EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 133

Results Generated From:
Embase <1980 to 2023 Week 22>
Embase Weekly Updates (updates since 2023-05-30)

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

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

<3>
Accession Number
2023144027
Title
The Rationalisation of Intra-Operative Imaging During Cardiac Surgery: A
Systematic Review.
Source
Heart Lung and Circulation. 32(5) (pp 567-586), 2023. Date of Publication:
May 2023.
Author
Jaffar-Karballai M.; Kayali F.; Botezatu B.; Satti D.I.; Harky A.
Institution
(Jaffar-Karballai) Department of Medicine, St George's University of
London, London, United Kingdom
(Kayali) School of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Botezatu) Queen's University Belfast, School of Medicine, Dentistry and
Biomedical Sciences, Belfast, Northern Ireland, United Kingdom
(Satti) Shifa College of Medicine, Shifa Tameer-e-millat University,
Islamabad, Pakistan
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
Elsevier Ltd
Abstract
Introduction: One critical complication of cardiac surgery is
cerebrovascular accidents (CVAs). Ascending aorta atherosclerosis poses a
significant risk of embolisation to distal vessels and to cerebral
arteries. Epi-aortic ultrasonography (EUS) is thought to offer a safe,
high-quality accurate visualisation of the diseased aorta to guide the
surgeon on the best surgical approach to the planned procedure and
potentially improve neurological outcomes post-cardiac surgery.
 Method(s): The authors conducted a comprehensive search of PubMed,
Scopus and Embase. Studies that reported on epi-aortic ultrasound use in
cardiac surgery were included. Major exclusion criteria were: (1)
abstracts, conference presentations, editorials, literature reviews; (2)
case series with <5 participants; (3) epi-aortic ultrasound in trauma or
other surgeries. Result(s): A total of 59 studies and 48,255 patients
were included in this review. Out of the studies that reported patient
co-morbidities prior to cardiac surgery, 31.6% had diabetes, 59.5% had
hyperlipidaemia and 66.1% had a diagnosis of hypertension. Of those that
reported significant ascending aorta atherosclerosis found on EUS, this
ranged from 8.3% of patients to 95.2% with a mean percentage of 37.8%.
Hospital mortality ranged from 7% to 13%; four studies reported zero
deaths. Long-term mortality and stroke rate varied significantly with
hospital duration. Conclusion(s): Current data have shown EUS to have
superiority over manual palpation and transoesophageal echocardiography in
the prevention of CVAs following cardiac surgery. Yet, EUS has not been
implemented as a routine standard of care. Extensive adoption of EUS in
clinical practice is warranted to aid large, randomised trials before
making prospective conclusions on the efficacy of this screening
method. Copyright © 2023 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

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

<5>
Accession Number
2022050810
Title
Effects of ranolazine on various outcomes in patients with stable angina:
an updated meta-analysis.
Source
Hellenic Journal of Cardiology. 71 (pp 26-32), 2023. Date of Publication:
01 May 2023.
Author
Manolis A.; Kallistratos M.; Poulimenos L.; Zamfir T.; Thomopoulos C.
Institution
(Manolis, Kallistratos, Zamfir) Metropolitan Hospital, Cardiology
Department, Greece
(Poulimenos) Asklepeion General Hospital, Cardiology Department, Greece
(Thomopoulos) Helena Venizelou Hospital, Cardiology Department, Greece
Publisher
Hellenic Cardiological Society
Abstract
Objective: We determined the effect of ranolazine vs. placebo in angina
patients on 1) selective measures of the ischemic burden, 2)
cardiovascular outcomes, including atrial fibrillation incidence, 3) the
in-treatment glycohemoglobin levels and the permanent discontinuations
because of side effects, and 4) the achieved between-arms blood pressure
and heart rate difference. Method(s): PubMed and Cochrane
Collaboration Library databases were searched for eligible trials until
end of September 2020. Trial quality was assessed by the Rob2 tool. Risk
ratios or achieved mean differences during follow-up and 95% confidence
interval (CI) of categorical or continuous outcomes, respectively, were
calculated (random-effects model). The relationship between
discontinuation rates and ranolazine's mean dose was investigated by
meta-regression analysis. Result(s): We selected 18 trials (n =
12,995 patients in patients with macro or microvascular coronary heart
disease. Achieved blood pressure and heart rate at rest were not different
between randomized arms. Ranolazine administration compared to placebo was
associated with an increase of 1) total exercise duration by 30 seconds
(95% CI, 18-42), 2) time to 1 mm ST-segment depression by 44 seconds (95%
CI, 30-54), and 3) time to angina onset by 40 seconds (95% CI, 30-54). On
average, the incidence of atrial fibrillation was reduced by 25% following
ranolazine treatment compared to placebo, while glycohemoglobin showed a
mean decrease of 0.4% (95% CI, 0.3-0.5%). Discussion(s): Ranolazine
remains an effective anti-ischemic drug, increases the angina-free
exercise duration, delays the onset of ST-segment depression. The
beneficial effects of ranolazine are extended to atrial fibrillation
reduction rates and better glycemic control. Copyright © 2022
Hellenic Society of Cardiology

<6>
Accession Number
2021191505
Title
Comparison of Safety and Effectiveness of Local or General Anesthesia
after Transcatheter Aortic Valve Implantation: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 12(2) (no pagination), 2023. Article Number:
508. Date of Publication: January 2023.
Author
Wang L.; Liu Y.; Gao H.; Zhang B.; Zhou S.; Xie M.; Sun X.
Institution
(Wang, Liu, Gao, Zhang, Zhou, Xie, Sun) Aortic and Vascular Surgery
Center, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing 100037, China
Publisher
MDPI
Abstract
It remains controversial to choose anesthesia for transcatheter aortic
valve implantation (TAVI). A meta-analysis of cohort studies was conducted
to assess the efficacy and safety of local anesthesia (LA) compared to
general anesthesia (GA) in TAVI. All relevant studies published from 1
January 2002, to 31 June 2022, were searched in Ovid, PubMed, Embase, Web
of Science, and Cochrane Library. A total of 34 studies involving 23,480
patients were included in the meta-analysis. TAVI with LA was associated
with a significant reduction in hospital stay [WMD = -2.48, 95% CI (-2.80,
-2.16), p < 0.00001], operative [WMD = -12.25, 95% CI (-13.73, -10.78), p
< 0.00001] and fluoroscopy time [WMD = -3.30, 95% CI (-5.40, -1.19), p =
0.002], and an increased risk of acute kidney injury [OR = 1.31, 95% CI
(1.01, 1.69), p = 0.04] and a reduced incidence of major bleeding [OR =
0.59, 95% CI (0.46, 0.75), p < 0.0001] and the use of cardiovascular drugs
[OR = 0.17, 95% CI (0.05, 0.57), p = 0.004]. No differences were found
between LA and GA for 30-day mortality, procedural success rate,
myocardial infarction, permanent pacemaker implantation, paravalvular
leak, shock, and cerebrovascular events. Overall, 4.4% of LA converted to
GA. Based on current evidence, our results suggested that LA strategies
reduced hospital stay, operative time, fluoroscopy time, cardiovascular
drug consumption, and major bleeding rates in patients undergoing TAVI but
led to increased acute kidney injury rates. Further studies and randomized
trials are required to verify the presented findings and to identify
patients who might benefit from LA. Copyright © 2023 by the
authors.

<7>
Accession Number
2021190849
Title
Redo Surgical Aortic Valve Replacement versus Valve-In-Valve Transcatheter
Aortic Valve Implantation: A Systematic Review and Reconstructed
Time-To-Event Meta-Analysis.
Source
Journal of Clinical Medicine. 12(2) (no pagination), 2023. Article Number:
541. Date of Publication: January 2023.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Pattuzzi C.; Celik M.; Singh G.; Ceccato E.; Niccoli G.;
Lorusso R.; Nicolini F.
Institution
(Formica, Pattuzzi, Ceccato, Niccoli, Nicolini) Department of Medicine and
Surgery, University of Parma, Parma 43124, Italy
(Gallingani, Pattuzzi, Nicolini) Cardiac Surgery Clinic, University
Hospital of Parma, Via Gramsci 14, Parma 43125, Italy
(Tuttolomondo, Niccoli) Cardiology Unit, University Hospital of Parma, Via
Gramsci 14, Parma 43125, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo 33004, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin
10144, Italy
(Celik) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam 3062, Netherlands
(Singh) Division of Cardiac Surgery, Department of Critical Care Medicine,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB
11220, Canada
(Ceccato) Medical Library, University of Parma, Parma 43124, Italy
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
6200, Netherlands
Publisher
MDPI
Abstract
Objective. Valve-in-valve transcatheter aortic valve implantation
(ViV-TAVI) has emerged as a useful alternative intervention to
redo-surgical aortic valve replacement (Redo-SVAR) for the treatment of
degenerated bioprosthesis valve. However, there is no robust evidence
about the long-term outcome of both treatments. The aim of this
meta-analysis was to analyze the long-term outcomes of Redo-SVAR versus
ViV-TAVI by reconstructing the time-to-event data. Methods. The search
strategy consisted of a comprehensive review of relevant studies published
between 1 January 2000 and 30 September 2022 in three electronic
databases, PubMed, Cochrane Central Register of Controlled Trials
(CENTRAL) and EMBASE. Relevant studies were retrieved for the analysis.
The primary endpoint was the long-term mortality for all death. The
comparisons were made by the Cox regression model and by landmark analysis
and a fully parametric model. A random-effect method was applied to
perform the meta-analysis. Results. Twelve studies fulfilled the
eligibility criteria and were included in the final analysis. A total of
3547 patients were included. Redo-SAVR group included 1783 patients, and
ViV-TAVI included 1764 subjects. Redo-SAVR showed a higher incidence of
all-cause mortality within 30-days [Hazard ratio (HR) 2.12; 95% CI =
1.49-3.03; p < 0.0001)], whereas no difference was observed between 30
days and 1 year (HR = 1.03; 95% CI = 0.78-1.33; p = 0.92). From one year,
Redo-SAVR showed a longer benefit (HR = 0.52; 95% CI = 0.40-0.67; p <
0.0001). These results were confirmed for cardiovascular death (HR = 2.04;
95% CI = 1.29-3.22; p = 0.001 within one month from intervention; HR =
0.35; 95% CI = 0.18-0.71; p = 0.003 at 4-years follow-up). Conclusions.
Although the long-term outcomes seem similar between Redo-SAVR and
ViV-TAVI at a five-year follow-up, ViV-TAVI shows significative lower
mortality within 30 days. This advantage disappeared between 30 days and 1
year and reversed in favor of redo-SAVR 1 year after the
intervention. Copyright © 2023 by the authors.

<8>
Accession Number
2021164837
Title
Best Practices for the Catheter Ablation of Ventricular Arrhythmias.
Source
Cardiac Electrophysiology Clinics. 14(4) (pp 571-607), 2022. Date of
Publication: December 2022.
Author
Atreya A.R.; Yalagudri S.D.; Subramanian M.; Rangaswamy V.V.; Saggu D.K.;
Narasimhan C.
Institution
(Atreya, Yalagudri, Subramanian, Rangaswamy, Saggu, Narasimhan)
Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and
Research, Hyderabad, India
(Atreya) Division of Cardiovascular Medicine, Electrophysiology Section,
University of Arkansas for Medical Sciences, Little Rock, AR, United
States
Publisher
W.B. Saunders

<9>
Accession Number
638774984
Title
The use of blood and crystalloid cardioplegia in adult open-heart surgery
on postsurgical outcomes: A systematic review of atrial fibrillation
incidence, myocardial infarction, inotropic use, length of stay in ICU,
and postoperative mortality.
Source
Bali Journal of Anesthesiology. 6(3) (pp 145-151), 2022. Date of
Publication: July-September 2022.
Author
Putro B.N.; Hidayat J.K.; Soenarto R.F.
Institution
(Putro) Department of Anesthesiology and Intensive Therapy, Faculty of
Medicine, Universitas Sebelas Maret, Dr. Moewardi Hospital, Surakarta,
Indonesia
(Hidayat, Soenarto) Department of Anesthesiology and Intensive Therapy,
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Myocardial ischemia can occur due to hypotension, shock,
coronary heart disease, and aortic cross-clamping during open-heart
surgery using a cardiopulmonary bypass machine. As the cardioprotective
method, cardioplegia is classified into blood or crystalloid base. This
systematic review is aimed to describe the effectiveness of blood and
crystalloid cardioplegic solutions in adult open-heart surgery procedures
by focusing on their effects on cardiac enzymes. Material(s) and
Method(s): This study investigated the effect of blood and crystalloid
cardioplegia on troponin (cTn) and creatinine kinase myocardial bound. The
literature search was carried out on several Cochrane, PubMed, PMC, and
Google Scholar databases from January 2014 to August 2020 using the MeSH
keywords and Boolean operator. Result(s): We obtained 346 articles
and identified six prospective randomized studies from four countries. The
majority discussed the comparison of blood cardioplegia and crystalloids
in coronary revascularization cardiac surgery (coronary artery bypass
grafting). Overall, the articles used have a low risk of bias despite
their high level of homogenicity. Conclusion(s): The current
literatures on cardioplegia in adults do not provide adequate
advanced-phase trials. Both types of cardioplegia provide a reasonable
protection for myocardium. However, several studies reveal that
crystalloid cardioplegia increases cardiac enzymes more significantly than
blood cardioplegia. Copyright © 2022 Bali Journal of
Anesthesiology.

<10>
Accession Number
638774980
Title
The use of blood versus crystalloid cardioplegia in adult open heart
surgery: A systematic review.
Source
Bali Journal of Anesthesiology. 6(3) (pp 133-144), 2022. Date of
Publication: July-September 2022.
Author
Putro B.N.; Purwoko P.; Supraptomo R.T.; Putra E.S.; Sunjoyo A.
Institution
(Putro, Purwoko, Supraptomo, Putra, Sunjoyo) Department of Anesthesiology
and Intensive Therapy, Universitas Sebelas Maret, Dr. Moewardi Hospital,
Surakarta, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Myocardial ischemia can occur due to hypotension, shock, coronary heart
disease, and aortic cross-clamping during open-heart surgery using a
cardiopulmonary bypass machine. Cardioplegia is classified into the blood
or crystalloid base as a cardioprotective method. This systematic review
and meta-analysis aimed to describe the effectiveness of blood and
crystalloids cardioplegic solutions in adult open-heart surgery by
focusing on their effects on cardiac enzymes. This study investigated the
effect of blood and crystalloid cardioplegia on troponin (cTn) and
creatinine kinase myocardial bound (CKMB). The literature search was
carried out on several Cochrane, PubMed, PMC, and Google Scholar databases
from January 2014 to August 2020 using the medical subject heading
keywords and Boolean operator. We obtained 346 articles and identified
nine prospective randomized studies from five countries that met the
eligibility criteria. The majority discussed the comparison of blood
cardioplegia and crystalloids in coronary revascularization cardiac
surgery (CABG). The cTn values (weighted mean difference [WMD] -2.67,
confidence interval [CI] -4.18 to 1.17, P = 0.0005) and CKMB values (WMD
-2.67, CI -4.18 to 1.17, P = 0.0005) 24 h operatively showed that the
level of the cardiac enzymes increased in the crystalloids cardioplegia
group more than the blood cardioplegia group. Overall, the articles used
have a low risk of bias despite their high level of homogenicity. The
current literature on cardioplegia in adults does not provide adequate
advanced-phase trials. Both types of cardioplegia provide reasonable
protection for the myocardium. However, several studies reveal that
crystalloid cardioplegia increases cardiac enzymes more significantly than
blood cardioplegia. Copyright © 2022 Bali Journal of
Anesthesiology.

<11>
Accession Number
2023448831
Title
Comparison of Effects of Liuzijue Exercise and Conventional Respiratory
Training on Patients after Cardiac Surgery: A Randomized Controlled Trial.
Source
Chinese Journal of Integrative Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Zhang Q.-L.; Ge M.; Chen C.; Fan F.-D.; Jin Y.; Zhang N.; Wang L.
Institution
(Zhang, Wang) Department of Rehabilitation Medicine, Nanjing Drum Tower
Hospital, Clinical College of Nanjing University of Chinese Medicine,
Nanjing 210008, China
(Zhang, Jin, Wang) Department of Rehabilitation, College of Acupuncture
and Moxibustion and Massage Health Preservation and Rehabilitation,
Nanjing University of Chinese Medicine, Nanjing 210023, China
(Ge, Chen, Fan) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, the Affiliated Hospital of Nanjing University Medical School,
Nanjing 210008, China
(Zhang) Department of Ultrasound, Nanjing Drum Tower Hospital, the
Affiliated Hospital of Nanjing University Medical School, Nanjing 210008,
China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To evaluate the feasibility and safety of Liuzijue exercise
(LE) for the clinical effect in patients after cardiac surgery.
 Method(s): Totally 120 patients who underwent cardiac surgery and
were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum
Tower Hospital between July and Oclober, 2022 were allocated to the LE
group, the conventional respiratory training (CRT) group, and the control
group by a random number table at a ratio of 1:1:1; 40 patients in each
group. All patients received routine treatment and cardiac rehabilitation.
LE group and CRT group respectively performed LE and CRT once a day for 30
min for 7 days. Control group did not receive specialized respiratory
training. The forced vital capacity, forced expiratory volume in 1 s, peak
inspiratory flow rate, peak expiratory flow rate, maximum inspiratory
pressure, maximum expiratory pressure, modified Barthel index (MBI), and
Hamilton Rating Scale for Anxiety (HAM-A) were evaluated before, after 3
and 7 days of intervention. In addition, the postoperative length of
hospital stay (LOS) and the adverse events that occurred during the
intervention period were compared. Result(s): A total of 107 patients
completed the study, 120 patients were included in the analysis. After 3
days of intervention, the pulmonary function, respiratory muscle strength,
MBI and HAM-A of all 3 groups improved compared with that before the
intervention (P<0.05 or P<0.01). Compared with the control group,
pulmonary function and respiratory muscle strength were significantly
improved in the CRT and LE groups (P<0.05 or P<0.01). MBI and HAM-A were
significantly improved in the LE group compared with the control and CRT
groups (P<0.05 or P<0.01). On the 7th day after intervention, the
difference was still statistically significant (P<0.01), and was
significantly different from that on the 3rd day (P<0.05 or P<0.01). In
addition, on the 7th day of intervention, the pulmonary function and
respiratory muscle strength in the LE group were significantly improved
compared with those in the CRT group (P<0.01). MBI and HAM-A were
significantly improved in the CRT group compared with the control group
(P<0.01). There were no significant differences in postoperative LOS among
the 3 groups (P>0.05). No training-related adverse events occurred during
the intervention period. Conclusion(s): LE is safe and feasible for
improving pulmonary function, respiratory muscle strength, the ability to
complete activities of daily living and for relieving anxiety of patients
after cardiac surgery (Registration No. ChiCTR2200062964). Copyright
© 2023, The Chinese Journal of Integrated Traditional and Western
Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.

<12>
Accession Number
2019010286
Title
Benefits of icosapent ethyl for enhancing residual cardiovascular risk
reduction: A review of key findings from REDUCE-IT.
Source
Journal of Clinical Lipidology. 16(4) (pp 389-402), 2022. Date of
Publication: 01 Jul 2022.
Author
Gaba P.; Bhatt D.L.; Mason R.P.; Miller M.; Verma S.; Steg P.G.; Boden
W.E.
Institution
(Gaba, Bhatt, Mason) Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115,
United States
(Mason) Elucida Research LLC, Beverly, MA, United States
(Miller) Crescenz Veterans Affairs, University of Pennsylvania School of
Medicine, Philadelphia, PA, United States
(Verma) Division of Cardiac Surgery, University of Toronto, Toronto,
Canada
(Steg) Universite de Paris-Cite, FACT (French Alliance for Cardiovascular
Trials), Assistance Publique-Hopitaux de Paris, Hopital Bichat, INSERM
Unite, Paris 1148, France
(Boden) VA Boston Healthcare System, Division of Cardiovascular Medicine,
Boston University School of Medicine, Boston, MA, United States
Publisher
Elsevier Ltd
Abstract
Background. REDUCE-IT was a multinational, double-blind trial that
randomized 8179 statin-treated patients with controlled low-density
lipoprotein cholesterol and moderately elevated triglycerides to icosapent
ethyl (IPE) or placebo. IPE was associated with a substantial reduction in
the primary composite endpoint of death from cardiovascular causes,
nonfatal myocardial infarction, nonfatal stroke, coronary
revascularization, or unstable angina requiring hospitalization. Since the
original publication of the trial, there have been a myriad of additional
analyses confirming the benefit of IPE in various patient groups. Our
objectives in this review are to summarize the key findings of the
REDUCE-IT trial and its subsequent analyses as well as to call for the
reevaluation and expansion of current guidelines to incorporate IPE as a
therapy for patients at elevated cardiovascular risk with mild or moderate
hypertriglyceridemia. Copyright © 2022

<13>
Accession Number
641432119
Title
Infective Endocarditis during Pregnancy-Keep It Safe and Simple!.
Source
Medicina (Kaunas, Lithuania). 59(5) (no pagination), 2023. Date of
Publication: 12 May 2023.
Author
Onofrei V.A.; Adam C.A.; Marcu D.T.M.; Crisan Dabija R.; Ceasovschih A.;
Constantin M.; Grigorescu E.-D.; Petroaie A.D.; Mitu F.
Institution
(Onofrei, Adam, Marcu, Crisan Dabija, Ceasovschih, Constantin, Grigorescu,
Petroaie, Mitu) Department of Medical Specialties I, III and Preventive
Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine
and Pharmacy, University Street No. 16, II, Iasi 700115, Romania
(Onofrei, Ceasovschih, Constantin) "St. Spiridon" Clinical Emergency
Hospital, Independence Boulevard No. 1, Iasi 700111, Romania
(Adam, Mitu) Cardiovascular Rehabilitation Clinic, Clinical Rehabilitation
Hospital, Pantelimon Halipa Street No. 14, Iasi 700661, Romania
(Marcu, Crisan Dabija) Clinical Hospital of Pneumophthisiology Iasi,
Doctor Iosif Cihac Street No. 30, Iasi 700115, Romania
(Mitu) Academy of Medical Sciences, Ion C. Bratianu Boulevard No. 1,
Bucharest 030167, Romania
(Mitu) Academy of Romanian Scientists, Professor Dr. Doc. Dimitrie
Mangeron Boulevard No. 433, Iasi 700050, Romania
Publisher
NLM (Medline)
Abstract
The diagnosis of infective endocarditis (IE) during pregnancy is
accompanied by a poor prognosis for both mother and fetus in the absence
of prompt management by multidisciplinary teams. We searched the
electronic databases of PubMed, MEDLINE and EMBASE for clinical studies
addressing the management of infective endocarditis during pregnancy, with
the aim of realizing a literature review ranging from risk factors to
diagnostic investigations to optimal therapeutic management for mother and
fetus alike. The presence of previous cardiovascular pathologies such as
rheumatic heart disease, congenital heart disease, prosthetic valves,
hemodialysis, intravenous catheters or immunosuppression are the main risk
factors predisposing patients to IE during pregnancy. The identification
of modern risk factors such as intracardiac devices and intravenous drug
administration as well as genetic diagnostic methods such as cell-free
deoxyribonucleic acid (DNA) next-generation sequencing require that these
cases be addressed in multidisciplinary teams. Guiding treatment to
eradicate infection and protect the fetus simultaneously creates
challenges for cardiologists and gynecologists alike.

<14>
Accession Number
641428698
Title
Effect of Prophylactic Fibrinogen Concentrate In Scoliosis Surgery
(EFISS): a study protocol of two-arm, randomised trial.
Source
BMJ open. 13(5) (pp e071547), 2023. 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, 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
(Hudec) Department of Anaesthesiology and Intensive Care Medicine,
University Hospital Brno, 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
NLM (Medline)
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 © 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.

<15>
Accession Number
641423533
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) (pp e063837), 2023. 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, Department of
Cardiothoracic Surgery, Skane University Hospital Lund, Lund University,
Lund, Sweden
(Moseby-Knappe, Mattsson-Carlgren) Department of Clinical Sciences Lund,
Department of Neurology, Skane University Hospital Lund, Lund University,
Lund, Sweden
(Ramgren) Department of Clinical Sciences Lund, Department of Diagnostic
Radiology, Skane University Hospital Lund, Lund University, Lund, Sweden
(Ederoth) Department of Clinical Sciences Lund, 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
NLM (Medline)
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 © 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.

<16>
Accession Number
641423511
Title
The effects of cold compress and transcutaneous electrical nerve
stimulation on the pain associated with chest tube removal among patients
with coronary bypass grafting.
Source
Journal of cardiothoracic surgery. 18(1) (pp 186), 2023. Date of
Publication: 25 May 2023.
Author
Hatefi F.; Kazemi M.; Manglian P.; Shahi Moridi D.; Heydari S.; Hasani H.
Institution
(Hatefi) Department of Medical Surgical Nursing, Faculty of Nursing and
Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,
Islamic Republic of
(Kazemi) Department of Medical Surgical Nursing, Faculty of Nursing and
Midwifery, Non-Communicable Disease Research Center, Rafsanjan University
of Medical Sciences, Nurse Street, Rafsanjan, Iran, Islamic Republic of
(Manglian) Department of Critical Care Nursing, Faculty of Nursing and
Midwifery, Kerman University of Medical Sciences, Kerman, Iran, Islamic
Republic of
(Shahi Moridi) Department of Basic Science, Faculty of Medicine, Rafsanjan
University of Medical Sciences, Rafsanjan, Iran, Islamic Republic of
(Heydari) Department of Fundamental Nursing, Geriatric Care Research
Center, Faculty of Nursing and Midwifery, Rafsanjan University of Medical
Sciences, Rafsanjan, Iran, Islamic Republic of
(Hasani) Department of Medical Surgical Nursing, Jovein School of Nursing,
Sabzevar University of Medical Sciences, Sabzevar, Iran, Islamic Republic
of
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIM: Chest tube removal (CTR) can cause severe acute pain
which is usually described by patients as a painful experience. This study
compared the effects of cold compress, transcutaneous electrical nerve
stimulation (TENS), and combined cold compress-TENS on CTR-associated pain
among patients with coronary artery bypass grafting (CABG).
 METHOD(S): This randomized controlled trial was conducted in
2018-2019 using a double-blind four-group design. Participants were 120
patients with CABG selected from Shafa hospital, Kerman, Iran, and
randomly allocated to a cold compress, a TENS, a combined cold
compress-TENS, and a placebo group (compress with room temperature) and
TENS with an off TENS device. Each participant received the intervention
for 15 min immediately before CTR. CTR-associated pain was assessed
before, during, immediately after, and 15 min after CTR. Data were
analyzed using the SPSS program (v. 22.0) at a significance level of less
than 0.05. RESULT(S): The data of 29 participants in the placebo
group, 26 in the TENS group, 30 in the cold compress group, and 26 in the
combined cold compress-TENS group was gathered. Baseline demographic and
clinical characteristics and pain intensity scores of participants had no
statistically significant differences among all four groups (P>0.05). The
mean score of pain intensity in all groups was at its highest level during
CTR and gradually decreased afterwards, but this pain intensity reduction
in the compress-TENS group was significantly greater than other groups
(P<0.001). CONCLUSION(S): Combined cold compress-TENS is more
effective than separate cold compress and TENS in reducing CTR-associated
pain among patients with CABG. Therefore, non-pharmacological methods such
as combined cold compress-TENS are recommended for managing CTR-associated
pain. Copyright © 2023. The Author(s).

<17>
Accession Number
641423510
Title
The 100 most cited papers on total anomalous pulmonary venous connection:
a bibliometric analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 187), 2023. Date of
Publication: 25 May 2023.
Author
Wen C.; Liu W.; Fang C.; Shentu J.; Ma R.; Zhang H.; Zhu Z.; Chen H.
Institution
(Wen, Liu, Shentu, Ma, Zhang, Zhang, Zhu, Chen) Department of
Cardiothoracic Surgery, Shanghai Children's Medical Center, School of
Medicine, Shanghai Jiao Tong University, Shanghai, China
(Fang) Department of Neurosurgery, Shanghai Children's Medical Center,
School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The number of citations a paper receives reflects its impact
on the scientific community. We aimed to identify and explore the
characteristics of the most cited papers on total anomalous pulmonary
venous connection (TAPVC). METHOD(S): Web of Science Core Collection
Expanded Science Citation Index (1900 to present) was searched and papers
on TAPVC were reviewed. Articles were ranked by the number of citations
and the 100 most cited papers were analyzed. RESULT(S): The 100 most
cited papers were published between 1952 and 2018 with a mean number of
citations of 52 (range 26 to 148). The 1990s was the most productive
decade. All articles except one were written in English. The 100 most
cited articles were published in 24 journals, led by Journal of Thoracic
and Cardiovascular Surgery (21 articles), followed by Annals of Thoracic
Surgery (20 articles), and Circulation (16 articles). The United States of
America contributed most of the 100 most cited papers (60 articles).
Hospital for Sick Children, Toronto led the list of citation classics with
six papers. Christopher A. Caldarone, John W. Kirklin, and P. E. F.
Daubeney were the most productive authors with 3 articles each. More than
half of the papers were cohort studies (51 articles). Surgery, radiology
and etiology were the main topics. Thirty-one articles were funded by
public foundations, and none received support from commercial companies.
 CONCLUSION(S): The bibliometric analysis gives a historical
perspective on scientific progress in the field of TAPVC and lays the
foundation for future research. Copyright © 2023. The Author(s).

<18>
Accession Number
2024003211
Title
Comparison of Intercostal Block and Epidural Analgesia for
Post-thoracotomy: A Systematic Review and Meta-analysis of Randomized
Controlled Trials.
Source
Pain Physician. 26(3) (pp 219-229), 2023. Date of Publication: May/June
2023.
Author
Zhou Z.; Zheng X.; Song J.; Jin X.; Zhao L.; Liu S.
Institution
(Zhou, Song, Zhao, Liu) Department of Anesthesiology, The Affiliated
Hospital of Qingdao University, Shandong Province, Qingdao, China
(Zheng) Department of Operating Room, The Affiliated Hospital of Qingdao
University, Shandong Province, Qingdao, China
(Jin) Department of Thoracic Surgery, The Affiliated Hospital of Qingdao
University, Shandong Province, Qingdao, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Thoracotomy is associated with severe postoperative pain.
Effective management of acute pain after thoracotomy may reduce
complications and chronic pain. Epidural analgesia (EPI) is considered the
gold standard for postthoracotomy analgesia; however, it is associated
with complications and limitations. Emerging evidence suggests that an
intercostal nerve block (ICB) has a low risk of severe complications.
Anesthetists will benefit from a review that assesses the advantages and
disadvantages associated with ICB and EPI in thoracotomy.
 Objective(s): This meta-analysis aimed to evaluate the analgesic
efficacy and adverse effects of ICB and EPI for pain treatment after
thoracotomy. Study Design: Systematic review. Method(s): This
study was registered in the International Prospective Register of
Systematic Reviews (CRD42021255127). Relevant studies were searched for in
PubMed, Embase, Cochrane, and Ovid databases. Primary (postoperative pain
at rest and during cough) and secondary (nausea and vomiting, morphine
consumption, and length of hospital stay) outcomes were analyzed. The
standard mean difference for continuous variables and the risk ratio for
dichotomous variables were calculated. Result(s): Nine randomized
controlled studies with a total of 498 patients who underwent thoracotomy
were included. The results of the meta-analysis demonstrated no
statistically significant differences between the 2 methods in terms of
the Visual Analog Scale scores for pain at 6-8, 12-15, 24-25, and 48-50
hours at rest and at 24 hours during coughing after surgery. There were no
significant differences in nausea and vomiting, morphine consumption, or
length of hospital stay between the ICB and EPI groups.
 Limitation(s): The number of included studies was small, and the
quality of evidence was low. Conclusion(s): ICB may be as effective
as EPI for pain relief after thoracotomy. Copyright © 2023,
American Society of Interventional Pain Physicians. All rights reserved.

<19>
Accession Number
2024765165
Title
A prospective double-blinded randomized control trial comparing erector
spinae plane block to thoracic epidural analgesia for postoperative pain
in video-assisted thoracic surgery.
Source
Saudi Medical Journal. 44(2) (pp 155-163), 2023. Date of Publication: 01
Feb 2023.
Author
Hong J.-M.; Kim E.; Jeon S.; Lee D.; Baik J.; Cho A.-R.; Cho J.S.; Ahn
H.Y.
Institution
(Hong, Kim, Jeon, Lee, Baik, Cho) The Department of Anesthesia and Pain
Medicine, School of Medicine, Pusan National University, Busan, South
Korea
(Hong, Kim) The Department of Anesthesia and Pain Medicine, Biomedical
Research Institute, Pusan National University Hospital, Busan, South Korea
(Cho, Ahn) The Department of Thoracic and Cardiovascular Surgery, Pusan
National University Hospital, Busan, South Korea
(Jeon) The Department of Anesthesia and Pain Medicine, School of
Dentistry, Kyungpook National University, Daegu, South Korea
Publisher
Saudi Arabian Armed Forces Hospital
Abstract
Objectives: To compare the analgesic efficacies of erector spinae plane
(ESP) block and thoracic epidural analgesia (TEA) in video-assisted
thoracic surgery (VATS). Method(s): Sixty patients undergoing VATS
received patient-controlled TEA with a basal rate of 3 ml/hour (h), a
bolus of 3 ml (Group E), or ESP block with programmed intermittent bolus
infusions of 15 mL/3 h and a bolus of 5 ml (Group ES) for 2 postoperative
days. The primary outcome was to compare pain scores at rest 24 h
postoperatively between the 2 groups. Secondary outcomes included NRS
score for 48 h, procedural time, dermatomal spread, use of rescue
medication, adverse events, and patient satisfaction. Result(s):
Patients with continuous ESP block had a higher NRS score than those with
TEA but no statistical difference at a specific time. The dermatomal
spread was more extensive in the TEA group than in the ESP block group
(p=0.016); cumulative morphine consumption was higher in the ESP block
group (p=0.047). The incidence of overall adverse events in the TEA group
was higher than in the ESP block group (p=0.045). Conclusion(s):
Erector spinae plane block may be inferior to TEA for analgesia following
VATS, but it could have tolerable analgesia and a better side effect
profile than TEA. Therefore, it could be an alternative to TEA as a
component of multimodal analgesia. Copyright © 2023 Saudi Arabian
Armed Forces Hospital. All rights reserved.

<20>
Accession Number
2023371314
Title
Comparison of landiolol and amiodarone for the treatment of new-onset
atrial fibrillation after cardiac surgery (FAAC) trial: study protocol for
a randomized controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 353. Date of
Publication: December 2023.
Author
Caspersen E.; Guinot P.-G.; Rozec B.; Oilleau J.-F.; Fellahi J.-L.;
Gaudard P.; Lorne E.; Mahjoub Y.; Besnier E.; Moussa M.D.; Mongardon N.;
Hanouz J.-L.; Briant A.R.; Paul L.P.S.; Tomadesso C.; Parienti J.-J.;
Descamps R.; Denisenko A.; Fischer M.-O.
Institution
(Caspersen, Hanouz, Descamps, Denisenko) Department of
Anaesthesiology-Resuscitation and Perioperative Medicine, Normandy
University, UNICAEN, Caen University Hospital, Normandy, Caen, France
(Guinot) Department of Anaesthesiology and Intensive Care, Dijon
University Hospital, Dijon, France
(Guinot) University of Bourgogne and Franche-Comte, LNC UMR1231, Dijon,
France
(Guinot) INSERM, Dijon LNC UMR1231, France
(Guinot) LipSTIC LabEx, FCS Bourgogne-Franche Comte, Dijon, France
(Rozec) Service d'Anesthesie-Reanimation, Hopital Laennec, CHU Nantes,
Nantes, France
(Rozec) Institut du Thorax, Universite de Nantes, CHU Nantes, CNRS,
INSERM, Nantes, France
(Oilleau) Department of Anesthesiology and Surgical Intensive Care Unit,
Brest University Hospital, Brest 29200, France
(Fellahi) Service d'Anesthesie-Reanimation, Hopital Universitaire Louis
Pradel, Hospices Civils de Lyon, Lyon, France
(Fellahi) Faculte de Medecine Lyon Est, Universite Claude-Bernard, Lyon 1,
Lyon, France
(Gaudard) Department of Anesthesiology and Critical Care Medicine Arnaud
de Villeneuve, CHU Montpellier, University of Montpellier, Montpellier,
France
(Lorne) Department of Anaesthesia and Critical Care Medicine, Clinique du
Millenaire, Cedex 2, Montpellier 34960, France
(Mahjoub) Anesthesia and Critical Care Department, Amiens Hospital
University, Amiens, France
(Besnier) Department of Anesthesiology and Critical Care, Rouen University
Hospital, Rouen, France
(Moussa) Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille
U1011- EGID, F-59000, France
(Mongardon) Universite Paris-Est Creteil Val de Marne, Creteil 27010,
France
(Briant, Parienti) Department of Biostatistics, Normandy University,
UNICAEN, Caen University Hospital, Normandy, Caen, France
(Paul, Tomadesso) Department of Clinical Research and Innovation, Normandy
University, UNICAEN, Caen University Hospital, Normandy, Caen, France
(Fischer) Institut Aquitain du Coeur, Clinique Saint Augustin, Elsan, 114
Avenue d'Ares, Bordeaux Cedex 33074, France
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative atrial fibrillation (PoAF) after cardiac surgery
has a high incidence of 30%, but its management is controversial. Two
strategies are recommended without evidence of a superiority of one
against the other: rate control with beta-blocker or rhythm control with
amiodarone. Landiolol is a new-generation beta-blocker with fast onset and
short half-life. One retrospective, single-center study compared landiolol
to amiodarone for PoAF after cardiac surgery with a better hemodynamic
stability and a higher rate of reduction to sinus rhythm with landiolol,
justifying the need for a multicenter randomized controlled trial. Our aim
is to compare landiolol to amiodarone in the setting of PoAF after cardiac
surgery with the hypothesis of a higher rate of reduction to sinus rhythm
with landiolol during the 48 h after the first episode of POAF.
 Method(s): The FAAC trial is a multicenter single-blind two
parallel-arm randomized study, which planned to include 350 patients with
a first episode of PoAF following cardiac surgery. The duration of the
study is 2 years. The patients are randomized in two arms: a landiolol
group and an amiodarone group. Randomization (Ennov Clinical) is performed
by the anesthesiologist in charge of the patient if PoAF is persistent for
at least 30 min after correction of hypovolemia, dyskalemia, and absence
of pericardial effusion on a transthoracic echocardiography done at
bedside. Our hypothesis is an increase of the percentage of patients in
sinus rhythm from 70 to 85% with landiolol in less than 48 h after onset
of PoAF (alpha risk = 5%, power = 90%, bilateral test).
 Discussion(s): The FAAC trial was approved by the Ethics Committee of
EST III with approval number 19.05.08. The FAAC trial is the first
randomized controlled trial comparing landiolol to amiodarone for PoAF
after cardiac surgery. In case of higher rate of reduction with landiolol,
this beta-blocker could be the drug of choice used in this context as to
reduce the need for anticoagulant therapy and reduce the risk of
complications of anticoagulant therapy for patients with a first episode
of postoperative atrial fibrillation after cardiac surgery. Trial
registration: ClinicalTrials.gov NCT04223739. Registered on January 10,
2020. Copyright © 2023, The Author(s).

<21>
Accession Number
2023062473
Title
Long-Term Outcomes of Sternal-Sparing Versus Sternotomy Approaches for
Mitral Valve Repair: Meta-Analysis of Reconstructed Time-to-Event Data.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 18(2) (pp 167-174), 2023. Date of Publication: March/April 2023.
Author
Sa M.P.; Jacquemyn X.; Erten O.; Van den Eynde J.; Caldonazo T.; Doenst
T.; Ruhparwar A.; Weymann A.; de Souza R.O.R.R.; Rodriguez R.; Ramlawi B.;
Goldman S.
Institution
(Sa, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic Surgery,
Lankenau Heart Institute, Lankenau Medical Center, Main Line Health,
Wynnewood, PA, United States
(Sa, Erten, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Belgium
(Caldonazo, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
(Ruhparwar, Weymann) Department of Cardiothoracic, Transplantation and
Vascular Surgery, Hannover Medical School, Medizinische Hochschule
Hannover (MHH), Germany
(de Souza) Department of Cardiothoracic Surgery, University of South
Florida, USF Health, Tampa, FL, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Since there are concerns about the durability of mitral valve
repair (MVRp) with minimally invasive techniques in patients with mitral
regurgitation (MR), we aimed to evaluate the long-term outcomes of these
sternal-sparing approaches when compared with conventional approaches with
sternotomy in patients undergoing MVRp. Method(s): We performed a
systematic review according to a preestablished protocol and performed a
pooled analysis of Kaplan-Meier-derived reconstructed time-to-event data
from studies with longer follow-up comparing sternal-sparing versus
sternotomy approaches for MVRp. Our outcomes of interest were survival,
freedom from recurrent MR, and freedom from reoperation. Result(s):
Eleven studies met our eligibility criteria comprising 7,596 patients with
follow-up (sternal sparing, n = 4,246; sternotomy, n = 3,350). Patients
who underwent sternal-sparing MVRp had a significantly lower risk of
mortality over time compared with patients who underwent MVRp with
sternotomy (hazard ratio [HR] = 0.29, 95% confidence interval [CI]: 0.23
to 0.36, P < 0.001) in the overall analysis. However, we found no
statistically significant difference between the groups in the sensitivity
analysis with adjusted populations (HR = 0.85, 95% CI: 0.63 to 1.15, P =
0.301). Regarding the outcomes freedom from recurrent MR and freedom from
reoperation, we found no statistically significant differences between the
groups in the follow-up in both overall and sensitivity analyses.
 Conclusion(s): In comparison with MVRp with sternotomy approaches,
sternal-sparing MVRp was not associated with worse outcomes in terms of
survival, recurrent MR, and reoperations over time. Copyright ©
The Author(s) 2023.

