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<1>
Accession Number
2022580270
Title
Combined CT Coronary Artery Assessment and TAVI Planning.
Source
Diagnostics. 13(7) (no pagination), 2023. Article Number: 1327. Date of
Publication: April 2023.
Author
Renker M.; Schoepf U.J.; Kim W.K.
Institution
(Renker, Kim) Department of Cardiology, Campus Kerckhoff of the Justus
Liebig University Giessen, Bad Nauheim 61231, Germany
(Renker, Kim) Department of Cardiac Surgery, Campus Kerckhoff of the
Justus Liebig University Giessen, Bad Nauheim 61231, Germany
(Renker, Kim) German Centre for Cardiovascular Research (DZHK), Partner
Site Rhine-Main, Bad Nauheim 61231, Germany
(Schoepf) Heart & Vascular Center, Medical University of South Carolina,
Charleston, SC 29425, United States
(Kim) Department of Cardiology, Justus Liebig University Giessen, Giessen
35392, Germany
Publisher
MDPI
Abstract
Computed tomography angiography (CTA) of the aorta and the iliofemoral
arteries is crucial for preprocedural planning of transcatheter aortic
valve implantation (TAVI) in patients with severe aortic stenosis (AS),
because it provides details on a variety of aspects required for heart
team decision-making. In addition to providing relevant diagnostic
information on the degree of aortic valve calcification, CTA allows for a
customized choice of the transcatheter heart valve system and the TAVI
access route. Furthermore, current guidelines recommend the exclusion of
relevant coronary artery disease (CAD) prior to TAVI. The feasibility of
coronary artery assessment with CTA in patients scheduled for TAVI has
been established previously, and accumulating data support its value. In
addition, fractional flow reserve determined from CTA (CT-FFR) and machine
learning-based CT-FFR were recently shown to improve its diagnostic yield
for this purpose. However, the utilization of CTA for coronary artery
evaluation remains limited in this specific population of patients due to
the relatively high risk of CAD coexistence with severe AS. Therefore, the
current diagnostic work-up prior to TAVI routinely includes invasive
catheter coronary angiography at most centers. In this article, the
authors address technological prerequisites and CT protocol
considerations, discuss pitfalls, review the current literature regarding
combined CTA coronary artery assessment and preprocedural TAVI evaluation,
and provide an overview of unanswered questions and future research goals
within the field. Copyright © 2023 by the authors.

<2>
Accession Number
2020779694
Title
Left Atrial Appendage Closure for Atrial Fibrillation in the Elderly >75
Years Old: A Meta-Analysis of Observational Studies.
Source
Diagnostics. 12(12) (no pagination), 2022. Article Number: 3174. Date of
Publication: December 2022.
Author
Han S.; Jia R.; Zhao S.; Chan J.; Bai Y.; Cui K.
Institution
(Han, Jia, Zhao, Chan, Bai, Cui) Department of Cardiology, West China
Hospital, Sichuan University, Chengdu 610041, China
Publisher
MDPI
Abstract
Background: Left atrial appendage closure (LAAC) is an established therapy
for patients with atrial fibrillation (AF); however, there is a limited
understanding of LAAC in elderly patients (>=75 years old). We conducted a
meta-analysis to investigate the procedural complications and long-term
outcomes after LAAC in the elderly versus the non-elderly. Method(s):
We screened PubMed, EMBASE, Cochrane Library, and Web of Science.
Procedural endpoints of interest included successful implantation LAAC
rates, in-hospital mortality, major bleeding events, pericardial
effusion/tamponade, stroke, and vascular access complications related to
LAAC. Long-term outcomes included all-cause mortality, major bleeding
events, and stroke/transient ischemic attack (TIA) during follow-up.
 Result(s): Finally, 12 studies were included in the analysis; these
included a total of 25,094 people in the elderly group and 36,035 people
in the non-elderly group. The successful implantation LAAC rates did not
differ between the groups, while the elderly patients experienced more
periprocedural mortality (OR 2.62; 95% CI 1.79-3.83, p < 0.01;
I2 = 0%), pericardial effusion/tamponade (OR 1.39; 95% CI:
1.06-1.82, p < 0.01; I2 = 0%), major bleeding events (OR 1.32;
95% CI 1.17-1.48, p < 0.01; I2 = 0%), and vascular access
complications (OR 1.34; 95% CI 1.16-1.55, p < 0.01; I2 = 0%)
than the non-elderly patients. The long-term stroke/TIA rates did not
differ between the elderly and the non-elderly at least one year after
follow-up. Conclusion(s): Even though successful implantation LAAC
rates are similar, elderly patients have a significantly higher incidence
of periprocedural mortality, major bleeding events, vascular access
complications, and pericardial effusion/tamponade after LAAC than
non-elderly patients. The stroke/TIA rates did not differ between both
groups after at least one-year follow-up. Copyright © 2022 by the
authors.

<3>
Accession Number
2015702271
Title
The Prognostic Performance of Ferritin in Patients with Acute Myocardial
Infarction: A Systematic Review.
Source
Diagnostics. 12(2) (no pagination), 2022. Article Number: 476. Date of
Publication: February 2022.
Author
Brinza C.; Floria M.; Popa I.V.; Burlacu A.
Institution
(Brinza, Floria, Popa, Burlacu) Faculty of Medicine, University of
Medicine and Pharmacy, Iasi 700115, Romania
(Brinza, Burlacu) Institute of Cardiovascular Diseases, Iasi 700503,
Romania
(Floria) Military Emergency Clinical Hospital, Iasi 700483, Romania
Publisher
MDPI
Abstract
The potential benefit of ferritin evaluation resides in its association
with adverse outcomes in patients with various pathological conditions. We
aimed to conduct the first systematic review evaluating the association
between ferritin levels and adverse cardiovascular outcomes in patients
with acute myocardial infarction (AMI) during short-or long-term
follow-up. Seven studies investigating various endpoints (mortality, major
adverse cardiovascular events-MACE, the decline of the left ventricular
ejection fraction-LVEF, left ventricular aneurysm development-LVA) were
included. AMI patients with low or increased ferritin values tended to
have higher in-hospital and 30-day mortality rates. Low and high ferritin
levels and chronic kidney disease were independently associated with
increased risk of LVA formation. High ferritin concentrations were linked
to an accentuated LVEF decline in ST-elevation myocardial infarction
patients treated by percutaneous coronary intervention. Both low and high
ferritin values were also associated with the duration of hospitalization
in patients with AMI during hospital stay and at more extended follow-up.
Ferritin evaluation represents a simple investigation that could identify
high-risk patients with AMI who might benefit from closer monitoring and
specific therapeutic interventions. These data should be confirmed in
large trials in the context of currently available therapies for heart
failure and AMI. Copyright © 2022 by the authors. Licensee MDPI,
Basel, Switzerland.

<4>
Accession Number
2007728961
Title
Association of excessive daytime sleepiness with the zung self-rated
depression subscales in adults with coronary artery disease and
obstructive sleep apnea.
Source
Diagnostics. 11(7) (no pagination), 2021. Article Number: 1176. Date of
Publication: July 2021.
Author
Celik Y.; Yapici-Eser H.; Balcan B.; Peker Y.
Institution
(Celik, Yapici-Eser, Peker) School of Medicine, Koc University Research
Center for Translational Medicine (KUTTAM), Istanbul 34450, Turkey
(Celik) Graduate School of Health Sciences, Koc University, Istanbul
34450, Turkey
(Yapici-Eser) Department of Psychiatry, School of Medicine, Koc
University, Istanbul 34450, Turkey
(Balcan) Department of Pulmonary Medicine, School of Medicine, Marmara
University, Istanbul 34722, Turkey
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, School of Medicine, Lund University, Lund 22185, Sweden
(Peker) Department of Molecular and Clinical Medicine/Cardiology,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg 40530, Sweden
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United
States
Publisher
MDPI
Abstract
Excessive daytime sleepiness (EDS) is a factor associated with both
obstructive sleep apnea (OSA) and depressive symptoms. Continuous positive
airway pressure (CPAP) treatment may decrease EDS in adults with OSA;
however, the modulatory role of depressive symptoms on the improvement of
EDS is not known. We aimed to explore the association between subscales of
the Zung Self-rated Depression Scale (SDS) and Epworth Sleepiness Scale
(ESS) over a 2-year period in coronary artery disease (CAD) patients with
OSA. This was a post-hoc analysis of the RICCADSA cohort, in which 399
adults with CAD (155 sleepy OSA [apnea-hypopnea index >= 15/h] and ESS
score >= 10, who were offered CPAP; and 244 nonsleepy OSA [ESS < 10]),
randomized to CPAP [n = 122] or no-CPAP [n = 122]) were included. Three
factors were extracted from the Zung SDS, based on the principal component
analysis: F1, cognitive symptoms and anhedonia; F2, negative mood; and F3,
appetite. In a mixed model, the ESS score decreased by 3.4 points (p <
0.001) among the sleepy OSA phenotype, which was predicted by the decline
in the F2, but not in the F1 and F3 scores. The fixed effects of time were
not significant in the nonsleepy OSA groups, and thus, further analyses
were not applicable. Additional within-group analyses showed a significant
decrease in all subscales over time both in the sleepy and nonsleepy OSA
patients on CPAP whereas there was a significant increase in the nonsleepy
OSA group randomized to no-CPAP. We conclude that the improvement in
negative mood symptoms of depression, but not changes in cognitive
symptoms and anhedonia as well as appetite, was a significant predictor of
decline in the ESS scores over a 2-year period in this CAD cohort with
sleepy OSA on CPAP treatment. Copyright © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<5>
Accession Number
2007324281
Title
Influence of internal thoracic artery harvesting on sternal osteoblastic
activity and perfusion.
Source
Diagnostics. 10(11) (no pagination), 2020. Article Number: 921. Date of
Publication: November 2020.
Author
Mamchur S.; Vecherskii Y.; Chichkova T.
Institution
(Mamchur, Chichkova) Department of Cardiovascular Surgery, Research
Institute for Complex Issues of Cardiovascular Diseases, Kemerovo 650002,
Russian Federation
(Vecherskii) Department of Cardiovascular Surgery, Research Institute of
Cardiology, Tomsk 634012, Russian Federation
Publisher
MDPI
Abstract
The purpose of this study was to assess the sternal osteoblastic activity
and perfusion in the early period after a coronary artery bypass graft
(CABG) using single-photon emission computed tomography (SPECT) and
three-phasic dynamic scintigraphy (3PDS) with 99mTc methylene
diphosphonate (MDP). Method(s): The study group consisted of 57 male
patients that were 57.3 +/- 6.6 years of age. Thirty-six of them were
randomized into two groups: in group I (n = 18), the internal thoracic
artery (ITA) was skeletonized, and in group II (n = 18), the ITA was
pedicled. All the patients in groups I and II underwent an off-pump CABG
using 1.7 +/- 0.3 grafts, including one anastomosis of the ITA to the left
anterior descending coronary artery. The control group III (n = 21)
consisted of patients that underwent mitral valve repair surgery, in whom
the sternotomy without the ITA harvesting was performed. The 3PDS and
SPECT of the thorax with 99mTc MDP were performed 2 weeks after surgery.
 Result(s): The sternal phosphates uptake in group I was approximately
twice as high as in group II and approximately 1.5 times higher than in
group III (p < 0.05). The MDP uptake asymmetry after the ITA
skeletonization was the same as in the group with both intact ITAs. In
contrast, after the pedicled ITA harvesting, the osteoblastic activity of
the ipsilateral side of the sternum was lower than in the contralateral
one. There was no statistically significant difference in scintillation
count in the xiphoid process between groups I and II (p > 0.05); however,
we observed a significant difference in the manubrium and body (p < 0.05).
 Conclusion(s): The main factor that improved the sternal perfusion
after a CABG was the preservation of branches supplying the sternum using
the skeletonization technique of ITA harvesting. Copyright © 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<6>
[Use Link to view the full text]
Accession Number
2007317674
Title
Aortic annular sizing using novel software in three-dimensional
transesophageal echocardiography for transcatheter aortic valve
replacement: A systematic review and meta-analysis.
Source
Diagnostics. 11(5) (no pagination), 2021. Article Number: 751. Date of
Publication: 22 Apr 2021.
Author
Mork C.; Wei M.; Jiang W.; Ren J.; Ran H.
Institution
(Mork, Wei, Jiang, Ren, Ran) Department of Ultrasound, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010,
China
(Jiang, Ren, Ran) Chongqing Key Laboratory of Ultrasound Molecular
Imaging, Chongqing 400010, China
Publisher
MDPI
Abstract
(1) Background: We performed this study to evaluate the agreement between
novel automated software of three-dimensional transesophageal
echocardiography (3D-TEE) and multidetector computed tomography (MDCT) for
aortic annular measurements of preprocedural transcatheter aor-tic valve
replacement (TAVR); (2) Methods: PubMed, EMBASE, Web of Science, and
Cochrane Library (Wiley) databases were systematically searched for
studies that compared 3D-TEE and MDCT as the reference standard for aortic
annular measurement of the following parameters: annular area, annular
perimeter, area derived-diameter, perimeter derived-diameter, maximum and
minimum diameter. Meta-analytic methods were utilized to determine the
pooled correlations and mean differences between 3D-TEE and MDCT.
Heterogeneity and publication bias were also assessed. Meta-regression
analyses were performed based on the potential factors affecting the
correlation of aortic annular area; (3) Results: A total of 889 patients
from 10 studies were included in the meta-analysis. Pooled correlation
coefficients between 3D-TEE and MDCT of annulus area, perimeter, area
derived-diameter, perimeter derived-diameter, maximum and minimum diameter
measurements were strong 0.89 (95% CI: 0.84-0.92), 0.88 (95% CI:
0.83-0.92), 0.87 (95% CI: 0.77-0.93), 0.87 (95% CI: 0.77-0.93), 0.79 (95%
CI: 0.64-0.87), and 0.75 (95% CI: 0.61-0.84) (Overall p < 0.0001),
respectively. Pooled mean differences between 3D-TEE and MDCT of annulus
area, perimeter, area derived-diameter, perimeter derived-diameter,
maximum and minimum diameter measurements were -20.01 mm2 ((95%
CI: -35.37 to -0.64), p = 0.011), -2.31 mm ((95% CI: -3.31 to -1.31), p <
0.0001), -0.22 mm ((95% CI: -0.73 to 0.29), p = 0.40), -0.47 mm ((95% CI:
-1.06 to 0.12), p = 0.12), -1.36 mm ((95% CI: -2.43 to -0.30), p = 0.012),
and 0.31 mm ((95% CI: -0.15 to 0.77), p = 0.18), respectively. There were
no statistically significant associations with the baseline patient
characteristics of sex, age, left ventricular ejection fraction, mean
transaortic gradient, and aortic valve area to the correlation between
3D-TEE and MDCT for aortic annular area sizing; (4) Conclusion(s):
The present study implies that 3D-TEE using novel software tools,
automatically analysis, is feasible to MDCT for annulus sizing in clinical
practice. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<7>
Accession Number
2005907951
Title
Biomarkers of muscle metabolism in peripheral artery disease: A dynamic
NIRS-assisted study to detect adaptations following revascularization and
exercise training.
Source
Diagnostics. 10(5) (no pagination), 2020. Article Number:
diagnostics10050312. Date of Publication: 01 May 2020.
Author
Manfredini F.; Lamberti N.; Ficarra V.; Tsolaki E.; Straudi S.; Zamboni
P.; Basaglia N.; Gasbarro V.
Institution
(Manfredini, Lamberti) Section of Sports Sciences, Department of
Biomedical and Surgical Specialties Sciences, University of Ferrara,
Italy-Via Luigi Borsari 46, Ferrara 44121, Italy
(Manfredini, Straudi, Basaglia) Unit of Physical Medicine and
Rehabilitation, Department of Neurosciences/Rehabilitation, University
Hospital of Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
(Ficarra, Tsolaki, Gasbarro) Unit of Vascular and Endovascular Surgery,
University Hospital of Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
(Zamboni) Vascular Diseases Center, University of Ferrara, Italy-Via Aldo
Moro 8, Ferrara 44124, Italy
Publisher
MDPI
Abstract
We assessed whether muscle metabolism biomarkers (MMb) identified by
near-infrared spectroscopy (NIRS) are valid for determining adaptations
following revascularization or exercise training in peripheral artery
disease (PAD). Eighteen patients (males n = 13; 69 +/- 7 years) were
randomized to receive revascularization (Rev = 6) or pain-free home-based
exercise (Ex = 12). MMb were safely collected via a NIRS-assisted
treadmill test as area-under-curve for the spectra of oxygenated (-oxy),
deoxygenated (-deoxy), differential (-diff) and total (-tot) hemoglobin
traces. MMb, ankle-brachial index (ABI), pain-free (PFWD) and 6-minute
(6MWD) walking distances were assessed at baseline and after four months.
MMb were correlated at baseline with ABI (MMb-oxy r = 0.46) and 6MWD
(MMb-tot r = 0.51). After treatments, MMb-oxy showed an expected increase,
which was more relevant for Rev group than the Ex (56% vs. 20%), with
trends towards normalization for the other MMb. These changes were
significantly correlated with variations in ABI (MMb-oxy r = 0.71; p =
0.002) and 6MWD (MMb-tot r = 0.58; p = 0.003). The MMb-diff in Rev group
and MMb-deoxy in Ex group at baseline predicted clinical outcomes being
correlated with PFWD improvements after 4-month (r=-0.94; p = 0.005 and r
= -0.57; p = 0.05, respectively). A noninvasive NIRS-based test, feasible
in a clinical setting, identified muscle metabolism biomarkers in PAD. The
novel MMb were associated with validated outcome measures, selectively
modified after different interventions and able to predict long-term
functional improvements after surgery or exercise training. Copyright
© 2020 by the authors.

<8>
Accession Number
2024966453
Title
Mapping the characteristics, methodological quality and standards of
reporting of network meta-analyses on antithrombotic therapies: An
overview.
Source
International Journal of Cardiology. 386 (pp 125-133), 2023. Date of
Publication: 01 Sep 2023.
Author
de Sousa P.G.; Mainka F.F.; Tonin F.S.; Pontarolo R.
Institution
(de Sousa) Department of Medical and Pharmaceutical Sciences, Universidade
Estadual do Oeste do Parana, Cascavel, Brazil
(Mainka, Tonin) Pharmaceutical Sciences Postgraduate Programme,
Universidade Federal do Parana, Curitiba, Brazil
(Pontarolo) Department of Pharmacy, Universidade Federal do Parana,
Curitiba, Brazil
(Tonin) Health & Technology Research Centre, Escola Superior de Tecnologia
da Saude (H&TRC-ESTeSL), Instituto Politecnico de Lisboa, Lisbon, Portugal
Publisher
Elsevier Ireland Ltd
Abstract
Background: Although a large number of network meta-analyses (NMAs) in the
field of cardiology are available, little is known about their
methodological quality. We aimed to map the characteristics and critically
appraised the standards of conduct and evidence reporting of NMAs
assessing antithrombotic therapies for the treatment or prophylaxis of
heart diseases and cardiac surgical procedures. Method(s): We
systematically searched PubMed and Scopus to identify NMAs comparing the
clinical effects of antithrombotic therapies. Overall characteristics of
the NMAs were extracted and their reporting quality and methodological
quality were evaluated using the PRISMA-NMA checklist and AMSTAR-2,
respectively. Result(s): We found 86 NMAs published between 2007 and
2022. Comparisons among direct-acting oral anticoagulants were available
in 61 (71%) NMAs. Although around 75% of NMAs stated that they followed
international guidelines for conduct and reporting, only one third
provided a protocol/register. Complete search strategies and publication
bias assessment were lacking in around 53% and 59% of studies,
respectively. Most NMAs (n = 77, 90%) provided supplemental material;
however, only 5 (6%) made the complete raw data available. Network
diagrams were depicted in most studies (n = 67, 78%), yet network geometry
was described in only 11 (12.8%) of them. Mean adherence to the PRISMA-NMA
checklist was 65.1 +/- 16.5%. AMSTAR-2 assessment showed 88% of the NMAs
had critically low methodological quality. Conclusion(s): Although
there is a wide diffusion of NMA-type studies on antithrombotics for heart
diseases, their methodological and reporting quality remains suboptimal.
This may reflect fragile clinical practices due to misleading conclusions
from critically low-quality NMAs. Copyright © 2023 Elsevier B.V.

<9>
Accession Number
2024193656
Title
Pain Management of Pecto-intercostal Fascial Block Versus Intravenous
Fentanyl after Pediatric Cardiac Surgery.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 30(11) (pp
e26-e35), 2023. Date of Publication: 2023.
Author
Ahmed S.G.; Salama M.A.; Elgamal M.-A.F.; Ghanem M.A.L.; Elmotlb E.A.A.
Institution
(Ahmed, Salama, Ghanem, Elmotlb) Department of Anesthesia and Surgical
Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Elgamal) Department of cardiothoracic surgery, Faculty of Medicine,
Mansoura University, Mansoura, Egypt
Publisher
Codon Publications
Abstract
Study objective: The intent of this investigation is to ascertain the
usefulness of pectointercostal fascial block in decreasing intraoperative
opioids consumption in non-cyanotic pediatric patients undergoing elective
cardiac surgery. Secondary objectives include intra-operative hemodynamic
reaction to stress surgical stimuli. Design(s): a single blinded,
prospective, randomized, controlled trial study. Setting(s): Mansoura
university children hospital (MUCH). Patient(s): Intravenous fentanyl
(control group) (n=40): Patients received only intravenous fentanyl
analgesia. Pecto intercostal fascial block group (experimental group)
(n=40): Cases underwent 0.3 mL/kg bupivacaine 0.25% with an optimum dose
of 2 mg/kg that was injected into pecto-intercostal space.
 Measurements and Main Results: show that significant lower pain score
among group with Pecto-intercostal group than control group at 2, 6, 12,
18 & 24 hours without statistically significant difference at 1
hour.Comparing pain score within each group with 1 hour shows
statistically significant decrease during follow up and show that there is
statistically significant higher total intraoperative consumption fentanyl
among control than Pecto-intercostal group (145 versus 70) and
statistically significant higher total postoperative 24 hours fentanyl
consumption among control than pecto-intercostal group (100 versus 50
mic). Conclusion(s): We might then assume that using a single shot
PIFB in children enduring cardiac operation via median sternotomy is
connected with stable intraoperative hemodynamics, lower perioperative
opioid analgesic necessities, and reduced pain severity in the 1st twenty
four hours after surgery. Copyright © 2021 Muslim OT et al.

<10>
Accession Number
2023598802
Title
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting
for Revascularization of Left Main Coronary Artery Disease.
Source
Korean Circulation Journal. 53(3) (pp 113-133), 2023. Date of Publication:
March 2023.
Author
Park S.; Park S.-J.; Park D.-W.
Institution
(Park) Department of Cardiology, Ulsan University Hospital, University of
Ulsan College of Medicine, Ulsan, South Korea
(Park, Park) Department of Cardiology, Asan Medical Center, University of
Ulsan College of Medicine, Seoul, South Korea
Publisher
Korean Society of Cardiology
Abstract
Owing to a large-jeopardized myocardium, left main coronary artery disease
(LMCAD) represents the substantial high-risk anatomical subset of
obstructive coronary artery disease. For several decades, coronary artery
bypass grafting (CABG) has been the "gold standard" treatment for LMCAD.
Along with advances in CABG, percutaneous coronary intervention (PCI) has
also dramatically evolved over time in conjunction with advances in the
stent or device technology, adjunct pharmacotherapy, accumulated
experiences, and practice changes, establishing its position as a safe,
reasonable treatment option for such a complex disease. Until recently,
several randomized clinical trials, meta-analyses, and observational
registries comparing PCI and CABG for LMCAD have shown comparable
long-term survival with tradeoffs between early and late risk-benefit of
each treatment. Despite this, there are still several unmet issues for
revascularization strategy and management for LMCAD. This review article
summarized updated knowledge on evolution and clinical evidence on the
treatment of LMCAD, with a focus on the comparison of state-of-the-art PCI
with CABG. Copyright © 2023. The Korean Society of Cardiology.

<11>
Accession Number
2023083526
Title
A randomised controlled trial of intrapleural balloon intercostal chest
drains to prevent drain displacement.
Source
European Respiratory Journal. 60(1) (no pagination), 2022. Article Number:
2101753. Date of Publication: 01 Jul 2022.
Author
Mercer R.M.; Mishra E.; Banka R.; Corcoran J.P.; Daneshvar C.; Panchal
R.K.; Saba T.; Caswell M.; Johnstone S.; Menzies D.; Ahmer S.; Shahidi M.;
Clive A.O.; Gautam M.; Cox G.; Orton C.; Lyons J.; Maddekar N.; De Fonseka
D.; Prior K.; Barnes S.; Robinson G.; Brown L.; Munavvar M.; Shah P.L.;
Hallifax R.J.; Blyth K.G.; Hedley E.; Maskell N.A.; Gerry S.; Miller R.F.;
Rahman N.M.; Kemp S.V.
Institution
(Mercer, Hallifax, Hedley, Rahman) University of Oxford Respiratory Trials
Unit, Churchill Hospital, Oxford, United Kingdom
(Mercer, Banka, Hallifax, Hedley, Rahman) Oxford Centre for Respiratory
Medicine, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
(Mishra, Banka) Dept of Respiratory Medicine, Norfolk and Norwich
University Hospitals, Norwich, United Kingdom
(Corcoran, Daneshvar) University Hospitals Plymouth NHS Trust, Plymouth,
United Kingdom
(Panchal, Johnstone) Institute for Lung Health, Glenfield Hospital,
University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
(Saba, Caswell) Blackpool Teaching Hospitals NHS Foundation Trust,
Blackpool, United Kingdom
(Menzies, Ahmer) Glan Clwyd Hospital, Rhyl, United Kingdom
(Shahidi) Buckinghamshire Healthcare NHS Trust, Amersham, United Kingdom
(Clive, Maskell) Academic Respiratory Unit, Bristol Medical School,
Southmead Hospital, University of Bristol, Bristol, United Kingdom
(Gautam) Dept of Respiratory Medicine, Royal Liverpool and Broadgreen
University Hospital, Liverpool, United Kingdom
(Cox) King's Mill Hospital, Mansfield, United Kingdom
(Orton, Shah, Kemp) Royal Brompton Hospital, London, United Kingdom
(Lyons) North West Lung Centre, Manchester University NHS Foundation
Trust, Manchester, United Kingdom
(Maddekar) University Hospitals of North Midlands, Stoke-on-Trent, United
Kingdom
(De Fonseka) Dept of Respiratory Medicine, Sheffield Teaching Hospitals,
Sheffield, United Kingdom
(Prior) University Hospitals Morecambe Bay, Kendal, United Kingdom
(Barnes) Somerset Lung Centre, Musgrove Park Hospital, Taunton, United
Kingdom
(Robinson) Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
(Brown) North Manchester General Hospital, Manchester, United Kingdom
(Munavvar) Lancashire Teaching Hospitals NHS Foundation Trust, Preston,
United Kingdom
(Shah, Kemp) National Heart and Lung Institute, Imperial College, London,
United Kingdom
(Blyth) Queen Elizabeth University Hospital, Glasgow, Institute of Cancer
Sciences, University of Glasgow, Glasgow, United Kingdom
(Gerry) Centre for Statistics in Medicine, Nuffield Dept of Orthopaedics,
Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford,
United Kingdom
(Miller) Institute for Global Health, University College London, London,
United Kingdom
(Rahman) NIHR Oxford Biomedical Research Centre, University of Oxford,
Oxford, United Kingdom
Publisher
European Respiratory Society
Abstract
Background Chest drain displacement is a common clinical problem that
occurs in 9-42% of cases and results in treatment failure or additional
pleural procedures conferring unnecessary risk. A novel chest drain with
an integrated intrapleural balloon may reduce the risk of displacement.
Methods A prospective randomised controlled trial comparing the balloon
drain to standard care (12 F chest drain with no balloon) with the primary
outcome of objectively defined unintentional or accidental chest drain
displacement. Results 267 patients were randomised (primary outcome data
available in 257, 96.2%). Displacement occurred less frequently using the
balloon drain (displacement 5 of 128, 3.9%; standard care displacement 13
of 129, 10.1%) but this was not statistically significant (OR for drain
displacement 0.36, 95% CI 0.13-1.0, Chi-squared 1 degree of freedom
(df)=2.87, p=0.09). Adjusted analysis to account for minimisation factors
and use of drain sutures demonstrated balloon drains were independently
associated with reduced drain fall-out rate (adjusted OR 0.27, 95% CI
0.08-0.87, p=0.028). Adverse events were higher in the balloon arm than
the standard care arm (balloon drain 59 of 131, 45.0%; standard care 18 of
132, 13.6%; Chi-squared 1 df=31.3, p<0.0001). Conclusion Balloon drains
reduce displacement compared with standard drains independent of the use
of sutures but are associated with increased adverse events specifically
during drain removal. The potential benefits of the novel drain should be
weighed against the risks, but may be considered in practices where
sutures are not routinely used. Copyright © The authors 2022.

<12>
Accession Number
2025101540
Title
An Updated Meta-Analysis on the Clinical Outcomes of Percutaneous Left
Atrial Appendage Closure Versus Direct Oral Anticoagulation in Patients
With Atrial Fibrillation.
Source
American Journal of Cardiology. 200 (pp 135-143), 2023. Date of
Publication: 01 Aug 2023.
Author
Jiang H.; Koh T.H.; Vengkat V.; Fei G.; Ding Z.P.; Ewe S.H.; Jappar I.;
Lim S.T.; Yap J.
Institution
(Jiang, Vengkat) Lee Kong Chian School of Medicine, Nanyang Technological
University, Singapore
(Jiang, Koh, Fei, Ding, Ewe, Jappar, Lim, Yap) Department of Cardiology,
National Heart Center Singapore, Singapore
(Koh, Ding, Ewe, Jappar, Lim, Yap) Duke-NUS Medical School, Singapore
Publisher
Elsevier Inc.
Abstract
The availability of direct oral anticoagulants (DOACs) with known lower
bleeding risk compared with warfarin have raised questions about the role
of left atrial appendage closure (LAAC). We aimed to perform a
meta-analysis to compare the clinical outcomes for LAAC versus DOACs. All
studies directly comparing LAAC with DOACs up to January 2023 were
included. The outcomes studied included the combined major adverse
cardiovascular (CV) events outcomes, ischemic stroke and thromboembolic
events, major bleeding, CV mortality, and all-cause mortality. Hazard
ratios (HRs) and their 95% confidence interval were extracted or estimated
from the data and pooled together with a random-effects model. A total of
7 studies (1 randomized controlled trial, 6 propensity-matched
observational studies) were finally included, with a pooled population of
4,383 patients who underwent LAAC and 4,554 patients on DOACs. There were
no significant differences between patients who underwent LAAC and
patients on DOACs in terms of baseline age (75.0 vs 74.7, p = 0.27),
CHA<inf>2</inf>DS<inf>2</inf>-VASc score (5.1 vs 5.1, p = 0.33), or
HAS-BLED score (3.3 vs 3.3, p = 0.36). After a mean weighted follow-up of
22.0 months, LAAC was associated with significantly lower rates of
combined major adverse CV event outcomes (HR 0.73 [0.56 to 0.95], p =
0.02), all-cause mortality (HR 0.68 [0.54 to 0.86], p = 0.02), and CV
mortality (HR 0.55 [0.41 to 0.72], p<0.01). There were no significant
differences in the rates of ischemic stroke or systemic embolism (HR 1.12
[0.92 to 1.35], p = 0.25), major bleeding (HR 0.94 [0.67 to 1.32], p =
0.71), or hemorrhagic stroke (HR 1.07 [0.74 to 1.54], p = 0.74) between
LAAC and DOAC. In conclusion, percutaneous LAAC was found to be as
efficacious as DOACs for stroke prevention, with lower all-cause and CV
mortality. The rates of major bleeding and hemorrhagic stroke were
similar. LAAC has a potential role to play in stroke prevention in
patients with atrial fibrillation in the era of DOACs, but further
randomized data are needed. Copyright © 2023 Elsevier Inc.

<13>
Accession Number
2024264287
Title
The Influence of baseline glycemic status on the effects of intensive
blood pressure lowering: Results from the STEP randomized trial.
Source
European Journal of Internal Medicine. 113 (pp 75-82), 2023. Date of
Publication: July 2023.
Author
Yang R.; Wang Y.; Tong A.; Yu J.; Zhao D.; Cai J.
Institution
(Yang, Wang, Cai) Hypertension Center, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, National Center for Cardiovascular
Diseases, Peking Union Medical College & Chinese Academy of Medical
Sciences, Beilishi Road 167, Xicheng District, Beijing 100037, China
(Tong) Department of Endocrinology, NHC key laboratory of Endocrinology,
Peking Union Medical College Hospital, Peking Union Medical College &
Chinese Academy of Medical Sciences, Beijing 100730, China
(Yu) Hypertension Center, Lanzhou University Second Hospital, No. 82
Cuiyingmen, Lanzhou 730030, China
(Zhao) Department of Cardiology, First Affiliated Hospital of Harbin
Medical University, No. 199 Dazhi Street, Harbin 150001, China
Publisher
Elsevier B.V.
Abstract
Background: Intensive systolic blood pressure (SBP) lowering showed
cardiovascular benefits in the Strategy of Blood Pressure Intervention in
the Elderly Hypertensive Patients (STEP) trial. We investigated whether
baseline glycemic status influences the effects of intensive SBP lowering
on cardiovascular outcomes. Method(s): In this post hoc analysis of
the STEP trial, participants were randomly assigned to receive intensive
(110 to <130 mmHg) or standard SBP treatment (130 to <150 mmHg) and
categorized by baseline glycemic status into three subgroups:
normoglycemia, prediabetes, and diabetes. The primary outcome was a
composite of stroke, acute coronary syndrome, acute decompensated heart
failure, coronary revascularization, atrial fibrillation, or death from
cardiovascular causes. A competing risk proportional hazards regression
model was used in the analysis. Result(s): Of the 8,318 participants,
3,275, 2,769, and 2,274 had normoglycemia, prediabetes, and diabetes,
respectively. Over a median follow-up of 3.33 years, intensive SBP
lowering significantly reduced the risk of the primary outcome (adjusted
hazard ratio 0.73, 95% confidence interval [CI] 0.59-0.91). The adjusted
hazard ratios for the primary outcome in the normoglycemia, prediabetes,
and diabetes subgroups were 0.72 (95% CI 0.49-1.04), 0.69 (95% CI
0.46-1.02), and 0.80 (95% CI 0.56-1.15), respectively. The intensive SBP
lowering strategy resulted in similar effects among participants in the
three subgroups (all interaction P >0.05). The sensitivity analyses showed
consistent results with the main analysis. Conclusion(s): The effects
of intensive SBP lowering on cardiovascular outcomes were consistent among
participants with normoglycemia, prediabetes, and diabetes. Copyright
© 2023 European Federation of Internal Medicine

<14>
Accession Number
2022474270
Title
Effect of BMI on patients undergoing transcatheter aortic valve
implantation: A systematic review and meta-analysis.
Source
Progress in Cardiovascular Diseases. 78 (pp 58-66), 2023. Date of
Publication: 01 May 2023.
Author
Gupta R.; Mahmoudi E.; Behnoush A.H.; Khalaji A.; Malik A.H.; Sood A.;
Bandyopadhyay D.; Zaid S.; Goel A.; Sreenivasan J.; Patel C.; Vyas A.V.;
Lavie C.J.; Patel N.C.
Institution
(Gupta, Patel, Vyas, Patel) Department of Cardiology, Lehigh Valley Health
Network, Allentown, PA, United States
(Mahmoudi, Behnoush, Khalaji) Universal Scientific Education and Research
Network, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Malik, Bandyopadhyay) Department of Cardiology, Westchester Medical
Center and New York Medical College, Valhalla, NY, United States
(Sood) Department of Internal Medicine, The Wright Center for Graduate
Medical Education, Scranton, PA, United States
(Zaid, Goel) Department of Cardiology, Houston Methodist DeBakey Heart and
Vascular Institute, Houston, TX, United States
(Sreenivasan) Department of Cardiovascular Medicine, Yale University
School of Medicine, New Haven, CT, United States
(Lavie) John Ochsner Heart and Vascular Institute, Ochsner Clinical
School, The University of Queensland School of Medicine, New Orleans, LA,
United States
Publisher
W.B. Saunders
Abstract
Background: The relationship of body mass index (BMI) and an "obesity
paradox" with cardiovascular risk prediction is controversial. This
systematic review and meta-analysis aims to compare the associations of
different BMI ranges on transcatheter aortic valve implantation (TAVI)
outcomes. Method(s): International databases, including PubMed, the
Web of Science, and the Cochrane Library, were systematically searched for
observational and randomized controlled trial studies investigating TAVI
outcomes in any of the four BMI categories: underweight, normal weight,
overweight, and obese with one of the predefined outcomes. Primary
outcomes were in-hospital, 30-day, and long-term all-cause mortality.
Random-effects meta-analysis was performed to calculate the odds ratio
(OR) or standardized mean differences (SMD) with 95% confidence interval
(CI) for each paired comparison between two of the BMI categories.
 Result(s): A total of 38 studies were included in our analysis,
investigating 99,829 patients undergoing TAVI. There was a trend toward
higher comorbidities such as hypertension, diabetes, and dyslipidemia in
overweight patients and individuals with obesity. Compared with
normal-weight, patients with obesity had a lower rate of 30-day mortality
(OR 0.42, 95% CI 0.25-0.72, p < 0.01), paravalvular aortic regurgitation
(OR 0.63, 95% CI 0.44-0.91, p = 0.01), 1-year mortality (OR 0.48, 95% CI
0.24-0.96, p = 0.04), and long-term mortality (OR 0.69, 95% CI 0.51-0.94,
p = 0.02). However, acute kidney injury (OR 1.16, 95% CI 1.04-1.30, p =
0.01) and permanent pacemaker implantation (OR 1.25, 95% CI 1.05-1.50, p =
0.01) odds were higher in patients with obesity. Noteworthy, major
vascular complications were significantly higher in underweight patients
in comparison with normal weight cases (OR 1.62, 95% CI 1.07-2.46, p =
0.02). In terms of left ventricular ejection fraction (LVEF), patients
with obesity had higher post-operative LVEF compared to normal-weight
individuals (SMD 0.12, 95% CI 0.02-0.22, p = 0.02). Conclusion(s):
Our results suggest the presence of the "obesity paradox" in TAVI outcomes
with higher BMI ranges being associated with lower short- and long-term
mortality. BMI can be utilized for risk prediction of patients undergoing
TAVI. Copyright © 2023 Elsevier Inc.

<15>
Accession Number
2022365812
Title
Atrial natriuretic peptide in the prevention of acute renal dysfunction
after heart transplantation-a randomized placebo-controlled double-blind
trial.
Source
Acta Anaesthesiologica Scandinavica. 67(6) (pp 738-745), 2023. Date of
Publication: July 2023.
Author
Tholen M.; Kolsrud O.; Dellgren G.; Karason K.; Lannemyr L.; Ricksten
S.-E.
Institution
(Tholen, Lannemyr, Ricksten) Department of Anesthesiology and Intensive
Care Medicine, Institute of Clinical Sciences, University of Gothenburg,
Gothenburg, Sweden
(Kolsrud, Dellgren) Department of Cardiothoracic Surgery, Institute of
Medicine, University of Gothenburg, Gothenburg, Sweden
(Dellgren, Karason) Deparment of Transplantation Surgery, Institute of
Transplantation, University of Gothenburg, Gothenburg, Sweden
(Karason) Department of Cardiology, Institute of Medicine, University of
Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Acute kidney injury (AKI) and renal dysfunction after heart
transplantation are common and serious complications. Atrial natriuretic
peptide (ANP) has been shown to increase glomerular filtration rate (GFR)
and exert renoprotective effects when used for the prevention/treatment of
AKI in cardiac surgery. We tested the hypothesis that intraoperative and
postoperative administration of ANP could prevent a postoperative decrease
in renal function early after heart transplantation. Method(s):
Seventy patients were randomized to receive either ANP (50 ng/kg/min) (n =
33) or placebo (n = 37) starting after induction of anesthesia and
continued for 4 days after heart transplantation or until treatment with
dialysis was started. The primary end-point of the present study was
measured GFR (mGFR) at day 4, assessed by plasma clearance of a renal
filtration marker. Also, the incidence of postoperative AKI and dialysis
were assessed. Result(s): Median (IQR) mGFR at day 4 postoperatively
was 60.0 (57.0) and 50.1 (36.3) ml/min/1.72 m2 for the placebo
and ANP groups, respectively (p =.705). During ongoing ANP infusion, the
need for dialysis was 21.6% and 9.1% for the placebo and ANP groups,
respectively (p =.197). The incidences of AKI for the placebo and the ANP
groups were 76.5% and 63.6%, respectively (p =.616). The incidences of AKI
stage 1 were 32.4% and 21.2% for the placebo and ANP groups, respectively
(p =.420) and for AKI stage 2 or 3, 37.8% and 42.4%, respectively (p
=.808). Conclusion(s): The study failed to detect that ANP infusion
attenuates renal dysfunction or decreases the incidence of AKI after heart
transplantation. Copyright © 2023 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<16>
Accession Number
641578790
Title
Single-injection serratus anterior plane block for cardiothoracic surgery
via thoracotomy in children: a systematic review and meta-analysis of
randomised controlled trials.
Source
BMJ paediatrics open. 7(1) (no pagination), 2023. Date of Publication: 01
Jun 2023.
Author
He Y.; Li Z.; Xu M.; Du B.; Zuo Y.
Institution
(He, Xu, Du, Zuo) Department of Anesthesiology, West China Hospital,
Sichuan University & The Research Units of West China (2018RU012), Chinese
Academy of Medical Sciences, Sichuan University West China Hospital,
Chengdu, Sichuan, China
(Li) Department of Critical Care Medicine, Cheng Du Shang Jin Nan Fu
Hospital, Sichuan University West China Hospital, Chengdu, Sichuan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Serratus anterior plane block (SAPB) has gained popularity in
cardiothoracic surgery due to its feasibility and simplicity. However, the
efficacy of ultrasound-guided single-injection SAPB in the paediatric
population has not been well evaluated, as only a few studies with small
sample sizes are available. METHOD(S): We searched PubMed, Embase
(Ovid), Cochrane Central Register of Controlled Trials, Wanfang databases
and China National Knowledge Infrastructure from their inception to 31
September 2022 for randomised comparative clinical trials that compared
single-injection SAPB with systemic analgesia or different forms of
regional analgesia in children. The primary outcomes included
postoperative opioid consumption and pain scores within 24 hours. The
secondary outcomes included postoperative adverse events, the need for
rescue analgesia and the time from the end of surgery to endotracheal tube
removal. RESULT(S): Five randomised controlled trials with 418
children meeting the inclusion criteria were included. SAPB markedly
reduced postoperative opioid consumption up to 24hours compared with
controls (mean difference (MD): -0.29mg/kg, 95% CI -0.38 to -0.20, I2
=67%]. The postoperative pain scores were reduced compared with controls:
1hour (MD -0.6, 95%CI -1.17 to -0.04, I2 =92%), 4-6hours (MD -1.16, 95%CI
-1.87 to -0.45, I2 =90%) and 12hours (MD -0.71, 95%CI -1.35 to -0.08, I2
=86%). The incidence of postoperative nausea and vomiting was comparable
between SAPB and controls. One trial suggested that the analgesic effect
of SAPB was comparable to that of ICNB (intercostal nerve block).
 CONCLUSION(S): Single-injection SAPB is associated with a reduction
in opioid consumption and pain intensity after cardiothoracic surgery via
thoracotomy in children. Due to the high heterogeneity, the Grading of
Recommendations Assessment, Development and Evaluation scores were low.
Clinical trials with rigorous methodological approaches as well as safety
endpoints are needed to confirm these preliminary findings. PROSPERO
REGISTRATION NUMBER: CRD42021241691. Copyright © Author(s) (or
their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<17>
Accession Number
2023461143
Title
Acute To Chronic Pain Signatures (A2CPS) Thoracic Enrollment.
Source
Journal of Pain. Conference: The 2023 Annual Scientific Meeting for the
United States Association for the Study of Pain (USASP). Durham United
States. 24(4 Supplement) (pp 4), 2023. Date of Publication: April 2023.
Author
Bayman E.O.; Nadel L.; Coffey C.; Sluka K.; Dailey D.L.; McCarthy R.;
Brummett C.
Institution
(Bayman, Nadel, Coffey, Sluka, Dailey, McCarthy, Brummett) University of
Iowa
Publisher
Elsevier B.V.
Abstract
Acute to chronic pain signatures (A2CPS) is a prospective observational
study which aims to characterize the predictive nature of biomarkers
(brain imaging, blood screening, quantitative sensory testing,
patient-reported outcome, and functional assessments) to identify
individuals who will develop chronic pain following surgical intervention
in total knee arthroplasty (TKA) and thoracic surgery cohorts. The
original plan was each of the multisite clinical center (MCC) to recruit
their own cohort of 1400 participants. Due to slow recruitment, both MCC's
are enrolling participants from both cohorts. Recruitment for the TKA
cohort is on target. However, recruitment for the thoracic surgery cohort
is challenging in both MCCs. The purpose of this presentation was to
describe the recruitment rate for patients undergoing thoracic surgery
from the A2CPS Consortium to that of other published thoracic surgery
studies. Sixteen randomized clinical trials (n=6) or prospective
observational studies (n=10) of chronic pain after thoracic surgery were
published between 2002 and 2017. None of these studies conducted brain
imaging. Enrollment/month has averaged 6 patients at the University of
Michigan, and 9 from the MCC2 sites throughout Michigan. It was 1.3 to 19
patients across the studies from the literature. Random effect estimate
from meta-analysis for enrollment/month across the studies was 6.8 (95%
CI: 5.1 to 8.5). Even though brain imaging is conducted at baseline and at
3 months in A2CPS, which generally increases the study complexity and
requires an extra research visit, thoracic surgery enrollment/month in
A2CPS was not lower than thoracic surgery enrollment from the literature.
The A2CPS Consortium is supported by the NIH Common Fund, which is managed
by the Office of Strategic Coordination (OSC). Consortium components
include: Clinical Coordinating Center (U01NS077179), Data Integration and
Resource Center (U01NS077352), Omics Data Generation Centers (U54DA049116,
U54DA049115, U54DA09113), Multisite Clinical Center 1 (UM1NS112874), and
Multisite Clinical Center 2 (UM1NS118922). Copyright © 2023

<18>
Accession Number
2025216551
Title
Minimum Core Data Elements for Transcatheter Mitral Therapies: Scientific
Statement by PASSION CV, HVC, and TVTR.
Source
JACC: Cardiovascular Interventions. 16(12) (pp 1437-1447), 2023. Date of
Publication: 26 Jun 2023.
Author
Vemulapalli S.; Simonato M.; Ben Yehuda O.; Wu C.; Feldman T.; Popma J.J.;
Sundareswaren K.; Krohn C.; Hardy K.M.; Guibone K.; Christensen B.; Alu
M.C.; Ng V.G.; Chau K.H.; Chen S.; Shahim B.; Vincent F.; MacMahon J.;
James S.; Mack M.; Leon M.B.; Thourani V.H.; Carroll J.; Krucoff M.W.
Institution
(Vemulapalli, Krucoff) Duke University Health/Duke Clinical Research
Institute, Durham, NC, United States
(Simonato) Yale School of Medicine, New Haven, CT, United States
(Ben Yehuda) University of California San Diego, San Diego, CA, United
States
(Ben Yehuda, Alu, Vincent) Cardiovascular Research Foundation, New York,
NY, United States
(Wu) U.S. Food and Drug Administration, Silver Spring, MD, United States
(Feldman) Edwards Lifesciences, Irvine, CA, United States
(Popma) Medtronic, Inc, Minneapolis, MN, United States
(Sundareswaren) Abbott Vascular, Santa Rosa, CA, United States
(Krohn) Society of Thoracic Surgeons, Chicago, IL, United States
(Hardy) Common Spirit Health, Chicago, IL, United States
(Guibone) Beth Israel Deaconness Medical Center, Boston, MA, United States
(Christensen) American College of Cardiology, Washington, DC, United
States
(Ng, Chau, Leon) Columbia University Irving Medical Center, New York, NY,
United States
(Chen) Cornell Weill Medical Center/New York-Presbyterian, New York, NY,
United States
(Shahim) Karolinska University Hospital, Stockholm, Sweden
(MacMahon) Mitre Medical Corporation, Morgan Hill, CA, United States
(James) Department of Medical Sciences and Uppsala Clinical Research
Center, Uppsala, Sweden
(Mack) Baylor Scott and White, Plano, TX, United States
(Thourani) Piedmont Heart and Vascular Institute, Atlanta, GA, United
States
(Carroll) University of Colorado School of Medicine, Denver, CO, United
States
Publisher
Elsevier Inc.
Abstract
Mitral regurgitation is the most common valvular disease and is estimated
to affect over 5 million Americans. Real-world data collection contributes
to safety and effectiveness evidence for the U.S. Food and Drug
Administration, quality evaluation for the Centers for Medicare and
Medicaid Services and hospitals, and clinical best practice research. We
aimed to establish a minimum core data set in mitral interventions to
promote efficient, reusable real-world data collection for all of these
purposes. Two expert task forces separately evaluated and reconciled a
list of candidate elements derived from: 1) 2 ongoing transcatheter mitral
trials; and 2) a systemic literature review of high-impact mitral trials
and U.S multicenter, multidevice registries. From 703 unique data elements
considered, unanimous consensus agreement was achieved on 127 "core" data
elements, with the most common reasons for exclusion from the minimum core
data set being burden or difficulty in accurate assessment (41.2%),
duplicative information (25.0%), and low likelihood of affecting outcomes
(19.6%). After a systematic review and extensive discussions, a
multilateral group of academicians, industry representatives, and
regulators established and implemented into the national Society of
Thoracic Surgery/American College of Cardiology Transcatheter Valve
Therapies Registry 127 interoperable, reusable core data elements to
support more efficient, consistent, and informative transcatheter mitral
device evidence for regulatory submissions, safety surveillance, best
practice development, and hospital quality assessments. Copyright
© 2023 American College of Cardiology Foundation

<19>
Accession Number
2025216433
Title
Cerebrovascular Events After Transcatheter Edge-to-Edge Repair and
Guideline-Directed Medical Therapy in the COAPT Trial.
Source
JACC: Cardiovascular Interventions. 16(12) (pp 1448-1459), 2023. Date of
Publication: 26 Jun 2023.
Author
Vincent F.; Redfors B.; Kotinkaduwa L.N.; Kar S.; Lim D.S.; Mishell J.M.;
Whisenant B.K.; Lindenfeld J.; Abraham W.T.; Mack M.J.; Stone G.W.
Institution
(Vincent, Redfors, Kotinkaduwa) Clinical Trials Center, Cardiovascular
Research Foundation, New York, NY, United States
(Vincent) Department of Cardiology, Regional Hospital ISSSTE Puebla,
Puebla, Mexico
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Sahlgrenska
Academy, Gothenburg University, Gothenburg, Sweden
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Mishell) Kaiser Permanente San Francisco Hospital, San Francisco, CA,
United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Department of Medicine, The Ohio State University, Columbus, OH,
United States
(Abraham) Department of Physiology and Cell Biology, The Ohio State
University, Columbus, OH, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Abraham) Davis Heart and Lung Research Institute, The Ohio State
University, Columbus, OH, United States
(Mack) Baylor Scott & White Heart Hospital Plano, Plano, TX, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Little is known regarding the risk of cerebrovascular events
(CVE) in patients with heart failure and severe secondary mitral
regurgitation treated with transcatheter edge-to-edge repair (TEER).
 Objective(s): The study sought to examine the incidence, predictors,
timing, and prognostic impact of CVE (stroke or transient ischemic attack)
in the COAPT (Cardiovascular Outcomes Assessment of the Mitraclip
Percutaneous Therapy for Heart Failure Patients with Functional Mitral
Regurgitation) trial. Method(s): A total of 614 patients with heart
failure and severe secondary mitral regurgitation were randomized to TEER
plus guideline-directed medical therapy (GDMT) vs GDMT alone.
 Result(s): At 4-year follow-up, 50 CVEs occurred in 48 (7.8%) of the
614 total patients enrolled in the COAPT trial; Kaplan-Meier event rates
were 12.3% in the TEER group and 10.2 in the GDMT alone group (P = 0.91).
Within 30 days of randomization, CVE occurred in 2 (0.7%) patients
randomized to TEER and 0% randomized to GDMT (P = 0.15). Baseline renal
dysfunction and diabetes were independently associated with increased risk
of CVE, while baseline anticoagulation was associated with a reduction of
CVE. A significant interaction was present between treatment group and
anticoagulation such that TEER compared with GDMT alone was associated
with a reduced risk of CVE among patients with anticoagulation (adjusted
HR: 0.24; 95% CI: 0.08-0.73) compared with an increased risk of CVE in
patients without anticoagulation (adjusted HR: 2.27; 95% CI: 1.08-4.81;
P<inf>interaction</inf> = 0.001). CVE was an independent predictor of
death within 30 days after the event (HR: 14.37; 95% CI: 7.61, 27.14; P <
0.0001). Conclusion(s): In the COAPT trial, the 4-year rate of CVE
was similar after TEER or GDMT alone. CVE was strongly associated with
mortality. Whether anticoagulation is effective at reducing CVE risk after
TEER warrants further study. (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation [The COAPT Trial] and COAPT CAS [COAPT);
NCT01626079) Copyright © 2023 American College of Cardiology
Foundation

<20>
Accession Number
2023803588
Title
Global trends in perioperative stroke research from 2003 to 2022: a web of
science-based bibliometric and visual analysis.
Source
Frontiers in Neurology. 14 (no pagination), 2023. Article Number: 1185326.
Date of Publication: 2023.
Author
Ji S.; Shi Y.; Fan X.; Jiang T.; Yang X.; Tao T.; Ye B.
Institution
(Ji, Shi, Fan, Jiang, Yang, Tao, Ye) Department of Anesthesiology, Air
Force Medical Center, Beijing, China
(Ji, Shi, Tao, Ye) Graduate School of China Medical University, Shenyang,
China
Publisher
Frontiers Media S.A.
Abstract
Background: Perioperative stroke is a potentially devastating complication
in surgical patients, which has attracted global attention. This
retrospective bibliometric and visual analysis evaluates the status and
global trends in perioperative stroke research. Method(s): Papers
published between 2003 and 2022 were retrieved from the Web of Science
core collection. Extracted data were summarized and analyzed using
Microsoft Excel and further bibliometric and co-occurrence analyses were
conducted using VOSviewer and CiteSpace software. Result(s):
Publications on perioperative stroke have increased over the years. The
USA topped the list of countries with the highest number of publications
and citations, while Canada had the highest mean citation frequency. The
Journal of Vascular Surgery and Annals of Thoracic Surgery had the highest
number of publications and citation frequency for perioperative stroke.
Regarding authors, Malas, Mahmoud B. contributed the most publications to
the field, and Harvard University had the highest number of publications
(409 papers). Based on an overlay visualization map, timeline view, and
the strongest strength burst of keywords, "antiplatelet therapy,"
"antithrombotic therapy," "carotid revascularization," "bleeding
complications," "postoperative cognitive dysfunction," "intraoperative
hypotension," "thrombectomy," "cerebral revascularization," "valve
surgery," "tranexamic acid," and "frozen elephant trunk" were trending
topics in perioperative stroke research. Conclusion(s): Publications
regarding perioperative stroke have experienced rapid growth in the past
20 years and are likely to continuously increase. Research on
perioperative antiplatelet and antithrombotic, cardiovascular surgery,
postoperative cognitive dysfunction, thrombectomy, tranexamic acid, and
frozen elephant trunk has attracted increasing attention, and these topics
are emerging hotspots of present research and possible candidates for
future research. Copyright © 2023 Ji, Shi, Fan, Jiang, Yang, Tao
and Ye.

