Source
Medicine (United States). 99(40) (pp E22195), 2020. Date of Publication:
02 Oct 2020.
Author
Sun F.; Liu H.; Zhang Q.; Lu F.; Zhan H.; Zhou J.; Zheng L.W.
Institution
(Sun, Lu, Zhan, Zhou, Zheng) Department of Cardiovascular Surgery, China
(Liu) Department of Emergency, China
(Zhang) Department of Endovascular Surgery, The First Affiliated Hospital
of Zhengzhou University, Zhengzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Conflicting data have been reported related to the impact of
atrial fibrillation (AF) on outcomes after transcatheter mitral valve
repair with MitraClip (MC) implantation. In this study, we assessed the
prognosis of MC-treated patients according to the presence of pre-existing
AF. <br/>Method(s):Randomized and observational studies reporting outcomes
of pre-existing AF or sinus rhythm in patients undergoing MC treatment
were identified with an electronic search. Outcomes of interest were
short-and long-term mortality, stroke, bleeding, rehospitalization,
myocardial infarction (MI), cardiogenic shock, acute procedure success,
the hospital stay, and the number of Clips implanted. <br/>Result(s):Eight
studies (8466 individuals) were eligible. Compared to sinus rhythm,
long-term mortality, the risk of bleeding, rehospitalization, and longer
hospital stay were significantly higher in AF groups, whereas similar
correlations were found in the analysis of other outcomes.
<br/>Conclusion(s):AF may be related with worse outcomes in patients
undergoing MC implantation, including long-term mortality, major bleeding,
and rehospitalization. AF should be taken into account when referring a
patient for MC treatment.<br/>Copyright &#xa9; 2020 Lippincott Williams
and Wilkins. All rights reserved.

<56>
[Use Link to view the full text]
Accession Number
2024571434
Title
The myocardial protective effect of monosodium phosphate cardioplegia in
cardiopulmonary bypass in infants with an atrial septal defect.
Source
Medicine (United States). 99(28) (pp E20934), 2020. Date of Publication:
10 Jul 2020.
Author
Yang F.; Wang J.; Zhai B.
Institution
(Yang, Wang, Zhai) Department of Cardiothoracic Surgery, Children's
Hospital Affiliated to Zhengzhou University, Henan Children's Hospital,
Zhengzhou Children's Hospital, Zhengzhou, Henan, China
Publisher
Lippincott Williams and Wilkins
Abstract
This study aimed to investigate the myocardial protective effect of liquid
sodium phosphocreatine cardiac arrest in extracorporeal circulation
surgery treating infants with atrial septal defects.Eighty-four infants
with atrial septal defects who required extracorporeal circulation surgery
treatment at our hospital from January 2016 to June 2018 were divided into
an observation group and a control group through a digitally randomized
method, with 42 cases in each group. The control group adopted the
conventional modified St Thomas II high potassium cold liquid crystal
cardiac arrest, while the observation group adopted the liquid sodium
phosphocreatine cardiac arrest.The myocardial enzyme indexes of the 2
groups 3, 6, 12, and 24 hours postoperatively were higher than before
establishing the cardiopulmonary bypass and the enzyme indexes of the
control group at the same time were higher than that of the observation
group; adenosine triphosphate, adenosine diphosphate, and other energy
levels and the postoperative recovery rate energy levels of the
observation group were higher than those in the control group, the
difference was statistically significant (P < .05).Liquid sodium
phosphocreatine cardiac arrest used in extracorporeal circulation surgery
treating infants with atrial septal defects can reduce myocardial
ischemia-reperfusion injury, maintain energy supply during ischemia,
strengthen the St Thomas II effect, and aid postoperative cardiac function
recovery of high potassium cold liquid crystal cardiac arrest used in
infants with atrial septal defects and treated with extracorporeal
circulation surgery.<br/>Copyright &#xa9; 2020 Lippincott Williams and
Wilkins. All rights reserved.

<57>
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.

<58>
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.

<59>
Accession Number
2024160652
Title
Multicentric randomized evaluation of a tricuspid valve percutaneous
repair system (clip for the tricuspid valve) in the treatment of severe
secondary tricuspid regurgitation Tri.Fr Design paper.
Source
European Heart Journal Cardiovascular Imaging. 23(12) (pp 1617-1627),
2022. Date of Publication: 01 Dec 2022.
Author
Donal E.; Leurent G.; Ganivet A.; Lurz P.; Coisne A.; De Groote P.;
Lafitte S.; Leroux L.; Karam N.; Biere L.; Rouleau F.; Sportouch C.;
Dreyfus J.; Nejjari M.; Josselin J.-M.; Anselmi A.; Galli E.; Bajeux E.;
Guerin P.; Obadia J.-F.; Trochu J.-N.; Oger E.
Institution
(Donal, Leurent, Anselmi, Galli) Univ Rennes, CHU Rennes, Inserm,
LTSI-UMR, Rennes 1099, France
(Ganivet) Direction for Research and Innovation, CHU Rennes, Rennes,
France
(Lurz) Heart Center, University of Leipzig, Leipzig, Germany
(Coisne, De Groote) CHU Lille, Department of Clinical Physiology and
Echocardiography, Univ Lille, U1011 -EGID, Lille, France
(Lafitte, Leroux) CHU Bordeaux, University of Bordeaux, Bordeaux, France
(Karam) University of Paris, Medico-Surgical Heart Valve Unit, European
Hospital Georges-Pompidou, INSERM, Paris U970, France
(Biere, Rouleau) Institute MitoVasc, Angers University, CHU Angers, CNRS
UMR6015, INSERM U, Angers 1083, France
(Sportouch) Clinique du Millenaire, Montpellier, France
(Dreyfus, Nejjari) Centre Cardiologique du Nord, Saint Denis, France
(Josselin, Bajeux) INSERM1085, IRSET, University Rennes, CHU Rennes,
Rennes, France
(Guerin, Trochu) Institut du Thorax, CHU Nantes, University Nantes,
Nantes, France
(Obadia) Department of Cardiac Surgery, Cardiologic CHU Lyon, University
Lyon, Lyon, France
(Oger) EA Reperes, CHU Rennes, University Rennes, Rennes, France
Publisher
Oxford University Press
Abstract
Aims Tricuspid regurgitation (TR) is associated with significant morbidity
and mortality. Its independent prognostic role has been repeatedly
demonstrated. However, this valvular heart condition is largely
undertreated because of the increased risk of surgical repair. Recently,
transcatheter techniques for the treatment of TR have emerged, but their
implications for the clinical endpoints are still unknown.Methods and The
Tri.fr trial will be a multicentre, controlled, randomized (1:1 ratio),
superior, open-label, and parallel-group results study conducted in 300
patients with severe secondary TR that is considered non-surgical by heart
teams. Inclusion will be possible only after core laboratory review of
transthoracic and transoesophageal echocardiography and after validation
by the clinical eligibility committee. A description of the mechanisms of
the TR will be conducted by the core laboratory. Atrial or ventricular
impacts on the severity of the secondary TR will be taken into account for
the randomization. The patients will be followed for 12-month, and the
primary outcome will be the Packer composite clinical endpoint [combining
New York Heart Association class, patient global assessment (PGA), and
major cardiovascular events]. It will test the hypothesis that a tricuspid
valve percutaneous repair strategy using a clip dedicated to the tricuspid
valve is superior to best guideline-directed medical therapy in
symptomatic patients with severe secondary TR.Conclusion Tri.fr will be
the first randomized, academic, multicentre study testing the value of
percutaneous correction in patients with severe secondary
TR.<br/>Copyright &#xa9; The Author(s) 2021.

<60>
Accession Number
2024153766
Title
The effect of head and facial massage on sleep condition after coronary
artery bypass graft surgery.
Source
Traditional Medicine Research. 8(4) (no pagination), 2023. Article Number:
24. Date of Publication: 01 Apr 2023.
Author
Ozudi M.R.; Bagheri-Nesami M.; Setareh J.; Moosazadeh M.; Habibi V.;
Saatchi K.
Institution
(Ozudi) Student Research Committee, Mazandaran University of Medical
Sciences, Sari 4816715793, Iran, Islamic Republic of
(Bagheri-Nesami) Traditional and Complementary Medicine Research Center,
Addiction Institute, Mazandaran University of Medical Sciences, Sari
4816715793, Iran, Islamic Republic of
(Bagheri-Nesami) World Federation of Acupuncture-Moxibustion Societies
(WFAS), Beijing 100000, China
(Setareh) Psychiatry and Behavioral Sciences Research Center, Addiction
Institute, Mazandaran University of Medical Sciences, Sari 4816715793,
Iran, Islamic Republic of
(Moosazadeh) Gastrointestinal Cancer Research Center, Non-communicable
Diseases Institute, Mazandaran University of Medical Sciences, Sari
4816715793, Iran, Islamic Republic of
(Habibi) Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran
University of Medical Sciences, Sari 4816715793, Iran, Islamic Republic of
(Saatchi) Board of Directors of Acupuncture Society of Iran, Tehran
1414734117, Iran, Islamic Republic of
Publisher
TMR Publishing Group
Abstract
Background: Sleep disorders after heart surgery lead to increased heart
rate, myocardial oxygen demand, and cause dysrhythmia that worsens heart
ischemia. The purpose of this study was to determine the effect of head
and facial massage on sleep conditions following coronary artery bypass
graft surgery. <br/>Material(s) and Method(s): A randomized controlled
trial was performed on 72 patients. They were randomly divided into
interventional (n = 36) and control groups (n = 36). On the third to fifth
day after the operation, head and the facial massage were done for 15 min
in the intervention group. The patients in the control group received only
routine care. Richard Campbell's Sleep Questionnaire was completed for
four consecutive days for each group. Data were analyzed in SPSS V26.
<br/>Result(s): Mean scores for sleep conditions before the intervention
no statistically significant difference seen between the two groups (P >
0.05). After the intervention, there was a statistically significant
difference between mean scores for sleep conditions of the interventional
and control groups (P < 0.001). Also with general estimated equation test
compared mean scores for sleep conditions between two groups. That
revealed sleep condition total score in the intervention group was more
than the control group and the trend of changes over time was
statistically significant (P < 0.001). <br/>Conclusion(s): Head and facial
massage is an effective nursing intervention in improving the sleep
condition of patients after coronary artery bypass graft. Due to the fact
that head and face massage is an easy method and brings patient
satisfaction, it is recommended to use this method as a suitable
supplement for drug therapy and postoperative interventions in these
patients.<br/>Copyright &#xa9; 2023 By Author(s). Published by TMR
Publishing Group Limited.

<61>
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.

<62>
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.