<22>
Accession Number
2024790674
Title
The Role of Hypnotherapy in Postoperative Cardiac Surgical Patients, A
Scoping Review of Current Literature.
Source
Current Problems in Cardiology. 48(9) (no pagination), 2023. Article
Number: 101787. Date of Publication: September 2023.
Author
Ahmad B.; Gill I.; Liblik K.; Uppal J.S.; El-Diasty M.
Institution
(Ahmad, Liblik, Uppal) Queen's University School of Medicine, Kingston,
ON, Canada
(Gill) Queen's University, Kingston, ON, Canada
(El-Diasty) Division of Cardiac Surgery, Department of Surgery, Queen's
University, Kingston, ON, Canada
Publisher
Elsevier Inc.
Abstract
Hypnotherapy has been proposed as an emerging tool that can be implemented
in management of different aspects of postoperative cardiac surgical care.
This technique involves hypnotic induction to redirect focus and attention
away from postsurgical pain. Emerging literature has shown that hypnosis
significantly improves emotional distress immediately preceding surgical
procedures and these effects have been demonstrated to extend into the
postoperative period. The purpose of this scoping review is to summarize
current literature on the role of hypnotherapy in the management of
perioperative pain, anxiety, and depression in patients undergoing cardiac
surgery. A database search was conducted using PubMed, Embase, and Google
Scholar. We included all comparative studies (randomized and
nonrandomized) that examined the effect of hypnotherapy on pain, anxiety,
and depression in patients undergoing cardiac surgery. Included articles
were restricted to adult patients and English language only. Literature
search yielded a total of 64 articles, of which, 14 duplicates were
removed. After title and abstract screening, only 18 articles were
included for full-text review. Six studies (with a total number of 420
patients) were included in the final analysis. Of these, 5 were randomized
control trials and 1 was a cohort study. Our findings suggest that there
may be a potential role for the use of hypnotherapy in the management of
pain, anxiety, and depressive symptoms in the perioperative period of
cardiac surgery. However, more robust evidence is required to justify its
incorporation in the routine perioperative management pathways in this
group of patients. Copyright © 2023 Elsevier Inc.

<23>
Accession Number
2024678140
Title
Efficacy and safety of carbon dioxide insufflation for brain protection
for patients undergoing planned left-sided open heart valve surgery:
Protocol for a multicentre, placebo-controlled, blinded, randomised
controlled trial (the CO2 Study).
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e074221. Date of
Publication: 17 May 2023.
Author
Todd R.; Rogers C.A.; Pufulete M.; Culliford L.; Pretorius P.; Voets N.;
Akowuah E.; Sayeed R.; Lazaroo M.; Kaur S.; Angelini G.D.; Gibbison B.
Institution
(Todd, Kaur) Bristol Trials Centre, University of Bristol, Bristol, United
Kingdom
(Rogers, Pufulete, Culliford, Lazaroo) Bristol Trials Centre, Bristol
Medical School, University of Bristol, Bristol, United Kingdom
(Pretorius, Voets) Wellcome Centre for Integrative Neuroimaging,
University of Oxford, Oxford, United Kingdom
(Akowuah) James Cook Hospital, South Tees Hospitals NHS Foundation Trust,
Middlesbrough, United Kingdom
(Sayeed) John Radcliffe Hospital, Oxford University Hospitals NHS
Foundation Trust, Oxford, United Kingdom
(Angelini, Gibbison) Bristol Heart Institute, University Hospitals
Bristol, Weston NHS Foundation Trust, Bristol, United Kingdom
(Angelini, Gibbison) Bristol Medical School, University of Bristol,
Bristol, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Brain injury is common following open heart valve surgery.
Carbon dioxide insufflation (CDI) has been proposed to reduce the
incidence of brain injury by reducing the number of air microemboli
entering the bloodstream in surgery. The CO2 Study will evaluate the
efficacy and safety of CDI in patients undergoing planned left-sided open
heart valve surgery. Methods and analysis The CO2 Study is a multicentre,
blinded, placebo-controlled, randomised controlled trial. Seven-hundred
and four patients aged 50 years and over undergoing planned left-sided
heart valve surgery will be recruited to the study, from at least eight UK
National Health Service hospitals, and randomised in a 1:1 ratio to
receive CDI or medical air insufflation (placebo) in addition to standard
de-airing. Insufflation will be delivered at a flow rate of 5 L/min from
before the initiation of cardiopulmonary bypass until 10 min after
cardiopulmonary bypass weaning. Participants will be followed up until 3
months post-surgery. The primary outcome is acute ischaemic brain injury
within 10 days post-surgery based on new brain lesions identified with
diffusion-weighted MRI or clinical evidence of permanent brain injury
according to the current definition of stroke. Ethics and dissemination
The study was approved by the East Midlands-Nottingham 2 Research Ethics
Committee in June 2020 and the Medicines and Healthcare products
Regulatory Agency in May 2020. All participants will provide written
informed consent prior to undertaking any study assessments. Consent will
be obtained by the principal investigator or a delegated member of the
research team who has been trained in the study and undergone Good
Clinical Practice training. Results will be disseminated through
peer-reviewed publications and presentations at national and international
meetings. Study participants will be informed of results through study
notifications and patient organisations. Trial registration number
ISRCTN30671536. 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.

<24>
Accession Number
2024678139
Title
Caffeine, Postoperative Delirium and Change in Outcomes after Surgery
(CAPACHINOS)-2: Protocol for a randomised controlled trial.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e073945. Date of
Publication: 15 May 2023.
Author
Vlisides P.E.; Ragheb J.; McKinney A.; Mentz G.; Runstadler N.; Martinez
S.; Jewell E.; Lee U.; Vanini G.; Schmitt E.M.; Inouye S.K.; Mashour G.A.
Institution
(Vlisides, Ragheb, McKinney, Mentz, Runstadler, Martinez, Jewell, Lee,
Vanini, Mashour) Anesthesiology, Michigan Medicine, Ann Arbor, MI, United
States
(Vlisides, Lee, Vanini, Mashour) Center for Consciousness Science,
University of Michigan, Ann Arbor, MI, United States
(Schmitt, Inouye) Hebrew SeniorLife Institute for Aging Research, Harvard
Medical School, Boston, MA, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Delirium is a major public health issue for surgical patients
and their families because it is associated with increased mortality,
cognitive and functional decline, prolonged hospital admission and
increased healthcare expenditures. Based on preliminary data, this trial
tests the hypothesis that intravenous caffeine, given postoperatively,
will reduce the incidence of delirium in older adults after major
non-cardiac surgery. Methods and analysis The CAffeine, Postoperative
Delirium And CHange In Outcomes after Surgery-2 (CAPACHINOS-2) Trial is a
single-centre, placebo-controlled, randomised clinical trial that will be
conducted at Michigan Medicine. The trial will be quadruple-blinded, with
clinicians, researchers, participants and analysts all masked to the
intervention. The goal is to enrol 250 patients with a 1:1:1: allocation
ratio: dextrose 5% in water placebo, caffeine 1.5 mg/kg and caffeine 3
mg/kg as a caffeine citrate infusion. The study drug will be administered
intravenously during surgical closure and on the first two postoperative
mornings. The primary outcome will be delirium, assessed via long-form
Confusion Assessment Method. Secondary outcomes will include delirium
severity, delirium duration, patient-reported outcomes and opioid
consumption patterns. A substudy analysis will also be conducted with
high-density electroencephalography (72-channel system) to identify neural
abnormalities associated with delirium and Mild Cognitive Impairment at
preoperative baseline. Ethics and dissemination This study was approved by
the University of Michigan Medical School Institutional Review Board
(HUM00218290). An independent data and safety monitoring board has also
been empanelled and has approved the clinical trial protocol and related
documents. Trial methodology and results will be disseminated via clinical
and scientific journals along with social and news media. Trial
registration number NCT05574400. 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.

<25>
[Use Link to view the full text]
Accession Number
2024734735
Title
Effects of modified ultrafiltration and conventional ultrafiltration
combination on perioperative clinical outcomes in pediatric cardiac
surgery: A meta-analysis.
Source
Medicine (United States). 100(3) (pp E24221), 2021. Date of Publication:
22 Jan 2021.
Author
Hu J.; Li P.; Chen X.; Yan J.; Zhang J.; Zhang C.
Institution
(Hu, Yan, Zhang) Department of Anesthesiology, China
(Li) Department of Obstetrics, China
(Li) Hunan Engineering Research Center of Early Life Development and
Disease Prevention, China
(Chen, Zhang) Department of Cardiovascular Surgery, Xiangya Hospital,
Changsha, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:This meta-analysis was performed to review the effects of the
addition of modified ultrafiltration (MUF) and conventional
ultrafiltration (CUF) to CUF alone on postoperative hemoglobin, surgical
and ultrafiltration data, and postoperative clinical outcomes in pediatric
patients undergoing cardiac surgery. Method(s):A systematic search
was performed to identify randomized controlled clinical trials that
compared MUF and CUF combination with CUF alone in pediatric cardiac
surgery undergoing cardiopulmonary bypass (CPB) in PubMed, Embase,
Cochrane Library, and Web of Science without any language or date
limitation in February 2020. For each included trial, the primary outcomes
including post-CPB and postoperative hematocrit, surgical and
ultrafiltration data, postoperative clinical outcomes including volume of
chest tube drainage within 48 hours after surgery and perioperative blood
requirement, ventilation support duration, and length of stay day in the
intensive care unit (ICU) and hospital were collected and analyzed. The
analysis was conducted using STATA version 12.0. Result(s):A total of
8 trials encompassing 405 patients were included in this analysis.
Analysis indicated that MUF + CUF increased the post-CPB hematocrit
(Standard mean difference, SMD = 1.85, 95% confidence interval, 95% CI
0.91-2.79). Meanwhile, ultrafiltration volume was higher in CUF+MUF
infants than CUF-alone infants (SMD = 1.46, 95% CI 0.51-2.41, P = .003).
The clinical outcomes, including postoperative hemodynamic changes, prime
volume, blood requirement, chest tube drainage volume, mechanical
ventilation duration, and ICU duration, were unclear because of the
unstable sensitivity analyses. Conclusion(s):Beneficial effects of
using MUF and CUF for pediatric cardiac surgery, including increase
post-CPB hematocrit and ultrafiltration volume when compared with CUF
alone. Meanwhile, MUF and CUF did not significantly influence the
postoperative hospital stay duration, CPB, and aortic occlusion duration.
 © Copyright 2021 the Author(s). Published by Wolters Kluwer
Health, Inc.

<26>
Accession Number
2023492087
Title
Use of cardiopulmonary bypass is associated with chronic postsurgical pain
among patients undergoing coronary artery bypass graft surgery: follow-up
of a randomized, clinical trial.
Source
Journal of Anesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Minami K.; Tadokoro N.; Fukushima S.; Fujita T.; Ohnishi Y.
Institution
(Minami) Department of Critical Care Medicine, National Cerebral and
Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita 564-8565, Japan
(Tadokoro, Fukushima, Fujita) Department of Cardiac Surgery, National
Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita
564-8565, Japan
(Ohnishi) Department of Anesthesiology, National Cerebral and
Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita 564-8565, Japan
Publisher
Springer
Abstract
Background: Chronic postsurgical pain (CPSP) worsens patients' mortality,
morbidity, and quality of life. Cardiopulmonary bypass is mandatory for
cardiac surgery, but it induces intense inflammation. The presence of
inflammation is a crucial part of pain sensitization. An extreme
inflammatory response due to cardiopulmonary bypass might cause a high
prevalence of CPSP after cardiac surgery. We hypothesized that the
prevalence and severity of CPSP are higher in patients after on-pump
coronary artery bypass graft (CABG) surgery than in those after off-pump
CABG surgery. Method(s): This prospective, observational study was
performed on a cohort from a randomized trial (on-pump CABG: 81 patients,
off-pump CABG: 86 patients). A questionnaire about the severity of
surgical wound pain that evaluated pain with the numerical rating scale
(NRS) was filled out by the patients. NRS responses for current pain, peak
pain in the last 4 weeks, and average pain in the last 4 weeks were
evaluated. The main outcomes were the severity of CPSP as evaluated using
the NRS and the prevalence of CPSP. CPSP was defined as pain with an NRS
score > 0. Differences in severity between groups were analyzed using
multivariate ordinal logistic regression models adjusted for age and sex,
and differences in prevalence between groups were analyzed using
multivariate logistic regression models adjusted for age and sex.
 Result(s): The questionnaire return rate was 77.0%. During a median
follow-up of 17 years, 26 patients complained of CPSP (on-pump CABG: 20
patients, off-pump CABG: 6 patients). Ordinal logistic regression showed
that the NRS response for current pain (odds ratio [OR] 2.34; 95% CI
1.12-4.92; P = 0.024) and the NRS response for peak pain in the last 4
weeks (OR 2.71; 95% CI 1.35-5.42; P = 0.005) were significantly higher in
patients who underwent on-pump CABG surgery than in those who underwent
off-pump CABG. Logistic regression showed that on-pump CABG surgery was an
independent predictor of CPSP (OR 2.59; 95% CI 1.06-6.31; P = 0.036).
 Conclusion(s): The prevalence and severity of CPSP are higher in
patients with on-pump CABG surgery than in those with off-pump CABG
surgery. Copyright © 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<27>
Accession Number
2023491069
Title
Role of dofetilide in patients with ventricular arrhythmias.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2023. Date of Publication: 2023.
Author
Shantha G.; Singleton M.; Kozak P.; Bodziock G.; Atreya A.R.; Narasimhan
B.; Deshmukh A.; Liang J.J.; Hranitzky P.; Whalen P.; Bhave P.
Institution
(Shantha, Kozak, Bodziock, Whalen, Bhave) Cardiac Electrophysiology, Wake
Forest University, 1, Medical Center Blvd, Winston-Salem, NC 27157, United
States
(Singleton) WellSpan Hospital, York, PA, United States
(Atreya) Cardiac Electrophysiology, University of Arkansas, Little Rock,
United States
(Narasimhan) Debakey Cardiovascular Center, Houston Methodist Hospital,
Houston, TX, United States
(Deshmukh) Cardiac Electrophysiology, Mayo Clinic, Rochester, MN, United
States
(Liang) Cardiac Electrophysiology, University of Michigan, Ann Arbor, MI,
United States
(Hranitzky) University of North Carolina, Chapel Hill, NC, United States
Publisher
Springer
Abstract
Background or Purpose: To assess effectiveness of dofetilide in reducing
the burden of ventricular arrhythmias (VAs). Background(s): Prior
small sample studies show that dofetilide has benefit in reducing VA.
However, large sample investigations with long-term follow-up are lacking.
 Method(s): Two hundred seventeen consecutive patients admitted
between January 2015 and December 2021 for dofetilide initiation for
control of VA were assessed. Dofetilide was successfully started in 176
patients (81%) and had to be discontinued in the remaining 41 patients
(19%). Dofetilide was initiated for control of ventricular tachycardia
(VT) in 136 patients (77%), whereas 40 (23%) patients were initiated on
dofetilide for reducing the burden of premature ventricular complexes
(PVCs). Result(s): The mean follow-up was 24 +/- 7 months. In total,
among the 136 VT patients, 33 (24%) died, 11 (8%) received a left
ventricular assist device (LVAD), and 3 (2%) received a heart transplant
during follow-up. Dofetilide was discontinued in 117 (86%) patients due to
lack of sustained effectiveness during follow-up. Dofetilide use was
associated with similar odds of the composite outcome of all-cause
mortality/LVAD/heart transplant (OR: 0.97, 0.55-4.23) in patients with
ischemic cardiomyopathy (ICM) compared to those with non-ischemic
cardiomyopathy (NICM). Dofetilide did not reduce PVC burden during
follow-up in the 40 patients with PVCs (mean baseline PVC burden: 15%, at
1-year follow-up: 14%). Conclusion(s): Dofetilide use was less
effective in reducing VA burden in our cohort of patients. Randomized
controlled studies are needed to confirm our findings. Copyright
© 2023, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<28>
Accession Number
641433911
Title
The anatomy of the atrioventricular nodal artery: A meta-analysis with
implications for cardiothoracic surgery and ablation procedures.
Source
Clinical anatomy (New York, N.Y.). (no pagination), 2023. Date of
Publication: 28 May 2023.
Author
Kuniewicz M.; Ostrowski P.; Bonczar M.; Kwiecinska M.; Mozdzen K.;
Murawska A.; Dziedzic M.; Zytkowski A.; Goncerz G.; Walocha J.; Koziej M.
Institution
(Kuniewicz, Ostrowski, Bonczar, Kwiecinska, Mozdzen, Murawska, Dziedzic,
Goncerz, Walocha, Koziej) Department of Anatomy, Jagiellonian University
Medical College, Krakow, Poland
(Ostrowski, Bonczar, Dziedzic, Walocha, Koziej) Youth Research
Organization, Krakow, Poland
(Zytkowski) Faculty of Philology, Department of Polish Dialectology and
Logopaedics, University of Lodz, Lodz, Poland
(Zytkowski) Norbert Barlicki Memorial Teaching Hospital No. 1 of the
Medical University of Lodz, Lodz, Poland
Publisher
NLM (Medline)
Abstract
The objective of the present meta-analysis was to evaluate recent and
applicable data regarding the location and variation of the
atrioventricular nodal artery (AVNA) in relation to adjacent structures.
In order to minimize postoperative risks and maintain physiological
anastomosis for proper cardiac function, understanding such possible
variations of vascularization of the AV node is of immense importance
prior to cardiothoracic surgery as well as ablations. In order to perform
this meta-analysis, a systematic search was conducted in which all
articles regarding, or at least mentioning, the anatomy of the AVNA was
searched. In general, the results were based on 3919 patients. AVNA was
found to originate only from the RCA in 82.41% (95% CI: 79.46%-85.18%).
The pooled prevalence of AVNA originating only from LCA was found to be
15.25% (95% CI: 12.71%-17.97%). The mean length of AVNA was found to be
22.64mm (SE=1.60). The mean maximal diameter of AVNA at its origin was
found to be 1.40mm (SE=0.14). In conclusion, we believe that this is the
most accurate and up-to-date study regarding the highly variable anatomy
of the AVNA. The AVNA was found to originate most commonly from the RCA
(82.41%). Furthermore, the AVNA was found to most commonly have no
(52.46%) or only one branch (33.74%). It is hoped that the results of the
present meta-analysis will be helpful for physicians performing
cardiothoracic or ablation procedures. Copyright © 2023 American
Association of Clinical Anatomists and British Association of Clinical
Anatomists.

<29>
Accession Number
641428607
Title
Effect of vitamin D on postoperative atrial fibrillation in patients who
underwent coronary artery bypass grafting: A systematic review and
Meta-analysis.
Source
Journal of cardiology. (no pagination), 2023. Date of Publication: 24 May
2023.
Author
Hameed I.; Malik S.; Nusrat K.; Siddiqui O.M.; Khan M.O.; Mahmood S.;
Memon A.; Usman M.S.; Siddiqi T.J.
Institution
(Hameed, Malik, Nusrat, Siddiqui, Khan, Mahmood, Memon) Dow University of
Health Sciences, Karachi, Pakistan
(Usman, Siddiqi) University of Mississippi Medical Center, Jackson, MS,
United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Vitamin D insufficiency/deficiency has been identified as a
risk factor for postoperative atrial fibrillation (POAF) after coronary
artery bypass grafting (CABG). This is associated with significantly
increased morbidity and mortality leading to not only prolonged hospital
and intensive care unit (ICU) stay, but increased risk of stroke, heart
failure, dementia, and long-term atrial fibrillation. This analysis aims
to evaluate the efficacy of vitamin D supplementation in preventing POAF
in patients undergoing CABG. METHOD(S): We searched PubMed, Cochrane
Central Register of Controlled Trials and SCOPUS from inception to June
2022 for randomized controlled trials (RCTs). The outcome of interest was
the incidence of POAF. Secondarily, we analyzed the length of ICU stay,
length of hospital stay, cardiac arrest, cardiac tamponade, and blood
transfusion. Results were pooled using a random-effect model. Three RCTs
consisting of 448 patients were included. RESULT(S): Our results
suggest that vitamin D significantly reduced the incidence of POAF (RR:
0.60; 95% CI: 0.40, 0.90; p=0.01; I2=8%). It was also observed that
vitamin D significantly reduced the duration of ICU stay (WMD: -1.639; 95%
CI: -1.857, -1.420; p<0.00001). Furthermore, the length of hospital stay
(WMD: -0.85; 95% CI: -2.14, 0.43; p=0.19; I2=87%) was also reduced,
however, the result was not significant. CONCLUSION(S): Our pooled
analysis suggests that vitamin D prevents POAF. Future large-scale
randomized trials are needed to confirm our results. Copyright ©
2023. Published by Elsevier Ltd.

<30>
Accession Number
641428242
Title
Effectiveness and quality of life in lung cancer, pre-, post- and
perioperative rehabilitation - A review.
Source
Physiology international. (no pagination), 2023. Date of Publication: 26
May 2023.
Author
Abidi Y.; Fekete M.; Farkas A.; Horvath A.; Varga J.T.
Institution
(Abidi, Varga) Department of Pulmonology, Semmelweis University, Budapest
H-1083, Hungary
(Fekete) Department of Public Health, Faculty of Medicine, Semmelweis
University, Budapest, Hungary
(Farkas) 3Centre for Energy Research, Budapest H-1121, Hungary
(Horvath) 4Chiesi Hungary Kft., Budapest H-1138, Hungary
(Varga) Department of Pulmonary Rehabilitation, National Koranyi Institute
of Pulmonology, Budapest H-1122, Hungary
Publisher
NLM (Medline)
Abstract
Functional conditions like lung function and exercise capacity are
important limiting factors of chest surgery in lung cancer with
co-morbidities (chronic obstructive pulmonary disease (COPD) and other
chronic respiratory diseases). Pulmonary rehabilitation has a favourable
effect on the cardiovascular system, metabolism, respiratory and
peripheral muscles and lung mechanics. Our aim was to assess the role of
pre-, post- and peri-operative pulmonary rehabilitation in lung cancer in
this review. We sought to size up the importance of pulmonary
rehabilitation in patients undergoing surgery with or without
(neo)adjuvant treatment, radiotherapy, chemotherapy, chemoradiotherapy,
major physiological impairments and complications. Searches were performed
in PubMed and ClinicalTrials.gov databases using the terms "exercise",
"rehabilitation", "small cell lung cancer", "non-small cell lung cancer",
"exercise capacity", "chest surgery" and "quality of life" from inception
to February 7th, 2022. Pulmonary rehabilitation has been recognized as an
effective intervention to reduce lung cancer related symptoms and improve
the pulmonary function, lung mechanics, chest kinematics, respiratory- and
peripheral muscle function, physical activity and quality of life (QoL) of
the patients. In conclusion, this review shows positive, highly
encouraging and effective results of pulmonary rehabilitation in terms of
the patients' lung function, functional mobility and quality of life. The
tools for complex pulmonary rehabilitation have evolved considerably over
the past two decades, thus this research has been conducted on a variety
of studies about this subject and serves as a synthesis of the systematic
and meta-analytic reviews.

<31>
[Use Link to view the full text]
Accession Number
2024544067
Title
Transcatheter Aortic Valve Replacement in Patients with Reduced Ejection
Fraction and Nonsevere Aortic Stenosis.
Source
Circulation: Cardiovascular Interventions. 16(5) (no pagination), 2023.
Article Number: e012768. Date of Publication: 01 May 2023.
Author
Ludwig S.; Schofer N.; Abdel-Wahab M.; Urena M.; Jean G.; Renker M.; Hamm
C.W.; Thiele H.; Iung B.; Ooms J.F.; Wiessman M.; Mogensen N.S.B.; Longere
B.; Perrin N.; Ben Ali W.; Coisne A.; Dahl J.S.; Van Mieghem N.M.;
Kornowski R.; Kim W.-K.; Clavel M.-A.
Institution
(Ludwig, Schofer) Department of Cardiology, University Heart and Vascular
Center, Hamburg, Germany
(Ludwig, Schofer) German Center for Cardiovascular Research, DZHK, Partner
Site Hamburg/Kiel/Lubeck, Germany
(Ludwig, Schofer) Cardiovascular Research Foundation, NY, United States
(Abdel-Wahab, Thiele) Heart Center Leipzig, University of Leipzig,
Department of Internal Medicine/Cardiology, Germany
(Urena, Longere) Department of Cardiology, Bichat-Claude Bernard Hospital,
Paris, France
(Jean, Clavel) Institut Universitaire de Cardiologie et de Pneumologie,
Universite Laval, Quebec, Canada
(Renker, Hamm, Kim) Department for Cardiology, Kerckhoff Heart Center, Bad
Nauheim, Germany
(Ooms, Van Mieghem) Department of Cardiology, Erasmus University Medical
Center, Rotterdam, Netherlands
(Wiessman, Kornowski) Department of Cardiology, Rabin Medical Center,
Tel-Aviv University, Israel
(Mogensen, Dahl) Department of Cardiology, Odense University Hospital,
Denmark
(Coisne) Universite Lille, Inserm, Centre Hospitalier Universitaire de
Lille, France
(Perrin, Ben Ali) Structural Valve Program, Montreal Heart Institute,
Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The potential benefit of transcatheter aortic valve
replacement (TAVR) in patients with nonsevere aortic stenosis (AS) and
heart failure is controversial. This study aimed to assess outcomes of
patients with nonsevere low-gradient AS (LGAS) and reduced left
ventricular ejection fraction undergoing TAVR or medical management.
 Method(s): Patients undergoing TAVR for LGAS and reduced left
ventricular ejection fraction (<50%) were included in a multinational
registry. True-severe low-gradient AS (TS-LGAS) and pseudo-severe
low-gradient AS (PS-LGAS) were classified according to computed
tomography-derived aortic valve calcification thresholds. A medical
control group with reduced left ventricular ejection fraction and moderate
AS or PS-LGAS was used (Medical-Mod). Adjusted outcomes between all groups
were compared. Among patients with nonsevere AS (moderate or PS-LGAS),
outcomes after TAVR and medical therapy were compared using propensity
score-matching. Result(s): A total of 706 LGAS patients undergoing
TAVR (TS-LGAS, N=527; PS-LGAS, N=179) and 470 Medical-Mod patients were
included. After adjustment, both TAVR groups showed superior survival
compared with Medical-Mod patients (all P<0.001), while no difference was
found between TS-LGAS and PS-LGAS TAVR patients (P=0.96). After propensity
score-matching among patients with nonsevere AS, PS-LGAS TAVR patients
showed superior 2-year overall (65.4%) and cardiovascular survival (80.4%)
compared with Medical-Mod patients (48.8% and 58.5%, both P<=0.004). In a
multivariable analysis including all patients with nonsevere AS, TAVR was
an independent predictor of survival (hazard ratio, 0.39 [95% CI,
0.27-0.55]; P<0.0001). Conclusion(s): Among patients with nonsevere
AS and reduced left ventricular ejection fraction, TAVR represents a major
predictor of superior survival. These results reinforce the need for
randomized-controlled trials comparing TAVR versus medical management in
heart failure patients with nonsevere AS. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04914481. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<32>
Accession Number
2023911908
Title
Individualised perioperative blood pressure and fluid therapy in
oesophagectomy - study protocol for a randomised clinical trial.
Source
Danish Medical Journal. 70(5) (no pagination), 2023. Article Number:
A10220640. Date of Publication: 2023.
Author
Hovgaard H.L.; Vistisen S.; Enevoldsen J.; de Paoli F.; Scheeren T.W.L.;
Katballe N.; Kjaer D.W.; Linnemann G.; Jorgensen M.R.S.; Karaliunaite Z.;
Jeppesen A.N.; Juhl-Olsen P.
Institution
(Hovgaard, Enevoldsen, Katballe, Linnemann, Jorgensen, Karaliunaite,
Jeppesen, Juhl-Olsen) Anaesthesia Section, Department of Cardiothoracic
and Vascular Surgery, Aarhus University Hospital, Denmark
(Vistisen) Department of Clinical Medicine, Aarhus University Hospital,
Denmark
(Vistisen) Department of Anaesthesia and Intensive Care, Aarhus University
Hospital, Denmark
(de Paoli) Department of Biomedicine, Aarhus University Hospital, Denmark
(Scheeren) Department fo Anaesthesiology, University Medical Center
Groningen, University of Groningen, Groningen, Netherlands
(Scheeren) Edwards Lifesciences, Unterschleissheim, Germany
(Kjaer) Department of Surgery, Aarhus University Hospital, Denmark
Publisher
Almindelige Danske Laegeforening
Abstract
INTRODUCTION. Oesophagectomy is the mainstay of curative treatment for
oesophageal cancer, but it is associated with a high risk of major
complications. Goal-directed fluid therapy and individualised blood
pressure management may prevent complications after surgery. Extending
goal-directed fluid therapy after surgery and applying an individual blood
pressure target may have substantial benefit in oesophagectomy. This is a
protocol for a clinical trial implementing a novel haemodynamic protocol
from the start of anaesthesia to the next day with the patient's own
night-time blood pressure as the lower threshold. METHODS. This is a
single-centre, single-blind, randomised, clinical trial. Oesophagectomy
patients are randomised 1:1 for either perioperative haemodynamic
management according to a goal-directed fluid therapy protocol with an
individual target blood pressure or for standard care. The primary
endpoint is the total burden of morbidity and mortality assessed by the
Comprehensive Complication Index 30 days after surgery. Secondary
endpoints are complications, reoperations, fluid and vasopressor dosage
and quality of life at 90 days after surgery CONCLUSIONS. The results from
this trial provide an objective and easy-to-follow algorithm for fluid
administration, which may improve patient-centred outcomes in
oesophagectomy patients. Copyright © 2023, Almindelige Danske
Laegeforening. All rights reserved.

<33>
Accession Number
2023093068
Title
Impact of a comprehensive cardiac rehabilitation programme versus coronary
revascularisation in patients with stable angina pectoris: study protocol
for the PRO-FIT randomised controlled trial.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
238. Date of Publication: December 2023.
Author
Heutinck J.M.; De Koning I.A.; Vromen T.; Van Geuns R.-J.M.; Thijssen
D.H.J.; Kemps H.M.C.; Adang E.M.; Geleijnse J.M.; van Gorp P.; van 't Hof
A.W.J.; Janssen V.R.; Jorstad H.T.; Kraaijenhagen R.A.; Lammers J.; de Man
F.H.A.F.; Nollen G.J.; van Ofwegen-Hanekamp C.E.E.; Onkelinx S.; Oostveen
L.M.L.C.; Roes K.C.B.; Sunamara M.; Tonino P.A.L.
Institution
(Heutinck, Kemps) Department of Industrial Design, Eindhoven University of
Technology, Eindhoven, Netherlands
(Heutinck, De Koning, Thijssen) Department of Medical BioSciences, Radboud
University Medical Centre, Nijmegen, Netherlands
(Vromen, Kemps) Department of Cardiology, Maxima Medical Centre,
Eindhoven, Netherlands
(Van Geuns) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Thijssen) Research Institute for Sport and Exercise Sciences, Liverpool
John Moores University, Liverpool, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Currently, in the majority of patients with stable angina
pectoris (SAP) treatment consists of optimal medical treatment,
potentially followed by coronary angiography and subsequent coronary
revascularisation if necessary". Recent work questioned the effectiveness
of these invasive procedures in reducing re-events and improving
prognosis. The potential of exercise-based cardiac rehabilitation on
clinical outcomes in patients with coronary artery disease is well-known.
However, in the modern era, no studies compared the effects of cardiac
rehabilitation versus coronary revascularisation in patients with SAP.
 Method(s): In this multicentre randomised controlled trial, 216
patients with stable angina pectoris and residual anginal complaints under
optimal medical treatment will be randomised to: 1) usual care (i.e.,
coronary revascularisation), or 2) a 12-month cardiac rehabilitation (CR)
programme. CR consists of a multidisciplinary intervention, including
education, exercise training, lifestyle coaching and a dietary
intervention with a stepped decline in supervision. The primary outcome
will be anginal complaints (Seattle Angina Questionnaire-7) following the
12-month intervention. Secondary outcomes include cost-effectiveness,
ischemic threshold during exercise, cardiovascular events, exercise
capacity, quality of life and psychosocial wellbeing. Discussion(s):
In this study, we will examine the hypothesis that multidisciplinary CR is
at least equally effective in reducing anginal complaints as the
contemporary invasive approach at 12-months follow-up for patients with
SAP. If proven successful, this study will have significant impact on the
treatment of patients with SAP as multidisciplinary CR is a less invasive
and potentially less costly and better sustainable treatment than coronary
revascularisations. Trial registration: Netherlands Trial Register,
NL9537. Registered 14 June 2021. Copyright © 2023, The Author(s).

<34>
Accession Number
2023023926
Title
Long term outcomes of percutaneous coronary intervention vs coronary
artery bypass grafting in patients with diabetes mellitus with multi
vessels diseases: A meta-analysis.
Source
IJC Heart and Vasculature. 46 (no pagination), 2023. Article Number:
101185. Date of Publication: June 2023.
Author
Jaiswal V.; Sattar Y.; Peng Ang S.; Ishak A.; Naz S.; Minahil Nasir Y.;
Song DO D.; Titus A.; Huang H.; Chaudhary G.; Rubinstein D.; Elgendy I.Y.;
Raina S.; Alam M.; Balla S.; Daggubati R.
Institution
(Jaiswal) Department of Research, Larkin Community Hospital, South Miami,
FL, United States
(Sattar, Raina, Balla, Daggubati) Division of Cardiovascular Medicine,
West Virginia University, WV, Morgantown, United States
(Peng Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Ishak) European University Cyprus - School of Medicine, Nicosia, Cyprus
(Naz) Division of Internal Medicine, BIDMC/Harvard Medical School, Boston,
United States
(Minahil Nasir) Division of Internal Medicine, Montefiore Medical Center,
NY, United States
(Song DO) Division of Internal Medicine, Icahn School of Medicine at Mount
Sinai Elmhurst Hospital Center, Queens, NY, United States
(Titus) Department of Internal Medicine, Saint Vincent Hospital,
Worcester, MA, United States
(Huang) Royal College of Surgeons in Ireland, University of Medicine and
Health Science, Dublin, Ireland
(Chaudhary) Department of Cardiology, King George Medical University,
Lucknow, India
(Rubinstein) Department of Cardiovascular Medicine, Icahn School of
Medicine at Mount Sinai Elmhurst Hospital Center, Queens, NY, United
States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY, United States
(Alam) Department of Medicine, Division of Cardiology, Baylor Medical
Center, TX, United States
Publisher
Elsevier Ireland Ltd
Abstract
Aims: Long term cardiovascular outcome comparison of multivessel coronary
disease among patients with diabetes mellitus (DM) undergoing percutaneous
coronary intervention (PCI) or coronary artery bypass graft (CABG) is
limited. The objective of this study was to compare the long-term
cardiovascular outcome PCI vs CABG among DM patients with multivessel
disease. Method and results: Online databases were explored to identify
studies that compared cardiovascular outcomes between PCI and CABG among
patients with DM. The primary outcome was all-cause mortality. Secondary
outcomes included major adverse cardiovascular and cerebrovascular events
(MACCE), myocardial infarction (MI), rate of revascularization, cardiac
death, and cerebrovascular accident (CVA). A total of 27 studies with
37,091 (PCI n = 19,838 (53 %) and CABG n = 17,253 (47 %)) patients were
included. The mean age was 64 +/- 5.9 years for PCI group and 63.8 +/- 5.3
years for CABG group; and, predominantly male (71.22 % vs 74.29 %) for PCI
and CABG respectively. The most common comorbidity was hypertension (64.35
% vs 62.88 %) in both PCI and CABG respectively. Compared with CABG, PCI
group had a higher odds of overall all-cause mortality (OR 1.18, 95 % CI
1.02-1.37, p = 0.03), MACCE (OR 1.52, 95 % CI 1.31-1.75, p = 0.00), MI (OR
1.85, 95 % CI 1.46-2.36, p = 0.00), repeat revascularization (OR 3.08, 95
% CI 2.34-4.05, p = 0.00) and cardiac death (OR 1.27, 95 % 1.02-1.59, p =
0.04), while CVA (0.57, 95 % CI 0.37-0.86, p = 0.01) was higher with CABG.
 Conclusion(s): Diabetic patients with multivessel coronary artery
disease have worse outcomes undergoing PCI as compared to CABG. However,
CVA was significantly higher with CABG. CABG remains the preferred
management among eligible patients with multivessel disease and
DM. Copyright © 2023 The Authors

<35>
Accession Number
2017317059
Title
The efficacy of the use of heparin in the emergency room in patients with
acute ST-segment elevation myocardial infarction.
Source
Journal of Radiation Research and Applied Sciences. 15(1) (pp 187-192),
2022. Date of Publication: March 2022.
Author
Zuo G.; Li Y.; Hu S.; Wang K.; Zhao H.; Wang D.; Qian X.; Du X.
Institution
(Zuo, Li, Hu, Wang, Zhao, Wang, Qian, Du) Department of Cardiology,
Tianjin Fifth Central Hospital, Tianjin 300450, China
Publisher
Egyptian Society of Radiation Science and Applications (ESRSA)
Abstract
Aim: To investigate the efficacy of the use of heparin in the emergency
room in patients with acute ST-segment elevation myocardial infarction
(STEMI). Method(s): 200 STEMI patients undergoing primary
percutaneous coronary intervention (PCI) were randomly divided into the
research and control groups (heparin administration in emergency room and
catheterization laboratory, respectively). Result(s): The rate of
thrombolysis in myocardial infarction (TIMI) grade 2 flow in the research
participants was significantly higher than that in the controls (P <
0.05). The stent diameter in the research patients was smaller than that
in the control participants (P < 0.05); while the stent length in the
research patients was shorter than that in the controls (P < 0.05). The
slow flow rate in the research patients was similar to that in the control
participants (P > 0.05). There were no differences between the groups in
the corrected TIMI frame counts or intraoperative complications (P >
0.05). The ST-segment resolution rate within 2 h post-PCI was 90.0% in the
research patients and 83.8% in the controls (P > 0.05). There was no
significant difference in the cardiac troponin and N terminal prohormone
of brain natriuretic peptide (NT-proBNP) levels between the two groups
post-PCI (P > 0.05). The left ventricular end-diastolic volume and left
ventricular ejection fraction (LVEF) during hospitalization were similar
between the groups (P > 0.05). Conclusion(s): Administering heparin
to STEMI patients in the emergency room can increase the rate of coronary
artery revascularization. Copyright © 2022 The Authors

<36>
Accession Number
2022619849
Title
Robotic vs other surgery techniques for mitral valve repair and/or
replacement: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. 71 (pp 16-25), 2023. Date of Publication:
01 May 2023.
Author
Husen T.F.; Kohar K.; Angelica R.; Saputro B.I.L.
Institution
(Husen, Kohar, Angelica, Saputro) Faculty of Medicine, University of
Indonesia, Pondok Cina, Beji, West Java, Depok City 16424, Indonesia
Publisher
Hellenic Cardiological Society
Abstract
Objective: Mitral valve repair or replacement (MVr/R) are procedures that
aim to correct mitral regurgitation. The three techniques, namely
conventional, minimally invasive, and robotic each present their
advantages and setbacks. Previous studies had compared each technique with
the other but mostly focused on two techniques. In this systematic review
and meta-analysis, we attempt to compare all three techniques, to provide
a reference for the clinical selection of the best surgical scheme.
 Method(s): The literature search was performed in databases including
PubMed, Scopus, Google Scholar, EBSCOHost, Wiley, ProQuest, and Embase, up
to June 1st, 2022. Critical appraisal of studies was performed
using Newcastle Ottawa Scale converted by Agency for Healthcare Research
and Quality (AHRQ). We used bayesian network meta-analysis and
conventional meta-analysis (random effects model) to rank and analyze
pooled odds ratios (OR) and mean differences (MD) with 95% confidence
intervals (CI). Forest plots of pooled effect estimates comparing each
treatment and ranking panel using Surface Under the Cumulative Ranking
(SUCRA) were used for the intervention measures. Result(s): A total
of 18 studies with 60,331 patients were included in this systematic review
and meta-analysis. Hospital stay was significantly lower in the group with
robotic procedure compared to the conventional interventions in terms of
ICU stay and overall length of stay. The mean difference of length of
hospital stay days of the conventional group was 2.27 (1.31-3.30) days and
of the minimally invasive -0.364 (-2.31-1.53) days compared to the robotic
group. The robotic procedure was associated with longer cross-clamp and
cardiopulmonary bypass (CPB) times. Nevertheless, the robotic procedure
was associated with lower infection (OR = 0.60 [95% CI 0.50-0.73)] rates
and in-hospital mortality compared to conventional techniques (OR=0.53
[95% CI 0.40-0.70)] but not the minimally invasive techniques (OR = 1.74
[95% CI 0.48-6.31]). Conclusion(s): Robotic surgery showed more
favorable surgical outcomes, including hospital stay, post-operational
complications and in-hospital mortality, although it was associated with
longer cross-clamp time and CPB time compared to other interventions.
However, its high cost is a difficult consideration for its widespread
clinical implementation. Copyright © 2022 Hellenic Society of
Cardiology

<37>
Accession Number
2024733674
Title
A review of numerical simulation in transcatheter aortic valve replacement
decision optimization.
Source
Clinical Biomechanics. 106 (no pagination), 2023. Article Number: 106003.
Date of Publication: June 2023.
Author
Huang X.; Zhang G.; Zhou X.; Yang X.
Institution
(Huang, Yang) Department of Cardiovascular Surgery, West China Biomedical
Big Data Center, West China Hospital/West China School of Medicine,
Sichuan University, Sichuan, Chengdu, China
(Huang, Yang) Med-X Center for Informatics, Sichuan University, Sichuan,
Chengdu, China
(Zhang, Zhou) Center for Computational Systems Medicine, School of
Biomedical Informatics, The University of Texas Health Science Center at
Houston, Houston, TX 77030, United States
(Zhou) McGovern Medical School, The University of Texas Health Science
Center at Houston, Houston, TX 77030, United States
(Zhou) School of Dentistry, The University of Texas Health Science Center
at Houston, Houston, TX 77030, United States
Publisher
Elsevier Ltd
Abstract
Background: Recent trials indicated a further expansion of clinical
indication of transcatheter aortic valve replacement to younger and
low-risk patients. Factors related to longer-term complications are
becoming more important for use in these patients. Accumulating evidence
indicates that numerical simulation plays a significant role in improving
the outcome of transcatheter aortic valve replacement. Understanding
mechanical features' magnitude, pattern, and duration is a topic of
ongoing relevance. Method(s): We searched the PubMed database using
keywords such as "transcatheter aortic valve replacement" and "numerical
simulation" and reviewed and summarized relevant literature.
 Finding(s): This review integrated recently published evidence into
three subtopics: 1) prediction of transcatheter aortic valve replacement
outcomes through numerical simulation, 2) implications for surgeons, and
3) trends in transcatheter aortic valve replacement numerical simulation.
 Interpretation(s): Our study offers a comprehensive overview of the
utilization of numerical simulation in the context of transcatheter aortic
valve replacement, and highlights the advantages, potential challenges
from a clinical standpoint. The convergence of medicine and engineering
plays a pivotal role in enhancing the outcomes of transcatheter aortic
valve replacement. Numerical simulation has provided evidence of potential
utility for tailored treatments. Copyright © 2023

<38>
Accession Number
2024703342
Title
The efficacy and safety of intravenous administration of tranexamic acid
in patients undergoing cardiac surgery: Evidence from a single
cardiovascular center.
Source
Medicine (United States). 102(20) (pp E33819), 2023. Date of Publication:
19 May 2023.
Author
Lin P.-S.; Yao Y.-T.; Tian L.-J.; Jiang J.-J.; Zhang Y.; He L.-X.; Yu
Y.-P.; Ma J.
Institution
(Lin, Yao, Tian, Yu) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Peking Union Medical College,
Chinese Academy of Medical Sciences, Beijing, China
(Lin) Department of Cardiovascular Surgery, Fujian Medical University
Affiliated First Quanzhou Hospital, Fujian, China
(Jiang) Key Laboratory of Clinical Research for Cardiovascular
Medications, Fuwai Hospital, National Center for Cardiovascular Diseases,
Peking Union Medical College, Chinese Academy of Medical Sciences,
Beijing, China
(Zhang) Department of Laboratory Medicine, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing, China
(He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Kunming, China
(Ma) Department of Pharmacy, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The current study was performed to systemically review the
efficacy and safety of tranexamic acid (TXA) in patients undergoing
cardiac surgery at a single large-volume cardiovascular center.
 Method(s): A computerized search of electronic databases was
performed to identify all relevant studies using search terms till
December 31st, 2021. The primary outcomes were postoperative
blood loss and the composite incidence of mortality and morbidities during
hospitalization. Secondary outcomes included postoperative massive
bleeding and transfusion, postoperative recovery profiles, coagulation
functions, inflammatory variables, and biomarkers of vital organ injury.
 Result(s): Database search yielded 23 qualified studies including
27,729 patients in total. Among them, 14,136 were allocated into TXA group
and 13,593 into Control group. The current study indicated that
intravenous TXA significantly reduced total volume of postoperative
bleeding in both adult and pediatric patients, and that medium- and
high-dose TXA were more effective than low-dose TXA in adult patients (P
<.05). The current study also demonstrated that intravenous TXA, as
compared to Control, remarkably reduced postoperative transfusion
incidences and volume of red blood cell and fresh frozen plasma, and
reduced postoperative transfusion incidence of platelet concentrates (PC)
(P <.05) without obvious dose-effects (P >.05), but TXA did not reduce PC
transfusion volume postoperatively in adult patients (P >.05). For
pediatrics, TXA did not significantly reduce postoperative transfusion
incidence and volume of allogenic red blood cell, fresh frozen plasma and
PC (P >.05). Additionally, the current study demonstrated that intravenous
TXA did not influence the composite incidence of postoperative mortality
and morbidities in either adults or pediatrics during hospitalization (P
>.05), and that there was no obvious dose-effect of TXA in adult patients
(P >.05). Conclusion(s): This current study suggested that
intravenous TXA significantly reduced total volume of postoperative
bleeding in both adult and pediatric patients undergoing cardiac surgery
at the single cardiovascular center without increasing the composite
incidence of mortality and morbidities. Copyright © 2023
Lippincott Williams and Wilkins. All rights reserved.