<21>
Accession Number
641600944
Title
Hemostatic efficacy of a flowable collagen-thrombin matrix during coronary
artery bypass grafting: a double-blind randomized controlled trial.
Source
Journal of cardiothoracic surgery. 18(1) (pp 193), 2023. Date of
Publication: 15 Jun 2023.
Author
Kim H.-H.; Lee K.J.; Kang D.R.; Lee J.H.; Youn Y.-N.
Institution
(Kim, Lee, Youn) Division of Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, 250 Seongsanno ,Seodaemun-gu, Seoul 03722, South
Korea
(Kim) Department of Cardiothoracic Surgery, Ilsan Hospital, National
Health Insurance Service, Goyang-si 10444, South Korea
(Kang, Lee) Department of Biostatistics, Wonju College of Medicine, Yonsei
University, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Flowable hemostatic agents have the advantage of being able to
be applied to irregular wound surfaces and difficult to reach areas. We
sought to compare the effectiveness and safety of the flowable hemostatic
sealants Collastat (collagen hemostatic matrix, [CHM]) and Floseal
(gelatin hemostatic matrix, [GHM]) during off-pump coronary artery bypass
(OPCAB). METHOD(S): In this prospective, double-blind, randomized
controlled trial, 160 patients undergoing elective OPCAB surgery were
enrolled between March 2018 and February 2020. After primary suture of the
aortocoronary anastomosis, an area of hemorrhage was identified, and
patients received either CHM or GHM (n=80, each). Study endpoints were the
following: proportion of successful intraoperative hemostasis and time
required for hemostasis overall postoperative bleeding, proportion of
transfusion of blood products, and surgical revision for bleeding.
 RESULT(S): Of the total patients, 23% were female, and the mean age
was 63 years (range 42-81 years). Successful hemostasis proportion within
5 min was achieved for 78 patients (97.5%) in the GHM group, compared to
80 patients (100%) in the CHM group (non-inferiority p=0.006). Two
patients receiving GHM required surgical revision to achieve hemostasis.
There were no differences in the mean time required to obtain hemostasis
[GHM vs. CHM, mean 1.49 (SD 0.94) vs. 1.35 (0.60) min, p=0.272], as
confirmed by time-to-event analysis (p=0.605). The two groups had similar
amounts of mediastinal drainage for 24 h postoperatively [538.5 (229.1)
vs. 494.7 (190.0) ml, p=0.298]. The CHM group required less packed red
blood cells, fresh frozen plasma, and platelets for transfusion than the
GHM group (0.5 vs. 0.7 units per patient, p=0.047; 17.5% vs. 25.0%,
p=0.034; 7.5% vs. 15.0%, p=0.032; respectively). CONCLUSION(S): CHM
was associated with a lower need for FFP and platelet transfusions. Thus,
CHM is a safe and effective alternative to GHM. TRIAL REGISTRATION:
ClinicalTrials.gov, NCT04310150. Copyright © 2023. The Author(s).

<22>
Accession Number
641598570
Title
Cardiovascular Safety of Testosterone-Replacement Therapy.
Source
The New England journal of medicine. (no pagination), 2023. Date of
Publication: 16 Jun 2023.
Author
Lincoff A.M.; Bhasin S.; Flevaris P.; Mitchell L.M.; Basaria S.; Boden
W.E.; Cunningham G.R.; Granger C.B.; Khera M.; Thompson I.M.; Wang Q.;
Wolski K.; Davey D.; Kalahasti V.; Khan N.; Miller M.G.; Snabes M.C.; Chan
A.; Dubcenco E.; Li X.; Yi T.; Huang B.; Pencina K.M.; Travison T.G.;
Nissen S.E.
Institution
(Lincoff, Bhasin, Flevaris, Mitchell, Basaria, Boden, Cunningham, Granger,
Khera, Thompson, Wang, Wolski, Davey, Kalahasti, Khan, Miller, Snabes,
Chan, Dubcenco, Li, Yi, Huang, Pencina, Travison, Nissen) From the
Cleveland Clinic Coordinating Center for Clinical Research, Department of
Cardiovascular Medicine, Cleveland Clinic, Cleveland (A.M.L., L.M.M.,
Q.W., K.W., D.D., V.K., S.E.N.); the Research Program in Men's Health:
Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School
(S. Bhasin, S. Basaria, K.M.P.), Veterans Affairs Boston Healthcare System
and Massachusetts Veterans Epidemiology, Research, and Information Center,
Boston University School of Medicine (W.E.B.), and Marcus Institute for
Aging Research, Beth Israel Deaconess Medical Center, Harvard Medical
School (T.G.T.) - all in Boston; AbbVie, North Chicago, IL (P.F., N.K.,
M.G.M., M.C.S., A.C., E.D., X.L., T.Y., B.H.); Baylor College of Medicine,
Houston (G.R.C., M.K.), and CHRISTUS Santa Rosa Health System and the
University of Texas Health Science Center, San Antonio (I.M.T.) - all in
Texas; and Duke Clinical Research Institute, Durham, NC (C.B.G.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: The cardiovascular safety of testosterone-replacement therapy
in middle-aged and older men with hypogonadism has not been determined.
 METHOD(S): In a multicenter, randomized, double-blind,
placebo-controlled, noninferiority trial, we enrolled 5246 men 45 to 80
years of age who had preexisting or a high risk of cardiovascular disease
and who reported symptoms of hypogonadism and had two fasting testosterone
levels of less than 300 ng per deciliter. Patients were randomly assigned
to receive daily transdermal 1.62% testosterone gel (dose adjusted to
maintain testosterone levels between 350 and 750 ng per deciliter) or
placebo gel. The primary cardiovascular safety end point was the first
occurrence of any component of a composite of death from cardiovascular
causes, nonfatal myocardial infarction, or nonfatal stroke, assessed in a
time-to-event analysis. A secondary cardiovascular end point was the first
occurrence of any component of the composite of death from cardiovascular
causes, nonfatal myocardial infarction, nonfatal stroke, or coronary
revascularization, assessed in a time-to-event analysis. Noninferiority
required an upper limit of less than 1.5 for the 95% confidence interval
of the hazard ratio among patients receiving at least one dose of
testosterone or placebo. RESULT(S): The mean (+/-SD) duration of
treatment was 21.7+/-14.1 months, and the mean follow-up was 33.0+/-12.1
months. A primary cardiovascular end-point event occurred in 182 patients
(7.0%) in the testosterone group and in 190 patients (7.3%) in the placebo
group (hazard ratio, 0.96; 95% confidence interval, 0.78 to 1.17; P<0.001
for noninferiority). Similar findings were observed in sensitivity
analyses in which data on events were censored at various times after
discontinuation of testosterone or placebo. The incidence of secondary
end-point events or of each of the events of the composite primary
cardiovascular end point appeared to be similar in the two groups. A
higher incidence of atrial fibrillation, of acute kidney injury, and of
pulmonary embolism was observed in the testosterone group.
 CONCLUSION(S): In men with hypogonadism and preexisting or a high
risk of cardiovascular disease, testosterone-replacement therapy was
noninferior to placebo with respect to the incidence of major adverse
cardiac events. (Funded by AbbVie and others; TRAVERSE ClinicalTrials.gov
number, NCT03518034.). Copyright © 2023 Massachusetts Medical
Society.

<23>
[Use Link to view the full text]
Accession Number
641598111
Title
Practice Advisory for Preoperative and Intraoperative Pain Management of
Cardiac Surgical Patients: Part 2.
Source
Anesthesia and analgesia. 137(1) (pp 26-47), 2023. Date of Publication: 01
Jul 2023.
Author
Makkad B.; Heinke T.L.; Sheriffdeen R.; Khatib D.; Brodt J.L.; Meng M.-L.;
Grant M.C.; Kachulis B.; Popescu W.M.; Wu C.L.; Bollen B.A.
Institution
(Makkad) From the Department of Anesthesiology, University of Cincinnati
Medical Center, Cincinnati, OH, United States
(Heinke) Department of Anesthesia and Perioperative Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Sheriffdeen) Department of Anesthesiology, Medstar Washington Hospital
Center, WA, United States
(Khatib) Department of Anesthesiology, Weil Cornell Medical College, NY,
United States
(Brodt) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University, Stanford, CA, United States
(Meng) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(Grant) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, Liberia
(Kachulis) Department of Anesthesiology, Columbia University, NY, United
States
(Popescu) Department of Anesthesiology, Yale School of Medicine, New
Haven, CT, United States
(Popescu) VA Connecticut Healthcare System, West Haven, CT, United States
(Wu) Department of Anesthesiology, Hospital of Special Surgery, Weill
Cornell Medical College, NY, United States
(Bollen) MissoulaMTBulgaria
(Bollen) MissoulaMTBulgaria
Publisher
NLM (Medline)
Abstract
Pain after cardiac surgery is of moderate to severe intensity, which
increases postoperative distress and health care costs, and affects
functional recovery. Opioids have been central agents in treating pain
after cardiac surgery for decades. The use of multimodal analgesic
strategies can promote effective postoperative pain control and help
mitigate opioid exposure. This Practice Advisory is part of a series
developed by the Society of Cardiovascular Anesthesiologists (SCA)
Quality, Safety, and Leadership (QSL) Committee's Opioid Working Group. It
is a systematic review of existing literature for various interventions
related to the preoperative and intraoperative pain management of cardiac
surgical patients. This Practice Advisory provides recommendations for
providers caring for patients undergoing cardiac surgery. This entails
developing customized pain management strategies for patients, including
preoperative patient evaluation, pain management, and opioid use-focused
education as well as perioperative use of multimodal analgesics and
regional techniques for various cardiac surgical procedures. The
literature related to this field is emerging, and future studies will
provide additional guidance on ways to improve clinically meaningful
patient outcomes. Copyright © 2023 International Anesthesia
Research Society.

<24>
[Use Link to view the full text]
Accession Number
641597776
Title
Prevalence and Characteristics of Persistent Postoperative Pain After
Thoracic Surgery: A Systematic Review and Meta-Analysis.
Source
Anesthesia and analgesia. 137(1) (pp 48-57), 2023. Date of Publication: 01
Jul 2023.
Author
Wang L.; Yang M.; Meng W.
Institution
(Wang, Meng) Department of Nursing, Xinyang Vocational and Technical
College, China
(Yang) Department of Coronary Intensive Care Unit, Xinyang Vocational and
Technical College Affiliated Hospital, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: A systematic review and meta-analysis was conducted to
investigate the prevalence and characteristics of persistent (>=3 months)
postoperative pain (PPP) after thoracic surgery. METHOD(S): For this
purpose, Medline, Embase, and CINAHL databases were searched for the
prevalence and characteristics of PPP after thoracic surgery from their
inception to May 1, 2022. Random-effect meta-analysis was used to estimate
pooled prevalence and characteristics. RESULT(S): We included 90
studies with 19,001 patients. At a median follow-up of 12 months, the
pooled overall prevalence of PPP after thoracic surgery was 38.1% (95%
confidence interval [CI], 34.1-42.3). Among patients with PPP, 40.6% (95%
CI, 34.4-47.2) and 10.1% (95% CI, 6.8-14.8) experienced moderate-to-severe
(rating scale >=4/10) and severe (rating scale >=7/10) PPP, respectively.
Overall, 56.5% (95% CI, 44.3-67.9) of patients with PPP required opioid
analgesic use, and 33.0% (95% CI, 22.5-44.3) showed a neuropathic
component. CONCLUSION(S): One in 3 thoracic surgery patients
developed PPP. There is a need for adequate pain treatment and follow-up
in patients undergoing thoracic surgery. Copyright © 2023
International Anesthesia Research Society.

<25>
Accession Number
641597186
Title
Change in cardiorespiratory parameters following surgical correction of
pectus excavatum: protocol for the historical-prospective HeartSoar
cohort.
Source
BMJ open. 13(6) (pp e070891), 2023. Date of Publication: 15 Jun 2023.
Author
Suehs C.M.; Molinari N.; Bourdin A.; Solovei L.
Institution
(Suehs) Respiratory Diseases, Medical Information, Univ Montpellier,
Centre Hospitalier Regional Universitaire de Montpellier, Montpellier,
France
(Molinari) Medical Information, IMAG; CNRS, Univ Montpellier, Centre
Hospitalier Regional Universitaire de Montpellier, Montpellier, France
(Bourdin) Respiratory Diseases, PhyMedExp, CNRS, INSERM, Univ Montpellier,
Centre Hospitalier Regional Universitaire de Montpellier, Montpellier,
France
(Solovei) Thoracic Surgery, Univ Montpellier, Centre Hospitalier Regional
Universitaire de Montpellier, Montpellier, France
Publisher
NLM (Medline)
Abstract
INTRODUCTION: How cardiorespiratory function changes following the
surgical correction of pectus excavatum (PE) often gives mixed results,
with meta-analyses demonstrating no benefit in terms of pulmonary function
but improvement in cardiac function. Functional responses may depend on
type of surgery, follow-up time and/or the patient's presurgical
functional status, and debate persists on the purely aesthetic nature of
such surgery. The aim of this protocol is to analyse data describing lung
function and incremental exercise testing before vs after the surgical
correction of PE. METHODS AND ANALYSIS: A historical-prospective
before-after surgical correction of PE cohort will be constituted.
Historical inclusions are recruited during follow-up visits at
approximately 12, 24, 36 or 48 months following a prior surgery (with
presurgical data mined from patient records). Prospective inclusions are
recruited during presurgical work-ups and followed for 1year following
surgery. The data collected include spirometry, incremental exercise
testing, body mass index, body composition, questionnaires targeting
general health status, self-esteem and body image. Any complications due
to surgery are also described.The primary outcome is oxygen pulse during
incremental exercise testing, and 44 data points are required to
demonstrate a moderate postsurgical change (ie, a Cohen's effect of
d=0.5). Wilcoxon signed-rank tests or t-tests for paired data will be used
for before-after comparisons (with false discovery rate corrections for
secondary analyses). ETHICS AND DISSEMINATION: This study will be
conducted according to the principles of the Declaration of Helsinki (as
revised in 2013) and was approved by a randomly assigned, independent,
ethics committee (Comite de Protection des Personnes Sud-Mediterranee II,
reference number: 218 B21) as per French law on 6 July 2018. Informed,
written consent for study participation is required of all study
candidates prior to enrolment. Results will be published in an
international peer-reviewed journal. TRIAL REGISTRATION NUMBER:
NCT03770390; Clinicaltrials.gov. Copyright © Author(s) (or their
employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<26>
Accession Number
2024817411
Title
Impact of Preprocedural Computed Tomography on Left Atrial Appendage
Closure Success: A Swiss-Apero Trial Subanalysis.
Source
JACC: Cardiovascular Interventions. 16(11) (pp 1332-1343), 2023. Date of
Publication: 12 Jun 2023.
Author
Galea R.; Aminian A.; Meneveau N.; De Marco F.; Heg D.; Anselme F.; Grani
C.; Huber A.T.; Teiger E.; Iriart X.; Franzone A.; Vranckx P.; Fischer U.;
Pedrazzini G.; Bedogni F.; Valgimigli M.; Raber L.
Institution
(Galea, Grani, Valgimigli, Raber) Department of Cardiology, Bern
University Hospital, University of Bern, Bern, Switzerland
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Meneveau) Besancon University Hospital, University of Burgundy
Franche-Comte, Besancon, France
(De Marco, Bedogni) Department of Cardiology, Istituti di Ricovero e Cura
a Carattere Scientifico Policlinico San Donato, San Donato Milanese,
Milan, Italy
(Heg) Department of Clinical Research, Clinical Trials Unit Bern,
University of Bern, Bern, Switzerland
(Anselme) Department of Cardiology, University Hospital of Rouen, Rouen,
France
(Huber) Department of Diagnostic, Interventional and Pediatric Radiology,
Bern University Hospital, University of Bern, Bern, Switzerland
(Teiger) Department of Cardiology, Henri-Mondor Hospital, Public
Assistance Hospitals of Paris, Creteil, France
(Iriart) Department of Pediatric and Adult Congenital Cardiology, Hopital
Cardiologique du Haut- Leveque, Centre Hospitalier Universitaire de
Bordeaux, Bordeaux-Pessac, France
(Franzone) Department of Advanced Biomedical Sciences, University Federico
II University, Naples, Italy
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, Hasselt University,
Hasselt, Belgium
(Fischer) Department of Neurology, Bern University Hospital, University of
Bern, Bern, Switzerland
(Fischer) Department of Neurology, University Hospital Basel, University
of Basel, Switzerland
(Pedrazzini, Valgimigli) Cardiocentro Ticino Institute and Universita
della Svizzera Italiana, Lugano, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: The benefit related to the use of preprocedural computed
tomography angiography (CCTA) on top of periprocedural echocardiography to
plan percutaneous left atrial appendage closure (LAAC) procedures is still
unclear. Objective(s): The authors sought to evaluate the impact of
preprocedural CCTA on LAAC procedural success. Method(s): In the
investigator-initiated SWISS-APERO (Comparison of Amplatzer Amulet and
Watchman Device in Patients Undergoing Left Atrial Appendage Closure)
trial, patients undergoing echocardiography-guided LAAC were randomly
assigned to receive the Amulet (Abbott) or Watchman 2.5/FLX (Boston
Scientific) device across 8 European centers. According to the study
protocol ongoing at the time of the procedure, the first operators had
(CCTA unblinded group) or did not have (CCTA blinded group) access to
preprocedural CCTA images. In this post hoc analysis, we compared blinded
vs unblinded procedures in terms of procedural success defined as complete
left atrial appendage occlusion as evaluated at the end of LAAC
(short-term) or at the 45-day follow-up (long-term) without
procedural-related complications. Result(s): Among 219 LAACs preceded
by CCTA, 92 (42.1%) and 127 (57.9%) were assigned to the CCTA unblinded
and blinded group, respectively. After adjusting for confounders, operator
unblinding to preprocedural CCTA remained associated with a higher rate of
short-term procedural success (93.5% vs 81.1%; P = 0.009; adjusted OR:
2.76; 95% CI: 1.05-7.29; P = 0.040) and long-term procedural success
(83.7% vs 72.4%; P = 0.050; adjusted OR: 2.12; 95% CI: 1.03-4.35; P =
0.041). Conclusion(s): In a prospective multicenter cohort of
clinically indicated echocardiography-guided LAACs, unblinding of the
first operators to preprocedural CCTA images was independently associated
with a higher rate of both short- and long-term procedural success.
Further studies are needed to better evaluate the impact of preprocedural
CCTA on clinical outcomes. Copyright © 2023 American College of
Cardiology Foundation

<27>
Accession Number
2025077315
Title
Assessment of Atherothrombotic Risk in Patients With Type 2 Diabetes
Mellitus.
Source
Journal of the American College of Cardiology. 81(25) (pp 2391-2402),
2023. Date of Publication: 27 Jun 2023.
Author
Berg D.D.; Moura F.A.; Bellavia A.; Scirica B.M.; Wiviott S.D.; Bhatt
D.L.; Raz I.; Bohula E.A.; Giugliano R.P.; Park J.-G.; Feinberg M.W.;
Braunwald E.; Morrow D.A.; Sabatine M.S.
Institution
(Berg, Moura, Bellavia, Scirica, Wiviott, Bohula, Giugliano, Park,
Braunwald, Morrow, Sabatine) TIMI Study Group, Division of Cardiovascular
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Raz) Faculty of Medicine, Hadassah Hebrew University Hospital, Jerusalem,
Israel
(Feinberg) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Risk of atherothrombotic events is not uniform in patients
with type 2 diabetes mellitus (T2DM). Tailored risk assessment may help
guide selection of pharmacotherapies for cardiovascular primary and
secondary prevention. Objective(s): The purpose of this study was to
develop a risk model for atherothrombosis in patients with T2DM.
 Method(s): We developed and validated a risk model for myocardial
infarction (MI) or ischemic stroke (IS) in a pooled cohort of 42,181
patients with T2DM from 4 TIMI (Thrombolysis In Myocardial Infarction)
clinical trial cohorts. Candidate variables were assessed with
multivariable Cox regression, and independent variables (P < 0.05) were
retained in the final model. Discrimination and calibration were assessed.
Treatment interactions with dapagliflozin (sodium-glucose cotransporter-2
inhibitor) and evolocumab (proprotein convertase subtilisin/kexin type 9
inhibitor) were explored in the DECLARE-TIMI 58 (Dapagliflozin Effect on
CardiovascuLAR Events-Thrombolysis In Myocardial Infarction 58) and
FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in
Subjects with Elevated Risk) trials, respectively. Result(s): Sixteen
variables were independent predictors of MI or IS. The model identified a
>8-fold gradient of MI or IS rates between the top vs bottom risk
quintiles in the validation cohort (3-year Kaplan-Meier rate: 14.9% vs
1.4%; P < 0.0001). C-indexes were 0.704 and 0.706 in the derivation and
validation cohorts, respectively. The model was well-calibrated in both
primary and secondary prevention. Absolute reduction in the rates of MI or
IS tended to be greater in patients with higher baseline predicted risk
for both dapagliflozin (absolute risk reduction: 2.1% vs 0.2%) and
evolocumab (absolute risk reduction: 3.2% vs 1.0%). Conclusion(s): We
developed and validated a risk score for atherothrombotic events,
leveraging 16 routinely assessed clinical variables in patients with T2DM.
The score has the potential to improve risk assessment and inform clinical
decision-making. Copyright © 2023 The Authors

<28>
Accession Number
2025057997
Title
The effect of driving pressure-guided versus conventional mechanical
ventilation strategy on pulmonary complications following on-pump cardiac
surgery: A randomized clinical trial.
Source
Journal of Clinical Anesthesia. 89 (no pagination), 2023. Article Number:
111150. Date of Publication: October 2023.
Author
Li X.-F.; Jiang R.-J.; Mao W.-J.; Xin J.; Yu H.
Institution
(Li, Yu, Xin, Yu) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu 610041, China
(Jiang) Department of Anesthesiology, Chengdu Second People's Hospital,
Chengdu 610041, China
(Mao) Department of Anesthesiology, Jianyang People's Hospital, Jianyang
641400, China
Publisher
Elsevier Inc.
Abstract
Study objective: Postoperative pulmonary complications occur frequently
and are associated with worse postoperative outcomes in cardiac surgical
patients. The advantage of driving pressure-guided ventilation strategy in
decreasing pulmonary complications remains to be definitively established.
We aimed to investigate the effect of intraoperative driving
pressure-guided ventilation strategy compared with conventional
lung-protective ventilation on pulmonary complications following on-pump
cardiac surgery. Design(s): Prospective, two-arm, randomized
controlled trial. Setting(s): The West China university hospital in
Sichuan, China. Patient(s): Adult patients who were scheduled for
elective on-pump cardiac surgery were enrolled in the study.
 Intervention(s): Patients undergoing on-pump cardiac surgery were
randomized to receive driving pressure-guided ventilation strategy based
on positive end-expiratory pressure (PEEP) titration or conventional
lung-protective ventilation strategy with fixed 5 cmH<inf>2</inf>O of
PEEP. Measurements: The primary outcome of pulmonary complications
(including acute respiratory distress syndrome, atelectasis, pneumonia,
pleural effusion, and pneumothorax) within the first 7 postoperative days
were prospectively identified. Secondary outcomes included pulmonary
complication severity, ICU length of stay, and in-hospital and 30-day
mortality. Main Result(s): Between August 2020 and July 2021, we
enrolled 694 eligible patients who were included in the final analysis.
Postoperative pulmonary complications occurred in 140 (40.3%) patients in
the driving pressure group and 142 (40.9%) in the conventional group
(relative risk, 0.99; 95% confidence interval, 0.82-1.18; P = 0.877).
Intention-to-treat analysis showed no significant difference between study
groups regarding the incidence of primary outcome. The driving pressure
group had less atelectasis than the conventional group (11.5% vs 17.0%;
relative risk, 0.68; 95% confidence interval, 0.47-0.98; P = 0.039).
Secondary outcomes did not differ between groups. Conclusion(s):
Among patients who underwent on-pump cardiac surgery, the use of driving
pressure-guided ventilation strategy did not reduce the risk of
postoperative pulmonary complications when compared with conventional
lung-protective ventilation strategy. Copyright © 2023

<29>
Accession Number
2025003659
Title
Rest-activity rhythms predict time to hospitalizations and emergency
department visits among participants in a randomized control of adults
with heart failure and insomnia.
Source
Sleep Medicine. 108 (pp 1-7), 2023. Date of Publication: August 2023.
Author
Jeon S.; Conley S.; Hollenbeak C.; O'Connell M.; Wang Z.; Tocchi C.;
Redeker N.S.
Institution
(Jeon) Yale School of Nursing, 400 West Campus Dr, Orange, CT 06477,
United States
(Conley) Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United
States
(Hollenbeak) Penn State University, 604E Donald H Ford Bldg, University
Park, PA 16802, United States
(O'Connell, Wang, Tocchi, Redeker) University of Connecticut School of
Nursing, 231 Glenbrook Road, Storrs, CT 06269, United States
Publisher
Elsevier B.V.
Abstract
Background: We examined the effects of insomnia and diurnal rest-activity
rhythms (RARs) on time to hospitalizations and emergency department (ED)
visits in a randomized controlled trial of cognitive behavioral therapy
for insomnia among people with chronic heart failure (HF) and insomnia.
 Method(s): Among 168 HF patients, we measured insomnia, CPAP use,
sleep, symptoms, and 24-h wrist actigraphy and computed the circadian
quotient (strength of the RAR) from wrist actigraphy and computed
cox-proportional hazard and frailty models. Result(s): Eighty-five
(50.1%) and ninety-one (54.2%) participants had at least one
hospitalization or ED visit, respectively. NYHA class and comorbidity
predicted time to hospitalizations and ED visits, while younger age and
male sex predicted earlier hospitalizations. Low ejection fraction
predicted time to first cardiac event and composite events. Independent of
clinical and demographic predictors, a lower circadian quotient and more
severe pain significantly predicted earlier hospitalizations. A more
robust circadian quotient, more severe insomnia, and fatigue predicted
earlier ED visits independent from clinical and demographic factors. Pain
and fatigue predicted composite events. Conclusion(s): Insomnia
severity and RARs independently predicted hospitalizations and ED visits
independent of clinical and demographic variables. Further research is
necessary to determine whether improving insomnia and strengthening RARs
improves outcomes among people with HF. Clinical Trials Registration:
NCT02660385. Copyright © 2023 Elsevier B.V.

<30>
Accession Number
2024999536
Title
Ultrasonic bone curette in thoracic spinal decompression: a comprehensive
systematic review and meta-analysis.
Source
European Review for Medical and Pharmacological Sciences. 27(10) (pp
4450-4461), 2023. Date of Publication: 2023.
Author
Chen F.-Y.; Wei X.-D.; Yang X.-P.; Yu C.-Q.; Huang S.-Q.; Ou J.-X.; Mu
X.-P.; Wei J.-X.
Institution
(Chen, Wei, Yang, Yu, Huang, Ou, Mu, Wei) Department of Spine Surgery, The
People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of
Medical Sciences, Nanning, China
(Chen, Ou) Graduate School, Guangxi Medical University, Nanning, China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: The aim of this study was to compare the efficacy and safety of
ultrasonic bone curette (UBC) and conventional surgical instruments in
thoracic laminectomy decompression (TLD) for the treatment of thoracic
spinal stenosis (TSS) by meta-analysis. MATERIALS AND METHODS: Two authors
independently searched Medline via PubMed, Embase, Cochrane Library, Web
of Science, Wanfang Database, and China National Knowledge Infrastructure
for the period from the establishment of the database until January 2023
to identify the studies on the safety and efficacy of UBC vs. conventional
instruments for TSS. Data extraction and quality assessment were performed
by two researchers independently. We used RevMan 5.4 software (Review
Manager Web, The Cochrane Collaboration, Copenhagen, Denmark) to analyze
the data. RESULT(S): Eight retrospective studies were included in the
present work. This meta-analysis revealed that no significant differences
in the preoperative JOA scores, the JOA scores at the last follow-up, the
improvement rate of JOA scores, and the incidence of cerebrospinal fluid
leakage/dura injury were detected between the two groups (p>=0.05).
However, there were significant differences in the operative time and
intraoperative blood loss during single-level TLD [operative time:
MD=-1.47, 95% CI (-1.86, -1.09), p<0.001; intraoperative blood loss:
MD=-46.62, 95% CI (-53.83, -39.40), p<0.001], total operative time
[MD=-56.88, 95% CI (-69.66, -44.10), p<0.001], total intraoperative blood
loss [MD=- 143.52, 95% CI (-212.49, -74.54), p<0.001], the incidence of
neurological deterioration/nerve root injury [RR= 0.29, 95% CI (0.09,
0.91), p=0.03] between the groups. CONCLUSION(S): The application of
UBC in TLD to treat TSS is safe and effective. UBC can significantly
shorten operation time and reduce intraoperative blood loss compared to
traditional surgical instruments. Moreover, it has the advantage of
reducing perioperative nerve injury. Copyright © 2023 Verduci
Editore s.r.l. All rights reserved.

<31>
Accession Number
2024825636
Title
Effect of Prophylactic Fibrinogen Concentrate in Scoliosis Surgery
(EFISS): A study protocol of two-arm, randomised trial.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e071547. Date of
Publication: 26 May 2023.
Author
Vrbica K.; Hudec J.; Hrdy O.; Galko M.; Horalkova H.; Demlova R.; Kubelova
M.; Repko M.; Gal R.
Institution
(Vrbica, Hudec, Hrdy, Horalkova, Gal) Department of Anaesthesiology and
Intensive Care Medicine, University Hospital Brno, Brno, Czechia
(Vrbica, Hudec, Hrdy, Horalkova, Gal) Department of Anaesthesiology and
Intensive Care Medicine, Masaryk University, Faculty of Medicine, Brno,
Czechia
(Galko, Repko) Department of Orthopaedic Surgery, University Hospital
Brno, Brno, Czechia
(Galko, Repko) Department of Orthopaedic Surgery, Masaryk University,
Faculty of Medicine, Brno, Czechia
(Demlova, Kubelova) Department of Pharmacology/CZECRIN, Masaryk
University, Faculty of Medicine, Brno, Czechia
Publisher
BMJ Publishing Group
Abstract
Introduction Fibrinogen is one of the essential coagulation factors.
Preoperative lower plasma fibrinogen level has been associated with higher
blood loss. Scoliosis surgery presents a challenge for the anaesthetic
team, one of the reasons being blood loss and transfusion management.
Recently, the prophylactic fibrinogen administration has been a debated
topic in various indications. It has been described for example, in
urological or cardiovascular surgery, as well as in paediatrics. This
pilot study is focused on verifying the feasibility of potential large
randomised trial and verifying the safety of prophylactic fibrinogen
administration in paediatric scoliosis surgery. Methods and analysis A
total of 32 paediatric patients indicated for scoliosis surgery will be
recruited. Participants will be randomised into study groups in a 1:1
allocation ratio. Patients in the intervention group will receive
prophylactic single dose of fibrinogen, in addition to standard of care.
Patients in the control group will receive standard of care without study
medication prior to skin incision. The primary aim is to assess the safety
of prophylactic fibrinogen administration during scoliosis surgery in
children, the incidence of any adverse events (AEs) and reactions will be
monitored during participation in the study. The secondary objective is to
investigate the additional safety information, feasibility and efficacy of
a prophylactic fibrinogen administration. The incidence of AEs and
reactions according to selected adverse events of special interest will be
monitored. All collected data will be subjected to statistical analysis
according to a separate statistical analysis plan. Ethics and
dissemination This trial follows the applicable legislation and
requirements for good clinical practice according to the International
Conference on Harmonisation E6(R2). All essential trial documents were
approved by the relevant ethics committee and national regulatory
authority (State Institute for Drug Control) and their potential
amendments will be submitted for approval. Trial registration number
NCT05391412. Copyright © 2023 BMJ Publishing Group. All rights
reserved.

<32>
Accession Number
2023632247
Title
Genetic Factors Influencing Warfarin Dose in Han Chinese Population: A
Systematic Review and Meta-Analysis of Cohort Studies.
Source
Clinical Pharmacokinetics. 62(6) (pp 819-833), 2023. Date of Publication:
June 2023.
Author
Zhao Z.; Zhao F.; Wang X.; Liu D.; Liu J.; Zhang Y.; Hu X.; Zhao M.; Tian
C.; Dong S.; Jin P.
Institution
(Zhao, Zhao, Zhang, Hu, Zhao, Jin) Department of Pharmacy, Beijing
Hospital; National Center of Gerontology; Institute of Geriatric Medicine,
Chinese Academy of Medical Sciences; Beijing Key Laboratory of Assessment
of Clinical Drugs Risk and Individual Application (Beijing Hospital), No.
1 Dahua Road, Dongdan, Dongcheng District, Beijing 100730, China
(Wang, Liu, Liu) Department of Cardiology, Beijing Hospital, National
Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of
Medical Sciences, Beijing 100730, China
(Tian) Department of Pharmacy, Beijing Children's Hospital, Capital
Medicine University, National Center for Children's Health, Beijing
100045, China
(Dong) Department of Pharmacy, Peking University Third Hospital, Beijing
100191, China
Publisher
Adis
Abstract
Objective: To investigate the association of single nucleotide
polymorphisms (SNPs) of various genes known to influence mean daily
warfarin dose (MDWD) in the Han Chinese population. Method(s): The
study is a systematic review and meta-analysis. Selected studies retrieved
by searching Pubmed, Embase (Ovid), Medline, CNKI, Wanfang data, and
SinoMed (from their inception to 31 August 2022) for the cohort studies
assessing genetic variations that may possibly influence MDWD in Chinese
patients were included. Result(s): A total of 46 studies including a
total of 10,102 Han Chinese adult patients were finally included in the
meta-analysis. The impact of 20 single nucleotide polymorphisms (SNPs) in
8 genes on MDWD was analyzed. The significant impact of some of these SNPs
on MDWD requirements was demonstrated. Patients with CYP4F2 rs2108622 TT,
EPHX1 rs2260863 GC, or NQO1 rs1800566 TT genotype required more than 10%
higher MDWD. Furthermore, patients with ABCB1 rs2032582 GT or GG, or CALU
rs2290228 TT genotype required more than 10% lower MDWD. Subgroup analysis
showed that patients with EPHX1 rs2260863 GC genotype required 7% lower
MDWD after heart valve replacement (HVR). Conclusion(s): This is the
first systematic review and meta-analysis assessing the association
between single nucleotide polymorphisms (SNPs) of various genes known to
influence MDWD besides CYP2C9 and VKORC1 in the Han Chinese population.
CYP4F2 (rs2108622), GGCX (rs12714145), EPHX1 (rs2292566 and rs2260863),
ABCB1 (rs2032582), NQO1 (rs1800566), and CALU (rs2290228) SNPs might be
moderate factors affecting MDWD requirements. Registered information:
PROSPERO International Prospective Register of Systematic Reviews
(CRD42022355130). Copyright © 2023, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<33>
Accession Number
2021614696
Title
Treatment of COVID-19 patients with a SARS-CoV-2-specific siRNA-peptide
dendrimer formulation.
Source
Allergy: European Journal of Allergy and Clinical Immunology. 78(6) (pp
1639-1653), 2023. Date of Publication: June 2023.
Author
Khaitov M.; Nikonova A.; Kofiadi I.; Shilovskiy I.; Smirnov V.; Elisytina
O.; Maerle A.; Shatilov A.; Shatilova A.; Andreev S.; Sergeev I.; Trofimov
D.; Latysheva T.; Ilyna N.; Martynov A.; Rabdano S.; Ruzanova E.; Savelev
N.; Pletiukhina I.; Safi A.; Ratnikov V.; Gorelov V.; Kaschenko V.;
Kucherenko N.; Umarova I.; Moskaleva S.; Fabrichnikov S.; Zuev O.; Pavlov
N.; Kruchko D.; Berzin I.; Goryachev D.; Merkulov V.; Shipulin G.; Udin
S.; Trukhin V.; Valenta R.; Skvortsova V.
Institution
(Khaitov, Nikonova, Kofiadi, Shilovskiy, Smirnov, Elisytina, Maerle,
Shatilov, Shatilova, Andreev, Sergeev, Trofimov, Latysheva, Ilyna,
Martynov, Valenta) National Research Center (NRC) Institute of Immunology
Federal Medical-Biological Agency (FMBA) of Russia, Moscow, Russian
Federation
(Khaitov, Kofiadi) Pirogov Russian National Research Medical University,
Moscow, Russian Federation
(Nikonova, Elisytina) RUDN University, Moscow, Russian Federation
(Smirnov, Merkulov, Valenta) I.M. Sechenov First Moscow State Medical
University (Sechenov University), Moscow, Russian Federation
(Rabdano, Ruzanova, Savelev, Pletiukhina, Safi, Trukhin) Federal State
Unitary Enterprise "The Saint Petersburg Scientific Research Institute of
Vaccines and Serums and the Enterprise for the Production of Bacterial
Preparations" of Federal Medical and Biologic Agency (FSUE SPbSRIVS FMBA
of Russia), St. Petersburg, Russian Federation
(Ratnikov, Gorelov, Kaschenko, Kucherenko, Umarova, Moskaleva,
Fabrichnikov) North-West District Scientific and Clinical Center named
after L.G. Sokolov Federal Medical and Biological Agency, St. Petersburg,
Russian Federation
(Zuev, Pavlov) Federal Clinical Center of High Medical Technologies of the
Federal Medical and Biological Agency of Russia, Moscow, Russian
Federation
(Kruchko, Berzin, Skvortsova) Federal Medico-biological Agency of Russia
(FMBA Russia), Moscow, Russian Federation
(Goryachev, Merkulov) Centre for Evaluation and Control of Finished
Pharmaceutical Products, Federal State Budgetary Institution "Scientific
Centre for Expert Evaluation of Medicinal Products" of the Ministry of
Health of the Russian Federation, Moscow, Russian Federation
(Shipulin, Udin) Centre for Strategic Planning of FMBA of Russia Federal
State Budgetary Institution "Centre for Strategic Planning and Management
of Biomedical Health Risks" of the Federal Medical Biological Agency,
Moscow, Russian Federation
(Valenta) Medical University of Vienna, Vienna, Austria
(Valenta) Karl Landsteiner University of Healthcare, Krems, Austria
Publisher
John Wiley and Sons Inc
Abstract
Background: Severe acute respiratory syndrome corona virus (SARS-CoV-2)
infection frequently causes severe and prolonged disease but only few
specific treatments are available. We aimed to investigate safety and
efficacy of a SARS-CoV-2-specific siRNA-peptide dendrimer formulation MIR
19 (siR-7-EM/KK-46) targeting a conserved sequence in known SARS-CoV-2
variants for treatment of COVID-19. Method(s): We conducted an
open-label, randomized, controlled multicenter phase II trial
(NCT05184127) evaluating safety and efficacy of inhaled siR-7-EM/KK-46
(3.7 mg and 11.1 mg/day: low and high dose, respectively) in comparison
with standard etiotropic drug treatment (control group) in patients
hospitalized with moderate COVID-19 (N = 52 for each group). The primary
endpoint was the time to clinical improvement according to predefined
criteria within 14 days of randomization. Result(s): Patients from
the low-dose group achieved the primary endpoint defined by simultaneous
achievement of relief of fever, normalization of respiratory rate,
reduction of coughing, and oxygen saturation of >95% for 48 h
significantly earlier (median 6 days; 95% confidence interval [CI]: 5-7,
HR 1.75, p =.0005) than patients from the control group (8 days; 95% CI:
7-10). No significant clinical efficacy was observed for the high-dose
group. Adverse events were reported in 26 (50.00%), 25 (48.08%), and 28
(53.85%) patients from the low-, high-dose and control group,
respectively. None of them were associated with siR-7-EM/KK-46.
 Conclusion(s): siR-7-EM/KK-46, a SARS-CoV-2-specific siRNA-peptide
dendrimer formulation is safe, well tolerated and significantly reduces
time to clinical improvement in patients hospitalized with moderate
COVID-19 compared to standard therapy in a randomized controlled
trial. Copyright © 2023 The Authors. Allergy published by
European Academy of Allergy and Clinical Immunology and John Wiley & Sons
Ltd.