<63>
Accession Number
2022976569
Title
Association of Oral or Intravenous Vitamin C Supplementation with
Mortality: A Systematic Review and Meta-Analysis.
Source
Nutrients. 15(8) (no pagination), 2023. Article Number: 1848. Date of
Publication: April 2023.
Author
Xu C.; Yi T.; Tan S.; Xu H.; Hu Y.; Ma J.; Xu J.
Institution
(Xu, Hu, Ma, Xu) Department of Neurosurgery, West China Hospital, Sichuan
University, No. 37, Guoxue Alley, Wuhou District, Chengdu 610000, China
(Yi) Department of Neurology, The Second People's Hospital of Deyang City,
No. 340 Minjiang West Road, Deyang 618000, China
(Tan) Outpatient Department, West China Hospital, Sichuan University, No.
37, Guoxue Alley, Wuhou District, Chengdu 610000, China
(Xu) Department of Neurosurgery, The Second People's Hospital of Liangshan
Yi, Autonomous Prefecture, Liangshan 615000, China
Publisher
MDPI
Abstract
Mortality is the most clinically serious outcome, and its prevention
remains a constant struggle. This study was to assess whether intravenous
or oral vitamin C (Vit-C) therapy is related to reduced mortality in
adults. Data from Medline, Embase, and the Cochrane Central Register
databases were acquired from their inception to 26 October 2022. All
randomized controlled trials (RCTs) involving intravenous or oral Vit-C
against a placebo or no therapy for mortality were selected. The primary
outcome was all-cause mortality. Secondary outcomes were sepsis, COVID-19,
cardiac surgery, noncardiac surgery, cancer, and other mortalities.
Forty-four trials with 26540 participants were selected. Although a
substantial statistical difference was observed in all-cause mortality
between the control and the Vit-C-supplemented groups (p = 0.009, RR 0.87,
95% CI 0.78 to 0.97, I² = 36%), the result was not validated by
sequential trial analysis. In the subgroup analysis, mortality was
markedly reduced in Vit-C trials with the sepsis patients (p = 0.005, RR
0.74, 95% CI 0.59 to 0.91, I² = 47%), and this result was
confirmed by trial sequential analysis. In addition, a substantial
statistical difference was revealed in COVID-19 patient mortality between
the Vit-C monotherapy and the control groups (p = 0.03, RR 0.84, 95% CI
0.72 to 0.98, I² = 0%). However, the trial sequential analysis
suggested the need for more trials to confirm its efficacy. Overall, Vit-C
monotherapy does decrease the risk of death by sepsis by 26%. To confirm
Vit-C is associated with reduced COVID-19 mortality, additional clinical
random control trials are required.<br/>Copyright &#xa9; 2023 by the
authors.

<64>
Accession Number
2021216923
Title
Long-term follow-up of patients with chronic total coronary artery
occlusion previously randomized to treatment with optimal drug therapy or
percutaneous revascularization of chronic total occlusion (COMET-CTO).
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1014664. Date of Publication: 09 Jan 2023.
Author
Juricic S.A.; Stojkovic S.M.; Galassi A.R.; Stankovic G.R.; Orlic D.N.;
Vukcevic V.D.; Milasinovic D.G.; Aleksandric S.B.; Tomasevic M.V.; Dobric
M.R.; Nedeljkovic M.A.; Beleslin B.D.; Dikic M.P.; Banovic M.D.; Ostojic
M.C.; Tesic M.B.
Institution
(Juricic, Stojkovic, Stankovic, Orlic, Vukcevic, Milasinovic, Aleksandric,
Tomasevic, Nedeljkovic, Beleslin, Dikic, Banovic, Tesic) Clinic for
Cardiology, University Clinical Center of Serbia, Belgrade, Serbia
(Stojkovic, Stankovic, Orlic, Vukcevic, Milasinovic, Aleksandric, Dobric,
Nedeljkovic, Beleslin, Banovic, Ostojic, Tesic) School of Medicine,
University of Belgrade, Belgrade, Serbia
(Galassi) Department of Health Promotion, Mother and Child Care, Internal
Medicine and Medical Specialties (ProMISE), University of Palermo,
Palermo, Italy
(Galassi) Royal Brompton & Harefield NHS Foundation Trust, London, United
Kingdom
(Stankovic, Ostojic) Serbian Academy of Sciences and Arts, Belgrade,
Serbia
(Tomasevic) Department of Internal Medicine, Faculty of Medical Sciences,
University of Kragujevac, Kragujevac, Serbia
(Dobric) Dedinje Cardiovascular Institute, Belgrade, Serbia
Publisher
Frontiers Media S.A.
Abstract
Background: The COMET-CTO trial was a randomized prospective study that
assessed long-term follow-up in patients with chronic total occlusion
(CTO) in coronary arteries treated with percutaneous coronary intervention
(PCI) or with optimal medical therapy (OMT). During the 9-month follow-up,
the incidence of major adverse cardiac events (MACE) did not differ
between the two groups; no death or myocardial infarction (MI) was
observed. There was a significant difference in quality of life (QoL),
assessed by the Seattle Angina Questionnaire (SAQ), in favor of the PCI
group. Here we report long-term follow-up results (56 +/- 12 months).
<br/>Method(s): Between October 2015 and May 2017, a total of 100 patients
with CTO were randomized into two groups of 50 patients: PCI CTO or OMT
group. The primary endpoint of the current study was the incidence of MACE
defined as cardiac death, MI, and revascularization [PCI or coronary
artery bypass graft (CABG)]. As the secondary exploratory outcome, we
analyzed all the cause-mortality rate. <br/>Result(s): Out of 100
randomized patients, 92 were available for long-term follow-up (44 in the
PCI group and 48 in the OMT group). The incidence of MACE did not differ
significantly between the two groups (p = 0.363). Individual components of
MACE were distributed, respectively: cardiac death (OMT vs. PCI group, 6
vs. 3, p = 0.489), MI (OMT vs. PCI group, 1 vs. 0, p = 1), and
revascularization (PCI: OMT vs. PCI group, 2 vs. 2, p = 1; CABG: OMT vs.
PCI group, 1 vs. 1, p = 1). There was no significant difference between
the two groups regarding the individual component of MACE. Six patients
died from non-cardiac causes [five deaths were reported in the OMT group
and one death in the PCI group (p = 0.206)]. Kaplan-Meier survival curves
for MACE did not differ significantly between the study groups (log-rank
0.804, p = 0.370). Regarding the secondary exploratory outcome, a total of
15 patients died at 56 +/- 12 months (11 in the OMT and 4 in the PCI
group) (p = 0.093). The Kaplan-Meier survival curves for all-cause
mortality rates did not differ significantly between the two groups (log
rank 3.404, p = 0.065). There were no statistically significant
differences between OMT and PCI groups in all five SAQ domains. There was
a significant improvement in three SAQ domains in the PCI group: PL (p <
0.001), AF (p = 0.007), and QoL (p = 0.001). <br/>Conclusion(s): After 56
+/- 12 months of follow-up, the incidence of MACE, as well as QoL measured
by SAQ, did not differ significantly between the PCI and OMT
groups.<br/>Copyright &#xa9; 2023 Juricic, Stojkovic, Galassi, Stankovic,
Orlic, Vukcevic, Milasinovic, Aleksandric, Tomasevic, Dobric, Nedeljkovic,
Beleslin, Dikic, Banovic, Ostojic and Tesic.

<65>
Accession Number
2021092117
Title
Supporting the "forgotten" ventricle: The evolution of percutaneous RVADs.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1008499. Date of Publication: 04 Jan 2023.
Author
James L.; Smith D.E.
Institution
(James, Smith) Department of Cardiothoracic Surgery, NYU Grossman School
of Medicine, New York, NY, United States
Publisher
Frontiers Media S.A.
Abstract
Right heart failure (RHF) can occur as the result of an acute or chronic
disease process and is a challenging clinical condition for surgeons and
interventionalists to treat. RHF occurs in approximately 0.1% of patients
after cardiac surgery, in 2-3% of patients following heart
transplantation, and in up to 42% of patients after LVAD implantation.
Regardless of the cause, RHF portends high morbidity and mortality and is
associated with longer hospital stays and higher healthcare costs. The
mainstays of traditional therapy for severe RHF have included
pharmacological support, such as inotropes and vasopressors, and surgical
right ventricular (RV) assist devices. However, in recent years
catheter-based mechanical circulatory support (MCS) strategies have
offered novel solutions for addressing RHF without the morbidity of open
surgery. This manuscript will review the pathophysiology of RHF, including
the molecular underpinnings, gross structural mechanisms, and hemodynamic
consequences. The evolution of techniques for supporting the right
ventricle will be explored, with a focus on various institutional
experiences with percutaneous ventricular assist devices.<br/>Copyright
&#xa9; 2023 James and Smith.

<66>
Accession Number
2020911475
Title
Atrial fibrillation in mechanical circulatory support patients.
Source
Vessel Plus. 6 (no pagination), 2022. Article Number: 43. Date of
Publication: 2022.
Author
Obeid J.M.; Yaligar A.; McLarty A.J.; Tannous H.J.; Bilfinger T.V.;
Shroyer A.W.L.
Institution
(Obeid, Yaligar, McLarty, Tannous, Bilfinger, Shroyer) Department of
Surgery, Stony Brook Renaissance School of Medicine, Stony Brook, NY
11794, United States
Publisher
OAE Publishing Inc.
Abstract
Atrial fibrillation (AF) is known to be one of the most common arrhythmias
noted in cardiac procedures and is frequently associated with heart
failure. As frequent interventions for patients with heart failure involve
implantation of mechanical circulatory assist devices (e.g., left
ventricular assist devices), it is timely to review the role this
arrhythmia has on adverse clinical outcomes. A comprehensive literature
search was conducted for PubMed. Relevant medical subject heading (MeSH)
terms used in the initial literature search include "Heart-Assist
Devices", "Extracorporeal Membrane Oxygenation", "Atrial Fibrillation",
"Heart Failure", "Mortality", "Hospital Readmission", "stroke",
"Postoperative Complications". In this review, the relevant literature was
highlighted to identify the incidence, clinical impacts, and management of
AF surrounding mechanical circulatory support implantation. The incidence
of AF in this mechanical circulatory support device population was similar
to that of patients with other cardiac procedures (10%-40%). Moreover, in
most studies, preoperative AF was not significantly associated with
adverse outcomes. In contrast, however, it appears that postoperative
atrial fibrillation may predispose patients to increased risk for
thromboembolic events and adverse long-term outcomes.<br/>Copyright &#xa9;
The Author(s) 2022.