<39>
Accession Number
2024678099
Title
Effect of multicomponent rehabilitation on independence and functioning in
elderly patients with common age-associated diseases: Protocol for a
scoping review (REHOLD).
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e068722. Date of
Publication: 18 May 2023.
Author
Baritello O.; Stein H.; Wolff L.L.; Hamann M.; Voller H.; Salzwedel A.
Institution
(Baritello, Stein, Wolff, Hamann, Voller, Salzwedel) Rehabilitation
Medicine, University of Potsdam, Potsdam, Germany
Publisher
BMJ Publishing Group
Abstract
Introduction Elderly patients after hospitalisation for acute events on
account of age-related diseases (eg, joint or heart valve replacement
surgery) are often characterised by a remarkably reduced functional
health. Multicomponent rehabilitation (MR) is considered an appropriate
approach to restore the functioning of these patients. However, its
efficacy in improving functioning-related outcomes such as care
dependency, activities of daily living (ADL), physical function and
health-related quality of life (HRQL) remains unclarified. We outline the
research framework of a scoping review designed to map the available
evidence of the effects of MR on the independence and functional capacity
of elderly patients hospitalised for age-related diseases in four main
medical specialties beyond geriatrics. Methods and analysis The biomedical
databases (PubMed, Cochrane Library, ICTRP Search Platform,
ClinicalTrials) and additionally Google Scholar will be systematically
searched for studies comparing centre-based MR with usual care in patients
>=75 years of age, hospitalised for common acute events due to age-related
diseases (eg, joint replacement, stroke) in one of the specialties of
orthopaedics, oncology, cardiology or neurology. MR is defined as exercise
training and at least one additional component (eg, nutritional
counselling), starting within 3 months after hospital discharge.
Randomised controlled trials as well as prospective and retrospective
controlled cohort studies will be included from inception and without
language restriction. Studies investigating patients <75 years, other
specialties (eg, geriatrics), rehabilitation definition or differently
designed will be excluded. Care dependency after at least a 6-month
follow-up is set as the primary outcome. Physical function, HRQL, ADL,
rehospitalisation and mortality will be additionally considered. Data for
each outcome will be summarised, stratified by specialty, study design and
type of assessment. Furthermore, quality assessment of the included
studies will be performed. Ethics and dissemination Ethical approval is
not required. Findings will be published in a peer-reviewed journal and
presented at national and/or international congresses. Trial registration
number https://doi.org/10.17605/OSF.IO/GFK5C. Copyright © 2023
BMJ Publishing Group. All rights reserved.

<40>
Accession Number
2024673529
Title
Biomarkers of biological aging in recipients of solid organ
transplantation and clinical outcomes: A scoping review.
Source
Transplant Immunology. 79 (no pagination), 2023. Article Number: 101851.
Date of Publication: August 2023.
Author
Cremen S.; Santiago R.M.; Robinson M.W.; Gallagher T.K.
Institution
(Cremen, Gallagher) Department of Hepatobiliary and Transplant Surgery, St
Vincent's University Hospital, Dublin, Ireland
(Cremen, Gallagher) School of Medicine, University College Dublin, Dublin,
Ireland
(Santiago, Robinson) Department of Biology, Kathleen Lonsdale Institute
for Human Health Research, Maynooth University, Kildare, Ireland
Publisher
Elsevier B.V.
Abstract
Introduction: Biological aging is the accumulation of cellular and
molecular damage within an individual over time. The biological age of a
donor organ is known to influence clinical outcomes of solid organ
transplantation, including delayed graft function and frequency of
rejection episodes. While much research has focused on the biological age
of donor organs, the recipient's biological age may also influence
transplantation outcomes. The aim of this scoping review was to identify
and provide an overview of the existing evidence regarding biological
aging in solid organ transplant recipients and the impact on patient
outcomes post-transplant. Method(s): Literature searches were carried
out on PubMed, Web of Science, Google Scholar, Embase and TRIP using the
phrases 'solid organ transplant', 'cell senescence', 'cell aging' and
'outcomes', using boolean 'and/or' phrases and MeSH terms. Duplicates were
removed and abstracts were reviewed by two independent reviewers. Full
papers were then screened for inclusion by two reviewers. Data extraction
was carried out using a standardised proforma agreed on prior to starting.
 Result(s): 32 studies, including data on a total of 7760 patients,
were identified for inclusion in this review; 23 relating to kidney
transplant recipients, three to liver transplant, five to lung transplant
and one to heart transplantation. A wide range of biomarkers of biological
aging have been assessed in kidney transplant recipients, whereas studies
of liver, lung and heart transplant have predominantly assessed recipient
telomere length. The most robust associations with clinical outcomes are
observed in kidney transplant recipients, possibly influenced by the
larger number of studies and the use of a wider range of biomarkers of
biological aging. In kidney transplant recipients reduced thymic function
and accumulation of terminally differentiated T cell populations was
associated with reduced risk of acute rejection but increased risk of
infection and mortality. Conclusion(s): Studies to date on biological
aging in transplant recipients have been heavily biased to kidney
transplant recipients. The results from these studies suggest recipient
biological age can influence clinical outcomes and future research is
needed to prioritise robust biomarkers of biological aging in transplant
recipients. Copyright © 2023 The Authors

<41>
[Use Link to view the full text]
Accession Number
2024734590
Title
Effect of dexmedetomidine on perioperative hemodynamics and organ
protection in children with congenital heart disease: A randomized
controlled trial.
Source
Medicine (United States). 100(1) (pp E23998), 2021. Date of Publication:
08 Jan 2021.
Author
Ming S.; Du X.; Huang H.; Fan Y.; Liang Q.; Xie Y.
Institution
(Ming, Xie, Du, Huang) Department of Anesthesiology, The Second Affiliated
Hospital of Guangxi Medical University, China
(Fan) Department of Cardiothoracic Surgery, Ruikang Hospital Affiliated to
Guangxi University of Chinese Medicine, Nanning, China
(Liang) Department of Anesthesiology, Ruikang Hospital Affiliated to
Guangxi University of Chinese Medicine, China
(Xie) Department of Anesthesiology, The First Affiliated Hospital of
Guangxi Medical University, Guangxi, Nanning, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:This study aimed to investigate the effects of dexmedetomidine
(Dex) on hemodynamics and organ protection in congenital heart disease
(CHD) children who underwent open-heart surgery under cryogenic
cardiopulmonary bypass. Method(s):Ninety children were randomly
allocated to group C (0.9% saline 0.2 mug/kg/hour), group D1 (Dex 0.2
mug/kg/hour), and group D2 (Dex 0.4 mug/kg/hour) (n = 30 per group). All
participants received fentanyl, propofol and 1% sevoflurane for anesthesia
induction. Hemodynamic data were measured from T0 (before the induction)
to T7 (30 minutes after extubation). The difference of arterial internal
jugular vein bulbar oxygen difference and cerebral oxygen extraction ratio
were calculated according to Fick formula. Enzyme-linked immunosorbent
assay was performed to detect the serum myocardial, brain and kidney
injury markers. The incidence of acute kidney injury (AKI) was calculated
by serum creatinine level. Tracheal extubation time, postoperative pain
score and emergence agitation score were also recorded.
 Result(s):Compared with group C, group D1, and D2 exhibited reduction
in hemodynamic parameters, myocardial and brain injury indicators, and
tracheal extubation time. There were no significant differences in blood
urea nitrogen and neutrophil gelatinase-associated lipocalin or incidence
of AKI among the 3 groups. Besides, the incidence of tachycardia, nausea,
vomiting and moderate agitation, and the FLACC scale in group D1 and D2
were lower than those in group C. Moreover, Dex 0.4 g/kg/hour could
further reduce the dosage of fentanyl and dopamine compared with Dex 0.2
g/kg/hour. Conclusion(s):Dex anesthesia can effectively maintain
hemodynamic stability and diminish organ injuries in CHD
children. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<42>
[Use Link to view the full text]
Accession Number
2024606593
Title
Effects of a preoperative forced-air warming system for patients
undergoing video-assisted thoracic surgery: A randomized controlled trial.
Source
Medicine (United States). 99(48) (pp E23424), 2020. Date of Publication:
25 Nov 2020.
Author
Xiao Y.; Zhang R.; Lv N.; Hou C.; Ren C.; Xu H.
Institution
(Xiao, Zhang, Lv, Hou) Department of Operation Room, China
(Ren, Xu) Department of Anaesthesiology, Liaocheng People's Hospital,
Liaocheng, Shandong, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:The incidence of intraoperative hypothermia is still high
despite the proposal of different preventive measures during thoracoscopic
surgery. This randomized control study evaluated the effects of 30-minute
prewarming combined with a forced-air warming system during surgery to
prevent intraoperative hypothermia in patients undergoing video-assisted
thoracic surgery under general anesthesia combined with erector spinae
nerve block. Method(s):Ninety-eight patients were randomly and
equally allocated to prewarming or warming groups (n = 49 each). The
primary outcome was the incidence of intraoperative hypothermia. Secondary
outcomes were core temperature, irrigation and infused fluid, estimated
blood loss, urine output, type of surgery, intraoperative anesthetic
dosage, hemodynamics, recovery time, the incidence of postoperative
shivering, thermal comfort, postoperative sufentanil consumption and pain
intensity, patient satisfaction, and adverse events. Result(s):The
incidence of intraoperative hypothermia was significantly lower in the
prewarming group than the warming group (12.24% vs 32.65%, P = .015). Core
temperature showed the highest decrease 30 minutes after surgery start in
both groups; however, the rate was lower in the prewarming than in the
warming group (0.31 +/- 0.04degreeC vs 0.42 +/- 0.06degreeC, P < .05).
Compared with the warming group, higher core temperatures were recorded
for patients in the prewarming group from T1 to T6 (P < .05).
Significantly fewer patients with mild hypothermia were in the prewarming
group (5 vs 13, P = .037) and recovery time was significantly reduced in
the prewarming group (P < .05). Although the incidence of postoperative
shivering was lower in the prewarming group, it was not statistically
significant (6.12% vs 18.37%, P = .064). Likewise, the shivering severity
was similar for both groups. Thermal comfort was significantly increased
in the prewarming group, although patient satisfaction was comparable
between the 2 groups (P > .05). No adverse events occurred associated with
the forced-air warming system. Both groups shared similar baseline
demographics, type of surgery, total irrigation fluid, total infused
fluid, estimated blood loss, urine output, intraoperative anesthetic
dosage, hemodynamics, duration of anesthesia and operation time,
postoperative sufentanil consumption, and pain intensity.
 Conclusion(s):In patients undergoing video-assisted thoracic surgery,
prewarming for 30 minutes before the induction of anesthesia combined with
a forced-air warming system may improve perioperative core temperature and
the thermal comfort, although the incidence of postoperative shivering and
severity did not improve. © Copyright 2020 the Author(s).
Published by Wolters Kluwer Health, Inc.

<43>
[Use Link to view the full text]
Accession Number
2024455530
Title
Considerations and experience driving expansion of combined heart-liver
transplantation.
Source
Current Opinion in Organ Transplantation. 25(5) (pp 496-500), 2020. Date
of Publication: 01 Oct 2020.
Author
Gong T.; Hall S.
Institution
(Gong, Hall) Center for Advanced Heart and Lung Disease, Baylor Annette C.
and Harold C. Simmons Transplant Institute, Baylor University Medical
Center, United States
(Gong, Hall) Division of Cardiology, Department of Advanced Heart Failure,
Mechanical Support, and Transplant, Baylor Heart and Vascular Hospital,
Dallas, United States
(Gong, Hall) Texas A&m University College of Medicine, Bryan, TX, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewHeart transplantation concomitant with a liver transplant
may be warranted when end-stage heart failure results in irreversible
liver failure. Previously reported outcomes have been excellent yet the
specific immunoprotective role of the liver allograft is not known. We
review the current literature about the immunologic benefit for combined
heart and liver transplantation (CHLT).Recent findingsThe total number of
combined heart and liver transplants continues to increase and accounts
for approximately 25 cases per year. Familial amyloid polyneuropathy with
cardiac cirrhosis is the most common indication for CHLT while adult
congenital heart disease (CHD) with associated cirrhosis is increasing in
frequency. The majority of recent registry data suggest a statistically
equivalent to modestly improved survival advantage for CHLT compared with
isolated heart transplantation. Direct mechanisms accounting for this
survival advantage are not proven, but combined heart and liver
transplants experience lower rates of acute cardiac rejection and cardiac
allograft vasculopathy (CAV).SummaryCombined heart and liver transplants
remain a small percentage of the total heart transplants worldwide, but
the majority of recent literature confirms the safety and viability of
this option for patients with end-stage heart and liver disease.
Equivalent to modestly improved survival outcomes, lower rates of acute
cardiac rejection and CAV warrant further investigation into the liver
allograft's immunoprotective effect on the transplanted heart. The key
mechanisms of tolerogenicity have important implications for surgical
technique and immunosuppression requirements. Future directions include
development of criteria for heart-liver transplant candidacy and
identification of equitable allocation protocols. Copyright ©
2021 Wolters Kluwer Health, Inc. All rights reserved.

<44>
Accession Number
641422587
Title
Mapping the characteristics, methodological quality and standards of
reporting of network meta-analyses on antithrombotic therapies: An
overview.
Source
International journal of cardiology. (no pagination), 2023. Date of
Publication: 23 May 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) Pharmaceutical Sciences Postgraduate Programme, Universidade
Federal do Parana, Curitiba, Brazil
(Tonin) Pharmaceutical Sciences Postgraduate Programme, Universidade
Federal do Parana, Curitiba, Brazil; Health & Technology Research Centre,
Escola Superior de Tecnologia da Saude (H&TRC-ESTeSL), Instituto
Politecnico de Lisboa, Lisbon, Portugal
(Pontarolo) Department of Pharmacy, Universidade Federal do Parana,
Curitiba, Brazil
Publisher
NLM (Medline)
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. Published by
Elsevier B.V.

<45>
Accession Number
2024766599
Title
Surgical vs transcatheter aortic valve replacement in bicuspid aortic
valve stenosis: A systematic review and meta-analysis.
Source
Trends in Cardiovascular Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Kang J.J.; Fialka N.M.; EL-Andari R.; Watkins A.; Hong Y.; Mathew A.;
Bozso S.J.; Nagendran J.
Institution
(Kang, EL-Andari, Hong, Bozso, Nagendran) Division of Cardiac Surgery,
Department of Surgery, Minimally Invasive and Transcatheter Valve Surgery,
Mazankowski Alberta Heart Institute, University of Alberta, 4-108A Li Ka
Shing Health Research Center, 8602 - 112 Street, Edmonton, AB T6G 2E1,
Canada
(Fialka, Watkins) Faculty of Medicine and Dentistry, University of
Alberta, Edmonton, AB, Canada
(Mathew) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
This systematic review and meta-analysis aim to provide a comprehensive
analysis of the literature directly comparing the outcomes of surgical
aortic valve replacement (SAVR) and TAVR in patients with BAV stenosis.
Medline, PubMed, and Scopus were systematically searched for articles
published between 2000 and 2023, 1862 studies were screened, and 6
retrospective studies met the inclusion criteria. We included 6550
patients in the final analyses: 3,292 and 3,258 in the SAVR and TAVR
groups, respectively. Both groups have similar rates of in-hospital
mortality (odds ratio (OR) 1.11; 95% CI 0.59-2.10; p = 0.75) and stroke
(OR 1.25; 95% CI 0.85-1.86; p = 0.26. Patients who underwent SAVR
experienced lower rates of permanent pacemaker implantation (OR 0.54; 95%
CI 0.35-0.83; p = 0.005) and paravalvular leak (OR 0.47; 95% CI 0.26-0.86;
p = 0.02). On the other hand, patients who underwent TAVR displayed lower
rates of acute kidney injury (OR 1.81; 95% CI 1.15-2.84; p = 0.010), major
bleeding (OR 3.76; 95% CI 2.18-6.49; p < 0.00001), and pulmonary
complications (OR 7.68; 95% CI 1.21-48.84; p = 0.03). Despite the early
mortality data suggesting that TAVR may be a reasonable strategy for
patients with bicuspid AS with low to intermediate surgical risk, the
increased risk of PPI and PVL is concerning. A prospective, randomized,
controlled trial reporting long-term outcomes with pre-defined subgroup
analyses based on BAV morphology is paramount. In the interim, caution
should be exercised in the widespread adoption of TAVR in lower
surgical-risk patients. Copyright © 2023

<46>
Accession Number
2024521559
Title
Ventricular Remodeling and Outcomes After Mitral Transcatheter
Edge-to-Edge Repair in Heart Failure: The COAPT Trial.
Source
JACC: Cardiovascular Interventions. 16(10) (pp 1160-1172), 2023. Date of
Publication: 22 May 2023.
Author
Lindman B.R.; Asch F.M.; Grayburn P.A.; Mack M.J.; Bax J.J.; Gonzales H.;
Goel K.; Barker C.M.; Zalawadiya S.K.; Zhou Z.; Alu M.C.; Weissman N.J.;
Abraham W.T.; Lindenfeld J.; Stone G.W.
Institution
(Lindman, Gonzales, Goel, Barker, Zalawadiya, Lindenfeld) Cardiovascular
Division, Vanderbilt University Medical Center, Nashville, TN, United
States
(Asch, Weissman) Cardiovascular Core Laboratories, MedStar Health Research
Institute, Washington, DC, United States
(Grayburn) Baylor University Medical Center, Baylor Heart and Vascular
Institute, Dallas, TX, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Zhou, Alu) Clinical Trials Center, Cardiovascular Research Foundation,
New York, NY, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The relationship between left ventricular (LV) remodeling and
clinical outcomes after treatment of severe mitral regurgitation (MR) in
heart failure (HF) has not been examined. Objective(s): The aim of
this study was to evaluate the association between LV reverse remodeling
and subsequent outcomes and assess whether transcatheter edge-to-edge
repair (TEER) and residual MR are associated with LV remodeling in the
COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous
Therapy for Heart Failure Patients With Functional Mitral Regurgitation)
trial. Method(s): Patients with HF and severe MR who remained
symptomatic on guideline-directed medical therapy (GDMT) were randomized
to TEER plus GDMT or GDMT alone. Baseline and 6-month core laboratory
measurements of LV end-diastolic volume index and LV end-systolic volume
index were examined. Change in LV volumes from baseline to 6 months and
clinical outcomes from 6 months to 2 years were evaluated using
multivariable regression. Result(s): The analytical cohort comprised
348 patients (190 treated with TEER, 158 treated with GDMT alone). A
decrease in LV end-diastolic volume index at 6 months was associated with
reduced cardiovascular death between 6 months and 2 years (adjusted HR:
0.90 per 10 mL/m2 decrease; 95% CI: 0.81-1.00; P = 0.04), with
consistent results in both treatment groups (P<inf>interaction</inf> =
0.26). Directionally similar but nonsignificant relationships were present
for all-cause death and HF hospitalization and between reduced LV
end-systolic volume index and all outcomes. Neither treatment group nor MR
severity at 30 days was associated with LV remodeling at 6 or 12 months.
The treatment benefits of TEER were not significant regardless of the
degree of LV remodeling at 6 months. Conclusion(s): In patients with
HF and severe MR, LV reverse remodeling at 6 months was associated with
subsequently improved 2-year outcomes but was not affected by TEER or the
extent of residual MR. (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation [The COAPT Trial] and COAPT CAS [COAPT];
NCT01626079) Copyright © 2023 American College of Cardiology
Foundation

<47>
Accession Number
2024639333
Title
von Willebrand factor, ADAMTS-13, and thrombospondin 1 in relation to
clinical outcomes in elderly patients with a recent myocardial infarction.
Source
Research and Practice in Thrombosis and Haemostasis. 7(4) (no pagination),
2023. Article Number: 100164. Date of Publication: May 2023.
Author
Warlo E.M.K.; Kalstad A.A.; Myhre P.L.; Solheim S.; Arnesen H.; Tveit A.;
Holme P.A.; Seljeflot I.; Bratseth V.
Institution
(Warlo, Kalstad, Solheim, Arnesen, Seljeflot, Bratseth) Center for
Clinical Heart Research, Department of Cardiology, Oslo University
Hospital, Ullevaal, Oslo, Norway
(Warlo, Myhre, Arnesen, Tveit, Holme, Seljeflot) Faculty of Medicine,
University of Oslo, Oslo, Norway
(Myhre) Department of Cardiology, Akershus University Hospital, Lorenskog,
Norway
(Tveit) Department of Medical Research, Vestre Viken Hospital Trust,
Baerum Hospital, Gjettum, Norway
(Holme) Department of Haematology, Oslo University Hospital, Oslo, Norway
Publisher
Elsevier B.V.
Abstract
Background: von Willebrand factor (VWF) multimers are cleaved by A
disintegrin and metalloproteinase with thrombospondin type 1 motif, member
13 (ADAMTS-13) into less active fragments. Thrombospondin 1 (TSP-1)
competes with VWF's cleavage site, protecting it from degradation. Low
ADAMTS-13 and high VWF have been associated with cardiovascular disease
and atrial fibrillation (AF). Objective(s): We aimed to investigate
whether VWF, ADAMTS-13, and TSP-1 are associated with clinical outcome.
 Method(s): Elderly patients with a recent myocardial infarction (MI)
(n = 1027) were followed for 2 years. Blood was collected 2 to 8 weeks
after the MI for ADAMTS-13, VWF, and TSP-1 measures. The primary endpoints
(major adverse cardiovascular events; n = 210) included the first event of
MI, stroke, heart failure hospitalization, coronary revascularization, and
all-cause death. Total mortality was also registered (n = 56). The
secondary endpoint was new-onset AF (n = 43). Result(s):
Concentrations of VWF, ADAMTS-13, and TSP-1 did not intercorrelate. The
risk of major adverse cardiovascular events was altered in patients with
VWF >= median (hazard ratio [HR], 1.4; 95% CI, 1.0-1.8; P = .03) and
ADAMTS-13 >= median (HR, 0.7; 95% CI, 0.5-0.9; P = .02); however, it was
not significant in adjusted models. VWF and ADAMTS-13 were significantly
associated with total mortality, with a HR of 2.7 (95% CI, 1.6-4.6; P <
.001) for VWF (Q4 vs. Q1-Q3) and HR of 0.3 (95% CI, 0.2-0.5; P < .001) for
ADAMTS-13 (Q2-4 vs. Q1). The associations persisted in multivariable
analysis, but the significance disappeared for VWF after correcting for
high-sensitivity C-reactive protein. The risk of new-onset AF was lower in
patients with VWF >= median (HR, 0.5; 95% CI, 0.3-1.0; P = .04]), and this
was still significant after adjustments. Conclusion(s): Although low
ADAMTS-13 predicted death, the cardiovascular risk associated with VWF and
ADAMTS-13 was weaker than previously reported. Low VWF is associated with
new-onset AF and needs further research. Copyright © 2023 The
Authors

<48>
Accession Number
2024584623
Title
Incidence of preoperative instrumental activities of daily living (IADL)
dependence and adverse outcomes in older surgical patients: A systematic
review and meta-analysis.
Source
Journal of Clinical Anesthesia. 89 (no pagination), 2023. Article Number:
111151. Date of Publication: October 2023.
Author
Chen A.; An E.; Yan E.; He D.; Saripella A.; Butris N.; Tsang J.;
Englesakis M.; Wong J.; Alibhai S.; Chung F.
Institution
(Chen, Yan, Saripella, Butris, Wong, Chung) Department of Anesthesia and
Pain Management, Toronto Western Hospital, University Health Network,
University of Toronto, Toronto, ON, Canada
(Yan, Butris, Wong, Alibhai, Chung) Institute of Medical Science,
University of Toronto, Toronto, ON, Canada
(An) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(He) Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital,
University of Toronto, Toronto, ON, Canada
(Alibhai) Department of Medicine, University Health Network and University
of Toronto, Toronto, Canada
(Tsang) Department of Immunology, Faculty of Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: Instrumental activities of daily living (IADLs) are
essential to patient function and quality of life after surgery. In older
surgical patients, the incidence of preoperative IADL dependence has not
been well characterized in the literature. This systematic review and
meta-analysis aimed to determine the pooled incidence of preoperative IADL
dependence and the associated adverse outcomes in the older surgical
population. Design(s): Systematic review and meta-analysis.
 Setting(s): MEDLINE, MEDLINE Epub Ahead of Print and In-Process,
In-Data-Review & Other Non-Indexed Citations, Embase/Embase Classic,
Cochrane CENTRAL, and Cochrane Database of Systematic Reviews,
ClinicalTrials.Gov, the WHO ICTRP (International Clinical Trials Registry
Platform) were searched for relevant articles from 1969 to April 2022.
 Patient(s): Patients aged >=60 years old undergoing surgery with
preoperative IADL assessed by the Lawton IADL Scale. Intervention(s):
Preoperative assessment. Measurement: The primary outcome was the pooled
incidence of preoperative IADL dependency. Additional outcomes included
post-operative mortality, postoperative delirium [POD], functional status
improvement, and discharge disposition. Main Result(s): Twenty-one
studies (n = 5690) were included. In non-cardiac surgeries, the pooled
incidence of preoperative IADL dependence was 37% (95% CI: 26.0%, 48.0%)
among 2909 patients. Within cardiac surgeries, the pooled incidence of
preoperative IADL dependence was 53% (95% CI: 24.0%, 82.0%) among 1074
patients. Preoperative IADL dependence was associated with an increased
risk of postoperative delirium than those without IADL dependence (44.9%
vs 24.4, OR 2.26; 95% CI: 1.42, 3.59; I2: 0%; P = 0.0005).
 Conclusion(s): There is a high incidence of IADL dependence in older
surgical patients undergoing non-cardiac and cardiac surgery. Preoperative
IADL dependence was associated with a two-fold risk of postoperative
delirium. Further work is needed to determine the feasibility of using the
IADL scale preoperatively as a predictive tool for postoperative adverse
outcomes. Copyright © 2023

<49>
[Use Link to view the full text]
Accession Number
2024544257
Title
The Thresholds of Caprini Score Associated with Increased Risk of Venous
Thromboembolism Across Different Specialties: A Systematic Review.
Source
Annals of Surgery. 277(6) (pp 929-937), 2023. Date of Publication: 01 Jun
2023.
Author
Lobastov K.; Urbanek T.; Stepanov E.; Lal B.K.; Marangoni J.; Krauss E.S.;
Cronin M.; Dengler N.; Segal A.; Welch H.J.; Gianesini S.; Chen X.;
Caprini J.A.
Institution
(Lobastov, Stepanov) Pirogov Russian National Research Medical University,
Moscow, Russian Federation
(Urbanek) Medical University of Silesia, Katowice, Poland
(Lal) University of Maryland School of Medicine, Baltimore, MD, United
States
(Marangoni) Legacy Good Samaritan Medical Center, Portland, OR, United
States
(Krauss, Cronin, Dengler, Segal) Department of Orthopaedic Surgery,
Syosset Hospital, Northwell Health, Syosset, NY, United States
(Welch) Division of Vascular Surgery, Lahey Hospital and Medical Center,
Burlington, MA, United States
(Gianesini) University of Ferrara, Ferrara, Italy
(Chen) Department of Respiratory and Critical Care Medicine, Beijing
Shijitan Hospital, Capital Medical University, Beijing, China
(Caprini) Pritzker School of Medicine, Chicago, IL, United States
Publisher
Wolters Kluwer Health
Abstract
Objective: Estimation of the specific thresholds of the Caprini risk score
(CRS) that are associated with the increased incidence of venous
thromboembolism (VTE) across different specialties, including identifying
the highest level of risk. Background(s): Accurate risk assessment
remains an important but often challenging aspect of VTE prophylaxis. One
well-established risk assessment model is CRS, which has been validated in
thousands of patients from many different medical and surgical
specialties. Method(s): A search of MEDLINE and the Cochrane Library
was performed in March 2022. Manuscripts that reported on (1) patients
admitted to medical or surgical departments and (2) had their VTE risk
assessed by CRS and (3) reported on the correlation between the score and
VTE incidence, were included in the analysis. Result(s): A total of
4562 references were identified, and the full text of 202 papers was
assessed for eligibility. The correlation between CRS and VTE incidence
was reported in 68 studies that enrolled 4,207,895 patients. In all
specialties, a significant increase in VTE incidence was observed in
patients with a CRS of >=5. In most specialties thresholds of >=7, >=9,
and >=11 to 12 were associated with dramatically increased incidences of
VTE. In COVID-19, cancer, trauma, vascular, general, head and neck, and
thoracic surgery patients with >=9 and >=11 to 12 scores the VTE incidence
was extremely high (ranging from 13% to 47%). Conclusion(s): The
Caprini score is being used increasingly to predict VTE in many medical
and surgical specialties. In most cases, the VTE risk for individual
patients increases dramatically at a threshold CRS of 7 to
11. Copyright © 2023 Lippincott Williams and Wilkins. All rights
reserved.

<50>
Accession Number
2024542466
Title
The impact of using fresh frozen plasma in cardiopulmonary bypass
preparation on thromboelastometric parameters and receiving blood products
among pediatric patients undergoing cardiac surgery.
Source
Journal of Cardiovascular and Thoracic Research. 15(1) (pp 9-13), 2023.
Date of Publication: March 2023.
Author
Abedzadeh M.; Kachoueian N.; Fazli A.; Pazhoha M.; Omid S.O.; Vahid P.;
Givtaj N.
Institution
(Abedzadeh, Omid, Vahid, Givtaj) Rajaie Cardiovascular Medical and
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Kachoueian) Department of Cardiac Surgery, Imam Hossein Educational
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Fazli) Azad University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Pazhoha) Mazandaran University of Medical Sciences, Mazandaran, Iran,
Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: The aim of this study was to determine the effect of fresh
frozen plasma (FFP) for priming of cardiopulmonary bypass (CPB) circuit on
rotational thromboelastometry (ROTEM) and transfusion in pediatric cardiac
surgery. Method(s): Eighty patients younger than seven years old,
were divided into case (FFP) (n = 40) and control (n = 40) groups. In the
case group,10-20 mL/kg fresh frozen plasm was used for priming the CPB.
The control group received 10-20 mL/kg of hydroxyethyl starch. ROTEM was
done before surgical incision and after separation from CPB. The amount of
transfusion (platelet and FFP) in the operating room and 24 hours after
surgery were recorded. Result(s): Statistically significant
difference was found between the case and control group in terms of
changes in the Rotem parameters. The amount of transfusion of platelets in
the operating room was significantly higher in the control group than in
the case group. Conclusion(s): It seems that adding FFP to the prime
solution is more effective in young patients and infants due to the higher
susceptibility of the infant coagulation system to coagulation and
hemorrhagic disorders in comparison with other patients. Copyright
© 2023 The Author(s).

<51>
Accession Number
2023292603
Title
Comparison of prognosis between coronary computed tomography angiography
versus invasive coronary angiography for stable coronary artery disease: a
systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1010536. Date of Publication: 2023.
Author
Xie Q.; Zhou L.; Li Y.; Zhang R.; Wei H.; Ma G.; Tang Y.; Xiao P.
Institution
(Xie, Zhang) Department of Cardiology, Sir Run Run Hospital, Nanjing
Medical University, Nanjing, China
(Zhou, Tang) Department of Orthopaedic Surgery, Children's Hospital of
Nanjing Medical University, Nanjing, China
(Li, Ma) State Key Laboratory of Natural Medicines, School of Traditional
Chinese Pharmacy, China Pharmaceutical University, Nanjing, China
(Wei) Department of Cardiology, Nanjing Drum Tower Hospital Group Suqian
Hospital, Suqian, China
(Xiao) Department of Cardiology, The Forth Affiliated Hospital, Nanjing
Medical University, Nanjing, China
Publisher
Frontiers Media S.A.
Abstract
Background: The impact of using invasive coronary angiography (ICA) or
coronary computed tomography angiography (CCTA) as an initial examination
on the incidence of major adverse cardiovascular events (MACEs) in
patients with stable coronary artery disease and the occurrence of major
operation-related complications is uncertain. Objective(s): This
study aimed to explore the effects of ICA vs. CCTA on MACEs, all-cause
death, and major operation-related complications. Method(s): A
systematic search of electronic databases (PubMed and Embase) was
conducted for randomized controlled trials and observational studies
comparing MACEs between ICA and CCTA from January 2012 to May 2022. The
primary outcome measure was analyzed using a random-effects model as a
pooled odds ratio (OR). The main observations were MACEs, all-cause death,
and major operation-related complications. Result(s): A total of six
studies, comprising 26,548 patients, met the inclusion criteria (ICA n =
8,472; CCTA n = 18,076). There were statistically significant differences
between ICA and CCTA for MACE [OR 1.37; 95% confidence interval (CI),
1.06-1.77; p = 0.02], all-cause death (OR 1.56; 95% CI, 1.38-1.78; p <
0.00001), and major operation-related complications (OR 2.10; 95% CI,
1.23-3.61; p = 0.007) among patients with stable coronary artery disease.
Subgroup analysis demonstrated statistically significant results in the
impact of ICA or CCTA on MACEs according to the length of follow-up.
Compared to CCTA, ICA was related to a higher incidence of MACEs in the
subgroup with a short follow-up (<=3 years) (OR 1.74; 95% CI, 1.54-1.96; p
< 0.00001). Conclusion(s): Among patients with stable coronary artery
disease, an initial examination with ICA was significantly associated with
the risk of MACEs, all-cause death, and major procedure-related
complications compared to CCTA in this meta-analysis. Copyright 2023
Xie, Zhou, Li, Zhang, Wei, Ma, Tang and Xiao.

<52>
Accession Number
2023036056
Title
Same-day discharge for left atrial appendage occlusion procedure: A
systematic review and meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. 34(5) (pp 1196-1205), 2023.
Date of Publication: May 2023.
Author
Khan J.A.; Parmar M.; Bhamare A.; Agarwal S.; Khosla J.; Liu B.; Abraham
R.; Khan T.; Clifton S.; Munir M.B.; DeSimone C.V.; Deshmukh A.; Po S.;
Stavrakis S.; Asad Z.U.A.
Institution
(Khan, Parmar, Bhamare, Agarwal, Khosla, Khan, Po, Stavrakis, Asad)
Department of Medicine, University of Oklahoma Health Sciences Center,
Oklahoma City, OK, United States
(Liu, Abraham) College of Medicine, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(Clifton) Robert M Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Munir) Section of Electrophysiology, Division of Cardiology, University
of California Davis, Davis, CA, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Most patients undergoing a left atrial appendage occlusion
(LAAO) procedure are admitted for overnight observation. A same-day
discharge strategy offers the opportunity to improve resource utilization
without compromising patient safety. We compared the patient safety
outcomes and post-discharge complications between same-day discharge
versus hospital admission (HA) (>1 day) in patients undergoing LAAO
procedure. Method(s): A systematic search of MEDLINE and Embase was
conducted. Outcomes of interest included peri-procedural complications,
re-admissions, discharge complications including major bleeding and
vascular complications, ischemic stroke, all-cause mortality, and
peri-device leak >5 mm. Mantel-Haenszel risk ratios (RRs) with 95% CIs
were calculated. Result(s): A total of seven observational studies
met the inclusion criteria. There was no statistically significant
difference between same-day discharge versus HA regarding readmission (RR:
0.61; 95% confidence interval [CI]: [0.29-1.31]; p =.21), ischemic stroke
after discharge (RR: 1.16; 95% CI: [0.49-2.73]), peri-device leak >5 mm
(RR: 1.27; 95% CI: [0.42-3.85], and all-cause mortality (RR: 0.60; 95% CI:
[0.36-1.02]). The same-day discharge study group had significantly lower
major bleeding or vascular complications (RR: 0.71; 95% CI: [0.54-0.94]).
 Conclusion(s): This meta-analysis of seven observational studies
showed no significant difference in patient safety outcomes and
post-discharge complications between same-day discharge versus HA. These
findings provide a solid basis to perform a randomized control trial to
eliminate any potential confounders. Copyright © 2023 Wiley
Periodicals LLC.