<34>
Accession Number
2020983670
Title
Meta-Analysis Comparing Left Atrial Appendage Occlusion, Direct Oral
Anticoagulants, and Warfarin for Nonvalvular Atrial Fibrillation.
Source
American Journal of Cardiology. 186 (pp 117-125), 2023. Date of
Publication: 01 Jan 2023.
Author
Abdelfattah O.M.; Sayed A.; Munir M.; Almotawally S.; Wilson K.; Gad M.M.;
Abushouk A.I.; Elsayed M.; Wazni O.M.; Saliba W.I.; Elgendy I.Y.; Jneid
H.; Kapadia S.
Institution
(Abdelfattah, Kapadia) Department of Cardiovascular Medicine, Heart,
Vascular & Thoracic Institute, Cleveland, Ohio, United States
(Abdelfattah, Abushouk) Department of Medicine, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(Sayed, Munir, Almotawally, Wilson) Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Gad) Department of Internal Medicine, Cleveland, Ohio, United States
(Elsayed) Division of Cardiovascular Disease, Allegheny General Hospital,
PittsburghPennsylvania
(Wazni, Saliba) Section of Cardiac Pacing and Electrophysiology, Heart,
Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, United
States
(Elgendy) Department of Medicine, Weill Cornell Medicine-Qatar, Doha,
Qatar
(Jneid) Division of Cardiovascular Medicine, Baylor School of Medicine,
Houston, Texas, United States
Publisher
Elsevier Inc.
Abstract
Randomized trials have shown that direct oral anticoagulants (DOACs) are
superior to warfarin in patients with nonvalvular atrial fibrillation.
However, long-term use of anticoagulation carries an inherent risk of
bleeding and nonadherence. Although the use of percutaneous left atrial
appendage occlusion (LAAO) has become readily available, its effectiveness
relative to oral anticoagulants is still unclear. The present study aimed
to compare the outcomes of warfarin, DOACs, and LAAO in patients with
atrial fibrillation. Medline, Embase, CENTRAL, and Web of Science were
systematically searched through December 2021 for randomized controlled
trials comparing warfarin, DOACs, or LAAO, reporting on all-cause
mortality, stroke, and clinically relevant bleeding. A random-effects
model was used to assess the safety and efficacy outcomes of these 3
treatments relative to each other in a Bayesian network meta-analysis. A
total of 40 trials with 95,469 patients (LAAO: 5 trials, 3,032 patients;
DOAC: 36 trials, 54,327 patients; warfarin: 37 trials, 38,110 patients)
were included. LAAO was associated with significantly lower mortality than
warfarin (odds ratio [OR] 0.68; 95% credible interval [CrI] 0.50 to 0.90)
and DOACs (OR 0.75, 95% CrI 0.55 to 0.99). LAAO was the best-ranked
treatment with respect to mortality reduction (surface under the
cumulative ranking curve [SUCRA] 98.77%) and bleeding avoidance (SUCRA
72.26%). Compared with warfarin, DOACs significantly reduced mortality (OR
0.91, 95% CrI 0.85 to 0.97), stroke (OR 0.80, 95% CrI 0.63 to 0.93), and
bleeding (OR 0.78, 95% CrI 0.63 to 0.95) and were ranked as the best
option at preventing stroke (SUCRA 82.63%). In conclusion, LAAO was
associated with lower mortality compared with DOACs, and both LAAO and
DOACs significantly reduce mortality compared with warfarin. Future trials
are needed to rule out a significant inferiority of LAAO compared with
DOACs in terms of stroke and bleeding risks. Copyright © 2022
Elsevier Inc.

<35>
Accession Number
2015266118
Title
Mitral repair with leaflet preservation versus leaflet resection and
ventricular reverse remodeling from a randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(1) (pp 74-83.e2),
2023. Date of Publication: July 2023.
Author
Hibino M.; Dhingra N.K.; Verma S.; Chan V.; Quan A.; Gregory A.J.; Chu
M.W.A.; Ong G.; Teoh H.; Mazer C.D.; Tsang W.; Messika-Zeitoun D.;
Leong-Poi H.; Connelly K.A.; Ali F.M.; de Varennes B.E.; Bouchard D.;
Whitlock R.P.; Latter D.A.
Institution
(Hibino, Dhingra, Verma, Quan, Teoh) Division of Cardiac Surgery, Li Ka
Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
(Hibino, Verma) Department of Surgery, University of Toronto, Toronto, ON,
Canada
(Verma) Department of Pharmacology and Toxicology, University of Toronto,
Toronto, ON, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Chan) School of Epidemiology, Public Health and Preventive Medicine,
University of Ottawa, Ottawa, ON, Canada
(Gregory) Department of Anesthesiology, Perioperative and Pain Medicine,
University of Calgary, Calgary, AB, Canada
(Gregory) Libin Cardiovascular Institute, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Chu) Division of Cardiac Surgery, London Health Sciences Center,
University of Western Ontario, London, ON, Canada
(Ong, Tsang, Leong-Poi, Connelly) Division of Cardiology, Li Ka Shing
Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
(Ong, Leong-Poi, Connelly) Department of Medicine, University of Toronto,
Toronto, ON, Canada
(Teoh) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute of St. Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute of St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Mazer, Connelly) Department of Physiology, University of Toronto,
Toronto, ON, Canada
(Tsang) Division of Cardiology, Toronto General Hospital, University
Health Network, University of Toronto, Toronto, ON, Canada
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Messika-Zeitoun) Department of Medicine, University of Ottawa, Ottawa,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: In the Canadian Mitral Research Alliance (CAMRA) Trial
CardioLink-2 leaflet resection versus preservation techniques for
posterior leaflet prolapse was investigated and no difference was shown in
their effect on mean mitral gradient at peak exercise at 12 months
postoperatively. The purpose of this subanalysis was to evaluate the
effect of the 2 strategies on left ventricular (LV) reverse remodeling
after repair. Method(s): A total of 104 patients were randomized to
either a leaflet resection or leaflet preservation strategy.
Echocardiograms, performed at baseline (preoperative), predischarge, and
12 months postoperatively, were analyzed in a blinded fashion at a core
laboratory. Result(s): All patients underwent successful mitral
repair. At discharge, 3 patients showed moderate mitral regurgitation,
whereas the remainder showed mild or less regurgitation. Compared with the
baseline echocardiogram, the indexed end diastolic volume was reduced at
the discharge echocardiogram (P <.0001) and was further reduced at the
12-month echocardiogram (P =.01). In contrast, the indexed end systolic
volume did not significantly change from baseline assessed at the
predischarge echocardiogram (P =.32) but improved at 12 months
postoperatively (P <.0001), resulting in a corresponding improvement in
ejection fraction at 12 months (P <.0001). The type of mitral repair
strategy had no significant effect on LV reverse remodeling trends.
 Conclusion(s): The mitral repair strategies used did not influence
postoperative LV reverse remodeling, which occurred in stages. Although LV
end diastolic dimensions recovered before discharge, improvements in LV
end systolic dimension were evident 12 months after repair. Copyright
© 2021 The American Association for Thoracic Surgery

<36>
Accession Number
2022867044
Title
Analysis of perioperative corticosteroid therapy in children undergoing
cardiac surgery: A systematic review and meta-analysis.
Source
Clinical Cardiology. 46(6) (pp 607-614), 2023. Date of Publication: June
2023.
Author
Chen D.; Du Y.
Institution
(Chen) Gastrointestinal Surgery, Chunzhou County Hospital of Huai'an City,
Huai'an, China
(Du) Pediatric Surgery, Huai'an Maternal and Child Health Care Hospital,
China
Publisher
John Wiley and Sons Inc
Abstract
The advantages and disadvantages of using corticosteroids in children
undergoing cardiac surgery is still contentious. To examine how
perioperative corticosteroids affect postoperative mortality and clinical
outcomes in pediatric cardiac surgery with cardiopulmonary bypass (CPB).
We used MEDLINE, EMBASE, and the Cochrane Database to conduct a
comprehensive search up through January 2023. Children aged 0-18
undergoing cardiac surgery were included in the meta-analysis of
randomized controlled studies comparing perioperative corticosteroids with
other therapeutic therapies, placebo, or no treatment. All-cause hospital
mortality was the primary endpoint of the study. Hospitalization duration
was a secondary result. The Cochrane Risk of Bias Assessment Tool was used
to evaluate the research quality. Ten trials and 7798 pediatric
participants were included in our analysis. Children taking
corticosteroids had no significant difference in all-cause in-hospital
mortality using a random-effect model with relative risk (RR) = 0.38, 95%
confidence interval (CI) = 0.16-0.91, I2 = 79%, p =.03 for
methylprednisolone and RR = 0.29, 95% CI = 0.09-0.97, I2 = 80%,
p =.04. For the secondary outcome, there was a significant difference
between the corticosteroid and placebo groups, with pooled standard mean
difference (SMD) = -0.86, 95% CI = -1.57 to -0.15, I2 = 85%, p
=.02 for methylprednisolone and SMD = -0.97, 95% CI -1.90 to -0.04,
I2 = 83%, p =.04 for dexamethasone. Perioperative
corticosteroids may not improve mortality, but they reduce hospital stay
compared to placebo. Further evidence from randomized controlled studies
with larger samples is required for approaching at a valid
conclusion. Copyright © 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<37>
Accession Number
2022466131
Title
Anticoagulation therapy and clinical outcomes following transcatheter
mitral valve repair for patients with mitral regurgitation: A
meta-analysis.
Source
Clinical Cardiology. 46(6) (pp 598-606), 2023. Date of Publication: June
2023.
Author
Zhang J.; Yang Y.; Jia L.; Su J.; Xiao A.; Lin X.
Institution
(Zhang, Yang, Jia, Su, Xiao, Lin) Cardiology Department, The First
Affiliated Hospital of Anhui Medical University, Anhui, Hefei, China
(Zhang, Yang, Jia, Su, Xiao) Graduate School, Anhui Medical University,
Anhui, China
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter mitral valve repair (TMVR) using MitraClip (MC) is now an
established technique in the interventional treatment of mitral
regurgitation. Common complications after MC procedure are bleeding and
ischemic events. However, 2017 ESC/EACTS and 2020 ACC/AHA did not give a
clear antithrombotic protocol, the policy has been based on clinical
experience. Here, we performed a meta-analysis comparing outcomes with and
without the addition of anticoagulants after TMVR. We searched the
Cochrane Library, EMBASE, PubMed, and Web of Science from inception to
October 6, 2022 to identify studies with or without the use of
anticoagulants after TMVR. From each study, we extracted the number of
people with bleeding, stroke, combined endpoints, and all-cause death.
Five observational cohort studies were included, enrolling a total of 1892
patients undergoing TMVR who were assigned to either the anticoagulation
group (n = 1209) or the no-anticoagulation group (n = 683). Pooled
analysis showed a significantly lower stroke rate in the anticoagulated
group (at least 4 weeks duration) compared with the non-anticoagulated
group (RR [95% CI] = 0.14 [0.0-0.77], p = 0.02), and similar rates of
bleeding, combined endpoints, and all-cause death in both groups (RR [95%
CI] = 0.76 [0.48-1.22], p = 0.26), (RR [95% CI] = 0.52 [0.10-2.63], p =
0.43), and (RR [95% CI] = 0.89 [0.58-1.35], p = 0.58). We observed a
reduced risk of stroke without elevated risk of bleeding, combined
endpoints, or all-cause death in patients using anticoagulants (at least 4
weeks duration) after TMVR compared to no anticoagulants. Copyright
© 2023 The Authors. Clinical Cardiology published by Wiley
Periodicals, LLC.

<38>
Accession Number
2024307319
Title
Effects of Dexmedetomidine Combined with Sufentanil on Hemodynamics,
Myocardial Injury and Pulmonary Function in Patients Undergoing Heart
Valve Replacement under Cardiopulmonary Bypass.
Source
Latin American Journal of Pharmacy. 42(1) (pp 13-18), 2023. Date of
Publication: 2023.
Author
Yang C.; Liang X.; Zheng Q.; Xing Z.
Institution
(Yang, Liang, Zheng, Xing) Western Hospital of Affiliated Hospital of
Yangzhou University, Yangzhou 225009, China
Publisher
Colegio de Farmaceuticos de la Provincia de Buenos Aires
Abstract
SUMMARY. This work explored the effects of dexmedetomidine combined with
sufentanil on hemodynamics, myocardial injury and pulmonary function in
patients undergoing heart valve replacement (HVR) under cardiopulmonary
bypass (CPB). A total of 92 patients with elective HVR under CPB were
randomly divided into control group (n = 46) and observation group (n =
46). The observation group was treated with dexmedetomidine combined with
sufentanil before anesthesia induction and during and after surgery, while
the control group was only treated with sufentanil. Results showed that,
the postoperative propofol dosage in observation group was significantly
lower than those in control group (p < 0.05). At the time point after
intubation, cutting skin, splitting sternum, before CPB and 10 min after
CPB shutdown, the heart rate and mean arterial pressure in observation
group WERE significantly lower than those in control group (p < 0.05). At
the time point 12 h after CPB shutdown, compared with control group, in
observation group the serum cardiac troponin I and creatine kinase
isoenzyme levels were significantly decreased (p < 0.05), the arterial
partial pressure of oxygen and oxygenation index were significantly
increased (p < 0.05), and the arterial partial pressure of carbondioxide
was significantly decreased (p < 0.05). In conclusion, for patients
undergoing HVR under CPB, dexmedetomidine combined with sufentanil has a
definite analgesic effect, and it is conducive to maintaining the
hemodynamic stability, reducing the myocardial injury, and improving the
pulmonary function. Copyright © 2023, Colegio de Farmaceuticos de
la Provincia de Buenos Aires. All rights reserved.

<39>
Accession Number
2023890995
Title
Cerebral embolic protection during transcatheter aortic valve replacement:
a systematic review and meta-analysis of propensity score matched and
randomized controlled trials using the Sentinel cerebral embolic
protection device.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
306. Date of Publication: December 2023.
Author
Wolfrum M.; Handerer I.J.; Moccetti F.; Schmeisser A.; Braun-Dullaeus
R.C.; Toggweiler S.
Institution
(Wolfrum, Moccetti, Toggweiler) Heart Center Lucerne, Luzerner
Kantonsspital, Lucerne, Switzerland
(Wolfrum, Handerer, Schmeisser, Braun-Dullaeus) Department of Internal
Medicine, Division of Cardiology and Angiology, Magdeburg University,
Magdeburg, Germany
Publisher
BioMed Central Ltd
Abstract
Background: The Sentinel cerebral embolic protection device (CEP) aims to
reduce the risk of stroke during transcatheter aortic valve replacement
(TAVR). We performed a systematic review and meta-analysis of propensity
score matched (PSM) and randomized controlled trials (RCT) investigating
the effect of the Sentinel CEP to prevent strokes during TAVR.
 Method(s): Eligible trials were searched through PubMed, ISI Web of
science databases, Cochrane database, and proceedings of major congresses.
Primary outcome was stroke. Secondary outcomes included all-cause
mortality, major or life-threatening bleeding, major vascular
complications and acute kidney injury at discharge. Fixed and random
effect models were used to calculate the pooled risk ratio (RR) with 95%
confidence intervals (CI) and absolute risk difference (ARD).
 Result(s): A total of 4066 patients from 4 RCTs (3'506 patients) and
1 PSM study (560 patients) were included. Use of Sentinel CEP was
successful in 92% of patients and was associated with a significantly
lower risk of stroke (RR: 0.67, 95% CI: 0.48-0.95, p = 0.02. ARD: -1.3%,
95% CI: -2.3 - -0.2, p = 0.02, number needed to treat (NNT) = 77), and a
reduced risk of disabling stroke (RR: 0.33, 95% CI: 0.17-0.65. ARD: -0.9%,
95% CI: -1.5 - -0.3, p = 0.004, NNT = 111). Use of Sentinel CEP was
associated with a lower risk of major or life-threatening bleeding (RR:
0.37, 95% CI: 0.16-0.87, p = 0.02). Risk for nondisabling stroke (RR:
0.93, 95% CI: 0.62-1.40, p = 0.73), all-cause mortality (RR: 0.70, 95% CI:
0.35-1.40, p = 0.31), major vascular complications (RR: 0.74, 95% CI:
0.33-1.67, p = 0.47) and acute kidney injury (RR: 0.74, 95% CI: 0.37-1.50,
p = 0.40) were similar. Conclusion(s): The use of CEP during TAVR was
associated with lower risks of any stroke and disabling stroke with an NNT
of 77 and 111, respectively. Copyright © 2023, The Author(s).

<40>
Accession Number
2023816661
Title
Esketamine opioid-free intravenous anesthesia versus opioid intravenous
anesthesia in spontaneous ventilation video-assisted thoracic surgery: a
randomized controlled trial.
Source
Frontiers in Oncology. 13 (no pagination), 2023. Article Number: 1145953.
Date of Publication: 2023.
Author
Fan Q.; Luo J.; Zhou Q.; Zhang Y.; Zhang X.; Li J.; Jiang L.; Lan L.
Institution
(Fan, Luo, Zhang, Zhang, Li, Lan) Department of Anesthesia, The First
Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
(Zhou) Department of Medical Imaging, Guangdong Second Provincial General
Hospital, Guangzhou, China
(Jiang) National Clinical Research Center for Respiratory Disease,
Departments of Thoracic Surgery, The First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Opioid-free anesthesia (OFA) provides adequate analgesia and
can reduce postoperative opioid consumption, but its efficacy in
spontaneous ventilation video-assisted thoracic surgery (SV-VATS) has not
been demonstrated. We aimed to investigate the hypothesis that OFA could
provide the same perioperative pain control as opioid anesthesia (OA),
maintain safe and stable respiration and hemodynamics during surgery, and
improve postoperative recovery. Method(s): Sixty eligible patients
(OFA group: n=30; OA group: n=30) treated between September 15, 2022, and
December 15, 2022, at The First Hospital of Guangzhou Medical University
were included. They were randomized to receive standard balanced OFA with
esketamine or OA with remifentanil combined with sufentanil. The primary
outcome was the pain numeric rating score (NRS) at postoperative 24 h, and
the secondary outcomes were intraoperative respiratory and hemodynamic
data, opioid consumption, vasoactive drug dosage, and recovery in the
post-anesthesia care unit and ward. Result(s): There was no
significant difference in the postoperative pain scores and recovery
quality between the two groups. The OFA group had a significantly lower
dose of phenylephrine (P=0.001) and a lower incidence of hypotension
(P=0.004) during surgery. The OFA group resumed spontaneous respiration
faster (P<0.001) and had a higher quality of lung collapse (P=0.02).
However, the total doses of propofol and dexmetomidine were higher (P=0.03
and P=0.02), and the time to consciousness was longer (P=0.039) in the OFA
group. Conclusion(s): OFA provides the same level of postoperative
pain control as OA, but it is more advantageous in maintaining circulatory
and respiratory stability and improving the quality of pulmonary collapse
in SV-VATS. Copyright © 2023 Fan, Luo, Zhou, Zhang, Zhang, Li,
Jiang and Lan.

<41>
Accession Number
2023816647
Title
Hemodynamic effects of intraoperative 30% versus 80% oxygen
concentrations: an exploratory analysis.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1200223.
Date of Publication: 2023.
Author
Reiterer C.; Fleischmann E.; Kabon B.; Taschner A.; Kurz A.; Adamowitsch
N.; von Sonnenburg M.F.; Fraunschiel M.; Graf A.
Institution
(Reiterer, Fleischmann, Kabon, Taschner, Adamowitsch, von Sonnenburg)
Department of Anesthesia, Intensive Care Medicine and Pain Medicine,
Medical University of Vienna, Vienna, Austria
(Reiterer, Fleischmann, Kabon, Taschner, Kurz) Outcome Research
Consortium, Cleveland, OH, United States
(Kurz) Department of General Anesthesiology, Cleveland Clinic, Anesthesia
Institute, Cleveland, OH, United States
(Kurz) Department of General Anesthesiology, Emergency Medicine and
Intensive Care Medicine, Medical University of Graz, Graz, Austria
(Fraunschiel) IT Systems and Communications, Medical University of Vienna,
Vienna, Austria
(Graf) Center for Medical Data Science, Medical University of Vienna,
Vienna, Austria
Publisher
Frontiers Media S.A.
Abstract
Background: Supplemental oxygen leads to an increase in peripheral
vascular resistance which finally increases systemic blood pressure in
healthy subjects and patients with coronary artery disease, heart failure,
undergoing heart surgery, and with sepsis. However, it is unknown whether
this effect can also be observed in anesthetized patients having surgery.
Thus, we evaluated in this exploratory analysis of a randomized controlled
trial the effect of 80% versus 30% oxygen on intraoperative blood pressure
and heart rate. Method(s): We present data from a previous study
including 258 patients, who were randomized to a perioperative inspiratory
FiO<inf>2</inf> of 0.8 (128 patients) versus 0.3 (130 patients) for major
abdominal surgery. Continuous arterial blood pressure values were recorded
every three seconds and were exported from the electronic anesthesia
record system. We calculated time-weighted average (TWA) and Average Real
Variability (ARV) of mean arterial blood pressure and of heart rate.
 Result(s): There was no significant difference in TWA of mean
arterial pressure between the 80% (80 mmHg [76, 85]) and 30% (81 mmHg [77,
86]) oxygen group (effect estimate -0.16 mmHg, CI -1.83 to 1.51; p =
0.85). There was also no significant difference in TWA of heart rate
between the 80 and 30% oxygen group (median TWA of heart rate in the 80%
oxygen group: 65 beats.min-1 [58, 72], and in the 30% oxygen
group: 64 beats.min-1 [58; 70]; effect estimate: 0.12
beats.min-1, CI -2.55 to 2.8, p = 0.94). Also for ARV values,
no significant differences between groups could be detected.
 Conclusion(s): In contrast to previous results, we did not observe a
significant increase in blood pressure or a significant decrease in heart
rate in patients, who received 80% oxygen as compared to patients, who
received 30% oxygen during surgery and for the first two postoperative
hours. Thus, hemodynamic effects of supplemental oxygen might play a
negligible role in anesthetized patients. Clinical Trail Registration:
https://clinicaltrials.gov/ct2/show/NCT03366857?term=vienna&cond=oxygen&dr
aw=2&rank=1 Copyright © 2023 Reiterer, Fleischmann, Kabon,
Taschner, Kurz, Adamowitsch, von Sonnenburg, Fraunschiel and Graf.

<42>
Accession Number
2004927166
Title
Pulmonary Valve Replacement for Pulmonary Regurgitation in Adults With
Tetralogy of Fallot: A Meta-analysis-A Report for the Writing Committee of
the 2019 Update of the Canadian Cardiovascular Society Guidelines for the
Management of Adults With Congenital Heart Disease.
Source
Canadian Journal of Cardiology. 35(12) (pp 1772-1783), 2019. Date of
Publication: December 2019.
Author
Mongeon F.-P.; Ben Ali W.; Khairy P.; Bouhout I.; Therrien J.; Wald R.M.;
Dallaire F.; Bernier P.-L.; Poirier N.; Dore A.; Silversides C.; Marelli
A.
Institution
(Mongeon, Khairy, Dore) Adult Congenital Heart Center, Department of
Specialized Medicine, Montreal Heart Institute, Universite de Montreal,
Montreal, Quebec, Canada
(Ben Ali, Bouhout, Poirier) Department of surgery, Montreal Heart
Institute, Universite de Montreal, Montreal, Quebec, Canada
(Therrien) Jewish General Hospital, McGill University, Montreal, Quebec,
Canada
(Wald, Silversides) Peter Munk Cardiac Centre, University Health Network,
Toronto, Ontario, Canada
(Dallaire) Division of Pediatric and Fetal Cardiology, Centre Hospitalier
Universitaire de Sherbrooke, Universite de Sherbrooke, Sherbrooke, Quebec,
Canada
(Bernier) Department of surgery, McGill University Health Center, McGill
University, Montreal, Quebec, Canada
(Poirier) Department of surgery, CHU-Sainte-Justine, Universite de
Montreal, Montreal, Quebec, Canada
(Marelli) McGill Adult Unit for Congenital Heart Disease (MAUDE Unit),
McGill University, Montreal, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background: There is no systematic evidence review of the long-term
results of surgical pulmonary valve replacement (PVR) dedicated to adults
with repaired tetralogy of Fallot (rTOF) and pulmonary regurgitation.
 Method(s): Our primary objective was to determine whether PVR reduced
long-term mortality in adults with rTOF compared with conservative
therapy. Secondary objectives were to determine the postoperative
incidence rate of death, the changes in functional capacity and in right
ventricular (RV) volumes and ejection fraction after PVR, and the
postoperative incidence rate of sustained ventricular arrhythmias. A
systematic search of multiple databases for studies was conducted without
limits. Result(s): No eligible randomized controlled trial or cohort
study compared outcomes of PVR and conservative therapy in adults with
rTOF. We selected 10 cohort studies (total 657 patients) reporting
secondary outcomes. After PVR, the pooled incidence rate of death was 1%
per year (95% confidence interval [CI] 0-1% per year) and the pooled
incidence rate of sustained ventricular arrhythmias was 1% per year (95%
CI 1%-2% per year). PVR improved symptoms (odds ratio for postoperative
New York Heart Association functional class > II 0.08, 95% CI 0.03-0.24).
Indexed RV end-diastolic (-61.29 mL/m2, -43.64 to -78.94
mL/m2) and end-systolic (-37.20 mL/m2, -25.58 to
-48.82 mL/m2) volumes decreased after PVR, but RV ejection
fraction did not change (0.19%, -2.36% to 2.74%). The effect of PVR on RV
volumes remained constant regardless of functional status.
 Conclusion(s): Studies comparing PVR and conservative therapy
exclusively in adults with rTOF are lacking. After PVR, the incidence
rates of death and ventricular tachycardia are both 1 per 100
patient-years. Pooled analyses demonstrated an improved functional status
and a reduction in RV volumes. Copyright © 2019 Canadian
Cardiovascular Society

<43>
Accession Number
2025212754
Title
Transcatheter vacuum aspiration of valvular and lead related infective
endocarditis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Gill G.S.; Chakrala T.; Kanmanthareddy A.; Alla V.M.
Institution
(Gill, Kanmanthareddy, Alla) Division of Cardiovascular Disease, Creighton
University School of Medicine, Omaha, NE, United States
(Chakrala) Department on Medicine, University of Florida, Gainesville, FL,
United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aspiration is utilized for removal of thrombi
and vegetations in inoperable patients and high-risk surgical candidates
where medical therapy alone is unlikely to achieve desired outcome. A
number of case reports and series have been published since the
introduction of AngioVac system (AngioDynamics Inc., Latham, NY) in 2012
where this technology was used in the treatment of endocarditis. However,
there is a lack of consolidated data reporting on patient selection,
safety and outcomes. Method(s): PubMed and Google Scholar databases
were queried for publications reporting cases where transcatheter
aspiration was used for endocarditis vegetation debulking or removal. Data
on patient characteristics, outcomes and complications from select reports
were extracted and systematically reviewed. Result(s): Data from 11
publications with 232 patients were included in the final analyses. Of
these, 124 had lead vegetation aspiration, 105 had valvular vegetation
aspiration, and 3 had both lead as well as valvular vegetation aspiration.
Among the 105 valvular endocarditis cases, 102 (97 %) patients had right
sided vegetation removal. Patients with valvular endocarditis were younger
(mean age 35 years) vs. patients with lead vegetations (mean age 66
years). Among the valvular endocarditis cases, there was a 50-85 %
reduction in vegetation size, 14 % had worsening valvular regurgitation, 8
% had persistent bacteremia and 37 % required blood transfusion. Surgical
valve repair or replacement was subsequently performed in 3 % and
in-hospital mortality was 11 %. Among patients with lead infection,
procedural success rate was reported at 86 %, 2 % had vascular
complications and in-hospital mortality was 6 %. Persistent bacteremia,
renal failure requiring hemodialysis, and clinically significant pulmonary
embolism occurred in about 1 % each. Conclusion(s): Transcatheter
aspiration of vegetations in infective endocarditis has acceptable success
rates in vegetation debulking as well as rates of morbidity or mortality.
Large prospective multi-center studies are warranted to determine
predictors of complications, thus helping identify suitable
patients. Copyright © 2023 Elsevier Inc.

<44>
Accession Number
2023904612
Title
The effects of ergonomic sleep mask use on sleep quality and comfort in
intensive care patients.
Source
Journal of Sleep Research. (no pagination), 2023. Date of Publication:
2023.
Author
Altintas S.; Celik S.; Karahan E.
Institution
(Altintas, Celik, Karahan) Department of Nursing, Bartin University
Faculty of Health Sciences, Bartin, Turkey
Publisher
John Wiley and Sons Inc
Abstract
This study was conducted to determine the effects of the use of ergonomic
sleep mask on sleep quality and comfort in intensive care patients. This
randomised controlled experimental study was completed with 128 surgical
intensive care patients (control = 64, experimental = 64). During the
second night of their stay in the unit, ergonomic sleep masks were given
to the patients in the experimental group, and earplugs and eye masks were
given to the patients in the control group. A Patient information form,
Visual analogue scale for discomfort, and the Richard-Campbell sleep
questionnaire were used to collect data. While 51.6% of the patients were
female, the mean age of the patients was 63.87 +/- 14.94 years. The
highest rates of patients had undergone cardiovascular surgery (28.9%) and
general anaesthesia (57.8%). It was determined that the sleep quality of
the patients in the experimental group was statistically and clinically
significantly higher after the intervention (50.86 +/- 21.46 vs 37.64 +/-
14.97, t = -5.355, Cohen's d = 0.450, p < 0.001). Likewise, the patients
who used ergonomic sleep masks had a statistically significantly lower
mean VAS for Discomfort score, and their comfort level was higher (p <
0.001), but the difference was not clinically significant (Cohen's d =
0.208). The results of this study showed that the use of ergonomic sleep
masks in surgical intensive care patients had a more positive effect on
both the sleep quality and comfort levels of patients compared with
earplugs and eye masks. The use of an ergonomic sleep mask is recommended
in the early period to facilitate sleep and rest in surgical intensive
care patients. Copyright © 2023 European Sleep Research Society.

<45>
Accession Number
2023891247
Title
Effect of Nicorandil, Diltiazem, or Isosorbide Mononitrate for Oral
Antispastic Therapy After Coronary Artery Bypass Grafting Using Radial
Artery Grafts-A Pilot Randomized Controlled Trial (ASRAB-Pilot): Rationale
and Study Protocol.
Source
Advances in Therapy. (no pagination), 2023. Date of Publication: 2023.
Author
Zhu Y.; Qing K.; Liu Y.; Yao H.; Zhang W.; Zhao Q.
Institution
(Zhu, Qing, Liu, Yao, Zhao) Department of Cardiovascular Surgery, Ruijin
Hospital Shanghai Jiao Tong University School of Medicine, No.197 Ruijin
Er Road, Shanghai, China
(Zhang) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai, China
Publisher
Adis
Abstract
Introduction: The current evidence for chronic oral antispastic medication
use after coronary artery bypass grafting using radial artery grafts
(RA-CABG) is controversial. Calcium channel blockers, such as diltiazem,
are the most commonly used antispastic medications after RA-CABG; other
options include nitrates and nicorandil, but to date no sufficiently
powered randomized controlled trials have been conducted to compare their
efficacy. Method(s): This is a single-center, open-label, parallel
three-arm, pilot randomized controlled trial. Patients without
contraindications to any study medications and who successfully underwent
RA-CABG surgery will be consecutively screened. Eligible patients will be
randomized in a ratio of 1:1:1 (a total of 150 patients, 50 per arm) to
receive nicorandil 5 mg orally thrice daily, diltiazem 180 mg orally once
daily, or isosorbide mononitrate 50 mg orally once daily for 24 weeks. The
primary outcomes are RA graft failure at week 1 and week 24. The secondary
outcomes include major adverse cardiovascular event (MACE, a composite of
all-cause death, myocardial infarction, stroke, and unplanned
revascularization) and angina recurrence. The safety outcomes include
hypotension occurrence, withdrawal of renin angiotensin aldosterone system
inhibitors, serious adverse events, and other concerned adverse events
within 24 weeks. Conclusion(s): This pilot trial will compare the
preliminary effects of nicorandil, diltiazem, and isosorbide mononitrate
on angiographic and clinical outcomes in patients who have undergone
RA-CABG. Recruitment began in June 2020, and the estimated primary
completion date is early 2023. Results of this study will provide much
needed information for design of large confirmatory trials on the
effectiveness of oral antispastic medications after RA-CABG. Copyright
© 2023, The Author(s), under exclusive licence to Springer Healthcare
Ltd., part of Springer Nature.

<46>
Accession Number
641578997
Title
The incidence of surgical site infections in China.
Source
The Journal of hospital infection. (no pagination), 2023. Date of
Publication: 12 Jun 2023.
Author
Lin J.; Peng Y.; Guo L.; Tao S.; Li S.; Huang W.; Yang X.; Qiao F.; Zong
Z.
Institution
(Lin) Center of Infectious Diseases, West China Hospital, Sichuan
University, Chengdu, China; Department of Infectious Control, West China
Hospital, Sichuan University, Chengdu, China
(Peng, Guo, Tao, Li, Huang, Qiao) Department of Infectious Control, West
China Hospital, Sichuan University, Chengdu, China
(Yang) Southern Central Hospital of Yunnan Province, China
(Zong) Center of Infectious Diseases, West China Hospital, Sichuan
University, Chengdu, China; Center for Pathogen Research, West China
Hospital, Sichuan University, Chengdu, China
Publisher
NLM (Medline)
Abstract
Surgical site infections (SSIs) are a common type of healthcare-associated
infections. We performed a literature review to demonstrate the incidence
of SSIs in the mainland of China based on studies since 2010. We included
231 eligible studies with >=30 postoperative patients, comprising 14
providing overall SSI data regardless of surgical sites and 217 reporting
SSIs for a specific site. We found that the overall SSI incidence was
2.91% (median; interquartile range: 1.05%, 4.57%) or 3.18% (pooled; 95%
confidence interval: 1.85%, 4.51%) and the SSI incidence varied remarkably
according to the surgical site between the lowest (median, 1.00%; pooled,
1.69%) in thyroid surgeries and the highest (median, 14.89%; pooled,
12.54%) in colorectal procedures. We uncovered that Enterobacterales and
staphylococci were the most common type of microorganisms associated with
SSIs after various abdominal surgeries and cardiac or neurological
procedures, respectively. We identified two, nine, and five studies
addressing the impact of SSIs on mortality, the length of stay (LOS) in
hospital, and additional healthcare-related economic burden, respectively,
all of which demonstrated increased mortality, prolonged LOS, and elevated
medical costs associated with SSIs among affected patients. Our findings
illustrate that SSIs remain a relatively common, serious threat of patient
safety in China, requiring more actions. To tackle SSIs, we propose to
establish a nationwide network for SSI surveillance using unified criteria
with the aid of informatic techniques and to tailor and implement
countermeasures based on local data and observation. We highlight that the
impact of SSIs in China is warranted for further studies. Copyright
© 2023 The Healthcare Infection Society. Published by Elsevier Ltd.
All rights reserved.

<47>
Accession Number
2024096127
Title
Moderate-Intensity Rosuvastatin Plus Ezetimibe Versus High-Intensity
Rosuvastatin for Target Low-Density Lipoprotein Cholesterol Goal
Achievement in Patients With Recent Ischemic Stroke: A Randomized
Controlled Trial.
Source
Journal of Stroke. 25(2) (pp 242-250), 2023. Date of Publication: May
2023.
Author
Hong K.-S.; Bang O.Y.; Park J.-H.; Jung J.-M.; Lee S.-H.; Song T.-J.; Nam
H.S.; Jung K.-H.; Heo S.H.; Koo J.; Yu K.-H.; Park K.-Y.; Kim C.K.; Park
H.-K.; Lee J.; Seo W.-K.
Institution
(Hong, Park) Department of Neurology, Ilsan Paik Hospital, Inje
University, Goyang, South Korea
(Bang, Seo) Department of Neurology, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, South Korea
(Park) Department of Neurology, Myongji Hospital, Hanyang University
College of Medicine, Goyang, South Korea
(Jung, Lee) Department of Neurology, Korea University Ansan Hospital,
Korea University College of Medicine, Ansan, South Korea
(Song) Department of Neurology, Seoul Hospital, Ewha Women's University
College of Medicine, Seoul, South Korea
(Nam) Department of Neurology, Yonsei University College of Medicine,
Seoul, South Korea
(Park) Department of Neurology, Inha University Hospital, Incheon, South
Korea
(Jung) Department of Neurology, Seoul National University College of
Medicine, Seoul, South Korea
(Heo) Department of Neurology, Kyung Hee University Medical Center, Seoul,
South Korea
(Koo) Department of Neurology, Seoul St. Mary's Hospital, The Catholic
University of Korea, Seoul, South Korea
(Yu) Department of Neurology, Hallym University Sacred Heart Hospital,
Anyang, South Korea
(Park) Department of Neurology, Chung-Ang University Hospital, Seoul,
South Korea
(Kim) Department of Neurology, Korea University Guro Hospital, Seoul,
South Korea
(Lee, Lee) Department of Biostatistics, Korea University College of
Medicine, Seoul, South Korea
Publisher
Korean Stroke Society
Abstract
Background and Purpose Moderate-intensity statin plus ezetimibe versus
high-intensity statin alone may provide a greater low-density lipoprotein
cholesterol (LDL-C) reduction in patients with recent ischemic stroke.
Methods This randomized, open-label, controlled trial assigned patients
with recent ischemic stroke <90 days to rosuvastatin/ezetimibe 10/10 mg
once daily (ROS10/EZT10) or to rosuvastatin 20 mg once daily (ROS20). The
primary endpoint was LDL-C reduction >=50% from baseline at 90 days. Key
secondary endpoints were LDL-C <70 mg/dL and multiple lipid goal
achievement, and composite of major vascular events. Results Of 584
randomized, 530 were included in the modified intention-to-treat analysis.
The baseline LDL-C level was 130.2+/-34.7 mg/dL in the ROS10/EZT10 group
and 131.0+/-33.9 mg/dL in the ROS20 group. The primary endpoint was
achieved in 198 patients (72.5%) in the ROS10/EZT10 group and 148 (57.6%)
in the ROS20 group (odds ratio [95% confidence interval], 1.944
[1.352-2.795]; P= 0.0003). LDL-C level <70 mg/dL was achieved in 80.2% and
65.4% in the ROS10/EZT10 and ROS20 groups (P=0.0001). Multiple lipid goal
achievement rate was 71.1% and 53.7% in the ROS10/EZT10 and ROS20 groups
(P<0.0001). Major vascular events occurred in 1 patient in the ROS10/EZT10
group and 9 in the ROS20 group (P=0.0091). The adverse event rates did not
differ between the two groups. Conclusion Moderate-intensity rosuvastatin
plus ezetimibe was superior to high-intensity rosuvastatin alone for
intensive LDL-C reduction in patients with recent ischemic stroke. With
the combination therapy, more than 70% of patients achieved LDL-C
reduction >=50% and 80% had an LDL-C <70 mg/dL at 90 days. Copyright
© 2023 Korean Stroke Society.

<48>
Accession Number
2024053327
Title
Regional block techniques for pain management after video-assisted
thoracoscopic surgery: a covariate-adjusted Bayesian network
meta-analysis.
Source
Wideochirurgia I Inne Techniki Maloinwazyjne. 18(1) (pp 52-68), 2023. Date
of Publication: 2023.
Author
Jiang T.; Mo X.; Zhan R.; Zhang Y.; Yu Y.
Institution
(Jiang, Mo, Zhang, Yu) Tongji Hospital, Tongji Medical College, Huazhong
University of Science and Technology, Hubei Province, Wuhan, China
(Zhan) The First Affiliated Hospital of Anhui Medical University Gaoxin
District, Anhui Province, Hefei, China
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Nerve block is widely used for pain management after
video-assisted thoracoscopic surgery (VATS). Thoracic paravertebral block
(TPVB), erector spinae plane block (ESPB), serratus anterior plane block
(SAPB), and intercostal nerve block (ICNB) are alternative treatments.
 Material(s) and Method(s): Network meta-analysis based on Bayesian
analyses was performed to obtain results for direct comparison, indirect
comparison, and network comparison, and to make rankings based on
probabilities. Covariates were adjusted to determine the effect of the
covariates on results of this study. Result(s): The study identified
61 randomized controlled trials (RCTs) (4468 patients). There were results
of probability ranking for the first ("best" treatment): 24 h morphine
consumption, TPVB > ESPB > ICNB > SAPB. Covariate adjustment allowed the
four treatments to change somewhat in the likelihood of the best choice.
 Conclusion(s): TPVB ranks best in our analysis. ESPB is a viable
alternative. SAPB and ICNB seem to play a limited role in postoperative
pain management. Copyright © 2023 Termedia Publishing House Ltd..
All rights reserved.

<49>
Accession Number
2023037330
Title
Colchicine for Prevention of Post-Cardiac Surgery and Post-Pulmonary Vein
Isolation Atrial Fibrillation: A Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 23(12) (no pagination), 2022. Article
Number: 387. Date of Publication: December 2022.
Author
Wang X.; Peng X.; Li Y.; Lin R.; Liu X.; Ruan Y.; Ma C.; Liu N.
Institution
(Wang, Peng, Li, Lin, Liu, Ruan, Ma, Liu) Department of Cardiology,
Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
(Wang, Peng, Li, Lin, Liu, Ruan, Ma, Liu) National Clinical Research
Center for Cardiovascular Diseases, Beijing 100029, China
Publisher
IMR Press Limited
Abstract
Background: Post-cardiac procedure atrial fibrillation (PCP-AF) is a
significant medical problem. Inflammation is one of the key factors in the
pathogenesis of PCP-AF. As a classical anti-inflammatory drug, colchicine
may prevent the occurrence of PCP-AF. This meta-analysis of 12 randomized
controlled trials (RCTs) analyzed the feasibility and safety of colchicine
for the prevention of PCP-AF. Method(s): PubMed, EMBASE, Web of
Science, the Cochrane Library, and Google Scholar were retrieved for RCTs
on the efficacy of colchicine in preventing atrial fibrillation. The
primary endpoint was the diagnosis of PCP-AF, which includes cardiac
surgery or pulmonary vein isolation. Evaluation was performed with
estimated odds ratios (OR) and 95% confidence intervals (CI).
 Result(s): In this meta-analysis, 12 RCTs were selected and a total
of 2297 patients were included. Colchicine therapy was associated with a
reduced incidence of PCP-AF both in post-cardiac surgery (OR: 0.62 95% CI:
0.49-0.78, p < 0.0001, I2 = 0%), and in post-pulmonary vein
isolation (OR: 0.43 95% CI: 0.30-0.62, p < 0.0001, I2 = 0%).
Colchicine therapy was associated with increased side effects (OR: 2.81
95% CI: 1.96-4.03, p < 0.00001, I2 = 26%). Conclusion(s):
Colchicine can effectively prevent post-cardiac operative atrial
fibrillation and relapse of atrial fibrillation after pulmonary vein
isolation (PVI). However, colchicine can also increase the incidence of
side effects, mainly gastrointestinal adverse events. More studies are
needed to find a more appropriate treatment dose and time. Copyright
© 2022 The Author(s). Published by IMR Press. This is an open access
article under the CC BY 4.0 license.

<50>
[Use Link to view the full text]
Accession Number
2017499683
Title
In Response.
Source
Anesthesia and Analgesia. 126(3) (pp 1090-1091), 2018. Date of
Publication: March 2018.
Author
Nagappa M.; Lam T.; Chung F.
Institution
(Nagappa) Department of Anesthesia and Perioperative Medicine, London
Health Sciences Centre, St. Joseph Health Care Western University, London,
ON, Canada
(Lam, Chung) Department of Anesthesiology and Pain Medicine, Toronto
Western Hospital, University Health Network, University of Toronto,
Toronto, ON, Canada
Publisher
Lippincott Williams and Wilkins

<51>
Accession Number
2025146741
Title
Minithoracotomy vs Conventional Sternotomy for Mitral Valve Repair: A
Randomized Clinical Trial.
Source
JAMA. 329(22) (pp 1957-1966), 2023. Date of Publication: 13 Jun 2023.
Author
Akowuah E.F.; Maier R.H.; Hancock H.C.; Kharatikoopaei E.; Vale L.;
Fernandez-Garcia C.; Ogundimu E.; Wagnild J.; Mathias A.; Walmsley Z.;
Howe N.; Kasim A.; Graham R.; Murphy G.J.; Zacharias J.
Institution
(Akowuah, Graham) Department of Cardiac Surgery, The James Cook University
Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Maier) Academic Cardiovascular Unit, The James Cook University Hospital,
South Tees Hosptials NHS Foundation Trust, Middlesbrough, United Kingdom
(Hancock, Mathias, Walmsley, Howe) Newcastle Clinical Trials Unit,
Newcastle University, Newcastle Upon Tyne, United Kingdom
(Kharatikoopaei, Wagnild, Kasim) Department of Anthropology, Durham
University, Durham, United Kingdom
(Vale, Fernandez-Garcia) Population Health Sciences Institute, Newcastle
University, Newcastle Upon Tyne, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
(Kasim) GSK, United Kingdom
(Murphy) Department of Cardiovascular Sciences, NIHR Leicester Biomedical
Research Unit in Cardiovascular Medicine, University of Leicester,
Leicester, United Kingdom
(Zacharias) The Lancashire Cardiac Center, Blackpool Teaching Hospitals
NHS Foundation Trust, Blackpool, United Kingdom
Publisher
American Medical Association
Abstract
Importance: The safety and effectiveness of mitral valve repair via
thoracoscopically-guided minithoracotomy (minithoracotomy) compared with
median sternotomy (sternotomy) in patients with degenerative mitral valve
regurgitation is uncertain. Objective(s): To compare the safety and
effectiveness of minithoracotomy vs sternotomy mitral valve repair in a
randomized trial. Design, Setting, and Participant(s): A pragmatic,
multicenter, superiority, randomized clinical trial in 10 tertiary care
institutions in the UK. Participants were adults with degenerative mitral
regurgitation undergoing mitral valve repair surgery.
 Intervention(s): Participants were randomized 1:1 with concealed
allocation to receive either minithoracotomy or sternotomy mitral valve
repair performed by an expert surgeon. Main Outcomes and Measures:
The primary outcome was physical functioning and associated return to
usual activities measured by change from baseline in the 36-Item Short
Form Health Survey (SF-36) version 2 physical functioning scale 12 weeks
after the index surgery, assessed by an independent researcher masked to
the intervention. Secondary outcomes included recurrent mitral
regurgitation grade, physical activity, and quality of life. The
prespecified safety outcomes included death, repeat mitral valve surgery,
or heart failure hospitalization up to 1 year. Result(s): Between
November 2016 and January 2021, 330 participants were randomized (mean
age, 67 years, 100 female [30%]); 166 were allocated to minithoracotomy
and 164 allocated to sternotomy, of whom 309 underwent surgery and 294
reported the primary outcome. At 12 weeks, the mean between-group
difference in the change in the SF-36 physical function T score was 0.68
(95% CI, -1.89 to 3.26). Valve repair rates (= 96%) were similar in both
groups. Echocardiography demonstrated mitral regurgitation severity as
none or mild for 92% of participants at 1 year with no difference between
groups. The composite safety outcome occurred in 5.4% (9 of 166) of
patients undergoing minithoracotomy and 6.1% (10 of 163) undergoing
sternotomy at 1 year. Conclusions and relevance: Minithoracotomy is not
superior to sternotomy in recovery of physical function at 12 weeks.
Minithoracotomy achieves high rates and quality of valve repair and has
similar safety outcomes at 1 year to sternotomy. The results provide
evidence to inform shared decision-making and treatment guidelines. Trial
Registration: isrctn.org Identifier: ISRCTN13930454. Copyright ©
2023 American Medical Association. All rights reserved.

<52>
Accession Number
2023816336
Title
Prophylactic intravenous tranexamic acid and thromboembolism in
non-cardiac surgery: a systematic review, meta-analysis and trial
sequential analysis.
Source
Anaesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Tsan S.E.H.; Viknaswaran N.L.; Cheong C.C.; Cheah S.; Ng K.T.; Mong
S.X.Y.; Wang C.Y.
Institution
(Tsan) Department of Anaesthesiology and Intensive Care, Faculty of
Medicine and Health Sciences, University of Malaysia Sarawak, Malaysia
(Viknaswaran) Department of Medicine, Victoria Hospital, Kirkcaldy, United
Kingdom
(Cheong, Ng) Department of Anaesthesia, Faculty of Medicine, University of
Malaya, Malaysia
(Cheah, Wang) Department of Anaesthesiology and Intensive Care, Hospital
Sultanah Nora Ismail, Batu Pahat, Malaysia
(Mong) Department of Anaesthesiology and Intensive Care, Hospital Raja
Permaisuri Bainun, Ipoh, Malaysia
Publisher
John Wiley and Sons Inc
Abstract
Tranexamic acid is an antifibrinolytic drug that is widely used during
surgery, but there are concerns about its thromboembolic effects. We aimed
to investigate the effect of prophylactic intravenous tranexamic acid on
thromboembolic outcomes in patients undergoing non-cardiac surgery. The
MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were
searched. Randomised controlled trials comparing intravenous tranexamic
acid with placebo or no treatment in patients undergoing non-cardiac
surgery were included. The primary outcome was a composite of
peri-operative cardiovascular thromboembolic events, defined as any deep
vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or
cerebral ischaemia/infarction. A total of 191 randomised controlled trials
(40,621 patients) were included in the review. The primary outcome
occurred in 4.5% of patients receiving intravenous tranexamic acid
compared with 4.9% of patients in the control group. Our analysis showed
that there was no difference between groups for composite cardiovascular
thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65,
I2 0%, n = 37,512). This finding remained robust when
sensitivity analysis was performed with continuity correction and in
studies with a low risk of bias. However, in trial sequential analysis,
our meta-analysis only achieved 64.6% of the required information size.
There was no association between intravenous tranexamic acid and seizure
rate or mortality rate within 30 days. Intravenous tranexamic acid was
associated with a reduced blood transfusion rate compared with control
(9.9% vs. 19.4%, risk ratio 0.46, 95%CI 0.41-0.51, p < 0.0001). It was
encouraging to see the evidence that the administration of intravenous
tranexamic in patients undergoing non-cardiac surgery was not associated
with an increased risk of thromboembolic outcomes. However, our trial
sequential analysis demonstrated that currently available evidence is not
yet sufficient to reach a firm conclusion. Copyright © 2023 The
Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists.