<67>
Accession Number
2017088513
Title
Robotically Assisted Surgery in Children-A Perspective.
Source
Children. 9(6) (no pagination), 2022. Article Number: 839. Date of
Publication: June 2022.
Author
Krebs T.F.; Schnorr I.; Heye P.; Hacker F.-M.
Institution
(Krebs) Department of General-, Visceral-, Thoracic-, Transplant-and
Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel
Campus, Arnold-Heller-Strasse 3, Kiel 24105, Germany
(Krebs, Heye, Hacker) Clinic for Pediatric Surgery, Children's Hospital of
Eastern Switzerland, Claudiusstrasse 6, St. Gallen 9006, Switzerland
(Schnorr) Faculty of Medicine, University Hospital Frankfurt-Goethe
University, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
Publisher
MDPI
Abstract
The introduction of robotically assisted surgery was a milestone for
minimally invasive surgery in the 21st century. Currently, there are two
FDA-approved robotically assisted surgery systems for use and development
in pediatrics. Specifically, tremor filtration and optimal visualization
are approaches which can have enormous benefits for procedures in small
bodies. Robotically assisted surgery in children might have advantages
compared to laparoscopic or open approaches. This review focuses on the
research literature regarding robotically assisted surgery that has been
published within the past decade. A literature search was conducted to
identify studies comparing robotically assisted surgery with laparoscopic
and open approaches. While reported applications in urology were the most
cited, three other fields (gynecology, general surgery, and "others") were
also identified. In total, 36 of the publications reviewed suggested that
robotically assisted surgery was a good alternative for pediatric
procedures. After several years of experience of this surgery, a strong
learning curve was evident in the literature. However, some authors have
highlighted limitations, such as high cost and a limited spectrum of
small-sized instruments. The recent introduction of reusable 3 mm
instruments to the market might help to overcome these limitations. In the
future, it can be anticipated that there will be a broader range of
applications for robotically assisted surgery in selected pediatric
surgeries, especially as surgical skills continue to improve and further
system innovations emerge.<br/>Copyright &#xa9; 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<68>
Accession Number
2023241858
Title
Enteral access and reflux management in neonates with severe
univentricular congenital heart disease: literature review and proposed
algorithm.
Source
European Journal of Pediatrics. (no pagination), 2023. Date of
Publication: 2023.
Author
Avasarala V.; Aitharaju V.; Encisco E.M.; Rymeski B.; Ponsky T.A.;
Huntington J.T.
Institution
(Avasarala, Aitharaju, Ponsky) Department of Surgery, Northeast Ohio
Medical University, Rootstown, OH, United States
(Encisco, Ponsky, Huntington) Department of Pediatric Surgery, Akron
Children's Hospital, 215 West Bowery Street, Level 6, Akron, OH 44308,
United States
(Encisco, Rymeski, Ponsky) Division of Pediatric General and Thoracic
Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH,
United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Neonates with severe congenital heart disease undergoing surgical repair
may face various complications, including failure to thrive. Feeding tube
placement and fundoplication are often performed to combat poor growth in
neonates. With the variety of feeding tubes available and controversy
surrounding when fundoplication is appropriate, there is no current
protocol to determine which intervention is necessary for this patient
population. We aim to provide an evidence-based feeding algorithm for this
patient population. Initial searches for relevant publications yielded 696
publications; after review of these studies and inclusion of additional
studies through external searches, a total of 38 studies were included for
qualitative synthesis. Many of the studies utilized did not directly
compare the different feeding modalities. Of the 38 studies included, five
studies were randomized control trials, three studies were literature
reviews, one study was an online survey, and the remaining twenty-nine
studies were observational. There is no current evidence to suggest that
this specific patient population should be treated differently regarding
enteral feeding. We propose an algorithm to assist optimal feeding for
neonates with congenital heart disease. <br/>Conclusion(s): Nutrition
remains a vital component of the care of neonates with congenital heart
disease; determining the optimal feeding strategy for these patients can
be approached like other neonates.<br/>Copyright &#xa9; 2023, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature.

<69>
Accession Number
2023225726
Title
The connotation between perioperative glycemic control approach and
sternal wound infection in individuals with diabetes mellitus experiencing
cardiac surgery: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Tan G.; Li Y.; Zhou G.
Institution
(Tan) Department of Cardiovascular Medicine, Sichuan Academy of Medical
Sciences & Sichuan Provincial People's Hospital, Sichuan, China
(Li) Department of Endoscopy, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
(Zhou) Department of Endocrinology, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation to measure the connotation between
perioperative glycemic control (GC) approach and sternal wound infection
(SWI) in individuals with diabetes mellitus (DM) experiencing cardiac
surgery (CS). A comprehensive literature inspection till February 2023 was
applied and 2654 interrelated investigations were reviewed. The 12 chosen
investigations enclosed 1564 individuals with DM and CS in the chosen
investigations' starting point, 790 of them were using strict GC, and 774
were using moderate GC. Odds ratio (OR) in addition to 95% confidence
intervals (CIs) were used to compute the value of the Connotation between
the perioperative GC approach and SWI in individuals with DM experiencing
CS by the dichotomous and continuous approaches and a fixed or random
model. Strict GC had significantly lower SWI (OR, 0.33; 95% CI,
-0.22-0.50, P <.001) compared with those with moderate GC in individuals
with DM and CS. Strict GC had significantly lower SWI compared with those
with moderate GC in individuals with DM and CS. However, caused of the
small sample sizes of several chosen investigations for this
meta-analysis, care must be exercised when dealing with its
values.<br/>Copyright &#xa9; 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<70>
Accession Number
2023143887
Title
Long term follow-up of the tacrolimus in combination, tacrolimus alone
compared (TICTAC) trial.
Source
Journal of Heart and Lung Transplantation. 42(6) (pp 838-845), 2023. Date
of Publication: June 2023.
Author
Baran D.A.; Kapoor S.; Grewal J.; Andries G.; Camacho M.
Institution
(Baran) Department of Cardiology, Cleveland Clinic Heart, Vascular and
Thoracic Institute, Cleveland, Ohio, United States
(Kapoor, Grewal, Andries) Division of Cardiology, Newark Beth Israel
Medical Center, Heart Failure Treatment and Transplant Program, Newark,
New Jersey, United States
(Camacho) Division of Cardiothoracic Surgery, Division of Cardiothoracic
Surgery, Newark Beth Israel Medical Center, Newark, New Jersey, United
States
Publisher
Elsevier Inc.
Abstract
Background: Tacrolimus (TAC) monotherapy has been compared to TAC and
mycophenolate mofetil (MMF) in the randomized Tacrolimus in Combination,
Tacrolimus Alone Compared (TICTAC) trial. Long term results are now
reported. <br/>Method(s): Demographics are presented with descriptive
statistics. Time to event was determined with Kaplan-Meier plots and
Mantel-Cox Logrank statistics used to compare groups. <br/>Result(s): One
hundred and forty-seven (98 %) of the initial 150 TICTAC trial patients
had long-term follow-up data available. The median follow-up was 13.4
years (interquartile range 7.2-15.1 years). Post-transplant survival at 5,
10 and 15 years in the TAC monotherapy group was 84.5 %, 66.9 %, and 52.7
%, and 94.4 %, 78.2 % and 56.1 % for patients randomized to TAC / MMF (p =
0.19 logrank). The freedom from cardiac allograft vasculopathy (>=grade 1)
was 100 %, 87.5 %, 69.3 % and 46.5 % at 1, 5, 10 and 15 years in the
monotherapy group and 100 %, 76.9 %, 68.1 % and 54.4 % in the TAC/MMF
group respectively (p = 0.96 logrank). Crossover of treatment assignment
did not alter these findings. The freedom from dialysis or renal
replacement was 92.8 %, 84.2 % and 68.4 % for TAC monotherapy patients
versus 100 %, 93.4 % and 82.3 % for TAC/MMF patients at 5, 10 and 15-years
post-transplant (p = 0.15 logrank). <br/>Conclusion(s): Patients
randomized to TAC/ MMF with 8-week steroid weaning had comparable outcomes
to those with similar steroid regimen but discontinuation of MMF at 2 week
post-transplant. The best outcomes were noted for patients initiated on
TAC/ MMF including those where MMF was discontinued for intolerance. Both
strategies are reasonable alternatives for patients post heart transplant.
Condensed Abstract: Tacrolimus monotherapy was compared to TAC and
mycophenolate mofetil without long term steroids in the randomized
Tacrolimus in Combination, Tacrolimus Alone Compared (TICTAC) trial.
Post-transplant survival at 5, 10 and 15 years in the TAC monotherapy
group was 84.5%, 66.9 %, and 52.7 %, and 94.4 %, 78.2 % and 56.1 % for
patients randomized to TAC / MMF (p = 0.19 logrank). Cardiac allograft
vasculopathy and kidney failure were similar between groups.
Immunosuppression should be individualized to avoid over treating some
patients while undertreating others.<br/>Copyright &#xa9; 2023
International Society for Heart and Lung Transplantation