<53>
Accession Number
2021799114
Title
Common Inflammatory Markers and Outcome After Pediatric Cardiac Surgery
With High Thoracic Epidural Anesthesia: A Randomized Controlled Study.
Source
World Journal for Pediatric and Congenital Heart Surgery. 14(3) (pp
334-344), 2023. Date of Publication: May 2023.
Author
Kumar A.; Ghotra G.S.; Dwivedi D.; Bhargava D.V.; Joshi A.; Tiwari N.;
Ramamurthy H.R.
Institution
(Kumar, Joshi) Department of Anaesthesia & Critical Care, Army Hospital
(Research & Referral), New Delhi, India
(Ghotra, Bhargava) Department of Anaesthesia & Critical Care, Army
Institute of Cardiothoracic Sciences, Pune, India
(Dwivedi) Department of Anaesthesia & Critical Care, Department of
Anaesthesia & Critical Care, Command Hospital (Eastern command), Kolkata,
India
(Tiwari) Department of Cardiothoracic Surgery, Army Hospital (Research &
Referral), New Delhi, India
(Ramamurthy) Department of Paediatrics, Army Hospital (Research &
Referral), New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: High thoracic epidural analgesia (HTEA) plays a pivotal role
in reducing stress and neuroendocrine response in cardiac surgeries.
 Aim(s): The primary objective is to assess the effect of HTEA, in
pediatric cardiac surgery, on inflammatory markers (interleukin [IL]-6,
IL-8, and tumor necrosis factor-alpha). The secondary objectives are to
assess its effect on various organ systems, that is, pulmonary (PaO2, P/F
ratio), renal (Creatinine clearance, somatic near infrared spectroscopy
[NIRS], serum neutrophil gelatinase-associated lipocalin values), cardiac
(cardiac index, serum Trop-I, and lactate levels), mechanical ventilation
duration, and length of stay in hospital (LOS). Method(s): The study
included 188 pediatric patients, who underwent, on-pump cardiac surgery
randomized into the Epidural Group (n = 92) and Non-Epidural Group (n =
96). After general anesthesia, a 23 G epidural catheter was placed at the
T4-5 level with a Bupivacaine infusion while the Non-epidural Group
received fentanyl infusion. Blood samples were collected at four-time
points, T0(preop), T1(4 h), and on the first and second postoperative days
(T2 and T3). Result(s): The inflammatory markers were reduced, while
the outcomes variables of mechanical ventilation (MV) duration had lower
values in the epidural group (19.5 h vs 47.3 h, P =.002). LOS was shorter
(10.1 days vs 13.3 days, P =.016). pO2, PF ratio, and renal NIRS values
were better in the Epidural Gp, while other parameters were comparable.
Non-epidural Gp had more complications esp. Acute kidney injury requires
RRT. Conclusion(s): HTEA use in pediatric, on-pump cardiac surgery
offers a favorable profile in terms of reduction in the inflammatory
markers and positive effect on the organ systems with lesser MV duration
and the LOS. Copyright © The Author(s) 2023.

<54>
Accession Number
2020247424
Title
Outcomes of catheter ablation of ventricular tachycardia in non-ischemic
idiopathic dilated cardiomyopathy: A systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1007392. Date of Publication: 11 Nov 2022.
Author
Ammar A.; Sharief M.; Abouelmagd K.; Riad O.; Ibrahim M.
Institution
(Ammar, Riad, Ibrahim) Department of Cardiology, Ain Shams University,
Cairo, Egypt
(Ammar) Department of Cardiology, Worcestershire Acute Hospitals NHS
Trust, Worcester, United Kingdom
(Sharief) Department of Cardiology, Specialized Medical Hospital, Mansoura
University, Mansoura, Egypt
(Sharief) Lancashire Teaching Hospitals NHS Foundation Trust, Preston,
United Kingdom
(Abouelmagd) Department of Cardiology, Dr. Mohammad Alfagih Hospital,
Riyadh, Saudi Arabia
(Riad) Department of Cardiology, Royal Brompton & Harefield NHS Trust,
London, United Kingdom
(Ibrahim) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
Publisher
Frontiers Media S.A.
Abstract
Objective: To perform a systematic review and meta-analysis of available
trials regarding the outcomes of ventricular tachycardia (VT) ablation in
patients with non-ischemic dilated cardiomyopathy (NIDCM). Method(s):
A comprehensive database search of large four electronic databases,
including PubMed, Cochrane, Scopus, and Institute for Scientific
Information network meta-analysis, identified five studies enrolling 666
patients for patients with idiopathic dilated cardiomyopathy (IDCM)
underwent catheter ablation (CA) for VT. The short-term outcomes assessed
included procedural success, VT non-inducibility and procedural
complications, whereas the long-term outcomes assessed included VT
recurrence, heart transplantation, antiarrhythmic drugs (AAD) use after
ablation and death. Result(s): A total of 5 observational studies
reported outcomes in 666 patients with NIDCM undergoing VT CA. The
complete procedural success was moderately high; 65.5% of the patients
(95% CI 0.402- 0.857, p < 0.001) and the procedural complications occurred
in 5.8% of the patients (95% CI 0.040-0.076, P = 0.685). Epicardial
mapping and ablation were performed among 61.5% and 37% of patients with
NIDCM respectively. During a follow up period of 12 to 45 months, there
were VT recurrence in 34.2% of the patients (95% CI 0.301-0.465, p <
0.080), death in 20.2% of the patients (95% CI 0.059-0.283, p < 0.017) and
heart transplantation in 12.9% of the patients (95% CI -0.026-0.245, P <
0.012). Conclusion(s): Ventricular tachycardia CA is effective and
safe approach for management of patients with NIDCM with the epicardial
approach to be considered as initial strategy especially in presence of
ECG and CMR findings suggestive of epicardial substrate. A multicenter
randomized trial is crucial to look at the short- and long-term outcomes
of VT ablation in NIDCM especially with the advances in mapping and
ablation techniques and predictors of success. Copyright © 2022
Ammar, Sharief, Abouelmagd, Riad and Ibrahim.

<55>
Accession Number
2024696105
Title
Comparison of Procedural Sedation With Propofol and Dexmedetomidine During
Transcatheter Aortic Valve Replacement Using the Transfemoral Approach.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Vovk Racman P.; Ksela J.; Racman M.; Zerjav U.; Sostaric M.
Institution
(Vovk Racman, Zerjav, Sostaric) Clinical Department of Anaesthesiology and
Perioperative Intensive Care, University Medical Centre Ljubljana,
Ljubljana, Slovenia
(Ksela, Racman) Clinical Department of Cardiovascular Surgery, University
Medical Centre Ljubljana, Ljubljana, Slovenia
(Ksela, Sostaric) University of Ljubljana Faculty of Medicine, Ljubljana,
Slovenia
Publisher
W.B. Saunders
Abstract
Objectives: Although procedural sedation is an established method of
anesthesia for transcatheter aortic valve replacement (TAVR), reliable
evidence to guide the choice of a suitable sedative agent remains scarce.
Accordingly, this trial aimed to compare the effect of procedural sedation
with dexmedetomidine versus propofol on postoperative neurocognitive and
related clinical outcomes in patients undergoing TAVR. Design(s):
Prospective, randomized, double-blind clinical trial. Setting(s): The
study was conducted at the University Medical Centre Ljubljana, Slovenia.
 Participant(s): The study enrolled 78 patients who underwent TAVR
under procedural sedation between January 2019 and June 2021. Seventy-one
patients randomized into the propofol group (n = 34) and dexmedetomidine
group (n = 37) were included in the final analysis. Intervention(s):
Patients in the propofol group received sedation with propofol (continuous
intravenous infusion of 0.5-2.5 mg/kg/h), whereas patients in the
dexmedetomidine group received sedation with dexmedetomidine (loading dose
of 0.5 microg/kg over 10 minutes followed by continuous intravenous
infusion of 0.2-1.0 microg/kg/h). Measurements and Main Results:
Minimental state examination (MMSE) was performed before and 48 hours
after TAVR. There was no statistically significant difference in MMSE
scores between groups before TAVR (p = 0.253), but the MMSE after the
procedure revealed a significantly lower incidence of delayed
neurocognitive recovery (p = 0.005) and thus better cognitive outcomes in
the dexmedetomidine group (p = 0.022). Conclusion(s): Compared with
propofol, procedural sedation with dexmedetomidine in TAVR was associated
with a significantly lower incidence of delayed neurocognitive
recovery. Copyright © 2023 Elsevier Inc.

<56>
Accession Number
2024696035
Title
Impact of Lower Tidal Volumes During One-Lung Ventilation: A 2022 Update
of the Meta-analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
El Tahan M.R.; Samara E.; Marczin N.; Landoni G.; Pasin L.
Institution
(El Tahan) Anesthesiology Department, College of Medicine, Imam
Abdulrahman Bin Faisal University, Al Khubar, Dammam, Saudi Arabia
(Samara) Department of Anesthesiology and Postoperative Intensive Care,
Faculty of Medicine, School of Health Sciences, University of Ioannina,
Ioannina, Greece
(Marczin) The Royal Brompton and Harefield NHS Foundation Trust, London,
United Kingdom
(Marczin) Section of Anesthesia, Pain Medicine, and Intensive Care,
Imperial College London, London, United Kingdom
(Marczin) Semmelweis University, Budapest, Hungary
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milano, Italy
(Pasin) Department of Anesthesia and Intensive Care, Azienda
Ospedale-Universita di Padova, Padua, Italy
Publisher
W.B. Saunders
Abstract
Objectives: To clarify the influence of lower tidal volume (4-7 mL/kg)
compared with higher tidal volume (8-15 mL/kg) during one-lung ventilation
(OLV) on gas exchange and postoperative clinical outcome. Design(s):
Meta-analysis of randomized trials. Setting(s): Thoracic surgery.
 Participant(s): Patients receiving OLV. Intervention(s): Lower
tidal volume during OLV. Measurements and Main Results: Primary
outcome was PaO<inf>2</inf><inf>-</inf>to-the oxygen fraction
(PaO<inf>2</inf>/FIO<inf>2</inf>) ratio at the end of the surgery, after
the reinstitution of two-lung ventilation. Secondary endpoints included
perioperative changes in PaO<inf>2</inf>/FIO<inf>2</inf> ratio and carbon
dioxide (PaCO<inf>2</inf>) tension, airway pressure, the incidence of
postoperative pulmonary complications, arrhythmia, and length of hospital
stay. Seventeen randomized controlled trials (1,463 patients) were
selected. Overall analysis showed that the use of low tidal volume during
OLV was associated with a significantly higher
PaO<inf>2</inf>/FIO<inf>2</inf> ratio 15 minutes after the start of OLV
and at the end of surgery (mean difference 33.7 mmHg [p = 0.02] and mean
difference 18.59 mmHg [p < 0.001], respectively). The low tidal volume
also was associated with higher PaCO<inf>2</inf> values 15 minutes and 60
minutes after the start of OLV and with lower airway pressure, which was
maintained during two-lung ventilation after surgery. Moreover, the
application of lower tidal volume was associated with fewer postoperative
pulmonary complications (odds ratio 0.50; p < 0.001) and arrhythmias (odds
ratio 0.58; p = 0.009), with no difference in length of hospital stay.
 Conclusion(s): The use of lower tidal volume, a component of
protective OLV, increases the PaO<inf>2</inf>/FIO<inf>2</inf> ratio,
reduces the incidence of postoperative pulmonary complications, and should
be considered strongly in daily practice. Copyright © 2023
Elsevier Inc.

<57>
Accession Number
2024439014
Title
REDEFINE: A Prospective Randomized Evaluation of the ControlRad System to
Reduce Radiation Exposure During Cardiac Implantable Device Procedures.
Source
JACC: Clinical Electrophysiology. 9(5) (pp 713-714), 2023. Date of
Publication: May 2023.
Author
Mehta N.K.; France J.; Shah K.; Kutinsky I.; Williamson B.; Goel A.; Dixon
S.; Haines D.E.
Publisher
Elsevier Inc.

<58>
Accession Number
2017527373
Title
Gender Differences and Outcomes of Hypoattenuated Leaflet Thickening
(HALT) Following Transcatheter Aortic Valve Replacement: A Meta-analysis
of Randomized and Cohort Studies.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101155. Date of Publication: July 2023.
Author
Salah H.M.; Almaddah N.; Xu J.; Al-Hawwas M.; Agarwal S.K.; Uretsky B.F.;
Dhar G.; Al'Aref S.J.
Institution
(Salah, Xu, Al-Hawwas, Dhar, Al'Aref) Department of Medicine, Division of
Cardiology. University of Arkansas for Medical Sciences, Little Rock, AR,
United States
(Almaddah) Arkansas Heart Hospital, Little Rock, AR, United States
(Agarwal, Uretsky) Central Arkansas Veterans Health System, Little Rock,
AR, United States
Publisher
Elsevier Inc.
Abstract
Subclinical leaflet thrombosis is characterized by hypoattenuated leaflet
thickening (HALT) after transcatheter aortic valve replacement (TAVR) on
computed tomography. However, given the low incidence of HALT after TAVR,
the clinical significance of HALT is still being investigated. We sought
to generate a more reliable estimate of the risk factors and adverse
outcomes associated with HALT after TAVR by pooling data from randomized
trials and cohort studies. PubMed/Medline database was systematically
searched from inception until November 24, 2021, using the following
terms: ("hypoattenuated leaflet thickening" and "transcatheter aortic
valve replacement") and ("Subclinical leaflet thrombosis" and
"transcatheter aortic valve replacement"). A random effects model
meta-analysis was conducted using Mantel-Haenszel odds ratios (ORs) and
the associated 95% confidence intervals (CIs), mean difference and the
associated 95%. Ten studies with a total of 1462 patients were included,
with follow-up ranging between 4 months and 3 years. HALT occurred in
14.4% of the patients undergoing TAVR. HALT was not associated with
increased risk of stroke/TIA (OR 1.38; 95% CI [0.61-3.11]; I2=0%) or
increased risk of all-cause mortality (OR 0.67; 95% CI [0.25-1.80]; I2=0).
HALT was associated with a greater post-procedural mean aortic valve
gradient (mean difference 2.31 mmHg; 95% CI [0.27, 4.35]; I2=71%).
Interestingly, there was a trend of higher risk of HALT in men (OR 1.37;
95% CI [0.82-2.30]; I2=44%) while there was a trend towards lower risk of
HALT in the presence of CKD (OR 0.76; 95% CI [0.49-1.19]; I2=0%); these
trends did not reach statistical significance. This meta-analysis shows
that the occurrence of HALT following TAVR is associated with a greater
post-procedural mean aortic valve gradient but no excess risk of death or
cerebrovascular events. The clinical significance of this higher
post-procedural mean aortic valve gradient is uncertain and requires
further investigations. Copyright © 2022 Elsevier Inc.

<59>
Accession Number
2024391617
Title
Process Development and Manufacturing: POTENCY ASSAY DEVELOPMENT OF AN
ADVANCED THERAPY MEDICINAL PRODUCT FOR POST-ACUTE MYOCARDIAL INFARCTION.
Source
Cytotherapy. Conference: 29th Annual ISCT Meeting. Paris France. 25(6
Supplement) (pp S181), 2023. Date of Publication: May 2023.
Author
Garitaonandia I.; Vignon C.; Aries A.; Zanetti C.; Goubaud A.; Cormier A.;
Lahlil R.; Henon P.
Institution
(Garitaonandia, Vignon, Goubaud, Cormier, Henon) CellProthera, Mulhouse,
France
(Aries, Zanetti, Lahlil, Henon) Institut de Recherche en Hematologie et
Transplantation, Mulhouse, France
Publisher
Elsevier B.V.
Abstract
Background & Aim: Acute myocardial infarction (AMI) affects over 120
million people globally and results from obstruction of a coronary artery.
In severe cases, heart transplantation is needed but there is a worldwide
donor shortage. We have shown in a small pilot study that intracardiac
delivery of autologous CD34+ cells after AMI is safe and leads
to long term improvement. The improvement was such that three patients
initially recommended for early heart transplantation, no longer required
it several years after the cell injection. After the successful results of
this pilot study, we started a multicenter, randomized, controlled Phase
I/IIb study in post-AMI (NCT02669810) to investigate the safety and
efficacy of intramyocardial injection of ProtheraCytes , our
Advanced Therapy Medicinal Product (ATMP) which is composed of expanded
autologous CD34+ cells. ProtheraCytes promote
cardiac regeneration and revascularisation of damaged myocardial tissue
via angiogenesis through the secretion of paracrine factors. The main goal
of this study was to design a potency assay that represents the product's
mechanism of action, quantitatively measures the relevant biological
product attribute, and has lot to lot consistency. Methods, Results &
 Conclusion(s): Here, a transcriptomic analysis showed that
ProtheraCytes express endothelial genes and genes involved in
angiogenesis and vasculogenesis. Flow cytometry characterization revealed
that ProtheraCytes have endothelial cell surface markers (CD31
and CD49b). ProtheraCytes differentiate in vitro into
endothelial cells (vWF+ and CD31+) and have
angiogenic activity as demonstrated by an in vitro tube formation assay.
Additionally, we showed that ProtheraCytes secrete exosomes
containing pro-angiogenic microRNAs (130a, 126, 378, and 26a),
anti-apoptotic miRNAs (21 and 146a), anti-fibrotic miRNAs (133a, 24, 29b,
and 132), and miRNAs that promote myocardial regeneration (199a and 590).
Finally, we quantified the secretion of Vascular Endothelial Growth Factor
(VEGF) via ELISA from ProtheraCytes manufactured in our Phase
I/IIb study and showed that the VEGF concentration is significantly
correlated to the number of CD34+ cells obtained after expansion. After
analyzing multiple ProtheraCytes clinical batches, we
established that measuring the concentration of VEGF was the most
practical, reliable, and consistent potency assay that represents the
ATMP's mechanism of action. Copyright © 2023 International
Society for Cell & Gene Therapy

<60>
[Use Link to view the full text]
Accession Number
2024455510
Title
Current status of normothermic ex-vivo perfusion of cardiac allografts.
Source
Current Opinion in Organ Transplantation. 25(3) (pp 237-240), 2020. Date
of Publication: 01 Jun 2020.
Author
Ragalie W.S.; Ardehali A.
Institution
(Ragalie, Ardehali) Department of Surgery, Division of Cardiac Surgery,
David Geffen School of Medicine at Ucla, Los Angeles, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewEx-vivo perfusion has emerged in recent years as an
alternative to cold static preservation of organs harvested for
transplant. Normothermic ex-vivo perfusion, the subject of this review,
maintains the donor heart in a near physiologic state, and allows the
transplant team to monitor and control perfusion to the organ prior to
implantation. A growing body of evidence has established the safety and
viability of this technique, which may improve on current standards of
donor management.Recent findingsFollowing initial single-arm studies over
a decade ago, ex-vivo perfusion has been studied in a prospective,
randomized fashion in standard donor hearts (PROCEED II trial). The short
and intermediate-term results demonstrated similar outcomes compared with
cold storage with significantly shorter cold ischemic time. Since then,
ex-vivo perfusion has been studied in extended-criteria donor hearts,
first in observational studies, and currently in randomized, prospective
fashion in the recently completed EXPAND-Heart trial, which is anticipated
to be reported in 2020.SummaryNormothermic ex-vivo perfusion has an
established literature base and holds promise for changing current
practices of heart preservation. Results of forthcoming pivotal studies
will help determine its role in more widespread clinical
adoption. Copyright © 2020 Wolters Kluwer Health, Inc. All rights
reserved.

<61>
Accession Number
2023392547
Title
Early and Long-Term Clinical and Echocardiographic Outcomes of Sutureless
vs. Sutured Bioprosthesis for Aortic Valve Replacement.
Source
Journal of Cardiovascular Development and Disease. 10(5) (no pagination),
2023. Article Number: 224. Date of Publication: May 2023.
Author
Dokollari A.; Torregrossa G.; Bisleri G.; Hassanabad A.F.; Sa M.P.;
Sicouri S.; Veshti A.; Prifti E.; Bacchi B.; Cabrucci F.; Ramlawi B.;
Bonacchi M.
Institution
(Dokollari, Torregrossa, Sa, Sicouri, Ramlawi) Department of Cardiac
Surgery, Lankenau Heart Institute, Wynnewood, PA 19096, United States
(Dokollari, Torregrossa, Sicouri, Ramlawi) Department of Cardiac Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA 19096,
United States
(Bisleri, Bacchi) St. Michael's Hospital, Toronto, ON M5B 1W8, Canada
(Hassanabad) Section of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute, Cumming School of Medicine, Calgary, AB
T2N 4N1, Canada
(Veshti, Prifti) Cardiac Surgery Department, Mother Teresa Hospital,
University of Tirana, Tirana 1000, Albania
(Bacchi, Cabrucci, Bonacchi) F.U. Clinical and Experimental Medicine,
University of Florence, Florence 50134, Italy
Publisher
MDPI
Abstract
Objective: The goal of this manuscript is to compare clinical and
echocardiographic outcomes of patients undergoing aortic valve replacement
(AVR) with Perceval sutureless bioprosthesis (SU-AVR) and sutured
bioprosthesis (SB). Method(s): Following the PRISMA statement, data
were extracted from studies published after August 2022 and found in
PubMed/MEDLINE, EMBASE, CENTRAL/CCTR, ClinicalTrials.gov, SciELO, LILACS,
and Google Scholar. The primary outcome of interest was post-procedural
permanent pacemaker implantation, and the secondary outcomes were new left
bundle branch block (LBBB), moderate/severe paravalvular leak (PVL), valve
dislocation (pop-out), need for a second transcatheter heart valve, 30-day
mortality, stroke, and echocardiographic outcomes. Result(s):
Twenty-one studies were included in the analysis. When SU-AVR was compared
to other SB, mortality ranged from 0 to 6.4% for Perceval and 0 to 5.9%
for SB. Incidence of PVL (Perceval 1-19.4% vs. SB 0-1%), PPI (Perceval
2-10.7% vs. SB 1.8-8.5%), and MI (Perceval 0-7.8% vs. SB 0-4.3%) were
comparable. In addition, the stroke rate was lower in the SU-AVR group
when compared to SB (Perceval 0-3.7% vs. SB 1.8-7.3%). In patients with a
bicuspid aortic valve, the mortality rate was 0-4% and PVL incidence was
0-2.3%. Long-term survival ranged between 96.7 and 98.6%. Valve cost
analysis was lower for the Perceval valve and higher for sutured
bioprosthesis. Conclusion(s): Compared to SB valves, Perceval
bioprosthesis has proved to be a reliable prosthesis for surgical aortic
valve replacement due to its non-inferior hemodynamics, implantation
speed, reduced cardiopulmonary bypass time, reduced aortic cross-clamp
time, and shorter length of stay. Copyright © 2023 by the
authors.

<62>
[Use Link to view the full text]
Accession Number
2024703332
Title
Economic Outcomes of Transcatheter Versus Surgical Aortic Valve
Replacement in Patients with Severe Aortic Stenosis and Low Surgical Risk:
Results from the PARTNER 3 Trial.
Source
Circulation. 147(21) (pp 1594-1605), 2023. Date of Publication: 23 May
2023.
Author
Galper B.Z.; Chinnakondepalli K.M.; Wang K.; Magnuson E.A.; Lu M.;
Thourani V.H.; Kodali S.; Makkar R.; Herrmann H.C.; Kapadia S.; Williams
M.; Webb J.; Smith C.R.; MacK M.J.; Leon M.B.; Cohen D.J.
Institution
(Galper) Mid-Atlantic Permanente Medical Group, McLean, VA, United States
(Chinnakondepalli, Wang, Magnuson) Saint-Luke's Mid America Heart
Institute, Kansas City, MO, United States
(Lu) Edwards Lifesciences, Irvine, CA, United States
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Kodali, Smith, Leon) New York-Presbyterian, Columbia University Irving
Medical Center, New York, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Herrmann) University of Pennsylvania, Philadelphia, United States
(Kapadia) Cleveland Clinic, OH, United States
(Williams) NYU-Langone Medical Center, New York, NY, United States
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
(MacK) Baylor Scott & White Health, Plano, TX, United States
(Leon, Cohen) Cardiovascular Research Foundation, New York, NY, United
States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In patients with severe symptomatic aortic stenosis at low
surgical risk, transfemoral transcatheter aortic valve replacement (TAVR)
with the SAPIEN 3 valve has been shown to reduce the composite of death,
stroke, or rehospitalization at 2-year follow-up compared with surgical
aortic valve replacement (SAVR). Whether TAVR is cost-effective compared
with SAVR for low-risk patients remains uncertain. Method(s): Between
2016 and 2017, 1000 low-risk patients with aortic stenosis were randomly
assigned to TAVR with the SAPIEN 3 valve or SAVR in the PARTNER 3 trial
(Placement of Aortic Transcatheter Valves). Of these patients, 929
underwent valve replacement, were enrolled in the United States, and were
included in the economic substudy. Procedural costs were estimated using
measured resource use. Other costs were determined by linkage with
Medicare claims or by regression models when linkage was not feasible.
Health utilities were estimated using the EuroQOL 5-item questionnaire.
With the use of a Markov model informed by in-trial data, lifetime
cost-effectiveness from the perspective of the US health care system was
estimated in terms of cost per quality-adjusted life-year gained.
 Result(s): Although procedural costs were nearly $19 000 higher with
TAVR, total index hospitalization costs were only $591 more with TAVR
compared with SAVR. Follow-up costs were lower with TAVR such that TAVR
led to 2-year cost savings of $2030/patient compared with SAVR (95% CI,
-$6222 to $1816) and a gain of 0.05 quality-adjusted life-years (95% CI,
-0.003 to 0.102). In our base-case analysis, TAVR was projected to be an
economically dominant strategy with a 95% probability that the incremental
cost-effectiveness ratio for TAVR would be <$50 000/quality-adjusted
life-year gained (consistent with high economic value from a US health
care perspective). These findings were sensitive to differences in
long-term survival, however, such that a modest long-term survival
advantage with SAVR would render SAVR cost-effective (although not cost
saving) compared with TAVR. Conclusion(s): For patients with severe
aortic stenosis and low surgical risk similar to those enrolled in the
PARTNER 3 trial, transfemoral TAVR with the SAPIEN 3 valve is cost saving
compared with SAVR at 2 years and is projected to be economically
attractive in the long run as long as there are no substantial differences
in late death between the 2 strategies. Long-term follow-up will be
critical to ultimately determine the preferred treatment strategy for
low-risk patients from both a clinical and economic
perspective. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<63>
[Use Link to view the full text]
Accession Number
2024703282
Title
The Rise and Fall of Antithrombin Supplementation in Cardiac Surgery.
Source
Anesthesia and Analgesia. 136(6) (pp 1043-1051), 2023. Date of
Publication: 01 Jun 2023.
Author
Ranucci M.; Baryshnikova E.; Pistuddi V.; Di Dedda U.
Institution
(Ranucci, Baryshnikova, Pistuddi, Di Dedda) Department of Cardiothoracic
and Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato,
Milan, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Various cohort studies, both retrospective and prospective, showed that
low antithrombin levels after cardiac surgery (at the arrival in the
intensive care unit and during the next days) were associated with a
number of adverse outcomes, including surgical reexploration and
thromboembolic events, eventually leading to prolonged stay in the
intensive care. Values lower than 58% to 64% of antithrombin activity were
indicative of this higher morbidity with good sensitivity and specificity.
The scenario generated the hypothesis that low antithrombin levels needed
to be corrected by supplementation to improve postoperative outcome.
However, randomized controlled studies run to test this idea failed to
demonstrate any benefit of antithrombin supplementation, showing no
effects on outcome, neither as preemptive preoperative strategy nor for
treating postoperative low antithrombin values. In addition, randomized
trials highlighted that those patients who received antithrombin
experienced significantly higher incidence of acute kidney injury with a
pooled odds ratio of 4.41 (95% CI, 1.90-10.23; P =.001). A strongly
decreased thrombin activity after antithrombin correction may eventually
affect the efficiency of the glomerular filtration and cause the
deterioration of kidney function, but underlying biological mechanisms
remain unclear. In conclusion, low levels of antithrombin activity after
cardiac surgery should be considered as a marker of greater severity of
the patient's conditions and/or of the complexity of the surgical
procedure. There are no indications for antithrombin supplementation in
cardiac surgery unless for correcting heparin resistance. Copyright
© 2022 International Anesthesia Research Society.

<64>
[Use Link to view the full text]
Accession Number
2024703278
Title
Postoperative Outcomes in Elderly Patients Undergoing Cardiac Surgery with
Preoperative Cognitive Impairment: A Systematic Review and Meta-Analysis.
Source
Anesthesia and Analgesia. 136(6) (pp 1016-1028), 2023. Date of
Publication: 01 Jun 2023.
Author
Au E.; Thangathurai G.; Saripella A.; Yan E.; Englesakis M.; Nagappa M.;
Chung F.
Institution
(Au, Saripella, Yan, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, Toronto, ON, Canada
(Thangathurai) Department of Medicine, McGill University, Montreal, QC,
Canada
(Yan) Department of Medical Science, University of Toronto, Toronto, ON,
Canada
(Englesakis) Department of Library & Information Services, University
Health Network, Toronto, ON, Canada
(Nagappa) Department of Anesthesia and Perioperative Medicine, London
Health Sciences Centre and St Joseph Health Care, Schulich School of
Medicine and Dentistry, Western University, London, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Older patients with preoperative cognitive impairment are at
risk for increased postoperative complications after noncardiac surgery.
This systematic review and meta-analysis aimed to determine the
association between preoperative cognitive impairment and dementia and
postoperative outcomes in older surgical patients after cardiac surgery.
 METHOD(S): Eight electronic databases were searched from inception to
January 4, 2022. Inclusion criteria were cardiac surgery patients >=60
years of age; preoperative cognitive impairment; >=1 postoperative
complication reported; comparator group with no preoperative cognitive
impairment; and written in English. Using a random-effects model, we
calculated effect sizes as odds ratio (OR) and standardized mean
differences (SMDs). Risk of random error was assessed by applying trial
sequential analysis. RESULT(S): Sixteen studies (62,179 patients)
were included. Preoperative cognitive impairment was associated with
increased risk of delirium in older patients after cardiac surgery (70.0%
vs 20.5%; OR, 8.35; 95% confidence interval [CI], 4.25-16.38; I2, 0%; P
<.00001). Cognitive impairment was associated with increased hospital
length of stay (LOS; SMD, 0.36; 95% CI, 0.20-0.51; I2, 22%; P <.00001) and
intensive care unit (ICU) LOS (SMD, 0.39; 95% CI, 0.09-0.68; I2, 70%; P
=.01). No significant association was seen for 30-day mortality (1.7% vs
1.1%; OR, 2.58; 95% CI, 0.64-10.44; I2, 55%; P =.18). CONCLUSION(S):
In older patients undergoing cardiac surgery, cognitive impairment was
associated with an 8-fold increased risk of delirium, a 5% increase in
absolute risk of major postoperative bleeding, and an increase in hospital
and ICU LOS by approximately 0.4 days. Further research on the feasibility
of implementing routine neurocognitive testing is warranted.
 Copyright © 2023 International Anesthesia Research Society.

<65>
[Use Link to view the full text]
Accession Number
2024544299
Title
Eliminating Medication Copayments for Low-Income Older Adults at High
Cardiovascular Risk: A Randomized Controlled Trial.
Source
Circulation. 147(20) (pp 1505-1514), 2023. Date of Publication: 16 May
2023.
Author
Campbell D.J.T.; Mitchell C.; Hemmelgarn B.R.; Tonelli M.; Faris P.; Zhang
J.; Tsuyuki R.T.; Fletcher J.; Au F.; Klarenbach S.; Exner D.V.; Manns
B.J.
Institution
(Campbell, Tonelli, Faris, Zhang, Fletcher, Exner, Manns) Department of
Community Health Sciences, University of Calgary, Canada
(Campbell, Tonelli, Au, Manns) Department of Medicine, University of
Calgary, Canada
(Campbell, Exner) Department of Cardiac Sciences, University of Calgary,
Canada
(Campbell, Tonelli, Exner, Manns) Libin Cardiovascular Institute,
University of Calgary, Canada
(Campbell, Tonelli, Manns) O'Brien Institute of Public Health, Cumming
School of Medicine, University of Calgary, Canada
(Mitchell) Pharmaceutical Branch, Alberta Health, Government of Alberta,
Edmonton, Canada
(Hemmelgarn, Tsuyuki, Klarenbach) Department of Medicine, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, Canada
(Faris) Data Integration, Management, and Reporting, Analytics, Alberta
Health Services, Edmonton, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: One in eight people with heart disease has poor medication
adherence that, in part, is related to copayment costs. This study tested
whether eliminating copayments for high-value medications among low-income
older adults at high cardiovascular risk would improve clinical outcomes.
 METHOD(S): This randomized 2x2 factorial trial studied 2 distinct
interventions in Alberta, Canada: eliminating copayments for high-value
preventive medications and a self-management education and support program
(reported separately). The findings for the first intervention, which
waived the usual 30% copayment on 15 medication classes commonly used to
reduce cardiovascular events, compared with usual copayment, is reported
here. The primary outcome was the composite of death, myocardial
infarction, stroke, coronary revascularization, and cardiovascular-related
hospitalizations over a 3-year follow-up. Rates of the primary outcome and
its components were compared using negative binomial regression. Secondary
outcomes included quality of life (Euroqol 5-dimension index score),
medication adherence, and overall health care costs. RESULT(S): A
total of 4761 individuals were randomized and followed for a median of 36
months. There was no evidence of statistical interaction (P=0.99) or of a
synergistic effect between the 2 interventions in the factorial trial with
respect to the primary outcome, which allowed us to evaluate the effect of
each intervention separately. The rate of the primary outcome was not
reduced by copayment elimination, (521 versus 533 events, incidence rate
ratio 0.84 [95% CI, 0.66-1.07], P=0.162). The incidence rate ratio for
nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death
(0.97 [95% CI, 0.67-1.39]), death (0.94 [95% CI, 0.80 to 1.11]), and
cardiovascular-related hospitalizations (0.78 [95% CI, 0.57 to 1.06]) did
not differ between groups. No significant between-group changes in quality
of life over time were observed (mean difference, 0.012 [95% CI, -0.006 to
0.030], P=0.19). The proportion of participants who were adherent to
statins was 0.72 versus 0.69 for the copayment elimination versus usual
copayment groups, respectively (mean difference, 0.03 [95% CI,
0.006-0.06], P=0.016). Overall adjusted health care costs did not differ
($3575 [95% CI, -605 to 7168], P=0.098). CONCLUSION(S): In low-income
adults at high cardiovascular risk, eliminating copayments (average,
$35/mo) did not improve clinical outcomes or reduce health care costs,
despite a modest improvement in adherence to medications. Copyright
© 2023 The Authors. Circulation is published on behalf of the
American Heart Association, Inc.

<66>
[Use Link to view the full text]
Accession Number
2024544298
Title
Self-Management Support Using Advertising Principles for Older Adults With
Low Income at High Cardiovascular Risk: A Randomized Controlled Trial.
Source
Circulation. 147(20) (pp 1492-1504), 2023. Date of Publication: 16 May
2023.
Author
Campbell D.J.T.; Tonelli M.; Hemmelgarn B.R.; Faris P.; Zhang J.; Au F.;
Tsuyuki R.T.; Mitchell C.; Pannu R.; Campbell T.; Ivers N.; Fletcher J.;
Exner D.V.; Manns B.J.
Institution
(Campbell, Tonelli, Faris, Zhang, Au, Fletcher, Exner, Manns) Department
of Community Health Sciences, University of Calgary, AB, Canada
(Campbell, Tonelli, Hemmelgarn, Manns) Department of Medicine, University
of Calgary, AB, Canada
(Campbell, Exner) Department of Cardiac Sciences, University of Calgary,
AB, Canada
(Campbell) Department of Psychology, University of Calgary, AB, Canada
(Campbell, Tonelli, Exner, Manns) Cumming School of Medicine, O'Brien
Institute for Public Health, University of Calgary, AB, Canada
(Campbell, Tonelli, Exner, Manns) Libin Cardiovascular Institute,
University of Calgary, AB, Canada
(Hemmelgarn, Tsuyuki) Department of Medicine, University of Alberta,
Edmonton, Canada
(Tsuyuki) Department of Pharmacology, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, Canada
(Faris) Data Integration, Management, and Reporting, Analytics, Alberta
Health Services, Edmonton, Canada
(Mitchell) Pharmaceutical and Supplementary Benefits Division, Alberta
Health, Government of Alberta, Edmonton, Canada
(Pannu) Emergence Creative, New York, NY, United States
(Ivers) Department of Family and Community Medicine, Temerty School of
Medicine, University of Toronto, Canada
(Ivers) Women's College Research Institute, Toronto, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Self-management education and support (SMES) interventions
have modest effects on intermediate outcomes for those at risk of
cardiovascular disease, but few studies have measured or demonstrated an
effect on clinical end points. Advertising for commercial products is
known to influence behavior, but advertising principles are not typically
incorporated into SMES design. METHOD(S): This randomized trial
studied the effect of a novel tailored SMES program designed by an
advertising firm among a population of older adults with low income at
high cardiovascular risk in Alberta, Canada. The intervention included
health promotion messaging from a fictitious "peer" and facilitated relay
of clinical information to patients' primary care provider and pharmacist.
The primary outcome was the composite of death, myocardial infarction,
stroke, coronary revascularization, and hospitalizations for
cardiovascular-related ambulatory care-sensitive conditions. Rates of the
primary outcome and its components were compared using negative binomial
regression. Secondary outcomes included quality of life (EQ-5D [EuroQoL
5-dimension] index score), medication adherence, and overall health care
costs. RESULT(S): We randomized 4761 individuals, with a mean age of
74.4 years, of whom 46.8% were female. There was no evidence of
statistical interaction (P=0.99) or of a synergistic effect between the 2
interventions in the factorial trial with respect to the primary outcome,
which allowed us to evaluate the effect of each intervention separately.
Over a median follow-up time of 36 months, the rate of the primary outcome
was lower in the group that received SMES compared with the control group
(incidence rate ratio, 0.78 [95% CI, 0.61 to 1.00]; P=0.047). No
significant between-group changes in quality of life over time were
observed (mean difference, 0.0001 [95% CI, -0.018 to 0.018]; P=0.99). The
proportion of participants who were adherent to medications was not
different between the 2 groups (P=0.199 for statins and P=0.754 for
angiotensin-converting enzyme inhibitors/angiotensin receptor blockers).
Overall adjusted health care costs did not differ between those receiving
SMES and the control group ($2015 [95% CI, -$1953 to $5985]; P=0.320).
 CONCLUSION(S): For older adults with low income, a tailored SMES
program using advertising principles reduced the rate of clinical outcomes
compared with usual care. The mechanisms of improvement are unclear and
further studies are required. Copyright © 2023 The Authors.
Circulation is published on behalf of the American Heart Association, Inc.

<67>
[Use Link to view the full text]
Accession Number
2024681410
Title
Clinical characteristics of systemic lupus erythematosus with chylothorax
and/or chylous ascites: An analysis of 15 cases in China.
Source
Medicine (United States). 99(51) (pp E23661), 2020. Date of Publication:
18 Dec 2020.
Author
Zhang G.-H.; Zhang L.-L.; Wang Y.-H.; Shen W.-B.
Institution
(Zhang, Zhang, Wang) Department of Rheumatology, China
(Shen) Department of Lymph Surgery, Beijing Shijitan Hospital, Capital
Medical University, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
AbstractThis analysis of clinical data from systemic lupus erythematosus
(SLE) patients with chylothorax and/or chylous ascites was conducted to
guide further clinical work.From June 2008 to June 2019, 15 SLE patients
(14 females and 1 male) with chylothorax and/or chylous ascites were
hospitalized at the Beijing Shijitan Hospital. Sixty SLE patients without
chylothorax and chylous ascites were randomly selected as controls.
Patients',clinical data was investigated.The mean age of onset
of chylothorax and/or chylous ascites in patients with SLE was 35.7+/-3.7
years (range, 15-69 years). The mean disease duration of chylothorax
and/or chylous ascites in patients with SLE was 13.7+/-3.4 months (range,
1-48 months). Patients with chylothorax and/or chylous ascites were always
diagnosed at later stages of SLE compared with the controls. Among cases,
glomerulonephritis and hematologic system involvement were the most common
complications. Anti-Sjogren's syndrome antigen A antibody was positive in
7 cases (46.7%). Among cases, direct lymphangiography was performed in 13
patients, indicating thoracic duct outlet obstruction or a poor backflow
at the terminal of the thoracic duct. Subsequently, 13 patients were
treated with corticosteroids, combined with immunosuppressants in 11
patients and thoracic duct surgery in 6 patients. Eleven patients were
followed up for 0.5 to 7.0 years. One patient died of infection. Eight
patients (53.3%) achieved remission.Chylothorax and/or chylous ascites are
rare complications of SLE. An early diagnosis and timely initiation of
glucocorticoids, immunosuppressants, and surgery are critical to relieve
symptoms and to improve prognosis. Copyright © 2020 Lippincott
Williams and Wilkins. All rights reserved.

<68>
Accession Number
641414338
Title
Percutaneous versus surgical approach to aortic valve replacement with
coronary revascularization: A systematic review andmeta-analysis.
Source
Perfusion. (pp 2676591231178894), 2023. Date of Publication: 24 May 2023.
Author
Guo Y.; Zhang W.; Wu H.
Institution
(Guo) Department of Graduate School, Changzhi Medical College, Changzhi,
Shanxi, China
(Zhang, Wu) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Changzhi, Shanxi, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The optimal treatment of patients with severe aortic stenosis
(AS) and complex coronary artery disease (CAD) remains controversial. We
conducted a meta-analysis to investigate outcomes of transcatheter aortic
valve replacement (TAVR) with percutaneous coronary intervention (PCI)
versus surgical aortic valve replacement (SAVR) with coronary artery
bypass grafting (CABG). METHOD(S): We searched PubMed, Embase, and
Cochrane databases from its inception up to 17 December 2022 for studies
that assessed TAVR + PCI versus SAVR + CABG in patients with AS and CAD.
The primary outcome was perioperative mortality. RESULT(S): Six
observational studies including 135,003 patients assessing TAVI + PCI (n =
6988) versus SAVR + CABG (n = 128,015) were included. Compared to SAVR +
CABG, TAVR + PCI was not significantly associated with perioperative
mortality (RR, 0.76; 95% CI, 0.48-1.21; p = 0.25), vascular complications
(RR, 1.85; 95% CI, 0.72-4.71; p = 0.20), acute kidney injury (RR, 0.99;
95% CI, 0.73-1.33; p = 0.95), myocardial infraction (RR, 0.73; 95% CI,
0.30-1.77; p = 0.49), or stroke (RR, 0.87; 95% CI, 0.74-1.02; p = 0.09).
TAVR + PCI significantly reduced the incidence of major bleeding (RR,
0.29; 95% CI, 0.24-0.36; p < 0.01) and length of hospital stay (MD, -1.60;
95% CI, -2.45 to -0.76; p < 0.01), but increased the incidence of
pacemaker implantation (RR, 2.03; 95% CI, 1.88-2.19; p < 0.01). At
follow-up, TAVR + PCI was significantly associated with coronary
reintervention (RR, 3.17; 95% CI, 1.03-9.71; p = 0.04) and a reduced rate
of long-term survival (RR, 0.86; 95% CI, 0.79-0.94; p < 0.01).
 CONCLUSION(S): In patients with AS and CAD, TAVR + PCI did not
increase perioperative mortality, but increased the rates of coronary
reintervention and long-term mortality.