<53>
Accession Number
2023127789
Title
An investigation on the respiratory mechanics of mechanically ventilated
patients during spontaneous breathing trials with enhanced low-level
pressure support ventilation.
Source
Clinical Respiratory Journal. 17(6) (pp 527-535), 2023. Date of
Publication: June 2023.
Author
Zhang B.; Zhang Z.; Qin H.; Jiang Z.; Deng Q.; Sun Q.; Wang Y.; Zhou J.;
Lin Z.; He W.; Hua D.; Xu Y.
Institution
(Zhang, Jiang, Deng, Sun, Wang, Zhou, Lin, He, Xu) Department of Critical
Care Medicine, The First Affiliated Hospital of Guangzhou Medical
University, Guangzhou, China
(Zhang) Guangzhou Respiratory Health Research Institute, The First
Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
(Qin) Department of Pulmonary and Critical Care Medicine, The Second
People's Hospital of Fengkai, Zhaoqing, China
(Hua) Department of General Medicine, Bunbury Regional Hospital, Bunbury,
WA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Low-level pressure support ventilation (PSV) is most
commonly adopted in spontaneous breathing trials (SBTs), and some have
proposed setting the positive end-expiratory pressure (PEEP) to 0
cmH<inf>2</inf>O in order to shorten the observation time of SBTs. This
study aims to investigate the effects of two PSV protocols on the
patients' respiratory mechanics. Material(s) and Method(s): A
prospective randomized self-controlled crossover design was adopted in
this study, which involved enrolling 30 difficult-to-wean patients who
were admitted to the intensive care unit of the First Affiliated Hospital
of Guangzhou Medical University between July 2019 and September 2021.
Patients were subjected to the S group (pressure support: 8
cmH<inf>2</inf>O, PEEP: 5 cmH<inf>2</inf>O) and S1 group (PS: 8
cmH<inf>2</inf>O, PEEP: 0 cmH<inf>2</inf>O) for 30 min in a random order,
and respiratory mechanics indices were dynamically monitored via a
four-lumen multi-functional catheter with an integrated gastric tube.
Among the 30 enrolled patients, 27 were successfully weaned.
 Result(s): The S group showed higher airway pressure (Paw),
intragastric pressure (Pga) and airway pressure-time product (PTP) than
the S1 group. The S group also showed a shorter inspiratory trigger delay,
(93.80 +/- 47.85) versus (137.33 +/- 85.66) ms (P = 0.004); and fewer
abnormal triggers, (0.97 +/- 2.65) versus (2.67 +/- 4.48) (P = 0.042)
compared with the S1 group. Stratification based on the causes of
mechanical ventilation revealed that under the S1 protocol, patients with
chronic obstructive pulmonary disease (COPD) had a longer inspiratory
trigger delay compared to both post-thoracic surgery (PTS) patients and
patients with acute respiratory distress syndrome. Despite providing
greater respiratory support, S group led to significant reductions in
inspiratory trigger delay and less abnormal triggers compared to S1 group,
especially among patients with chronic obstructive pulmonary disease.
 Conclusion(s): These findings suggest that the zero PEEP group was
more likely to induce a higher number of patient-ventilator asynchronies
in difficult-to-wean patients. Copyright © 2023 The Authors. The
Clinical Respiratory Journal published by John Wiley & Sons Ltd.

<54>
Accession Number
2017001383
Title
Structural valve degeneration of bioprosthetic aortic valves: A network
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(1) (pp 52-59), 2023.
Date of Publication: July 2023.
Author
Squiers J.J.; Robinson N.B.; Audisio K.; Ryan W.H.; Mack M.J.; Rahouma M.;
Cancelli G.; Kirov H.; Doenst T.; Gaudino M.; DiMaio J.M.
Institution
(Squiers, Ryan, Mack, Rahouma, DiMaio) Department of Cardiothoracic
Surgery, Baylor Scott & White The Heart Hospital, Plano, Tex, United
States
(Robinson, Audisio, Cancelli, Gaudino) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(Kirov, Doenst) Department of Cardiothoracic Surgery, University of Jena,
Jena, Germany
Publisher
Elsevier Inc.
Abstract
Objective: To compare the rate of structural valve degeneration (SVD)
following surgical aortic valve replacement associated with the Trifecta
(TF) valve (St Jude Medical) versus other bioprosthetic valves.
 Method(s): A systematic literature search was conducted for studies
comparing durability of the TF prosthesis to other valve types, including
Perimount (Edwards Lifesciences), Carpentier-Edwards Perimount Magna Ease
(ME) (Edwards Lifesciences), and Mitroflow (LivaNova USA) after surgical
aortic valve replacement. Random effect pairwise and network meta-analyses
were performed to compare the incident rate ratio of the composite primary
outcome of SVD or reintervention due to SVD. Result(s): Ten studies
with 31,029 patients were included, of whom 6832 received TF, 19,023
received Perimount, 3514 received ME, and 713 received Mitroflow. When
compared with TF, ME was associated with lower rates of SVD or
reintervention for SVD (incident rate ratio, 0.13; 95% CI, 0.02-0.92; P =
.04). Similarly, at network meta-analysis, when compared with TF, only ME
was associated with significantly lower rates of SVD or reintervention for
SVD (incident rate ratio, 0.13; 95% CI, 0.02-0.97). ME (incident rate
ratio, 0.18; 95% CI, 0.07-0.47) and PM (incident rate ratio, 0.34; 95% CI,
0.12-0.98) were associated with significantly lower rate of all-cause
reintervention when compared with TF. No differences in the other
secondary outcomes were found. Conclusion(s): The TF valve is
associated with significantly higher rates of SVD or reintervention for
SVD than the ME valve, but not the Mitroflow valve. The TF valve was also
associated with higher rates of all-cause reintervention than ME and
Perimount valves. The underlying mechanism(s) of these findings warrant
further investigation. Copyright © 2022 The American Association
for Thoracic Surgery

<55>
Accession Number
2014637874
Title
Percutaneous coronary intervention versus coronary artery surgery for left
main disease according to lesion site: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(1) (pp 120-132.e11),
2023. Date of Publication: July 2023.
Author
De Filippo O.; Di Franco A.; Boretto P.; Bruno F.; Cusenza V.; Desalvo P.;
Demetres M.; Saglietto A.; Franchin L.; Piroli F.; Marengo G.; Elia E.;
Falk V.; Conrotto F.; Doenst T.; Rinaldi M.; De Ferrari G.M.; D'Ascenzo
F.; Gaudino M.
Institution
(De Filippo, Boretto, Bruno, Cusenza, Desalvo, Saglietto, Franchin,
Piroli, Marengo, Elia, Conrotto, De Ferrari, D'Ascenzo) Division of
Cardiology, Cardiovascular and Thoracic Department, AOU Citta della Salute
e della Scienza di Torino and University of Turin, Turin, Italy
(Di Franco, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
(Falk) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Falk) Department of Cardiothoracic Surgery, Charite-Universitatsmedizin
Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat
Berlin, Berlin Institute of Health, Berlin, Germany
(Falk) Department of Health Sciences, Translational Cardiovascular
Technologies, ETH Zurich, Zurich, Switzerland
(Doenst) Jena University Hospital, Friedrich-Schiller-University of Jena,
Jena, Germany
(Rinaldi) Division of Cardiac Surgery, Cardiovascular and Thoracic
Department, AOU Citta della Salute e della Scienza di Torino and
University of Turin, Turin, Italy
Publisher
Elsevier Inc.
Abstract
Background: Comparative data after percutaneous coronary intervention
(PCI) or coronary artery bypass grafting (CABG) for unprotected left main
coronary artery (ULMCA) disease according to lesion site (ostial/shaft vs
distal) are scant. The aim of this meta-analysis was to investigate
outcomes after PCI or CABG for ULMCA disease according to lesion site.
 Method(s): Randomized controlled trials (RCTs) and adjusted
observational studies that compared PCI versus CABG in patients with ULMCA
disease and reported outcomes according to lesion site were systematically
identified. Major adverse cardiovascular events (MACE; a composite of
all-cause death, myocardial infarction, stroke, and repeat
revascularization) and all-cause death were the co-primary end points.
Individual components of MACE were secondary end points. Sensitivity
analysis including RCTs only were performed for each outcome.
 Result(s): Nine studies (3 RCTs, 6 adjusted observational),
encompassing 6296 patients (2274 and 4022 treated for ostial/shaft or
distal ULMCA, respectively) were included. At the 5-year follow-up, there
were no significant differences between CABG and PCI for MACE, death, or
any other secondary outcome for ostial/shaft ULMCA lesions (MACE: hazard
ratio [HR], 1.0 [95% confidence interval (CI), 0.79-1.27]; death: HR, 1.10
[95% CI, 0.84-1.46]). For distal ULMCA, PCI was associated with an
increased risk of MACE (HR, 1.32; 95% CI, 1.10-1.58), death (HR, 1.56; 95%
CI, 1.19-2.04), and revascularization (HR, 2.07; 95% CI, 1.5-2.84). The
benefit of CABG for MACE and revascularization was confirmed in the
analysis limited to RCTs, whereas the benefit for mortality was not.
 Conclusion(s): Among patients with distal ULMCA disease, CABG is
associated with lower incidence of MACE and revascularization compared
with PCI, whereas no differences in outcomes were observed for
ostial/shaft ULMCA disease. Copyright © 2021 The American
Association for Thoracic Surgery

<56>
Accession Number
641557577
Title
Evaluation of the Effect of New Multimodal Analgesia Regimen for Cardiac
Surgery: A Prospective, Randomized Controlled, Single-Center Clinical
Study.
Source
Drug design, development and therapy. 17 (pp 1665-1677), 2023. Date of
Publication: 2023.
Author
Jin L.; Liang Y.; Yu Y.; Miao P.; Huang Y.; Xu L.; Wang H.; Wang C.; Huang
J.; Guo K.
Institution
(Jin, Yu, Miao, Huang, Xu, Wang, Guo) Department of Anesthesia, Zhongshan
Hospital, Fudan University, Shanghai, China
(Liang) Department of Anesthesiology, University of Texas Health Center at
Houston, Houston, TX, United States
(Wang) Department of Cardiac Surgery, Zhongshan Hospital, Fudan
University, Shanghai, China
(Huang) Department of Anesthesiology & Perioperative Medicine University
of Louisville, Louisville, KY, United States
Publisher
NLM (Medline)
Abstract
Objective: To investigate the feasibility of multimodal regimen by
paracetamol, gabapentin, ketamine, lidocaine, dexmedetomidine and
sufentanil among cardiac surgery patients, and compare the analgesia
efficacy with conventional sufentanil-based regimen. Design(s): A
single-center, prospective, randomized, controlled clinical trial.
 Setting(s): One participating center, the cardiovascular center of
the major integrated teaching hospital. Participant(s): A total of
115 patients were assessed for eligibility: 108 patients were randomized,
7 cases were excluded. Intervention(s): The control group (group T)
received conventional anesthesia management. Interventions in the
multimodal group (group M) were as follows in addition to the standard of
care: gabapentin and acetaminophen 1 hour before surgery; ketamine for
induction and to maintain anesthesia with lidocaine and dexmedetomide.
Ketamine, lidocaine, and dexmedetomidine were added to routine sedatives
postoperatively in group M. Measurements and Main Results: The
incidence of moderate-to-severe pain on coughing made no significant
difference (68.5% vs 64.8%, P=0.683). Group M had significantly less
sufentanil use (135.72microg vs 94.85microg, P=0.000) and lower rescue
analgesia rate (31.5% vs 57.4%, P=0.007). There was no significant
difference in the incidence of chronic pain, PONV, dizziness, inflammation
index, mechanical ventilation time, length of stay, and complications
between the two groups. Conclusion(s): Our multimodal regimen in
cardiac surgery is feasible, but was not superior to traditional
sufentanil-based regimen in the aspects of analgesia effects; however, it
did reduce perioperative opioid consumption along with rescue analgesia
rate. Moreover, it showed the same length of stay and the incidences of
postoperative complications. Copyright © 2023 Jin et al.

<57>
Accession Number
2023109401
Title
IMPACT OF OBESITY ON OUTCOMES OF TRANSCATHETER AORTIC VALVE IMPLANTATION
IN PATIENTS WITH AORTIC STENOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF
REAL-WORLD DATA.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 876), 2023. Date of
Publication: 07 Mar 2023.
Author
Yasmin F.; Aamir M.; Shaikh A.; Moeed A.; Pervez N.; Sattar Y.; Kranick
S.; Samad Z.; Khattak F.H.; Ullah W.; Ruggiero N.J.; Fischman D.L.
Institution
(Yasmin, Aamir, Shaikh, Moeed, Pervez, Sattar, Kranick, Samad, Khattak,
Ullah, Ruggiero, Fischman) Thomas Jefferson University, Philadelphia, PA,
United States
(Yasmin, Aamir, Shaikh, Moeed, Pervez, Sattar, Kranick, Samad, Khattak,
Ullah, Ruggiero, Fischman) Dow Medical College, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Background Most recent large-scale global analyses on transcatheter aortic
valve implantation (TAVI) for aortic stenosis (AS) showed favourable
survival outcomes with high body mass index (BMI). We performed a
meta-analysis pooling all clinical studies to access the validity of
improved post-TAVI prognosis in obese patients. Methods MEDLINE and Scopus
were queried till August 2022 to identify studies comparing AS patients
with BMI >=30 kg/m2, and BMI 18.5 to <25 undergoing TAVI. Data were
analysed using a random-effects model to derive odds ratios (ORs) for all
outcomes, and hazard ratios (HRs) for survival with 95% confidence
intervals. Results 24 studies with 38,743 patients were included.
All-cause mortality at 30-days was significantly reduced with BMI?>30kg/m2
(OR 0.71, p<0.0001) vs. normal BMI. Every 1kg/m2 increase in
BMI was associated with better overall survival (HR 0.96, p<0.0001). Obese
patients had greater long-term overall survival (HR 0.87, p<0.00001). No
significant differences in MI (OR 0.84, 95% CI 0.52-1.34), major bleeding
(OR 0.94, 95% CI 0.72-1.21), major vascular events (OR 1.18, 95% CI
0.97-1.43) and AKI (OR 1.17, 95% CI 0.87-1.56). Conclusion Obese AS
patients might have similar procedural complications, but reduced
mortality, and increased overall survival vs. normal weight. Figure 1:
30-day mortality (A), long-term overall survival as a continuous outcome
(B) and as a comparison between obese and normal patients (C). [Formula
presented] Copyright © 2023 American College of Cardiology
Foundation

<58>
Accession Number
2023109362
Title
OUTCOMES OF TRANSCAVAL VERSUS OTHER ALTERNATIVE ACCESS ROUTES FOR
TRANSCATHETER AORTIC VALVE REPLACEMENT.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1017), 2023. Date of
Publication: 07 Mar 2023.
Author
Halboni A.; Al-abcha A.; Dayco J.; Alhusain R.; Bdiwi M.; El-khatib L.;
Al-Asad K.S.; Zghouzi M.; Ullah W.; Sattar Y.; Alraies M.C.
Institution
(Halboni, Al-abcha, Dayco, Alhusain, Bdiwi, El-khatib, Al-Asad, Zghouzi,
Ullah, Sattar, Alraies) Wayne State University School of Medicine,
Detroit, MI, United States
(Halboni, Al-abcha, Dayco, Alhusain, Bdiwi, El-khatib, Al-Asad, Zghouzi,
Ullah, Sattar, Alraies) Detroit Medical Center, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background In patients where the standard transfemoral access for
transcatheter aortic valve replacement (TAVR) is not possible, alternative
approaches have been utilized. Short and long-term complications are
associated with different alternative routes. In our meta-analysis, we
compare the outcomes of a transcaval (TCV) approach to TAVR versus other
alternative accesses. Methods We conducted a systematic search of
electronic databases for studies comparing the outcomes of TAVR utilizing
different alternative accesses. A meta-analysis was performed to compare
TCV access versus other alternative accesses for TAVR, mainly
transsubclavian/axillary (TSA), transcarotid (TC), and transapical (TA).
Results Four studies (n=682; TCV access = 338, other alternative access =
344) were included in the final analysis. There was no statistically
significant difference between utilizing a TCV approach versus other
alternative approaches for all-cause mortality (8.6% vs 12.2%; p=0.92),
stroke or transient ischemic attack (5% vs 10.5%; p=0.87), major vascular
complications (2% vs 2.3%; p=0.57), any bleeding (11.3% vs 13%; p=0.92),
and acute kidney injury (3.8% vs 9.6%; p=0.05) (figure 1) Conclusion There
is no difference in the outcomes of all-cause mortality, stroke or
transient ischemic attack, major vascular complications, bleeding, or
acute kidney injury between utilizing a TCV versus TSA, TC, or TA approach
to TAVR. Further studies are needed to confirm these results. [Formula
presented] Copyright © 2023 American College of Cardiology
Foundation

<59>
Accession Number
2023109275
Title
PROGNOSTIC VALUE OF POSITRON EMISSION TOMOGRAPHY-DERIVED MYOCARDIAL FLOW
RESERVE: SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1496), 2023. Date of
Publication: 07 Mar 2023.
Author
Ahmed A.I.; Saad J.M.; Alahdab F.; Rifai M.A.; Han Y.; Nayfeh M.;
Al-Mallah M.H.
Institution
(Ahmed, Saad, Alahdab, Rifai, Han, Nayfeh, Al-Mallah) Houston Methodist
Debakey Heart & Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Positron Emission Tomography (PET)-derived myocardial flow
reserve (MFR) has an established role in the diagnosis and prognosis of
patients with coronary artery disease (CAD). We performed a systematic
review and meta-analysis to summarize the prognostic role of PET-derived
MFR in patients with known or suspected CAD. Methods Cohort studies
examining the prognostic value of PET imaging at baseline and assessing
MFR in patients of any age and gender, and with either suspected or
confirmed CAD, were included. Results A total of 9 studies were included,
with a total of 29,999 patients (mean age 63 years, 47.3% women). The mean
follow-up duration was 41 months (range 10 - 85). Cardiovascular risk
factors were prevalent (hypertension, diabetes and dyslipidemia ranging
from 29-88%, 13-63%, and 39-73%, respectively). The definition of the
composite outcome varied between studies, with various combinations of
mortality, non-fatal myocardial infarction, hospitalization, and coronary
revascularization. Pooled impaired MFR was significantly associated with
an increased risk of adverse outcomes (RR=2.9, 95% CI 2.3-3.7, P <0.001).
Conclusion Impaired MFR is strongly associated with an increased risk of
adverse cardiovascular events. [Formula presented] Copyright ©
2023 American College of Cardiology Foundation

<60>
Accession Number
2023109241
Title
USE OF CEREBRAL EMBOLIC PROTECTION DEVICE IS ASSOCIATED WITH IMPROVED
SURVIVAL AMONGST PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE
REPLACEMENT: UPDATED META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1060), 2023. Date of
Publication: 07 Mar 2023.
Author
Das D.; Atallah I.; Nafee T.; Lin C.-J.; Harjai K.J.; Nasir A.; Forsberg
M.; Mikhalkova D.; Mar P.L.; Mani K.; Sampath-Kumar S.; Prasad S.; Cahill
A.; Verma D.R.
Institution
(Das, Atallah, Nafee, Lin, Harjai, Nasir, Forsberg, Mikhalkova, Mar, Mani,
Sampath-Kumar, Prasad, Cahill, Verma) Saint Louis University, SAINT LOUIS,
MO, United States
Publisher
Elsevier Inc.
Abstract
Background Stroke after transcatheter aortic valve replacement (TAVR) is
associated with up to 77% mortality (data from ASTRO-TAVI). Adequately
powered studies for mortality have not been conducted while smaller
studies have shown mixed benefit from routine use of cerebral embolic
protection (CEP) devices. Studies have consistently shown benefit of CEP
devices with debilitating strokes. We report the results of meta-analysis
of available data. Methods Search strategy included PubMed, EBSCO, Google
Scholar, Journal of the American College of Cardiology, New England
Journal of Medicine. Studies evaluating CEP and reporting stroke and
mortality outcomes were included. Results Fourteen studies (low
heterogeneity I2=29%) with 2,20,601 patients were included in this
analysis (Figure 1). Use of CEP during TAVR was associated with reduced
odds of overall mortality (OR 0.65; 95% CI 0.54- 0.79, p<0.001),
in-hospital mortality (OR 0.66, 95% CI 0.51- 0.87, p=0.002), and 30-day
mortality (OR 0.64, 95% CI 0.42- 0.99, p=0.04). [Formula presented]
Conclusion In this large meta-analysis, use of CEP was associated with
reduced odds of mortality. This may be related to decreased odds of
debilitating stroke, which are associated with significant mortality, with
CEP device usage shown in prior studies. Large studies adequately powered
for mortality are needed. Copyright © 2023 American College of
Cardiology Foundation

<61>
Accession Number
641568129
Title
TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENTS WITH CHRONIC
THROMBOCYTOPENIA: PREVALENCE AND IN-HOSPITAL OUTCOMES.
Source
European Heart Journal, Supplement. Conference: 54th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
25(Supplement D) (pp D83-D84), 2023. Date of Publication: May 2023.
Author
Zuin M.; Bilato C.; Pasquetto G.; Rigatelli G.
Institution
(Zuin, Bilato, Pasquetto, Rigatelli) Dipartimento di Medicina
Trnaslazionale, Ferrara; Ospedali dell'Ovest Vicentino, Arzignano;
Ospedali Riuniti Padova Sud, Schaivonia; Ospedali Riuniti Padova Sud,
Schiavonia
Publisher
Oxford University Press
Abstract
Background: Thrombocytopenia represents an important issue in patients
undergoing Transcatheter aortic valve replacement (TAVR) due to severe
aortic stenosis. We performed a systematic review and meta-analysis to
establish the pooled prevalence and the in-hospital outcomes of Chronic
thrombocytopenia (cTCP) in patients after TAVR. Method(s): PubMed and
Scopus databases were systematically searched for articles, published in
any language, from inception through September 15, 2022, reporting the
prevalence of cTCP in patients who underwent TAVR and providing data on
the hospital outcomes. The pooled prevalence and the outcomes were
evaluated pooling the adjusted odds ratio (OR) with the related 95%
confidence interval (CI) using a random- effect models. Statistical
heterogeneity between groups was measured using the Higgins I2 statistic
Results: Overall, 1,402,431 patients (mean age 87.2 years, 45.1% females)
where hospitalized for TAVR. Among them, cTCP was observed in 7.0% of
cases (95% CI: 1.7-24.5%, p<0.0001, I2:84.5%). No significant differences
were observed for in- hospital mortality and stroke comparing patients
with cTCP to those without (OR: 1.07, 95% CI: 0.62-1.82, p=0.802, I2:
79.6% and OR: 0.90, 95% CI: 0.67-1.21, p=0.48, I2: 0%, respectively).
Conversely, cTCP subjects showed a significant higher risk of vascular
complications (OR: 1.72, 95% ci 1.37-2.16, p<0.0001, I2:0%), acute kidney
injury (OR: 1.60, 95% CI: 1.16-2.20, p=0.004, I2:81.4%) and cardiac
tamponade (OR: 3.31, 95% ci: 1.85-5.94, p<0.0001, I2: 0%) (Figure 1).
 Conclusion(s): cTCP is present in about 7% of patients underoing TAVR
and was results associated with an increased risk of vascular
complications and cardiac tamponade during the periprocedural period.
(Figure Presented).

<62>
Accession Number
641567847
Title
NATURAL HISTORY AND CLINICAL BURDEN OF MODERATE AORTIC STENOSIS: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
European Heart Journal, Supplement. Conference: 54th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
25(Supplement D) (pp D75-D76), 2023. Date of Publication: May 2023.
Author
Morelli M.; Galasso M.; Soriano F.; Nava S.; Da Pozzo C.; Esposito G.;
Piccaluga E.; Bossi I.; Montalto C.; Oliva F.; Oreglia J.; Giannattasio C.
Institution
(Morelli, Galasso, Soriano, Nava, Da Pozzo, Esposito, Piccaluga, Bossi,
Montalto, Oliva, Oreglia, Giannattasio) Universita degli Studi di
Milano-Bicocca, Milano; ASST Grande Ospedale Metropolitano Niguarda,
Milano; Universita degli Studi di Milano, Milano; Universita degli Studi
di Milano-Bicocca; ASST Grande Ospedale Metropolitano Niguarda, Milano
Publisher
Oxford University Press
Abstract
Objectives: The aim of this study was to assess the natural history and
clinical burden of moderate aortic stenosis and to investigate the
interaction of left ventricular ejection fraction and of age with
prognosis. Background(s): The mortality risk of patients with
moderate aortic stenosis is not well known but recent studies suggested
that it might negatively affect prognosis. Method(s): A systematic
research was conducted on PubMed. The inclusion criteria were: 1)
inclusion of patients with moderate aortic stenosis; 2) report of the
survival at 1-year follow-up (minimum). Incidence ratios related to
all-cause mortality in patients and controls of each study were estimated
and then pooled using a fixed effects model. Meta-regression analysis was
performed to assess the impact of left ventricular ejection fraction and
age on the prognosis of patients with moderate aortic stenosis.
 Result(s): Fifteen studies and 11,596 patients with moderate aortic
stenosis were included. All-cause mortality was significantly higher among
patients with moderate aortic stenosis than among controls: 10.7% (95% CI:
0.1010-0.1136) vs 4.5% (95% CI: 0.0438-0.0454) at 1-year (p < 0.0001),
17.7% (95% CI: 0.1692-0.1854) vs 7.6% (95% CI: 0.0754-0.0775) at 2-year,
23.0% (95% CI: 0.2204-0.2387) vs 9.9% (95% CI: 0.0973-0.0997) at 3-year,
27.9% (95% CI: 0.2685-0.2899) vs 11.9% (95% CI: 0.1177-0.1203) at 4-year,
and 32.4% (95% CI: 0.3125-0.3360) vs 14.2% (95% CI: 0.1402-0.1430) at
5-year follow-up. Left ventricular ejection fraction did not significantly
impact on the prognosis of patients with moderate aortic stenosis
(estimate = -0.0020; 95% CI: -0.0078- 0.0038; p = 0.4584), unlike of age
(estimate = 0.0067; 95% CI: 0.0007- 0.0127; p = 0.0323).
 Conclusion(s): Moderate aortic stenosis is not a benign disease.
Further studies are necessary to confirm the prognostic impact of this
valvulopathy and the possible benefit of the aortic valve replacement.
Figure 1: All-cause mortality of patients with moderate aortic stenosis
(red) vs controls (black) at 1-, 2-, 3-, 4- and 5-year follow-up. Figure
2: Impact of left ventricular ejection fraction on prognosis of patients
with moderate aortic stenosis. Figure 3: Impact of age on prognosis of
patients with moderate aortic stenosis. (Figure Presented).

<63>
Accession Number
641567818
Title
TRANS-AXILLARY ACCESS AS AN ALTERNATIVE ROUTE IN TRANSCATHETER AORTIC
VALVE IMPLANTATION.
Source
European Heart Journal, Supplement. Conference: 54th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
25(Supplement D) (pp D157), 2023. Date of Publication: May 2023.
Author
De Michele G.; Moscarella E.; Acerbo V.; Raucci G.; Scherillo G.; Signore
G.; Rotolo F.; Scialla F.; Cesaro A.; Calabro P.
Institution
(De Michele, Moscarella, Acerbo, Raucci, Scherillo, Signore, Rotolo,
Scialla, Cesaro, Calabro) AORN 'Sant'Anna e San Sebastiano' di Caserta,
Caserta, Italy
Publisher
Oxford University Press
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is the main
procedure for treating severe aortic stenosis in patients considered at
high surgical risk. Generally, this procedure is performed through
percutaneous femoral arterial access. The presence of anatomical variants
or peripheral atherosclerotic pathology sometimes necessitates the use of
alternative vascular accesses, including access through the axillary
artery. Data from a meta-analysis involving 1793 patients who underwent
TAVR through trans axillary or transapical access showed a statistically
significant reduction in 30-day mortality in the former group. We wait for
future randomized trials to confirm the consistency of these data.
Clinical case: 71-year-old man, smoker, hypertensive and dyslipidaemic. In
2018, he underwent bilateral aorta-iliac-femoral bypass surgery for severe
lower limb arteriopathy. Due to the onset of angina and dyspnea at rest,
he went to the ER where a diagnosis of NSTEMI was made. On echocardiogram,
there was evidence of severe high-gradient aortic stenosis while coronary
angiography showed 80% RCA stenosis in the middle tract. Because of the
high surgical risk (EUROSCORE II: 12%) and the evidence of bilateral
femoral artery occlusion on CT-angiography, the Heart Team concluded to
perform TAVR through percutaneous left trans-axillary access with
concomitant percutaneous coronary revascularization. Obtained the backup
access on the left radial artery, PTCA+DES was performed on RCA through
the right radial access with subsequent placement of a pigtail catheter in
the non-coronary sinus of Valsalva. Once the temporary pacemaker had been
placed through the right femoral vein, an angio-guided puncture of the
left axillary artery was performed with placement of the 14 Fr introducer
for implantation of the Medtronic Evolut R 26 mm aortic biological
prosthesis. Post-procedure ultrasound examination showed a residual mean
aortic valve gradient of 17 mmHg with evidence of a small periprosthetic
leak. Seven days after the procedure, the patient was discharged,
asymptomatic and in good hemodynamic compensation without vascular
complications. Conclusion(s): Trans-axillary arterial access should
be considered a viable alternative to transfemoral access for the
performance of TAVR.

<64>
Accession Number
641567711
Title
DEL NIDO VS SERVATOR H CARDIOPLEGIA.
Source
European Heart Journal, Supplement. Conference: 54th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
25(Supplement D) (pp D178), 2023. Date of Publication: May 2023.
Author
Rosciano A.; Paduvakis I.; Cerillo A.; Stefano P.
Institution
(Rosciano, Paduvakis, Cerillo, Stefano) AOU Careggi, Firenze, Italy
Publisher
Oxford University Press
Abstract
Background and aim: One-shot long-lasting cardioplegia is particularly
useful during right minithoracotomy mitral valve surgery (RT-MS), and the
Servator H cristalloid solution has been widely used in this setting.
However, the Servator H cardioplegia requires the administration of large
volumes of fluids and the frequent recourse to ultrafiltration. we
compared Servator H versus the Del Nido Cardioplegia, that contains blood
and requires smaller volumes, in patients undergoing RT-MS.
 Method(s): 36 consecutive patients undergoing RT-MS (+/- tricuspid
and AF surgery) were randomly assigned to receive Servator H or Del Nido
Cardioplegia. There were no differences between the two groups at
baseline. Result(s): Although there were no differences in terms of
mortality and incidence of major complications, the use of Servator H
cardioplegia was associated with a significantly increased release of
CK-MB (but not of TnI) during the early postoperative period. Moreover,
patients receiving Servator H were more likely to require defibrillation
or pacing after removal of the aortic cross-clamp (8, 40% vs 2, 12.5%),
and experienced a significantly higher rate of postoperative atrial
fibrillation (10, 50% vs 4, 25%, p < 0.05). Conclusion(s): Our data
show that the Del Nido cardioplegia could offer improved myocardial
protection during minimally invasive mitral valve surgery, resulting in
reduced need for post-cardioplegia defibrillation and of postoperative
atrial fibrillation. This is consistent with the results of similar,
recent research. Further studies on larger populations are needed to
consolidate these data.

<65>
Accession Number
641567645
Title
ACUTE ACALCULOUS CHOLECYSTITIS AND CARDIOVASCULAR DISEASE, WHICH CAME
FIRST?.
Source
European Heart Journal, Supplement. Conference: 54th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
25(Supplement D) (pp D218), 2023. Date of Publication: May 2023.
Author
Fiore D.; De Rosa S.
Institution
(Fiore, De Rosa) AOU Mater Domini, Catanzaro, Italy
Publisher
Oxford University Press
Abstract
Background: The existence of a close association between disease of the
biliary tract and heart 's disease is known from the mists of time. Acute
acalculous cholecystitis (AAC) is a challenging diagnosis. The atypical
clinical onset associated to a paucity and similarity of symptoms and to
laboratory data mimicking cardiovascular disease (CVD) often results in
under and misdiagnosed cases. Moreover, AAC is often associated with
gangrene, perforation and empyema as well as considerable morbidity and
mortality(up 50%). Early diagnosis is crucial to increase survivability.
Even today, there is still a lot of confusion regarding the relationship
and consequently the clinical management AAC and CVD. Aim The aim of this
review was to provide evidence regarding epidemiology, pathophysiology,
clinical presentation and treatment of the complex association between AAC
and CVD. Method(s): we searched for publications addressing
Acalculous cholecystitis and cardiovascular disease, consulting Medline
and Scopus databases. Any retrospective or prospective study design or
systematic review focusing on the aforementioned topic was accepted. This
study was conducted in accordance with the PRISMA and AMSTAR Guidelines.
Our search rendered 1422 hits (995 from Medline and 427 from Scopus).
After progressive screening, 268 full texts were assessed for eligibility
and 135 studies were included in qualitative synthesis. Result(s):
According to the literature, 11 cases of AAC were reported after
cardiopulmonary bypass surgery. Similarly, in 6 of 7 patients following
aortic reconstruction. Small vessel occlusion has shown to be the
predominant phenomenon in AAC. Histological analysis suggest involvement
of ischaemia and reperfusion mediated injury. The most common ECG
alterations noted in AAC are changes in Twaves in significant leads,
slurring and notching of the QRS complex and elevation or depression of
the S-T segment, hypothesizing a vagally reflex mechanism, due to the
distention of the common bile duct, with a reduced coronary blood flow.
Finally it was reported a resolution of ECG changes due to AAC after
cholecystectomy or antibiotic treatment within a few days.
 Conclusion(s): AAC should be suspected after each general disease
leading to hypoperfusion such as cardiovascular diseases and major heart
or aortic surgery. ECG changes in absence of significant laboratory data
for IMA could be related to a misdiagnosed AAC. (Figure Presented).

<66>
Accession Number
641567623
Title
SACUBITRIL/VALSARTAN IN HEART FAILURE WITH REDUCED EJECTION FRACTION:
REAL-WORLD EXPERIENCE FROM ITALY (THE REAL. IT STUDY).
Source
European Heart Journal, Supplement. Conference: 54th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
25(Supplement D) (pp D134), 2023. Date of Publication: May 2023.
Author
Di Lenarda A.; Di Gesaro G.; Sarullo F.; Miani D.; Driussi M.; Correale
M.; Bilato C.; Passantino A.; Carluccio E.; Villani A.; Degli Esposti L.;
D'Agostino C.; Peruzzi E.; Monopoli S.; Iacoviello M.
Institution
(Di Lenarda, Di Gesaro, Sarullo, Miani, Driussi, Correale, Bilato,
Passantino, Carluccio, Villani, Degli Esposti, D'Agostino, Peruzzi,
Monopoli, Iacoviello) 1ASUGI Trieste, Trieste; ARNAS P.O. Civico e
Benfratelli, Palermo; Ospedale Buccheri La Ferla Fatebenefrate, Palermo;
POU 'Santa Maria della Misericordia', Udine; Policlinico Riuniti, Foggia;
Ospedale Civile, Arzignano; Ics Maugeri Spa Societa' Benefit IRCCS B,
Bari; Azienda Ospedaliera di Perugia, Perugia; Ospedale Nuovo del Mugello,
Borgo San Lorenzo
Publisher
Oxford University Press
Abstract
Background: Sacubitril/valsartan reduced heart failure (HF)-related
hospitalizations and cardiovascular mortality in PARADIGM-HF and has
become a foundational treatment for HF with reduced ejection fraction
(HFrEF). However, data of its routine real-world use is limited, and
evidence from Italian settings is lacking. Aim of the study. The REAL. IT
study aimed to characterize the demographics, pharmacotherapy, clinical
characteristics, and outcomes of sacubitril/valsartan-treated Italian
patients with HFrEF. Method(s): Electronic medical records of
patients initiating sacubitril/valsartan from October 2016 to June 2019 at
nine specialized hospital outpatient HF Centers across Italy were
reviewed. Result(s): Overall, 924 adults (mean age 64.5 years, 84.6%
male) were included. Clinical characteristics are shown in Table 1. At
baseline, 38.7% had an ischemic HF etiology, 45.9% hypertension, 23.2%
atrial fibrillation, 25.4% diabetes mellitus, 26.1% an implantable
cardioverter-defibrillator, 31.9% coronary artery bypass grafting. There
were no clear patterns of patient selection over time. As shown in Table
1, during follow-up NYHA class improved in 37.5% after a mean of 5.3 +/-
3.8 months; 36.1% and 16.7% of patients were in NYHA class III during
characterization and after one year of follow-up, respectively. Left
ventricular ejection fraction (LVEF) improved >=5% in 56.3% of patients at
one year; 39.7% had >=30% reduction of N-terminal pro-B-type natriuretic
peptide; 2.2% had hyperkalemia during characterization and 2.6% during
follow-up; 3.8% had hypotension during characterization and 12% during
follow-up. A total of 50 (5.8%) of patients had device implantation
(ICD/CRT) during follow-up. HF- related hospitalization was recorded in
19.6% of patients during follow-up; 3.8% of patients died, approximately
1.3% from cardiovascular causes. Conclusion(s): Our real-world data
confirmthe favorable effectiveness and tolerability of
sacubitril/valsartan observed in pivotal randomized controlled trials.

<67>
Accession Number
641567457
Title
EFFICACY AND SAFETY OF LEFT ATRIAL APPENDAGE CLOSURE COMPARED WITH ORAL
ANTICOAGULATION IN ATRIAL FIBRILLATION: A META-ANALYSIS OF RANDOMIZED
CONTROLLED TRIALS AND PROPENSITY- MATCHED STUDIES.
Source
European Heart Journal, Supplement. Conference: 54th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
25(Supplement D) (pp D43-D44), 2023. Date of Publication: May 2023.
Author
Piroli F.; Franchin L.; Demola P.; Navazio A.
Institution
(Piroli, Franchin, Demola, Navazio) Ospedale AMSN Reggio Emilia, Reggio
Emilia; Ospedale Santa Maria della Misericordia, Udine; Ospedale ASMN
Reggio Emilia, Reggio Emilia
Publisher
Oxford University Press
Abstract
Backgrounds: In the recent years, two randomized controlled trials (RCTs),
the PROTECT-AF trial and the PREVAIL trial demonstrated that in atrial
fibrillation (AF) patients, left atrial appendage closure (LAAC) compared
with oral anticoagulants (OAC), showed a non-inferiority in the prevention
of stroke and even a reduction in mortality. Nevertheless, this net
clinical benefit was not confirmed in the most recent RCT comparing LAAC
vs OAC, the PRAGUE-17 trial. The aim of the present meta-analysis was to
evaluate the efficacy and safety of LAAC compared to OAC among available
high-quality studies. Method(s): A systematic search of electronic
databases (Medline, Scopus, Embase and the Cochrane Library) was performed
to identify eligible RCTs and observational studies with propensity score
matching (PSM) analysis. PRISMA guidelines were used for abstracting data
and assessing data quality and validity. Outcomes of interest were the
occurrence of cardiovascular death (CVD), all cause death, all-type
stroke, and major bleedings. Result(s): A total of 3 RCTs and 6 PMS
studies involving 6924 patients were identified. After a median follow-up
of 2.7 years (IQR 2-4.5), patients who received LAAC had a lower risk of
CVD (OR=0.58; 95%CI 0.48-0.71, I2=0%), all cause death (0.59; 95% CI
0.45-0.76, I2 67%) and major bleedings (OR=0.58; 95%CI 0.43-78 I2=52%)
compared with patients on OAC. No difference was found between the two
groups regarding strokes incidence (OR=0.94; 95% CI 0.76-1.16, I2=0%).
 Conclusion(s): According to this meta-analysis, LAAC presents a
comparable efficacy in the prevention of stroke compared to OAC with a
reduced risk of major bleedings, all cause death and CVD that may stand
out with longer follow-up. (Figure Presented).

<68>
Accession Number
2025131370
Title
Efficacy of Multiple Exercise Therapy after Coronary Artery Bypass Graft:
A Systematic Review of Randomized Control Trials.
Source
Reviews in Cardiovascular Medicine. 24(5) (no pagination), 2023. Article
Number: 141. Date of Publication: May 2023.
Author
Moneruzzaman Md.; Sun W.-Z.; Changwe G.J.; Wang Y.-H.
Institution
(Moneruzzaman, Sun, Wang) Rehabilitation Center, Qilu Hospital of Shandong
University, Shandong, Jinan 250012, China
(Changwe) Department of Cardiac Surgery, Qilu Hospital of Shandong
University, Shandong, Jinan 250012, China
(Changwe) Department of Cardiovascular and Thoracic Surgery, National
Heart Hospital, Lusaka 10101, Zambia
Publisher
IMR Press Limited
Abstract
Background: Coronary artery bypass graft (CABG) is intended to restore
myocardial perfusion and alleviate morbidity among patients suffering from
coronary artery disease. Due to procedural complexity, and anesthetic
medications, post-operative complications are more prevalent, requiring
the integration of rehabilitation strategies. This review aimed to
determine the effect of single and multiple exercise therapy on
rehabilitation after CABG surgery. Method(s): We conducted a
systematic search of databases (EBSCOhost, Scopus, PubMed, and Web of
Science) from 01 January 2000 to 15 September 2022. The protocol of this
systematic review is registered to PROSPERO. Result(s): We found nine
randomized control trials composed of 599 CABG patients. In-patient
cardiac rehabilitation (CR), a combination of inspiratory muscle training,
mobilization, active upper and lower limb exercise, and aerobic exercise
as multiple exercise therapy, found significant improvement in 6-minute
walking distance (6MWD) than single exercise therapy (breathing exercise)
at discharge and follow-up (moderate quality evidence). Contrary, multiple
exercises group compared to single exercise groups did not improve the
peak volume of oxygen (VO2) at discharge. Still, significant improvement
was found at follow-up (moderate quality of evidence). On the other hand,
the out-patient CR made up of high-intensity inspiratory muscle training,
upper and lower limbs resistance training, and aerobic exercise as
multiple exercise therapy significantly improved 6MWD and peak VO2 at
discharge (High-quality evidence). Conclusion(s): Our review revealed
that multiple exercise therapy significantly improves functional and
exercise capacity in in-patient and out-patient cardiac rehabilitation
settings than single exercise therapy, but more than double exercise
therapy protocol may be inefficient for improvement of quality of life.
Inspiratory muscle training and resistance training in exercise therapy
protocols significantly supplant the outcome, which requires further
investigation. Copyright © 2023 The Author(s).

<69>
Accession Number
2025131361
Title
The Place of Transaxillary Access in Transcatheter Aortic Valve
Implantation (TAVI) Compared to Alternative Routes-A Systematic Review
Article.
Source
Reviews in Cardiovascular Medicine. 24(5) (no pagination), 2023. Article
Number: 150. Date of Publication: May 2023.
Author
Herremans A.; Stevesyns D.T.; El Jattari H.; Rosseel M.; Rosseel L.
Institution
(Herremans, Stevesyns, El Jattari, Rosseel, Rosseel) Department of
Cardiology, Algemeen Stedelijk Ziekenhuis, Oost-Vlaanderen, Aalst 9300,
Belgium
(Herremans, Stevesyns) Faculty of Medicine and Health Sciences, University
Gent, Oost-Vlaanderen, Gent 9000, Belgium
Publisher
IMR Press Limited
Abstract
Background: Transfemoral transcatheter aortic valve implantation (TAVI)
has proven non-inferior or superior against surgical aortic valve
replacement (SAVR) for patients at high, intermediate or low surgical
risk. However, transfemoral access is not always feasible in patients with
severely atherosclerotic or tortuous iliofemoral arteries. For these
cases, alternative access techniques have been developed, such as
transcarotid, transcaval, direct aortic or transaxillary access. In recent
years, growing preference towards the transaxillary access has emerged. To
provide a summary of data available on transaxillary TAVI and compare this
approach to other alternative access techniques. Method(s): A
literature search was performed in PubMed by two independent reviewers.
Studies reporting the outcome of at least 10 patients who underwent
transaxillary TAVI, either in case series or in comparative studies, were
included in this review. Articles not reporting outcomes according to the
Valve Academic Research Consortium (VARC) 1-3 definitions were excluded.
 Result(s): In total 193 records were found of which 18 were withheld
for inclusion in this review. This review reports on the combined data of
the 1519 patients who underwent transaxillary TAVI. Procedural success was
achieved in 1203 (92.2%) of 1305 cases. Life-threatening, major, and minor
bleeding occurred respectively in 4.5% (n = 50 in 1112 cases), 12.9% (n =
143 in 1112 cases) and 8.8% (n = 86 in 978 cases). Major and minor
vascular complications were reported in respectively 6.6% (n = 83 in 1256
cases) and 10.0% (n = 105 in 1048 cases) of patients. 30-day mortality was
5.2% (n = 76 out of 1457 cases). At one year follow-up, the mortality rate
was 1% (n = 184 out of 1082 cases). Similar 30-day and 1-year mortality is
observed in studies that compare with transaxillary, transfemoral or other
alternative access techniques (p > 0.05). Conclusion(s): A wide
application of transaxillary access as an alternative approach for TAVI
has emerged. This technique has an excellent procedural success rate up to
92.0%, with low procedural complication rates. Clinical outcome of
transaxillary TAVI is comparable to the other alternative TAVI approaches.
However, these conclusions are solely based on observational
data. Copyright © 2023 The Author(s).

<70>
[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. 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.
 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. 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. Copyright © 2022 Lippincott Williams and Wilkins.
All rights reserved.

<71>
Accession Number
2005112379
Title
Quality of life changes in acute coronary syndromes patients: A systematic
review and meta-analysis.
Source
International Journal of Environmental Research and Public Health. 17(18)
(pp 1-28), 2020. Article Number: 6889. Date of Publication: 02 Sep 2020.
Author
Kaambwa B.; Gesesew H.A.; Horsfall M.; Chew D.
Institution
(Kaambwa, Gesesew, Horsfall, Chew) College of Medicine and Public Health,
Flinders University, Adelaide 5042, Australia
(Gesesew) Epidemiology, College of Health Sciences, Mekelle University,
Mekelle 231, Ethiopia
Publisher
MDPI
Abstract
There is little up-to-date evidence about changes in quality of life
following treatment for acute coronary syndrome (ACS) patients. The main
aim of this review was to assess the changes in QoL in ACS patients after
treatment. We undertook a systematic review and meta-analysis of
quantitative studies. The search included studies that described the
change of QoL of ACS patients after receiving treatment options such as
percutaneous coronary intervention (PCI), coronary artery bypass grafting
(CABG) and medical therapy (MT). We synthesized findings using content
analysis and pooled the estimates using meta-analysis. We used the PRISMA
guidelines to select and appraise the studies and report the findings.
Twenty-nine (29) articles were included in the review. We found a
significant improvement of QoL in ACS patients after receiving treatment.
Particularly, the meta-analytic association found that the mean QoL of
patients diagnosed with ACS was higher after receiving treatment compared
to baseline (overall pooled mean difference = 31.88; 95% CI = 31.64-52.11,
I2 = 98) with patients on PCI having slightly lower QoL gains
(pooled mean difference = 30.22; 95% CI = 29.9-30.53, I2 = 0%)
compared to those on CABG (pooled mean difference = 34.01; 95% CI =
33.66-34.37, I2 = 0%). The review confirmed that QoL of ACS
patients improved after receiving treatment therapies although varied by
the treatment options and patients' preferences. This suggests the need to
perform further study on the QoL, patient preferences and physicians'
decision to prescription of treatment options. Copyright © 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<72>
Accession Number
2025043585
Title
Evaluation of functional and aesthetic outcomes of free dermal fat graft
versus superficial musculoaponeurotic system flap after superficial
parotidectomy: randomized clinical trial.
Source
BJS Open. 7(3) (no pagination), 2023. Article Number: zrac173. Date of
Publication: 01 Jun 2023.
Author
Fawzy A.; Balbaa M.A.; Hagag M.
Institution
(Fawzy, Balbaa, Hagag) Department of General Surgery, Faculty of Medicine,
Menoufia University, Menoufia, Shebin El Kom, Egypt
Publisher
Oxford University Press
Abstract
Background: Parotidectomy is the standard procedure for treatment of many
parotid lesions; however, it has several drawbacks. Facial asymmetry and
Frey's syndrome are the most annoying complications to patients. Insertion
of interpositioning grafts into the parotidectomy bed can decrease these
complications significantly. Free dermal fat graft (FDFG) and superficial
musculoaponeurotic system (SMAS) flap have very promising results. This
RCT aimed to compare these two techniques regarding functional and
aesthetic outcomes. Method(s): Between February 2016 and October
2021, adult patients undergoing superficial conservative parotidectomy in
a single centre for a benign indication were randomized into two equal
groups using a closed envelope method. In one group, FDFG was inserted at
the parotidectomy bed, whereas, in the other group, SMAS flap was
performed. Preoperative, operative, and postoperative data were recorded
and analysed. The primary outcome was the development of Frey's syndrome.
 Result(s): Seventy-eight patients were randomized into two equal
groups of 39 patients. There was no significant difference between the two
groups regarding development of Frey's syndrome. There was no significant
statistical difference between study groups regarding demographic data,
co-morbidities, parotid pathologies, specimen volumes, total operating
time, and postoperative complications. A tendency for over correction was
observed in FDFG and under correction in SMAS flap. There was no
statistically significant difference between the study groups regarding
the patients' aesthetic satisfaction with the majority displaying
excellent satisfaction with no poor results. Conclusion(s): FDFG and
SMAS flap are simple, rapid, and reliable procedures and are effective in
improving both functional and aesthetic outcomes post-parotidectomy. They
have comparable results; however, selection of either procedure can be
determined according to patient and tumour characteristics. Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf
of BJS Society Ltd.