<71>
Accession Number
2022344681
Title
Is There a Role for Vitamin K Antagonist in the Management of Atrial
Fibrillation in 2023?.
Source
Current Cardiology Reports. 25(5) (pp 391-399), 2023. Date of Publication:
May 2023.
Author
Burg M.R.; Ha A.C.T.
Institution
(Burg, Ha) Peter Munk Cardiac Centre, Toronto General Hospital, University
Health Network, Toronto M5G 2C4, Canada
(Ha) Department of Medicine, University of Toronto, Toronto, Canada
Publisher
Springer
Abstract
Purpose of Review: To address the following question: Are vitamin K
antagonists (VKA) obsolete as stroke prevention therapy for patients with
atrial fibrillation (AF) and thromboembolic risk factors? Recent Findings:
A patient-level meta-analysis of the pivotal phase III randomized trials
confirmed the favorable treatment effect of direct oral anticoagulants
(DOAC) over VKA in multiple key patient subgroups. Among patients with AF
and rheumatic heart disease (85% of whom had mitral stenosis), a
randomized trial showed that rivaroxaban was not superior to VKA for
stroke prevention. Caution should be exercised when prescribing DOAC for
AF-related stroke prevention for patients with elevated body mass indices
or history of bariatric surgery, patients with bioprosthetic heart valves,
and those who require treatment with drugs that interact with cytochrome
P450 and P-glycoprotein. Drug costs associated with DOAC remain
considerably higher than VKA, by up to 30-fold. <br/>Summary: Direct oral
anticoagulants are preferable over VKA in the large majority of eligible
patients with AF and thromboembolic risk factors. The use of DOAC should
be avoided for patients with mechanical heart valves or moderate/severe
rheumatic mitral stenosis. Vitamin K antagonist is a reasonable option for
patients who are under-represented in randomized trials, when there are
significant drug-drug interactions or when patients cannot afford DOAC
agents due to their higher costs.<br/>Copyright &#xa9; 2023, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<72>
Accession Number
2021994328
Title
Perioperative transfusion and long-term mortality after cardiac surgery: a
meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. 71(6) (pp 323-330), 2023.
Date of Publication: June 2023.
Author
Woldendorp K.; Manuel L.; Srivastava A.; Doane M.; Bassin L.; Marshman D.
Institution
(Woldendorp, Manuel, Bassin, Marshman) Department of Cardiothoracic
Surgery, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
(Srivastava, Doane) Department of Anaesthetics, Royal North Shore
Hospital, Sydney, Australia
(Doane) The University of Sydney, Sydney, Australia
(Doane, Marshman) The Kolling Institute, Royal North Shore Hospital,
Sydney, Australia
(Doane) The Northern Sydney Anaesthesia Research Institute, Royal North
Shore Hospital, Sydney, Australia
Publisher
Springer
Abstract
Objectives: Cardiac surgical procedures are associated with a high
incidence of periprocedural blood loss and blood transfusion. Although
both may be associated with a range of postoperative complications there
is disagreement on the impact of blood transfusion on long-term mortality.
This study aims to provide a comprehensive review of the published
outcomes of perioperative blood transfusion, examined as a whole and by
index procedure. <br/>Method(s): A systematic review of perioperative
blood transfusion cardiac surgical patients was conducted. Outcomes
related to blood transfusion were analysed in a meta-analysis and
aggregate survival data were derived to examine long-term survival.
<br/>Result(s): Thirty-nine studies with 180,074 patients were identified,
the majority (61.2%) undergoing coronary artery bypass surgery.
Perioperative blood transfusions were noted in 42.2% of patients and was
associated with significantly higher early mortality (OR 3.87, p < 0.001).
After a median of 6.4 years (range 1-15), mortality remained significantly
higher for those who received a perioperative transfusion (OR 2.01, p <
0.001). Pooled hazard ratio for long-term mortality similar for patients
who underwent coronary surgery compared to isolated valve surgery.
Differences in long-term mortality for all comers remained true when
corrected for early mortality and when only including propensity matched
studies. <br/>Conclusion(s): Perioperative red blood transfusion appears
to be associated with a significant reduction in long-term survival for
patients after cardiac surgery. Strategies such as preoperative
optimisation, intraoperative blood conservation, judicious use of
postoperative transfusions, and professional development into minimally
invasive techniques should be utilised where appropriate to minimise the
need for perioperative transfusions.<br/>Copyright &#xa9; 2023, The
Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery.

<73>
Accession Number
640884327
Title
Effect of glucagon-like peptide-1 receptor agonists administration during
coronary artery bypass grafting: a systematic review and meta-analysis of
randomized control trials.
Source
Future cardiology. 19(2) (pp 105-115), 2023. Date of Publication: 01 Feb
2023.
Author
Watkins A.R.; Fialka N.; El-Andari R.; Kang J.J.; Bozso S.J.; Nagendran J.
Institution
(Watkins, Fialka) Faculty of Medicine & Dentistry, University of Alberta,
Edmonton, AB T6G 2B7, Canada
(El-Andari, Kang, Bozso, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada
Publisher
NLM (Medline)
Abstract
Aim: To determine if glucagon-like peptide-1 receptor agonists (GLP-1 RAs)
can benefit patients receiving coronary artery bypass graft (CABG), GLP-1
RAs administration alongside standard insulin was compared with
perioperative insulin alone. <br/>Material(s) and Method(s): All articles
from Pubmed and Scopus databases that compared GLP-1 RA administration to
insulin alone during CABG were included for meta-analysis. Short-term
postoperative outcomes were analyzed between groups. <br/>Result(s):
Average postoperative blood glucose levels significantly favored GLP-1 RA
with a mean difference of -0.72 (p < 0.001). No other variables were
significantly different between GLP-1 RA and insulin alone.
<br/>Conclusion(s): GLP-1 RA is a safe option for perioperative care of
CABG patients that can potentially improve postoperative outcomes of CABG
patients by improving glycemic control and reducing hyperglycemic
episodes.

<74>
Accession Number
2023226503
Title
Postoperative short-term mortality between insulin-treated and
non-insulin-treated patients with diabetes after non-cardiac surgery: a
systematic review and meta-analysis.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1142490.
Date of Publication: 2023.
Author
Jiang J.; Wang S.; Sun R.; Zhao Y.; Zhou Z.; Bi J.; Luo A.; Li S.
Institution
(Jiang, Wang, Sun, Zhao, Zhou, Bi, Luo, Li) Department of Anesthesiology,
Hubei Key Laboratory of Geriatric Anesthesia, Perioperative Brain Health,
Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Diabetes mellitus is an independent risk factor for
postoperative complications. It has been reported that insulin-treated
diabetes is associated with increased postoperative mortality compared to
non-insulin-treated diabetes after cardiac surgery; however, it is unclear
whether this finding is applicable to non-cardiac surgery.
<br/>Objective(s): We aimed to assess the effects of insulin-treated and
non-insulin-treated diabetes on short-term mortality after non-cardiac
surgery. <br/>Method(s): Our study was a systematic review and
meta-analysis of observational studies. PubMed, CENTRAL, EMBASE, and ISI
Web of Science databases were searched from inception to February 22,
2021. Cohort or case-control studies that provided information on
postoperative short-term mortality in insulin-treated diabetic and
non-insulin-treated diabetic patients were included. We pooled the data
with a random-effects model. The Grading of Recommendations, Assessment,
Development, and Evaluation system was used to rate the quality of
evidence. <br/>Result(s): Twenty-two cohort studies involving 208,214
participants were included. Our study suggested that insulin-treated
diabetic patients was associated with a higher risk of 30-day mortality
than non-insulin-treated diabetic patients [19 studies with 197,704
patients, risk ratio (RR) 1.305; 95% confidence interval (CI), 1.127 to
1.511; p < 0.001]. The studies were rated as very low quality. The new
pooled result only slightly changed after seven simulated missing studies
were added using the trim-and-fill method (RR, 1.260; 95% CI, 1.076-1.476;
p = 0.004). Our results also showed no significant difference between
insulin-treated diabetes and non-insulin-treated diabetes regarding
in-hospital mortality (two studies with 9,032 patients, RR, 0.970; 95% CI,
0.584-1.611; p = 0.905). <br/>Conclusion(s): Very-low-quality evidence
suggests that insulin-treated diabetes was associated with increased
30-day mortality after non-cardiac surgery. However, this finding is
non-definitive because of the influence of confounding factors. Systematic
review registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021246752,
identifier: CRD42021246752.<br/>Copyright &#xa9; 2023 Jiang, Wang, Sun,
Zhao, Zhou, Bi, Luo and Li.

<75>
Accession Number
2024584623
Title
Incidence of preoperative instrumental activities of daily living (IADL)
dependence and adverse outcomes in older surgical patients: A systematic
review and meta-analysis.
Source
Journal of Clinical Anesthesia. 89 (no pagination), 2023. Article Number:
111151. Date of Publication: October 2023.
Author
Chen A.; An E.; Yan E.; He D.; Saripella A.; Butris N.; Tsang J.;
Englesakis M.; Wong J.; Alibhai S.; Chung F.
Institution
(Chen, Yan, Saripella, Butris, Wong, Chung) Department of Anesthesia and
Pain Management, Toronto Western Hospital, University Health Network,
University of Toronto, Toronto, ON, Canada
(Yan, Butris, Wong, Alibhai, Chung) Institute of Medical Science,
University of Toronto, Toronto, ON, Canada
(An) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(He) Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital,
University of Toronto, Toronto, ON, Canada
(Alibhai) Department of Medicine, University Health Network and University
of Toronto, Toronto, Canada
(Tsang) Department of Immunology, Faculty of Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: Instrumental activities of daily living (IADLs) are
essential to patient function and quality of life after surgery. In older
surgical patients, the incidence of preoperative IADL dependence has not
been well characterized in the literature. This systematic review and
meta-analysis aimed to determine the pooled incidence of preoperative IADL
dependence and the associated adverse outcomes in the older surgical
population. <br/>Design(s): Systematic review and meta-analysis.
<br/>Setting(s): MEDLINE, MEDLINE Epub Ahead of Print and In-Process,
In-Data-Review & Other Non-Indexed Citations, Embase/Embase Classic,
Cochrane CENTRAL, and Cochrane Database of Systematic Reviews,
ClinicalTrials.Gov, the WHO ICTRP (International Clinical Trials Registry
Platform) were searched for relevant articles from 1969 to April 2022.
<br/>Patient(s): Patients aged >=60 years old undergoing surgery with
preoperative IADL assessed by the Lawton IADL Scale. <br/>Intervention(s):
Preoperative assessment. Measurement: The primary outcome was the pooled
incidence of preoperative IADL dependency. Additional outcomes included
post-operative mortality, postoperative delirium [POD], functional status
improvement, and discharge disposition. <br/>Main Result(s): Twenty-one
studies (n = 5690) were included. In non-cardiac surgeries, the pooled
incidence of preoperative IADL dependence was 37% (95% CI: 26.0%, 48.0%)
among 2909 patients. Within cardiac surgeries, the pooled incidence of
preoperative IADL dependence was 53% (95% CI: 24.0%, 82.0%) among 1074
patients. Preoperative IADL dependence was associated with an increased
risk of postoperative delirium than those without IADL dependence (44.9%
vs 24.4, OR 2.26; 95% CI: 1.42, 3.59; I²: 0%; P = 0.0005).
<br/>Conclusion(s): There is a high incidence of IADL dependence in older
surgical patients undergoing non-cardiac and cardiac surgery. Preoperative
IADL dependence was associated with a two-fold risk of postoperative
delirium. Further work is needed to determine the feasibility of using the
IADL scale preoperatively as a predictive tool for postoperative adverse
outcomes.<br/>Copyright &#xa9; 2023