<69>
[Use Link to view the full text]
Accession Number
2024624954
Title
Epicardial Adipose Tissue Assessed by Computed Tomography and
Echocardiography Are Associated with Adverse Cardiovascular Outcomes: A
Systematic Review and Meta-Analysis.
Source
Circulation: Cardiovascular Imaging. 16(5) (pp E015159), 2023. Date of
Publication: 01 May 2023.
Author
Chong B.; Jayabaskaran J.; Ruban J.; Goh R.; Chin Y.H.; Kong G.; Ng C.H.;
Lin C.; Loong S.; Muthiah M.D.; Khoo C.M.; Shariff E.; Chan M.Y.;
Lajeunesse-Trempe F.; Tchernof A.; Chevli P.; Mehta A.; Mamas M.A.;
Dimitriadis G.K.; Chew N.W.S.
Institution
(Chong, Jayabaskaran, Ruban, Goh, Chin, Kong, Ng, Lin, Loong, Muthiah,
Chan) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Muthiah) Division of Gastroenterology and Hepatology, Department of
Medicine, National University Hospital, Singapore, Singapore
(Khoo) Division of Endocrinology, Department of Medicine, National
University Hospital, Singapore, Singapore
(Muthiah) National University Centre for Organ Transplantation, National
University Health System, Singapore, Singapore
(Khoo, Chew) Department of Cardiology, National University Heart Centre,
National University Health System, Singapore, Singapore
(Shariff) Universiti Teknologi MARA, UiTM Sungai Buloh, Selangor, Malaysia
(Lajeunesse-Trempe, Tchernof) Quebec Heart and Lung Institute, Quebec
City, Canada
(Lajeunesse-Trempe) Department of Nutrition, Laval University, Quebec
City, Canada
(Lajeunesse-Trempe, Dimitriadis) Department of Endocrinology ASO/EASO COM,
King's College Hospital NHS Foundation Trust, Denmark Hill, London, United
Kingdom
(Chevli) Section on Hospital Medicine, Department of Internal Medicine,
Wake Forest School of Medicine, Winston-Salem, NC, United States
(Mehta) VCU, Health Pauley Heart Center, Division of Cardiology,
Department of Internal Medicine, Virginia Commonwealth University,
Richmond, United States
(Mamas) Institute of Population Health, University of Manchester, United
Kingdom
(Mamas) Keele Cardiac Research Group, Centre for Prognosis Research, Keele
University, Stoke-on-Trent, United Kingdom
(Dimitriadis) Obesity, Type 2 Diabetes and Immunometabolism Research
Group, Department of Diabetes, Faculty of Cardiovascular Medicine &
Sciences, School of Life Course Sciences, King's College London, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Epicardial adipose tissue (EAT) has garnered attention as a
prognostic and risk stratification factor for cardiovascular disease. This
study, via meta-analyses, evaluates the associations between EAT and
cardiovascular outcomes stratified across imaging modalities, ethnic
groups, and study protocols. Method(s): Medline and Embase databases
were searched without date restriction on May 2022 for articles that
examined EAT and cardiovascular outcomes. The inclusion criteria were (1)
studies measuring EAT of adult patients at baseline and (2) reporting
follow-up data on study outcomes of interest. The primary study outcome
was major adverse cardiovascular events. Secondary study outcomes included
cardiac death, myocardial infarction, coronary revascularization, and
atrial fibrillation. Result(s): Twenty-nine articles published
between 2012 and 2022, comprising 19 709 patients, were included in our
analysis. Increased EAT thickness and volume were associated with higher
risks of cardiac death (odds ratio, 2.53 [95% CI, 1.17-5.44]; P=0.020;
n=4), myocardial infarction (odds ratio, 2.63 [95% CI, 1.39-4.96];
P=0.003; n=5), coronary revascularization (odds ratio, 2.99 [95% CI,
1.64-5.44]; P<0.001; n=5), and atrial fibrillation (adjusted odds ratio,
4.04 [95% CI, 3.06-5.32]; P<0.001; n=3). For 1 unit increment in the
continuous measure of EAT, computed tomography volumetric quantification
(adjusted hazard ratio, 1.74 [95% CI, 1.42-2.13]; P<0.001) and
echocardiographic thickness quantification (adjusted hazard ratio, 1.20
[95% CI, 1.09-1.32]; P<0.001) conferred an increased risk of major adverse
cardiovascular events. Conclusion(s): The utility of EAT as an
imaging biomarker for predicting and prognosticating cardiovascular
disease is promising, with increased EAT thickness and volume being
identified as independent predictors of major adverse cardiovascular
events. Registration: URL: https://www.crd.york.ac.uk/prospero; Unique
identifier: CRD42022338075. Copyright © 2023 Lippincott Williams
and Wilkins. All rights reserved.

<70>
Accession Number
2024605063
Title
Anterolateral territory coronary artery bypass grafting strategies: a
non-inferiority randomized clinical trial: the AMI-PONT trial.
Source
European Journal of Cardio-thoracic Surgery. 63(4) (no pagination), 2023.
Article Number: ezad060. Date of Publication: 01 Apr 2023.
Author
Stevens L.-M.; Chartrand-Lefebvre C.; Mansour S.; Beland V.; Soulez G.;
Forcillo J.; Basile F.; Prieto I.; Noiseux N.
Institution
(Stevens, Forcillo, Basile, Prieto, Noiseux) Division of Cardiac Surgery,
Department of Surgery, Centre Hospitalier de l'Universite de Montreal,
Montreal, QC, Canada
(Stevens, Chartrand-Lefebvre, Mansour, Beland, Soulez, Forcillo, Noiseux)
CHUM Research Centre (CRCHUM), Montreal, QC, Canada
(Chartrand-Lefebvre, Soulez) Department of Radiology, Centre Hospitalier
de l'Universite de Montreal, Montreal, QC, Canada
(Mansour) Division of Cardiology, Department of Medicine, Centre
Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The main objective was to assess whether a composite coronary
artery bypass grafting strategy including a saphenous vein graft bridge to
distribute left internal mammary artery outflow provides non-inferior
patency rates compared to conventional grafting surgery with separated
left internal mammary artery to left anterior descending coronary graft
and aorto-coronary saphenous vein grafts to other anterolateral targets.
 METHOD(S): All patients underwent isolated grafting surgery with
cardiopulmonary bypass and received >_2 grafts/patients on the
anterolateral territory. The graft patency (i.e. non-occluded) was
assessed using multislice spiral computed tomography at 1 year.
 RESULT(S): From 2012 to 2021, 208 patients were randomized to a
bridge (n = 105) or conventional grafting strategy (n = 103). Patient
characteristics were comparable between groups. The anterolateral graft
patency was non-inferior in the composite bridge compared to conventional
grafting strategy at 1 year [risk difference 0.7% (90% confidence interval
-4.8 to 6.2%)]. The graft patency to the left anterior descending coronary
was no different between groups (P = 0.175). Intraoperatively, the bridge
group required shorter vein length for anterolateral targets (P < 0.001)
and exhibited greater Doppler flow in the mammary artery pedicle (P =
0.004). The composite outcome of death, myocardial infarction or target
vessel reintervention at 30 days was no different (P = 0.164).
 CONCLUSION(S): Anterolateral graft patency of the composite bridge
grafting strategy is non-inferior to the conventional grafting strategy at
1 year. This novel grafting strategy is safe, efficient, associated with
several advantages including better mammary artery flow and shorter vein
requirement, and could be a valuable alternative to conventional grafting
strategies. Ten-year clinical follow-up is underway. Copyright ©
The Author(s) 2023. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<71>
Accession Number
2024439005
Title
Randomized Comparison of a Radiofrequency Wire Versus a Radiofrequency
Needle System for Transseptal Puncture.
Source
JACC: Clinical Electrophysiology. 9(5) (pp 611-619), 2023. Date of
Publication: May 2023.
Author
Dewland T.A.; Gerstenfeld E.P.; Moss J.D.; Lee A.C.; Vedantham V.; Lee
R.J.; Tseng Z.H.; Hsia H.H.; Lee B.K.; Wall G.C.; Chang K.R.; Yang M.H.;
Marcus G.M.
Institution
(Dewland, Gerstenfeld, Moss, Lee, Vedantham, Lee, Tseng, Hsia, Lee, Wall,
Chang, Yang, Marcus) Department of Medicine, Division of Cardiology,
Electrophysiology Section, University of California-San Francisco, San
Francisco, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transseptal puncture is a necessary component of many
electrophysiology and structural heart procedures. Improving this
technique has broad ramifications for the overall efficiency and safety of
these interventions. A new technology uses a specialized introducer wire
to cross the septum with radiofrequency (RF) energy, eliminating the need
for a transseptal needle and wire/needle exchanges. Objective(s):
This study sought to compare the efficacy and safety of an RF needle
versus RF wire approach for transseptal puncture. Method(s):
Individuals >=18 years of age undergoing double transseptal puncture for
atrial fibrillation or left atrial flutter ablation were randomized to a
transseptal approach with either an RF needle or RF wire. The primary
outcome was time to achieve first transseptal puncture. Secondary outcomes
included second and combined transseptal puncture time, fluoroscopy time,
number of equipment exchanges, and complications. Result(s): A total
of 75 participants were enrolled (36 RF needle, 39 RF wire). No crossovers
occurred. Randomization to the RF wire resulted in a significant reduction
in first transseptal time compared with the RF needle (median 9.2 [IQR:
5.7-11.2] minutes vs 6.9 [IQR: 5.2-8.4] minutes, P = 0.03). Second and
combined transseptal times, and number of equipment exchanges, were also
reduced with the RF wire. One participant in the RF needle group
experienced transient atrioventricular block due to mechanical trauma from
the sheath/dilator assembly. There were no complications in the RF wire
group. Conclusion(s): The RF wire technique resulted in faster time
to transseptal puncture and fewer equipment exchanges compared with an RF
needle with no difference in complications. Copyright © 2023
American College of Cardiology Foundation

<72>
Accession Number
2024423096
Title
Dual antiplatelet therapy duration after percutaneous coronary
intervention in patients with indication to oral anticoagulant therapy. A
systematic review and meta-analysis of randomized controlled trials.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 9(3) (pp
220-230), 2023. Date of Publication: 01 Apr 2023.
Author
Montalto C.; Costa F.; Leonardi S.; Micari A.; Oreglia J.A.; Vranckx P.;
Capodanno D.; ten Berg J.; Lopes R.D.; Valgimigli M.
Institution
(Montalto, Leonardi) Department of Molecular Medicine, University of
Pavia, Pavia 27100, Italy
(Montalto, Oreglia) De Gasperis Cardio Center, Interventional Cardiology
Unit, Niguarda Hospital, Milan 20162, Italy
(Costa, Micari) Interventional Cardiology Unit, A.O.U. Policlinic
"G.Martino", University of Messina, Messina 98124, Italy
(Micari) Department of Biomedical and Dental Sciences and Morphological
and Functional Imaging, A.O.U. Policlinic "G. Martino- Messina University
of Messina, Messina 98122, Italy
(Vranckx) Department of Cardiology, Jessa Hospital, Stadsomvaart 11,
Hasselt 3500, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, University of Hasselt,
Hasselt 3500, Belgium
(Capodanno) Division of Cardiology, Azienda Ospedaliero-Universitaria
Policlinico "G. Rodolico-San Marco", University of Catania, Catania 95123,
Italy
(ten Berg) Department of Cardiology, St Antonius Hospital, Netherlands and
MUMC, 3435 Nieuwegein, Maastricht 6229, Netherlands
(Lopes) Duke Clinical Research Institute, Duke University Medical Center,
Durham, NC 27708, United States
(Valgimigli) Cardiocentro Ticino Institute, Division of Cardiology,
Universita della Svizzera italiana (USI), Lugano 6900, Switzerland
Publisher
Oxford University Press
Abstract
Aims Optimal duration of dual antiplatelet therapy (DAPT) in patients with
concomitant indication to oral anticoagulation (OAC) is still debated.
Methods and results A systematic review was performed on electronic
databases to search for randomized controlled trials comparing an
abbreviated or prolonged (>=3 months) DAPT regimen in patients with OAC
and they were analysed in the framework of standard and network
meta-analyses. Co-primary endpoints were major or clinically relevant
non-major bleedings (MCRB) and major bleeding, while the composite of
major adverse cardiovascular events (MACE) was the key safety endpoint.
Five studies and 7 665 patients (abbreviated DAPT n = 3 843; prolonged
DAPT n = 3 822) were included. Both MCRB and major bleeding were lower
with abbreviated DAPT [risk ratio (RR) 0.69 (0.52-0.91); P = 0.01 and 0.70
(0.52-0.95); P = 0.01, respectively] while MACE [RR: 0.96 (0.70-1.33); P =
0.6], all-cause death, cardiovascular death, stent thrombosis, or
myocardial infarction did not differ. Network meta-analysis showed that
peri-procedural DAPT had the highest probability to prevent MCRB and major
bleeding (97.1 and 92.0% respectively) when compared with both short (4-6
weeks) and longer (>=3 months) DAPT regimens. Sensitivity analyses and
meta-regressions showed consistency in different clinical scenarios and
suggested a larger bleeding reduction with P2Y<inf>12</inf> inhibitors vs.
aspirin after DAPT discontinuation. Conclusion In patients undergoing PCI
with concomitant OAC indication, an abbreviated DAPT regimen reduced MCRB
and major bleeding without increasing MACE or other ischaemic events.
Peri-procedural DAPT and P2Y<inf>12</inf> inhibitor monotherapy after DAPT
withdrawal appear to be the best strategies to optimize the bleeding and
ischaemic risk tradeoff. Abbreviated vs. prolonged Dual Antiplatelet
Therapy after Percutaneous Coronary Intervention or Acute Coronary
Syndromes in patients with indication to long-term Oral Anticoagulation.
This Figure shows the PICO summary for the analysis (Population of
interest, Intervention, Comparison, and Outcomes). DAPT, Dual Antiplatelet
Therapy; MACE, Major Adverse Cardiovascular Events; MI, Myocardial
Infacrtion; RR, Relative Risk; SUCRA, Surface Under Cumulative Ranking
curve Analysis Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<73>
Accession Number
2024351850
Title
Effects of qCON and qNOX-guided general anaesthesia management on patient
opioid use and prognosis: a study protocol.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e069134. Date of
Publication: 02 May 2023.
Author
Kang J.; Fang C.; Yuan Y.; Niu K.; Zheng Y.; Yu Y.; Wang G.; Li Y.
Institution
(Kang, Fang, Li, Yuan, Zheng, Yu, Wang, Li) Department of Anesthesiology,
Tianjin Medical University General Hospital, Tianjin, China
(Kang, Fang, Li, Yuan, Zheng, Yu, Wang, Li) Tianjin Research Institute of
Anesthesiology, Tianjin, China
(Niu) Nutritional Epidemiology Institute, School of Public Health, Tianjin
Medical University, Tianjin, China
Publisher
BMJ Publishing Group
Abstract
Introduction The adverse effects of general anaesthetic drugs (especially
opioids) cannot be ignored. However, current nociceptive-monitoring
techniques still lack consistency in guiding the use of opioids. This
trial will study the demand for opioid use and patient prognosis in qCON
and qNOX-guided general anaesthesia management. Methods and analysis This
prospective, randomised, controlled trial will randomly recruit 124
patients undergoing general anaesthesia for non-cardiac surgery in equal
numbers to either the qCON or BIS group. The qCON group will adjust
intraoperative propofol and remifentanil dosage according to qCON and qNOX
values, while the BIS group will adjust according to BIS values and
haemodynamic fluctuations. The differences between the two groups will be
observed in remifentanil dosing and prognosis. The primary outcome will be
intraoperative remifentanil use. Secondary outcomes will include propofol
consumption; the predictive ability of BIS, qCON and qNOX on conscious
responses, noxious stimulus and body movements; and changes in cognitive
function at 90 days postoperatively. Ethics and dissemination This study
involves human participants and was approved by the Ethics Committee of
the Tianjin Medical University General Hospital (IRB2022-YX-075-01).
Participants gave informed consent to participate in the study before
taking part. The study results will be published in peer-reviewed journals
and presented at relevant academic conferences. Trial registration number
ChiCTR2200059877 Copyright © 2023 BMJ Publishing Group. All
rights reserved.

<74>
Accession Number
2023871814
Title
Serratus anterior and pectoralis plane blocks for robotically assisted
mitral valve repair: a randomised clinical trial.
Source
British Journal of Anaesthesia. 130(6) (pp 786-794), 2023. Date of
Publication: June 2023.
Author
Alfirevic A.; Marciniak D.; Duncan A.E.; Kelava M.; Yalcin E.K.;
Hamadnalla H.; Pu X.; Sessler D.I.; Bauer A.; Hargrave J.; Bustamante S.;
Gillinov M.; Wierup P.; Burns D.J.P.; Lam L.; Turan A.
Institution
(Alfirevic, Marciniak, Duncan, Kelava, Bauer, Hargrave, Bustamante)
Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland,
OH, United States
(Duncan, Yalcin, Pu, Sessler, Turan) Department of Outcomes Research,
Cleveland Clinic, Cleveland, OH, United States
(Yalcin, Turan) Department of General Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Hamadnalla) Department of Anesthesiology, Pain Management and
Perioperative Medicine, Henry Ford Health System, Detroit, MI, United
States
(Pu) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Gillinov, Burns) Department of Thoracic and Cardiovascular Surgery and
Cleveland Clinic, Cleveland, OH, United States
(Wierup) Department of Cardiothoracic Surgery, Lund University, Lund,
Sweden
(Lam) Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Elsevier Ltd
Abstract
Background: Minimally invasive cardiac surgery provokes substantial pain
and therefore analgesic consumption. The effect of fascial plane blocks on
analgesic efficacy and overall patient satisfaction remains unclear. We
therefore tested the primary hypothesis that fascial plane blocks improve
overall benefit analgesia score (OBAS) during the initial 3 days after
robotically assisted mitral valve repair. Secondarily, we tested the
hypotheses that blocks reduce opioid consumption and improve respiratory
mechanics. Method(s): Adults scheduled for robotically assisted
mitral valve repairs were randomised to combined pectoralis II and
serratus anterior plane blocks or to routine analgesia. The blocks were
ultrasound-guided and used a mixture of plain and liposomal bupivacaine.
OBAS was measured daily on postoperative Days 1-3 and were analysed with
linear mixed effects modelling. Opioid consumption was assessed with a
simple linear regression model and respiratory mechanics with a linear
mixed model. Result(s): As planned, we enrolled 194 patients, with 98
assigned to blocks and 96 to routine analgesic management. There was
neither time-by-treatment interaction (P=0.67) nor treatment effect on
total OBAS over postoperative Days 1-3 with a median difference of 0.08
(95% confidence interval [CI]: -0.50 to 0.67; P=0.69) and an estimated
ratio of geometric means of 0.98 (95% CI: 0.85-1.13; P=0.75). There was no
evidence of a treatment effect on cumulative opioid consumption or
respiratory mechanics. Average pain scores on each postoperative day were
similarly low in both groups. Conclusion(s): Serratus anterior and
pectoralis plane blocks did not improve postoperative analgesia,
cumulative opioid consumption, or respiratory mechanics during the initial
3 days after robotically assisted mitral valve repair. Clinical trial
registration: NCT03743194. Copyright © 2023 British Journal of
Anaesthesia

<75>
Accession Number
2023226690
Title
PCSK9 inhibitors for acute coronary syndrome: the era of early
implementation.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1138787. Date of Publication: 2023.
Author
Chen H.; Chen X.
Institution
(Chen, Chen) Ningbo First Hospital, Ningbo, China
Publisher
Frontiers Media S.A.
Abstract
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a new
cholesterol-lowering strategy, can decrease low-density lipoprotein
cholesterol (LDL-C) levels by inhibiting PCSK9 and reducing the
degradation of LDL receptors; thus, they are impacting the management of
dyslipidemia to the prevention of cardiovascular events. Recent guidelines
recommend PCSK9 inhibitors for patients who fail to achieve target lipids
after ezetimibe/statin therapy. As PCSK9 inhibitors have been demonstrated
to significantly and safely reduce LDL-C, discussions have begun to
explore its optimal timing in coronary artery disease, especially in
subjects with acute coronary syndrome (ACS). Also, their additional
benefits, such as anti-inflammatory effects, plaque regression effects,
and cardiovascular event prevention, have become the focus of recent
research. Several studies, including EPIC-STEMI, suggest the
lipid-lowering effects of early PCSK9 inhibitors in ACS patients, while
some studies such as PACMAN-AMI suggest that early PCSK9 inhibitors can
decelerate plaque progression and reduce short-term risks of
cardiovascular events. Thus, PCSK9 inhibitors are entering the era of
early implementation. In this review, we are committed to summarizing the
multidimensional benefits of early implementation of PCSK9 inhibitors in
ACS. Copyright 2023 Chen and Chen.

<76>
Accession Number
2023184274
Title
Left Atrial Appendage Occlusion in the Elderly: Insights From PROTECT-AF,
PREVAIL, and Continuous Access Registries.
Source
JACC: Clinical Electrophysiology. 9(5) (pp 669-676), 2023. Date of
Publication: May 2023.
Author
Sulaiman S.; Roy K.; Wang H.; de Backer O.; Alloco D.; Reddy V.Y.; Holmes
D.R.; Alkhouli M.
Institution
(Sulaiman, Holmes, Alkhouli) Department of Cardiovascular Disease, Mayo
Clinic, Rochester, MN, United States
(Roy, Wang, Alloco) Boston Scientific Corporation, Marlborough, MA, United
States
(de Backer) Department of Cardiology, The Heart Center, Copenhagen
University Hospital, Copenhagen, Rigshospitalet, Denmark
(Reddy) Helmsley Electrophysiology Center, Department of Cardiology, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Data on the safety and efficacy of left atrial appendage
occlusion (LAAO) in elderly patients are limited. Objective(s): This
study aimed to compare the outcomes of LAAO between patients >=80 and <80
years of age. Method(s): We included patients enrolled in randomized
trials and nonrandomized registries of the Watchman 2.5 device. The
primary efficacy endpoint was a composite of cardiovascular/unknown death,
stroke, or systemic embolism at 5 years. Secondary endpoints included
cardiovascular/unknown death, stroke, systemic embolism, and major and
nonprocedural bleeding. Survival analyses were performed using the
Kaplan-Meier, Cox proportional hazards, and competing risk analysis
methods. Interaction terms were used to compare the 2 age groups. We also
estimated the average treatment effect of the device with the use of
inverse probability weighting. Result(s): We studied 2,258 patients,
of whom 570 (25.2%) were >=80 years old, and 1,688 (74.8%) were <80 years
old. Procedural complications at 7 days were similar in both age groups.
The primary endpoint occurred in 12.0% in the device group vs 13.8% in the
control group (HR: 0.9; 95% CI: 0.6-1.4) among patients <80 years of age
and in 25.3% vs 21.7%, respectively (HR: 1.2; 95% CI: 0.7-2.0) among
patients >=80 (interaction P = 0.48). There was no interaction between age
and treatment effect for any of the secondary outcomes. The average
treatment effects of LAAO (compared with warfarin) were similar in the
elderly population (compared with younger patients). Conclusion(s):
Despite the higher event rates, octogenarians derive similar benefits from
LAAO as their younger counterparts. Age alone should not preclude LAAO in
otherwise suitable candidates. Copyright © 2023 American College
of Cardiology Foundation

<77>
Accession Number
2023164001
Title
A randomised controlled, feasibility study to establish the acceptability
of early outpatient review and early cardiac rehabilitation compared to
standard practice after cardiac surgery and viability of a future
large-scale trial (FARSTER).
Source
Pilot and Feasibility Studies. 9(1) (no pagination), 2023. Article Number:
79. Date of Publication: December 2023.
Author
Ngaage D.L.; Mitchell N.; Dean A.; Mitchell A.; Hinde S.; Akowuah E.;
Doherty P.; Nichols S.; Fairhurst C.; Flemming K.; Hewitt C.; Ingle L.;
Watson J.
Institution
(Ngaage) Castle Hill Hospital, Hull University Teaching Hospitals NHS
Trust, Castle Road Cottingham, Hull, United Kingdom
(Mitchell, Dean, Mitchell, Doherty, Fairhurst, Flemming, Hewitt, Watson)
Department of Health Sciences, University of York, ARRC Building, York,
United Kingdom
(Hinde) Centre for Health Economics, Alcuin A Block, University of York,
York, United Kingdom
(Akowuah) James Cook Hospital, South Tees Hospitals NHS Foundation Trust,
Marton Road, Middlesbrough, United Kingdom
(Nichols) Sport and Physical Activity Research Centre, Sheffield Hallam
University, Collegiate Campus, Sheffield, United Kingdom
(Ingle) Department of Sport, Health and Exercise Science, University of
Hull, Hull, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Objective: To determine the acceptability and feasibility of delivering
early outpatient review following cardiac surgery and early cardiac
rehabilitation (CR), compared to standard practice to establish if a
future large-scale trial is achievable. Method(s): A randomised
controlled, feasibility trial with embedded health economic evaluation and
qualitative interviews, recruited patients aged 18-80 years from two UK
cardiac centres who had undergone elective or urgent cardiac surgery via a
median sternotomy. Eligible, consenting participants were randomised 1:1
by a remote, centralised randomisation service to postoperative outpatient
review 6 weeks after hospital discharge, followed by CR commencement from
8 weeks (control), or postoperative outpatient review 3 weeks after
hospital discharge, followed by commencement of CR from 4 weeks
(intervention). The primary outcome measures related to trial feasibility
including recruitment, retention, CR adherence, and acceptability to
participants/staff. Secondary outcome measures included health-rated
quality of life using EQ-5D-5L, NHS resource-use, Incremental Shuttle Walk
Test (ISWT) distance, 30- and 90-day mortality, surgical site
complications and hospital readmission rates. Result(s): Fifty
participants were randomised (25 per group) and 92% declared fit for CR.
Participant retention at final follow-up was 74%; completion rates for
outcome data time points ranged from 28 to 92% for ISWT and 68 to 94% for
follow-up questionnaires. At each time point, the mean ISWT distance
walked was greater in the intervention group compared to the control. Mean
utility scores increased from baseline to final follow-up by 0.202 for the
intervention (0.188 control). Total costs were 1519 for the intervention
(2043 control). Fifteen participants and a research nurse were
interviewed. Many control participants felt their outpatient review and CR
could have happened sooner; intervention participants felt the timing was
right. The research nurse found obtaining consent for willing patients
challenging due to discharge timings. Conclusion(s): Recruitment and
retention rates showed that it would be feasible to undertake a full-scale
trial subject to some modifications to maximise recruitment. Lower than
expected recruitment and issues with one of the clinical tests were
limitations of the study. Most study procedures proved feasible and
acceptable to participants, and professionals delivering early CR. Trial
registration: ISRCTN80441309 (prospectively registered on
24/01/2019). Copyright © 2023, Crown.

<78>
Accession Number
2023135073
Title
Postoperative intermittent pneumatic compression for preventing venous
thromboembolism in Chinese lung cancer patients: a randomized clinical
trial.
Source
Thrombosis Journal. 21(1) (no pagination), 2023. Article Number: 56. Date
of Publication: December 2023.
Author
Li J.; Huang A.; Han Z.; Zhou Y.; Tang M.; Wu W.; Zhang S.; Liao K.; Xie
Y.; Chen Q.; Zou X.; Liu S.; Gao S.; Ren J.; Xu Q.; Liu X.; Liao Y.; Jing
T.; Tan W.F.; Qiu Y.; Wang H.
Institution
(Li, Huang, Han, Zhou, Tang, Wu, Zhang, Liao, Xie, Chen, Liu, Gao, Xu,
Liu, Liao, Tan, Qiu, Wang) Department of Thoracic Surgery, Southwest
Hospital, Army Medical University, (Third Military Medical University),
Chongqing 400038, China
(Zou, Jing) Department of Vasculocardiology, Southwest Hospital, Army
Medical University, (Third Military Medical University), Chongqing, China
(Ren) Department of Neck and Chest Surgery, Affiliated Hospital of
Sergeant School of Army Medical University, Shijiazhuang, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative lung cancer patients belong to the high-risk
group for venous thromboembolism (VTE). The standardized preventive
measures for perioperative VTE in lung cancer are not perfect, especially
for the prevention and treatment of catheter-related thrombosis (CRT)
caused by carried central venous catheters (CVCs) in lung cancer surgery.
 Patients and Methods: This study included 460 patients with lung
cancer undergoing video-assisted thoracic surgery (VATS) in our center
from July 2020 to June 2021. Patients were randomized into two groups, and
intraoperatively-placed CVCs would be carried to discharge. During
hospitalization, the control group was treated with low-molecular-weight
heparin (LMWH), and the experimental group with LMWH + intermittent
pneumatic compression (IPC). Vascular ultrasound was performed at three
time points which included before surgery, before discharge, and one month
after discharge. The incidence of VTE between the two groups was studied
by the Log-binomial regression model. Result(s): CRT occurred in
71.7% of the experimental group and 79.7% of the control group. The
multivariate regression showed that the risk of developing CRT in the
experimental group was lower than in the control group (Adjusted RR =
0.889 [95%CI0.799-0.989], p = 0.031), with no heterogeneity in subgroups
(P for Interaction > 0.05). Moreover, the fibrinogen of patients in the
experimental group was lower than control group at follow-up (P = 0.019).
 Conclusion(s): IPC reduced the incidence of CRT during
hospitalization in lung cancer patients after surgery. Trial registration:
No. ChiCTR2000034511. Copyright © 2023, The Author(s).

<79>
Accession Number
2023011682
Title
Is valve-sparing aortic root replacement better than total aortic root
replacement? An overview of reviews.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1115290. Date of Publication: 2023.
Author
Wang W.; Zhang X.; Shi Y.; Xu S.; Shi T.; Han X.; Gu T.; Shi E.
Institution
(Wang, Zhang, Shi, Xu, Shi, Han, Gu, Shi) Department of Cardiac Surgery,
First Affiliated Hospital, China Medical University, Shenyang, China
Publisher
Frontiers Media S.A.
Abstract
Background: Total aortic root replacement (TRR) is certainly beneficial
for aortic root disease, but does it still have an advantageous prognosis
for patients compared to valve-sparing aortic root replacement (VSRR)? An
overview of reviews was conducted to assess each of their clinical
efficacy/effectiveness. Review methods: Systematic reviews
(SRs)/Meta-analyses comparing the prognosis of TRR and VSRR in aortic root
surgery were collected from 4 databases, all searched from the time of
database creation to October 2022. Two evaluators independently screened
the literature, extracted information and applied the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, A
Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) tool, Grading
of Recommendations, Assessment, Development and Evaluations (GRADE), and
Risk of Bias in Systematic Reviews (ROBIS) to evaluate the quality of
reporting, methodological quality, risk of bias, and level of evidence of
the included studies. Main Result(s): A total of 9 SRs/Meta-analyses
were ultimately included. In terms of the reporting quality of the
included studies, PRISMA scores ranged from 14 to 22.5, with issues mainly
in reporting bias assessment, risk of study bias, credibility of evidence,
protocol and registration, and funding sources. The methodological quality
of the included SRs/Meta-analyses was generally low, with key items 2, 7,
and 13 having major flaws and non-key items 10, 12, and 16. In terms of
risk of bias assessment, the overall assessment of the included 9 studies
was high-risk. The quality of the evidence was rated as low to very low
quality for the three outcome indicators selected for the GRADE quality of
evidence rating: early (within 30 days postoperatively or during
hospitalization) mortality, late mortality, and valve reintervention rate.
 Conclusion(s): VSRR has many benefits including reduced early and
late mortality after aortic root surgery and reduced rates of
valve-related adverse events, but the methodological quality of the
relevant studies is low, and there is a lack of high-quality evidence to
support this. Systematic Review Registration: https://www.PROSPERO,
identifier: CRD42022381330. Copyright 2023 Wang, Zhang, Shi, Xu, Shi,
Han, Gu and Shi.

<80>
Accession Number
2022818430
Title
Usefulness of analgesia nociception index for guiding intraoperative
opioid administration: a systematic review and meta-analysis.
Source
Minerva Anestesiologica. 89(1-2) (pp 74-84), 2023. Date of Publication:
January 2023.
Author
Hung K.-C.; Chang P.-C.; Hsu C.-W.; Lan K.-M.; Liao S.-W.; Lin Y.-T.;
Huang P.-W.; Sun C.-K.
Institution
(Hung, Lan, Liao, Lin) Department Of Anesthesiology, Chi Mei Medical
Center, Tainan, Taiwan (Republic of China)
(Chang) Division Of Thoracic Surgery, Department Of Surgery, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung,
Taiwan (Republic of China)
(Chang) Weight Management Center, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung, Taiwan (Republic of China)
(Chang) Department Of Sports Medicine, College Of Medicine, Kaohsiung
Medical University, Kaohsiung, Taiwan (Republic of China)
(Chang) Program In Biomedical Engineering, College Of Medicine, Kaohsiung
Medical University, Kaohsiung, Taiwan (Republic of China)
(Hsu) Department Of Psychiatry, Kaohsiung Chang Gung Memorial Hospital,
Chang Gung University College Of Medicine, Kaohsiung, Taiwan (Republic of
China)
(Huang) Department Of Emergency Medicine, Show Chwan Memorial Hospital,
Changhua City, Taiwan (Republic of China)
(Sun) Department Of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan
(Republic of China)
(Sun) College Of Medicine, I-Shou University, Kaohsiung, Taiwan (Republic
of China)
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: This study primarily aimed at investigating the efficacy of
Analgesia Nociception Index (ANI) for guiding intraoperative opioid
administration in patients receiving surgery under general anesthesia.
eviDence acQUisition: the Medline, embase, google scholar, and the
cochrane library databases were searched from inception to april 2022 for
randomized controlled trials. the primary outcome was intraoperative
opioid adminis-tration, while the secondary outcomes included
postoperative opioid consumption, pain score, emergency time, risk of
nausea/vomiting (PONV), and Postanesthesia Care Unit (PACU) stay. EVIDENCE
SYNTHESIS: Six studies including 399 participants (published from 2015 to
2022) focused on non-cardiac surgery, including spine surgery (two
trials), breast surgery (two trials), gynecologic surgery (one trial), and
laparoscopic cholecystectomy (one trial) were included. Meta-analysis
revealed no difference in intraoperative opioid administration with the
use of ANI-guided analgesia compared to the control group that used
conventional clinical measurements (e.g., heart rate) to guide opioid use
[standardized mean difference (SMD)=-0.17, 95% CI: -0.56 to 0.22, P=0.39,
I2=72%, six trials, 399 participants]. gender-based subgroup analysis
showed effectiveness of ani for reducing opioid administration in female
patients (SMD=-0.53, P=0.02). There were no differences in postoperative
recovery characteristics including pain score [Mean difference (MD):
-0.03, P=0.79], opioid consumption (SMD: -0.34, P=0.08), emergence time
(MD=1.12, P=0.47), length of stay in the PACU (MD: -0.56, P=0.83), and
risk of PONV [risk ratio(RR): 0.75, P=0.46] between the two groups.
conclUsions: analgesia nociception index-guided analgesia was unable to
reduce intraoperative opioid administra-tion compared to monitoring using
conventional clinical parameters. Further studies are required to support
our findings. Copyright © 2023 Edizioni Minerva Medica. All
rights reserved.

<81>
Accession Number
2022388463
Title
Efficacy of Buteyko Breathing Technique on Anxiety, Depression and Self
Efficacy in Coronary Artery Bypass Graft Patients: A Randomised Clinical
Trial.
Source
Journal of Clinical and Diagnostic Research. 17(1) (pp YC11-YC14), 2023.
Date of Publication: January 2023.
Author
Jain M.; Vardhan V.; Yadav V.; Harjpal P.
Institution
(Jain, Vardhan, Yadav) Department of Cardio-respiratory Physiotherapy,
Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical
Sciences, Maharashtra, Wardha, India
(Harjpal) Department of Neuro Physiotherapy, Ravi Nair Physiotherapy
College, Datta Meghe Institute of Medical Sciences, Maharashtra, Wardha,
India
Publisher
Journal of Clinical and Diagnostic Research
Abstract
Introduction: Psychiatric issues, particularly depression and anxiety,
have been observed in the proportions of patients undergoing
cardiovascular surgery.Such findings provide a window of opportunity for
integrating intervention, targeting psychological components into
post-Coronary Artery Bypass Graft (CABG) patient management to provide
effective care. The Buteyko Breathing Technique (BBT), which is named
after its inventor Konstantin Pavlovich Buteyko, is one of the numerous
breathing techniques that aims to regulate breathing. By alternating
between periods of controlled breathing reduction and breath holding.
 Aim(s): To explore the effect of BBT as a psychological
rehabilitation technique on anxiety, depression, and self-efficacy in
post-CABG subjects having anxiety and depression. Material(s) and
Method(s): This randomised clinical trial was performed at Cardiovascular
and Thoracic Surgery Unit, Acharya Vinobha Bhave Rural Hospital, Sawangi,
Wardha, Maharashtra, India, from June 2021 to May 2022. Total 44 post CABG
patients who all screened positive for anxiety and depression by General
Anxiety Disorder-7 (GAD-7) questionnaire and Patient Health
Questionnaire-9 (PHQ-9) were enrolled. They were randomly assigned using
computed generated block randomisation. They were allocated using the
Sequentially Numbered Opaque Sealed Envelope (SNOSE) method to group A
Conventional group (n=22) and group B Experimental group (n=22). Both
groups competed the in-hospital phase 1 cardiac rehabilitation as per
American Association of Cardiovascular and Pulmonary Rehab (AACVPR)
guidelines, whereas group B received additional BBT for psychosocial
rehabilitation for 2 weeks post surgery. The evaluations were performed
using the GAD-7 questionnaire, PHQ-9, General Self-Efficiency Scale (GSS),
Breath Holding Test (BHT), and Borg Rate of Perceived Exertion Scale
(RPE), at baseline on Post Operative Day (POD)1 and at their last
rehabilitation session. Patients in both groups were given self management
and education hand-outs at the time of discharge. Statistical Package for
Social Sciences (SPSS) version 27.0 was used for statistical analysis.
 Result(s): The mean age of patients in A-group was 59.72+/-7.84 years
and in B-group 60.81+/-7.42 years, respectively. The age, gender, height,
weight, and BMI of the patients were similar between the groups. On intra
group comparison,there was statistically significant difference observed
for GAD-7, PHQ-9, GSS, BHT, and RPE in group A and group B following the
intervention, but the change was more pronounced in group B. The results
for the inter group comparison showed a significant difference in group B
on Anxiety, Depression, self-efficacy, BHT, and RPE as compared to the
group A, i.e. group B showed a larger improvement in outcome measure
scores than group A. Conclusion(s): The present study demonstrated
that On intra group weeks of BBT along with phase 1 cardiac rehabilitation
in post CABG patients brings favourable changes in levels of anxiety,
depression and self-efficacy. Copyright © 2023 Journal of
Clinical and Diagnostic Research. All rights reserved.

<82>
Accession Number
2021964514
Title
Risk factors associated with positive bacterial culture in salvaged red
blood cells during cardiac surgery and postoperative infection incidence:
A prospective cohort study.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1099351.
Date of Publication: 2023.
Author
Zhou Y.; Chen T.; Yang C.; Liu J.; Yang X.; Zhang B.; Jin Z.
Institution
(Zhou, Chen, Yang, Liu, Yang, Zhang, Jin) Department of Cardiovascular
Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
Publisher
Frontiers Media S.A.
Abstract
Background: This study was designed to explore factors associated with the
incidence of positive bacterial culture of salvaged red blood cells
(sRBCs) recovered with a Cell Saver instrument during cardiac surgery and
the impact of such positive outcomes on postoperative infection-related
morbidity. Method(s): The cohort study enrolled 204 patients
scheduled for cardiac surgery with intraoperative blood cell salvage and
retransfusion from July 2021 to July 2022. These patients were stratified
into two groups based on intraoperative sRBCs bacterial culture results:
culture (+) and culture (-) groups. Preoperative and intraoperative
variables were compared between these groups aim to detect possible
predictors of positive culture in sRBCs. In addition, differences in
postoperative infection-related morbidity and other clinical outcomes were
compared between these groups. Result(s): Of these patients, 49% were
sRBCs culture (+), with Staphylococcus epidermidis as the most commonly
identified pathogen. Risk factors independently associated with the risk
of positive culture in sRBCs included BMI >=25 kg/m2, a history
of smoking, an operative duration >=277.5 min, the higher number of staff
in the operating room and higher surgical case order. Patients in the
sRBCs culture (+) group exhibited a longer average ICU stay [3.5 days
(2.0-6.0) vs. 2 days (1.0-4.0), P < 0.01], a longer duration of
ventilation [20.45 h (12.0-17.8) vs. 13 h (11.0-17.0, P = 0.02)],
underwent more allogeneic blood transfusions, exhibited higher
transfusion-related costs [2,962 (1,683.0-5,608.8) vs. 2,525
(1,532.3-3,595.0), P = 0.01], and had higher rates of postoperative
infections (22 vs. 9.6%, P = 0.02) as compared to patients in the sRBCs
culture (-) group. In addition, culture (+) in sRBCs was an independent
risk factor for postoperative infection (OR 2.62, 95% CI 1.16-5.90, P =
0.02). Conclusion(s): Staphylococcus epidermidis was the most common
pathogen detected in sRBCs in the culture (+) group in this study,
identifying it as a potential driver of postoperative infection. Positive
sRBCs culture may contribute to postoperative infection and its incidence
was significantly associated with patient BMI, history of smoking,
operative duration, the number of staff in the operating room and surgical
case order. Copyright © 2023 Zhou, Chen, Yang, Liu, Yang, Zhang
and Jin.