<73>
Accession Number
2024999237
Title
The NO-cGMP-PKG Axis in HFpEF: From Pathological Mechanisms to Potential
Therapies.
Source
Aging and Disease. 14(1) (pp 46-62), 2023. Date of Publication: 01 Feb
2023.
Author
Cai Z.; Wu C.; Xu Y.; Cai J.; Zhao M.; Zu L.
Institution
(Cai, Wu, Xu, Cai, Zhao, Zu) Department of Cardiology, Peking University
Third Hospital, Beijing 100191, China
(Cai, Wu, Xu, Cai, Zhao, Zu) Department of Cardiology, Institute of
Vascular Medicine, Peking University Third Hospital, China
(Zu) Key Laboratory of Cardiovascular Molecular Biology and Regulatory
Peptides, Ministry of Health, China
(Zu) Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing
100191, China
Publisher
International Society on Aging and Disease
Abstract
Heart failure with preserved ejection fraction (HFpEF) accounts for almost
half of all heart failure (HF) cases worldwide. Unfortunately, its
incidence is expected to continue to rise, and effective therapy to
improve clinical outcomes is lacking. Numerous efforts currently directed
towards the pathophysiology of human HFpEF are uncovering signal
transduction pathways and novel therapeutic targets. The nitric
oxide-cyclic guanosine phosphate-protein kinase G (NO-cGMP-PKG) axis has
been described as an important regulator of cardiac function. Suppression
of the NO-cGMP-PKG signalling pathway is involved in the progression of
HFpEF. Therefore, the NO-cGMP-PKG signalling pathway is a potential
therapeutic target for HFpEF. In this review, we aim to explore the
mechanism of NO-cGMP-PKG in the progression of HFpEF and to summarize
potential therapeutic drugs that target this signalling
pathway. Copyright: © 2022 Cai Z. et al.

<74>
Accession Number
2024972178
Title
Does targeted positioning of the left ventricular pacing lead towards the
latest local electrical activation in cardiac resynchronization therapy
reduce the incidence of death or hospitalization for heart failure?.
Source
American Heart Journal. 263 (pp 112-122), 2023. Date of Publication:
September 2023.
Author
Kronborg M.B.; Frausing M.H.J.P.; Svendsen J.H.; Johansen J.B.; Riahi S.;
Haarbo J.; Poulsen S.H.; Eiskjaer H.; Kober L.; Ovrehus K.; Sommer A.M.;
Schou M.; Norgaard B.L.; Risum N.; Poulsen M.K.; Sogaard P.; Sandgaard N.;
Kofoed K.F.; Hansen T.F.; Graff C.; Pedersen S.S.; Skals R.G.; Nielsen
J.C.
Institution
(Kronborg, Frausing, Poulsen, Eiskjaer, Norgaard, Nielsen) Department of
Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Kronborg, Frausing, Poulsen, Eiskjaer, Norgaard, Nielsen) Department of
Clinical Medicine, Aarhus University, Aarhus, Denmark
(Svendsen, Kober, Risum, Kofoed) Department of Cardiology, Copenhagen
University Hospital - Rigshospitalet, Copenhagen, Denmark
(Svendsen, Kofoed) Department of Clinical Medicine, Faculty of Health and
Medical Sciences, University of Copenhagen, Copenhagen, Denmark
(Johansen, Ovrehus, Poulsen, Sandgaard, Pedersen) Department of
Cardiology, Odense University Hospital, Odense, Denmark
(Riahi, Sommer, Sogaard) Department of Cardiology, Aalborg University
Hospital, Aalborg, Denmark
(Riahi) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Haarbo, Schou, Hansen) Department of Cardiology, Copenhagen University
Hospital - Herlev and Gentofte, Copenhagen, Denmark
(Kofoed) Department of Radiology, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
(Graff) Department of Health Science and Technology, Aalborg University,
Aalborg, Denmark
(Pedersen) Department of Psychology, University of Southern Denmark,
Odense, Denmark
(Skals) Unit of Biostatistics, Aalborg University Hospital, Aalborg,
Denmark
Publisher
Elsevier Inc.
Abstract
Background: Cardiac resynchronization therapy (CRT) improves symptoms,
health-related quality of life and long-term survival in patients with
systolic heart failure (HF) and shortens QRS duration. However, up to one
third of patients attain no measurable clinical benefit from CRT. An
important determinant of clinical response is optimal choice in left
ventricular (LV) pacing site. Observational data have shown that achieving
an LV lead position at a site of late electrical activation is associated
with better clinical and echocardiographic outcomes compared to standard
placement, but mapping-guided LV lead placement towards the site of latest
electrical activation has never been investigated in a randomized
controlled trial (RCT). The purpose of this study was to evaluate the
effect of targeted positioning of the LV lead towards the latest
electrically activated area. We hypothesize that this strategy is superior
to standard LV lead placement. Method(s): The DANISH-CRT trial is a
national, double-blinded RCT (ClinicalTrials.gov NCT03280862). A total of
1,000 patients referred for a de novo CRT implantation or an upgrade to
CRT from right ventricular pacing will be randomized 1:1 to receive
conventional LV lead positioning preferably in a nonapical posterolateral
branch of the coronary sinus (CS) (control group) or targeted positioning
of the LV lead to the CS branch with the latest local electrical LV
activation (intervention group). In the intervention group, late
activation will be determined using electrical mapping of the CS. The
primary endpoint is a composite of death and nonplanned HF
hospitalization. Patients are followed for a minimum of 2 years and until
264 primary endpoints occurred. Analyses will be conducted according to
the intention-to-treat principle. Enrollment for this trial began in March
2018, and per April 2023, a total of 823 patients have been included.
Enrollment is expected to be complete by mid-2024. Conclusion(s): The
DANISH-CRT trial will clarify whether mapping-guided positioning of the LV
lead according to the latest local electrical activation in the CS is
beneficial for patients in terms of reducing the composite endpoint of
death or nonplanned hospitalization for heart failure. Results from this
trial are expected to impact future guidelines on CRT. ClinicalTrials.gov
identifier: NCT03280862. Copyright © 2023 The Author(s)

<75>
Accession Number
2024794643
Title
The anxiolytic effects of Lavandula angustifolia (lavender): An overview
of systematic reviews.
Source
Journal of Herbal Medicine. 40 (no pagination), 2023. Article Number:
100672. Date of Publication: August 2023.
Author
Shamabadi A.; Hasanzadeh A.; Ahmadzade A.; Ghadimi H.; Gholami M.;
Akhondzadeh S.
Institution
(Shamabadi, Ahmadzade, Gholami) School of Medicine, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Shamabadi, Hasanzadeh, Akhondzadeh) Psychiatric Research Center, Roozbeh
Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Ghadimi) School of Medicine, Qom University of Medical Sciences, Qom,
Iran, Islamic Republic of
Publisher
Elsevier GmbH
Abstract
Introduction: Aromatherapy and decoctions of lavender have been
traditionally used for their anxiolytic harboring-soothing effects without
proper evidence. This study aims to systematically identify and appraise
systematic reviews on the anxiolytic effects of Lavandula angustifolia
(lavender). Method(s): The study protocol was published in PROSPERO
(CRD42021279573). ISI Web of Science, Scopus, PubMed, Embase, Cochrane
Library, CINAHL, Google Scholar, and PROSPERO were searched up to August
2022 without any limitation for systematic reviews studying the anxiolytic
effects of lavender in humans. The report from each study as whether or
not lavender was anxiolytic was considered the primary outcome. The AMSTAR
II was utilized for the quality assessment. Result(s): Thirty
systematic reviews met the inclusion criteria, fifteen of which conducted
meta-analyses. All studies were published after 2010 and reported
promising effects through different methods of lavender
administration-namely: inhalation, massage, and oral routes-on anxiety
relief. Oral doses of 80 mg and 160 mg were both effective, the higher
dose being more efficient. The studies were conducted on various subjects,
including preoperative patients, cardiovascular patients, hemodialysis
patients, cancer patients, dental patients, and women in pre-labor. When
assessed by AMSTAR II, four studies were of high quality, one had medium
quality, and the rest were of low or critically low quality. No major
adverse event was reported. Conclusion(s): Lavender has shown
promising potential for anxiety in various settings. Lavender was
effective when inhaled, used as a massage oil, or taken orally. The oral
route was the preferred long-term option and inhalation was recommended
for the short term. Copyright © 2023 Elsevier GmbH

<76>
Accession Number
2024766571
Title
EXpansion of stents after intravascular lithoTripsy versus conventional
predilatation in CALCified coronary arteries.
Source
International Journal of Cardiology. 386 (pp 24-29), 2023. Date of
Publication: 01 Sep 2023.
Author
Oomens T.; Vos N.S.; van der Schaaf R.J.; Amoroso G.; Ewing M.M.;
Patterson M.S.; Herrman J.-P.R.; Slagboom T.; Vink M.A.
Institution
(Oomens, Vos, van der Schaaf, Amoroso, Ewing, Patterson, Herrman,
Slagboom, Vink) Department of Cardiology, Onze Lieve Vrouwe Gasthuis,
Amsterdam, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: Coronary artery calcification is a strong predictor for
procedural failure and is independently associated with adverse events
after percutaneous coronary intervention (PCI). An important contributor
to the impaired outcome is the inability to achieve optimal results due to
stent underexpansion or stent deformation/fracture. Intravascular
lithotripsy (IVL) has emerged as an alternative technique to change the
integrity of calcified plaques. Aim(s): Our aim was to investigate if
pre-treatment with IVL in severely calcified lesions increases stent
expansion, assessed by optical coherence tomography (OCT), when compared
to predilatation with conventional and/or specialty balloon strategy.
 Method(s): EXIT-CALC was a prospective, single-centre, randomised
controlled study. Patients with an indication for PCI and severe
calcification of the target lesion were allocated to predilatation with
conventional angioplasty balloons or pre-treatment with IVL, followed by
drug-eluting stenting and mandatory postdilatation. Primary endpoint was
stent expansion assessed by OCT. Secondary endpoints were the occurrence
of peri-procedural events and major adverse cardiac events (MACE) in
hospital and during follow-up. Result(s): A total of 40 patients were
included. The minimal stent expansion in the IVL-group (n = 19) was 83.9
+/- 10.3% and 82.2 +/- 11.5% in the conventional group (n = 21) (p =
0.630). Minimal stent area was 6.6 +/- 1.5 mm2 and 6.2 +/- 1.8
mm2, respectively (p = 0.406). No peri-procedural, in-hospital
and 30-day follow-up MACE were reported. Conclusion(s): In severely
calcified coronary lesions we found no significant difference in stent
expansion measured by OCT when comparing IVL, as plaque modification, with
conventional and/or specialty angioplasty balloons. Copyright ©
2023

<77>
Accession Number
2024765106
Title
Clinical factors affecting survival in patients with D-transposition of
the great arteries after atrial switch repair: A meta-analysis.
Source
Kardiologia Polska. 81(1) (pp 38-47), 2023. Date of Publication: 2023.
Author
Nartowicz S.A.; Jakielska E.; Cieplucha A.; Ratajczak P.; Grajek S.;
Lesiak M.; Trojnarska O.
Institution
(Nartowicz, Jakielska, Grajek, Lesiak, Trojnarska) Poznan University of
Medical Sciences, Poznan, Poland
(Cieplucha) 1st Department of Cardiology, Poznan University of Medical
Sciences, Poznan, Poland
(Ratajczak) Department of Pharmacoeconomics and Social Pharmacy, Poznan
University of Medical Sciences, Poznan, Poland
Publisher
Via Medica
Abstract
Background: Atrial switch repair (AtrSR) was the initial operation method
in patients with D-transposition of the great arteries (D-TGA)
constituting the right ventricle as a systemic one. Currently, it has been
replaced with arterial switch operation (ASO), but the cohort of adults
after AtrSR is still large and requires strict cardiological management of
late complications. For this reason, we aimed to evaluate potential
long-term mortality risk factors in patients with D-TGA after AtrSR
(either Mustard or Senning procedures) Methods: We searched the MEDLINE
database for suitable trials. We included 22 retrospective and prospective
cohort studies of patients with D-TGA with at least 5 years mean/median
follow-up time after Mustard or Senning procedures, with an endpoint of
non-sudden cardiac death (n-SCD) and sudden cardiac death (SCD) after at
least 30 days following surgery. Result(s): A total of 2912 patients
were enrolled, of whom 351 met the combined endpoint of n-SCD/SCD. The
long-term mortality risk factors were New York Heart Association (NYHA)
class >=III/heart failure hospitalization (odds ratio [OR], 7.25; 95%
confidence interval [CI], 2.67-19.7), tricuspid valve regurgitation (OR,
4.64; 95% CI, 1.95-11.05), Mustard procedure (OR, 2.15; 95% CI,
1.37-3.35), complex D-TGA (OR, 2.41; 95% CI, 1.31-4.43), and right
ventricular dysfunction (OR, 1.94; 95% CI, 0.99-3.79). Supraventricular
arrhythmia (SVT; OR, 2.07; 95% CI, 0.88-4.85) and pacemaker implantation
(OR, 2.37; 95% CI, 0.48-11.69) did not affect long-term survival in this
group of patients. In an additional analysis, SVT showed a statistically
significant impact on SCD (OR, 2.74; 95% CI, 1.36-5.53) but not on n-SCD
(OR, 1.5; 95% CI, 0.37-6.0). Conclusion(s): This meta-analysis
demonstrated that at least moderate tricuspid valve regurgitation, NYHA
class >=III/heart failure hospitalization, right ventricular dysfunction,
complex D-TGA, and Mustard procedure are risk factors for long-term
mortality in patients after AtrSR. Copyright by the Author(s), 2023.

<78>
Accession Number
2024551240
Title
The usefulness of [99mTc]MIBI scintigraphy in the diagnostic algorithm of
ultrasonographical suspected thyroid nodules by using EU-TIRADS criteria.
Source
Nuclear Medicine Review. 26 (pp 29-33), 2023. Date of Publication: 2023.
Author
Manevska N.; Makazlieva T.; Rizova B.S.; Stojanoski S.
Institution
(Manevska, Makazlieva, Rizova, Stojanoski) Institute of Pathophisiology
and Nuclear Medicine, Faculty of Medicine, Ss Cyril and Methodius
University, North Macedonia
Publisher
Via Medica
Abstract
Background: Although not yet involved in the algorithm of thyroid nodules,
99mTc-methoxy-isobutyl-isonitrile ([99mTc]MIBI) scintigraphy may help in
the individual diagnostic workup of a thyroid patient, especially where
indeterminate fine needle aspiration biopsy (FNAB) is present. The aim of
this study was to evaluate the usefulness of [99mTc]MIBI thyroid
scintigraphy in the diagnostic algorithm of thyroid nodules, particularly
in ultrasound EU-TIRADS 4 or 5 lesions, that cytologically were either
indeterminate or benign. Material(s) and Method(s): A retrospective
randomized study, including 42 thyroid patients, with mean age 47 +/- 17
years, was conducted. [99mTc]MIBI scan was compared with ultrasound (US)
EU-TIRADS criteria, pertechnetate scan, FNAB and histopathological
findings for the differentiation of malignant thyroid nodules from benign
lesions. Result(s): The US mainly detected hypoechoic inhomogeneous
presentation of the thyroid nodules (35/42, 83.33%), 4 cases with
isoechoic nodules and 2 cases presented with hyperechoic thyroid nodules.
Histopathology revealed malignancy in 15/42 (35.71%), while all other
patients 27/42 (64.29%) were benign. Visual analysis score showed that
patients scored with 1+ and 2+ were statistically significant to be
benign, while 13 vs. 10 pts that were visual score 3+ were malignant vs.
benign (p > 0.05). Sensitivity was 100%, while specificity was very low
22.22%, PPV was 41.67%. Conclusion(s): Even [99mTc]MIBI scan is not
routinely used as a daily practice diagnostic tool of thyroid nodules, we
will further apply it on a larger group of patients and try to quantify
the uptake of the radiotracer to see whether it will help in the
diagnostic algorithm of thyroid nodules. Copyright © 2022 Via
Medica.

<79>
Accession Number
2024192378
Title
Treatment of Heart Diseases Using Stem Cell Therapy: Cell Types and
Regeneration.
Source
Latin American Journal of Pharmacy. 42(4) (pp 859-873), 2023. Date of
Publication: 2023.
Author
Guo Y.; Li C.; Su X.; Mi J.
Institution
(Guo, Mi) Department of Internal Medicine, The Third Outpatient
Department, General Hospital of Northern Theater Command, No. 49 Beiling
Road, Huanggu District, Liaoning, Shenyang 110032, China
(Li) Department of Geriatrics, General Hospital of The Northern Theater
Command, No. 83 Wenhua Road, Shenhe District, Liaoning, Shenyang 110016,
China
(Su) Department of Internal Medicine, The First Affiliated Hospital of
China Medical University, No. 155 Nanjing Road, Heping District, Liaoning,
Shenyang 110001, China
Publisher
Colegio de Farmaceuticos de la Provincia de Buenos Aires
Abstract
Cardiovascular diseases are the significant determinants of morbidity.
Apoptosis in cardiomyocytes impedes cardiac function, generates cardiac
decompensation, and culminates in terminal cardiac arrest. Understanding
the signaling networks that influence cardiac cell viability provides
constructive therapeutic indications about their efficacy. The ability of
cardiomyocytes to regenerate and recover itself is constrained. For the
effective repair and regeneration of ischemic cardiomyocytes, stem cell
treatment is employed. Stem cell therapy has demonstrated to be a
potential treatment strategy for cardiovascular disorders in numerous
clinical studies. Several stem cell types, notably BMC, CSC, and ESCs and
their progenies, are employed in various studies. Although stem cells
exhibit multipotency or pluripotency and are capable of regeneration,
these processes are adversely affected by the overexpression of apoptosis
pathways, which results in a marked reduction in survivability and
differentiated signals in response to cardiovascular damage.
Investigations that concentrate on preventing the extensive apoptosis
following transplantation are extremely limited, despite the successful
attempts to determine various cell types and their underlying molecular
pathways that enhance heart regeneration of the cardiac tissues. This
review outlines significant ongoing clinical trials on stem cells against
cardiovascular diseases, and various stem cells employed in the treatment
of cardiovascular diseases, their advantages, and
limitations. Copyright © 2023, Colegio de Farmaceuticos de la
Provincia de Buenos Aires. All rights reserved.

<80>
Accession Number
2024160525
Title
The great performance of the edge-to-edge repair in the anterior leaflet
prolapse: a surprise?.
Source
European Journal of Cardio-thoracic Surgery. 63(2) (no pagination), 2023.
Article Number: ezad026. Date of Publication: 01 Feb 2023.
Author
Alfieri O.; De Bonis M.; Lapenna E.; Maisano F.
Institution
(Alfieri, De Bonis, Lapenna, Maisano) Department of Cardiac Surgery, IRCCS
San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
Publisher
European Association for Cardio-Thoracic Surgery

<81>
Accession Number
2024160518
Title
Comparison of meta-analytical estimates of outcomes after Alfieri or
neochordal repair in isolated anterior mitral prolapse.
Source
European Journal of Cardio-thoracic Surgery. 63(2) (no pagination), 2023.
Article Number: ezac587. Date of Publication: 01 Feb 2023.
Author
Khairallah S.; Rahouma M.; Dabsha A.; Demetres M.; Gaudino M.Fl.; Mick
S.L.
Institution
(Khairallah, Rahouma, Dabsha, Gaudino, Mick) Cardiothoracic Surgery
Department, Weill Cornell Medicine New York-Presbyterian Hospital (WCM),
New York, NY, United States
(Demetres) Scholarly Communications Librarian, Weill Cornell Medicine
(WCM), Samuel J. Wood Library & C.V. Starr Biomedical Information Center,
New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Repair of the isolated degenerative anterior mitral leaflet
has been considered more challenging and associated with compromised
durability compared with isolated posterior leaflet in major series.
Implantation of neochordae or Alfieri edge-to-edge is the most employed
repair technique for isolated anterior repair currently, but little data
exist comparing their relative durability. We sought to investigate this
issue with this meta-analysis. METHOD(S): A literature search was
performed (Ovid MEDLINE, Ovid Embase and The Cochrane Library). The
primary outcome was the incidence rate (IR) of reoperation, the secondary
outcomes were recurrent moderately severe/severe mitral regurgitation
(MR), in-hospital/ 30-day reoperation and mortality and follow-up
mortality. A random-effect model was used. Leave-one-out, subgroup
analysis (Alfieri versus neochordae) and meta-regression were done.
 RESULT(S): Seventeen studies (including 1358 patients) were included.
At a weighted mean follow-up of 5.56 +/- 3.31 years, the IR for
reoperation was 14.45 event per 1000 person-year and significantly lower
in Alfieri than neochordae repair (9.40 vs 18.61, P = 0.04) on subgroup
analysis. The IR of follow-up moderately severe/severe MR was 19.89 event
per 1000 person-year and significantly lower in Alfieri than neochordae
repair (10.68 and 28.63, P = 0.01). In a sensitivity analysis comparing
homogenous studies, a significant difference in the recurrence of
regurgitation in favour of the Alfieri approach remained. There were no
differences in operative outcomes or survival. There were significant
associations between increased incidence of late reoperation and New York
Heart Association class III/IV and associated coronary artery bypass graft
procedure for whole cohort. CONCLUSION(S): Alfieri repair may be
associated with a lower incidence of recurrent MR compared with
neochordae-based repair in the setting of isolated degenerative anterior
mitral pathology. This is the first such meta-analysis and further inquiry
into this area is needed. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<82>
Accession Number
2023169227
Title
A Protocol to help the Prevent Postoperative Delirium in Cardiac Surgery.
Source
Trauma Monthly. 27(6) (pp 643-660), 2022. Date of Publication: November
2022.
Author
Moradi A.; Azimi A.V.; Moradian S.T.; Motamedi M.H.K.; Zavareh S.M.A.;
Mahmoudi H.
Institution
(Moradi) Students Research Center, Nursing Faulty, Baqiyatallah University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Azimi, Mahmoudi) Trauma research center, Nursing Faulty Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Moradian, Motamedi, Zavareh) Atherosclerosis Research Center,
Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Official Publication of the National Center for Trauma Research
Abstract
Introduction: Postoperative delirium (POD), a highly prevalent syndrome
after cardiac surgery, is characterized by a rapid decline in brain
function with inattention, disorganized thinking, and an altered level of
consciousness. It is clinically important because it is associated with
severe negative consequences. This study aimed to develop a protocol to
help the prevent postoperative delirium in cardiac surgery.
 Method(s): This multiphase design study consisted of two phases. The
first phase was a scoping review to identify risk factors associated with
POD in cardiac surgery. The second phase included three consecutive rounds
of expert panels based on a Delphi method to obtain consensus from experts
to determine and use these risk factors to develop a protocol. A scoping
review was performed using the Arksey and O'Malley framework. Literature
searches using PubMed/MEDLINE, Scopus, Web of Science, and ProQuest
databases were conducted. Two independent investigators performed the
selection of studies and data extraction via checklists. In the second
phase, based on two Delphi rounds, risk factors with a significant effect
on postoperative delirium in cardiac surgery were identified according to
the consensus of experts (>=75% agreement). In the third round of the
expert panel, only modifiable factors that could improve based on existing
conditions and context were used to develop a protocol. Result(s):
The final protocol was developed based on 20 pharmacological and
non-pharmacological interventions to prevent POD in three stages pre-,
intra-, and post-cardiac surgery. Conclusion(s): Interventions such
as prescribing melatonin instead of benzodiazepines, dexmedetomidine
treatment, preoperative education patients that were candidated for
cardiac surgery, training nurses, use of arterial filters and pre-bypass
filters in the perfusion circuit, prevention of intraoperative
hyperglycemia, cerebral oximetry and temperature management during CPB and
some interventions in ICU-OH can reduce POD in cardiac
surgery. Copyright © 2021 The Author(s).

<83>
Accession Number
2023037353
Title
Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand?.
Source
Reviews in Cardiovascular Medicine. 24(1) (no pagination), 2023. Article
Number: 10. Date of Publication: January 2023.
Author
Rakocevic J.; Dobric M.; Borovic M.L.; Milutinovic K.; Milenkovic S.;
Tomasevic M.
Institution
(Rakocevic, Borovic, Milutinovic) Institute of Histology and Embryology
"Aleksandar D. Kostic", Faculty of Medicine, University of Belgrade,
Belgrade 11000, Serbia
(Dobric) Institute for Cardiovascular Diseases "Dedinje", Belgrade 11000,
Serbia
(Dobric) Faculty of Medicine, University of Belgrade, Belgrade 11000,
Serbia
(Milenkovic) Faculty of Pharmacy, University of Belgrade, Belgrade 11000,
Serbia
(Tomasevic) Department of Internal Medicine, Faculty of Medical Sciences,
University of Kragujevac, Kragujevac 34000, Serbia
(Tomasevic) Cardiology Clinic, University Clinical Center of Serbia,
Belgrade 11000, Serbia
Publisher
IMR Press Limited
Abstract
Inflammation plays an important role in all stages of atherosclerosis -
from endothelial dysfunction, to formation of fatty streaks and
atherosclerotic plaque, and its progression to serious complications, such
as atherosclerotic plaque rupture. Although dyslipidemia is a key driver
of atherosclerosis, pathogenesis of atherosclerosis is now considered
interplay between cholesterol and inflammation, with the significant role
of the immune system and immune cells. Despite modern therapeutic
approaches in primary and secondary cardiovascular prevention,
cardiovascular diseases remain the leading cause of mortality worldwide.
In order to reduce residual cardiovascular risk, despite the
guidelines-guided optimal medical therapy, novel therapeutic strategies
are needed for prevention and management of coronary artery disease. One
of the innovative and promising approaches in atherosclerotic
cardiovascular disease might be inflammation-targeted therapy. Numerous
experimental and clinical studies are seeking into metabolic pathways
underlying atherosclerosis, in order to find the most suitable pathway and
inflammatory marker/s that should be the target for anti-inflammatory
therapy. Many anti-inflammatory drugs have been tested, from the
well-known broad range anti-inflammatory agents, such as colchicine,
allopurinol and methotrexate, to targeted monoclonal antibodies
specifically inhibiting a molecule included in inflammatory pathway, such
as canakinumab and tocilizumab. To date, there are no approved
anti-inflammatory agents specifically indicated for silencing inflammation
in patients with coronary artery disease. The most promising results came
from the studies which tested colchicine, and studies where the
inflammatory-target was NOD-, LRR- and pyrin domain-containing protein 3
(NLRP3) inflammasome/interleukin-1 beta (IL-1beta)/interleukin-6
(IL-6)/C-reactive protein (CRP) pathway. A growing body of evidence, along
with the ongoing clinical studies, suggest that the anti-inflammatory
therapy might become an additional strategy in treating atherosclerotic
cardiovascular disease. Herein we present an overview of the role of
inflammation in atherosclerosis, the most important inflammatory markers
chosen as targets of anti-inflammatory therapy, along with the critical
review of the major clinical trials which tested non-targeted and targeted
anti-inflammatory drugs in patients with atherosclerotic cardiovascular
disease. Copyright © 2023 The Author(s). Published by IMR Press.

<84>
Accession Number
2023037347
Title
The Effects of Inspiratory Muscle Training (IMT) on Patients Undergoing
Coronary Artery Bypass Graft (CABG) Surgery: A Systematic Review and
Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(1) (no pagination), 2023. Article
Number: 16. Date of Publication: January 2023.
Author
Zhang S.; Li B.; Meng X.; Zuo H.; Hu D.
Institution
(Zhang, Zuo, Hu) Division of Cardiology, Department of Internal Medicine,
Tongji Hospital, Tongji Medical College, Huazhong University of Science
and Technology, Hubei, Wuhan 430000, China
(Li) Department of Thoracic Surgery, Second Hospital of Jilin University,
Jilin, Changchun 130041, China
(Meng) Department of Cardiovascular and Cardiac Rehabilitation, Affiliated
Hospital of Changchun Traditional Chinese Medicine, Jilin, Changchun
130000, China
Publisher
IMR Press Limited
Abstract
Background: To determine the effects of inspiratory muscle training (IMT)
alone on inspiratory muscle strength and endurance, pulmonary function,
pulmonary complications, and length of hospital stay in patients
undergoing coronary artery bypass graft surgery (CABG). Method(s): We
conducted a literature search across databases (Ovid MEDLINE(R) and Epub
Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid
Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane
Database of Systematic Reviews, and Scopus) from inception to December
2021. The eligibility criteria were randomized controlled trials that
investigated the effects of IMT versus usual care or sham IMT in patients
undergoing CABG. Result(s): A total of 12 randomized clinical trials
with 918 patients were included in the meta-analysis. Postoperative IMT
was associated with improved maximal inspiratory pressure (MIP), maximum
inspiratory pressure (PImax), and six-minute walking test (6MWT) and with
a decrease in length of hospital stay (LOS). For preoperative IMT, there
was statistical significance between intervention and MIP, PImax, forced
expiratory volume in one second (FEV1), forced vital capacity (FVC),
postoperative pulmonary complications (PPCs), and LOS. Pre- and
postoperative IMT resulted in improvements in MIP. Conclusion(s):
Isolated IMT in patients who underwent CABG improved their inspiratory
muscle strength and endurance, pulmonary function, and 6MWT and helped
decrease postoperative pulmonary complications and the length of hospital
stay. Copyright © 2023 The Author(s). Published by IMR Press.

<85>
Accession Number
2023037343
Title
Low-Volume and High-Intensity Aerobic Interval Training May Attenuate
Dysfunctional Ventricular Remodeling after Myocardial Infarction: Data
from the INTERFARCT Study.
Source
Reviews in Cardiovascular Medicine. 24(1) (no pagination), 2023. Article
Number: 20. Date of Publication: January 2023.
Author
Aispuru-Lanche G.R.; Gallego-Munoz M.; Jayo-Montoya J.A.; Villar-Zabala
B.; Maldonado-Martin S.
Institution
(Aispuru-Lanche) Department of Physiology, Faculty of Medicine, University
of the Basque Country (UPV/EHU), Bizkaia, Basque Country, Leioa 48940,
Spain
(Aispuru-Lanche, Villar-Zabala) Primary Care Administration of Burgos,
Salud Castilla y Leon (Sacyl), Burgos 09267, Spain
(Gallego-Munoz) Department of Physiology, Faculty of Pharmacy, University
of the Basque Country (UPV/EHU), Alava/Araba, Basque Country,
Vitoria-Gasteiz 01006, Spain
(Jayo-Montoya) Department of Physical Education and Sport, Faculty of
Education and Sport, Physical Activity and Sport Sciences Section,
University of the Basque Country (UPV/EHU), Alava, Basque Country,
Vitoria-Gasteiz 01007, Spain
(Maldonado-Martin) GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea
(GIKAFIT), Society, Sports, and Physical Exercise Research Group,
Department of Physical Education and Sport, Faculty of Education and
Sport-Physical Activity and Sport Sciences Section, University of the
Basque Country (UPV/EHU), Araba/Alava, Basque Country, Vitoria-Gasteiz
01007, Spain
(Maldonado-Martin) Bioaraba Health Research Institute, Physical Activity,
Exercise, and Health group, Basque Country, Vitoria-Gasteiz 01007, Spain
Publisher
IMR Press Limited
Abstract
Background: Aerobic high-intensity interval training (HIIT) has
demonstrated benefits for ventricular remodeling after myocardial
infarction (MI) through various mechanisms. Despite this, the optimal
training volume is not well known. The present study aimed to assess the
effects of different (low vs. high volume) aerobic HIIT compared to an
attentional control (AC) group on echocardiographic and biochemical
indicators of left ventricular (LV) remodeling in adults after MI.
 Method(s): Randomized clinical trial conducted on post-MI patients
with preserved ventricular function. Participants were assigned to three
study groups. Two groups performed HIIT 2 d/week, one group with
low-volume HIIT (20 min, n = 28) and another with high-volume HIIT (40
min, n = 28). A third group was assigned to AC (n = 24) with
recommendations for unsupervised aerobic training. Left ventricular
echocardiographic parameters and cardiac biomarker levels (N-terminal
pro-b-type natriuretic peptide, NT-proBNP, soluble growth stimulation
expressed gene 2, ST2, troponin T, and creatine kinase) were assessed at
baseline and after the intervention (16 weeks). Result(s): Eighty
participants (58.4 +/- 8.3 yrs, 82.5% male) were included. Both low- and
high-volume HIIT showed increases (p < 0.05) in left ventricular
end-diastolic diameter (1.2%, 2.6%), and volume (1.1%, 1.3%),
respectively. Interventricular septal and posterior walls maintained their
thickness (p = 0.36) concerning the AC. Significant (p < 0.05) gain in
diastolic function was shown with the improvements in E (-2.1%, -3.3%), e'
waves (2.2%, 5.5%), and the deceleration time (2.1%, 2.9%), and in
systolic function with a reduction in global longitudinal strain (-3.2%,
-4.7%), respectively. Significant (p < 0.05) reductions of N-terminal
pro-B-type natriuretic peptide (NT-proBNP) (-4.8%, -11.1%) and of ST2
(-21.7%, -16.7%)were found in both HIIT groups respectively compared to
the AC group. Creatine kinase elevation was shown only in high-volume HIIT
(19.3%, p < 0.01). Conclusion(s): Low-volume HIIT is proposed as a
clinically time-efficient and safer strategy to attenuate dysfunctional
remodeling by preventing wall thinning and improving LV function in
post-MI patients. Copyright © 2023 The Author(s). Published by
IMR Press.

<86>
Accession Number
2023037326
Title
The Risk of Ventricular Arrhythmias between Alcohol Septal Ablation and
Septal Myectomy in Hypertrophic Cardiomyopathy: A Meta-Analysis on Septal
Reduction Therapy.
Source
Reviews in Cardiovascular Medicine. 23(12) (no pagination), 2022. Article
Number: 391. Date of Publication: December 2022.
Author
Tang W.; Liu M.; Li J.; Chang R.; Su C.; Zhang X.; Wang L.
Institution
(Tang, Liu, Li, Chang, Su, Zhang, Wang) Department of Cardiology, First
Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou
510080, China
(Tang, Liu, Li, Chang, Su, Zhang, Wang) Department of Medicine College,
Sun Yat-sen University, Guangdong, Guangzhou 510080, China
Publisher
IMR Press Limited
Abstract
Background: Alcohol septal ablation (ASA) has been more commonly applied
in medical refractory hypertrophic obstructive cardiomyopathy (HOCM)
compared with septal myectomy (SM), however its potential to create a
proarrhythmic substrate is increased. Method(s): A systematic search
was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library
from inception to October 2020. Fixed or random effects models were used
to estimate the risk ratios (RR) for ventricular arrhythmia events or
other outcomes between the SM and ASA cohorts. Result(s): Twenty
studies with 8025 patients were included. Pool analysis showed that the
incidence of ventricular tachycardia (VT)/ventricular fibrillation (VF),
which included appropriate implantable cardioverter defibrillator (ICD)
intervention, was significantly higher in the ASA cohort than that in the
SM cohort (ASA vs SM: 10% (345/3312) vs 5% (161/3227) (RR = 1.98, 95% CI
(confidence interval), 1.65-2.37 p < 0.00001, I2 = 0%). In both
groups, more than 90% of VT/VF events occurred in the early phase (during
the procedure, during hospitalization or within 30 days after the
procedure) (ASA: 94.20% SM: 94.41%). Further subgroup analysis also showed
that the ASA group had a higher incidence of VT/VF in both the early phase
(RR = 1.94, 95% CI, 1.61-2.33 p < 0.0001, I2 = 0%) and the late
phase (RR = 2.80, 95% CI, 1.00-7.89 p = 0.05, I2 = 33%).
Furthermore, although the risks of sudden cardiac death (SCD) were similar
between the ASA and SM groups, a higher incidence of sudden cardiac arrest
(SCA), which included SCD and resuscitated SCA, was observed in the ASA
group (RR = 2.30, 95% CI, 1.35-3.94 p = 0.002, I2 = 0%).
 Conclusion(s): In patients with HOCM, those who received ASA showed a
higher incidence of VF/VT and SCD combined with resuscitated SCA. The
majority of VT/VF occurred in the early phase. Copyright © 2022
The Author(s). Published by IMR Press. This is an open access article
under the CC BY 4.0 license.

<87>
Accession Number
2022921651
Title
Cardiac Fibrosis and Innervation State in Uncorrected and Corrected
Transposition of the Great Arteries: A Postmortem Histological Analysis
and Systematic Review.
Source
Journal of Cardiovascular Development and Disease. 10(4) (no pagination),
2023. Article Number: 180. Date of Publication: April 2023.
Author
Engele L.J.; van der Palen R.L.F.; Egorova A.D.; Bartelings M.M.; Wisse
L.J.; Glashan C.A.; Kies P.; Vliegen H.W.; Hazekamp M.G.; Mulder B.J.M.;
Ruiter M.C.D.; Bouma B.J.; Jongbloed M.R.M.
Institution
(Engele, Mulder, Bouma) Center for Congenital Heart Disease
Amsterdam-Leiden (CAHAL), Department of Clinical and Experimental
Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, Amsterdam
UMC, University of Amsterdam, Amsterdam 1105 AZ, Netherlands
(Engele) Netherlands Heart Institute, Utrecht 3511 EP, Netherlands
(van der Palen) Center for Congenital Heart Disease Amsterdam-Leiden
(CAHAL), Department of Pediatric Cardiology, Leiden University Medical
Center, Leiden 2333 ZA, Netherlands
(Egorova, Glashan, Kies, Vliegen, Jongbloed) Center for Congenital Heart
Disease Amsterdam-Leiden (CAHAL), Department of Cardiology, Leiden
University Medical Center, Leiden 2333 ZA, Netherlands
(Bartelings, Wisse, Ruiter, Jongbloed) Center for Congenital Heart Disease
Amsterdam-Leiden (CAHAL), Department of Anatomy and Embryology, Leiden
University Medical Center, Leiden 2333 ZA, Netherlands
(Hazekamp) Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL),
Department of Cardiothoracic Surgery, Leiden University Medical Center,
Leiden 2333 ZA, Netherlands
Publisher
MDPI
Abstract
In the transposition of the great arteries (TGA), alterations in
hemodynamics and oxygen saturation could result in fibrotic remodeling,
but histological studies are scarce. We aimed to investigate fibrosis and
innervation state in the full spectrum of TGA and correlate findings to
clinical literature. Twenty-two human postmortem TGA hearts, including TGA
without surgical correction (n = 8), after Mustard/Senning (n = 6), and
arterial switch operation (ASO, n = 8), were studied. In newborn
uncorrected TGA specimens (1 day-1.5 months), significantly more
interstitial fibrosis (8.6% +/- 3.0) was observed compared to control
hearts (5.4% +/- 0.8, p = 0.016). After the Mustard/Senning procedure, the
amount of interstitial fibrosis was significantly higher (19.8% +/- 5.1, p
= 0.002), remarkably more in the subpulmonary left ventricle (LV) than in
the systemic right ventricle (RV). In TGA-ASO, an increased amount of
fibrosis was found in one adult specimen. The amount of innervation was
diminished from 3 days after ASO (0.034% +/- 0.017) compared to
uncorrected TGA (0.082% +/- 0.026, p = 0.036). In conclusion, in these
selected postmortem TGA specimens, diffuse interstitial fibrosis was
already present in newborn hearts, suggesting that altered oxygen
saturations may already impact myocardial structure in the fetal phase.
TGA-Mustard/Senning specimens showed diffuse myocardial fibrosis in the
systemic RV and, remarkably, in the LV. Post-ASO, decreased uptake of
nerve staining was observed, implicating (partial) myocardial denervation
after ASO. Copyright © 2023 by the authors.

<88>
Accession Number
2021562020
Title
A Practical Approach to Systemic Mastocytosis Complications in Cardiac
Surgery: A Case Report and Systematic Review of the Literature.
Source
Journal of Clinical Medicine. 12(3) (no pagination), 2023. Article Number:
1156. Date of Publication: February 2023.
Author
Suleiman M.N.; Brueckl V.; Fechner J.; Kaemmerer A.-S.; Wilk F.; Weyand
M.; Harig F.
Institution
(Suleiman, Kaemmerer, Weyand, Harig) Department of Cardiac Surgery,
University Hospital Erlangen, Friedrich-Alexander-University
Erlangen-Nurnberg, Erlangen 91054, Germany
(Brueckl) Department of Haematology and Oncology, University Hospital
Erlangen, Friedrich-Alexander-University Erlangen-Nurnberg, Erlangen
91054, Germany
(Fechner, Wilk) Department of Anesthesiology, University Hospital
Erlangen, Friedrich-Alexander-University Erlangen-Nurnberg, Erlangen
91054, Germany
Publisher
MDPI
Abstract
(1) Background: Systemic mastocytosis is a rare, non-curable disease with
potential life-threatening complications in patients receiving cardiac
surgery. (2) Methods: This systematic review of the literature was
prompted by the case of a life-threatening anaphylactic reaction during
cardiac surgery related to systemic mastocytosis. The search of all types
of studies, using several databases (Pubmed, Scopus and Web of Science),
was conducted through September 2022 to identify the relevant studies. (3)
Results: Twelve studies were included describing cases of patients
undergoing cardiac surgery who were diagnosed with systemic mastocytosis.
An adverse effect, namely anaphylaxis, has happened in three cases.
Different strategies of premedication, intraoperative and postoperative
management were used. In our case, the patient was admitted for elective
biological aortic valve replacement due to severe aortic stenosis.
Intraoperatively, the patient developed an anaphylactic shock during the
administration of protamine after separation from the cardiopulmonary
bypass. This anaphylaxis reaction was a complication of the pre-existing
systemic mastocytosis and could be successfully managed by the
administration of epinephrine, antihistamines and corticosteroids. (4)
 Conclusion(s): This systematic literature search and case report
highlight the importance of careful preoperative planning, as well as
coordination between cardiac surgeons, anesthesiologists and
hemato-oncological specialists, in patients with rare but
complication-prone diseases such as systemic mastocytosis. Copyright
© 2023 by the authors.

<89>
Accession Number
2021135856
Title
Risk Factors for Anticoagulant-Associated Intracranial Hemorrhage: A
Systematic Review and Meta-analysis.
Source
Neurocritical Care. 38(3) (pp 812-820), 2023. Date of Publication: June
2023.
Author
Zeng Z.; Chen J.; Qian J.; Ma F.; Lv M.; Zhang J.
Institution
(Zeng, Chen, Qian, Ma, Zhang) Department of Pharmacy, Fujian Maternity and
Child Health Hospital, College of Clinical Medicine for Obstetrics and
Gynecology and Pediatrics, Fujian Medical University, #18 Daoshan Road,
Fuzhou 350001, China
(Lv) Department of Pharmacy, Fujian Medical University Union Hospital,
Fuzhou, China
Publisher
Springer
Abstract
Background: Anticoagulant-associated intracranial hemorrhage has a high
mortality rate, and many factors can cause intracranial hemorrhage. Until
now, systematic reviews and assessments of the certainty of the evidence
have not been published. Method(s): We conducted a systematic review
to identify risk factors for anticoagulant-associated intracranial
hemorrhage. The protocol for this systematic review was prospectively
registered with PROSPERO (CRD42022316750). All English studies that met
the inclusion criteria published before January 2022 were obtained from
PubMed, EMBASE, Web of Science, and Cochrane Library. Two researchers
independently screened articles, extracted data, and evaluated the quality
and evidence of the included studies. Risk factors for intracranial
hemorrhage were used as the outcome index of this review. Random or
fixed-effect models were used in statistical methods. I2
statistics were used to evaluate heterogeneity. Result(s): Of 7322
citations, we included 20 studies in our analysis. For intracranial
hemorrhage, moderate-certainty evidence showed a probable association with
race, Glasgow Coma Scale, stroke, leukoaraiosis, cerebrovascular disease,
tumor, atrial fibrillation, previous bleeding, international normalized
ratio, serum albumin, prothrombin time, diastolic blood pressure, and
anticoagulant. Low-certainty evidence may be associated with age, cerebral
microbleeds, smoking, alcohol intake, platelet count, and antiplatelet
drug. In addition, we found very low-certainty evidence that there may be
little to no association between the risk of intracranial hemorrhage and
hypertension and creatinine clearance. Leukoaraiosis, cerebral
microbleeds, cerebrovascular disease, and international normalized ratio
are not included in most risk assessment models. Conclusion(s): This
study informs risk prediction for anticoagulant-associated intracranial
hemorrhage and informs guidelines for intracranial hemorrhage prevention
and future research. Copyright © 2023, Springer Science+Business
Media, LLC, part of Springer Nature and Neurocritical Care Society.

<90>
Accession Number
2021011244
Title
Cost-Effectiveness of SAPIEN 3 Transcatheter Aortic Valve Implantation
Versus Surgical Aortic Valve Replacement in German Severe Aortic Stenosis
Patients at Low Surgical Mortality Risk.
Source
Advances in Therapy. 40(3) (pp 1031-1046), 2023. Date of Publication:
March 2023.
Author
Kuck K.H.; Leidl R.; Frankenstein L.; Wahlers T.; Sarmah A.; Candolfi P.;
Shore J.; Green M.
Institution
(Kuck) Department of Cardiology, University Heart Center, Lubeck, Germany
(Leidl) Institute of Health Economics and Health Care Management,
Helmholtz Zentrum Munchen, Neuherberg, Germany
(Frankenstein) Department of Cardiology, Angiology, and Pulmonology,
University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120,
Germany
(Wahlers) Department of Cardiothoracic Surgery, University Hospital of
Cologne, Cologne, Germany
(Sarmah, Candolfi) Edwards Lifesciences SA, Nyon, Switzerland
(Shore, Green) York Health Economics Consortium, University of York, York,
United Kingdom
(Kuck) LANS Cardio, Hamburg, Germany
(Leidl) Munich School of Management, Ludwig-Maximilians-Universitat,
Munich, Germany
Publisher
Adis
Abstract
Introduction: In the randomized PARTNER 3 trial, transcatheter aortic
valve implantation (TAVI) with the SAPIEN 3 device significantly reduced a
composite of all-cause death, stroke, and rehospitalization, compared with
surgical aortic valve replacement (SAVR), in patients with severe
symptomatic aortic stenosis and low risk of surgical mortality.
Furthermore, TAVI has been shown to be cost-effective in low-risk
patients, compared with SAVR, in a number of countries. This study aimed
to determine the cost-effectiveness of TAVI with SAPIEN 3 versus SAVR in
Germany. Method(s): A previously published two-stage Markov-based
model that captured clinical outcomes from the PARTNER 3 trial was adapted
for the German context using the German Statutory Health Insurance
perspective. The model had a lifetime horizon. The cost-utility analysis
estimated changes in direct healthcare costs as well as survival and
health-related quality of life using TAVI with SAPIEN 3 compared with
SAVR. Result(s): TAVI with SAPIEN 3 increased quality-adjusted life
years (QALYs) by + 0.72 at an increased cost of 8664 per patient. The
incremental cost-effectiveness/QALY ratio was 12,037, which fell below
that of other cardiovascular interventions in use in Germany. The
cost-effectiveness of TAVI over SAVR remained robust across multiple
challenging scenarios and was driven by lower longer-term management costs
compared with SAVR. Conclusion(s): TAVI with SAPIEN 3 appears to be a
clinically meaningful, cost-effective treatment option over SAVR for
patients with severe symptomatic aortic stenosis and low risk for surgical
mortality in Germany. Clinical Trial Registration Number:
www.clinicaltrials.gov identifier: NCT02675114. Copyright © 2023,
The Author(s).