<76>
Accession Number
2024424041
Title
Comparison of intranasal midazolam-fentanyl with dexmedetomidine-fentanyl
as pre-medication in the paediatric age group.
Source
Indian Journal of Medical Research. 157(1) (pp 51-56), 2023. Date of
Publication: January 2023.
Author
Kaur T.; Kumar P.; Kundra T.S.; Kaur I.
Institution
(Kaur, Kumar, Kundra) Department of Anaesthesiology & ICU, Government
Medical College, Punjab, Patiala, India
(Kaur) Department of Anaesthesia, Jeevan Hospital, Punjab, Patiala, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & objectives: Intranasal midazolam-fentanyl is commonly used as
pre-medication in paediatric patients, but there is a risk of respiratory
depression with this combination. Dexmedetomidine is a drug that preserves
respiratory function. The objective of this study was to compare the
efficacy of intranasal midazolam-fentanyl and dexmedetomidine-fentanyl in
paediatric patients undergoing elective surgeries. <br/>Method(s): Hundred
children in the age group of 3-8 yr of American Society of
Anaesthesiologists physical status grade 1 were randomized into two
groups- group A received intranasal midazolam (0.2 mg/kg)-fentanyl (2
mug/kg) and group B received intranasal dexmedetomidine (1
mug/kg)-fentanyl (2 mug/kg) 20 min before induction of general
anaesthesia. Heart rate and SpO 2 were monitored. Sedation score, parental
separation and response to intravenous cannulation were seen after 20 min.
Children were monitored for 2 h for post-operative analgesia by Oucher's
Facial Pain Scale. <br/>Result(s): Sedation scores were satisfactory in
both groups, although children in group A were more sedated than in group
B. Parental separation and response to intravenous cannulation were
comparable in both the groups. The two groups were also haemodynamically
comparable intraoperatively. Post-operative heart rate was also comparable
at all-time intervals in both the groups except for heart rate at 100 and
120 min which were more in group A. Group A experienced more
post-operative pain as assessed by Oucher's Facial Pain Scale as compared
to group B. Children receiving intranasal dexmedetomidine-fentanyl had
better post-operative analgesia as compared to those who received
intranasal midazolam-fentanyl. Interpretation & conclusions: Both
intranasal midazolam with fentanyl and intranasal dexmedetomidine with
fentanyl provided satisfactory sedation. Both groups were comparable in
separation reaction and response to intravenous cannulation with better
post-operative analgesia in children receiving intranasal
dexmedetomidine-fentanyl.<br/>Copyright &#xa9; 2023 Wolters Kluwer Medknow
Publications. All rights reserved.

<77>
[Use Link to view the full text]
Accession Number
2024571025
Title
Incidence, predictors, and outcome of prosthesis-patient mismatch after
transcatheter aortic valve replacement: A meta-analysis.
Source
Medicine (United States). 99(24) (pp E20717), 2020. Date of Publication:
12 Jun 2020.
Author
He S.; Fang Z.
Institution
(He, Fang) Department of Cardiology, The Second Xiangya Hospital, Central
South University, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Prosthesis-patient mismatch (PPM) following transcatheter
aortic valve replacement (TAVR) is common, but the incidence, predictors
and outcome of PPM are still controversial. <br/>Method(s):A total of 18
articles incorporating 72,016 patients were identified form PubMed and
Embase online database. <br/>Result(s):The pooled incidences of overall,
and severe PPM following TAVR were 32.0% and 10.0% separately. Comparing
to surgical aortic valve replacement (SAVR), TAVR had lower incidence of
overall (OR, 0.31, 95% CI, 0.20-0.50) and severe PPM (OR, 0.38, 95% CI,
0.28-0.52). PPM was associated with a larger body surface area (BSA),
larger body mass index (BMI) and previous myocardial infarction in
comparison with those patients without PPM. Although PPM was not rare
after TAVR, no significant differences were observed both in short- and
mid-term all-cause mortality (30 day: OR: 1.51, 95% CI, 0.79-2.87, 1 year:
OR: 1.02, 95% CI, 0.96-1.08, and 2 years: OR: 0.99, 95% CI, 0.79-1.24)
between patients with PPM and those without PPM.
<br/>Conclusion(s):Despite the fact that the incidence of PPM was lower
than that of SAVR, PPM was not seen to have an impact on short- and
mid-term survival.<br/>Copyright &#xa9; 2020 Lippincott Williams and
Wilkins. All rights reserved.

<78>
Accession Number
2024497414
Title
Risk Prediction Models for Long-Term Survival after Cardiac Surgery: A
Systematic Review.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2023. Date of
Publication: 2023.
Author
Argus L.; Taylor M.; Ouzounian M.; Venkateswaran R.; Grant S.W.
Institution
(Argus) The University of Manchester, Manchester, United Kingdom
(Taylor, Venkateswaran) Department of Cardiothoracic Surgery, Manchester
University NHS Foundation Trust, Manchester, United Kingdom
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Grant) Division of Cardiovascular Sciences, University of Manchester,
Manchester, United Kingdom
(Grant) Academic Cardiovascular Unit, South Tees Hospitals NHS Foundation
Trust, Middlesbrough, United Kingdom
Publisher
Georg Thieme Verlag
Abstract
Background The reporting of alternative postoperative measures of quality
after cardiac surgery is becoming increasingly important as in-hospital
mortality rates continue to decline. This study aims to systematically
review and assess risk models designed to predict long-term outcomes after
cardiac surgery. Methods The MEDLINE and Embase databases were searched
for articles published between 1990 and 2020. Studies developing or
validating risk prediction models for long-term outcomes after cardiac
surgery were included. Data were extracted using checklists for critical
appraisal and systematic review of prediction modeling studies. Results
Eleven studies were identified for inclusion in the review, of which nine
studies described the development of long-term risk prediction models
after cardiac surgery and two were external validation studies. A total of
70 predictors were included across the nine models. The most frequently
used predictors were age (n = 9), peripheral vascular disease (n = 8),
renal disease (n = 8), and pulmonary disease (n = 8). Despite all models
demonstrating acceptable performance on internal validation, only two
models underwent external validation, both of which performed poorly.
Conclusion Nine risk prediction models predicting long-term mortality
after cardiac surgery have been identified in this review. Statistical
issues with model development, limited inclusion of outcomes beyond 5
years of follow-up, and a lack of external validation studies means that
none of the models identified can be recommended for use in contemporary
cardiac surgery. Further work is needed either to successfully externally
validate existing models or to develop new models. Newly developed models
should aim to use standardized long-term specific reproducible outcome
measures.<br/>Copyright &#xa9; 2023 Georg Thieme Verlag. All rights
reserved.

<79>
Accession Number
2024497413
Title
Comparison of Bretschneider HTK and Blood Cardioplegia (4:1): A
Prospective Randomized Study.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2023. Date of
Publication: 2023.
Author
Ak K.; Dericioglu O.; Midi A.; Kararmaz A.; Er Z.; Dogusan Z.; Arsan S.
Institution
(Ak) Department of Cardiovascular Surgery, Marmara University, School of
Medicine, Marmara Uninersitesi Hastanesi Mimar Sinan Cad. Fevzi Cakmak
Mah. Ust Kaynarca Kalp Ve Damar Cerrahisi Bolumu Pendik, Istanbul, Turkey
(Dericioglu, Arsan) Department of Cardiovascular Surgery, Marmara
University, School of Medicine, Istanbul, Turkey
(Midi) Department of Pathology, Bahcesehir University, School of Medicine,
Istanbul, Turkey
(Kararmaz) Department of Anesthesiology and Reanimation, Marmara
University, School of Medicine, Istanbul, Turkey
(Er) Department of Cardiovascular Surgery, Bozok University, Faculty of
Medicine Ringgold Standard Institution, Yozgat, Yozgat, Turkey
(Dogusan) Department of Pathology, Bone Marrow Transplantation Unite, Yeni
Yuzyll University, School of Medicine, Istanbul, Turkey
Publisher
Georg Thieme Verlag
Abstract
Background We compared the effect of intermittent blood and
histidine-tryptophan-ketoglutarate (HTK) solution of Bretschneider on
myocardial histopathology and perioperative outcome. Methods Forty adult
cardiac surgery patients were grouped into two (n = 20 for each): (1)
Intermittent blood cardioplegia (IBC): had repeated cold 4:1 blood
cardioplegia and (2) HTK: had a single dose of cold HTK for
cardioprotection. Creatine kinase (CK)-MB, Troponin-I (cTn-I), pH, and
lactate were studied in coronary sinus blood before and after aortic
cross-clamping (AXC) and systemic blood at postoperative 6^th,
24^th, and 48^thhours. Myocardial biopsy was performed
before and after AXC for light microscopy. Vacuolation, inflammation,
edema, and glycogen were graded semiquantitatively (from 0 to 3). The
myocardial apoptotic index was evaluated via the terminal deoxynucleotidyl
transferase dUTP nick end labeling. Results There were no differences in
perioperative clinical outcomes between the groups. The coronary sinus
samples after AXC were more acidotic (7.15 +/- 0.14 vs. 7.32 +/- 0.07, p =
0.001) and revealed higher CK-MB (21.0 +/- 12.81 vs. 12.60 +/- 11.80, p =
0.008) in HTK compared with IBC. The HTK had significantly a higher amount
of erythrocyte suspension intraoperatively compared with IBC (0.21 +/-
0.53 vs. 1.68 +/- 0.93 U, p = 0.001). Microscopically, myocardial edema
was more pronounced in HTK compared with IBC after AXC (2.25 +/- 0.91 vs.
1.50 +/- 0.04, p = 0.013). While a significant increase in the apoptotic
index was seen after AXC in both groups (p = 0.001), no difference was
detected between the groups (p = 0.417). Conclusion IBC and HTK have a
similar clinical outcome and protective effect, except for more pronounced
myocardial edema and increased need for intraoperative transfusion with
HTK.<br/>Copyright &#xa9; 2023 Georg Thieme Verlag. All rights reserved.

<80>
Accession Number
2023223246
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: 2023.
Author
Shell D.
Institution
(Shell) Department of Cardiothoracic Surgery, St Vincent's Hospital
Melbourne, St Vincent's Health Australia, Melbourne, Australia
Publisher
Springer
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. <br/>Aim(s): 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.

<81>
Accession Number
641339567
Title
The Role of Hypnotherapy in Postoperative Cardiac Surgical Patients, A
Scoping Review of Current Literature.
Source
Current problems in cardiology. (pp 101787), 2023. Date of Publication:
13 May 2023.
Author
Ahmad B.; Gill I.; Liblik K.; Uppal J.S.; El-Diasty M.
Institution
(Ahmad, Liblik, Uppal) Queen's University School of Medicine, Kingston,
ON, Canada
(Gill) Queen's University, Kingston, ON, Canada
(El-Diasty) Division of Cardiac Surgery, Department of Surgery, Queen's
University, Kingston, ON, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Hypnotherapy has been proposed as an emerging tool that can be
implemented in management of different aspects of postoperative cardiac
surgical care. This technique involves hypnotic induction to redirect
focus and attention away from post-surgical pain. Emerging literature has
shown that hypnosis significantly improves emotional distress immediately
preceding surgical procedures and these effects have been demonstrated to
extend into the postoperative period. The purpose of this scoping review
is to summarize current literature on the role of hypnotherapy in the
management of perioperative pain, anxiety, and depression in patients
undergoing cardiac surgery. <br/>METHOD(S): A database search was
conducted using PubMed, Embase, and Google Scholar. We included all
comparative studies (randomized and non-randomized) that examined the
effect of hypnotherapy on pain, anxiety, and depression in patients
undergoing cardiac surgery. Included articles were restricted to adult
patients and English language only. <br/>RESULT(S): Literature search
yielded a total of 64 articles, of which, 14 duplicates were removed.
After title and abstract screening, only 18 articles were included for
full-text review. Six studies (with a total number of 420 patients) were
included in the final analysis. Of these, five were randomized control
trials and one was a cohort study. <br/>CONCLUSION(S): Our findings
suggest that there may be a potential role for the use of hypnotherapy in
the management of pain, anxiety, and depressive symptoms in the
perioperative period of cardiac surgery. However, more robust evidence is
required to justify its incorporation in the routine perioperative
management pathways in this group of patients.<br/>Copyright &#xa9; 2023
Elsevier Ltd. All rights reserved.