<83>
Accession Number
2021962674
Title
The effects of COVID-19 on pediatric and adult solid organ transplant
recipients and the emergence of telehealth.
Source
Pediatric Transplantation. 27(4) (no pagination), 2023. Article Number:
e14490. Date of Publication: June 2023.
Author
Raina R.; Shah R.; Marks S.D.; Johnson J.N.; Nied M.; Bhatt G.C.; Bonham
C.A.; Datla N.; Sethi S.K.; Bartosh S.M.
Institution
(Raina, Shah, Datla) Akron Nephrology Associates/Cleveland Clinic Akron
General Medical Center, Akron, OH, United States
(Raina) Department of Nephrology, Akron Children's Hospital, Akron, OH,
United States
(Marks) NIHR Great Ormond Street Hospital Biomedical Research Centre,
University College London Great Ormond Street Institute of Child Health,
London, United Kingdom
(Marks) Department of Pediatric Nephrology, Great Ormond Street Hospital
for Children NHS Foundation Trust, London, United Kingdom
(Johnson) Division of Pediatric Cardiology, Department of Pediatric and
Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
(Nied) Northeast Ohio Medical University, Rootstown, OH, United States
(Bhatt) Division of Pediatric Nephrology, Department of Pediatrics, All
India Institute of Medical Sciences (AIIMS), Bhopal, India
(Bonham) Division of Abdominal Transplant Surgery, Stanford University
School of Medicine, California, United States
(Sethi) Paediatric Nephrology & Paediatric Kidney Transplantation, Kidney
and Urology Institute, Medanta, The Medicity Hospital, Gurgaon, India
(Bartosh) Division of Pediatric Nephrology, University of Wisconsin,
Madison, WI, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The SARS-CoV-2 pandemic and corresponding acute respiratory
syndrome have affected all populations and led to millions of deaths
worldwide. The pandemic disproportionately affected immunocompromised and
immunosuppressed adult patients who had received solid organ transplants
(SOTs). With the onset of the pandemic, transplant societies across the
world recommended reducing SOT activities to avoid exposing
immunosuppressed recipients. Due to the risk of COVID-19-related outcomes,
SOT providers adapted the way they deliver care to their patients, leading
to a reliance on telehealth. Telehealth has helped organ transplant
programs continue treatment regimens while protecting patients and
physicians from COVID-19 transmission. This review highlights the adverse
effects of COVID-19 on transplant activities and summarizes the increased
role of telehealth in the management of solid organ transplant recipients
(SOTRs) in both pediatric and adult populations. Method(s): A
comprehensive systematic review and meta-analysis were conducted to
accentuate the outcomes of COVID-19 and analyze the efficacy of telehealth
on transplant activities. This in-depth examination summarizes extensive
data on the clinical detriments of COVID-19 in transplant recipients,
advantages, disadvantages, patient/physician perspectives, and
effectiveness in transplant treatment plans via telehealth.
 Result(s): COVID-19 has caused an increase in mortality, morbidity,
hospitalization, and ICU admission in SOTRs. Telehealth efficacy and
benefits to both patients and physicians have increasingly been reported.
 Conclusion(s): Developing effective systems of telehealth delivery
has become a top priority for healthcare providers during the COVID-19
pandemic. Further research is necessary to validate the effectiveness of
telehealth in other settings. Copyright © 2023 Wiley Periodicals
LLC.

<84>
Accession Number
2020530226
Title
Treatment of the New Era: Long-Term Ticagrelor Monotherapy for the
Treatment of Patients with Type 2 Diabetes Mellitus following Percutaneous
Coronary Intervention: A Meta-analysis.
Source
Diabetes Therapy. 14(1) (pp 47-61), 2023. Date of Publication: January
2023.
Author
Wang H.; Xie X.; Zu Q.; Lu M.; Chen R.; Yang Z.; Gao Y.; Tang Z.
Institution
(Wang) Jinan University, Guangdong, Guangzhou 510632, China
(Xie) Macau University of Science and Technology, Macao
(Zu, Lu) College of Management and Economics, Tianjin University, Tianjin
300072, China
(Chen, Yang) The State Key Laboratory Management and Control for Complex
Systems, Institute of Automation, Chinese Academy of Sciences, Beijing
100190, China
(Wang, Gao) Department of Cardiology, The People's Hospital of Guangxi
Zhuang Autonomous Region, Guangxi, Nanning 530021, China
(Tang) Department of Cardiology, Tongji Hospital of Tongji Medical College
of Huazhong University of Science and Technology, Tongji, Wuhan, China
Publisher
Adis
Abstract
Introduction: Type 2 diabetes mellitus (T2DM) is a risk factor for the
development of coronary artery disease (CAD). In patients with acute
coronary syndrome (ACS), guidelines recommend a potent P2Y12 inhibitor in
addition to aspirin. For those with complicated and advanced CAD requiring
complex percutaneous coronary intervention (PCI), the risk for adverse
ischemic events is even higher. Prolonged dual antiplatelet therapy (DAPT)
use is controversial. A new antiplatelet regimen after PCI should be
considered. In this analysis, we aimed to systematically show the impact
of long-term ticagrelor monotherapy after a short course of DAPT use on
the outcomes in patients with T2DM following PCI. Method(s):
Electronic databases were searched for relevant publications. Studies that
were based on patients with T2DM and that included patients with T2DM were
selected on the basis of the inclusion and exclusion criteria. Statistical
analysis was carried out with RevMan software. The data are presented as
risk ratios (RR) with 95% confidence intervals (CI). Result(s): A
total of 8621 patients were included in this analysis, whereby 4357
participants with T2DM were assigned to ticagrelor monotherapy and 4264
were assigned to DAPT. Our results showed long-term ticagrelor monotherapy
after a short course of DAPT use to be associated with a significantly
lower risk of major adverse cardiac events (RR 0.86, 95% CI 0.77-0.98; P =
0.02) and all-cause mortality (RR 0.77, 95% CI 0.60-0.98; P = 0.03).
However, no significant difference was observed in cardiac death,
myocardial infarction, stroke, stent thrombosis, or repeated
revascularization. Ticagrelor monotherapy was associated with
significantly lower risk of thrombolysis in myocardial infarction (TIMI)
defined minor or major bleeding (RR 0.71, 95% CI 0.54-0.93; P = 0.01)
compared with the DAPT regimen. Conclusion(s): Long-term ticagrelor
monotherapy after a short course of DAPT use showed better results in
patients with T2DM following PCI. Therefore, ticagrelor monotherapy after
a short course of DAPT use could be considered an evolution in
antiplatelet therapy of this decade for the treatment of patients with
T2DM after PCI. However, newer studies with a larger population size and
cost-effectiveness are factors that should further be
considered. Copyright © 2022, The Author(s).

<85>
Accession Number
2015662833
Title
The Legacy of the TTASAAN Report-Premature Conclusions and Forgotten
Promises: A Review of Policy and Practice Part I.
Source
Frontiers in Neurology. 12 (no pagination), 2022. Article Number: 749579.
Date of Publication: 28 Mar 2022.
Author
Pavel D.G.; Henderson T.A.; DeBruin S.
Institution
(Pavel) Pathfinder Brain SPECT Imaging, Deerfield, IL, United States
(Pavel, Henderson, DeBruin) The International Society of Applied
Neuroimaging (ISAN), Denver, CO, United States
(Henderson) The Synaptic Space, Inc, Denver, CO, United States
(Henderson) Neuro-Luminance, Inc, Denver, CO, United States
(Henderson) Theodore Henderson, Inc, Denver, CO, United States
(DeBruin) Good Lion Imaging, Columbia, SC, United States
Publisher
Frontiers Media S.A.
Abstract
Brain perfusion single photon emission computed tomography (SPECT) scans
were initially developed in 1970's. A key radiopharmaceutical,
hexamethylpropyleneamine oxime (HMPAO), was originally approved in 1988,
but was unstable. As a result, the quality of SPECT images varied greatly
based on technique until 1993, when a method of stabilizing HMPAO was
developed. In addition, most SPECT perfusion studies pre-1996 were
performed on single-head gamma cameras. In 1996, the Therapeutics and
Technology Assessment Subcommittee of the American Academy of Neurology
(TTASAAN) issued a report regarding the use of SPECT in the evaluation of
neurological disorders. Although the TTASAAN report was published in
January 1996, it was approved for publication in October 1994.
Consequently, the reported brain SPECT studies relied upon to derive the
conclusions of the TTASAAN report largely pre-date the introduction of
stabilized HMPAO. While only 12% of the studies on traumatic brain injury
(TBI) in the TTASAAN report utilized stable tracers and multi-head
cameras, 69 subsequent studies with more than 23,000 subjects describe the
utility of perfusion SPECT scans in the evaluation of TBI. Similarly,
dementia SPECT imaging has improved. Modern SPECT utilizing multi-headed
gamma cameras and quantitative analysis has a sensitivity of 86% and a
specificity of 89% for the diagnosis of mild to moderate Alzheimer's
disease-comparable to fluorodeoxyglucose positron emission tomography.
Advances also have occurred in seizure neuroimaging. Lastly, developments
in SPECT imaging of neurotoxicity and neuropsychiatric disorders have been
striking. At the 25-year anniversary of the publication of the TTASAAN
report, it is time to re-examine the utility of perfusion SPECT brain
imaging. Herein, we review studies cited by the TTASAAN report vs. current
brain SPECT imaging research literature for the major indications
addressed in the report, as well as for emerging indications. In Part II,
we elaborate technical aspects of SPECT neuroimaging and discuss scan
interpretation for the clinician. Copyright © 2022 Pavel,
Henderson and DeBruin.

<86>
Accession Number
2014136331
Title
Direct oral anticoagulants versus vitamin K antagonists in patients with
atrial fibrillation and bioprosthetic valves: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(6) (pp 2052-2059.e4),
2023. Date of Publication: June 2023.
Author
Yokoyama Y.; Briasoulis A.; Ueyama H.; Mori M.; Iwagami M.; Misumida N.;
Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, Pa, United States
(Briasoulis) Division of Cardiovascular Diseases, University of Iowa
Hospitals and Clinics, Iowa City, IA, United States
(Ueyama) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Mori) Division of Cardiac Surgery, Yale School of Medicine, New Haven,
Conn, United States
(Iwagami) Department of Health Services Research, University of Tsukuba,
Tsukuba, Japan
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, Ky, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal anticoagulation strategy for patients with
bioprosthetic valves and atrial fibrillation remains uncertain. We
conducted a meta-analysis using updated evidence comparing direct
anticoagulants (DOACs) and vitamin K antagonists (VKAs) in patients with
bioprosthetic valves and atrial fibrillation. Method(s): Medline and
Embase were searched through March 2021 to identify randomized controlled
trials (RCTs) and observational studies investigating the outcomes of DOAC
therapy and VKA therapy in patients with bioprosthetic valves and atrial
fibrillation. The outcomes of interest were all-cause death, major
bleeding, and stroke or systemic embolism. Result(s): Our analysis
included 4 RCTs and 6 observational studies enrolling a total of 6405
patients with bioprosthetic valves and atrial fibrillation assigned to a
DOAC group (n = 2142) or a VKA group (n = 4263). Pooled analysis
demonstrated the similar rates of all-cause death (hazard ratio [HR],
0.90; 95% confidence interval [CI], 0.77-1.05; P = .18; I2 =
0%) in the DOAC and VKA groups. However, the rate of major bleeding was
significantly lower in the DOAC group (HR, 0.66; 95% CI, 0.48-0.89; P =
.006; I2 = 0%), whereas the rate of stroke or systemic embolism
was similar in the 2 groups (HR, 0.72; 95% CI, 0.44-1.17; P = .18;
I2 = 39%). Conclusion(s): DOAC might decrease the risk of
major bleeding without increasing the risk of stroke or systemic embolism
or all-cause death compared with VKA in patients with bioprosthetic valves
and atrial fibrillation. Copyright © 2021 The American
Association for Thoracic Surgery

<87>
Accession Number
2022914359
Title
Predictors of mitral valve haemodynamics after mitral valve repair for
degenerative mitral regurgitation.
Source
Heart. 109(11) (pp 866-873), 2023. Date of Publication: 01 Jun 2023.
Author
Rumman R.K.; Verma S.; Chan V.; Mazer D.; Quan A.; Hibino M.; De Varennes
B.; Chu M.W.A.; Latter D.; Teoh H.; Yanagawa B.; Leong-Poi H.; Connelly
K.A.
Institution
(Rumman, Leong-Poi, Connelly) Department of Medicine, University of
Toronto, Toronto, ON, Canada
(Rumman, Leong-Poi, Connelly) Division of Cardiology, Li Ka Shing
Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
(Verma, Quan, Latter, Teoh, Yanagawa) Division of Cardiac Surgery, Li Ka
Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
(Verma, Latter, Yanagawa) Department of Surgery, University of Toronto,
Toronto, ON, Canada
(Verma, Yanagawa) Department of Pharmacology 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
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Hibino) Division of Cardiothoracic Surgery, Emory University School of
Medicine, Atlanta, GA, United States
(De Varennes) Division of Cardiac Surgery, Royal Victoria Hospital, McGill
University Health Center, Montreal, QC, Canada
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Teoh) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute, St. Michael's Hospital, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objective Intraoperative predictors of functional mitral valve (MV)
stenosis after surgical repair of mitral regurgitation (MR) caused by
prolapse remain poorly characterised. This study evaluated the effect of
annuloplasty size on postoperative MV haemodynamics during exercise and
evaluated predictors of MV hemodynamics. Methods 104 patients were
randomly assigned to leaflet resection or preservation for surgical repair
of MR in the Canadian Mitral Research Alliance CardioLink-2 study. In this
post hoc analysis, we compared MV haemodynamics between the two surgical
groups and examined the relationship between annuloplasty size and MV
haemodynamics 1 year after repair in the combined groups. Echocardiograms
were performed at baseline and intraoperatively. Exercise transthoracic
echocardiography was performed 1 year postoperatively. Multivariable
linear regression analysis was used to identify predictors of exercise MV
gradients at follow-up. Results Mean age of participants was 65+/-10
years, and 83% were male. Median annuloplasty size was 34 (IQR 32-36).
Dividing by the median, 48 (46%) had annuloplasty size of <34 mm and 56
(54%) had >=34 mm. Mean and peak exercise gradients at 1 year were 11+/-5
mm Hg and 22+/-9 mm Hg in <34, and 6+/-3 mm Hg and 14+/-5 mm Hg in >=34
(p<0.001). Rate of residual MR was similar in both groups. In
multivariable analyses, annuloplasty size of >=34 mm was associated with
lower mean and peak exercise gradients at 12 months, after adjustment for
repair type, age, sex, heart rate and body surface area (beta -4.1, 95% CI
-6 to -3, p<0.001, and beta -7 95% CI -10 to -4, p<0.001, respectively).
Intraoperative mean and peak MV gradients by transesophageal
echocardiography independently predicted mean and peak resting and
exercise gradients at follow-up (p<0.001). Similar results were obtained
in both leaflet resection and preservation. Conclusion Annuloplasty size
of >=34 mm is associated with a 4 and 7 mm Hg reduction in mean and peak
exercise MV gradients, respectively, 1 year post MV repair regardless of
the repair strategy used. Intraoperative TEE MV gradients predict exercise
MV gradients 1 year post repair. Trial registration number
NCT02552771. Copyright © 2023 BMJ Publishing Group. All rights
reserved.

<88>
Accession Number
2022861315
Title
Evaluating the value of progressive muscle relaxation therapy for patients
with lumbar disc herniation after surgery based on a
difference-in-differences model.
Source
Biotechnology and Genetic Engineering Reviews. (no pagination), 2023.
Date of Publication: 2023.
Author
Chen X.; Chen G.; Zhao Y.; Chen Q.; Huang J.; Hu G.
Institution
(Chen, Zhao, Chen, Huang, Hu) Ward of Nursing Department of the First
Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
(Chen) Department of Orthopedics, The First Affiliated Hospital of Wenzhou
Medical University, Zhejiang, China
Publisher
Taylor and Francis Ltd.
Abstract
We evaluate the value of progressive muscle relaxation (PMR) for patients
with lumbar disc herniation after surgery based on a
difference-in-differences model. A total of 128 patients with lumbar disc
herniation who underwent surgery were randomly assigned to undergo either
conventional intervention (conventional intervention group, n = 64) or
conventional intervention combined with PMR (PMR group, n = 64).
Perioperative anxiety level, stress level and lumbar function were
compared between the two groups and compared pain between the two groups
before and 1 week and 1 and 3 months after surgery. After 3 months, no one
was lost to follow-up. At 1 day before surgery and 3 days after surgery,
Self-rating Anxiety Scale score in the PMR group was significantly lower
than that in the conventional intervention group (P < 0.05). At 30 min
before surgery, heart rate and systolic blood pressure in the PMR group
were significantly lower than those in the conventional intervention group
(P < 0.05). After intervention, the scores of subjective symptoms,
clinical signs and restrictions on activities of daily living were
significantly higher in the PMR group than those in the conventional
intervention group (all P < 0.05). Visual Analogue Scale score in the PMR
group was significantly lower than that in the conventional intervention
group (all P < 0.05). The amplitude of change in VAS score in the PMR
group was greater than that in the conventional intervention group (P <
0.05). PMR can relieve perioperative anxiety and stress in patients with
lumbar disc herniation, reduce postoperative pain and improve lumbar
function. Copyright © 2023 Informa UK Limited, trading as Taylor
& Francis Group.

<89>
Accession Number
2017525300
Title
A Cardiovascular Risk Assessment Model According to Behavioral,
Psychosocial and Traditional Factors in Patients With ST-Segment Elevation
Myocardial Infarction (CRAS-MI): Review of Literature and Methodology of a
Multi-Center Cohort Study.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101158. Date of Publication: July 2023.
Author
Roohafza H.; Noohi F.; Hosseini S.G.; Alemzadeh-Ansari M.; Bagherieh S.;
Marateb H.; Mansourian M.; Mousavi A.F.; Seyedhosseini M.; Farshidi H.;
Ahmadi N.; Yazdani A.; Sadeghi M.
Institution
(Roohafza) Assistance Professor, Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Noohi) Professor, Cardiovascular Intervention Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Hosseini) Research Assistant, Cardiac Rehabilitation Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Alemzadeh-Ansari) Associate Professor, Cardiovascular Intervention
Research Center, Rajaie Cardiovascular Medical and Research Center,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bagherieh) Biomedical Engineering Department, Engineering Faculty,
University of Isfahan, Isfahan, Iran, Islamic Republic of
(Marateb) Department of Automatic Control, Biomedical Engineering Research
Center, Universitat Politecnica de Catalunya, BarcelonaTech (UPC),
Barcelona, Spain
(Marateb, Mansourian) Pediatric Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Mansourian) Cardiovascular Diseases Research Center, Department of
Cardiology, Heshmat Hospital, School of Medicine, Guilan University of
Medical Sciences, Rasht, Iran, Islamic Republic of
(Mousavi) Yazd Cardiovascular Research Center, Shahid Sadoughi University
of Medical Sciences, Yazd, Iran, Islamic Republic of
(Seyedhosseini) Cardiovascular Research Center, Hormozgan University of
Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Farshidi) Professor, Cardiovascular Research Center, Hormozgan University
of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Ahmadi) Research Assistant, Yazd Cardiovascular Research Center, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Yazdani) Research Assistant, Rajaie Cardiovascular Medical and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Sadeghi) Professor, Cardiac Rehabilitation Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
This study aims to provide a comprehensive risk-assessment model including
lifestyle, psychological parameters, and traditional risk factors to
determine the risk of major adverse cardiovascular events (MACE) in
patients with the first acute ST-segment elevation myocardial infarction
episode. Patients were recruited from new hospital admissions of acute
ST-segment elevation myocardial infarction and will be followed up to 3
years. Clinical and paraclinical characteristics, lifestyle,
psychological, and MACE information are collected and will be used in the
risk-assessment model. Totally, 1707 patients were recruited (male: 81.4%,
mean age: 56.60 +/- 10.34). Primary percutaneous coronary intervention was
the most prevalent type of coronary revascularization (81.9%). In case of
baseline psychological characteristics, mean depression score was 5.40 +/-
4.88, and mean distress score was 7.64 +/- 5.08. A comprehensive approach,
focusing on medical, lifestyle, and psychological factors, will lead to
better identification of cardiovascular disease patients at risk of
developing MACE through comprehensive risk-assessment
models. Copyright © 2022 Elsevier Inc.

<90>
Accession Number
635273898
Title
Improvement in Physical Function After Coronary Artery Bypass Graft
Surgery Using a Novel Rehabilitation Intervention A RANDOMIZED CONTROLLED
TRIAL.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 41(6) (pp
413-418), 2021. Date of Publication: 01 Nov 2021.
Author
Rengo J.L.; Savage P.D.; Hirashima F.; Leavitt B.J.; Ades P.A.; Toth M.J.
Institution
(Rengo, Savage, Ades, Toth) Division of Cardiology, Department of
Medicine, College of Medicine, The University of Vermont, Burlington,
United States
(Hirashima, Leavitt) Division of Cardiothoracic Surgery, Department of
SurgeryCollege of Medicine, The University of Vermont, Burlington, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Cardiorespiratory and skeletal muscle deconditioning occurs
following coronary artery bypass graft surgery and hospitalization.
Outpatient, phase 2 cardiac rehabilitation (CR) is designed to remediate
this deconditioning but typically does not begin until several weeks
following hospital discharge. Although an exercise program between
discharge and the start of CR could improve functional recovery,
implementation of exercise at this time is complicated by postoperative
physical limitations and restrictions. Our objective was to assess the
utility of neuromuscular electrical stimulation (NMES) as an adjunct to
current rehabilitative care following postsurgical discharge and prior to
entry into CR on indices of physical function in patients undergoing
coronary artery bypass graft surgery. Method(s): Patients were
randomized to 4 wk of bilateral, NMES (5 d/wk) to their quadriceps muscles
or no intervention (control). Physical function testing was performed at
hospital discharge and 4 wk post-discharge using the Short Physical
Performance Battery and the 6-min walk tests. Data from 37 patients (19
control/18 NMES) who completed the trial were analyzed. The trial was
registered at ClinicalTrials.gov (NCT03892460). Result(s): Physical
function measures improved from discharge to 4 wk post-surgery across our
entire cohort (P < .001). Patients randomized to NMES, however, showed
greater improvements in 6-min walk test distance and power output compared
with controls (P < .01). Conclusion(s): Our results provide evidence
supporting the utility of NMES to accelerate recovery of physical function
after coronary artery bypass graft surgery. Copyright © 2021
Wolters Kluwer Health, Inc. All rights reserved.

<91>
Accession Number
641389940
Title
Minimally invasive versus conventional sternotomy for aortic valve
replacement: A systematic review and meta-analysis.
Source
Perfusion. Conference: EuroELSO 2023. Lisbon Portugal. 38(1 Supplement)
(pp 165), 2023. Date of Publication: May 2023.
Author
Shaboub A.; Jasim Althawadi Y.; Alaa Abdelaal S.; Hussein Abdalla M.; Amr
Elzahaby H.; Mohamed M.; Ghaith H.S.; Negida A.
Institution
(Shaboub, Hussein Abdalla) Ain Shams University, Cairo, Egypt
(Jasim Althawadi) Alexandria University, Alexandria, Egypt
(Alaa Abdelaal) Kharkiv National Medical University, Kharkiv, Ukraine
(Amr Elzahaby) Menofia University, Shebien El-kom, Egypt
(Mohamed) Zagazig University, Egypt
(Ghaith) Al-Azhar University, Cairo, Egypt
(Negida) Harvard Medical School, Boston, MA, United States
Publisher
SAGE Publications Inc.
Abstract
Objectives: We aimed to compare the safety and outcomes of the minimally
invasive approaches versus conventional sternotomy procedure for aortic
valve replacement Methods: We conducted a PRISMA-compliant systematic
review and meta-analysis. We ran an electronic search of PubMed, Cochrane
CENTRAL, Scopus, and Web of Science to identify the relevant published
studies. Data were extracted and pooled as standardized mean difference
(SMD) or risk ratio (RR) using StataMP version 17 for macOS.
 Result(s): Forty-one studies with a total of 15,065 patients were
included in this meta-analysis (minimally invasive approaches n=7231 vs.
conventional sternotomy n=7834). The pooled effect size showed that
minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI
[0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and
-0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to
-0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]),
RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR
0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46
to 0.93]) However, minimally invasive approaches had longer operative
time, cross clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD
0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45],
respectively). There were no differences between the two groups in blood
loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia,
pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or
myocardial infarction, (all P>0.05). Conclusion(s): Current evidence
showed higher safety and better operative outcomes with minimally invasive
aortic valve replacement compared to the conventional approach. Future
RCTs with long term follow up are recommended (Figure Presented).

<92>
Accession Number
641389894
Title
ECMO supported patient outcome undergoing Trans-catheter Aortic Valve
Replacement (TAVR).
Source
Perfusion. Conference: EuroELSO 2023. Lisbon Portugal. 38(1 Supplement)
(pp 104), 2023. Date of Publication: May 2023.
Author
Guru P.; Pattnaik H.; Banga A.; Amal T.; Brigham T.; Agarwal A.; Bansal V.
Institution
(Guru, Pattnaik, Amal, Brigham, Agarwal) Mayo Clinic, Critical Care
Medicine, Jacksonville, United States
(Banga) SMS Medical College, Internal Medicine, Jaipur, India
(Bansal) Mayo Clinic, Pulmonary and Critical Care Medicine, Rochester,
United States
Publisher
SAGE Publications Inc.
Abstract
Objectives: To conduct a systemic review and meta-analysis of efficacy and
safety of ECMO support during TAVR. Method(s): We conducted a
systematic search of various bibliographic databases: PubMed, Embase,
Cochrane, Scopus, Science Citation Index and Emerging Sources Citation
Index from inception to May 27, 2022 using various relevant search terms
and keywords. Studies that included patients 18 years of age and older,
who underwent TAVR procedure and in whom ECMO was used emergently or
prophylactically were included. Our primary outcomes of interest were
patient mortality and procedural success rate. The key secondary outcomes
were incidence of peri or postoperative complications including major
bleeding, acute renal failure, myocardial infarction, vascular
complication, and stroke. Result(s): We identified eleven
observational cohort studies including total of 2,275 participants (415
ECMO & 1860 non-ECMO). The unadjusted risk of mortality in ECMO supported
patient was higher compared to nonECMO patients (OR 1.73; 95% CI 0.70-4.28
P=0.24, I 2 =90%). In patients with prophylactic ECMO the unadjusted risk
of mortality remained high (OR 3.89; 95% CI 1.45-10.39 P=0.007,
I2 =0%) and reached statistical significance. Prophylactic ECMO
use was associated with lower mortality compared to emergent ECMO use (OR
0.17; 95% CI 0.02-1.21 P=0.08, I2 =0%) but this was not
significant. The procedural success rate was found to be lower in ECMO
supported patient (OR 0.10; 95% CI 0.01-0.93 P=0.04, I2 =42%).
We found significant increased risk of bleeding (OR 3.32; 95% CI 2.48-4.44
P<0.00001, I2 =0%), renal failure (OR 2.38; 95% CI 1.19-4.78
P=0.01, I2 =40%), post-operative myocardial infarction (OR
1.89; 95% CI 1.42-2.53 P<0.0001, I2 =0%) and stroke (OR 2.32;
95% CI 1.14-4.74 P=0.02, I2 =14%) in ECMO patients undergoing
TAVR compared to those not on ECMO. Conclusion(s): ECMO support in
high-risk patients undergoing TAVR is not associated with improved
clinical outcomes. Use of prophylactic ECMO has better outcomes than
emergent ECMO. Overall, ECMO is associated with higher mortality and
post-operative complications. Prophylactic ECMO could be used in selected
high-risk cases for better outcomes in TAVR. (Figure Presented).

<93>
Accession Number
641389869
Title
Spinal cord infarction in patients supported with extracorporeal membrane
oxygenation: A review of incidence, risk factors and outcomes.
Source
Perfusion. Conference: EuroELSO 2023. Lisbon Portugal. 38(1 Supplement)
(pp 102-103), 2023. Date of Publication: May 2023.
Author
Zhu A.; Tan C.; Orr Y.; Chard R.
Institution
(Zhu, Tan, Orr, Chard) Westmead Hospital, Cardiothoracic Surgery,
Westmead, Australia
Publisher
SAGE Publications Inc.
Abstract
Objectives: Spinal cord infarction (SCI) in patients requiring
extracorporeal membrane oxygenation (ECMO) for cardiogenic shock is an
uncommon complication with only a few case reports detailing its
incidence. SCI carries with it a high risk of long-term morbidity in the
event of hospital survival. This review aims to investigate the incidence,
risk factors and outcomes of patients with SCI following ECMO.
 Method(s): A systematic review of the literature was conducted
through PubMed and EMBASE through December 2022. Articles reporting on
spinal cord infarction in patients supported with ECMO were included.
Appraisal of studies for inclusion and data extraction were performed
independently by two reviewers. Meta-analysis was not feasible due to the
small number of studies available. Result(s): Seven studies with a
total of 19 patients (9 female, 10 male) were reviewed. The mean age was
49.4+/-17.2 years old. The most common indication for ECMO was acute
cardiovascular failure (n=12, 63%) followed by primary graft failure
following cardiac transplantation (n=5, 26%). All patients were supported
on veno-arterial ECMO (VA-ECMO) with one patient converted to
veno-pulmonary artery ECMO for right heart support. The average duration
of ECMO was 12.2+/-11.3 days. Five patients (31%) had concomitant
intra-aortic balloon pump (IABP) therapy and four patients (25%) had
concomitant renal replacement therapy. Average time to evidence of
neurological deficit was 11.6+/-6.8 days, with radiological diagnosis
delayed to an average of 34.7+/-24.5 days. The thoracic spinal cord was
the most common level of spinal cord infarction (n=15, 79%). Incidence of
paraplegia was 84% (n=16) with neurological recovery in only 16% of cases
(n=3). Hospital survival was 31% (n=6). Conclusion(s): Spinal cord
infarction is a rare but devastating complication of ECMO. We have noted
in our institution that patients who have been on VA-ECMO and IABP may be
at a higher risk of SCI and this is reflected in this review. However,
there is a paucity of data on this dire complication, and we have
demonstrated that more long-term and international data is required.

<94>
Accession Number
641389839
Title
Chasing the dream (of Equipoise): Design and execution challenges of the
multicenter TITRE trial of indication-based red blood cell transfusion in
pediatric ECMO.
Source
Perfusion. Conference: EuroELSO 2023. Lisbon Portugal. 38(1 Supplement)
(pp 211-212), 2023. Date of Publication: May 2023.
Author
Sleeper L.A.; Alexander P.M.; Kelly D.P.; Bembea M.M.; Bellinger D.C.B.;
Sadhwani A.; Sun L.; Shrivastava M.; Klein G.L.; Newburger J.W.;
Thiagarajan R.R.
Institution
(Sleeper, Alexander, Bellinger, Sadhwani, Sun, Shrivastava, Klein,
Newburger, Thiagarajan) Boston Children;s Hospital, Harvard Medical
School, Department of Cardiology, Boston, MA, United States
(Kelly) Boston Children;s Hospital, Harvard Medical School, Medical
Critical Care, Boston, MA, United States
(Bembea) Johns Hopkins School of Medicine, Anesthesiology and Critical
Care Medicine, Baltimore, MD, United States
Publisher
SAGE Publications Inc.
Abstract
Objectives: To describe the challenges in the design and execution of a
multicenter randomized clinical trial (RCT) of indication-based red blood
cell (RBC) transfusion for the pediatric ECMO population, in a landscape
characterized by heterogeneity in standard of care (SOC) and stakeholders
from multiple disciplines and specialties. Method(s): RBC transfusion
during ECMO is necessary to improve delivery of oxygen to tissues and
manage bleeding; however, the hemoglobin (Hb) level for optimal tissue
oxygen delivery is unknown, thus exposing ECMO patients to unnecessary RBC
transfusions. Further, RBC transfusion during ECMO is independently
associated with increased morbidity and mortality. The TITRETrial is the
first RCT in the field of pediatric ECMO in decades and aims to address
this knowledge gap. It is designed to answer the question of whether
indication-based RBC transfusion based on reduced tissue oxygen delivery,
compared with RBC transfusion based on institutional-specific Hb
thresholds, reduces organ dysfunction by the time of decannulation, and
improves 1-year neurodevelopment and functioning in children receiving
ECMO. Result(s): TITRE was funded in July 2022 with a network of 18
sites and planned trial launch by April 2023. The trial is pragmatic,
i.e., each site;s SOC for RBC transfusion will be the comparator to the
indication-based RBC transfusion arm. The collaboration has identified
important challenges with respect to equipoise that will be highlighted. A
reluctance to randomize jeopardizes timely accrual if fewer programs are
willing to enroll. Conversely, rapid changes in SOC towards an
indication-based transfusion strategy and adoption of lower Hb thresholds
for RBC transfusion during ECMO jeopardize the separation of treatments
necessary to test TITRE;s hypothesis. The elusive nature of equipoise is
further compounded by multiplicity with respect to ECMO delivery, i.e.,
cardiac, medical/surgical, and neonatal intensive care programs. Trial
site consensus meetings with changes to the original protocol have helped
address some of these challenges to allow trial launch.
 Conclusion(s): Execution of a pragmatic multicenter RCT with SOC as
the comparator in a multidisciplinary care setting (ECMO) presents unique
challenges that we have successfully addressed to launch the TITRE Trial.
While TITRE will initially roll out in North America, we would welcome
extension of the study into European centers to determine whether
indication-based RBC transfusion during ECMO can improve patient outcomes.

<95>
Accession Number
641389687
Title
Implementation of structured eCPR programme to improve outcomes in a
specialist hospital in the United Kingdom.
Source
Perfusion. Conference: EuroELSO 2023. Lisbon Portugal. 38(1 Supplement)
(pp 89-90), 2023. Date of Publication: May 2023.
Author
Akhtar W.; Pinto S.; Gerlando E.; Pitt T.; Panoulas V.; Rosenberg A.
Institution
(Akhtar, Pinto, Gerlando, Pitt, Panoulas, Rosenberg) Harefield Hospital,
London, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Objectives: With increasing randomised evidence to support the use of
extracorporeal cardiopulmonary resuscitation (eCPR) we sought to implement
an evidence-based protocol and training programme to improve outcomes.
 Method(s): A retrospective analysis of our centre;s eCPR activity was
performed between 1st May 2019 and 1st October 2021 for 6 month survival
and functional outcome defined by cerebral performance category (CPC). We
also analysed cardiac arrest calls between 1st June 2020 and 1st October
2021 to determine if patients were appropriately considered for eCPR. A
multi-disciplinary working group discussed our current practice and
evaluated the evidence base for eCPR then utilised a modified delphi
method to develop a standard operating procedure best suited to our
population base and service. This was designed to be applicable to in and
out of hospital cardiac arrests. We developed an extensive training
programme and a rapid, systematic screening process of all in and out of
hospital cardiac arrests led by our critical care outreach nursing team.
We prospectively analysed eCPR cases with the new service from 1st April
2022 to 1stDecember 2022. Result(s): The cardiac arrest team was
activated 185 times from 1June 2020 to 1October 2021. 14 Patients received
eCPR, 6 patients met eCPR criteria but were treated with conventional CPR
and all died. Survival to discharge home for eCPR was 21% (3/14 patients).
All eCPR survivors at discharge had CPC 1 or higher. The delphi process
occurred over a 3-month period with 9 rounds to the final version shown in
Figure 1. The training programme was implanted over a further 3 months and
the service was launched 1st April 2022. The prospective analysis has
shown a survival to discharge home of 83% (5/6 patients). One patient from
the survivor group underwent heart transplantation prior to discharge
home. All survivors had CPC 1 or higher on discharge. Conclusion(s):
We demonstrated that in our institution a standard operating procedure,
strict adherence to predefined selection criteria, systematic screening
and extensive training improved outcomes for eCPR. (Figure Presented).

<96>
[Use Link to view the full text]
Accession Number
641388996
Title
The Use of Virtual Reality in the Immediate Postoperative Period for Pain
Control: A Systematic Review.
Source
Journal of the American College of Surgeons. Conference: American College
of Surgeons 2022 Annual Clinical Congress. San Diego, CA United States.
236(5 Supplement 3) (pp S140), 2023. Date of Publication: May 2023.
Author
Weiss K.; Nikas C.; Moreton E.; Smith A.B.
Institution
(Weiss, Nikas, Moreton, Smith) FACS University of North Carolina, Chapel
Hill, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: An innovative method to reduce postoperative pain control is
the use of virtual reality (VR). The objective of this study was to
systematically review whether VR can decrease pain in the immediate
postoperative period. Method(s): A systematic review of patient
discomfort, VR intervention during or immediately after operation, and
operation requiring admission was performed in Embase, Pubmed, PsychInfo
and Web of Science and yielded 2512 results. Studies were excluded if they
described non-sarcopenia in patients with end stage liver disease: trends
in amino acid and one-carbon molecule metabolismsurgical procedures,
non-pain related outcomes, augmented reality or other non-VR tech, use in
rehabilitation/PT, ambulatory operation, or simulation for training or
education. Result(s): Ten papers met inclusion criteria, six of which
were randomized controlled trials (RCTs), including 520 patients.
Surgeries included major cardiac (3), knee and hip replacements (3),
minimally invasive foregut (1), and multiple general surgeries (3). Timing
of VR ranged from postoperative day 0 to 3 and lasted between 5-45
minutes. VR content was diverse, including scenes of mountains, fields and
underwater. Three RCTs found significant reductions in postoperative pain
after VR. Four studies analyzed opioid usage as a secondary outcome to
capture pain intensity, none of which showed a significant difference. VR
timing did not appear to be a significant predictor of postoperative pain,
nor did operation type or VR content. Conclusion(s): A small number
of studies have investigated the impact of VR on postoperative pain,
showing variable impact. Larger, well-designed cohort studies are needed
to investigate the impact of VR on reducing postoperative pain and opioid
use among diverse surgeries.