<91>
Accession Number
2019190380
Title
Minimally Invasive Bimanual Fetal Surgery-A Review.
Source
Children. 9(9) (no pagination), 2022. Article Number: 1377. Date of
Publication: September 2022.
Author
Brunner S.E.; Durmaz L.-O.; Meinzer A.; Arp M.; Krebs T.F.; Bergholz R.
Institution
(Brunner, Durmaz, Meinzer, Arp, Krebs, Bergholz) Department of General,
Visceral, Thoracic, Transplant and Pediatric Surgery, University Medical
Center Schleswig-Holstein (UKSH), Kiel Campus, Arnold-Heller-Strasse 3,
Kiel 24105, Germany
(Krebs) Department of Pediatric Surgery, Children's Hospital of Eastern
Switzerland, Claudiusstrasse 6, St. Gallen 9006, Switzerland
Publisher
MDPI
Abstract
Background: The aim of this review is to discuss experimental and clinical
techniques and interventions of fetal surgery which have been performed
minimally invasively by the means of a three-port approach for the
fetoscope and instruments for the left and right hand of the surgeon
(bimanual minimally invasive fetal surgery). Method(s): a print and
electronic literature search was performed; the titles and abstracts were
screened and included reports were reviewed in a two-step approach. First,
reports other than minimally invasive fetal surgery were excluded, then a
full text review and analysis of the reported data was performed.
 Result(s): 17 reports were included. The heterogeneity of the
included reports was high. Although reports on human fetoscopic surgical
procedures can be found, most of them do not pick out bimanual fetal
surgery as a central theme but rather address interventions applying a
fetoscope with a working channel for a laser fiber, needle or flexible
instrument. Most reports were on experimentation in animal models, the
human application of minimally invasive fetoscopic bimanual surgery is
rare and has at best been explored for the prenatal treatment of spina
bifida. Some reported bimanual fetoscopic procedures were performed on the
exteriorized uterus via a maternal laparotomy and can therefore not be
classified as being truly minimally invasive. Discussion(s): our
results demonstrate that minimally invasive fetoscopic bimanual surgery is
rare, even in animal models, excluding many other techniques and
procedures that are loosely termed 'minimally invasive fetal surgery'
which we suggest to better label as 'interventions'. Thus, more research
on percutaneous minimally invasive bimanual fetoscopic surgery is
warranted, with the aim to reduce the maternal, uterine and fetal trauma
for correction of congenital malformations. Copyright © 2022 by
the authors.

<92>
Accession Number
2025050957
Title
Predicting 5-Year Clinical Outcomes After Transcatheter or Surgical Aortic
Valve Replacement (a Risk Score from the SURTAVI Trial).
Source
American Journal of Cardiology. 200 (pp 78-86), 2023. Date of Publication:
01 Aug 2023.
Author
van Bergeijk K.H.; Wykrzykowska J.J.; van Mieghem N.M.; Windecker S.;
Sondergaard L.; Gada H.; Li S.; Hanson T.; Deeb G.M.; Voors A.A.; Reardon
M.J.
Institution
(van Bergeijk, Wykrzykowska, Voors) University Medical Center Groningen,
University of Groningen, Groningen, Netherlands
(van Mieghem) Erasmus University Medical Center Rotterdam, Rotterdam,
Netherlands
(Windecker) University of Bern, Bern, Switzerland
(Sondergaard) The Heart Center Copenhagen, Copenhagen, Denmark
(Gada) University of Pittsburgh Medical Center Pinnacle Health,
Pittsburgh, Pennsylvania, United States
(Li, Hanson) Statistical Services, Medtronic, Minneapolis, MN, United
States
(Deeb) University of Michigan, Ann Arbor, MI, United States
(Reardon) Houston Methodist DeBakey Heart and Vascular Center, Houston,
Texas
Publisher
Elsevier Inc.
Abstract
Risk prediction scores for long-term outcomes after transcatheter aortic
valve implantation (TAVI) or surgical aortic valve replacement (SAVR) are
lacking. This study aimed to develop preprocedural risk scores for 5-year
clinical outcomes after TAVI or SAVR. This analysis included 1,660
patients at an intermediate surgical risk with severe aortic stenosis
randomly assigned to TAVI (n = 864) or SAVR (n = 796) from the SURTAVI
(Surgical Replacement and Transcatheter Aortic Valve Implantation) trial.
The primary end point was a composite of all-cause mortality or disabling
stroke at 5 years. The secondary end point was a composite of
cardiovascular mortality or hospitalizations for valve disease or
worsening heart failure at 5 years. Preprocedural multivariable predictors
of clinical outcomes were used to calculate a simple risk score for both
procedures. At 5 years, the primary end point occurred in 31.3% of the
patients with TAVI and 30.8% of the patients with SAVR. Preprocedural
predictors differed between TAVI and SAVR. Baseline anticoagulant use was
a common predictor for events in both procedures, whereas male sex and a
left ventricular ejection fraction <60% were significant predictors for
events in patients with TAVI and SAVR, respectively. A total of 4 simple
scoring systems were created based on these multivariable predictors. The
C-statistics of all models were modest but performed better than the
contemporary risk scores. In conclusion, preprocedural predictors of
events differ between TAVI and SAVR, necessitating separate risk models.
Despite the modest predictive value of the SURTAVI risk scores, they
appeared superior to other contemporary scores. Further research is needed
to strengthen and validate our risk scores, possibly by including
biomarker and echocardiographic parameters. Copyright © 2023 The
Author(s)

<93>
Accession Number
2023804300
Title
Ultrasonic scalpel versus electrocautery for internal mammary artery
harvesting: a meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2023. Date
of Publication: 2023.
Author
Kaneyuki D.; Patil S.; Jackson J.; Ahmad D.; Plestis K.A.; Guy T.S.;
Massey H.T.; Entwistle J.W.; Morris R.J.; Tchantchaleishvili V.
Institution
(Kaneyuki, Patil, Jackson, Ahmad, Plestis, Guy, Massey, Entwistle, Morris,
Tchantchaleishvili) Division of Cardiac Surgery, Department of Surgery,
Thomas Jefferson University, 1025 Walnut St, Suite 607, Philadelphia, PA
19107, United States
Publisher
Springer
Abstract
Objective: Although an ultrasonic harmonic scalpel (HS) has been used to
harvest the internal mammary artery (IMA) for coronary artery bypass
grafting, the benefits and risks compared to conventional electrocautery
(EC) are not clear. We aimed to compare the outcomes of HS versus EC for
IMA harvesting. Method(s): An electronic search was performed to
identify all relevant studies. Baseline characteristics, perioperative
variables, and clinical outcomes were extracted and pooled for
meta-analysis. Result(s): This meta-analysis included 12 studies.
Pooled analyses demonstrated that both groups had comparable preoperative
baseline characteristics including age, gender, and left ventricular
ejection fraction. HS included more diabetic patients [33% (95% CI 30, 35)
vs. 27% (23, 31), p = 0.01]. Harvest time for unilateral IMA was
significantly longer with HS than EC [39 (31, 47) minutes vs. 25 (17, 33)
minutes, p < 0.01]. However, the rate of pedicled unilateral IMA was
significantly higher for EC compared with HS [20% (17, 24) vs. 8% (7, 9),
p < 0.01]. The rate of intact endothelium was significantly higher with HS
than EC [95% (88, 98) vs. 81% (68, 89), p < 0.01). There was no
significant difference in postoperative outcomes including bleeding [3%
(2, 4)], sternal infection [3% (2, 4)], and operative/30-day mortality [3%
(2, 4)]. Conclusion(s): HS required longer IMA harvest times which
could be partially attributed to a higher skeletonization rate in this
category. HS may cause less endothelial injury than EC; however, no
significant differences in postoperative outcomes were seen between the
groups. Copyright © 2023, The Author(s), under exclusive licence
to The Japanese Association for Thoracic Surgery.

<94>
Accession Number
2022708433
Title
Pragmatic evaluation of events and benefits of lipid lowering in older
adults (PREVENTABLE): Trial design and rationale.
Source
Journal of the American Geriatrics Society. 71(6) (pp 1701-1713), 2023.
Date of Publication: June 2023.
Author
Joseph J.; Pajewski N.M.; Dolor R.J.; Sellers M.A.; Perdue L.H.; Peeples
S.R.; Henrie A.M.; Woolard N.; Jones W.S.; Benziger C.P.; Orkaby A.R.;
Mixon A.S.; VanWormer J.J.; Shapiro M.D.; Kistler C.E.; Polonsky T.S.;
Chatterjee R.; Chamberlain A.M.; Forman D.E.; Knowlton K.U.; Gill T.M.;
Newby L.K.; Hammill B.G.; Cicek M.S.; Williams N.A.; Decker J.E.; Ou J.;
Choudhary G.; Gazmuri R.J.; Schmader K.E.; Roumie C.L.; Vaughan C.P.;
Effron M.B.; Cooper-DeHoff R.M.; Supiano M.A.; Shah R.C.; Whittle J.C.;
Hernandez A.F.; Ambrosius W.T.; Williamson J.D.; Alexander K.P.; Romashkan
S.; Fine L.; Weiner M.; Cooper-DeHoff R.; Jones S.; Callahan K.; Espinoza
S.; Rubinstein J.; Snyder H.; Carrillo M.; Rothman R.; Shenkman B.; Carton
T.; Nauman B.; McTique K.; Jefferson M.; Wing J.; Bloodworth S.; Owens A.;
Bordelon L.; Heimberg M.; Massey J.; Gonzalez M.; Brashears B.; Kaczkowski
K.; King M.; Hoisington K.; Lovato J.; Almonte J.; White J.; Gaziano M.;
Lovato L.; Poddar K.; Taylor Z.; Hunt D.; Hervey J.; Kelsey M.; Leverty
R.; Batch B.; Richmond A.; Hufstedler M.; Chang A.; Hetzel J.; Laffey M.;
Pahor M.; Houston D.; Kitzman D.; Rapp S.; Sachs B.; Lang S.; Nulph R.;
Rives E.; Zieman S.; Newman A.; Kapitanovsky K.; Reboussin D.; Cicek M.;
Halverson K.; Gaussoin S.; Dohner C.; Monds P.; Alred C.; Bowman J.; Bunke
J.; Deckard N.; Lowe T.; Thiel R.; VanDoren K.; Whiteside H.; Reuben D.;
Peduzzi P.; Solomon S.; Florez H.; Breitner J.; Greenland P.; Travison T.;
Waitman R.; Bancks M.; Burnet K.; Telzak A.; Vanterpool Y.E.; Oberembt S.;
Davies I.; Shade L.; Strout K.; Kitzman H.; Patel M.; Rao G.; Ufholz K.;
Rao S.; Cardoso E.; Allen J.; Kulshreshtha A.; Brown W.; Cripps S.; Ford
D.; Gauvey-Kern M.; Meilander A.; Kohnhorst D.; Rosas S.; Druckrey J.;
Loepfe T.; Kaseno J.; Berendt M.; Akatue R.; Houtschilt S.; Linder J.;
Brown T.; Bazzano L.; Williams S.; Brill S.; Jindra M.; Yurko E.; Tapan
M.; Kirkwood L.; Azhar G.; Pangle A.; Carlson M.; Lu J.; Wells B.; Gordon
H.; Ashley N.; Ernst M.; Grdinovac K.; Lower E.; Hart J.; Carrasquillo O.;
Linares V.; Hall M.; Boyer L.; Hahn-Cover K.; Grieshaber V.; Fisher A.;
Kirke S.; Ake J.; Klawson E.; Lee J.; Johnson K.; Musi N.; Brown K.; Rubin
C.; Thompson G.; Bah H.; Wharton J.; Wall M.; Zamora E.; Betancourt J.;
Binder E.; Young A.; Goyal P.; Park F.; Almonte A.; Carlsson C.; Zylstra
H.; Munoz A.; Tinker A.; Soe K.; Clarke J.-A.; Vu K.; Hy C.; Lee C.; Zeng
A.; Hallock A.; Reuben-Hallock K.; Malm B.; Spreyer K.; Yaksic E.; Lee P.;
Runge C.; Kundu S.; Chau K.; Rodriguez-Cintron W.; Fuentes-Medina S.;
White S.M.; Liu M.; Romero I.; Tavabi A.; Penny W.; St. John M.; Eleazer
P.; Thongsa S.; Krishnasamy S.; Ricks J.; Walsh J.; Espique L.; Fernandes
J.; Willis T.; Ricci A.; Peek B.; Michael J.; Lockhart M.; Hall D.; Withee
C.; Markland A.; Davis D.; Todela T.; Sullivan D.; Sawyer L.; Lorscheter
J.; Gupta A.; Castle T.; Reynolds J.; Kramer H.; Kirchner K.; Spencer
A.K.; Godschalk M.; Taylor C.; Atlas S.; Guerrero R.B.; Kansal M.; Tenorio
J.; Singh V.; Kiran S.; Albert M.; Knipping V.; Childress R.; Beaverson
B.; Tamariz L.; Denizard J.; Peruvemba S.; Venetucci J.; Shivaswamy V.;
Ramalingam R.
Institution
(Joseph) VA Providence Healthcare System, Providence, RI, United States
(Pajewski, Perdue, Woolard, Shapiro, Ambrosius, Williamson) Wake Forest
University School of Medicine, Winston-Salem, NC, United States
(Dolor, Sellers, Jones, Chatterjee, Newby, Hammill, Hernandez, Alexander)
Duke Clinical Research Institute, Duke University School of Medicine,
Durham, NC, United States
(Peeples) VA Boston Healthcare System, Boston, MA, United States
(Henrie) Cooperative Studies Program Clinical Research Pharmacy
Coordinating Center, Office of Research and Development, Department of
Veterans Affairs, Albuquerque, NM, United States
(Benziger) Essentia Health, Duluth, MN, United States
(Orkaby) New England Geriatric Research, Education, and Clinical Center
(GRECC), VA Boston Healthcare System, and Division of Aging, Brigham &
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Mixon, Roumie) Vanderbilt University Medical Center and Geriatric
Research Education and Clinical Center (GRECC), VA Tennessee Valley
Healthcare System, Nashville, TN, United States
(VanWormer) Marshfield Clinical Research Institute, Marshfield, WI, United
States
(Kistler) Department of Family Medicine, School of Medicine, University of
North Carolina at Chapel Hill, NC, United States
(Polonsky) University of Chicago Medicine, Chicago, IL, United States
(Chamberlain, Cicek) Mayo Clinic, Rochester, MN, United States
(Forman) Department of Medicine, Sections of Geriatrics and Cardiology,
University of Pittsburgh, Pittsburgh GRECC, VA Pittsburgh Healthcare
System, Pittsburgh, PA, United States
(Knowlton) Intermountain Healthcare, Salt Lake City, UT, United States
(Gill) Yale School of Medicine, New Haven, CT, United States
(Williams) TN CEAL, Nashville, TN, United States
(Decker) Section of Primary Care Medicine, Medical College of Wisconsin,
Milwaukee, WI, United States
(Ou) Cardiology Division, John Cochran VA Medical Center and Cardiology
Division, Washington University School of Medicine, St. Louis, MO, United
States
(Rubinstein) Division of Cardiology, Cincinnati VAMC and Division of
Cardiovascular Diseases, Department of Internal Medicine, College of
Medicine, University of Cincinnati, Cincinnati, OH, United States
(Choudhary) Providence VA Medical Center, and Lifespan Cardiovascular
Institute, Alpert Medical School of Brown University, Providence, RI,
United States
(Gazmuri) Captain James A. Lovell Federal Health Care Center, Rosalind
Franklin University of Medicine and Science, Chicago, IL, United States
(Schmader) Duke University and GRECC, Durham VA Medical Center, Durham,
NC, United States
(Vaughan) Birmingham/Atlanta Geriatric Research Education and Clinical
Center (GRECC), Department of Veterans Affairs, and Division of Geriatrics
& Gerontology, Department of Medicine, Emory University, Atlanta, GA,
United States
(Effron) John Ochsner Heart and Vascular Institute, The University of
Queensland Ochsner Clinical School, New Orleans, LA, United States
(Cooper-DeHoff) University of Florida, College of Pharmacy and College of
Medicine, Gainesville, FL, United States
(Supiano) The University of Utah, Salt Lake, UT, United States
(Shah) Family & Preventive Medicine and the Rush Alzheimer's Disease
Center, Rush University, Chicago, IL, United States
(Whittle) Clement J Zablocki VA Medical Center, Milwaukee, WI, United
States
Publisher
John Wiley and Sons Inc
Abstract
Whether initiation of statins could increase survival free of dementia and
disability in adults aged >=75 years is unknown. PREVENTABLE, a
double-blind, placebo-controlled randomized pragmatic clinical trial, will
compare high-intensity statin therapy (atorvastatin 40 mg) with placebo in
20,000 community-dwelling adults aged >=75 years without cardiovascular
disease, disability, or dementia at baseline. Exclusion criteria include
statin use in the prior year or for >5 years and inability to take a
statin. Potential participants are identified using computable phenotypes
derived from the electronic health record and local referrals from the
community. Participants will undergo baseline cognitive testing, with
physical testing and a blinded lipid panel if feasible. Cognitive testing
and disability screening will be conducted annually. Multiple data sources
will be queried for cardiovascular events, dementia, and disability;
survival is site-reported and supplemented by a National Death Index
search. The primary outcome is survival free of new dementia or persisting
disability. Co-secondary outcomes are a composite of cardiovascular death,
hospitalization for unstable angina or myocardial infarction, heart
failure, stroke, or coronary revascularization; and a composite of mild
cognitive impairment or dementia. Ancillary studies will offer mechanistic
insights into the effects of statins on key outcomes. Biorepository
samples are obtained and stored for future study. These results will
inform the benefit of statins for increasing survival free of dementia and
disability among older adults. This is a pioneering pragmatic study
testing important questions with low participant burden to align with the
needs of the growing population of older adults. Copyright © 2023
The American Geriatrics Society. This article has been contributed to by
U.S. Government employees and their work is in the public domain in the
USA.

<95>
Accession Number
2020930749
Title
Assessing the impact of publications: A bibliometric analysis of the
top-cited articles from The Journal of Thoracic and Cardiovascular
Surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(5) (pp 1901-1916),
2023. Date of Publication: May 2023.
Author
Castro-Varela A.; Schaff H.V.
Institution
(Castro-Varela, Schaff) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minn, United States
Publisher
Elsevier Inc.
Abstract
Objective: After 90 years, The Journal of Thoracic and Cardiovascular
Surgery (JTCVS) remains one of the most influential and widely read
journals in our specialty. This study analyzes the characteristics of its
top-cited articles over the past 6 decades. Method(s): Using
Elsevier's Scopus database, we identified all papers published in JTCVS
since 1959. After exclusion of expert consensus guidelines, articles were
grouped by decade and ranked by the total number of citations. We included
the field-weighted citation impact (FWCI) when available. We analyzed the
characteristics of the 10 most cited documents overall and per decade.
 Result(s): The Journal published a total of 32,335 papers, of which
14,052 were published between 2010 and 2021. The order of the top-cited
articles differs when ranked by citations versus FWCI. During the last 6
decades, the 10 most cited articles per decade have a mean number of 604
citations (range, 240-1670) and a mean FWCI of 13.1 (range, 4.3-24.7).
There is no overlap in positions when articles are ranked by citations
versus FWCI. The majority of the 60 top 10 cited articles over the past 6
decades were presented at a major meeting (n = 38, 63%), most commonly the
Annual Meeting of the American Association for Thoracic Surgery. Topics in
adult cardiac surgery and general thoracic surgery predominated among the
most-cited papers, which originated most often from the United States
followed by Japan, Canada, France, England, and Germany.
 Conclusion(s): JTCVS continues to provide a global platform to share
impactful knowledge related to surgery for thoracic diseases. The use of
citations to determine an article's impact has limitations and
nontraditional metrics may prove to be an excellent complementary tool for
more equitable evaluations. Copyright © 2022 The American
Association for Thoracic Surgery

<96>
Accession Number
2005150148
Title
Effect of early mobilization on physical function in patients after
cardiac surgery: A systematic review and meta-analysis.
Source
International Journal of Environmental Research and Public Health. 17(19)
(pp 1-11), 2020. Article Number: 7091. Date of Publication: 01 Oct 2020.
Author
Kanejima Y.; Shimogai T.; Kitamura M.; Ishihara K.; Izawa K.P.
Institution
(Kanejima, Shimogai, Kitamura, Ishihara, Izawa) Department of Public
Health, Graduate School of Health Sciences, Kobe University, Kobe
654-0142, Japan
(Kanejima, Shimogai, Kitamura, Ishihara, Izawa) Cardiovascular Stroke
Renal Project (CRP), Kobe 654-0142, Japan
(Kanejima, Shimogai) Department of Rehabilitation, Kobe City Medical
Center General Hospital, Kobe 650-0047, Japan
(Kitamura) Department of Physical Therapy, Kokura Rehabilitation College,
2-10 Kuzuharahigashi 2-chome, Kokuraminami-ku, Kitakyushu 800-0206, Japan
(Ishihara) Department of Rehabilitation, Sakakibara Heart Institute of
Okayama, 5-1 Nakaicho 2-chome, Kita-ku, Okayama 700-0804, Japan
Publisher
MDPI
Abstract
The objective effects of early mobilization on physical function in
patients after cardiac surgery remain unknown. The purpose of the present
study was to clarify the effects of early mobilization on physical
function in patients after cardiac surgery through meta-analysis. Four
electronic databases were searched on 2 August 2019. We used search
keywords related to "early mobilization", "cardiac surgery", and
"randomized controlled trials". All randomized controlled trials
conducting early mobilization after cardiac surgery were included. We
defined early mobilization as the application of physical activity within
the first five postoperative days. Citations and data extraction were
independently screened in duplicate by two authors. The meta-analysis was
conducted using random-effects modeling with EZR software. The primary
outcome was the distance walked during the six-minute walking test at
hospital discharge. Six randomized controlled trials comprising 391
patients were included following screening of 591 studies. All studies
included coronary artery bypass grafting as the cardiac surgery conducted.
Early mobilization started on postoperative days 1-2 and was conducting
twice daily. Early mobilization showed a trend of being combined with
respiratory exercise or psychoeducation. The meta-analysis showed that the
distance walked during the 6-min walking test improved by 54 m (95%
confidence interval, 31.1-76.9; I2 = 52%) at hospital
discharge. The present study suggested that early mobilization after
cardiac surgery may improve physical function at discharge. Copyright
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.

<97>
Accession Number
2003238021
Title
Intraoperative blood pressure variability predicts postoperative mortality
in non-cardiac surgery-A prospective observational cohort study.
Source
International Journal of Environmental Research and Public Health. 16(22)
(no pagination), 2019. Article Number: 4380. Date of Publication: 02 Nov
2019.
Author
Wiorek A.; Krzych L.J.
Institution
(Wiorek, Krzych) Department of Anaesthesiology and Intensive Care, School
of Medicine in Katowice, Medical University of Silesia, 14 Medykow Street,
Katowice 40-752, Poland
Publisher
MDPI
Abstract
Little is known about the clinical importance of blood pressure
variability (BPV) during anesthesia in non-cardiac surgery. We sought to
investigate the impact of intraoperative BPV on postoperative mortality in
non-cardiac surgery subjects, taking into account patient-and
procedure-related variables. This prospective observational study covered
835 randomly selected patients who underwent gastrointestinal (n = 221),
gynecological (n = 368) and neurosurgical (n = 246) procedures. Patient's
and procedure's risks were assessed according to the validated tools and
guidelines. Blood pressure (systolic, SBP, and diastolic, DBP) was
recorded in five-minute intervals during anesthesia. Mean arterial
pressure (MAP) was assessed. Individual coefficients of variation (Cv)
were calculated. Postoperative 30-day mortality was considered the
outcome. Median SBP_Cv was 11.2% (IQR 8.4-14.6), DBP_Cv was 12.7% (IQR
9.8-16.3) and MAP_Cv was 10.96% (IQR 8.26-13.86). Mortality was 2%. High
SBP_Cv (i.e., >=11.9%) was associated with increased mortality by 4.5
times (OR = 4.55; 95% CI 1.48-13.93; p = 0.008). High DBP_Cv (i.e.,
>=22.4%) was associated with increased mortality by nearly 10 times (OR =
9.73; 95% CI 3.26-28.99; p < 0.001). High MAP_Cv (i.e., >=13.6%) was
associated with increased mortality by 3.5 times (OR = 3.44; 95% CI
1.34-8.83; p = 0.01). In logistic regression, it was confirmed that the
outcome was dependent on both SBPV and DBPV, after adjustment for
perioperative variables, with AUCSBP_Cv = 0.884 (95% CI 0.859-0.906; p <
0.001) and AUCDBP_Cv = 0.897 (95% CI 0.873-0.918; p < 0.001). Therefore,
intraoperative BPV may be considered a prognostic factor for the
postoperative mortality in non-cardiac surgery, and DBPV seems more
accurate in outcome prediction than SBPV. Copyright © 2019 by the
authors. Licensee MDPI, Basel, Switzerland.

<98>
[Use Link to view the full text]
Accession Number
634770247
Title
Prevalence of ICU Delirium in Postoperative Pediatric Cardiac Surgery
Patients.
Source
Pediatric Critical Care Medicine. 22(1) (pp 68-78), 2021. Date of
Publication: 01 Jan 2021.
Author
Staveski S.L.; Pickler R.H.; Khoury P.R.; Ollberding N.J.; Donnellan A.L.;
Mauney J.A.; Lincoln P.A.; Baird J.D.; Gilliland F.L.; Merritt A.D.;
Presnell L.B.; Lanese A.R.; Lisanti A.J.; Large B.J.; Fineman L.D.; Gibson
K.H.; Mohler L.A.; Callow L.; Barnes S.S.; Whalen R.L.; Grant M.J.C.;
Sheppard C.; Kline-Tilford A.M.; Steadman P.W.; Shafland H.C.; Corlett
K.M.; Kelly S.P.; Ortman L.A.; Peyton C.E.; Hagstrom S.K.; Shields A.M.;
Nye T.; Alvarez T.C.E.; Justice L.B.; Kidwell S.T.; Redington A.N.; Curley
M.A.Q.
Institution
(Staveski) University of California San Francisco, School of Nursing, San
Francisco, CA, United States
(Pickler) The Ohio State University College of Nursing, Columbus, OH,
United States
(Khoury, Donnellan, Justice, Kidwell) Cincinnati Children's Hospital
Medical Center, Heart Institute, Cincinnati, OH, United States
(Ollberding) Division of Biostatistics and Epidemiology, Cincinnati
Children's Hospital Medical Center, Cincinnati, OH, United States
(Mauney) Department of Pediatrics, Critical Care Baylor, College of
Medicine, Houston, TX, United States
(Lincoln) Cardiac Intensive Care Unit, Department of Nursing, Boston
Children's Hospital, Boston, MA, United States
(Baird) Institute for Nursing and Interprofessional Research, Children's
Hospital Los Angeles, Los Angeles, CA, United States
(Gilliland) Cardiovascular Intensive Care Unit, Department of Nursing,
John Hopkins All Children's Hospital, St. Petersburg, FL, United States
(Merritt) Cardiac Intensive Care Unit, Department of Nursing, Children's
National Health Systems, Washington, DC, United States
(Presnell) Cardiovascular Intensive Care Unit, Department of Nursing,
Lucile Packard Children's Hospital, Palo Alto, CA, United States
(Lanese) Department of Child Health Evaluative Sciences, The Hospital for
Sick Children, Toronto, ON, Canada
(Lisanti) Cardiac Nursing, Department of Nursing, Children's Hospital of
Philadelphia, Philadelphia, PA, United States
(Large) Division of Cardiovascular Intensive Care, Phoenix Children's
Hospital, Phoenix, AZ, United States
(Fineman) Pediatric Intensive Care Unit, Department of Nursing, Ucsf
Benioff Children's Hospital, San Francisco, CA, United States
(Gibson) Cardiac Intensive Care Unit, Department of Nursing, Children's
Healthcare of Atlanta, Atlanta, GA, United States
(Mohler) Cardiovascular Intensive Care Unit, Department of Nursing,
Children's Hospital of Orange County, Orange, CA, United States
(Callow) Pediatric Cardiac Surgery, Department of Nursing, Congenital
Heart Center, Mott Children's Hospital, Ann Arbor, MI, United States
(Barnes) Department of Anesthesiology and Critical Care Medicine, John
Hopkins Hospital, Baltimore, MD, United States
(Whalen) Cardiac Care Center, The Heart Program, Nicklaus Children's
Hospital, Miami, FL, United States
(Grant) Pediatric Critical Care Services, Primary Children's Hospital,
Salt Lake City, UT, United States
(Sheppard) Pediatric Pulmonary Hypertension, Stollery Children's Hospital,
Edmonton, AB, Canada
(Kline-Tilford) Cardiovascular Surgery, Children's Hospital of Michigan,
Detroit, MI, United States
(Steadman) Cardiac Care Unit, Ann & Robert H. Lurie Children's, Hospital
of Chicago, Chicago, IL, United States
(Shafland) Cardiovascular Intensive Care Unit, Department of Nursing,
Children's Minnesota, Minneapolis, MN, United States
(Corlett) Cardiac Intensive Care Unit, Department of Nursing, Seattle
Children's Hospital, Seattle, WA, United States
(Kelly) Pediatric Critical Care, Department of Nursing, Doernbecher
Children's Hospital, Portland, OR, United States
(Ortman) Division of Critical Care, Department of Pediatrics, Omaha
Children's Hospital and Medical Center, Omaha, NE, United States
(Peyton) Department of Nursing, Children's Hospital Heart Institute,
Children's Hospital Colorado, Aurora, CO, United States
(Hagstrom) Pediatric Critical Care, Department of Nursing, University of
Minnesota Masonic Children's Hospital, Minneapolis, MN, United States
(Shields) Cardiac Intensive Care, Department of Nursing, Upmc Children's
Hospital of Pittsburgh, Pittsburgh, PA, United States
(Nye) Department of Nursing, Advocate Children's Hospital, Oak Lawn, IL,
United States
(Alvarez) Research in Patient Services, Department of Nursing, Cincinnati
Children's Hospital Medical Center, Cincinnati, OH, United States
(Redington) Cardiology Clinic, Cincinnati Children's Hospital Medical
Center, Cincinnati, OH, United States
(Curley) Family and Community Health, Department of Nursing, University of
Pennsylvania, School of Nursing, Philadelphia, PA, United States
(Curley) Anesthesia and Critical Care Medicine, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, PA, United States
(Curley) The Research Institute, Children's Hospital of Philadelphia,
Philadelphia, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: The objective of this study was to determine the prevalence of
ICU delirium in children less than 18 years old that underwent cardiac
surgery within the last 30 days. The secondary aim of the study was to
identify risk factors associated with ICU delirium in postoperative
pediatric cardiac surgical patients. Design(s): A 1-day, multicenter
point-prevalence study of delirium in pediatric postoperative cardiac
surgery patients. Setting(s): Twenty-seven pediatric cardiac and
general critical care units caring for postoperative pediatric cardiac
surgery patients in North America. Patient(s): All children less than
18 years old hospitalized in the cardiac critical care units at 06:00 on a
randomly selected, study day. Intervention(s): Eligible children were
screened for delirium using the Cornell Assessment of Pediatric Delirium
by the study team in collaboration with the bedside nurse. Measurement and
Main Results: Overall, 181 patients were enrolled and 40% (n = 73)
screened positive for delirium. There were no statistically significant
differences in patient demographic information, severity of defect or
surgical procedure, past medical history, or postoperative day between
patients screening positive or negative for delirium. Our bivariate
analysis found those patients screening positive had a longer duration of
mechanical ventilation (12.8 vs 5.1 d; p = 0.02); required more vasoactive
support (55% vs 26%; p = 0.0009); and had a higher number of invasive
catheters (4 vs 3 catheters; p = 0.001). Delirium-positive patients
received more total opioid exposure (1.80 vs 0.36 mg/kg/d of morphine
equivalents; p < 0.001), did not have an ambulation or physical therapy
schedule (p = 0.02), had not been out of bed in the previous 24 hours (p <
0.0002), and parents were not at the bedside at time of data collection (p
= 0.008). In the mixed-effects logistic regression analysis of modifiable
risk factors, the following variables were associated with a positive
delirium screen: 1) pain score, per point increase (odds ratio, 1.3;
1.06-1.60); 2) total opioid exposure, per mg/kg/d increase (odds ratio,
1.35; 1.06-1.73); 3) SBS less than 0 (odds ratio, 4.01; 1.21-13.27); 4)
pain medication or sedative administered in the previous 4 hours (odds
ratio, 3.49; 1.32-9.28); 5) no progressive physical therapy or ambulation
schedule in their medical record (odds ratio, 4.40; 1.41-13.68); and 6)
parents not at bedside at time of data collection (odds ratio, 2.31;
1.01-5.31). Conclusion(s): We found delirium to be a common problem
after cardiac surgery with several important modifiable risk
factors. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<99>
[Use Link to view the full text]
Accession Number
633622922
Title
Nurse-Implemented Goal-Directed Strategy to Improve Pain and Sedation
Management in a Pediatric Cardiac ICU.
Source
Pediatric Critical Care Medicine. 21(12) (pp 1064-1070), 2020. Date of
Publication: 01 Dec 2020.
Author
Lincoln P.A.; Whelan K.; Hartwell L.P.; Gauvreau K.; Dodsen B.L.; Larovere
J.M.; Thiagarajan R.R.; Hickey P.A.; Curley M.A.Q.
Institution
(Lincoln, Whelan, Hickey) Department of Cardiovascular and Critical Care
Nursing Services, Boston Children's Hospital, Boston, MA, United States
(Hartwell, Gauvreau, Larovere, Thiagarajan) Department of Cardiology,
Boston Children's Hospital, Boston, MA, United States
(Dodsen) Information Services Department, Clinical Integration Architect,
Boston Children's Hospital, Boston, MA, United States
(Larovere, Thiagarajan, Hickey) Department of Pediatrics, Harvard School
of Medicine, Boston, MA, United States
(Hickey) Department of Cardiovascular Services, Boston Children's
Hospital, Boston, MA, United States
(Curley) Department of Family and Community Health, School of Nursing,
University of Pennsylvania, Philadelphia, PA, United States
(Curley) Department of Anesthesia and Critical Care, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, PA, United States
(Curley) Research Institute, Children's Hospital of Philadelphia,
Philadelphia, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: To assess the impact of a nurse-implemented goal-directed
sedation strategy on patient care and nursing practice in a pediatric
cardiac ICU. Design(s): Quality improvement project with a pre-post
interval measurement plan. Setting(s): Thirty-one bed pediatric
cardiac ICU in a freestanding tertiary care children's hospital.
 Patient(s): Postoperative pediatric cardiac surgery patients.
 Intervention(s): The implementation of cardiac-Randomized Evaluation
of Sedation Titration for Respiratory Failure (RESTORE), a
nurse-implemented goal directed strategy to improve pain and sedation
management in a pediatric cardiac ICU which included daily team discussion
of the patient's trajectory of illness (acute, titration, or weaning
phase), prescription of a sedation target score based on the patient's
trajectory of illness, arousal assessments, and opioid and/or sedative
titration. Withdrawal Assessment Scores were used to assess and manage
iatrogenic withdrawal symptoms. Measurements and Main Results: Data
related to opioid and sedation use, pain and sedation scores, and the
occurrence and management of iatrogenic withdrawal symptoms were reviewed
on 1,243 patients during four separate time periods: one
pre-implementation and three discontinuous post-implementation time
intervals. Patient age and complexity were consistent across the data
collection periods. Post-implementation opioids and benzodiazepines use
was reduced about 50% without a concomitant increase in the use of other
sedative classes. Few post-intervention patients were discharged from the
pediatric cardiac ICU or to home on methadone (pediatric cardiac ICU: pre
19% to post 3%; hospital: pre 12% to post 1.3%). Documentation of pain,
sedation, and withdrawal scores became more consistent and nurses reported
satisfaction with their patient's comfort management. Conclusion(s):
The implementation of a nurse-driven goal-directed plan such as
cardiac-RESTORE to manage pediatric cardiac ICU patient pain and sedation
is possible, sustainable, and associated with reduced sedative and
methadone use. Copyright © 2020 Lippincott Williams and Wilkins.
All rights reserved.

<100>
Accession Number
2025024702
Title
EFFICACY AND SAFETY OF PURASTAT FOR HEMOSTASIS IN GASTROINTESTINAL
BLEEDING: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Gastrointestinal Endoscopy. Conference: DDW 2023 Digestive Disease Week.
Chicago United States. 97(6 Supplement) (pp AB758), 2023. Date of
Publication: June 2023.
Author
Dahiya D.S.; Chandan S.; Bapaye J.; Gangwani M.K.; Ramai D.; Mohan B.;
Facciorusso A.; Al-Haddad M.
Publisher
Elsevier Inc.
Abstract
Institutions: CMU Medical Education Partners, USA; Creighton University
School of Medicine, USA; Rochester General Hospital, USA; The University
of Toledo, USA; University of Utah Health, USA; Universita degli Studi di
Foggia Dipartimenti di Area Medica, Italy; Indiana University School of
Medicine, USA. Disclosure compliance: I understand. Participant
disclosure: Dushyant Singh Dahiya: NO financial relationship with a
commercial interest; Saurabh Chandan: NO financial relationship with a
commercial interest; Jay Bapaye: NO financial relationship with a
commercial interest; Manesh Kumar Gangwani: NO financial relationship with
a commercial interest; Daryl Ramai: NO financial relationship with a
commercial interest; Babu Mohan: NO financial relationship with a
commercial interest; Antonio Facciorusso: NO financial relationship with a
commercial interest; Mohammad Al-Haddad: Grant/Research Support: Cook
endoscopy, Amplified Sciences, Creatics LLC; Other activities not in list:
Interpace diagnostics. Introduction: The utilization of PuraStat (3D
Matrix Europe SAS, Caluire-et-Cuire, France), a viscous transparent gel
which utilizes self-assembling peptide (SAP) technology, as a hemostatic
agent has been reported in cardiac and sinus surgery. Recently, several
studies have evaluated its use in acute gastrointestinal bleeding (GIB).
To appraise the published literature further, we conducted a systematic
review & meta-analysis of the efficacy and safety of PuraStat in upper and
lower GIB. Method(s): A systematic search of several databases was
performed through November 2022 to identify studies assessing the
utilization of endoscopically delivered PuraStat as a primary or salvage
hemostatic agent for upper and lower GIB. Endpoints assessed included
technical success, defined as complete coverage of the lesion by the gel,
initial hemostasis, defined as visual confirmation of bleeding cessation
following application, and cumulative 7-day and 30-day rebleeding rates.
Pooled proportions of outcomes assessed were calculated using the
random-effects model. Heterogeneity was assessed using I2
statistics. All p-values <0.05 were considered statistically significant.
 Result(s): A total of 7 studies with 404 patients (256 males and 148
females) were included in the final analysis. The mean/median age ranged
from 66.9 to 76 years. A variety of lesions and etiologies of high-risk
(oozing/spurting) GIB including peptic ulcer disease (PUD), vascular
lesions e.g., angiectasias, mucosal lesions e.g., Mallory-Weiss,
refractory radiation proctitis as well as post-resection bleeding
[endoscopic mucosal resection (EMR)/endoscopic submucosal dissection
(ESD)], among others, were included. The overall pooled rate of technical
success was 100% [95% Confidence Interval (CI) 0-100; I2 0%].
The pooled rate of initial hemostasis as primary and salvage therapy was
92.98% (95% CI 87.5-96.17; I2 32%) and 86.12% (95% CI
70.55-94.15; I2 81%), respectively. The quantity of PuraStat
needed to achieve hemostasis ranged from 1-6 mL and the average
application time was 2 minutes (from 2 studies). The pooled proportions of
cumulative, 7-day, and 30-day rebleeding rates were 11.39% (95%CI
4.78-24.79; I2 84%), 10.56% (95%CI 1.53-47.29; I2
88%), 10.46% (95%CI 5.97-17.67; I2 54%), respectively. No
adverse events were noted after PuraStat application. Conclusion(s):
Our study demonstrates that application of PuraStat to bleeding culprit
gastrointestinal lesions is safe, technically feasible and is highly
effective in achieving hemostasis as primary as well as salvage therapy.
Furthermore, it can be applied quickly and significantly reduces the risk
of delayed bleeding. Further studies are warranted to validate our
findings. [Formula presented] Copyright © 2023

<101>
Accession Number
2025024692
Title
EFFICACY AND SAFETY OF PURASTAT FOR HEMOSTASIS IN GASTROINTESTINAL
BLEEDING: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Gastrointestinal Endoscopy. Conference: DDW 2023 Digestive Disease Week.
Chicago United States. 97(6 Supplement) (pp AB296), 2023. Date of
Publication: June 2023.
Author
Dahiya D.S.; Chandan S.; Bapaye J.; Gangwani M.K.; Ramai D.; Mohan B.;
Facciorusso A.; Al-Haddad M.
Publisher
Elsevier Inc.
Abstract
Institutions: CMU Medical Education Partners, USA; Creighton University
School of Medicine, USA; Rochester General Hospital, USA; The University
of Toledo, USA; University of Utah Health, USA; Universita degli Studi di
Foggia Dipartimenti di Area Medica, Italy; Indiana University School of
Medicine, USA. Disclosure compliance: I understand. Participant
disclosure: Dushyant Singh Dahiya: NO financial relationship with a
commercial interest; Saurabh Chandan: NO financial relationship with a
commercial interest; Jay Bapaye: NO financial relationship with a
commercial interest; Manesh Kumar Gangwani: NO financial relationship with
a commercial interest; Daryl Ramai: NO financial relationship with a
commercial interest; Babu Mohan: NO financial relationship with a
commercial interest; Antonio Facciorusso: NO financial relationship with a
commercial interest; Mohammad Al-Haddad: Grant/Research Support: Cook
endoscopy, Amplified Sciences, Creatics LLC; Other activities not in list:
Interpace diagnostics. Introduction: The utilization of PuraStat (3D
Matrix Europe SAS, Caluire-et-Cuire, France), a viscous transparent gel
which utilizes self-assembling peptide (SAP) technology, as a hemostatic
agent has been reported in cardiac and sinus surgery. Recently, several
studies have evaluated its use in acute gastrointestinal bleeding (GIB).
To appraise the published literature further, we conducted a systematic
review & meta-analysis of the efficacy and safety of PuraStat in upper and
lower GIB. Method(s): A systematic search of several databases was
performed through November 2022 to identify studies assessing the
utilization of endoscopically delivered PuraStat as a primary or salvage
hemostatic agent for upper and lower GIB. Endpoints assessed included
technical success, defined as complete coverage of the lesion by the gel,
initial hemostasis, defined as visual confirmation of bleeding cessation
following application, and cumulative 7-day and 30-day rebleeding rates.
Pooled proportions of outcomes assessed were calculated using the
random-effects model. Heterogeneity was assessed using I2
statistics. All p-values <0.05 were considered statistically significant.
 Result(s): A total of 7 studies with 404 patients (256 males and 148
females) were included in the final analysis. The mean/median age ranged
from 66.9 to 76 years. A variety of lesions and etiologies of high-risk
(oozing/spurting) GIB including peptic ulcer disease (PUD), vascular
lesions e.g., angiectasias, mucosal lesions e.g., Mallory-Weiss,
refractory radiation proctitis as well as post-resection bleeding
[endoscopic mucosal resection (EMR)/endoscopic submucosal dissection
(ESD)], among others, were included. The overall pooled rate of technical
success was 100% [95% Confidence Interval (CI) 0-100; I2 0%].
The pooled rate of initial hemostasis as primary and salvage therapy was
92.98% (95% CI 87.5-96.17; I2 32%) and 86.12% (95% CI
70.55-94.15; I2 81%), respectively. The quantity of PuraStat
needed to achieve hemostasis ranged from 1-6 mL and the average
application time was 2 minutes (from 2 studies). The pooled proportions of
cumulative, 7-day, and 30-day rebleeding rates were 11.39% (95%CI
4.78-24.79; I2 84%), 10.56% (95%CI 1.53-47.29; I2
88%), 10.46% (95%CI 5.97-17.67; I2 54%), respectively. No
adverse events were noted after PuraStat application. Conclusion(s):
Our study demonstrates that application of PuraStat to bleeding culprit
gastrointestinal lesions is safe, technically feasible and is highly
effective in achieving hemostasis as primary as well as salvage therapy.
Furthermore, it can be applied quickly and significantly reduces the risk
of delayed bleeding. Further studies are warranted to validate our
findings. [Formula presented] Clinical outcomes for utilization of
endoscopically delivered PuraStat for upper and lower gastrointestinal
bleeding. Copyright © 2023

<102>
Accession Number
2023438551
Title
Evaluation Of Plasma Thiamine Concentrations In Critically Ill Patients
Receiving Chronic Diuretic Therapy Prior To Admission To Turkish Intensive
Care Units: A Multicenter, Prospective Study.
Source
Clinical Nutrition ESPEN. Conference: ESPEN 2022 Congress. Vienna Austria.
54 (pp 639-640), 2023. Date of Publication: April 2023.
Author
Sahin Ergul S.; Gundogan K.; Temel S.; Gunes Sahin G.; Ozer N.T.; Akbas
T.; Ercan T.; Dizdar O.S.; Yildiz H.; Simsek Z.; Aydin K.; Ulu R.; Zerman
A.; Cankar Dal H.; Aydin E.; Ozyilmaz E.; Ates N.; Gonderen K.; Yalcin N.;
Topeli A.; Tok G.; Ediboglu O.; Ergan B.; Ozturk M.C.; Akbudak I.H.; Ergun
R.; Yuksel R.C.; Sungur M.; Ziegler T.R.
Institution
(Sahin Ergul, Gunes Sahin) Clinical Nutrition
(Gundogan, Temel) Internal Medicine, Erciyes University
(Ozer) Clinical Nutrition, Erciyes Univesity, Kayseri, Turkey
(Akbas, Ercan) Internal Medicine, Duzce University, Duzce
(Dizdar, Simsek, Aydin) Internal Medicine, Kayseri Training and Research
Hospital, Kayseri, Turkey
(Yildiz) Internal Medicine, Gaziantep University, Gaziantep, Turkey
(Ulu) Nephrology, Firat Medical Faculty, Elazig, Turkey
(Zerman) Intensive Care Unit, Kirsehir Ahi Evran University, Kirsehir,
Turkey
(Cankar Dal) Intensive Care Unit, Turkiye Yuksek Ihtisas Training and
Research Hospital, Ankara
(Aydin) Nephrology, Dicle University, Diyarbakir, Turkey
(Ozyilmaz, Ates) Intensive Care Unit, Cukurova University, Adana
(Gonderen, Yalcin) Intensive Care Unit, Kutahya Evliya Celebi Training and
Research Hospital, Kutahya
(Topeli, Tok) Intensive Care Unit, Hacettepe University, Ankara
(Ediboglu) Intensive Care Unit, Izmir Dr.Suat Seren Chest Diseases and
Thoracic Surgery Training and Research Hospital
(Ergan, Ozturk) Intensive Care Unit, Dokuz Eylul University School of
Medicine Hospital, Izmir, Turkey
(Akbudak) Internal Medicine, Pamukkale University, Denizli, Turkey
(Ergun) Chest Diseases, Selcuk University, Konya
(Yuksel, Sungur) Intensive Care Unit, Erciyes University, Kayseri, Turkey
(Ziegler) Endocrinology, Metabolism and Lipids, Emory University, Atlanta,
United States
Publisher
Elsevier Ltd
Abstract
Rationale: Thiamine plays a pivotal role in energy metabolism (1).
Thiamine depletion is associated with adverse clinical outcomes in some
critically ill patients (2,3). The aim of the study was to determine
serial plasma thiamine concentrations in critically ill adult patients
receiving chronic diuretic treatment before ICU admission and to correlate
thiamine levels with clinically-determined serum phosphorus
concentrations. Method(s): This prospective observational study was
performed in 15 adult medical ICUs in Turkey. Serial plasma thiamine
concentrations were measured by high-performance liquid chromatography
(HPLC). Result(s): A total of 221 participants were included. The
median age of was 71 years and 49% were male. The mean (SD) APACHE II
score on ICU admission was 17.7 +/- 7.4. Reasons for ICU admissions
included respiratory failure (54%) and metabolic diseases (31%). Heart
failure and chronic obstructive pulmonary disease were the most frequent
underlying diseases requiring chronic diuretics. Median plasma thiamine
levels ranged from 42.1 to 46.5 mug/L from baseline to day 10 after
admission (normal range = 28-85 mug/L). A total of 18% of participants
were thiamine deficient upon admission to the ICU, while 26% of
participants were deficient at some point during the 10-day study period.
At baseline, 47% of participants were orally fed (regular food and/or oral
nutritional supplements), while 23% and 10% received tube feedings or
parenteral nutrition, respectively. At baseline, the median daily energy
intake was 993 kcal/day and reached a maximum by day 9 (1261 kcal/day).
Hypophosphatemia was detected in 40% of participants at some point during
the 10-day period of observation. Plasma thiamine levels were
significantly and positively correlated with serum phosphorus levels at
each time point (P<0.05 for all). Conclusion(s): In adult critically
ill patients receiving diuretics, plasma thiamine levels were deficient in
18% on ICU admission and in 26% during the initial 10 ICU days,
respectively. The pattern of correlation between thiamine and phosphorus
levels suggests a possible refeeding effect in adult medical ICU patients
requiring chronic diuretic therapy. References: 1. Kerns JC, Gutierrez JL:
Thiamin. Advances in nutrition (Bethesda, Md) 2017, 8(2):395-397. 2. Costa
NA, Gut AL, de Souza Dorna M, Pimentel JA, Cozzolino SM, Azevedo PS,
Fernandes AA, Zornoff LA, de Paiva SA, Minicucci MF: Serum thiamine
concentration and oxidative stress as predictors of mortality in patients
with septic shock. Journal of critical care 2014, 29(2):249-252. 3.
Andersen LW, Holmberg MJ, Berg KM, Chase M, Cocchi MN, Sulmonte C, Balkema
J, MacDonald M, Montissol S, Senthilnathan V et al: Thiamine as an
adjunctive therapy in cardiac surgery: a randomized, double-blind,
placebo-controlled, phase II trial. Critical care (London, England) 2016,
20:92. Disclosure of Interest: None declared Copyright © 2022