<82>
Accession Number
2024236666
Title
Effect of Routine Invasive vs Conservative Strategy in Older Adults With
Frailty and Non-ST-Segment Elevation Acute Myocardial Infarction: A
Randomized Clinical Trial.
Source
JAMA Internal Medicine. 183(5) (pp 407-415), 2023. Date of Publication: 01
May 2023.
Author
Sanchis J.; Bueno H.; Minana G.; Guerrero C.; Marti D.; Martinez-Selles
M.; Dominguez-Perez L.; Diez-Villanueva P.; Barrabes J.A.; Marin F.; Villa
A.; Sanmartin M.; Llibre C.; Sionis A.; Carol A.; Garcia-Blas S.; Calvo
E.; Morales Gallardo M.J.; Elizaga J.; Gomez-Blazquez I.; Alfonso F.;
Garcia Del Blanco B.; Nunez J.; Formiga F.; Ariza-Sole A.
Institution
(Sanchis, Minana, Garcia-Blas, Nunez) Cardiology Department, University
Clinic Hospital of Valencia, University of Valencia, INCLIVA, CIBERCV,
Valencia 46010, Spain
(Bueno, Dominguez-Perez, Gomez-Blazquez) Centro Nacional de
Investigaciones Cardiovasculares (CNIC), Madrid, Spain
(Guerrero, Calvo, Formiga, Ariza-Sole) Cardiology Department, University
Hospital of Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
(Marti, Morales Gallardo) Central Defense Hospital, Alcala University,
Madrid, Spain
(Martinez-Selles, Elizaga) Cardiology Department, University Hospital
Gregorio Maranon, CIBERCV, Complutense University, European University,
Madrid, Spain
(Diez-Villanueva, Alfonso) University Hospital La Princesa, Autonomous
University of Madrid, IIS-IP, CIBERCV, Madrid, Spain
(Barrabes, Garcia Del Blanco) University Hospital Vall d'Hebron, CIBERCV,
Barcelona, Spain
(Marin) University Hospital Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV,
El Palmar, Murcia, Spain
(Villa) Southeast University Hospital, Arganda del Rey, Madrid, Spain
(Sanmartin) University Hospital Ramon y Cajal, CIBERCV, Madrid, Spain
(Llibre) University Hospital Germans Trias i Pujol, CIBERCV, Badalona,
Barcelona, Spain
(Sionis) University Hospital Sant Pau, CIBERCV, Barcelona, Spain
(Carol) Moises Broggi Hospital, Sant Joan Despi, Barcelona, Spain
(Sanchis) Cardiology Department, Universisty Hospital 12 de Octubre,
Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12)
Madrid, CIBERCV, Madrid, Spain
(Sanchis) Complutense University, Madrid, Spain
Publisher
American Medical Association
Abstract
Importance: To our knowledge, no randomized clinical trial has compared
the invasive and conservative strategies in frail, older patients with
non-ST-segment elevation acute myocardial infarction (NSTEMI).
<br/>Objective(s): To compare outcomes of invasive and conservative
strategies in frail, older patients with NSTEMI at 1 year. <br/>Design,
Setting, and Participant(s): This multicenter randomized clinical trial
was conducted at 13 Spanish hospitals between July 7, 2017, and January 9,
2021, and included 167 older adult (>=70 years) patients with frailty
(Clinical Frailty Scale score >=4) and NSTEMI. Data analysis was performed
from April 2022 to June 2022. <br/>Intervention(s): Patients were
randomized to routine invasive (coronary angiography and revascularization
if feasible; n = 84) or conservative (medical treatment with coronary
angiography for recurrent ischemia; n = 83) strategy. <br/>Main Outcomes
and Measures: The primary end point was the number of days alive and out
of the hospital (DAOH) from discharge to 1 year. The coprimary end point
was the composite of cardiac death, reinfarction, or postdischarge
revascularization. <br/>Result(s): The study was prematurely stopped due
to the COVID-19 pandemic when 95% of the calculated sample size had been
enrolled. Among the 167 patients included, the mean (SD) age was 86 (5)
years, and mean (SD) Clinical Frailty Scale score was 5 (1). While not
statistically different, DAOH were about 1 month (28 days; 95% CI, -7 to
62) greater for patients managed conservatively (312 days; 95% CI, 289 to
335) vs patients managed invasively (284 days; 95% CI, 255 to 311; P
=.12). A sensitivity analysis stratified by sex did not show differences.
In addition, we found no differences in all-cause mortality (hazard ratio,
1.45; 95% CI, 0.74-2.85; P =.28). There was a 28-day shorter survival in
the invasive vs conservatively managed group (95% CI, -63 to 7 days;
restricted mean survival time analysis). Noncardiac reasons accounted for
56% of the readmissions. There were no differences in the number of
readmissions or days spent in the hospital after discharge between groups.
Neither were there differences in the coprimary end point of ischemic
cardiac events (subdistribution hazard ratio, 0.92; 95% CI, 0.54-1.57; P
=.78). <br/>Conclusions and Relevance: In this randomized clinical trial
of NSTEMI in frail older patients, there was no benefit to a routine
invasive strategy in DAOH during the first year. Based on these findings,
a policy of medical management and watchful observation is recommended for
older patients with frailty and NSTEMI. Trial Registration:
ClinicalTrials.gov Identifier: NCT03208153.<br/>Copyright &#xa9; 2023
American Medical Association. All rights reserved.

<83>
Accession Number
2024156249
Title
Feasibility pilot trial for the Trajectories of Recovery after Intravenous
propofol versus inhaled VolatilE anesthesia (THRIVE) pragmatic randomised
controlled trial.
Source
BMJ Open. 13(4) (no pagination), 2023. Article Number: 070096. Date of
Publication: 17 Apr 2023.
Author
Tellor Pennington B.R.; Colquhoun D.A.; Neuman M.D.; Politi M.C.; Janda
A.M.; Spino C.; Thelen-Perry S.; Wu Z.; Kumar S.S.; Gregory S.H.; Avidan
M.S.; Kheterpal S.
Institution
(Tellor Pennington, Gregory, Avidan) Anesthesiology, Washington
University, School of Medicine, St. Louis, MO, United States
(Colquhoun, Janda, Kumar, Kheterpal) Anesthesiology, University of
Michigan Health System, Ann Arbor, MI, United States
(Neuman) Anesthesiology & Critical Care, University of Pennsylvania,
Philadelphia, PA, United States
(Politi) Surgery, Washington University in St. Louis, St. Louis, MO,
United States
(Spino, Thelen-Perry, Wu) Biostatistics, University of Michigan, Ann
Arbor, MI, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Millions of patients receive general anaesthesia for surgery
annually. Crucial gaps in evidence exist regarding which technique,
propofol total intravenous anaesthesia (TIVA) or inhaled volatile
anaesthesia (INVA), yields superior patient experience, safety and
outcomes. The aim of this pilot study is to assess the feasibility of
conducting a large comparative effectiveness trial assessing patient
experiences and outcomes after receiving propofol TIVA or INVA. Methods
and analysis This protocol was cocreated by a diverse team, including
patient partners with personal experience of TIVA or INVA. The design is a
300-patient, two-centre, randomised, feasibility pilot trial. Patients 18
years of age or older, undergoing elective non-cardiac surgery requiring
general anaesthesia with a tracheal tube or laryngeal mask airway will be
eligible. Patients will be randomised 1:1 to propofol TIVA or INVA,
stratified by centre and procedural complexity. The feasibility endpoints
include: (1) proportion of patients approached who agree to participate;
(2) proportion of patients who receive their assigned randomised
treatment; (3) completeness of outcomes data collection and (4)
feasibility of data management procedures. Proportions and 95% CIs will be
calculated to assess whether prespecified thresholds are met for the
feasibility parameters. If the lower bounds of the 95% CI are above the
thresholds of 10% for the proportion of patients agreeing to participate
among those approached and 80% for compliance with treatment allocation
for each randomised treatment group, this will suggest that our planned
pragmatic 12 500-patient comparative effectiveness trial can likely be
conducted successfully. Other feasibility outcomes and adverse events will
be described. Ethics and dissemination This study is approved by the
ethics board at Washington University (IRB# 202205053), serving as the
single Institutional Review Board for both participating sites.
Recruitment began in September 2022. Dissemination plans include
presentations at scientific conferences, scientific publications,
internet-based educational materials and mass media. Trial registration
number NCT05346588.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<84>
Accession Number
2023726264
Title
The efficacy and safety of quantitative flow ratio-guided complete
revascularization in patients with ST-segment elevation myocardial
infarction and multivessel disease: A pilot randomized controlled trial.
Source
Cardiology Journal. 30(2) (pp 178-187), 2023. Date of Publication: 2023.
Author
Zhang J.; Yao M.; Jia X.; Feng H.; Fu J.; Tang W.; Cong H.
Institution
(Zhang, Jia, Feng, Tang) Department of Cardiology, Affiliated Hospital of
Hebei University, Baoding, China
(Zhang, Cong) Department of Cardiology, Thoracic Clinical College, Tianjin
Medical University, Tianjin, China
(Yao) Department of Endocrinology, Baoding No. 1 Central Hospital,
Baoding, China
(Fu) Department of Cardiology, Fengfeng General Hospital, North China
Medical and Health Group, Handan, China
Publisher
Via Medica
Abstract
Background: In patients with ST-segment elevation myocardial infarction
(STEMI) and multivessel disease (MVD), the treatment strategy for
non-infarct-related artery (non-IRA) remains controversial. Quantitative
flow ratio (QFR) is a new angiography-based physiological assessment
index. However, there is little evidence on the practical clinical
application of QFR. <br/>Method(s): Two hundred and twenty-nine patients
with STEMI and MVD were recruited for this study. Patients were randomly
assigned to either receive QFR-guided complete revascularization
(QFR-G-CR) of non-IRA or receive no further invasive treatment. The
primary (1degree) endpoint analyzed included death due to all causes,
non-fatal myocardial infarction (MI), and ischemia-induced
revascularization at 12 months post-surgery. Secondary (2degree) endpoints
included cardiovascular death, unstable angina, stent thrombosis, New York
Heart Association (NYHA) class IV heart failure, and stroke at 1 year post
surgery. Massive bleeding and contrast-associated acute kidney injury
(CAKI) were used as safety endpoints. <br/>Result(s): Around the 12 month
follow up, the 1^o outcome was recorded in 11/115 patients
(9.6%) in the QFR-G-CR population, relative to 23/114 patients (20.1%) in
the IRA-only PCI population (hazard ratio [HR]: 0.45; 95% confidence
interval [CI]: 0.22-0.92; p = 0.025). Unstable angina in 6 (5.2%) and 16
(14.0%) patients (HR: 0.36; 95% CI: 0.14-0.92; p = 0.026), respectively.
No marked alterations were found in the massive bleeding and CAKI
categories. <br/>Conclusion(s): In conclusion, STEMI and MVD patients can
benefit from QFR-G-CR of non-IRA lesions in the initial stages of acute
MI. This can help reduce incidences of major adverse cardiovascular events
and unstable angina, relative to IRA treatment only.<br/>Copyright &#xa9;
2023 Via Medica.