<97>
Accession Number
2024629840
Title
The Effect of Pre-Operative Anaemia On Patient Outcomes After Surgical
Revascularisation For PAD.
Source
European Journal of Vascular and Endovascular Surgery. Conference: The
European Society for Vascular Surgery 36th Annual Meeting 2022. Rome
Italy. 65(5) (pp e66-e67), 2023. Date of Publication: May 2023.
Author
Birmpili P.; Cromwell D.; Atkins E.; Li Q.; Johal A.; Waton S.; Pherwani
A.; Williams R.; Richards T.; Nandhra S.
Institution
(Birmpili, Cromwell, Atkins, Li, Johal, Waton) Clinical Effectiveness
Unit, Royal College of Surgeons of England, London, United Kingdom
(Pherwani) Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
(Williams, Nandhra) Freeman Hospital, Newcastle Upon Tyne Hospitals NHS
Foundation Trust, Newcastle-upon-Tyne, United Kingdom
(Richards) Department of Vascular Surgery, University of Western
Australia, Perth, WA, Australia
Publisher
W.B. Saunders Ltd
Abstract
Objective: Anaemia in patients undergoing surgery is associated with
adverse peri-operative outcomes and mortality.1,2 However, the
effect of anaemia on vascular specific outcomes such as amputation has not
been evaluated in large studies. The purpose of this study was to explore
the association between the presence of pre-operative anaemia and
post-operative outcomes after surgical revascularisation for peripheral
arterial disease (PAD), using National Vascular Registry (NVR) and linked
administrative data. Method(s): Data from the National Vascular
Registry (NVR), a clinical database of vascular procedures in the United
Kingdom, were interrogated for all patients who underwent open surgical
lower limb revascularisation between January 2016 and December 2019. Those
undergoing amputations or endovascular revascularisation procedures in the
30 days prior to the first surgical revascularisation within the study
period and procedures due to trauma were excluded. Patient demographics
and procedural details were extracted from the NVR, while 30 day and one
year outcome data were extracted from linked Hospital Episodes Statistics
(HES) database, a national administrative database in England, with follow
up to December 2020. Complete case analysis was performed. Four categories
of anaemia severity were defined using the WHO criteria for men and
women.3 The primary outcome was one year amputation free
survival (AFS). Secondary outcomes were length of in hospital stay, and 30
day AFS, mortality and ipsilateral major lower limb amputation (MLLA)
rate. Multinomial logistic regression was used to analyse the effect of
anaemia on 30 day outcomes and a flexible parametric survival model was
used to estimate the effect of anaemia on one year amputation free
survival, adjusting for patient and admission characteristics.
 Result(s): Some 11 680 patients were included in the study, 8 682
(74.3%) of whom were men, 4 304 (36.9%) were admitted non-electively, and
4 945 (42.3%) had anaemia (Table 1). Pre-operative anaemia was associated
with increased median length of hospital stay (10 days [IQR 5, 21] for
anaemic patients vs. 6 days [IQR 3, 10] for non-anaemic, p <.001). Overall
30 day mortality rate was 2.56%, 30 day MLLA rate 3.19%, 30 day AFS
94.46%, and one year AFS 80.94%. Pre-operative anaemia was associated with
worse one year amputation free survival, with increasing severity related
to decreasing AFS (Fig. 1). After adjustment for age, gender, American
Society of Anaesthesiologists (ASA) grade, smoking, diabetes, respiratory,
cardiac and renal comorbidities, white cell count, as well as mode of
admission and presenting problem (Fontaine stage), patients with anaemia
were at increased risk of one year amputation or death with a hazard ratio
of 1.45 (1.32 - 1.58) (Table 2). Pre-operative anaemia was also associated
with worse 30 day amputation free survival (adjusted estimates 93.79 [95%
CI 93.22 - 94.37] vs. 95.31 [94.73 - 95.89] for non-anaemic patients).
Patients with pre-operative anaemia had 1.5 times (95% CI 1.16 - 1.87)
higher relative risk of 30 day ipsilateral major amputation, after
adjusting for the same factors and creatinine levels (Table 2). The effect
of anaemia severity on 30 day outcomes, adjusting for patient and
admission factors is depicted in Figure 2, with moderate and severe
anaemia having a statistically significant impact on 30 day mortality and
amputation. Conclusion(s): In a large contemporary registry dataset,
this study confirms that pre-operative anaemia is statistically
significantly associated with increased 30 day mortality rate and
amputation rate, and decreased one year amputation free survival for
patients undergoing surgical revascularisation procedures. Despite
national recommendations,4 anaemia correction remains an
underconsidered factor for optimisation for patients in the peri-operative
period and further studies are warranted in this area. [Formula presented]
[Formula presented] [Formula presented] [Formula presented] REFERENCES 1
Fowler AJ, Ahmad T, Phull MK, Allard S, Gillies MA, Pearse RM.
Meta-analysis of the association between preoperative anaemia and
mortality after surgery. Br J Surg 2015;102:1314-24. 2 Hogan M, Klein AA,
Richards T. The impact of anaemia and intravenous iron replacement therapy
on outcomes in cardiac surgery. Eur J Cardiothorac Surg 2014;47:218-26. 3
World Health Organization. Haemoglobin concentrations for the diagnosis of
anaemia and assessment of severity. (WHO/NMH/NHD/MNM/11.1). Available at:.
4 National Institute for Health and Care Excellence. NICE guideline NG24:
Blood transfusion. Available at:. Copyright © 2023

<98>
Accession Number
641393205
Title
Minimally Invasive Versus Sternotomy for Mitral Valve Surgery in Elderly
Patients After Previous Sternotomy: A Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 57S), 2023. Date of Publication: April 2023.
Author
Hage A.; Hage F.; Al-Amodi H.; Gupta S.; Papatheodorou S.; Hawkins R.;
Ailawadi G.; Mittleman M.; Chu M.W.A.
Institution
(Hage, Hage, Al-Amodi, Chu) Western University, London, ON, Canada
(Gupta, Papatheodorou, Mittleman) Harvard TH Chan School of Public Health,
Boston, MA, United States
(Hawkins, Ailawadi) University of Virginia, Charlottesville, VA, United
States
Publisher
SAGE Publications Ltd
Abstract
Objective: Despite the evidence demonstrating similar outcomes of
minimally-invasive, endoscopic mitral valve surgery (MIMVS) as compared to
the conventional sternotomy (CS) approach, the safety of MIMVS in elderly
patients with previous sternotomy is still unclear. We performed a
systematic review and meta-analysis of observational studies comparing
MIMVS with CS in elderly patients (>=65 years old) with previous
sternotomy. Method(s): We searched PubMed, EMBACE, Web of Science,
clinicaltrials.gov, and Cochrane for trials and observational studies
comparing the MIMVS technique with CS in patients >=65 years old with
previous sternotomy presenting for mitral valve surgery (repair or
replacement). We performed a random-effects meta-analysis of all outcomes.
 Result(s): There were 7 retrospective observational cohort studies
including 543 patients. The meta-analysis showed significantly lower
mortality (odds ratio [OR] 0.37; 95% CI 0.18 to 0.76), acute renal failure
(OR 0.27; 95% CI 0.12 to 0.62), wound infection (OR 0.13; 95% CI 0.02 to
0.79) and sepsis (OR 0.14; 95% CI 0.04 to 0.47) in favour of the minimally
invasive, endoscopic approach. MIMVS also resulted in shorter hospital
length of stay (LOS) (weighted mean difference [WMD]: -4.1 days; 95% CI
-5.5 days to -2.7 days) and shorter intensive care unit LOS (WMD: -1.6
days; 95% CI -3.4 days to 0.3 days). As compared to the re-sternotomy
approach, MIMVS resulted in similar odds of reoperation for bleeding,
stroke, blood transfusion, respiratory infection, atrial fibrillation, and
long intubation. MIMVS was also associated with similar crossclamp time
and cardiopulmonary bypass times. Conclusion(s): Current evidence
suggests that MIMVS in elderly patients presenting for reoperation is
associated with lower mortality, major morbidities and shorter hospital
LOS. MIMVS is not associated with longer cross-clamp and bypass times in
this population. (Figure Presented).

<99>
Accession Number
641393203
Title
Is Patient Controlled Analgesia Necessary After Robotic Thoracic Surgery?.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 32S), 2023. Date of Publication: April 2023.
Author
Singh V.; Rao K.
Institution
(Singh, Rao) Zucker Hofstra School of Medicine, Bay Shore, NY, United
States
Publisher
SAGE Publications Ltd
Abstract
Objective: Postoperative pain after Robotic Thoracic surgery is a
challenge to manage. The variability of one's ability to tolerate pain
makes this topic an ongoing discussion. Patient controlled analgesia (PCA)
is long considered to be optimal due to the ability for a patient to
control administration. The waste of unused portions of anaesthesia and
daily Anesthesiologist consultation can add significant cost to a
patient's hospital stay. Therefore, we asked the question if PCA is
necessary for the acute postoperative course. Method(s): We
randomized 20 patients undergoing lobectomy for stage I non small cell
lung cancer. All patients had no previous thoracic surgical history. Five
ports sites were used along the entire 8th intercostal space for the
procedure. 30 milliliters of liposomal bupivicaine was administered
between the 5th to 9th intercostal spaces at the conclusion of the
procedure. 10 patients were managed with a timed regimen of oxycodone and
morphine every three hours versus 10 patients were given a PCA. A
numerical rating scale (1-10) was used to asses daily pain levels.
Specifically, the number 1 being applicable to no pain versus a rating of
10 being given for severe pain. Result(s): The mean length of stay
was 3 days. Chest tubes were removed on average on post op day 1.5 for all
patients. The mean pain scores dropped from 7 to 5 after removal of chest
tube. There was no demonstrable difference in scores of either group.
Depending on the length of stay, the PCA group averaged a cost of $400
more for the hospital stay. Conclusion(s): We conclude the the use of
PCA does not provide a significant impact in a patient's pain control, but
can add significant cost and waste of medication. The lack of PCA but a
strong pain regimen is non inferior and more economical after a robotic
assisted lobectomy.

<100>
Accession Number
641393144
Title
Minimal Access Surgical TAVI in a High Risk Group.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 77S), 2023. Date of Publication: April 2023.
Author
Mansoor M.; Gamal A.; Itani O.; Bose A.; Wiper A.; Raimondo C.; More R.;
Roberts D.
Institution
(Mansoor, Gamal, Itani, Bose, Wiper, Raimondo, More, Roberts) Blackpool
Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: Transcatheter aortic valve implantation (TAVI) is the
recommended treatment for high-risk patients with aortic valve stenosis.
It is advantageous compared to surgery offering shortened recovery times.
Compared to national data in the UK we perform a significant proportion of
non-femoral TAVI. We conducted a study to compare outcomes including
allcause mortality, stroke, myocardial infarction, AKI, bleeding and
vascular complications for non-transfemoral TAVI against national and
international standards. Method(s): We collected data for all
patients who underwent TAVI through alternative vascular access sites
(non-transfemoral TAVI) at our unit between 2013 and 2020. Patient
demographics, vascular access point including Transfemoral (TF),
Trans-/Direct-Aortic, Subclavian and transapical and outcomes were
recorded for each patient. These were compared with international and
national TAVI registry statistics. Result(s): Out of a total of 680
patients, 141 patients had TAVI via mini surgical non-femoral approach; 46
patients had Trans-/Direct-Aortic, 26 patients underwent subclavian and 69
underwent transapical approaches. There was a total of 1(0.7%) MI, 2(1.4%)
strokes, 10(7.1%) vascular complications, 22(15.6%) AKI and 10(7.1%)
deaths. Trans-/Direct-aortic access showed the best overall outcome rates.
 Conclusion(s): Patients who had surgical access TAVI and in
particular via Transaortic access had acceptable outcomes compared to the
national and international standards despite the high risk of these
patients who are not eligible for TF TAVI and have a high risk profile
with many comorbidities. Large scale randomized studies should focus on
safety of Transaortic TAVI in this high-risk patient cohort.

<101>
Accession Number
641393106
Title
Cost Benefits With Robotic Cardiac Surgery in Comparison to Sternotomy.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 96S-97S), 2023. Date of Publication: April
2023.
Author
Khaliel F.
Institution
(Khaliel) KFSHandRC, Riyadh, Saudi Arabia
Publisher
SAGE Publications Ltd
Abstract
Objective: Robotic cardiac surgery has been established since 1997, and
hasn't taken off significantly due to steep learning curve and limited
budgets at health institute. Our study is to compare costs of matched
procedure in Saudi Riyal (SR) with conventional sternotomy (CS).
 Method(s): Between Feb2019 and Feb 2021, over 150 patients underwent
robotic cardiac surgery. A randomized study matching 48 patients (group1
n=24 Robotic MVR and Group2 n=24 CS MVR) were compared. Group3 n=12
Robotic OPCAB, group4 CS CABG) were also randomized and matched.
 Result(s): EUROSCOREII group1 was 2.1% Vs. 1.1% in group2, and 1.4%
group3 Vs. 1.46% in group4. Average length of stay (LOS) in group1 to
group2 were 6.8 and 10.4days, respectively. While LOS in group3 to group4
were 4.9 and 8.5days, respectively. Average BMI were equal in all group
30kg/m2. Mechanical ventilation in group1,2,3, and 4 were 12.6,
15, 4.8 and 11 hours, respectively. Blood transfusion rate were 0.25Unit
group1, Vs. 2Units in group2, while zero in group3 Vs. 2.6Units. Hospital
costs in group1, 2, 3 and 4 were 3.6M, 5.1M, 1.98M, 2.2M SR, respectively.
Cost difference in group 1 to group2 were 1.51M per 24 patients, and
group3 to group4 were 190k per 12 patients, favoring the robotic cohort
group1 & group3. Conclusion(s): Robotic Cardiac surgery has improved
patient outcome, lowered blood product transfusion, mechanical ventilation
time, length of stay by over 50%. Hence, lowering cost by 40% in
comparison to their counterpart the CS.

<102>
Accession Number
641393084
Title
Are There Differences in Mortality and Morbidity Outcomes for
Cardiothoracic Surgical Procedures Performed by Trainee Versus Attending?.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 70S-71S), 2023. Date of Publication: April
2023.
Author
Comanici M.; Salmasi Y.M.; Raja S.G.; Attia R.Q.
Institution
(Comanici, Salmasi, Raja, Attia) Harefield Hospital, Uxbridge, United
Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: There are increasing pressures to decrease training time in the
operating room. We sought to assess the safety of training in
cardiothoracic surgery comparing cases performed by trainee's vs
consultants. Method(s): EmBase, Scopus, PubMed and OVID MEDLINE were
assessed in August 2021 independently by two authors while a third author
arbitrated decisions to resolve disagreements. Inclusion criteria were
articles on cardiothoracic surgery, training, and outcomes. Studies were
assessed for appropriateness as per CBEM criteria. 892 results were
obtained, 51 meet the specified criteria. 27 represented best evidence
(2-Meta-analyses, 1-RCT and 24 retrospective cohort studies).
 Result(s): 474,160 operative outcomes were assessed including 434,535
CABG (431,329 on-pump vs 3206 off-pump), 3090 AVR, 1740 MVR/repair, 26,433
mixed, 3565 congenital and 4797 thoracic. 398,058 cases were performed by
trainees and 75,943 by consultants. 159 cases were indeterminate. There
were no statistically significant differences in the patients'
pre-operative risk scores. All studies excluded extreme high-risk patients
in emergency setting, those with poor left ventricular function and
re-operation cases that were operated on by consultants. There were no
differences in CPB and clamp times for CABG, times for valve replacement
and repair cases were longer for trainees. There were no differences in
the post-operative outcomes including peri-operative myocardial
infarction, resternotomy for bleeding, stroke, renal failure, ITU and
total length of stay. One study reported no differences on angiographic
graft patency at 1-year. There were no differences in in-hospital or
mid-term mortality out to five-years. Conclusion(s): Published data
indicate that trainees can perform cardiothoracic surgical procedures in
dedicated high-volume units with outcomes comparable to those of trainers.
Academic programs should focus on strategies to maximise trainees'
exposure as primary operating surgeons.

<103>
Accession Number
641393078
Title
Quality of Life and Pulmonary Function After Minimally Invasive Aortic
Valve Replacement Surgery: A Systematic Review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 41S-42S), 2023. Date of Publication: April
2023.
Author
Hackney M.
Institution
(Hackney) University of Bristol, Bristol, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: Aortic valve replacement surgery (AVR) via midline sternotomy
is the standard surgical intervention used for AVR, however a minimally
invasive approach is becoming more widely used. This review focuses on
quality of life (QoL) and pulmonary function after minimally invasive AVR
(MIAVR). The aim of this review is to comprehensively analyse the current
body of evidence of the QoL and pulmonary function after MIAVR. A second
aim is to see whether a conclusion can be made on the current literature:
is the minimally invasive technique more beneficial to the patient over
conventional full sternotomy approach, and therefore should this be
standard practice going forward? Methods: A thorough literature search was
conducted in the PubMed database, using relevant searches. Papers were
either included or excluded based on their title. Through a cross
reference check from the papers identified by the search, further articles
were identified. Result(s): Several studies compared postoperative
QoL between MIAVR and full sternotomy AVR (FSAVR). Some had no significant
differences between the groups, however a couple were able to show
differences in some categories within the ShortForm-36 such as a more
improved 'physical function' and 'physical role function'. With regards to
pulmonary function, several studies showed a greater improvement in both
FEV1 and FVC postoperatively in the MIAVR group. Conclusion(s):
Overall, MIAVR can be performed with acceptable postoperative QoL and
pulmonary function, and with added benefits in postoperative lung function
over FSAVR. The literature currently available is sparse, so in terms of
which approach is more beneficial to the patient, more well-designed,
blind studies, especially randomised controlled trials with larger sample
sizes, are needed in order to draw more definitive conclusions.

<104>
Accession Number
641393046
Title
Review of Graft Patency in Robotically Assisted Coronary Artery Bypass and
Totally Endoscopic Coronary Bypass Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 66S-67S), 2023. Date of Publication: April
2023.
Author
Sherazee E.A.; Guenther T.M.; Kiaii B.
Institution
(Sherazee, Guenther, Kiaii) UC Davis Medical Center, Sacramento, CA,
United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Robotically assisted coronary artery bypass grafting surgery
(RACABG) avoids the morbidities of a sternotomy and cardiopulmonary bypass
and is becoming increasingly popular. Robotically assisted minimally
invasive direct CABG (RMIDCAB) and totally endoscopic CABG (TECAB) have
been shown to have similar patency rates compared to conventional CABG
(Left internal mammary artery patency: 98%, 95%, 88% at 5, 10 and 15
years, respectively). A systematic review was performed to evaluate graft
patency and clinical outcomes in patients who underwent RACABG.
 Method(s): A systematic review of studies reporting graft patency
after RACABG was performed using PubMed, Google Scholar, and Embase.
 Result(s): Between June 1998 and August 2018, 4,344 patients
underwent RACABG, either by RMIDCAB (2,662) or TECAB (1,682) approach.
Both cohorts were evaluated with post operative CTA or angiogram at
similar rates (TECAB 70% vs. RMIDCAB 69%). The average graft patency at
short- (<1 month), mid- (<5 years) and long-term (>=5 years) follow up was
97.6%, 95.3% and 94.2% for RMIDCAB, respectively and 98%, 95.6% and 93.7%
for TECAB, respectively. Rates of 30-day mortality, conversion to
sternotomy and post op reintervention for an occluded graft were 0.3%,
1.5% and 1.6%, respectively. Conclusion(s): RACABG has comparable
patency rates to conventional CABG with a low rate of reintervention.
Short term patency rates are well documented in the literature; however,
there are only a few studies reporting on the mid- and long-term outcomes.
Although the initial data is very encouraging, further investigation is
warranted to further assess this minimally invasive technique for surgical
coronary artery revascularization.

<105>
Accession Number
641393031
Title
In Search of Optimal Cardioplegia: Diminished Delivery Dose of Long Acting
Solutions Resulting In Less Hemodilution.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 10S), 2023. Date of Publication: April 2023.
Author
Gunaydin S.; Babaroglu S.; Simsek E.; Karaca O.G.
Institution
(Gunaydin, Babaroglu, Simsek, Karaca) University of Health Sciences,
Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objective: Despite promising results regarding the use of single-dose
cardioplegia in minimally invasive surgery, there are still concerns
regarding the impact of hemodilution hindering the clinical advantages of
this surgical technique. This study aims to document the safety and
feasibility of 1000 mL single dose delivery of del Nido cardioplegia (DNC)
and histidinetryptophan- ketoglutarate (HTK) solution with a target of 60
min ischemic time in minimally invasive aortic valve replacement (m-AVR).
 Method(s): Following ethics approval, during a one-year period, 87
patients undergoing mAVR with an expectation of cross-clamp time< 60 min
were prospectively randomized to receive DNC (N=46) or HTK (N=41),
4-8degreeC, 1000 mL in 5 min via 80-100 mmHg pressure (up to 60 min
ischemic time). Inclusion criteria were patients aged 50-79 years,
providing informed consent, scheduled for mAVR with x-clamp time expected
to be <60 min. Exclusion criteria were hemodynamic instability, renal
failure, previous cardiac surgery, conversion to sternotomy and
neurological dysfunction. Patients needing earlier and additional dosing
were excluded. Redosing was done with half dose of the initial regimen. No
ultrafiltration was used. Blood samples were collected at the following
time intervals: after induction of anesthesia before CPB (T1), after
cessation of CPB (T2), ICU on the first postoperative day at 8 am (T3).
Primary endpoints were the hematocrit levels at T2 and the perioperative
rate of blood products transfusion. Result(s): In two patients from
DNC and one in HTK, there was a need for conversion to full sternotomy;
three patients in the DNC and one in the HTK group needed earlier redosing
(<60 minutes; heart started beating/fibrillation); five patients in DNC
and two in HTK received redosing and were all excluded. The feasibility of
60-min ischemic time was 82% for DNC and 93% for HTK. Perioperative
outcome is summarized in Table C1-1. Conclusion(s): Diminished dose
(one-liter) of single-dose cardioplegic solutions provided safe and
acceptable myocardial protection in 82/93% of patient population within
60-min ischemic time. Potential concerns of full dosing represented by
hemodilution, increased transfusion, need for ultrafiltration, sodium
imbalance and arrhythmia were overruled. Further studies with larger
patient population are warranted.

<106>
Accession Number
641392984
Title
A Case of Robotic Left Internal Mammary Harvest in a Patient Undergoing
Maxillo-Facial Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: International Society for Minimally Invasive
Cardiothoracic Surgery Annual Scientific Meeting, ISMICS 2022. Warsaw
Poland. 18(1 Supplement) (pp 85S-86S), 2023. Date of Publication: April
2023.
Author
Massey J.; Modi P.
Institution
(Massey) Northern General Hospital, Sheffield, United Kingdom
(Modi) Liverpool Heart and Chest, Liverpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: The introduction of robotic devices to surgical practice has
offered an attractive option for reducing the burden of morbidity
associated with maximal access incisions such as median sternotomy.
Systematic review of comparative studies comparing coronary artery bypass
grafting by sternotomy and robotic coronary artery bypass grafting have
shown lower rates of post-operative pneumonia, ventilation time, pain and
post-operative stay with minimal access approach. The skills learnt in
minimal access cardiac surgery may be used to benefit patients undergoing
surgery by other specialties. We present a case of robotic left internal
mammary artery harvest in a patient undergoing major maxillo-facial
resection and reconstruction. Method(s): N/A. Result(s): A 44
year old patient was presented to the minimal access cardiac surgical team
by the maxillo-facial surgeons. The patient had undergone two major head
and neck operative procedures on the floor of the mouth and the mandible
for recurrent squamous cell carcinoma of the anterior tongue.
Unfortunately, following radiotherapy to the surgical site, the patient
developed osteoradionecrosis. Due to the nature of the previous surgery,
the left internal mammary artery was planned to be used for the
microvascular reconstruction of the jaw. Due to the complexity of the
redo-facial surgery, the addition of sternotomy for mammary harvest would
have added further burden to the patient, therefore a minimal access
approach to the mammary artery was utilised. The surgeon used the Da Vinci
Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) to harvest the
left internal mammary artery, the vessel was then tunneled into the neck
for use by the maxillo-facial surgeons in reconstructing the jaw. The
patient made a full recovery and was discharged home without the added
burden of a sternotomy. Conclusion(s): In conclusion, we performed
robotic internal mammary vessel harvesting using the da Vinci Surgical
System safely, with excellent results to aid a patient undergoing major
head and neck reconstruction. Robotic assistance provides the advantages
of harvesting a longer internal mammary pedicle more safely and quickly
with lower morbidity than that associated with a median sternotomy.

<107>
Accession Number
2024665648
Title
The diagnostic accuracy of procalcitonin in infectious patients after
cardiac surgery: A systematic review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 22(4) (pp 305-312), 2021. Date of
Publication: 01 Apr 2021.
Author
Li Q.; Zheng S.; Zhou P.Y.; Xiao Z.; Wang R.; Li J.
Institution
(Li, Zheng, Zhou, Xiao, Wang) Department of the Cardiovascular Surgery,
China
(Li) School of Nursing, Southern Medical University, Guangzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiac surgery with cardiopulmonary bypass (CPB) induces an acute
inflammatory response that may lead to a systemic inflammatory response
syndrome. The interest in procalcitonin (PCT) in the diagnosis of
bacterial infection in patients after cardiac surgery remains less
defined. The aim of this meta-analysis is to prospectively examine the
discriminatory power of PCT as markers of infection in hospitalized
patients with after cardiac surgery. The bivariate generalized nonlinear
mixed-effect model and the hierarchical summary receiver operating
characteristic model were used to estimate the pooled sensitivity,
specificity and summary receiver operating characteristic curve. The
pooled sensitivity and specificity were 0.81 (95% CI 0.75-0.87) and 0.78
(95% CI 0.73-0.83), respectively. The pooled positive likelihood ratio,
and negative likelihood ratio of PCT were 3.74 (95% CI 2.98-4.69) and 0.24
(95% CI 0.17-0.32), respectively. The pooled area under the summary
receiver operating characteristic curve of PCT using the HSROC method was
0.87 (95% CI 0.84- 0.90). This study indicated that PCT is a promising
marker for the diagnosis of sepsis for those patients who undergo cardiac
surgery. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<108>
Accession Number
2024665646
Title
Comparison of coronary artery bypass graft versus drug-eluting stents in
dialysis patients: An updated systemic review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 22(4) (pp 285-296), 2021. Date of
Publication: 01 Apr 2021.
Author
Prasitlumkum N.; Cheungpasitporn W.; Sato R.; Thangjui S.; Thongprayoon
C.; Kewcharoen J.; Bathini T.; Vallabhajosyula S.; Ratanapo S.;
Chokesuwattanaskul R.
Institution
(Prasitlumkum) Department of Cardiology, University of California
Riverside, Riverside, CA, United States
(Cheungpasitporn) Department of Internal Medicine, University of
Mississippi Medical Center, Jackson, MI, United States
(Sato) Department of Critical Care Medicine, Respiratory Institute,
Cleveland Clinic, OH, United States
(Thangjui) Department of Internal Medicine, Basset Healthcare Network,
Cooperstown, NY, United States
(Thongprayoon) Department of Medicine, Mayo Clinic, Rochester, MN, United
States
(Kewcharoen) Department of Medicine, University of Hawaii, Honolulu, HI,
United States
(Bathini) Department of Internal Medicine, University of Arizona, Tucson,
AZ, United States
(Vallabhajosyula) Section of Interventional Cardiology, Division of
Cardiovascular Medicine, Department of Medicine, Emory University School
of Medicine, Atlanta, GA, United States
(Ratanapo) Department of Cardiovascular Medicine, Phramongkutklao
Hospital, Thailand
(Chokesuwattanaskul) Faculty of Medicine, King Chulalongkorn Memorial
Hospital, Chulalongkorn University, Bangkok, Thailand
Publisher
Lippincott Williams and Wilkins
Abstract
IntroductionAs percutaneous coronary intervention (PCI) technologies have
been far improved, we hence conducted an updated systemic review and
meta-analysis to determine the comparability between coronary artery
bypass graft (CABG) and PCI with drug-eluting stent (DES) in ESRD
patients.MethodsWe comprehensively searched the databases of MEDLINE,
EMBASE, PUBMED and the Cochrane from inception to January 2020. Included
studies were published observational studies that compared the risk of
cardiovascular outcomes among dialysis patients with CABG and DES. Data
from each study were combined using the random-effects, generic inverse
variance method of DerSimonian and Laird to calculate risk ratios and 95%
confidence intervals. Subgroup analyses and meta-regression were performed
to explore heterogeneity.ResultsThirteen studies were included in this
analysis, involving total 56 422 (CABG 21 740 and PCI 34 682). Compared
with DES, our study demonstrated CABG had higher 30-day mortality [odds
ratio (OR) 3.85, P = 0.009] but lower cardiac mortality (OR 0.78, P <
0.001), myocardial infarction (OR 0.5, P < 0.001) and repeat
revascularization (OR 0.35, P < 0.001). No statistical differences were
found between CABG and DES for long-term mortality (OR 0.92, P = 0.055),
composite outcomes (OR 0.88, P = 0.112) and stroke (OR 1.49, P = 0.457).
Meta-regression suggested diabetes and the presence of left main coronary
artery disease as an effect modifier of long-term mortality.ConclusionPCI
with DES shared similar long-term mortality, composite outcomes and stroke
outcomes to CABG among dialysis patients but still was associated with an
improved 30-day survival. However, CABG had better rates of myocardial
infarction, repeat revascularization and cardiac mortality. Copyright
© 2021 Lippincott Williams and Wilkins. All rights reserved.

<109>
Accession Number
2024699923
Title
Association Between Postoperative Delirium and Long-Term Subjective
Cognitive Decline in Older Patients Undergoing Cardiac Surgery: A
Secondary Analysis of the Minimizing Intensive Care Unit Neurological
Dysfunction with Dexmedetomidine-Induced Sleep Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Namirembe G.E.; Baker S.; Albanese M.; Mueller A.; Qu J.Z.; Mekonnen J.;
Wiredu K.; Westover M.B.; Houle T.T.; Akeju O.
Institution
(Namirembe, Baker, Albanese, Mueller, Qu, Mekonnen, Wiredu, Houle, Akeju)
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts
General Hospital, Harvard Medical School, Boston, MA, United States
(Westover) Department of Neurology, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Objectives: This study aimed to evaluate whether a measure of subjective
cognitive decline (SCD), the Patient-Reported Outcomes Measurement
Information System (PROMIS) Applied Cognition-Abilities questionnaire, was
associated with postoperative delirium. It was hypothesized that delirium
during the surgical hospitalization would be associated with a decrease in
subjective cognition up to 6 months after cardiac surgery. Design(s):
This was a secondary analysis of data from the Minimizing Intensive Care
Unit Neurological Dysfunction with Dexmedetomidine-induced Sleep
randomized, placebo-controlled, parallel-arm superiority trial.
 Setting(s): Data from patients recruited between March 2017 and
February 2022 at a tertiary medical center in Boston, Massachusetts were
analyzed in February 2023. Participant(s): Data from 337 patients
aged 60 years or older who underwent cardiac surgery with cardiopulmonary
bypass were included. Intervention(s): Patients were assessed
preoperatively and postoperatively at 30, 90, and 180 days using the
subjective PROMIS Applied Cognition-Abilities and telephonic Montreal
Cognitive Assessment. Measurement and Main Results: Postoperative delirium
occurred within 3 days in 39 participants (11.6%). After adjusting for
baseline function, participants who developed postoperative delirium
self-reported worse cognitive function (mean difference [MD] -2.64 [95% CI
-5.25, -0.04]; p = 0.047) up to 180 days after surgery, as compared with
nondelirious patients. This finding was consistent with those obtained
from objective t-MoCA assessments (MD -0.77 [95% CI -1.49, -0.04]; p =
0.04). Conclusion(s): In this cohort of older patients undergoing
cardiac surgery, in-hospital delirium was associated with SCD up to 180
days after surgery. This finding suggested that measures of SCD may enable
population-level insights into the burden of cognitive decline associated
with postoperative delirium. Copyright © 2023 Elsevier Inc.

<110>
Accession Number
2024695274
Title
Analysis of Repair Type and Hypogastric Artery Antegrade Perfusion and
Erectile Function following Repair of Abdominal Aortic Aneurysms.
Source
Annals of Vascular Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Bennett K.M.; Hurley L.; Kyriakides T.C.; Matsumura J.S.
Institution
(Bennett, Matsumura) Department of Surgery, University of Wisconsin School
of Medicine and Public Health, Madison, WI, United States
(Bennett, Matsumura) Middleton Veterans Affairs Medical Center, Surgery
Service, Madison, WI, United States
(Hurley, Kyriakides) Department of Veterans Affairs, Cooperative Studies
Program Coordinating Center, West Haven, CT, United States
(Hurley) Department of Biostatistics, School of Public Health, Yale
University, New Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Background: Published reports suggest that exclusion of antegrade
hypogastric artery flow may have deleterious effects on erectile function
after abdominal aortic aneurysm (AAA) repair. Off-label and open surgical
hybrid procedures and, more recently, purpose-built branched devices have
been developed to maintain antegrade pelvic perfusion in patients
undergoing endovascular repair. Maintaining antegrade perfusion may reduce
a spectrum of risks, including buttock claudication, colorectal ischemia,
and spinal cord ischemia when patients undergo subsequent thoracic aortic
procedures, as well as erectile dysfunction (ED). This project
specifically focuses on erectile function, and analyzes baseline
associations and relationships of hypogastric artery exclusion on changes
in erectile function following aneurysm repair. Method(s): Male
patients in the Veterans Affairs Open Versus Endovascular Repair (CSP#498;
OVER) Trial had erectile function assessed preoperatively and
postoperatively by administration of the International Index of Erectile
Function-5 questionnaire. Bayesian mixed-effects regression models were
created with the outcome variable (erectile function) treated as a latent
variable. Primary effects of differences in erectile function between
groups with and without preservation of bilateral antegrade hypogastric
flow were compared. Result(s): 876 men (442 randomized to
endovascular repair) were enrolled in the trial and included in the
analysis comparing treatment assignment. There is significant ED in
elderly men with aortic aneurysm at baseline. Over 5 years of follow-up,
there is modest decrease in erectile function and the endovascular group
has improved function compared to open repair (0.082; 95% credible
interval (CI) 0.008 and 0.155). A fifth of patients did not have bilateral
preservation of antegrade hypogastric artery perfusion, with no difference
in erectile function by univariate analysis. A more detailed regression
analysis was applied-and after adjustment for baseline score, age, beta
blocker use, diabetes, activity level, ejection fraction, preoperative
ankle-brachial indices and time-preservation of both antegrade hypogastric
arteries' perfusion showed transient improvement in survey scores compared
to occlusion of at least 1 hypogastric artery at 6 months and 12 months
after treatment, although this was not sustained at 60 months (score
change: 0.046; 95% CI: -0.123, 0.215). Retesting this model in the cohort
with complete data as a sensitivity analysis did not meaningfully change
the conclusions. Conclusion(s): In this large prospective aneurysm
treatment trial with systematic measurement of erectile function with a
validated instrument, endovascular repair is associated with improved
erectile function. Preservation of antegrade hypogastric flow with any
repair is associated with early improved erectile function; however, it is
not a sustained benefit. There is limited benefit of maintaining bilateral
hypogastric artery perfusion for this specific indication in unselected
men undergoing AAA repair. Copyright © 2023 Elsevier Inc.

<111>
Accession Number
2023772167
Title
Effectiveness of a health educational program on quality life and
nutrition of coronary artery bypass graft patients.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 30(8) (pp
e111-e122), 2023. Date of Publication: 2023.
Author
Qadir D.O.; Younis Y.M.
Institution
(Qadir, Younis) Department of Nursing, College of Nursing, Hawler Medical
University, Kurdistan Region, Erbil, Iraq
Publisher
Codon Publications
Abstract
Background and Objective: The healing and quality of life of CABG patients
might be impacted by changes in lifestyle. Therefore, this study aims to
the impact of a health-related education program on the nutritional needs
and quality of life following coronary artery bypass surgery at Surgical
Specialty Hospital-Erbil Cardiac Center. Patients and Methods: This
study is a quesi-experimental conducted between 2021 and 2023. The samples
were divided into two groups by random allocation, each group of 100
people. Data collection was based on a researcher-made questionnaire
including demographic section and SF-36 questionnaire. The intervention
consisted of 6 sessions, which included 2 sessions of general training for
patients, and 4 sessions of training including physiological aspects,
self-concept, Reciprocal relations and the fulfillment of obligations.
 Result(s): When the intervention program was implemented, the
health-related quality of life in the intervention group improved in
comparison to the control group in terms of vitality, pain, overall
health, physical role function, emotional role functioning, and mental
health (P<0.05). The educational program's impact on participants'
nutritional status revealed a shift in the intake of unhealthy meals and
an increase in the consumption of nutritious foods (P<0.05).
 Conclusion(s): This study demonstrated the beneficial effects of the
health education program on patients who had had coronary artery bypass
grafts (CABG) in terms of quality of life and diet quality. Copyright
© 2021 Muslim OT et al.

<112>
Accession Number
2023385507
Title
Visual analysis based on CiteSpace software: a bibliometric study of
atrial myxoma.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1116771. Date of Publication: 2023.
Author
Gao A.; Yang J.; Tian T.; Wu Y.; Sun X.; Qi N.; Tian N.; Wang X.; Wang J.
Institution
(Gao, Yang, Wu, Tian, Wang) Department of Internal
Medicine-Cardiovascular, Dongzhimen Hospital, Beijing University of
Chinese Medicine, Beijing, China
(Tian) Department of Gastroenterology, Dongzhimen Hospital, Beijing
University of Chinese Medicine, Beijing, China
(Sun) Department of Orthopedics, Zhengzhou Orthopedic Hospital, Zhengzhou,
China
(Qi) Department of Encephalology, Dongzhimen Hospital, Beijing University
of Chinese Medicine, Beijing, China
(Wang) Department of Andrology, Dongzhimen Hospital, Beijing University of
Chinese Medicine, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Objective: To use CiteSpace and VOSviewer visual metrology to analyze the
research status, frontier hotspots, and trends in research on atrial
myxoma. Method(s): The Web of Science core collection database was
used to retrieve relevant literature on atrial myxoma from 2001 to 2022.
CiteSpace software was used to analyze keywords with a co-occurrence
network, co-polymerization class, and burst terms, and a corresponding
visual atlas was drawn for analysis. Result(s): A total of 893 valid
articles were included. The country with the highest number of articles
was the United States (n = 186). The organization with the highest number
of articles was the Mayo Clinic (n = 15). The author with the highest
number of articles was Yuan SM (n = 12). The highest cited author was
Reynen K (n = 312). The highest cited journal was Annals of Thoracic
Surgery (n = 1,067). The most frequently cited literature was published in
the New England Journal of Medicine in 1995, which was cited 233 times.
The keywords co-occurrence, copolymerization analysis, and Burst analysis
revealed that the main research focuses were surgical methods, case
reports, and genetic and molecular level studies on the pathogenesis of
myxoma. Conclusion(s): This bibliometric analysis revealed that the
main research topics and hotspots in atrial myxoma included surgical
methods, case reports, genetic and molecular studies. Copyright 2023
Gao, Yang, Tian, Wu, Sun, Qi, Tian, Wang and Wang.

<113>
Accession Number
2024605686
Title
Impact of aortic valve replacement in symptomatic low-risk patients with
less than severe aortic stenosis.
Source
Open Heart. 10(1) (no pagination), 2023. Article Number: e002297. Date of
Publication: 12 May 2023.
Author
Ito S.; Laham R.; Nkomo V.T.; Forrest J.K.; Reardon M.J.; Little S.H.;
Mumtaz M.; Gada H.; Bajwa T.; Langholz D.; Heiser J.; Chawla A.; Jenson
B.; Attizanni G.; Markowitz A.H.; Huang J.; Oh J.K.
Institution
(Ito, Nkomo, Oh) Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, MN, United States
(Laham) Department of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Forrest) Department of Internal Medicine (Cardiology), Yale-New Haven
Hospital, New Haven, CT, United States
(Reardon, Little) Departments of Cardiology and Cardiothoracic Surgery,
Houston Methodist Debakey Heart and Vascular Center, Houston, TX, United
States
(Mumtaz, Gada) Departments of Cardiothoracic Surgery and Interventional
Cardiology, University of Pittsburgh Medical Center Pinnacle Health,
Wormsleyburg, PA, United States
(Bajwa) Aurora Cardiovascular and Thoracic Services, Aurora Saint Luke's
Medical Center, Milwaukee, WI, United States
(Langholz, Heiser) Department of Cardiothoracic Surgery, Spectrum Health,
Grand Rapids, MI, United States
(Chawla, Jenson) Department of Cardiology, Mercy Medical Center, Ia, Mercy
Medical Center, Des Moines, IA, United States
(Attizanni, Markowitz) Harrington Heart & Vascular Institute, University
Hospitals Cleveland Medical Center, Cleveland, OH, United States
(Huang) Structural Heart and Aortic, Medtronic Inc, Mounds View, MN,
United States
Publisher
BMJ Publishing Group
Abstract
Objective To evaluate whether transcatheter or surgical aortic valve
replacement (TAVR or SAVR) affects clinical and haemodynamic outcomes in
symptomatic patients with moderately-severe aortic stenosis (AS). Methods
Echocardiographic evidence of severe AS for enrolment in the Evolut Low
Risk trial was based on site-reported measurements. For this post hoc
analysis, core laboratory measurements identified patients with
symptomatic moderately-severe AS (1.0<aortic valve area (AVA)<1.5 cm 2,
3.0<peak velocity<4.0 m/s and 20<=mean gradient (MG) <40 mm Hg). Clinical
outcomes were reported through 2 years. Results Moderately-severe AS was
identified in 113 out of 1414 patients (8%). Baseline AVA was 1.1+/-0.1 cm
2, peak velocity 3.7+/-0.2 m/s, MG 32.7+/-4.8 mm Hg and aortic valve
calcium volume 588 (364, 815) mm 3. Valve haemodynamics improved following
TAVR (AVA 2.5+/-0.7 cm 2, peak velocity 1.9+/-0.5 m/s and MG 8.4+/-4.8 mm
Hg; p<0.001 for all) and SAVR (AVA 2.0+/-0.6 cm 2, peak velocity 2.1+/-0.4
m/s and MG 10.0+/-3.4 mm Hg; p<0.001 for all). At 24 months, the rates of
death or disabling stroke were similar (TAVR 7.7% vs SAVR 6.5%; p=0.82).
Kansas City Cardiomyopathy Questionnaire overall summary score assessing
quality of life improved from baseline to 30 days after TAVR (67.0+/-20.6
to 89.3+/-13.4; p<0.001) and SAVR (67.5+/-19.6 to 78.3+/-22.3; p=0.001).
Conclusions In symptomatic patients with moderately-severe AS, AVR appears
to be beneficial. Determination of the clinical and haemodynamic profile
of patients who can benefit from earlier isolated AVR needs further
investigation in randomised clinical trials. Copyright © 2023
BMJ Publishing Group. All rights reserved.

<114>
Accession Number
2023353753
Title
Current status of transcatheter mitral valve replacement: systematic
review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1130212. Date of Publication: 2023.
Author
Alperi A.; Avanzas P.; Leon V.; Silva I.; Hernandez-Vaquero D.; Almendarez
M.; Alvarez R.; Fernandez F.; Moris C.; Pascual I.
Institution
(Alperi, Avanzas, Leon, Silva, Hernandez-Vaquero, Almendarez, Alvarez,
Fernandez, Moris, Pascual) Department of Cardiology, Heart Area, Hospital
Universitario Central de Asturias, Oviedo, Spain
(Alperi, Avanzas, Hernandez-Vaquero, Almendarez, Moris, Pascual) Health
Research Institute of Asturias (Instituto de Investigacion Sanitaria del
Principado de Asturias), Oviedo, Spain
(Avanzas, Hernandez-Vaquero, Moris, Pascual) Department of Medicine,
Faculty of Medicine, University of Oviedo, Oviedo, Spain
Publisher
Frontiers Media S.A.
Abstract
Introduction: Mitral Regurgitation (MR) has a strong impact on quality of
life and on mid-term survival. Transcatheter mitral valve replacement
(TMVR) is rapidly expanding and a growing number of studies have been
published recently. Method(s): A systematic review of studies
reporting on clinical data for patients with symptomatic severe MR
undergoing TMVR was performed. Early- and mid-term outcomes (clinical and
echocardiographic) were evaluated. Overall weighted means and rates were
calculated. Risk ratios or mean differences were calculated for pre- and
post-procedural comparisons. Result(s): A total of 12 studies and 347
patients who underwent TMVR with devices clinically available or under
clinical evaluation were included. Thirty-day mortality, stroke and major
bleeding rates were 8.4%, 2.6%, and 15.6%, respectively. Pooled
random-effects demonstrated a significant reduction of >= grade 3+ MR (RR:
0.05; 95% CI: 0.02-0.11; p < 0.001) and in the rates of patients in NYHA
class 3-4 after the intervention (RR: 0.27; 95% CI: 0.22-0.34; p < 0.001).
Additionally, the pooled fixed-effect mean difference for quality of life
based on the KCCQ score yielded an improvement in 12.9 points (95%
CI:7.4-18.4, p < 0.001), and exercise capacity improved by a pooled
fixed-effect mean difference of 56.8 meters in the 6-minute walk test (95%
CI 32.2-81.3, p < 0.001). Conclusion(s): Among 12 studies and 347
patients comprising the updated evidence with current TMVR systems there
was a statistically significant reduction in >= grade 3+ MR and in the
number of patients exhibiting poor functional class (NYHA 3 or 4) after
the intervention. Overall rate of major bleeding was the main shortcoming
of this technique. Copyright 2023 Alperi, Avanzas, Leon, Silva,
Hernandez-Vaquero, Almendarez, Alvarez, Fernandez, Moris and Pascual.