<103>
Accession Number
2023108954
Title
USING PRE-OPERATIVE NEUTROPHIL TO LYMPHOCYTE RATIO (NLR) AS A PREDICTOR TO
DETERMINE MORTALITY IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE
REPLACEMENT (TAVR) : A SYSTEMIC REVIEW.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 252), 2023. Date of
Publication: 07 Mar 2023.
Author
Akbar U.; Qasid S.H.A.; Khan M.A.; Umer A.M.; Qureshi A.; Farooq S.; Wasay
A.; Sheikh H.M.; Mukhtar S.; Basit J.; Fatima M.; Anwar R.U.; Ur Rehman
M.E.; Chaudhary A.J.
Institution
(Akbar, Qasid, Khan, Umer, Qureshi, Farooq, Wasay, Sheikh, Mukhtar, Basit,
Fatima, Anwar, Ur Rehman, Chaudhary) North Shore University Hospital,
Manhasset, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Neutrophil to Lymphocyte (NLR) ratio is being investigated as a
new predictor of cardiovascular risk as an important inflammatory marker.
This is the first review of its kind assessing the prognostic value of NLR
as an independent predictor to determine mortality in patients undergoing
Transcatheter Aortic Valve Replacement (TAVR). Methods Relevant clinical
studies were retrieved from PubMed, EMBASE, Cochrane, and
Clinicaltrials.gov from inception to September 2022. The clinical
endpoints included 30 day mortality, 3-year mortality, Major adverse
cardiovascular events (MACE) and post-operative renal outcomes. Results In
five observational studies, short term and long term effects of
pre-operative NLR were assessed in relation to the outcomes. (figure 1)
Habib et al. reported 9.4% 30-day mortality in NLR >=3 patients. Non-NLR
patients had 0% 30-day mortality. In another study, individuals who met
the NLR criterion of 2.7 had a 30-day mortality of 23.3% vs 8.4%.
Long-term mortality was similar in patients with similar baselines. If the
NLR cutoff was 3, 3-year mortality was 27.35% vs. 3.78 Using a baseline
NLR of 4.1 increased 3-year mortality from 16.3% to 26.4%. High NLR also
increased MACE. The results are discussed in figure 1. Conclusion Higher
NLR increases short- and long-term mortality and comorbidities. Cutoff
levels and patient characteristics are crucial. Determining the correct
NLR cutoff requires a large randomized controlled trials with identical
patient guidelines. [Formula presented] Copyright © 2023 American
College of Cardiology Foundation

<104>
Accession Number
2023108935
Title
LONG-TERM OUTCOMES OF HEART TRANSPLANTATION AND LEFT VENTRICULAR ASSIST
DEVICES IN PATIENTS LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS: A SYSTEMATIC
REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 296), 2023. Date of
Publication: 07 Mar 2023.
Author
Haji M.S.; Agyeman H.; Erqou S.
Institution
(Haji, Agyeman, Erqou) Department of Medicine, Brown University,
Providence, RI, United States
(Haji, Agyeman, Erqou) Department of Medicine, Providence VA Medical
Center, Providence, RI, United States
Publisher
Elsevier Inc.
Abstract
Background As the prevalence of heart failure (HF) among patients living
with human immunodeficiency virus (PLWH) rises, naturally, more PLWH will
need to be considered for advanced HF therapies such as heart
transplantation (HT) and left ventricular assist devices (LVAD). This
study aims to synthesize the limited data on HT and LVAD outcomes among
PLWH compared to controls without human immunodeficiency virus (HIV).
Methods We systematically searched multiple databases to identify studies
of PLWH who received HT and LVAD. We extracted relevant data on patient
characteristics and outcomes. We estimated values from Kaplan-Meier
survivor curves for studies that did not explicitly report mortality
figures. The main outcomes (mortality rates and hazard ratios) were pooled
across studies using a random-effects model meta-analysis. Results This
review found 9 studies (5 HT, 4 LVAD studies) that identified 190 and 185
PLWH, and 533,932 and 65,037 patients without HIV who received HT and
LVAD, respectively. The PLWH receiving HT and LVAD were 7 years younger
than comparable control groups. PLWH and controls who received HT and LVAD
were predominantly male. PLWH Due to limitations from registries, most
studies did not report data on the status of HIV-specific traits. The
pooled average 1- year mortality for HT and LVAD for PLWH was 5.8% and
22.6%, compared to controls was 13.3% and 18.9%, respectively. The 5-year
mortality of PLWH for HT was 20.1% and for controls was 23.7%. Two studies
for HT and LVAD reported hazard ratios (HR) for mortality, which we pooled
to show a HR of 0.64 (0.26-1.57) for HT and 1.36 (0.87-2.11) for LVAD. A
combined HR for HT and LVAD was also calculated and was 1.16 (0.75-1.78).
A limitation of our study is that certain studies evaluate the same
database at different periods, and overlap may exist. Conclusion Synthesis
of limited extant data on PLWH who received advanced HF treatment suggests
that these patients have comparable 1-year and 5-year mortality with
HIV-negative controls, although the HIV group was younger. The findings
support the idea that HIV-status should no longer be considered an
advanced risk factor or contraindication to advanced HF
therapies. Copyright © 2023 American College of Cardiology
Foundation

<105>
Accession Number
2023108915
Title
PHYSICIANS' PERSPECTIVES ON PERCUTANEOUS LEFT ATRIAL APPENDAGE OCCLUSION
FOR PATIENTS WITH ATRIAL FIBRILLATION.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 113), 2023. Date of
Publication: 07 Mar 2023.
Author
Yao X.; Kir D.; Van Houten H.; Walvatne K.; Behnken E.; Alkhouli M.A.;
Graff-Radford J.; Melduni R.; Gersh B.J.; Friedman P.A.; Shah N.;
Noseworthy P.
Institution
(Yao, Kir, Van Houten, Walvatne, Behnken, Alkhouli, Graff-Radford,
Melduni, Gersh, Friedman, Shah, Noseworthy) Mayo Clinic, Rochester, MN,
United States
Publisher
Elsevier Inc.
Abstract
Background Transcatheter LAAO is an alternative to anticoagulation for AF
stroke prevention. Since the device's approval in the US in 2015, there
has been an increasing uptake but great practice variations exist. Hence,
we sought to assess the perceptions and approaches among physicians
commonly involved in the decision-making process of LAAO. Methods Using
the AMA Physician Masterfile, we selected a random sample of 500
physicians from each of the four specialties: general cardiologists,
interventional cardiologists, electrophysiologists, and vascular
neurologists. The participants received the survey by mail up to three
times from 11/9/2021-1/14/2022. The survey instrument includes 28
questions related to experiences, perceptions, approaches, and a patient
vignette. Physicians were randomly assigned to one of the four versions:
white man, white woman, black man, and black woman, to investigate
potential disparities in decision making. Results Among the 122
respondents, 59.8% considered "procedural risks & complications" as
reasons for limiting their recommendations for LAAO, followed by 42.6%
"limiting efficacy data comparing LAAO to NOAC." Although 97.5% of the
respondents considered evidence from RCTs as extremely or very useful,
only 29.5% said so for observational studies. The top 3 reasons for
considering LAAO were a history of intracranial bleeding (94.3%), a
history of major extracranial bleeding (91.8%), and GI lesions (59.0%).
The top 3 reasons for withholding LAAO were: other indications for
long-term oral anticoagulation (87.7%), low bleeding risk (77.0%), and low
stroke risk (65.6%). There was no difference in decision-making by
patients' race (p=0.73), gender (p=0.12), or race and gender combined
(p=0.30) using the patient vignette, indicating no unconscious bias
against women or minorities. Among the participants performing LAAO, 83.8%
would consider NOACs after device implant. Conclusion In the first US
national physician survey, we found considerable variations in perceptions
and approaches related to the practice of LAAO. Future RCTs are needed to
close the evidence gaps and establish consistent best practices for this
important device therapy. Copyright © 2023 American College of
Cardiology Foundation

<106>
Accession Number
2023108905
Title
TREATMENT STRATEGIES FOR PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFT
WITH CONCOMITANT SEVERE CAROTID ARTERY OCCLUSIVE DISEASE: SYSTEMATIC
REVIEW AND NETWORK META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1185), 2023. Date of
Publication: 07 Mar 2023.
Author
Tsukagoshi J.; Yokoyama Y.; Fujisaki T.; Takagi H.; Shirasu T.; Kuno T.
Institution
(Tsukagoshi, Yokoyama, Fujisaki, Takagi, Shirasu, Kuno) University of
Texas Medical Branch at Galveston, Galeston, TX, United States
(Tsukagoshi, Yokoyama, Fujisaki, Takagi, Shirasu, Kuno) Albert Einstein
College of Medicine, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Stroke is one of the devastating complications following
coronary artery bypass graft (CABG) and underlying carotid artery
occlusive disease (CAOD) is known to be an independent risk factor. The
optimal treatment strategy for these patients remains under debate. We
aimed to perform a network meta-analysis to determine the optimal strategy
to prevent perioperative neurologic events for patients with CAOD who
require CABG. Methods MEDLINE and EMBASE were searched through February
2022 to identify studies that investigated outcomes of CABG only as well
as additional staged versus combined carotid interventions by both carotid
endarterectomy (CEA) and carotid artery stenting (CAS). Perioperative
outcomes were assessed using a network meta-analysis. Results Two
randomized control trials and 25 observational studies were included,
yielding a total of 41 474 patients who underwent combined CEA and CABG (n
= 20 593), CEA and staged CABG (n = 7 492), CABG and staged CEA (n = 340),
CAS and CABG regardless of timing and sequences (n = 1 229), and CABG only
(n = 11 820). CEA and staged CABG was associated with the lowest
perioperative stroke/transient ischemic attack (TIA) rate, significantly
lower compared to CAS and CABG as well as CABG and staged CEA (Odds ratio
[OR] [95% confidence interval (CI)] = 0.51 [0.33-0.77], OR [95% CI] = 0.38
[0.21-0.69], respectively), but was also associated with the highest
perioperative myocardial infarction rate. CABG and staged CEA was
associated with the highest perioperative stroke/TIA rate. No strategy
showed a significant advantage over CABG only in all perioperative
outcomes. Conclusion CEA and staged CABG is beneficial in reducing the
risk of perioperative stroke/TIA with a tradeoff of higher myocardial
infarction rate. No strategy showed significant advantage over CABG only
in all perioperative outcomes, outlining the importance of determining
proper indications for carotid intervention in these
patients. Copyright © 2023 American College of Cardiology
Foundation

<107>
Accession Number
2023108793
Title
COMPARISON OF TRANSCATHETER, MINIMALLY INVASIVE AND CONVENTIONAL SURGICAL
AORTIC VALVE REPLACEMENT: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 879), 2023. Date of
Publication: 07 Mar 2023.
Author
Fong K.Y.; Yap J.; Ewe S.H.; Chao V.; Amanullah M.; Sivaraj G.; Aziz Z.A.;
Tan V.H.H.; Ho K.W.
Institution
(Fong, Yap, Ewe, Chao, Amanullah, Sivaraj, Aziz, Tan, Ho) National Heart
Center Singapore, Singapore, Singapore
(Fong, Yap, Ewe, Chao, Amanullah, Sivaraj, Aziz, Tan, Ho) Changi General
Hospital, Singapore, Singapore
Publisher
Elsevier Inc.
Abstract
Background Aortic valve replacement (AVR) has evolved dramatically over
the years, but long-term outcomes have yet to be explored in-depth. This
study compares mortality rates among transcatheter (TAVI), minimally
invasive (MIAVR), and conventional AVR (CAVR). Methods An online
literature search was performed for randomized trials (RCTs) of TAVI vs
CAVR, and RCTs or propensity score-matched (PSM) studies of MIAVR vs CAVR
or MIAVR vs TAVI. Individual patient data for mortality was derived from
graphical reconstruction of Kaplan-Meier curves. Pairwise comparisons and
network meta-analysis (NMA) were conducted. Sensitivity analyses were
performed in the TAVI arm for transfemoral (TF-TAVI) patients. Results 27
studies (16554 patients) were included. In the pairwise comparison of TAVI
versus CAVR, TAVI showed superior mortality to CAVR until 39.5 months,
after which there was no significant difference. When restricted to
TF-TAVI versus CAVR, consistent mortality benefit favoring TAVI was seen
(HR 1.17, 95%CI 1.03-1.33, p=0.016). In the NMA, MIAVR was associated with
significantly lower mortality than TAVI (HR 0.69, 95%CI 0.59-0.82) and
CAVR (HR 0.68, 95%CI 0.58-0.80); this significant association was not seen
when compared to TF-TAVI patients. Conclusion The initial short-to-medium
term mortality benefit for TAVI over CAVR was attenuated over the longer
term, but persisted in the subset of TF-TAVI patients. There may be a
potential role for MIAVR in treating patients ineligible for TF-TAVI.
[Formula presented] Copyright © 2023 American College of
Cardiology Foundation

<108>
Accession Number
2023108743
Title
IMPACT OF CORONARY BYPASS GRAFT MARKERS ON ANGIOGRAPHIC PROCEDURAL
OUTCOMES: A META-ANALYSIS STUDY.
Source
Journal of the American College of Cardiology. Conference: ACC.23. New
Orleans United States. 81(8 Supplement) (pp 1058), 2023. Date of
Publication: 07 Mar 2023.
Author
Gonuguntla K.; Sattar Y.; Faisaluddin M.; Yasmin F.; Alharbi A.A.; Alsaud
A.; Chobufo M.D.; Shaik A.; Daggubati R.B.; Bianco C.
Institution
(Gonuguntla, Sattar, Faisaluddin, Yasmin, Alharbi, Alsaud, Chobufo, Shaik,
Daggubati, Bianco) West Virginia University, Morgantown, WV, United States
Publisher
Elsevier Inc.
Abstract
Background Limited data exists comparing the outcomes of percutaneous
coronary intervention (PCI) with and without coronary artery bypass graft
(CABG) markers. Impact of a proximal radio-opaque marker of coronary graft
in procedural metrics of angiography is of interest for prevention of
procedural risks. To the best of our knowledge, this is the first
meta-analysis conducted to evaluate the association between procedural
angiographic metrics, and CABG markers. Methods MEDLINE and Scopus
databases were queried till August 2022 to identify relevant studies
evaluating procedural metrics among patients with prior CABG with and
without radio-opaque markers undergoing angiography. Procedural metrics of
interest were fluoroscopy time, amount of contrast, and duration of
angiography. Data were analyzed using random-effects model to derive odds
ratio (OR) with 95% confidence intervals (CI). Results A total of 4
studies with 2046 CABG patients (CABG with markers n=688, CABG without
markers n =1518) were included. Amount of contrast required (OR -33.41,
p=<0.01), and total fluoroscopy time (OR -3.63, p=<0.01) were
significantly reduced among patients with CABG markers vs. no markers. A
non-significant reduction in the total duration of angiographic procedure
(OR -36.39, p=0.13) was noted with CABG markers compared to no markers.
Conclusion Radiopaque CABG markers improve angiographic procedural metrics
by reducing fluoroscopic time, and amount of contrast agent required
compared to no markers. [Formula presented] Copyright © 2023
American College of Cardiology Foundation

<109>
[Use Link to view the full text]
Accession Number
2025146886
Title
Prehabilitation before elective coronary artery bypass grafting surgery: a
scoping review.
Source
JBI Evidence Synthesis. 21(6) (pp 1190-1242), 2023. Date of Publication:
20 Jun 2023.
Author
Olsen D.B.; Pedersen P.U.; Noergaard M.W.
Institution
(Olsen) Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Pedersen, Noergaard) Danish Centre of Systematic Reviews: A Jbi Centre of
Exellence, Centre of Clinical Guidelines, Danish National Clearinghouse,
Aalborg University, Denmark
(Noergaard) Department of Cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The objective of this scoping review was to identify and map
existing preoperative interventions, referred to as prehabilitation, in
adult patients at home awaiting elective coronary artery bypass grafting
surgery. This review also sought to report feasibility and patient
experiences to shape clinical practice and underpin a future systematic
review. Introduction: As patients age, comorbidities become more common.
Strategies to improve postoperative outcomes and to accelerate recovery
are required in patients undergoing coronary artery bypass grafting.
Prehabilitation refers to a proactive process of increasing functional
capacity before surgery to improve the patient's ability to withstand
upcoming physiologic stress and, thus, avoid postoperative complications.
Inclusion criteria: Studies that included adult patients waiting for
coronary artery bypass grafting surgery at home and that described
interventions optimizing preoperative physical and psychological health in
any setting were included. Method(s): The JBI methodology for
conducting scoping reviews was used to identify relevant studies in
MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Library, Embase (Ovid),
Scopus, SweMed+, PsycINFO (EBSCOhost), and PEDro. Gray literature was
identified searching Google Scholar, ProQuest Dissertations and Theses,
MedNar, OpenGrey, NICE Evidence search, and SIGN. Studies in Danish,
English, German, Norwegian, and Swedish were considered for inclusion,
with no geographical or cultural limitations, or date restrictions. Two
independent reviewers screened titles and abstracts, and studies meeting
the inclusion criteria were imported into Covidence. Sixty-seven studies
from November 1987 to September 2022 were included. The data extraction
tool used for the included papers was developed in accordance with the
review questions and tested for adequacy and comprehensiveness with the
first 5 studies by the same 2 independent reviewers. The tool was then
edited to best reflect the review questions. Extracted findings are
described and supported by figures and tables. Result(s): Sixty-seven
studies were eligible for inclusion, representing 28,553 participants.
Analyses of extracted data identified various preoperative interventions
for optimizing postoperative and psychological outcomes for adult patients
awaiting elective coronary artery bypass grafting surgery. Based on
similarities, interventions were grouped into 5 categories. Eighteen
studies reported on multimodal interventions, 17 reported on psychological
interventions, 14 on physical training interventions, 13 on education
interventions, and 5 on oral health interventions. Conclusion(s):
This scoping review provides a comprehensive summary of strategies that
can be applied when developing a prehabilitation program for patients
awaiting elective coronary artery bypass surgery. Although prehabilitation
has been tested extensively and appears to be feasible, available evidence
is mostly based on small studies. For patients undergoing elective
coronary artery bypass grafting to derive benefit from prehabilitation,
methodologically robust clinical trials and knowledge synthesis are
required to identify optimal strategies for patient selection,
intervention design, adherence, and intervention duration. Future research
should also consider the cost-effectiveness of prehabilitation
interventions before surgery. Finally, there is a need for more
qualitative studies examining whether individual interventions are
meaningful and appropriate to patients, which is an important factor if
interventions are to be effective. Copyright © JBI Evidence
Synthesis. All Rights Reserved.

<110>
[Use Link to view the full text]
Accession Number
2025099543
Title
Assessment of Vocal Cord Motion Using Laryngeal Ultrasound in Children: A
Systematic Review and Meta-Analysis.
Source
Pediatric Critical Care Medicine. 22(10) (pp E532-E539), 2021. Date of
Publication: 01 Oct 2021.
Author
Hamilton C.E.; Su E.; Tawfik D.; Fernandez E.; Veten A.; Conlon T.;
Ginsburg S.; Mariano K.; Sidell D.; Haileselassie B.
Institution
(Hamilton, Tawfik, Mariano, Sidell, Haileselassie) Department of
Pediatrics, Division of Critical Care Medicine, Stanford University,
School of Medicine, Stanford, CA, United States
(Su, Fernandez) Department of Pediatrics, Division of Critical Care
Medicine, McGovern Medical School, Houston, TX, United States
(Veten) Department of Pediatrics, Division of Critical Care Medicine, Penn
State Health Milton S. Hershey Medical Center, Hershey, PA, United States
(Conlon) Department of Anesthesiology and Critical Care Medicine, The
Children's Hospital of Philadelphia, Philadelphia, PA, United States
(Ginsburg) Department of Pediatrics, Division of Critical Care Medicine,
University of Texas, Southwestern Medical Center, Houston, TX, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Laryngeal ultrasound is a nonirradiating, noninvasive method
for assessing the upper airway in children. This systematic review and
meta-analysis examine available evidence for accuracy of laryngeal
ultrasound in diagnosing vocal cord immobility in infants and children
after surgery and trauma affecting the vocal cords. DESIGN: Medical
subject heading terms were used to search MEDLINE, Embase, Google Scholar,
Web of Science, and the Cochrane Library for relevant citations.
Publications from January 1, 2000, to June 30, 2020 were included in the
search strategy. Study inclusion criteria consisted of randomized control
trials and nonrandomized retrospective or prospective observational
studies where vocal cord motion was evaluated by laryngeal ultrasound and
compared with a reference test. Studies were excluded if there was
insufficient data to compute a sensitivity/specificity table. Case
reports, case series less than 10, and manuscripts not published in
English were also excluded. PATIENTS: Studies which included subjects
younger than or equal to 18 years were considered for full article review.
SETTINGS: No restrictions on study settings were imposed in this
systematic review. MEASUREMENTS AND MAIN RESULTS: The initial search
returned 1,357 citations. After de-duplication, abstract, and full review,
eight citations were included in the final meta-analysis. A bivariate
random-effects meta-analysis was performed, which revealed a pooled
sensitivity for laryngeal ultrasound in detecting vocal cord immobility of
91% (95% CI, 83-95%), specificity of 97% (95% CI, 82-100%), diagnostic
odds ratio 333.56 (95% CI, 34.00-3,248.71), positive likelihood ratio
31.58 (95% CI, 4.50-222.05), and negative likelihood ratio 0.09 (95% CI,
0.05-0.19). CONCLUSION(S): Laryngeal ultrasound demonstrates high
sensitivity and specificity for detecting vocal cord motion in children in
a wide range of clinical settings. Laryngeal ultrasound offers a low-risk
imaging option for assessing vocal cord function in children compared with
the current gold standard of laryngoscopy. Copyright © 2021
Lippincott Williams and Wilkins. All rights reserved.

<111>
Accession Number
2025075210
Title
Just TRAC it! Transitioning Responsibly to Adult Care Using Smart Phone
Technology.
Source
Journal of Adolescent Health. (no pagination), 2023. Date of Publication:
2023.
Author
Han A.; Gingrich J.; Yaskina M.; Rankin K.; San Martin-Feeney D.; Mackie
A.S.
Institution
(Han, Gingrich, Mackie) Stollery Children's Hospital, Edmonton, Alberta
(Han, Rankin, San Martin-Feeney, Mackie) Department of Pediatrics,
University of Alberta, Edmonton, Alberta
(Yaskina, Mackie) Women and Children's Health Research Institute,
Edmonton, Alberta
Publisher
Elsevier Inc.
Abstract
Purpose: There is little evidence on whether smartphone technology
influences transition readiness among adolescents with heart disease. Just
TRAC it! is a method of using existing smartphone features (Notes,
Calendar, Contacts, Camera) to manage personal health. We evaluated the
impact of Just TRAC it! on self-management skills. Method(s):
Randomized clinical trial of 16-18 year-olds with heart disease.
Participants were randomly allocated 1:1 to either usual care (education
session) or intervention (education session including Just TRAC it!). The
primary outcome was change in TRANSITION-Q score between baseline, 3 and 6
months. Secondary outcomes were frequency of use and perceived usefulness
of Just TRAC it! Analysis was intention-to-treat. Result(s): We
enrolled 68 patients (41% female, mean age 17.3 years), 68% having
previous cardiac surgery and 26% had cardiac catheterization. TRANSITION-Q
scores were similar at baseline and increased over time in both groups but
were not significantly different between groups. Each additional point at
the baseline score brought, on average, a 0.7-point increase in
TRANSITION-Q score (95% CI 0.5-0.9) at each of 3 and 6 months. The Camera,
Calendar and Notes apps were reported as most useful. All intervention
participants would recommend Just TRAC it! to others. Discussion(s):
A nurse-led transition teaching with versus without Just TRAC it! improved
transition readiness, with no significant difference between groups.
Higher baseline TRANSITION-Q scores were associated with greater increase
in scores over time. Participants had a positive reception to Just TRAC
it! and would recommend it to others. Smartphone technology may be useful
in transition education. Copyright © 2023 Society for Adolescent
Health and Medicine

<112>
Accession Number
2023778207
Title
Regional anesthesia for transplantation surgery - A white paper part 1:
Thoracic transplantation surgery.
Source
Clinical Transplantation. (no pagination), 2023. Date of Publication:
2023.
Author
Ander M.; Mugve N.; Crouch C.; Kassel C.; Fukazawa K.; Izaak R.; Deshpande
R.; McLendon C.; Huang J.
Institution
(Ander, Mugve, McLendon) Department of Anesthesiology & Perioperative
Medicine, Loyola University Medical Center, Maywood, IL, United States
(Crouch) Department of Anesthesiology, University of Colorado Anschutz
Medical Campus, Aurora, CO, United States
(Kassel) Department of Anesthesiology, Nebraska Medical Center, 984455
Nebraska Medical Center, Omaha, NE, United States
(Fukazawa) Department of Anesthesiology, University of Washington School
of Medicine, Seattle, WA, United States
(Izaak) Department of Anesthesiology, UNC Hospitals, N2198 UNC Hospitals,
NC, United States
(Deshpande) Department of Anesthesiology, Yale University/Yale New Haven
Hospital, New Haven, CT, United States
(Huang) Department of Anesthesiology & Perioperative Medicine, University
of Louisville, Louisville, KY, United States
Publisher
John Wiley and Sons Inc
Abstract
Transplantation surgery continues to evolve and improve through
advancements in transplant technique and technology. With the increased
availability of ultrasound machines as well as the continued development
of enhanced recovery after surgery (ERAS) protocols, regional anesthesia
has become an essential component of providing analgesia and minimizing
opioid use perioperatively. Many centers currently utilize peripheral and
neuraxial blocks during transplantation surgery, but these techniques are
far from standardized practices. The utilization of these procedures is
often dependent on transplantation centers' historical methods and
perioperative cultures. To date, no formal guidelines or recommendations
exist which address the use of regional anesthesia in transplantation
surgery. In response, the Society for the Advancement of Transplant
Anesthesia (SATA) identified experts in both transplantation surgery and
regional anesthesia to review available literature concerning these
topics. The goal of this task force was to provide an overview of these
publications to help guide transplantation anesthesiologists in utilizing
regional anesthesia. The literature search encompassed most
transplantation surgeries currently performed and the multitude of
associated regional anesthetic techniques. Outcomes analyzed included
analgesic effectiveness of the blocks, reduction in other analgesic
modalities-particularly opioid use, improvement in patient hemodynamics,
as well as associated complications. The findings summarized in this
systemic review support the use of regional anesthesia for postoperative
pain control after transplantation surgeries. Part 1 of the manuscript
focuses on regional anesthesia performed in thoracic transplantation
surgeries, and part 2 in abdominal transplantations. Copyright ©
2023 The Authors. Clinical Transplantation published by John Wiley & Sons
Ltd.

<113>
Accession Number
2023677220
Title
Management of oral anticoagulant therapy after intracranial hemorrhage in
patients with atrial fibrillation.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1061618. Date of Publication: 2023.
Author
Luca F.; Colivicchi F.; Oliva F.; Abrignani M.; Caretta G.; Di Fusco S.A.;
Giubilato S.; Cornara S.; Di Nora C.; Pozzi A.; Di Matteo I.; Pilleri A.;
Rao C.M.; Parlavecchio A.; Ceravolo R.; Benedetto F.A.; Rossini R.;
Calvanese R.; Gelsomino S.; Riccio C.; Gulizia M.M.
Institution
(Luca, Rao, Parlavecchio, Benedetto) Cardiology Department, Grande
Ospedale Metropolitano di Reggio Calabria, GOM, Azienda Ospedaliera
Bianchi Melacrino Morelli, Italy
(Colivicchi, Di Fusco) Cardiology Division, San Filippo Neri Hospital, ASL
Roma 1, Roma, Italy
(Oliva, Di Matteo) De Gasperis Cardio Center, ASST Niguarda Hospital,
Milano, Italy
(Abrignani) Cardiology Unit, Paolo Borsellino Hospital, ASP Trapani,
Marsala, Italy
(Caretta) Cardiology Unit, Sant'Andrea Hospital, ASL 5 Liguria, La Spezia,
Italy
(Giubilato) Cardiology Division Cannizzaro Hospital, Catania, Italy
(Cornara) Cardiology Division San Paolo Hospital, ASL 2, Savona, Italy
(Di Nora, Pozzi) Cardiology Division, Maria della Misericordia di Udine,
Italy
(Pilleri) Cardiology Division, Brotzu Hospital, Cagliari, Italy
(Ceravolo) Cardiology Division, Giovanni Paolo II Hospital, Lamezia Terme,
Italy
(Rossini) Cardiology Division S. Croce e Carle Hospital, Cuneo, Italy
(Calvanese) Cardiology Division, Ospedale del Mare, Napoli, Italy
(Gelsomino) Cardiothoracic Department, Maastricht University, Maastricht,
Netherlands
(Riccio, Gulizia) Cardiovascular Department, A.O.R.N. Sant'Anna e San
Sebastiano, Caserta, Italy
Publisher
Frontiers Media S.A.
Abstract
Intracranial hemorrhage (ICH) is considered a potentially severe
complication of oral anticoagulants (OACs) and antiplatelet therapy (APT).
Patients with atrial fibrillation (AF) who survived ICH present both an
increased ischemic and bleeding risk. Due to its lethality, initiating or
reinitiating OACs in ICH survivors with AF is challenging. Since ICH
recurrence may be life-threatening, patients who experience an ICH are
often not treated with OACs, and thus remain at a higher risk of
thromboembolic events. It is worthy of mention that subjects with a recent
ICH and AF have been scarcely enrolled in randomized controlled trials
(RCTs) on ischemic stroke risk management in AF. Nevertheless, in
observational studies, stroke incidence and mortality of patients with AF
who survived ICH had been shown to be significantly reduced among those
treated with OACs. However, the risk of hemorrhagic events, including
recurrent ICH, was not necessarily increased, especially in patients with
post-traumatic ICH. The optimal timing of anticoagulation initiation or
restarting after an ICH in AF patients is also largely debated. Finally,
the left atrial appendage occlusion option should be evaluated in AF
patients with a very high risk of recurrent ICH. Overall, an
interdisciplinary unit consisting of cardiologists, neurologists,
neuroradiologists, neurosurgeons, patients, and their families should be
involved in management decisions. According to available evidence, this
review outlines the most appropriate anticoagulation strategies after an
ICH that should be adopted to treat this neglected subset of
patients. Copyright 2023 Luca, Colivicchi, Oliva, Abrignani, Caretta,
Di Fusco, Giubilato, Cornara, Di Nora, Pozzi, Di Matteo, Pilleri, Rao,
Parlavecchio, Ceravolo, Benedetto, Rossini, Calvanese, Gelsomino, Riccio
and Gulizia.

<114>
Accession Number
2023671558
Title
Subclinical postoperative atrial fibrillation: a randomized trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1153275. Date of Publication: 2023.
Author
Sabbag A.; Berkovich A.; Raanani E.; Volvovitch D.; McIntyre W.F.; Kassif
Y.; Kogan A.; Glikson M.; Beinart R.
Institution
(Sabbag, Berkovich, Beinart) Davidai Arrhythmia Center, Sheba Medical
Center, Ramat Gan, Israel
(Sabbag, Berkovich, Raanani, Volvovitch, Kassif, Kogan, Beinart) Sackler
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
(Raanani, Volvovitch, Kassif, Kogan) Department of Cardiac Surgery, Sheba
Medical Center, Ramat Gan, Israel
(McIntyre) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
(Glikson) Jesselson Integrated Heart Center, Shaare Zedek Medical Center,
Jerusalem, Israel
Publisher
Frontiers Media S.A.
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
complication of cardiac surgery, requiring interventions and prolonging
hospital stay. POAF is associated with increased mortality and a higher
rate of systemic thrombo-embolism. The rates of recurrent AF, optimal
follow-up and management remain unclear. We aimed to evaluate the
incidence of recurrent atrial fibrillation (AF) events, during long term
follow-up in patients with POAF following cardiac surgery. Method(s):
Patients with POAF and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score of >=2
were randomized in a 2:1 ratio to either implantation of a loop recorder
(ILR) or ECG monitoring using periodic Holters. Participants were followed
prospectively for 2 years. The primary end point was the occurrence of AF
longer than 5 min. Result(s): The final cohort comprised of 22
patients, of whom 14 received an ILR. Over a median follow up of 25.7 (IQR
of 24.7-44.4) months, 8 patients developed AF, representing a cumulative
annualized risk of AF recurrence of 35.7%. There was no difference between
ILR (6 participants, 40%) and ECG/Holter (2 participants, 25% p = 0.917).
All 8 patients with AF recurrence were treated with oral anticoagulation.
There were no cases of mortality, stroke or major bleeding. Two patients
underwent ILR explantation due to pain at the implantation site.
 Conclusion(s): The rate of recurrent AF in patients with POAF after
cardiac surgery and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score of >=2 is
approximately 1 in 3 when followed systematically. Further research is
need to assess the role of ILRs in this population. Copyright 2023
Sabbag, Berkovich, Raanani, Volvovitch, McIntyre, Kassif, Kogan, Glikson
and Beinart.

<115>
Accession Number
2023037329
Title
The Relationship between the Incidence of Postoperative Cognitive
Dysfunction and Intraoperative Regional Cerebral Oxygen Saturation after
Cardiovascular Surgery: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Reviews in Cardiovascular Medicine. 23(12) (no pagination), 2022. Article
Number: 388. Date of Publication: December 2022.
Author
Wang L.; Lang Z.; Gao H.; Liu Y.; Dong H.; Sun X.
Institution
(Wang, Gao, Liu, Sun) Aortic and Vascular Surgery Center, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing 100037, China
(Lang, Dong) First Clinical Medical College, Lanzhou University, Gansu,
Lanzhou 730000, China
Publisher
IMR Press Limited
Abstract
Background: To assess whether intraoperative monitoring and intervention
of regional cerebral oxygen saturation levels can reduce the incidence of
postoperative cognitive dysfunction in patients undergoing cardiovascular
surgery and contribute to patient prognosis. Method(s): The Cochrane
Library, PubMed, and the Web of Science were systematically searched for
relevant randomized controlled trials involving the effects of cerebral
oxygen saturation on the cognitive function of patients after
cardiovascular surgery from January 1, 2000 to May 1, 2022. The primary
outcome was the incidence of postoperative cognitive dysfunction. The
secondary outcomes were length of hospital stay, length of intensive care
unit (ICU) stay, length of mechanical ventilation, length of
cardiopulmonary bypass, and other major postoperative outcomes such as
renal failure, infection, arrhythmia, hospital mortality, and stroke. Data
were pooled using the risk ratio or standardized mean difference with 95%
confidence interval (CI). The original study protocol was registered
prospectively with PROSPERO (CRD42020178068). Result(s): A total of
13 randomized controlled trials involving 1669 cardiovascular surgery
patients were included. Compared with the control group, the risk of
postoperative cognitive dysfunction was significantly lower in the
intervention group (RR = 0.50 95% CI: 0.30 to 0.85 p = 0.01 I2
= 71%). The Duration of stay in intensive care units in the intervention
group was also significantly shorter than that in the control group
(standard mean difference (SMD) = -0.14 95% CI: -0.26 to -0.01 p = 0.03
I2 = 26%). Univariate meta-regression analyses showed that age
is a major source of heterogeneity. Conclusion(s): Our current study
suggests that intraoperative cerebral oxygen saturation monitoring and
intervention can significantly reduce the incidence of postoperative
cognitive dysfunction, and the length of intensive care unit stay after
intervention is considerably reduced. Given that some limits in this
review, more high-quality, and long-term trials are still needed to
certify our findings. Copyright © 2022 The Author(s). Published
by IMR Press. This is an open access article under the CC BY 4.0 license.

<116>
Accession Number
2021160038
Title
A systematic review and meta-analysis of general versus regional
anesthesia for lower extremity amputation.
Source
Journal of Vascular Surgery. 77(5) (pp 1542-1552.e9), 2023. Date of
Publication: May 2023.
Author
Mufarrih S.H.; Qureshi N.Q.; Yunus R.A.; Katsiampoura A.; Quraishi I.;
Sharkey A.; Mahmood F.; Matyal R.
Institution
(Mufarrih, Qureshi, Yunus, Katsiampoura, Quraishi, Sharkey, Mahmood,
Matyal) Department of Anesthesia, Critical Care and Pain Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
Publisher
Elsevier Inc.
Abstract
Objective: Postoperative morbidity in patients undergoing lower extremity
amputation (LEA) has remained high. Studies investigating the influence of
the anesthetic modality on the postoperative outcomes have yielded
conflicting results. The aim of our study was to assess the effects of
regional anesthesia vs general anesthesia on postoperative complications
for patients undergoing LEA. Method(s): We systematically searched
PubMed, Embase, MEDLINE, Web of Science, and Google Scholar from 1990 to
2022 for studies investigating the effect of the anesthetic modality on
the postoperative outcomes after LEA. Regional anesthesia (RA) included
neuraxial anesthesia and peripheral nerve blocks. The outcomes included
30-day mortality, respiratory failure (unplanned postoperative intubation,
failure to wean, mechanical ventilation >24 hours), surgical site
infection, cardiac complications, urinary tract infection, renal failure,
sepsis, venous thrombosis, pneumonia, and myocardial infarction.
 Result(s): Of the 25 studies identified, we included 10 retrospective
observational studies with 81,736 patients, of whom 69,754 (85.3%) had
received general anesthesia (GA) and 11,980 (14.7%) had received RA. In
the GA group, 50,468 patients were men (63.8%), and in the RA group, 7813
patients were men (62.3%). The results of the meta-analyses revealed that
GA was associated with a higher rate of respiratory failure (odds ratio,
1.38; 95% confidence interval, 1.06-1.80; P = .02) and sepsis (odds ratio,
1.21; 95% confidence interval, 1.11-1.33; P < .0001) compared with RA. No
differences were found in postoperative 30-day mortality, surgical site
infection, cardiac complications, urinary tract infection, renal failure,
venous thrombosis, pneumonia, and myocardial infarction between the GA and
RA groups. Conclusion(s): The results of our meta-analysis have shown
that GA could be associated with a higher rate of respiratory failure and
sepsis compared with RA for LEA. Copyright © 2023

<117>
Accession Number
2017334225
Title
Effect of Ascorbic Acid on Postoperative Acute Kidney Injury in Coronary
Artery Bypass Graft Patients: A Pilot Study.
Source
Heart Surgery Forum. 20(5) (pp E124-E128), 2017. Date of Publication:
2017.
Author
Antonic M.
Institution
(Antonic) Dept. for Cardiac Surgery, University Medical Centre Maribor,
Ljubljanska ulica 5, Maribor SI-2000, Slovenia
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Even minor postoperative reductions in renal function
influence the outcome of cardiac surgery. The mechanisms of postoperative
renal injury in cardiac surgery are multifactorial and include
ischemia-reperfusion injury. The study investigates the effect of the
antioxidant ascorbic acid on the postoperative acute kidney injury after
elective CABG surgery. Method(s): A prospective randomized
single-center trial was conducted in on-pump coronary artery bypass
patients. The patients in the ascorbic acid group received 2 grams of
ascorbic acid 24 hours and 2 hours preoperatively and 1 gram twice daily
five days after the surgery. Postoperatively, the subjects were monitored
for renal dysfunction and other complications. Result(s): 100
patients were included, with 50 patients in each study group. The groups
were well matched for baseline demographics, preoperative medications,
comorbidities, and had similar intraoperative characteristics. The
incidence of postoperative acute kidney injury in the ascorbic acid group
was 16% and 14% in the control group (P = .779). The groups also did not
differ in peak postoperative serum creatinine (83 [33] mumol/L versus 83
[39] mumol/L; P = .434), the lowest postoperative creatinine clearance
(96.40 +/- 35.78 mL/min versus 90.89 +/- 36.18 mL/min; P = .766), and time
from surgery to the onset of peak postoperative serum creatinine (1.64 +/-
1.34 days versus 1.92 +/- 1.54 days; P= .393). There was no dialysis
required in any patient. Conclusion(s): The results of this study did
not demonstrate a significant protective effect of ascorbic acid on the
incidence of postoperative acute renal injury in elective on- pump CABG
patients. Copyright © 2017 Forum Multimedia Publishing LLC. All
rights reserved.

<118>
Accession Number
2025071443
Title
Impact of Regional Anesthesia on Subjective Quality of Recovery in
Patients Undergoing Thoracic Surgery: A Systematic Review and
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Xu M.; Zhang G.; Tang Y.; Wang R.; Yang J.
Institution
(Xu, Zhang, Tang, Wang, Yang) Department of Anesthesiology, West China
Hospital of Sichuan University, Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: Regional anesthesia can be effective for managing pain after
thoracic surgery. This study evaluated whether it can also improve
patient-reported quality of recovery (QoR) after such surgery.
 Design(s): Meta-analysis of randomized controlled trials.
 Setting(s): Postoperative care. Intervention(s): Perioperative
regional anesthesia. Patient(s): Adults undergoing thoracic surgery.
 Measurements and Main Results: The primary outcome was total QoR
scores 24 hours after surgery. Secondary outcomes were postoperative
opioid consumption, pain scores, pulmonary function, respiratory
complications, and other adverse effects. Eight studies were identified,
of which 6 involving 532 patients receiving video-assisted thoracic
surgery were included in the quantitative analysis of QoR. Regional
anesthesia significantly improved QoR-40 score (mean difference 9.48; 95%
CI 3.53-15.44; I2 = 89%; 4 trials involving 296 patients) and
QoR-15 score (mean difference 6.7; 95% CI 2.58-10.82; I2 = 0%;
2 trials involving 236 patients). Regional anesthesia also significantly
reduced postoperative opioid consumption and the incidence of nausea and
vomiting. Insufficient data were available to meta-analyze the effects of
regional anesthesia on postoperative pulmonary function or respiratory
complications. Conclusion(s): The available evidence suggests that
regional anesthesia can enhance QoR after video-assisted thoracic surgery.
Future studies should confirm and extend these findings. Copyright
© 2023 Elsevier Inc.

<119>
Accession Number
2025028681
Title
Bilateral Ultrasound-Guided Mid-Point Transverse Process to Pleura Block
for Perioperative Analgesia in Pediatric Cardiac Surgery: A Randomized
Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Abdelbaser I.; Abourezk A.R.; Badran A.; Abdelfattah M.
Institution
(Abdelbaser, Abourezk, Badran, Abdelfattah) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: Mid-point transverse process to pleura (MTP) block is a new
regional analgesia technique. This study aimed to assess the perioperative
analgesic effects of MTP block in children undergoing open-heart surgery.
 Design(s): A single-center, randomized, double-blinded, controlled,
superiority study. Setting(s): At a University Children's Hospital.
 Participant(s): Fifty-two patients aged 2 to 10 years who underwent
open-heart surgery. Intervention(s): Patients were randomized to
receive either bilateral MTP block or no block (control).
 Measurements and Main Results: The primary outcome was fentanyl
consumption in the first postoperative 24 hours. The secondary outcomes
were intraoperative fentanyl consumption, modified objective pain score
(MOPS) measured at 1, 4, 8, 16, and 24 hours after extubation, and the
duration of stay in the intensive care unit (ICU). The mean (SD)
postoperative fentanyl consumption (microg/kg) in the first 24 hours was
significantly reduced in the MTP block group (4.4 +/- 1.2) compared to the
control group (6.0 +/- 1.4, p < 0.001). The mean (SD) intraoperative
fentanyl requirement (microg/ kg) was significantly reduced in the MTP
block group (9.1 +/- 1.9) compared to the control group (13.0 +/- 2.1, p <
0.001). The MOPS was significantly reduced in the MTP block group compared
to the control group at 1, 4, 8, and 16 hours after extubation but was
comparable in both groups at 24 hours. The mean (SD) duration of ICU stay
(hours) was significantly reduced in the MTP block group (25.0 +/- 2.9)
compared to the control group (30.7 +/- 4.2, p < 0.001).
 Conclusion(s): Single-shot bilateral ultrasound-guided MTP block in
children undergoing cardiac surgery reduced the mean fentanyl consumption
in the first postoperative 24 hours, intraoperative fentanyl requirements,
pain score at rest, time to extubation, and duration of ICU
stay. Copyright © 2023 Elsevier Inc.

<120>
Accession Number
2023727262
Title
Interventional Cardio-Oncology: Unique Challenges and Considerations in a
High-Risk Population.
Source
Current Treatment Options in Oncology. (no pagination), 2023. Date of
Publication: 2023.
Author
Leiva O.; Alam U.; Bohart I.; Yang E.H.
Institution
(Leiva) Division of Cardiology, Department of Medicine, New York
University Grossman School of Medicine, New York, NY, United States
(Alam, Bohart) Department of Medicine, New York University Grossman School
of Medicine, New York, NY, United States
(Yang) Division of Cardiology, Department of Medicine, UCLA
Cardio-Oncology Program, University of California at Los Angeles, 100
Medical Plaza, Suite 630, Los Angeles, CA 90095, United States
Publisher
Springer
Abstract
Patients with cancer are at risk of developing cardiovascular disease
(CVD) including atherosclerotic heart disease (AHD), valvular heart
disease (VHD), and atrial fibrillation (AF). Advances in percutaneous
catheter-based treatments, including percutaneous coronary intervention
(PCI) for AHD, percutaneous valve replacement or repair for VHD, and
ablation and left atrial appendage occlusion devices (LAAODs) for AF, have
provided patients with CVD significant benefit in the recent decades.
However, trials and registries investigating outcomes of these procedures
often exclude patients with cancer. As a result, patients with cancer are
less likely to undergo these therapies despite their benefits. Despite the
inclusion of cancer patients in randomized clinical trial data, studies
suggest that cancer patients derive similar benefits of percutaneous
therapies for CVD compared with patients without cancer. Therefore,
percutaneous interventions for CVD should not be withheld in patients with
cancer, as they may still benefit from these procedures. Copyright
© 2023, The Author(s).