<85>
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.

<86>
Accession Number
2020416707
Title
Antithrombotic Strategy After Transcatheter Aortic Valve Replacement: A
Network Meta-Analysis.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101348. Date of Publication: December 2022.
Author
Mahalwar G.; Kumar A.; Majmundar M.; Adebolu O.; Yendamuri R.; Lao N.;
Barve N.; Kreutz R.P.; Reed G.W.; Puri R.; Dani S.S.; Kalra A.
Institution
(Mahalwar, Kumar, Adebolu, Yendamuri, Lao, Barve) Department of Medicine,
Cleveland Clinic Akron General, Akron, OH, United States
(Majmundar) Department of Cardiovascular Medicine, Maimonides Medical
Center, New York, NY, United States
(Kreutz) Division of Cardiovascular Medicine, Krannert Cardiovascular
Research Center, Indiana University School of Medicine, Indianapolis, IN,
United States
(Reed, Puri) Department of Cardiovascular Medicine, Heart, Vascular,
Thoracic Institute, Cleveland Clinic, Cleveland, OH
(Dani) Department of Cardiovascular Medicine, Lahey Hospital & Medical
Center, Burlington, MA
(Kalra) Division of Cardiology, Department of Medicine, Cardiovascular
Institute, Kalra Hospitals, New Delhi, India
Publisher
Elsevier Inc.
Abstract
The ideal antithrombotic therapy post transcatheter aortic valve
replacement (TAVR) remains uncertain. We performed a network meta-analysis
of RCTs to report the outcomes with various antithrombotic strategies to
determine the optimal therapy. A systematic search of the PubMed/Medline
and Cochrane databases was performed through January 6, 2022. The primary
outcome was stroke and the secondary outcomes were major/life-threatening
bleeding, myocardial infarction, all-cause mortality, and cardiac
mortality. A network meta-analysis was conducted with a random-effects
model. All analysis was carried out using R version 4.0.3. Six RCTs were
included in the final analysis. SAPT when compared with DAPT was
associated with a reduced risk of major or life-threatening bleeding [OR:
0.42; 95% CI: 0.25-0.70]. Other antithrombotic strategies were associated
with similar odds of major and life-threatening bleeding post TAVR
compared with DAPT. There was no difference in the incidence of stroke,
myocardial infarction, all-cause and cardiac mortality between the various
antithrombotic strategies post TAVR. The present analysis reported SAPT as
the preferred antithrombotic regimen post TAVR compared with other
regimens in patients who do not have other indications for
anticoagulation. Additional studies such as ADAPT-TAVR, CLOE and ATLANTIS
trials will further add to our understanding of the adequate
antithrombotic regimen post TAVR in patients with otherwise no indication
for anticoagulation.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<87>
Accession Number
2016587284
Title
Respect versus resect approaches for mitral valve repair: A study-level
meta-analysis.
Source
Trends in Cardiovascular Medicine. 33(4) (pp 225-239), 2023. Date of
Publication: May 2023.
Author
Sa M.P.; Cavalcanti L.R.P.; Van den Eynde J.; Amabile A.; Escorel Neto
A.C.; Perazzo A.M.; Weymann A.; Ruhparwar A.; Sicouri S.; Bisleri G.;
Torregrossa G.; Geirsson A.; Ramlawi B.
Institution
(Sa, Torregrossa) Department of Cardiac Surgery, Lankenau Heart Institute
/ Main Line Health, Philadelphia, PA, United States
(Sa, Sicouri, Torregrossa) Division of Cardiac Surgery Research, Lankenau
Institute for Medical Research / Main Line Health, Philadelphia, PA,
United States
(Cavalcanti, Escorel Neto, Perazzo, Ramlawi) Division of Cardiovascular
Surgery of Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Recife,
Brazil
(Cavalcanti, Escorel Neto, Perazzo, Ramlawi) University of Pernambuco -
UPE., Recife, Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Amabile, Geirsson) Division of Cardiac Surgery, Department of Surgery,
Yale School of Medicine, New Haven, CT, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
(Bisleri) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Mitral valve repair (MVr) restores leaflets coaptation while preserving
the patient's own valve. The two main techniques are: (a) chordal
replacement ("respect approach"), whereby artificial neochordae are used
to resuspend prolapsed segments of the affected leaflet - and (b) leaflet
resection ("resect approach"), whereby diseased leaflet segment is
resected, and the remaining segments are sutured together. Both techniques
of MVr are associated with better long-term results, fewer valve-related
complications and lower mortality when compared with mitral valve
replacement (MVR). They also restore quality of life and improve survival
to rates equivalent to those of the general population. We performed a
meta-analysis to pool data of clinical studies that compared outcomes of
MVr stratified by the surgical technique. Seventeen studies accounting for
6,046 patients fulfilled our eligibility criteria. The "respect approach"
outperformed the "resect approach" with lower permanent pacemaker
implantation rates and lower mean gradients. Despite any possible
advantages of one technique over the other, which approach is best for
each patient must be decided on a case-by-case basis and more long-term
follow-up data are warranted.<br/>Copyright &#xa9; 2022

<88>
Accession Number
2024504866
Title
Transcatheter Aortic Valve Implantation in Cardiac Amyloidosis and Aortic
Stenosis.
Source
American Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Riley J.M.; Junarta J.; Ullah W.; Siddiqui M.U.; Anzelmi A.; Ruge M.;
Vishnevsky A.; Alvarez R.J.; Ruggiero N.J.; Rajapreyar I.N.; Brailovsky Y.
Institution
(Riley, Junarta, Anzelmi, Ruge) Department of Medicine, Thomas Jefferson
University Hospitals, Philadelphia, Pennsylvania, United States
(Ullah, Siddiqui, Vishnevsky, Alvarez, Ruggiero, Rajapreyar, Brailovsky)
Department of Jefferson Heart Institute, Thomas Jefferson University
Hospitals, Philadelphia, Pennsylvania, United States
Publisher
Elsevier Inc.
Abstract
Aortic stenosis (AS) and cardiac amyloidosis (CA) occur concomitantly in a
significant number of patients and portend a higher risk of all-cause
mortality. Previous studies have investigated outcomes in patients with
concomitant CA/AS who underwent transcatheter aortic valve implantation
(TAVI) versus medical therapy alone, but no evidence-based consensus
regarding the ideal management of these patients has been established.
Medline, Scopus, and Cochrane Central Register of Controlled Trials were
systematically searched to identify relevant studies. Methodologic bias
was assessed using the modified Newcastle-Ottawa scale for observational
studies. A total of 4 observational studies comprising 83 patients were
included. Of these, 45 patients (54%) underwent TAVI, whereas 38 (46%)
were managed conservatively. Of the 3 studies that included baseline
characteristics by treatment group, 30% were women. The risk of all-cause
mortality was found to be significantly lower in patients who underwent
TAVI than those treated with conservative medical therapy alone (odds
ratio 0.24, 95% confidence interval 0.08 to 0.73). In conclusion, this
meta-analysis suggests a lower risk of all-cause mortality in patients
with CA with AS who underwent TAVI than those managed with medical therapy
alone.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<89>
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.

<90>
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.

<91>
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

<92>
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.