<121>
Accession Number
2022651685
Title
Computed tomography-derived membranous septum length as predictor of
conduction abnormalities and permanent pacemaker implantation after TAVI:
A meta-analysis of observational studies.
Source
Catheterization and Cardiovascular Interventions. 101(7) (pp 1203-1213),
2023. Date of Publication: 01 Jun 2023.
Author
Michel Pompeu S.a.; Van den Eynde J.; Jacquemyn X.; Erten O.; Rodriguez
R.; Goldman S.; Coady P.M.; Gnall E.; Gray W.A.; Jarrett H.; Abramson
S.V.; Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Michel Pompeu, Rodriguez, Goldman, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Medical Center, Lankenau Heart Institute, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Erten, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Coady, Gnall, Gray) Department of Interventional Cardiology, Lankenau
Medical Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA,
United States
(Jarrett, Abramson) Department of Cardiovascular Imaging, Lankenau Medical
Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA, United
States
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, QC, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, QC, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Permanent pacemaker implantation (PPI) after transcatheter
aortic valve implantation (TAVI) is associated with higher risk of
mortality and rehospitalization for heart failure. Efforts to prevent
conduction abnormalities (CA) requiring PPI after TAVI should be made. The
membranous septum (MS) length and its interaction with implantation depth
(ID-DELTAMSID) could provide useful information about the risk of CA/PPI
following TAVI. Objective(s): To identify MS length and DELTAMSID as
predictors of CA/PPI following TAVI. Method(s): Study-level
meta-analysis of studies published by September 30, 2022. Result(s):
Eighteen studies met our eligibility including 5740 patients. Shorter MS
length was associated with a significantly higher risk of CA/PPI (per 1 mm
decrease: odds ratio [OR] 1.60, 95% confidence interval [CI] 1.28-1.99, p
< 0.001). Similarly, lower DELTAMSID was associated with a significantly
higher risk of CA/PPI (per 1 mm decrease: OR 1.75, 95% CI 1.32-2.31, p <
0.001). Meta-regression analyses revealed a statistically significant
modulation of the effect of shorter MS length and lower DELTAMSID on the
outcome (CA/PPI) by balloon postdilatation (positive regression
coefficients with p < 0.001); with increasing use of balloon
postdilatation, the effect of shorter MS length and lower DELTAMSID on the
outcome increased. MS length and DELTAMSID demonstrated excellent
discriminative abilities, with diagnostic ORs equaling 9.49 (95% CI
4.73-19.06), and 7.19 (95% CI 3.31-15.60), respectively.
 Conclusion(s): Considering that short MS length and low DELTAMSID are
associated with higher risk of CA and PPI, we should include measurement
of MS length in the pre-TAVI planning with MDCT and try to establish
optimal ID values before the procedure to avoid CA/PPI. Copyright
© 2023 Wiley Periodicals LLC.

<122>
Accession Number
641546412
Title
Systematic review and meta-analysis of the efficacy of olprinone and MEFV
gene in treating heart failure.
Source
Cellular and molecular biology (Noisy-le-Grand, France). 69(3) (pp 82-91),
2023. Date of Publication: 31 Mar 2023.
Author
Fu Y.; Wang X.; Pan Y.; Zhang H.
Institution
(Fu, Wang, Pan, Zhang) Department of Emergency Intensive Medicine,
Tangshan Central Hospital, Hebei Province, Tangshan, China
Publisher
NLM (Medline)
Abstract
Cardiovascular failure is the main cause of death in industrialized
societies. The results of recent studies have shown that some mutations in
the MEFV gene are common in heart failure patients. For this reason, the
study of mutations and genetic factors has been of great help in the
treatment of this disease, but despite this, due to the heterogeneity of
clinical symptoms, multiple pathophysiological processes, and
environmental genetic factors, the complete understanding of the genetic
causes of this disease is very complicated. As the new generation of
phosphodiesterase (PDE) III inhibitor, olprinone, the inhibition of human
heart PDE III by olprinone is highly selective. It is suitable for the
treatment of acute heart failure (HF) and acute cardiac insufficiency
after cardiac surgery. In this study Olprinone, milrinone, PDE inhibitors,
cardiac failure, and HF were selected as the search terms to retrieve
articles published between January 1999 and March 2022. RevMan5.3 and
Stata were employed to analyze and evaluate the risk bias of the included
articles. Besides, the Q test and heterogeneity were utilized to evaluate
the heterogeneity between articles. The results of this research showed No
heterogeneity was found between each research group. The sensitivity (Sen)
and specificity (Spe) of the two methods were compared. Olprinone showed
more significant therapeutic effects than other PDE inhibitors. Besides,
the therapeutic effect on the patients with HF in the two groups was
obvious. The incidence of postoperative adverse reactions among the
patients without relieving HF was low. The influences on urine flow of the
two group's demonstrated heterogeneity, and its effect revealed no
statistical meaning. The meta-analysis confirmed that the Spe and Sen of
olprinone treatment were higher than those of other PDE inhibitors. In
terms of hemodynamics, there was little difference between various
treatment methods.

<123>
Accession Number
2025083406
Title
10 Years of SYNTAX: Closing an Era of Clinical Research After Identifying
New Outcome Determinants.
Source
JACC: Asia. Part 2. 3(3) (pp 409-430), 2023. Date of Publication: June
2023.
Author
Serruys P.W.; Revaiah P.C.; Ninomiya K.; Masuda S.; Kotoku N.; Kageyama
S.; Onuma Y.; Morel M.A.; Garg S.; Feldman T.; Kappetein A.P.; Holmes
D.R.; Mack M.J.; Mohr F.-W.
Institution
(Serruys, Revaiah, Ninomiya, Masuda, Kotoku, Kageyama, Onuma, Morel)
Department of Cardiology, National University of Ireland, Galway (NUIG),
and CORRIB Research Centre for Advanced Imaging and Core Laboratory,
Galway, Ireland
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Feldman) Edwards Lifesciences, Irvine, CA, United States
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Mack) Department of Cardiothoracic Surgery, Baylor Scott & White Health,
Dallas, TX, United States
(Mohr) University Department of Cardiac Surgery, Heart Centre Leipzig,
Leipzig, Germany
Publisher
Elsevier Inc.
Abstract
The SYNTAX trial randomized patients equally eligible for coronary artery
bypass grafting or percutaneous coronary intervention using the Heart Team
approach. The SYNTAXES study achieved a follow-up rate of 93.8% and
reported the 10-year vital status. Factors associated with increased
mortality at 10 years were pharmacologically treated diabetes mellitus,
increased waist circumference, reduced left ventricular function, prior
cerebrovascular and peripheral vascular disease, western Europe and North
American descent, current smoking, chronic obstructive pulmonary disease,
elevated C-reactive protein, anemia, and an increase in HbA1c. Procedural
factors associated with higher 10 years mortality include periprocedural
myocardial infarction, extensive stenting, small stents, >=1 heavily
calcified lesion, >=1 bifurcation lesion, residual SYNTAX score >8, and
staged percutaneous coronary intervention. Optimal medical therapy at 5
years, use of statins, on-pump coronary artery bypass grafting, multiple
arterial grafts, and higher physical component score and mental component
score were associated with lower mortality at 10 years. Numerous scores
and prediction models were developed to help individualize risk
assessment. Machine learning has emerged as a novel approach for
developing risk models. Copyright © 2023 The Authors

<124>
Accession Number
2024825640
Title
Comparison of the effects of remimazolam tosylate and propofol on
postoperative delirium among older adults undergoing major non-cardiac
surgery: Protocol for a randomised controlled trial.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e071912. Date of
Publication: 29 May 2023.
Author
Li H.-X.; Li B.-L.; Wang T.-H.; Xu X.; Wang F.; Zhang X.; Li H.-Y.; Mu B.;
Sun Y.-L.; Zheng H.; Yan T.
Institution
(Li, Li, Wang, Xu, Zhang, Li, Mu, Zheng, Yan) Department of
Anesthesiology, National Cancer Center, National Clinical Research Center
for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
(Wang) Office of Cancer Screening, National Cancer Center, National
Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Zhang) Department of Pathergasiology, Peking University Sixth Hospital,
Peking University Institute of Mental Health, NHC Key Laboratory of Mental
Health (Peking University), National Clinical Research Center for Mental
Disorders (Peking University Sixth Hospital), Beijing, China
(Sun) State Key Laboratory of Molecular Oncology, National Cancer Center,
National Clinical Research Center for Cancer, Cancer Hospital, Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common cognitive
disturbance in elderly individuals that is characterised by acute and
fluctuating impairments in attention and awareness. Remimazolam tosylate
is a novel, ultrashort-acting benzodiazepine, and there is limited
evidence of its correlation with the incidence of early POD. The aim of
this study is to evaluate the incidence of POD after anaesthesia induction
and maintenance with remimazolam tosylate or propofol in elderly patients
undergoing major non-cardiac surgery. Methods and analysis This is a
single-centre, randomised controlled trial. 636 elderly patients
undergoing major non-cardiac surgery will be enrolled and randomised at a
1:1 ratio to receive total intravenous anaesthesia with either remimazolam
tosylate or propofol. The primary outcome is the incidence of POD within 5
days after surgery. Delirium will be assessed twice daily by the 3 min
Diagnostic Interview for the Confusion Assessment Method or the Confusion
Assessment Method for the intensive care unit (ICU) for ICU patients.
Secondary outcomes are the onset and duration of delirium, cognitive
function at discharge and within 1-year postoperatively, postoperative
analgesia within 5 days, chronic pain at 3 months, quality of recovery and
postoperative inflammatory biomarker levels. Ethics and dissemination The
study was approved by the institutional ethics committee of the National
Cancer Center/National Clinical Research Center for Cancer/Cancer
Hospital, Chinese Academy of Medical Sciences (approval No. 22/520-3722).
Written informed consent will be obtained from each patient before
enrolment. The results of this trial will be presented at scientific
conferences and in peer-reviewed scientific journals. Trial registration
number ChiCTR2300067368. Copyright © 2023 BMJ Publishing Group.
All rights reserved.

<125>
Accession Number
2024825572
Title
Carbon dioxide flooding to reduce postoperative neurological injury
following surgery for acute type A aortic dissection: A prospective,
randomised, blinded, controlled clinical trial, CARTA study protocol -
Objectives and design.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e063837. Date of
Publication: 25 May 2023.
Author
Ede J.; Teurneau-Hermansson K.; Moseby-Knappe M.; Ramgren B.; Bjursten H.;
Ederoth P.; Larsson M.; Mattsson-Carlgren N.; Sjogren J.; Wierup P.;
Nozohoor S.; Zindovic I.
Institution
(Ede, Teurneau-Hermansson, Bjursten, Larsson, Sjogren, Wierup, Nozohoor,
Zindovic) Department of Clinical Sciences Lund, Skane University Hospital
Lund, Lund University, Lund, Sweden
(Moseby-Knappe, Mattsson-Carlgren) Department of Neurology, Skane
University Hospital Lund, Lund University, Lund, Sweden
(Ramgren) Department of Diagnostic Radiology, Skane University Hospital
Lund, Lund University, Lund, Sweden
(Ederoth) Department of Anaesthesiology and Intensive Care, Skane
University Hospital Lund, Lund University, Lund, Sweden
(Mattsson-Carlgren) Clinical Memory Research Unit, Faculty of Medicine,
Lund University, Lund, Sweden
Publisher
BMJ Publishing Group
Abstract
Introduction Neurological complications after surgery for acute type A
aortic dissection (ATAAD) increase patient morbidity and mortality. Carbon
dioxide flooding is commonly used in open-heart surgery to reduce the risk
of air embolism and neurological impairment, but it has not been evaluated
in the setting of ATAAD surgery. This report describes the objectives and
design of the CARTA trial, investigating whether carbon dioxide flooding
reduces neurological injury following surgery for ATAAD. Methods and
analysis The CARTA trial is a single-centre, prospective, randomised,
blinded, controlled clinical trial of ATAAD surgery with carbon dioxide
flooding of the surgical field. Eighty consecutive patients undergoing
repair of ATAAD, and who do not have previous neurological injuries or
ongoing neurological symptoms, will be randomised (1:1) to either receive
carbon dioxide flooding of the surgical field or not. Routine repair will
be performed regardless of the intervention. The primary endpoints are
size and number of ischaemic lesions on brain MRI performed after surgery.
Secondary endpoints are clinical neurological deficit according to the
National Institutes of Health Stroke Scale, level of consciousness using
the Glasgow Coma Scale motor score, brain injury markers in blood after
surgery, neurological function according to the modified Rankin Scale and
postoperative recovery 3 months after surgery. Ethics and dissemination
Ethical approval has been granted by Swedish Ethical Review Agency for
this study. Results will be disseminated through peer-reviewed media.
Trial registration number NCT04962646. Copyright © 2023 BMJ
Publishing Group. All rights reserved.

<126>
Accession Number
2023726704
Title
Chronological comparison of TAVI and SAVR stratified to surgical risk: a
systematic review, meta-analysis, and meta-regression: Comparison of TAVI
versus SAVR.
Source
Acta Cardiologica. (no pagination), 2023. Date of Publication: 2023.
Author
Park D.Y.; An S.; Kassab K.; Jolly N.; Attanasio S.; Sawaqed R.; Malhotra
S.; Doukky R.; Vij A.
Institution
(Park) Department of Medicine, John H. Stroger Jr Hospital of Cook County,
Chicago, IL, United States
(An) Department of Biomedical Science, Seoul National University Graduate
School, Seoul, South Korea
(Kassab) Division of Cardiology, Ascension Borgess Hospital/Michigan State
University, Kalamazoo, MI, United States
(Jolly, Attanasio) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
(Sawaqed) Division of Cardiothoracic Surgery, Cook County Health, Chicago,
IL, United States
(Sawaqed) Division of Cardiothoracic Surgery, Rush Medical College,
Chicago, IL, United States
(Malhotra, Doukky, Vij) Division of Cardiology, Cook County Health,
Chicago, IL, United States
(Malhotra, Doukky, Vij) Division of Cardiology, Rush Medical College,
Chicago, IL, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has been
established as a reasonable alternative to surgical aortic valve
replacement (SAVR) in patients with severe aortic stenosis. However,
long-term outcomes including valve durability and the need for
reintervention are unanswered, especially in younger patients who tend to
be low surgical risk. We performed a meta-analysis comparing clinical
outcomes after TAVI and SAVR over 5 years stratified to low, intermediate,
and high surgical risks. Method(s): We identified propensity
score-matched observational studies and randomised controlled trials
comparing TAVI and SAVR. Primary outcomes, including all-cause mortality,
moderate or severe aortic regurgitation, moderate or severe paravalvular
regurgitation, pacemaker placement, and stroke, were extracted.
Meta-analyses of outcomes after TAVI compared to SAVR were conducted for
different periods of follow-up. Meta-regression was also performed to
analyse the correlation of outcomes over time. Result(s): A total of
36 studies consisting of 7 RCTs and 29 propensity score-matched studies
were selected. TAVI was associated with higher all-cause mortality at 4-5
years in patients with low or intermediate surgical risk. Meta-regression
time demonstrated an increasing trend in the risk of all-cause mortality
after TAVI compared with SAVR. TAVI was generally associated with a higher
risk of moderate or severe aortic regurgitation, moderate or severe
paravalvular regurgitation, and pacemaker placement. Conclusion(s):
TAVI demonstrated an increasing trend of all-cause mortality compared with
SAVR when evaluated over a long-term follow-up. More long-term data from
recent studies using newer-generation valves and state-of-the-art
techniques are needed to accurately assign risks. Copyright ©
2023 Belgian Society of Cardiology.

<127>
Accession Number
2023093447
Title
A review and meta-analysis of conventional sternotomy versus minimally
invasive mitral valve surgery for degenerative mitral valve disease
focused on the last decade of evidence.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Hussain S.; Swystun A.G.; Caputo M.; Angelini G.D.; Vohra H.A.
Institution
(Hussain) University of Bristol, Bristol, United Kingdom
(Swystun) University of Bradford, Bradford, United Kingdom
(Caputo, Angelini, Vohra) Department of Cardiac Surgery, Bristol Heart
Institute, Bristol, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objectives: Early meta-analyses comparing minimally invasive mitral valve
surgery (MIMVS) with conventional sternotomy (CS) have determined the
safety of MIMVS. We performed this review and meta-analysis based on
studies from 2014 onwards to examine the differences in outcomes between
MIMVS and CS. Specifically, some outcomes of interest included renal
failure, new onset atrial fibrillation, mortality, stroke, reoperation for
bleeding, blood transfusion and pulmonary infection. Method(s): A
systematic search was performed in six databases for studies comparing
MIMVS with CS. Although the initial search identified 821 papers in total,
nine studies were suitable for the final analysis. All studies included
compared CS with MIMVS. The Mantel - Haenszel statistical method was
chosen due the use of inverse variance and random effects. A meta-analysis
was performed on the data. Result(s): MIMVS had significantly lower
odds of renal failure (OR: 0.52; 95% CI 0.37 to 0.73, p < 0.001), new
onset atrial fibrillation (OR: 0.78; 95% CI 0.67 to 0.90, p < 0.001),
reduced prolonged intubation (OR: 0.50; 95% CI 0.29 to 0.87, p = 0.01) and
reduced mortality (OR: 0.58; 95% CI 0.38 to 0.87, p < 0.01). MIMVS had
shorter ICU stay (WMD: -0.42; 95% CI -0.59 to -0.24, p < 0.001) and
shorter time to discharge (WMD: -2.79; 95% CI -3.86 to -1.71, p < 0.001).
 Conclusion(s): In the modern era, MIMVS for degenerative disease is
associated with improved short-term outcomes when compared to the
CS. Copyright © The Author(s) 2023.

<128>
Accession Number
641549037
Title
Is Transcatheter Aortic Valve Implantation Effective in Improving Quality
of Life?: A Systematic Review.
Source
The Journal of cardiovascular nursing. (no pagination), 2023. Date of
Publication: 12 Jun 2023.
Author
Pollock M.; Hutchinson A.M.; Ockerby C.; Driscoll A.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Aortic stenosis (AS) without surgical intervention is
associated with morbidity and mortality and is the most common valvular
disease in the western world. Transcatheter aortic valve implantation
(TAVI) is a minimally invasive surgical option that has become a common
treatment for people unable to undergo open aortic valve replacement;
despite the increase in TAVI offerings in the last decade, patient quality
of life (QoL) outcomes postoperatively are poorly understood.
 OBJECTIVE(S): The aim of this review was to determine whether TAVI is
effective in improving QoL. METHOD(S): A systematic review following
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines was conducted, and the protocol was registered on PROSPERO
(CRD42019122753). MEDLINE, CINAHL, EMBASE, and PsycINFO were searched for
studies published between 2008 and 2021. Search terms included
"transcatheter aortic valve replacement" and "quality of life" and their
synonyms. Included studies were evaluated, dependent on study design,
using either the Risk of Bias-2 or the Newcastle-Ottawa Scale. Seventy
studies were included in the review. RESULT(S): Authors of the
studies used a wide variety of QoL assessment instruments and follow-up
durations; authors of most studies identified an improvement in QoL, and a
small number identified a decline in QoL or no change from baseline.
 CONCLUSION(S): Although authors of the vast majority of studies
identified an improvement in QoL, there was very little consistency in
instrument choice or follow-up duration; this made analysis and comparison
difficult. A consistent approach to measuring QoL for patients who undergo
TAVI is needed to enable comparison of outcomes. A richer, more nuanced
understanding of QoL outcomes after TAVI could help clinicians support
patient decision making and evaluate outcomes. Copyright © 2023
Wolters Kluwer Health, Inc. All rights reserved.

<129>
Accession Number
641548277
Title
The association between preoperative multidisciplinary team care and
patient outcome in frail cardiac surgery patients.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2023. Date of Publication: 09 Jun 2023.
Author
Smoor R.M.; van Dongen E.P.A.; Daeter E.J.; Emmelot-Vonk M.H.; Cremer
O.L.; Vernooij L.M.; Noordzij P.G.
Institution
(Smoor, Vernooij, Noordzij) Department of Anesthesiology, Intensive Care,
and Pain Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands;
Department of Intensive Care Medicine, University Medical Centre Utrecht,
Utrecht University, Utrecht, The Netherlands
(van Dongen) Department of Anesthesiology, Intensive Care, Pain Medicine,
St. Antonius Hospital, Nieuwegein, Netherlands
(Daeter) Department of Cardiothoracic surgery, St. Antonius Hospital,
Nieuwegein, Netherlands
(Emmelot-Vonk) Department of Geriatric Medicine, University Medical Centre
Utrecht, Utrecht University, Utrecht, Netherlands
(Cremer) Department of Intensive Care Medicine, University Medical Centre
Utrecht, Utrecht University, Utrecht, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the impact of preoperative MDT care on
perioperative management and outcomes of frail cardiac surgery patients.
BACKGROUND: Frail patients are at increased risk for complications and
poor functional outcome after cardiac surgery. In these patients,
preoperative multidisciplinary team (MDT) care may improve outcome.
 METHOD(S): Between 2018 and 2021, 1168 patients >= 70 years were
scheduled for cardiac surgery of whom 98 (8.4%) frail patients were
referred for MDT care. The MDT discussed surgical risk, prehabilitation
and alternative treatment. Outcomes of MDT patients were compared with 183
frail patients (non-MDT group) from a historical study cohort (2015-2017).
Inverse probability of treatment weighting was used to minimize bias from
non-random allocation of MDT vs. non-MDT care. Outcomes were severe
postoperative complications, total days in hospital (DIH120), disability,
and health-related quality of life (HRQL) after 120 days. RESULT(S):
This study included 281 patients (98 MDT and 183 non-MDT patients). Of the
MDT patients, 67 (68%) had open surgery, 21 (21%) underwent minimal
invasive procedures and 10 (10%) received conservative treatment. In the
non-MDT group, all patients had open surgery. Fourteen (14%) MDT patients
suffered a severe complication vs 42 (23%) non-MDT patients (adjusted RR
0.76; 95% CI 0.51 - 0.99). Adjusted DIH120 was 8 (IQR 3 - 12) vs 11 (IQR 7
- 16) days for MDT and non-MDT patients, respectively (P = 0.01). There
was no difference in disability or HRQL. CONCLUSION(S): Preoperative
MDT care for frail cardiac surgery patients is associated with alterations
in surgical management and with a lower risk for severe
complications. Copyright © 2023. Published by Elsevier Inc.

<130>
Accession Number
641547990
Title
Impact of Malnutrition in Patients With Heart Failure and Secondary Mitral
Regurgitation: The COAPT Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2023.
Date of Publication: 27 May 2023.
Author
Scotti A.; Coisne A.; Granada J.F.; Driggin E.; Madhavan M.V.; Zhou Z.;
Redfors B.; Kar S.; Lim D.S.; Cohen D.J.; Lindenfeld J.; Abraham W.T.;
Mack M.J.; Asch F.M.; Stone G.W.
Institution
(Scotti) Cardiovascular Research Foundation, New York, New York, USA;
Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical
Center, Albert Einstein College of Medicine, Bronx, New York, USA
(Coisne) Cardiovascular Research Foundation, New York, New York, USA;
Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical
Center, Albert Einstein College of Medicine, Bronx, New York, USA;
University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille,
France
(Granada, Zhou) Cardiovascular Research Foundation, NY, United States
(Driggin) Division of Cardiology, New York-Presbyterian Hospital/Columbia
University Irving Medical Center, NY, United States
(Madhavan) Cardiovascular Research Foundation, New York, New York, USA;
Division of Cardiology, New York-Presbyterian Hospital/Columbia University
Irving Medical Center, New York, New York, USA
(Redfors) Cardiovascular Research Foundation, New York, New York, USA;
Division of Cardiology, New York-Presbyterian Hospital/Columbia University
Irving Medical Center, New York, New York, USA; Department of Cardiology,
Sahlgerenska University Hospital, Gothenburg, Sweden
(Kar) Los Robles Regional, Thousand Oaks, California, USA; Bakersfield
Heart Hospital, Bakersfield, California, USA
(Lim) Division of Cardiology, Department of Medicine, University of
Virginia Health System, Charlottesville, VA, United States
(Cohen) Cardiovascular Research Foundation, New York, New York, USA; Saint
Francis Hospital, Roslyn, New York, USA
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University,
Columbus, OH, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Asch) MedStar Health Research Institute, Georgetown University, WA,
United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although malnutrition is associated with poor prognosis in
several diseases, its prognostic impact in patients with heart failure
(HF) and secondary mitral regurgitation (SMR) is not understood.
 OBJECTIVE(S): The purpose of this study was to assess the prevalence
and impact of malnutrition in HF patients with severe SMR randomized to
transcatheter edge-to-edge repair (TEER) with the MitraClip plus
guideline-directed medical therapy (GDMT) vs GDMT alone in the COAPT
trial. METHOD(S): Baseline malnutrition risk was calculated using the
validated geriatric nutritional risk index (GNRI) score. Patients were
categorized as having "malnutrition" (GNRI <=98) vs "no malnutrition"
(GNRI >98). Outcomes were assessed through 4 years. The primary endpoint
of interest was all-cause mortality. RESULT(S): Among 552 patients,
median baseline GNRI was 109 (IQR: 101-116); 94 (17.0%) had malnutrition.
All-cause mortality at 4 years was greater in patients with vs those
without malnutrition (68.3% vs 52.8%; P = 0.001). Using multivariable
analysis, both baseline malnutrition (adjusted-HR [adj-HR]: 1.37; 95% CI:
1.03-1.82; P = 0.03) and randomization to TEER plus GDMT compared with
GDMT alone (adj-HR: 0.65; 95% CI: 0.51-0.82; P = 0.0003) were independent
predictors of 4-year mortality. In contrast, GNRI was unrelated to the
4-year rate of heart failure hospitalization (HFH), although TEER
treatment reduced HFH (adj-HR: 0.46; 95% CI: 0.36-0.56). The reductions in
death (adj-Pinteraction = 0.46) and HFH (adj-Pinteraction = 0.67) with
TEER were consistent in patients with and without malnutrition.
 CONCLUSION(S): Malnutrition was present in 1 of 6 patients with HF
and severe SMR enrolled in COAPT and was independently associated with
increased 4-year mortality (but not HFH). TEER reduced mortality and HFH
in patients with and without malnutrition. (Cardiovascular Outcomes
Assessment of the MitraClip Percutaneous Therapy for Heart Failure
Patients With Functional Mitral Regurgitation [The COAPT Trial] and COAPT
CAS [COAPT]; NCT01626079). Copyright © 2023 American College of
Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

<131>
Accession Number
641547913
Title
Tricuspid valve repair concomitant with mitral valve surgery: a systematic
review and meta-analysis.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 08 Jun 2023.
Author
Yi K.; Xu J.; Zhang X.; Wang W.; Liu C.; Li X.; You T.
Institution
(Yi, You) Department of Cardiovascular Surgery, Gansu Provincial Hospital,
Gansu Province, Lanzhou, China
(Yi, Xu, Zhang, Wang, You) Gansu International Scientific and
Technological Cooperation Base of Diagnosis and Treatment of Congenital
Heart Disease, Gansu Province, Lanzhou, China
(Wang) Department of Cardiac Surgery, First Hospital of China Medical
University, Shenyang, Liaoning, China
(Xu) Evidence-Based Medicine Center, School of Basic Medical Sciences,
Lanzhou University, Lanzhou, China
(Zhang, Wang) First School of Clinical Medicine of Gansu University of
Chinese Medicine, Lanzhou, China
(Liu, Li) First Clinical Medical College of Lanzhou University, Lanzhou,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Uncertainties persist about whether to aggressively and
effectively treat tricuspid regurgitation (TR) during mitral valve (MV)
surgery. REVIEW METHODS: Systematic literature searches were performed in
five databases to collect all relevant studies published before May 2022
on whether the tricuspid valve (TV) was treated during MV surgery.
Separate meta-analyses were performed on data from Unmatched studies and
Randomized controlled trials (RCT)/Adjusted studies. MAIN RESULTS: A total
of 44 publications were included, of which eight were RCT studies and the
rest were retrospective studies. There was no difference in 30-day
mortality [odds ratio (OR): 1.00, 95% confidence interval (95%CI):
0.71-1.42, OR: 0.66, 95%CI: 0.30-1.41)] or overall survival [hazard ratio
(HR): 1.01, 95%CI: 0.85-1.19, HR: 0.77, 95%CI: 0.52-1.14] in Unmatched
studies and RCT/Adjusted studies. Late mortality (OR: 0.37, 95%CI:
0.21-0.64) and cardiac-related mortality (OR: 0.36, 95%CI: 0.21-0.62) were
lower in the TV repair (TVR) group in the RCT/Adjusted studies. In the
Unmatched studies, overall cardiac mortality (OR: 0.48, 95%CI: 0.26-0.88)
was lower in the TVR group. In the late TR progression analysis, the late
TR progression was lower among patients in the concomitantly intervened
tricuspid group, and patients in the untreated tricuspid group were prone
to TR progression in both studies (HR: 0.30, 95%CI: 0.22-0.41, HR: 0.37,
95%CI: 0.23-0.58). CONCLUSION(S): TVR concomitant with MV surgery is
most effective in patients with significant TR and dilated tricuspid
annulus, especially those with a significantly reduced risk of distant TR
progression. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, identifier:
CRD42022380967. Copyright © 2023 The Author(s). Published by
Wolters Kluwer Health, Inc.

<132>
Accession Number
641547453
Title
P2Y12 inhibitor monotherapy versus dual antiplatelet therapy in patients
with acute coronary syndromes undergoing coronary stenting: rationale and
design of the NEOMINDSET Trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 12 Jun 2023.
Author
Guimaraes P.O.; Franken M.; Tavares C.A.M.; Silveira F.S.; Antunes M.O.;
Bergo R.R.; Joaquim R.M.; Hirai J.C.S.; Andrade P.B.; Pitta F.G.; Mariani
J.; Nascimento B.R.; de Paula J.E.T.; Silveira M.S.; Costa T.A.O.;
Dall'Orto F.T.C.; Serpa R.G.; Sampaio F.B.A.; Ohe L.N.; Mangione F.M.;
Furtado R.H.M.; Sarmento-Leite R.; Monfardini F.; Assis S.R.L.; Nicolau
J.C.; Sposito A.C.; Lopes R.D.; Onuma Y.; Valgimigli M.; Angiolillo D.J.;
Serruys P.W.J.C.; Berwanger O.; Bacal F.; Lemos P.A.
Institution
(Guimaraes, Franken, Tavares, Hirai, Pitta, Mariani, Monfardini, Assis,
Berwanger, Bacal, Lemos) Hospital Israelita Albert Einstein, Sao Paulo,
Brazil
(Tavares, Pitta, Furtado, Nicolau, Bacal, Lemos) Instituto do Coracao
(InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Brazil and
Universidade de Sao Paulo, Sao Paulo, Brazil
(Silveira, Silveira) Research Center, Clinica do Coracao, Aracaju, Brazil
(Antunes, Costa) Hospital Universitario Sao Francisco de Assis na
Providencia de Deus, Braganca Paulista, Brazil
(Bergo, Dall'Orto) Hospital Santa Lucia, Pocos de Caldas, Brazil
(Joaquim) Instituto de Cardiologia de Santa Catarina, Sao Jose, Brazil
(Andrade) Irmandade da Santa Casa de Misericordia de Marilia, Marilia,
Brazil
(Nascimento) Hospital Universitario Ciencias Medicas, Belo Horizonte,
Brazil
(de Paula) Instituto Cardiovascular de Linhares, Linhares, Brazil
(Serpa) Hospital Santa Casa de Misericordia de Vitoria, Vitoria, Brazil
(Sampaio) Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
(Ohe) Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Mangione) Beneficiencia Portuguesa de Sao Paulo, Sao Paulo, Brazil
(Sarmento-Leite) Instituto de Cardiologia do Rio Grande do Sul/Fundacao
Universitaria de Cardiologia, Porto Alegre, Brazil
(Sposito) Department of Internal Medicine, School of Medical Sciences,
State University of Campinas, Campinas, Brazil
(Lopes) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Onuma, Serruys) Department of Cardiology, University of Galway, Galway,
Ireland
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Valgimigli) Universita della Svizzera Italiana, Lugano, Switzerland
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
Publisher
NLM (Medline)
Abstract
Dual antiplatelet therapy (DAPT) is currently the standard of care after
percutaneous coronary intervention (PCI). Recent studies suggest that
reducing DAPT to 1-3 months followed by an aspirin-free single
antiplatelet therapy (SAPT) strategy with a potent P2Y12 inhibitor is safe
and associated with less bleeding. However, to date, no randomised trial
has tested the impact of initiating SAPT immediately after PCI,
particularly in patients with acute coronary syndromes (ACS). NEOMINDSET
is a multicentre, randomised, open-label trial with a blinded outcome
assessment designed to compare SAPT versus DAPT in 3,400 ACS patients
undergoing PCI with the latest-generation drug-eluting stents (DES). After
successful PCI and up to 4 days following hospital admission, patients are
randomised to receive SAPT with a potent P2Y12 inhibitor (ticagrelor or
prasugrel) or DAPT (aspirin plus a potent P2Y12 inhibitor) for 12 months.
Aspirin is discontinued immediately after randomisation in the SAPT group.
The choice between ticagrelor and prasugrel is at the investigator's
discretion. The primary hypothesis is that SAPT will be non-inferior to
DAPT with respect to the composite endpoint of all-cause mortality,
stroke, myocardial infarction or urgent target vessel revascularisation,
but superior to DAPT on rates of bleeding defined by Bleeding Academic
Research Consortium 2, 3 or 5 criteria. NEOMINDSET is the first study that
is specifically designed to test SAPT versus DAPT immediately following
PCI with DES in ACS patients. This trial will provide important insights
on the efficacy and safety of withdrawing aspirin in the early phase of
ACS. (ClinicalTrials.gov: NCT04360720).

<133>
Accession Number
641547089
Title
The Left Atrial Appendage Closure by Surgery-2 (LAACS-2) trial protocol
Rationale and design of a randomized multicenter trial investigating if
left atrial appendage closure prevents stroke in patients undergoing
open-heart surgery irrespective of preoperative atrial fibrillation status
and stroke risk.
Source
American heart journal. (no pagination), 2023. Date of Publication: 09
Jun 2023.
Author
Madsen C.L.; Park-Hansen J.; Irmukhamedov A.; Carranza C.L.; Rafiq S.;
Lecoq R.R.; Camino N.P.; Modrau I.S.; Hansson E.C.; Jeppsson A.; Hadad R.;
Moya-Mitjans A.; Greve A.M.; Christensen R.; Carstensen H.G.; Host N.B.;
Dixen U.; Torp-Pedersen C.; Kober L.; Gogenur I.; Truelsen T.C.; Kruuse
C.; Sajadieh A.; Dominguez H.
Institution
(Madsen, Dominguez) Department of Cardiology, Copenhagen University
Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department
of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
(Park-Hansen, Hadad, Carstensen, Host, Sajadieh) Department of Cardiology,
Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen,
Denmark
(Irmukhamedov) Department of Heart, Lung, Vascular Surgery, Odense
University Hospital, Odense, Denmark
(Carranza, Rafiq) Department of Cardio-Thoracic Surgery, Copenhagen
University Hospital - Rigshospitalet, Copenhagen, Denmark
(Lecoq, Camino) Department of Cardiac Surgery, Hospital Vall d'Hebron,
Barcelona, Spain
(Modrau) Department of Department of Cardiothoracic and Vascular Surgery,
Aarhus University Hospital, Skejby, Denmark; Institute of Clinical
Medicine, Aarhus University, Aarhus, Denmark
(Hansson, Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden; Department of Molecular and
Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University
of Gothenburg, Gothenburg, Sweden
(Moya-Mitjans) Department of Cardiology, Hospital Vall d'Hebron,
Barcelona, Spain
(Greve) Department of Clinical Biochemistry, Copenhagen University
Hospital, Rigshospitalet, Copenhagen, Denmark
(Christensen) Section for Biostatistics and Evidence-Based Research, the
Parker Institute, Copenhagen University Hospital - Bispebjerg and
Frederiksberg, Copenhagen, Denmark; Research Unit of Rheumatology,
Department of Clinical Research, University of Southern Denmark, Odense
University Hospital, Denmark
(Dixen) Department of Cardiology, Copenhagen University Hospital - Amager
and Hvidovre, Hvidovre, Denmark
(Torp-Pedersen) Department of Cardiology, Copenhagen University Hospital -
North Zealand, Denmark
(Kober) Department of Cardiology, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
(Gogenur) Department of Surgery, Zealand University Hospital, Denmark
(Truelsen) Department of Neurology, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
(Kruuse) Department of Neurology, Neurovascular Research Unit, Copenhagen
University Hospital - Herlev and Gentofte, Herlev, Denmark
Publisher
NLM (Medline)
Abstract
Current recommendations regarding the use of surgical left atrial
appendage (LAA) closure to prevent thromboembolisms lack high-level
evidence. Patients undergoing open-heart surgery often have several
cardiovascular risk factors and a high occurrence of postoperative atrial
fibrillation (AF) - with a high recurrence rate - and are thus at a high
risk of stroke. Therefore, we hypothesized that concomitant LAA closure
during open-heart surgery will reduce mid-term risk of stroke
independently of preoperative AF status and CHA2DS2-VASc score. This
protocol describes a randomized multicenter trial. Consecutive
participants >=18 years scheduled for first-time planned open-heart
surgery from cardiac surgery centers in Denmark, Spain, and Sweden are
included. Both patients with a previous diagnosis of paroxysmal or chronic
AF, as well as those without AF, are eligible to participate, irrespective
of their CHA2DS2-VASc score. Patients already planned for ablation or LAA
closure during surgery, with current endocarditis, or where follow-up is
not possible are considered non-eligible. Patients are stratified by site,
surgery type, and preoperative or planned oral anticoagulation treatment.
Subsequently, patients are randomized 1:1 to either concomitant LAA
closure or standard care (i.e., open LAA). The primary outcome is stroke,
including transient ischemic attack, as assigned by two independent
neurologists blinded to the treatment allocation. To recognize a 60%
relative risk reduction of the primary outcome with LAA closure, 1500
patients are randomized and followed for two years (significance level of
0.05 and power of 90%). The LAACS-2 trial is likely to impact the LAA
closure approach in most patients undergoing open-heart
surgery. Copyright © 2023. Published by Elsevier Inc.

<134>
Accession Number
641546122
Title
Systematic Review and Meta-Analysis of Transradial Access for Carotid
Artery Stenting.
Source
Angiology. (pp 33197231183231), 2023. Date of Publication: 11 Jun 2023.
Author
Du M.; Hu Y.; Zhu D.; Cao W.; Li P.; Qi D.; Wu C.; He J.; Ye S.; Li S.;
Fang Y.
Institution
(Du, Hu, Zhu, Cao, Li, Qi, Wu, He, Ye, Li, Fang) Department of
Neurovascular Disease, Shanghai Fourth People's Hospital, School of
Medicine, Tongji University, Shanghai, China
Publisher
NLM (Medline)
Abstract
There is an increasing number of studies on the transradial approach (TRA)
for carotid artery stenting. We aimed to summarize the published data on
TRA vs the transfemoral approach (TFA). We searched Science Direct,
Embase, PubMed, and Web of Science databases for the relevant literature.
Primary outcomes included surgical success and cardiovascular and
cerebrovascular complication rates; secondary outcomes included the rates
of vascular access-related and other complications. We also compared the
crossover rate, success rate, and complications between TRA and TFA
carotid stenting. This is the first such meta-analysis regarding TRA and
TFA. Twenty studies on TRA carotid stenting were included (n = 1300).
Among 19 studies, the success rate of TRA carotid stenting was .951 (95%
confidence interval [CI]: .926-.975); death rate was .022 (.011-.032);
stroke rate was .005 (.001-.008); radial artery occlusion rate was .008
(.003-.013); and forearm hematoma rate was .003 (-.000 to .006). Among 4
studies comparing TRA and TFA, the success rate was lower (odds ratio:
.02; 95% CI: .00-.23) and crossover rate was higher (odds ratio: 40.16;
95% CI: 4.41-365.73) with TRA. Thus, transradial neuro-interventional
surgery has a lower success rate than TFA.

<135>
Accession Number
641544698
Title
Meta-analysis of post-transcatheter aortic valve replacement outcomes in
patients with cardiac amyloidosis and aortic stenosis.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 08 Jun 2023.
Author
Jaiswal V.; Joshi A.; Ishak A.; Nataraj M.; Ang S.P.; Khan N.; Daneshvar
F.; Aguilera-Alvarez V.H.; Verma D.; Shrestha A.B.; Sharma P.
Institution
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Joshi) Vydehi Institute of Medical Sciences and Research Centre,
Bangalore, India
(Ishak) European University Cyprus, School of Medicine, Nicosia, Cyprus
(Nataraj) Cardio-Pulmonary Physiotherapist and Research, Manipal,
Karnataka, India
(Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Khan) Jinnah Sindh Medical University, Karachi, Pakistan
(Daneshvar) Department of Cardiology, FL, United States
(Aguilera-Alvarez) Universidad Autonoma de Baja, CA, United States
(Verma) Janaki Medical College, Nepal
(Shrestha, Sharma) Abdur Rahim Medical College, Dinajpur, Bangladesh
Publisher
NLM (Medline)

<136>
Accession Number
641544129
Title
Safety of Biologic and Small Molecule Therapy for Inflammatory Bowel
Disease Among Solid Organ Transplant Recipients: Systematic Review and
Meta-Analysis.
Source
Inflammatory bowel diseases. (no pagination), 2023. Date of Publication:
10 Jun 2023.
Author
Taneja V.; Anand R.S.; El-Dallal M.; Dong J.; Desai N.; Taneja I.;
Feuerstein J.D.
Institution
(Taneja, Anand, Dong, Desai, Feuerstein) Beth Israel Deaconess Medical
Center, Harvard Medical School, Boston, MA, United States
(El-Dallal) *Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, MA, United States
(El-Dallal) Cambridge Health Alliance, Harvard Medical School, Boston, MA,
United States
(Taneja) Massachusetts General Hospital for Children, Harvard Medical
School, Boston, MA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients undergoing organ transplantation are often on
immunosuppressing medications to prevent rejection of the transplant. The
data on use of concomitant immunosuppression for inflammatory bowel
disease (IBD) and organ transplant management are limited. This study
sought to evaluate the safety of biologic and small molecule therapy for
the treatment of IBD among solid organ transplant recipients.
 METHOD(S): Medline, Embase, and Web of Science databases were
systematically searched for studies reporting on safety outcomes
associated with the use of biologic and small molecule therapy
(infliximab, adalimumab, certolizumab, golimumab, vedolizumab,
ustekinumab, and tofacitinib) in patients with IBD postsolid organ
transplant (eg, liver, kidney, heart, lung, pancreas). The primary outcome
was infectious complications. Secondary outcomes included serious
infections, colectomy, and discontinuation of biologic therapy.
 RESULT(S): Seven hundred ninety-seven articles were identified for
screening, yielding 16 articles for the meta-analyses with information on
163 patients. Antitumor necrosis factor alpha (Anti-TNFs; infliximab and
adalimumab) were used in 8 studies, vedolizumab in 6 studies, and a
combination of ustekinumab or vedolizumab and anti-TNFs in 2 studies. Two
studies reported outcomes after kidney and cardiac transplant
respectively, whereas the rest of the studies included patients with liver
transplants. The rates of all infections and serious infections were 20.09
per 100 person-years (100-PY; 95% CI, 12.23-32.99 per 100-PY, I2 = 54%)
and 17.39 per 100-PY (95% CI, 11.73-25.78 per 100-PY, I2 = 21%),
respectively. The rates of colectomy and biologic medication
discontinuation were 12.62 per 100-PY (95% CI, 6.34-25.11 per 100-PY, I2 =
34%) and 19.68 per 100-PY (95% CI, 9.97-38.84 per 100-PY, I2 = 74%),
respectively. No cases of venous thromboembolism or death attributable to
biologic use were reported. CONCLUSION(S): Biologic therapy is
overall well tolerated in patients with solid organ transplant. Long-term
studies are needed to better define the role of specific agents in this
patient population. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of Crohn's & Colitis Foundation. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<137>
Accession Number
641543950
Title
Opioid-free anesthesia versus opioid-based anesthesia in patients
undergoing cardiovascular and thoracic surgery: a meta-analysis and
systematic review.
Source
Seminars in cardiothoracic and vascular anesthesia. (pp
10892532231180227), 2023. Date of Publication: 10 Jun 2023.
Author
Mathew D.M.; Fusco P.J.; Varghese K.S.; Awad A.K.; Vega E.; Mathew S.M.;
Polizzi M.; George J.; Mathew C.S.; Thomas J.J.; Calixte R.; Ahmed A.
Institution
(Fusco, Varghese, Vega, Mathew, Polizzi, Mathew, Thomas, Ahmed) CUNY
School of Medicine, New York, NY, USA
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, USA
(Calixte) Epidemiology and Biostatistics, SUNY Downstate Health Sciences
University, Brooklyn, NY, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite their extensive clinical use, opioids are
characterized by several side effects. These complications, coupled with
the ongoing opioid epidemic, have favored the rise of
opioid-free-anesthesia (OFA). Herein, we perform the first pairwise
meta-analysis of clinical outcomes for OFA vs opioid-based anesthesia
(OBA) in patients undergoing cardiovascular and thoracic surgery.
 METHOD(S): We comprehensively searched medical databases to identify
studies comparing OFA and OBA in patients undergoing cardiovascular or
thoracic surgery. Pairwise meta-analysis was performed using the
Mantel-Haenszel method. Outcomes were pooled as risk ratios (RR) or
standard mean differences (SMD) and their 95% confidence intervals (95%
CI). RESULT(S): Our pooled analysis included 919 patients (8
studies), of whom 488 underwent surgery with OBA and 431 with OFA. Among
cardiovascular surgery patients, compared to OBA, OFA was associated with
significantly reduced post-operative nausea and vomiting (RR, 0.57; P =
.042), inotrope need (RR .84, P = .045), and non-invasive ventilation (RR,
.54; P = .028). However, no differences were observed for 24hr pain score
(SMD, -.35; P = .510) or 48hr morphine equivalent consumption (SMD, -1.09;
P = .139). Among thoracic surgery patients, there was no difference
between OFA and OBA for any of the explored outcomes, including
post-operative nausea and vomiting (RR, 0.41; P = .025).
 CONCLUSION(S): Through the first pooled analysis of OBA vs OFA in a
cardiothoracic-exclusive cohort, we found no significant difference in any
of the pooled outcomes for thoracic surgery patients. Although limited to
2 cardiovascular surgery studies, OFA was associated with significantly
reduced postoperative nausea and vomiting, inotrope need, and non-invasive
ventilation in these patients. With growing use of OFA in invasive
operations, further studies are needed to assess their efficacy and safety
in cardiothoracic patients.

<138>
Accession Number
641543668
Title
Efficacy and Safety of Moderate-Intensity Continuous Training on the
Improvement of Cardiopulmonary Function in Patients After Transcatheter
Aortic Valve Replacement (ENERGY): A Randomized Controlled Trial.
Source
Journal of the American Medical Directors Association. (no pagination),
2023. Date of Publication: 06 Jun 2023.
Author
Hu Q.; Li Y.-S.; Ren Q.; Liang Y.-C.; Zhang J.; Wang Y.-X.; Wang C.-L.;
Hong T.-L.; Wang S.-Y.; Zhang Y.; Zhang Q.-Y.; Han Y.-L.
Institution
(Hu) Department of Cardiology, General Hospital of Northern Theater
Command, Shenyang, China; Department of Cardiology, Air Force Hospital of
Western Theater Command, Chengdu, China
(Li, Ren, Liang, Zhang, Wang, Wang, Hong, Wang, Zhang, Han) Department of
Cardiology, General Hospital of Northern Theater Command, Shenyang, China
(Zhang) Department of Cardiology, General Hospital of Northern Theater
Command, Shenyang, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To investigate the effect of moderate-intensity continuous
training (MICT) on the improvement of cardiopulmonary function for
patients undergoing transcatheter aortic valve replacement (TAVR). DESIGN:
Randomized controlled study. SETTING AND PARTICIPANTS: Between August 20,
2021, and February 28, 2022, a total of 66 patients after TAVR were
screened for inclusion and randomly divided into the MICT and control
groups at a ratio of 1:1. MICT was scheduled 3 times per week for 3 months
in the intervention group. Patients in the control group received one-time
advice on physical activity according to the current guideline.
 METHOD(S): The primary endpoint was the 3-month change in peak oxygen
consumption (peak V.o2) assessed by cardiopulmonary exercise testing. The
secondary endpoints included the 3-month change in 6-minute walk test
(6MWT), the 12-Item Short Form Health Survey (SF-12), New York Heart
Association (NYHA) class, echocardiographic parameters, and laboratory
parameters. RESULT(S): After 3 months, the change in peak V.o2 was
higher in the MICT group than that in the control group (1.63 mL/kg/min,
95% CI 0.58-2.67, P = .003). Change in 6MWT (21.55 m, 95% CI 0.38-42.71, P
= .046) was higher in the MICT group compared with the control group. A
significant change in favor of MICT was also observed for low-density
lipoprotein cholesterol (-0.62 mmol/L, 95% CI -1.00 to -0.23, P = .002).
However, there were no significant changes in other echocardiographic
indices, laboratory parameters, and SF-12 between the 2 groups (all P >
.05). CONCLUSIONS AND IMPLICATIONS: MICT had a positive effect on the
cardiopulmonary function and physical capacity of patients after
TAVR. Copyright © 2023 AMDA - The Society for Post-Acute and
Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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