<93>
Accession Number
2017986908
Title
Aggressive intraoperative warming versus routine thermal management during
non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority
trial.
Source
The Lancet. 399(10337) (pp 1799-1808), 2022. Date of Publication: 07 May
2022.
Author
Sessler D.I.; Pei L.; Li K.; Cui S.; Chan M.T.V.; Huang Y.; Wu J.; He X.;
Bajracharya G.R.; Rivas E.; Lam C.K.M.; Sun H.; Hu Z.; Li W.; Han W.; Zhao
P.; Ye H.; Chen P.; Zhu Z.; Dai W.; Jin L.; Bian W.; Liu Y.; Fung B.B.Y.;
Lee E.; Hui K.Y.; Choi G.Y.S.; Wong W.T.; Chan C.S.; Xiao Y.; Wu B.; Kang
W.; Lan L.; Sun C.; Qiu Y.; Tang W.; Zhang Y.; Huang Q.; Lu X.; Li T.; Yu
Q.; Yu J.; Wang R.; Chang H.; Zuo Y.; Sun Z.; Hou W.; Pan C.; Liu X.;
Zhang X.; Wang S.; Kang Y.; Ma Z.; Gu X.; Miao C.; Bravo M.; Kurz A.;
Turan A.; Ruetzler K.; Maheshwari K.; Mao G.; Han Y.; Yamak Altinpulluk
E.; Montalvo Compana M.; Almonacid-Cardenas F.; Leung S.M.; Hanline C.K.;
Chelnick D.M.; Tanios M.; Walters M.; Rosen M.J.; Ezoke S.; Mascha E.J.;
Cheng B.C.P.; Yip R.P.L.; Devereaux P.J.
Institution
(Sessler, Bajracharya, Rivas) Department of Outcomes Research,
Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States
(Sessler) Population Health Research Institute, McMaster University, ON,
Canada
(Pei, Huang) Department of Anesthesiology, Peking Union Medical College
Hospital, Beijing, China
(Li, Cui) China-Japan Union Hospital of Jilin University, Jilin, China
(Chan) The Chinese University of Hong Kong, Hong Kong Special
Administrative Region, China
(Wu) Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai,
China
(He) West China Hospital, Sichuan University, Sichuan, China
(Rivas) Department of Anesthesia, Hospital Clinic of Barcelona, IDIBAPS,
Universidad de Barcelona, Barcelona, Spain
(Lam) Tuen Mun Hospital, Hong Kong Special Administrative Region, China
Publisher
Elsevier B.V.
Abstract
Background: Moderate intraoperative hypothermia promotes myocardial
injury, surgical site infections, and blood loss. Whether aggressive
warming to a truly normothermic temperature near 37degreeC improves
outcomes remains unknown. We aimed to test the hypothesis that aggressive
intraoperative warming reduces major perioperative complications.
<br/>Method(s): In this multicentre, parallel group, superiority trial,
patients at 12 sites in China and at the Cleveland Clinic in the USA were
randomly assigned (1:1) to receive either aggressive warming to a target
core temperature of 37degreeC (aggressively warmed group) or routine
thermal management to a target of 35.5degreeC (routine thermal management
group) during non-cardiac surgery. Randomisation was stratified by site,
with computer-generated, randomly sized blocks. Eligible patients (aged
>=45 years) had at least one cardiovascular risk factor, were scheduled
for inpatient non-cardiac surgery expected to last 2-6 h with general
anaesthesia, and were expected to have at least half of the anterior skin
surface available for warming. Patients requiring dialysis and those with
a body-mass index exceeding 30 kg/m² were excluded. The primary
outcome was a composite of myocardial injury (troponin elevation,
apparently of ischaemic origin), non-fatal cardiac arrest, and all-cause
mortality within 30 days of surgery, as assessed in the modified
intention-to-treat population. This study is registered with
ClinicalTrials.gov, NCT03111875. <br/>Finding(s): Between March 27, 2017,
and March 16, 2021, 5056 participants were enrolled, of whom 5013 were
included in the intention-to-treat population (2507 in the aggressively
warmed group and 2506 in the routine thermal management group). Patients
assigned to aggressive warming had a mean final intraoperative core
temperature of 37.1degreeC (SD 0.3) whereas the routine thermal management
group averaged 35.6degreeC (SD 0.3). At least one of the primary outcome
components (myocardial injury after non-cardiac surgery, cardiac arrest,
or mortality) occurred in 246 (9.9%) of 2497 patients in the aggressively
warmed group and in 239 (9.6%) of 2490 patients in the routine thermal
management group. The common effect relative risk of aggressive versus
routine thermal management was an estimated 1.04 (95% CI 0.87-1.24,
p=0.69). There were 39 adverse events in patients assigned to aggressive
warming (17 of which were serious) and 54 in those assigned to routine
thermal management (30 of which were serious). One serious adverse event,
in an aggressively warmed patient, was deemed to be possibly related to
thermal management. <br/>Interpretation(s): The incidence of a 30-day
composite of major cardiovascular outcomes did not differ significantly in
patients randomised to 35.5degreeC and to 37degreeC. At least over a
1.5degreeC range from very mild hypothermia to full normothermia, there
was no evidence that any substantive outcome varied. Keeping core
temperature at least 35.5degreeC in surgical patients appears sufficient.
<br/>Funding(s): 3M and the Health and Medical Research Fund, Food and
Health Bureau, Hong Kong. Translation: For the Chinese translation of the
abstract see Supplementary Materials section.<br/>Copyright &#xa9; 2022
Elsevier Ltd

<94>
Accession Number
641323637
Title
Biomarkers of biological aging in recipients of solid organ
transplantation and clinical outcomes: A scoping review.
Source
Transplant immunology. (pp 101851), 2023. Date of Publication: 12 May
2023.
Author
Cremen S.; Santiago R.-M.; Robinson M.W.; Gallagher T.K.
Institution
(Cremen, Gallagher) Department of Hepatobiliary and Transplant Surgery, St
Vincent's University Hospital, Dublin, Ireland; School of Medicine,
University College Dublin, Dublin, Ireland
(Santiago, Robinson) Department of Biology, Kathleen Lonsdale Institute
for Human Health Research, Maynooth University, Kildare, Ireland
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Biological aging is the accumulation of cellular and
molecular damage within an individual over time. The biological age of a
donor organ is known to influence clinical outcomes of solid organ
transplantation, including delayed graft function and frequency of
rejection episodes. While much research has focused on the biological age
of donor organs, the recipient's biological age may also influence
transplantation outcomes . The aim of this scoping review was to identify
and provide an overview of the existing evidence regarding biological
aging in solid organ transplant recipients and the impact on patient
outcomes post-transplant. <br/>METHOD(S): Literature searches were carried
out on PubMed, Web of Science, Google Scholar, Embase and TRIP using the
phrases 'solid organ transplant', 'cell senescence', 'cell aging' and
'outcomes', using boolean 'and/or' phrases and MeSH terms. Duplicates were
removed and abstracts were reviewed by two independent reviewers. Full
papers were then screened for inclusion by two reviewers. Data extraction
was carried out using a standardised proforma agreed on prior to starting.
<br/>RESULT(S): 32 studies, including data on a total of 7724 patients,
were identified for inclusion in this review; 23 relating to kidney
transplant recipients, three to liver transplant, five to lung transplant
and one to heart transplantation. A wide range of biomarkers of biological
aging have been assessed in kidney transplant recipients, whereas studies
of liver, lung and heart transplant have predominantly assessed recipient
telomere length. The most robust associations with clinical outcomes are
observed in kidney transplant recipients, possibly influenced by the
larger number of studies and the use of a wider range of biomarkers of
biological aging. In kidney transplant recipients reduced thymic function
and accumulation of terminally differentiated T cell populations was
associated with reduced risk of acute rejection but increased risk of
infection and mortality. <br/>CONCLUSION(S): Studies to date on biological
aging in transplant recipients have been heavily biased to kidney
transplant recipients. The results from these studies suggest recipient
biological age can influence clinical outcomes and future research is
needed to prioritise robust biomarkers of biological aging in transplant
recipients.<br/>Copyright &#xa9; 2023. Published by Elsevier B.V.

<95>
Accession Number
641316186
Title
Cardiac surgery in Jehovah's Witnesses patients and association with
peri-operative outcomes: a systematic review and meta-analysis.
Source
Current problems in cardiology. (pp 101789), 2023. Date of Publication:
10 May 2023.
Author
Vitolo M.; Mei D.A.; Cimato P.; Bonini N.; Imberti J.F.; Cataldo P.;
Menozzi M.; Filippini T.; Vinceti M.; Boriani G.
Institution
(Vitolo, Imberti) Cardiology Division, Department of Biomedical, Metabolic
and Neural Sciences, University of Modena and Reggio Emilia, Policlinico
di Modena, Modena, Italy; Clinical and Experimental Medicine PhD Program,
University of Modena and Reggio Emilia, Modena, Italy
(Mei, Bonini, Cataldo, Menozzi, Boriani) Cardiology Division, Department
of Biomedical, Metabolic and Neural Sciences, University of Modena and
Reggio Emilia, Policlinico di Modena, Modena, Italy
(Cimato) Department of Cardiac Surgery, Villa Torri Hospital, GVM Care &
Research, Bologna, Italy
(Filippini) Environmental, Genetic and Nutritional Epidemiology Research
Center, Department of Biomedical, Metabolic and Neural Sciences,
University of Modena and Reggio Emilia Modena Italy; School of Public
Health, University of California Berkeley, Berkeley, CA, USA
(Vinceti) Environmental, Genetic and Nutritional Epidemiology Research
Center, Department of Biomedical, Metabolic and Neural Sciences,
University of Modena and Reggio Emilia Modena Italy; Department of
Epidemiology, Boston University School of Public Health, Boston, MA, USA
Publisher
NLM (Medline)
Abstract
BACKGROUND: Strategies for blood conservation, coupled with a careful
preoperative assessment, may be applied to Jehovah's Witnesses (JW)
patients who are candidates for cardiac surgery interventions. There is a
need to assess clinical outcomes and safety of bloodless surgery in JW
patients undergoing cardiac surgery. <br/>METHOD(S): We performed a
systematic review and meta-analysis of studies comparing JW patients with
controls undergoing cardiac surgery. The primary endpoint was short-term
mortality (in-hospital or 30-day mortality). Peri-procedural myocardial
infarction, re-exploration for bleeding, pre-and post-operative Hb levels
and cardiopulmonary bypass (CPB) time were also analyzed. <br/>RESULT(S):
A total of 10 studies including 2,302 patients were included. The pooled
analysis showed no substantial differences in terms of short-term
mortality among the two groups (OR 1.13, 95% CI 0.74-1.73, I2=0%). There
were no differences in peri-operative outcomes among JW patients and
controls (OR 0.97, 95% CI 0.39-2.41, I2=18% for myocardial infarction; OR
0.80, 95% CI 0.51-1.25, I2=0% for re-exploration for bleeding). JW
patients had a higher level of pre-operative Hb (Standardized Mean
Difference [SMD] 0.32, 95% CI 0.06-0.57) and a trend toward a higher level
of post-operative Hb (SMD 0.44, 95% CI -0.01-0.90). A slightly lower CPB
time emerged in JWs compared with controls (SMD -0.11, 95% CI -0.30-0.07).
<br/>CONCLUSION(S): JW patients undergoing cardiac surgery, with avoidance
of blood transfusions, did not have substantially different peri-operative
outcomes compared with controls, with specific reference to mortality,
myocardial infarction, and re-exploration for bleeding. Our results
support the safety and feasibility of bloodless cardiac surgery, applying
patient blood management strategies.<br/>Copyright &#xa9; 2023. Published
by Elsevier Inc.

<96>
Accession Number
641315953
Title
Utility of Intracardiac Echocardiography for Infective Endocarditis and
Cardiovascular Device-Related Endocarditis: A Contemporary Systematic
Review.
Source
Current problems in cardiology. (pp 101791), 2023. Date of Publication:
10 May 2023.
Author
Sanchez-Nadales A.; Cedeno J.; Sonnino A.; Sarkar A.; Igbinomwanhia E.;
Asher C.R.; Xu B.
Institution
(Sanchez-Nadales) Department of Cardiovascular Medicine, Cleveland Clinic
Florida, Weston FL 33321
(Cedeno) Department of Internal Medicine, Cleveland Clinic Florida, Weston
FL 33321
(Sonnino) Department of Internal Medicine, Cleveland Clinic Florida,
Weston FL 33321
(Sarkar, Asher) Department of Cardiovascular Medicine, Cleveland Clinic
Florida, Weston FL 33321
(Igbinomwanhia) Department of Cardiovascular Disease, MetroHealth System,
Cleveland, OH 44109, United States
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
44195, United States
Publisher
NLM (Medline)