<115>
Accession Number
2023311731
Title
Difficult airway management and low Bispectral Index (BIS) in a patient
with left Bochdalek congenital diaphragmatic hernia (CDH).
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 172. Date
of Publication: December 2023.
Author
Dahaba A.A.
Institution
(Dahaba) Department of Anaesthesiology and Intensive Care Medicine, Suez
Canal University, Ismailia 41522, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Bochdalek congenital diaphragmatic hernia (CDH) is a
developmental defect in the posterolateral diaphragm, allowing herniation
of abdominal contents into the thorax causing mechanical compression of
the developing lung parenchyma and lung hypoplasia. We describe a case of
an adult patient with a Bochdalek hernia who underwent minimally invasive
right thoracotomy Perceval bioprosthetic aortic valve replacement (AVR)
requiring one-lung ventilation (OLV) on the side of the hernia. This is a
complex and challenging case that brings up numerous thought-provoking
anesthetic implications. To the best of our knowledge, a Pubmed search did
not reveal any publication to date of difficult airway management in an
adult patient with CDH. Case presentation: The first major problem
encountered was patient's crus habitus anatomical condition (exceedingly
ventrally displaced trachea) Mallampati Class IV and Cormack-Lehane grade
IV extremely difficult endotracheal intubation. Neither glottis nor
epiglottis was visible on laryngoscopy; resulting in failed placement of
the double-lumen endobronchial tube (DLT) following numerous attempts. The
DLT was eventually placed via GlideScope videolaryngoscopy. Whereas the
endobroncheal right lung block for left OLV was successfully placed using
fiberopticscopy. The crus habitus encroached on OLV tidal volume by the
cranially displaced ascending colon and left kidney. Anesthesia was
maintained with remifentanil /sevoflurane; adjusted to maintain bispectral
index (BIS) at 40-60. Digitally recorded BIS was 38-62 except when BIS
precipitously declined to 14-38 (SR, suppression ratio < 10) for 25 min
after termination of the cardiopulmonary bypass. Conclusion(s): We
report a case essentially dealing with an anatomically distorted difficult
airway in a patient with left Bochdalek CDH undergoing a complex AVR. We
describe anesthetic difficulties and unforeseen issues encountered; such
as an extremely difficult DLT placement. Copyright © 2023, The
Author(s).

<116>
[Use Link to view the full text]
Accession Number
2024594238
Title
Surgical Care of Patients Experiencing Homelessness: A Scoping Review
Using a Phases of Care Conceptual Framework.
Source
Journal of the American College of Surgeons. 235(2) (pp 350-360), 2022.
Date of Publication: 01 Aug 2022.
Author
Abel M.K.; Schwartz H.; Lin J.A.; Decker H.C.; Wu C.L.; Grant M.C.; Kushel
M.; Wick E.C.
Institution
(Abel, Schwartz) The University of California, San Francisco School of
Medicine, San Francisco, CA, United States
(Abel, Schwartz, Lin, Decker, Wick) Department of Surgery, University of
California, San Francisco, San Francisco, CA, United States
(Kushel) Department of Medicine, University of California, San Francisco,
San Francisco, CA, United States
(Wu) Department of Anesthesia, Critical Care, and Pain Management, New
York, NY, United States
(Wu) Hospital for Special Surgery, New York, NY, United States
(Wu) Department of Anesthesiology, Weill Cornell Medicine, New York, NY,
United States
(Grant) Department of Anesthesiology and Critical Care Medicine, The Johns
Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Homelessness is a growing concern across the world, particularly as
individuals experiencing homelessness age and face an increasing burden of
chronic health conditions. Although substantial research has focused on
the medical and psychiatric care of patients experiencing homelessness,
literature about the surgical care of these patients is sparse. Our
objective was to review the literature to identify areas of concern unique
to patients experiencing homelessness with surgical disease. A scoping
review was conducted using a comprehensive database for studies from 1990
to September 1, 2020. Studies that included patients who were unhoused and
discussed surgical care were included. The inclusion criteria were
designed to identify evidence that directly affected surgical care,
systems management, and policy making. Findings were organized within a
Phases of Surgical Care framework: preoperative care, intraoperative care,
postoperative care, and global use. Our search strategy yielded 553 unique
studies, of which 23 met inclusion criteria. Most studies were performed
at public and/or safety-net hospitals or via administrative datasets, and
surgical specialties that were represented included orthopedic, cardiac,
plastic surgery trauma, and vascular surgery. Using the Surgical Phases of
Care framework, we identified studies that described the impact of housing
status in pre- and postoperative phases as well as global use. There was
limited identification of barriers to surgical and anesthetic best
practices in the intraoperative phase. More than half of studies (52.2%)
lacked a clear definition of homelessness. Thus, there is a marked gap in
the surgical literature regarding the impact of housing status on optimal
surgical care, with the largest area for improvement in the intraoperative
phase of surgical and anesthetic decision making. Consistent use of clear
definitions of homelessness is lacking. To promote improved care, a
standardized approach to recording housing status is needed, and studies
must explore vulnerabilities in surgical care unique to this
population. Copyright © 2022 Elsevier Inc.. All rights reserved.

<117>
[Use Link to view the full text]
Accession Number
2024571772
Title
The effect of nebivolol on erectile function in the cases with coronary
artery bypass surgery: A protocol for a systematic review and
meta-analysis of randomized controlled trials.
Source
Medicine (United States). 99(32) (pp E21588), 2020. Date of Publication:
2020.
Author
Yang Y.; Yong S.; Li F.; Dong L.; Chang D.
Institution
(Yang, Yong, Li, Chang) Hospital of Chengdu University of Traditional
Chinese Medicine, Chengdu University of Traditional Chinese Medicine,
Sichuan Province, Chengdu, China
(Dong) Department of Andrology, The Reproductive and Women-Children
Hospital, Chengdu University of Traditional Chinese Medicine, Sichuan
Province, Chengdu, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Erectile dysfunction is a common disease. It affects the
quality of life of both husband and wife and its prevalence is higher in
patients with overt cardiovascular disease or cardiovascular risk factors.
In recent years, multiple studies confirm that nebivolol exerts protective
effects on erectile function against the disruptive effects of
cardiopulmonary bypass in patients undergoing coronary artery bypass
grafting, but its quality and efficacy have not been systematically
evaluated. Therefore, it is necessary to carry out a systematic review and
meta-analysis to fully evaluate the efficacy and safety of nebivolol on
erectile function in the cases with coronary artery bypass
grafting.Methods and analysis:Chinese and English literature of nebivolol
on erectile function in the cases with coronary artery bypass surgery
published before August 31, 2020 will be comprehensive searched in PubMed,
Cochrane Library, EMBASE, WANFANG, China National Knowledge
Infrastructure, VIP Chinese Science and Technology Journal Database,
Chinese biomedical document service system, and Clinicaltrials.gov. Only
randomized controlled trials that meet the eligibility criteria will be
included. Two researchers will independently complete literature
screening, data extraction and assess the risk of bias, and the third
investigator will handle disagreements. Our main evaluation includes 2
outcome indicators including the international index of erectile function
5 score and adverse events. RevMan 5.3 and Stata 14.0 will be used to
conduct this systematic review. The preferred reporting items for
systematic reviews and meta-analysis protocols (PRISMA-P) statement is
followed in this protocol and the PRISMA statement will be followed in the
completed systematic review.Conclusion and dissemination:The efficacy and
safety of nebivolol on erectile function in the cases with coronary artery
bypass grafting will be evaluated. We will publish the results of this
systematic review in peer-reviewed journals to provide new evidence to
clinicians.Ethics and dissemination:Ethical approval is not required as
the review is a secondary study based on published literature. The results
will be published in a public issue journal to provide evidence-based
medical evidence for urologists and andrologists to make better clinical
decisions.Registration information:INPLASY202060110. Copyright ©
2020 Lippincott Williams and Wilkins. All rights reserved.

<118>
[Use Link to view the full text]
Accession Number
2024588543
Title
Prosthetic valve endocarditis by Trichosporon mucoides: A case report and
review of literature.
Source
Medicine (United States). 99(41) (pp E22584), 2020. Date of Publication:
09 Oct 2020.
Author
Oh T.H.; Shin S.U.; Kim S.S.; Kim S.E.; Kim U.J.; Kang S.-J.; Jang H.-C.;
Jung S.I.; Shin J.-H.; Park K.-H.
Institution
(Oh, Shin, Kim, Kim, Kim, Kang, Jang, Jung, Park) Department of Infectious
Diseases, Chonnam National University Hospital, South Korea
(Kim, Kang, Jang, Jung, Park) Department of Infectious Diseases, South
Korea
(Shin) Department of Laboratory Medicine, Chonnam National University,
Medical School, Gwangju, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Nationale:Trichosporon species are widely distributed in nature and are
emerging opportunistic human pathogens. Trichosporon infections are
associated with superficial cutaneous involvement in immunocompetent
individuals to severe systemic disease in immunocompromised patients.
Until now, there is no report in infective endocarditis by Trichosporon
mucoides confirmed by molecular diagnosticsPatient concerns:A 66-year-old
man presented with a fever that had occurred for a period of 6 months. He
had undergone aortic valve replacement 10 years prior. Transthoracic
echocardiography showed vegetations on the prosthetic aortic valve and
native mitral valve. T mucoides was detected in the cultures of blood and
vegetations.Diagnosis:DNA sequencing using D/D2 region of rRNA and
internal transcribed spacer were performed.
 Intervention(s):Infections were successfully controlled with valve
replacement and voriconazole plus liposomal amphotericin B therapy.
 Outcome(s):There has been no sign of recurrence for 18-months after
treatment completion.Lessons:This is the first reported case of infective
endocarditis due to T mucoides. Clinicians should consider Trichosporon
species as causative agents of endocarditis in patients who have undergone
cardiac surgery. Copyright © 2020 Lippincott Williams and
Wilkins. All rights reserved.

<119>
Accession Number
2023337193
Title
Brain injury and long-term outcome after neonatal surgery for non-cardiac
congenital anomalies.
Source
Pediatric Research. (no pagination), 2023. Date of Publication: 2023.
Author
Aalten M.; Tataranno M.L.; Dudink J.; Lemmers P.M.A.; Lindeboom M.Y.A.;
Benders M.J.N.L.
Institution
(Aalten, Tataranno, Dudink, Lemmers, Benders) Department of Neonatology,
University Medical Center, Utrecht Brain Center and Wilhelmina Children's
Hospital, University Utrecht, Utrecht, Netherlands
(Lindeboom) Department of Pediatric Surgery, Wilhelmina Children's
Hospital, University Medical Center Utrecht, Utrecht, Netherlands
Publisher
Springer Nature
Abstract
Background: There is growing evidence that neonatal surgery for
non-cardiac congenital anomalies (NCCAs) in the neonatal period adversely
affects long-term neurodevelopmental outcome. However, less is known about
acquired brain injury after surgery for NCCA and abnormal brain maturation
leading to these impairments. Method(s): A systematic search was
performed in PubMed, Embase, and The Cochrane Library on May 6, 2022 on
brain injury and maturation abnormalities seen on magnetic resonance
imaging (MRI) and its associations with neurodevelopment in neonates
undergoing NCCA surgery the first month postpartum. Rayyan was used for
article screening and ROBINS-I for risk of bias assessment. Data on the
studies, infants, surgery, MRI, and outcome were extracted.
 Result(s): Three eligible studies were included, reporting 197
infants. Brain injury was found in n = 120 (50%) patients after NCCA
surgery. Sixty (30%) were diagnosed with white matter injury. Cortical
folding was delayed in the majority of cases. Brain injury and delayed
brain maturation was associated with a decrease in neurodevelopmental
outcome at 2 years of age. Conclusion(s): Surgery for NCCA was
associated with high risk of brain injury and delay in maturation leading
to delay in neurocognitive and motor development. However, more research
is recommended for strong conclusions in this group of patients. Impact:
Brain injury was found in 50% of neonates who underwent NCCA surgery.NCCA
surgery is associated with a delay in cortical folding.There is an
important research gap regarding perioperative brain injury and NCCA
surgery. Copyright © 2023, The Author(s), under exclusive licence
to the International Pediatric Research Foundation, Inc.

<120>
Accession Number
2023336557
Title
Effects of levosimendan on the outcome of veno-arterial extracorporeal
membrane oxygenation: a systematic review and meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Liu Y.; Zhang L.; Yao Y.; Qin W.; Li Y.; Xue W.; Li P.; Chen Y.; Chen X.;
Guo H.
Institution
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Guo) Department of Critical
Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong
University, 107 Wenhua Xi Road, Shandong, Jinan 250012, China
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Chen, Guo) The Key
Laboratory of Emergency and Critical Care Medicine of Shandong Province,
Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong,
Jinan, China
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Chen, Guo) The Key
Laboratory of Cardiovascular Remodeling and Function Research, Chinese
Ministry of Education and Chinese Ministry of Health, Qilu Hospital,
Cheeloo College of Medicine, Shandong University, Shandong, Jinan, China
(Chen) Department of Emergency Medicine and Chest Pain Center, Qilu
Hospital, Cheeloo College of Medicine, Shandong University, Shandong,
Jinan, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: For patients with severe cardiopulmonary failure, such as
cardiogenic shock, veno-arterial extracorporeal membrane oxygenation
(VA-ECMO) is primarily utilized to preserve their life by providing
continuous extracorporeal respiration and circulation. However, because of
the complexity of patients' underlying diseases and serious complications,
successful weaning from ECMO is often difficult. At present, there have
been limited studies on ECMO weaning strategies, so the principal purpose
of this meta-analysis is to examine how levosimendan contributes to the
weaning of extracorporeal membrane oxygenation. Method(s): The
Cochrane Library, Embase, Web of Science, and PubMed were browsed for all
potentially related research about clinical benefits of levosimendan in
weaning patients receiving VA-ECMO and included 15 of them. The main
outcome is success of weaning from extracorporeal membrane oxygenation,
with the secondary outcomes of 1-month mortality (28 or 30 days), ECMO
duration, hospital or intensive care unit (ICU) length of stay, and use of
vasoactive drugs. Result(s): 1772 patients altogether from 15
publications were incorporated in our meta-analysis. We used fixed and
random-effect models to combine odds ratio (OR) and 95% confidence
interval (CI) for dichotomous outcomes and standardized mean difference
(SMD) for continuous outcomes. The weaning success rate in the
levosimendan group was considerably higher in contrast to the comparison
(OR = 2.78, 95% CI 1.80-4.30; P < 0.00001; I 2 = 65%), and
subgroup analysis showed that there was less heterogeneity in patients
after cardiac surgery (OR = 2.06, 95% CI, 1.35-3.12; P = 0.0007; I
2 = 17%). In addition, the effect of levosimendan on improving
weaning success rate was statistically significant only at 0.2 mcg/kg/min
(OR = 2.45, 95% CI, 1.11-5.40; P = 0.03; I 2 = 38%). At the
same time, the 28-day or 30-day proportion of deaths in the sample
receiving levosimendan also decreased (OR = 0.47, 95% CI, 0.28-0.79; P =
0.004; I 2 = 73%), and the difference was statistically
significant. In terms of secondary outcomes, we found that individuals
undergoing levosimendan treatment had a longer duration of VA-ECMO
support. Conclusion(s): In patients receiving VA-ECMO, levosimendan
treatment considerably raised the weaning success rate and helped lower
mortality. Since most of the evidence comes from retrospective studies,
more randomized multicenter trials are required to verify the conclusion.
Graphical abstract: [Figure not available: see fulltext.]. Copyright
© 2023, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany.

<121>
Accession Number
641397159
Title
Thoracic Epidural Anesthesia in Cardiac Surgery: A Systematic Review,
Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled
Trials.
Source
Anesthesia and analgesia. (no pagination), 2023. Date of Publication: 23
May 2023.
Author
Chiew J.K.; Low C.J.W.; Zeng K.; Goh Z.J.; Ling R.R.; Chen Y.; Ti L.K.;
Ramanathan K.
Institution
(Chiew, Low, Ling, Chen, Ti, Ramanathan) From the Yong Loo Lin School of
Medicine, National University of Singapore, National University Health
System, Singapore
(Zeng) Faculty of Medicine, University of New South Wales, Sydney, NSW,
Australia
(Goh) Lee Kong Chian School of Medicine, Nanyang Technological University,
Singapore
(Chen) Agency of Science, Technology and Research, Singapore
(Ti) Department of Anaesthesia, National University Hospital, National
University Health System, Singaporeand
(Ramanathan) Department of Cardiac, Thoracic and Vascular Surgery,
Cardiothoracic Intensive Care Unit, National University Heart Centre,
National University Hospital, National University Health System, Singapore
Publisher
NLM (Medline)
Abstract
BACKGROUND: Research on fast-track recovery protocols postulates that
thoracic epidural anesthesia (TEA) in cardiac surgery contributes to
improved postoperative outcomes. However, concerns about TEA's safety
hinder its widespread usage. We conducted a systematic review and
meta-analysis to assess the benefits and risks of TEA in cardiac surgery.
 METHOD(S): We searched 4 databases for randomized controlled trials
(RCTs) assessing the use of TEA against only general anesthesia (GA) in
adults undergoing cardiac surgery, up till June 4, 2022. We conducted
random-effects meta-analyses, evaluated risk of bias using the Cochrane
Risk-of-Bias 2 tool, and rated certainty of evidence via the Grading of
Recommendations, Assessment, Development, and Evaluations (GRADE)
approach. Primary outcomes were intensive care unit (ICU), hospital length
of stay, extubation time (ET), and mortality. Other outcomes included
postoperative complications. Trial sequential analysis (TSA) was conducted
on all outcomes to elicit statistical and clinical benefit.
 RESULT(S): Our meta-analysis included 51 RCTs (2112 TEA patients and
2220 GA patients). TEA significantly reduced ICU length of stay (-6.9
hours; 95% confidence interval [CI], -12.5 to -1.2; P = .018), hospital
length of stay (-0.8 days; 95% CI, -1.1 to -0.4; P < .0001), and ET (-2.9
hours; 95% CI, -3.7 to -2.0; P < .0001). However, we found no significant
change in mortality. TSA found that the cumulative Z-curve passed the
TSA-adjusted boundary for ICU length of stay, hospital length of stay, and
ET, suggesting a clinical benefit. TEA also significantly reduced pain
scores, pooled pulmonary complications, transfusion requirements,
delirium, and arrhythmia, without additional complications such as
epidural hematomas, of which the risk was estimated to be <0.14%.
 CONCLUSION(S): TEA reduces ICU and hospital length of stay, and
postoperative complications in patients undergoing cardiac surgery with
minimal reported complications such as epidural hematomas. These findings
favor the use of TEA in cardiac surgery and warrant consideration for use
in cardiac surgeries worldwide. Copyright © 2023 International
Anesthesia Research Society.

<122>
Accession Number
2024544063
Title
Prognostic Importance of NT-proBNP (N-Terminal Pro-B-Type Natriuretic
Peptide) Following High-Risk Myocardial Infarction in the PARADISE-MI
Trial.
Source
Circulation: Heart Failure. 16(5) (pp E010259), 2023. Date of Publication:
01 May 2023.
Author
Jering K.S.; Claggett B.L.; Pfeffer M.A.; Granger C.B.; Kober L.; Lewis
E.F.; Maggioni A.P.; Mann D.L.; McMurray J.J.V.; Prescott M.F.; Rouleau
J.L.; Solomon S.D.; Steg P.G.; Von Lewinski D.; Braunwald E.
Institution
(Jering, Claggett, Pfeffer, Solomon, Braunwald) Cardiovascular Division,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Granger) Division of Cardiology, Duke University School of Medicine,
Durham, NC, United States
(Kober) Heart Centre, Ringshospitalet, Copenhagen University Hospital,
Denmark
(Lewis) Division of Cardiovascular Medicine, Stanford University School of
Medicine, Palo Alto, CA, United States
(Maggioni) ANMCO Research Center, Heart Care Foundation, Florence, Italy
(Mann) Department of Medicine, Washington University, St Louis, MO, United
States
(McMurray) British Heart Foundation, Cardiovascular Research Centre,
University of Glasgow, United Kingdom
(Prescott) Novartis Pharmaceutical Corporation, East Hanover, NJ, United
States
(Rouleau) Institut de Cardiologie de Montreal, Universite de Montreal QB,
Canada
(Steg) Universite Paris-Cite, Institut Universitaire de France, AP-HP
(Assistance Publique-Hopitaux de Paris), FACT (French Alliance for
Cardiovascular Trials), INSERM U-1148, Paris, France
(Von Lewinski) Department of Cardiology, Medical University of Graz,
Austria
Publisher
Lippincott Williams and Wilkins
Abstract
Background: NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a
potent predictor of death and heart failure (HF) across multiple
populations. We evaluated the prognostic importance of NT-proBNP in
patients with acute myocardial infarction (MI) complicated by left
ventricular systolic dysfunction, pulmonary congestion, or both and >=1 of
8 risk-augmenting factors enrolled in the PARADISE-MI trial (Prospective
ARNI vs ACE Inhibitor Trial to Determine Superiority in Reducing Heart
Failure Events After Myocardial Infarction). Method(s): Patients were
randomized to sacubitril/valsartan 200 mg or ramipril 5 mg twice daily
within 0.5 to 7 days of a MI. Patients with prior HF were excluded.
NT-proBNP and hs-cTnT (high-sensitivity troponin T) were collected at
randomization in a prespecified substudy of 1129 patients. The primary end
point of PARADISE-MI was a composite of cardiovascular death or incident
HF (hospitalization or outpatient symptomatic HF), analyzed as
time-to-first event; additional end points included all-cause death and
the composite of fatal or nonfatal MI or stroke. Result(s): Median
NT-proBNP was 1757 ng/L (25th-75th percentiles, 896-3462 ng/L) at
randomization (4.0+/-1.8 days after the index MI). Patients in the highest
quartile of NT-proBNP were older, more commonly women and had more
hypertension, atrial fibrillation, renal dysfunction, and pulmonary
congestion on presentation (all P<0.001). NT-proBNP was strongly
associated with the primary end point (adjusted hazard ratio, 1.45 per
doubling of NT-proBNP; [95% CI, 1.23-1.70]), adjusted for clinical
variables and baseline hs-cTnT. NT-proBNP was also independently
associated with all-cause death (adjusted hazard ratio, 1.74 [95% CI,
1.38-2.21]) and fatal or nonfatal MI or stroke (adjusted hazard ratio,
1.24 [95% CI, 1.05-1.45]). NT-proBNP did not significantly modify the
neutral treatment effect of sacubitril/valsartan relative to ramipril (P
interaction=0.46). Conclusion(s): Within the first week of a
high-risk MI NT-proBNP is associated with incident HF, death and
atherosclerotic events. This prognostic information is independent of
hs-cTnT. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT02924727. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<123>
Accession Number
2024473149
Title
Influence of recombinant human B-type natriuretic peptide on improving
ventricular function in patients with ST elevation myocardial infarction.
Source
European Review for Medical and Pharmacological Sciences. 27(8) (pp
3420-3429), 2023. Date of Publication: 2023.
Author
Yao L.; Liu C.-J.; Zhang L.; Lin Y.; Hu Y.-M.
Institution
(Yao, Hu) Department of Cardiology, Cangzhou Central Hospital, Cangzhou,
China
(Liu) Medical Examination Center, Cangzhou Central Hospital, Cangzhou,
China
(Zhang) Department of Image Center, Cangzhou Central Hospital, Cangzhou,
China
(Lin) Department of Catheter Room, Cangzhou Central Hospital, Cangzhou,
China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: The aim of this study was to investigate the effect of
recombinant human B-type natriuretic peptide (rhBNP) on improving
ventricular function in patients with ST-elevation myocardial infarction
(STEMI). PATIENTS AND METHODS: In this retrospective study, 96
patients with STEMI admitted to Cangzhou Central Hospital from June 2017
to June 2019 were recruited and randomized to either a control group or an
experimental group, with 48 patients in each group. Patients in both
groups were given conventional pharmacological therapy, and an emergency
coronary intervention was performed within 12 hours. Patients in the
experimental group received rhBNP intravenously postoperatively, whereas
patients in the control group received an equal amount of 0.9% NaCl
solution through an intravenous drip. Postoperative recovery indicators
were compared between the two groups. RESULT(S): Patients treated
with rhBNP showed better postoperative respiratory frequency, heart rate,
blood oxygen saturation, pleural effusion, acute left heart remodeling
after surgery and central venous pressure at 1-3 days after surgery than
those without (p<0.05). Early diastolic blood flow velocity/early
diastolic motion velocity (E/Em) and wall-motion score indices (WMSI) of
patients in the experimental group were markedly lower compared to the
control group one week after surgery (p<0.05). Patients receiving rhBNP
had better left ventricular ejection fraction (LVEF) and WMSI six months
after surgery and higher left ventricular end diastolic volume (LVEDV) and
LVEF one week after surgery than the controls (p<0.05). Administration of
rhBNP for patients with ST-MI provided a higher treatment safety by
significantly reducing the incidence of left ventricular remodeling and
complication than conventional medication (p<0.05). CONCLUSION(S):
Intervention with rhBNP in STEMI patients could effectively inhibit
ventricular remodeling, alleviate symptoms, reduce adverse complications
and improve ventricular function. Copyright © 2023 Verduci
Editore s.r.l. All rights reserved.

<124>
Accession Number
2024471189
Title
The remote exercise SWEDEHEART study-Rationale and design of a multicenter
registry-based cluster randomized crossover clinical trial (RRCT).
Source
American Heart Journal. 262 (pp 110-118), 2023. Date of Publication:
August 2023.
Author
Back M.; Leosdottir M.; Ekstrom M.; Hambraeus K.; Ravn-Fischer A.; Oberg
B.; Ostlund O.; James S.
Institution
(Back) Department of Occupational Therapy and Physiotherapy, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Back, Ravn-Fischer) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Back, Oberg) Department of Medical and Health Sciences, Division of
Physiotherapy, Linkoping University, Linkoping, Sweden
(Leosdottir) Department of Cardiology, Skane University Hospital, Malmo,
Sweden
(Leosdottir) Department of Clinical Sciences Malmo, Lund University,
Malmo, Sweden
(Ekstrom) Division of Cardiovascular Medicine, Department of Clinical
Sciences, Danderyd Hospital, Stockholm, Sweden
(Hambraeus) Department of Cardiology, Falu Hospital, Falun, Sweden
(Ostlund, James) Uppsala Clinical Research Center, Uppsala University,
Uppsala, Sweden
(James) Department of Medical Sciences, Uppsala University, Uppsala,
Sweden
Publisher
Elsevier Inc.
Abstract
Background: Despite proven benefits of exercise-based cardiac
rehabilitation (EBCR), few patients with myocardial infarction (MI)
participate in and complete these programs. Study design and objectives:
The Remote Exercise SWEDEHEART study is a large multicenter registry-based
cluster randomized crossover clinical trial with a planned enrollment of
1500 patients with a recent MI. Patients at intervention centers will be
offered supervised EBCR, either delivered remotely, center-based or as a
combination of both modes, as self-preferred choice. At control centers,
patients will be offered supervised center-based EBCR, only. The duration
of each time period (intervention/control) for each center will be 15
months and then cross-over occurs. The primary aim is to evaluate if
remotely delivered EBCR, offered as an alternative to center-based EBCR,
can increase participation in EBCR sessions. The proportion completers in
each group will be presented in a supportive responder analysis. The key
secondary aim is to investigate if remote EBCR is as least as effective as
center-based EBCR, in terms of physical fitness and patient-reported
outcome measures. Follow-up of major adverse cardiovascular events
(cardiovascular- and all-cause mortality, recurrent hospitalization for
acute coronary syndrome, heart failure hospitalization, stroke, and
coronary revascularization) will be performed at 1 and 3 years. Safety
monitoring of serious adverse events will be registered, and a
cost-effectiveness analysis will be conducted to estimate the cost per
quality-adjusted life-year (QALY) associated with the intervention
compared with control. Conclusion(s): The cluster randomized
crossover clinical trial Remote Exercise SWEDEHEART study is evaluating if
participation in EBCR sessions can be increased, which may contribute to
health benefits both on a group level and for individual patients
including a more equal access to health care. Trial registration: The
study is registered at ClinicalTrials.gov (Identifier:
NCT04260958) Copyright © 2023 Elsevier Inc.

<125>
Accession Number
2024466876
Title
A practical approach to pseudoexudative pleural effusions.
Source
Respiratory Medicine. 214 (no pagination), 2023. Article Number: 107279.
Date of Publication: August 2023.
Author
Mohan G.; Bhide P.; Agrawal A.; Kaul V.; Chaddha U.
Institution
(Mohan, Bhide) Department of Internal Medicine, Rutgers-Monmouth Medical
Center, Long Branch, NJ, United States
(Agrawal) Division of Pulmonary, Critical Care & Sleep Medicine, Zucker
School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States
(Kaul) Crouse Health/SUNY Upstate Medical University, Syracuse, NY, United
States
(Chaddha) Division of Pulmonary, Critical Care & Sleep Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
W.B. Saunders Ltd
Abstract
Light's criteria falsely label a significant number of effusions as
exudates. Such exudative effusions with transudative etiologies are
referred to as "pseduoexudates". In this review, we discuss a practical
approach to correctly classify an effusion that may be a pseudoexudate. A
PubMed search yielded 1996 manuscripts between 1990 and 2022. Abstracts
were screened and 29 relevant studies were included in this review
article. Common etiologies for pseudoexudates include diuretic therapy,
traumatic pleural taps, and coronary artery bypass grafting. Here, we
explore alternative diagnostic criteria. Concordant exudates (CE), defined
as effusions where proteins in pleural fluid/serum (PF/SPr) > 0.5 and
pleural fluid LDH level of >160 IU/L (>2/3 upper limit of normal) confer
higher predictive value to the Light's criteria. Serum-pleural effusion
albumin gradient (SPAG) > 1.2 g/dL and serum-pleural effusion protein
gradient (SPPG) > 3.1 g/dL together yielded a sensitivity of 100% in heart
failure and a sensitivity of 99% in hepatic hydrothorax whe n identifying
pseudoexudates (Bielsa et al., 2012) [5]. Pleural fluid N-Terminal Pro
Brain Natriuretic Peptide (NTPBNP) offered a specificity and sensitivity
of 99% in identifying pseudoexudates when using a cut-off of >1714 pg/mL
(Han et al., 2008) [24]. However, its utility remains questionable.
Additionally, we also looked at pleural fluid cholesterol and imaging
modalities such as ultrasound and CT scan to measure pleural thickness and
nodularity. Finally, the diagnostic algorithm we suggest involves using
SPAG >1.2 g/dL and SPPG >3.1 g/dL in effusions classified as exudates when
there is a strong clinical suspicion for pseudoexudates. Copyright
© 2023 Elsevier Ltd

<126>
Accession Number
2022990376
Title
Ventilatory Muscle Strength Six Months After Coronary Artery Bypass
Grafting in Patients Submitted to Inspiratory Muscular Training Based on
Anaerobioc Threshold: A Clinical Trial.
Source
International Journal of Cardiovascular Sciences. 36 (no pagination),
2023. Article Number: e20210238. Date of Publication: 2023.
Author
Cordeiro A.L.L.; Almeida L.C.; Leite J.F.S.; Barbosa H.C.M.; Guimaraes
A.R.F.; Junior L.A.F.; Cena J.; Petto J.
Institution
(Cordeiro, Almeida, Leite, Barbosa, Cena) Centro Universitario Nobre, BA,
Feira de Santana, Brazil
(Cordeiro, Barbosa, Petto) Bahian School of Medicine and Public Health,
BA, Salvador, Brazil
(Guimaraes) Instituto Nobre de Cardiologia, BA, Feira de Santana, Brazil
(Junior) La Salle University, RS, Canoas, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Introduction: Coronary artery bypass grafting (CABG) surgery is associated
with a decline in ventilatory muscle strength and lung function.
Inspiratory muscle training (IMT) based on anaerobic threshold (AT) has
been used to minimize the impact of CABG on these parameters, but the
long-term impact is unknown. Objective(s): To test the hypothesis
that AT-based IMT improves inspiratory muscle strength and lung function
even six months after CABG. Method(s): This is a randomized
controlled clinical trial. In the preoperative period, maximum inspiratory
pressure (MIP), maximum expiratory pressure (MEP), vital capacity (VC) and
peak expiratory flow (PEF) rate were assessed. On the first postoperative
day, patients were randomized into two groups: AT-based IMT (IMT-AT)
(n=21) where the load was prescribed based on glycemic threshold and
conventional IMT (IMT-C) (n=21), with load of 40% of MIP. Patients were
trained during hospitalization until the day of discharge and were
assessed at discharge and six months later. For within-group comparison,
paired Student's t-test or Wilcoxon test was used, and independent
Student's t-test or the Mann-Whitney test was used to analyze the
different time points. A p<0.05 was considered significant.
 Result(s): At six months after CABG surgery, statistical difference
was found between the IMT-AT and the IMT-C groups in MIP (difference
between the means of-5cmH2; 95% CI=-8.21to-1.79) and VC (difference
between the means of-2ml/kg;95%CI=-3.87to-0.13). No difference was found
between groups in the other variables analyzed. Conclusion(s): IMT-AT
promoted greater recovery of inspiratory muscle strength and VC after six
months of CABG when compared to conventional training. Copyright
© 2023, Sociedade Brasileira de Cardiologia. All rights reserved.

<127>
Accession Number
2021216811
Title
Secondary prevention of antithrombotic therapy in patients with stable
cardiovascular disease at high ischemic risk: A network meta-analysis of
randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1040473. Date of Publication: 09 Jan 2023.
Author
Zhu H.; Xu X.; Wang H.; Chen Q.; Fang X.; Zheng J.; Gao B.; Tong G.; Zhou
L.; Chen T.; Huang J.
Institution
(Zhu, Chen, Fang, Zheng, Chen) Department of Cardiology, Hangzhou TCM
Hospital Affiliated to Zhejiang Chinese Medical University, Zhejiang,
Hangzhou, China
(Xu) Affiliated Hangzhou Chest Hospital, Zhejiang University School of
Medicine, Zhejiang, Hangzhou, China
(Wang) The Fourth School of Clinical Medicine, Zhejiang Chinese Medical
University, Zhejiang, Hangzhou, China
(Gao, Tong, Zhou, Huang) Department of Cardiology, The Affiliated Hangzhou
First People's Hospital, Zhejiang University School of Medicine, Zhejiang,
Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Aims: Antithrombotic secondary prevention in stable cardiovascular disease
(SCVD) patients at high ischemic risk remains unclear. We compared the
efficacy and safety of aspirin monotherapy, clopidogrel monotherapy,
ticagrelor monotherapy, rivaroxaban monotherapy, clopidogrel plus aspirin,
ticagrelor plus aspirin, and rivaroxaban plus aspirin in the high-risk
ischemic cohorts. Methods and Results: Eleven randomized controlled
trials were included (n = 111737). The primary outcomes were major
cardiovascular and cerebrovascular events (MACEs) and major bleeding. A
random effects model was used for frequentist network meta-analysis. Odds
ratio (OR) and 95% credible intervals (CI) were reported as a summary
statistic. Compared with aspirin monotherapy, rivaroxaban plus aspirin [OR
0.79 (95% CI, 0.69, 0.89)], ticagrelor plus aspirin [0.88 (0.80, 0.98)],
clopidogrel plus aspirin [0.56 (0.41, 0.77)] were associated with a
reduced risk of MACEs, but rivaroxaban monotherapy [0.92 (0.79, 1.07)],
ticagrelor monotherapy [0.68 (0.45, 1.05)], and clopidogrel monotherapy
[0.67 (0.43, 1.05)] showed no statistically significant difference.
However, rivaroxaban monotherapy and all dual antithrombotic strategies
increased the risk of major bleeding to varying degrees, with ticagrelor
plus aspirin associated with the highest risk of major bleeding. The net
clinical benefit favored clopidogrel or ticagrelor monotherapy, which have
a mild anti-ischemic effect without an increase in bleeding risk.
 Conclusion(s): The present network meta-analysis suggests that
clopidogrel or ticagrelor monotherapy may be recommended first in this
cohort of SCVD at high ischemic risk. But clopidogrel plus aspirin or
rivaroxaban plus aspirin can still be considered for use in patients with
recurrent MACEs. Copyright © 2023 Zhu, Xu, Wang, Chen, Fang,
Zheng, Gao, Tong, Zhou, Chen and Huang.

<128>
Accession Number
2014611560
Title
Impact of Pharmacist-Driven Transitions of Care Interventions on
Post-hospital Outcomes Among Patients With Coronary Artery Disease: A
Systematic Review.
Source
Journal of Pharmacy Practice. 36(3) (pp 668-678), 2023. Date of
Publication: June 2023.
Author
Weeda E.; Gilbert R.E.; Kolo S.J.; Haney J.S.; Hazard L.T.; Taber D.J.;
Axon R.N.
Institution
(Weeda, Gilbert, Kolo, Haney, Taber, Axon) Charleston Patient Safety
Center of Inquiry, Ralph H Johnson VAMC, Charleston, SC, United States
(Weeda, Gilbert, Kolo, Haney, Taber, Axon) Charleston Health Equity and
Rural Outreach Innovation Center, Ralph H Johnson VAMC, Charleston, SC,
United States
(Weeda, Haney, Hazard) College of Pharmacy, Medical University of South
Carolina, Charleston, SC, United States
(Taber) Department of Surgery, Medical University of South Carolina,
Charleston, SC, United States
(Axon) Department of Medicine, Medical University of South Carolina,
Charleston, SC, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Transitions of care (ToC) aim to provide continuity while
preventing loss of information that may result in poor outcomes such as
hospital readmission. Readmissions not only burden patients, they also
increase costs. Given the high prevalence of coronary artery diseases
(CAD) in the United States (US), patients with CAD often make up a
significant portion of hospital readmissions. Objective(s): To
conduct a systematic review evaluating the impact of pharmacist-driven ToC
interventions on post-hospital outcomes for patients with CAD.
 Method(s): MEDLINE, Scopus, and CINAHL were searched from database
inception through 03/2020 using key words for CAD and pharmacists. Studies
were included if they: (1) identified adults with CAD at US hospitals, (2)
evaluated pharmacist-driven ToC interventions, and (3) assessed
post-discharge outcomes. Outcomes were summarized qualitatively.
 Result(s): Of the 1612 citations identified, 11 met criteria for
inclusion. Pharmacist-driven ToC interventions were multifaceted and
frequently included medication reconciliation, medication counseling,
post-discharge follow-up and initiatives to improve medication adherence.
Hospital readmission and emergency room visits were numerically lower
among patients receiving vs not receiving pharmacist-driven interventions,
with statistically significant differences observed in 1 study. Secondary
prevention measures and adherence tended to be more favorable in the
pharmacist-driven intervention groups. Conclusion(s): Eleven studies
of multifaceted, ToC interventions led by pharmacists were identified.
Readmissions were numerically lower and secondary prevention measures and
adherence were more favorable among patients receiving pharmacist-driven
interventions. However, sufficiently powered studies are still required to
confirm these benefits. Copyright © The Author(s) 2021.

<129>
Accession Number
2024699862
Title
Dual elevated remnant cholesterol and C-reactive protein in myocardial
infarction, atherosclerotic cardiovascular disease, and mortality.
Source
Atherosclerosis. (no pagination), 2023. Date of Publication: 2023.
Author
Doi T.; Langsted A.; Nordestgaard B.G.
Institution
(Doi, Langsted, Nordestgaard) Department of Clinical Biochemistry,
Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls
Vej 73, Herlev 2730, Denmark
(Doi, Langsted, Nordestgaard) The Copenhagen General Population Study,
Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester
Ib Juuls Vej 73, Herlev 2730, Denmark
(Doi, Langsted, Nordestgaard) Institute of Clinical Medicine, Faculty of
Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B,
Copenhagen 2200, Denmark
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: Elevated remnant cholesterol and low-grade
inflammation each cause atherosclerotic cardiovascular disease (ASCVD);
however, it is unknown whether joint elevation of both factors confers the
highest risk. We tested the hypothesis that dual elevated remnant
cholesterol and low-grade inflammation marked by elevated C-reactive
protein is associated with the highest risk of myocardial infarction,
ASCVD, and all-cause mortality. Method(s): The Copenhagen General
Population Study randomly recruited white Danish individuals aged 20-100
years in 2003-2015 and followed them for a median 9.5 years. ASCVD was
cardiovascular mortality, myocardial infarction, stroke, and coronary
revascularization. Result(s): In 103,221 individuals, we observed
2,454 (2.4%) myocardial infarctions, 5,437 (5.3%) ASCVD events, and 10,521
(10.2%) deaths. The hazard ratios increased with each of stepwise higher
remnant cholesterol and stepwise higher C-reactive protein. In individuals
with the highest tertile of both remnant cholesterol and C-reactive
protein compared to individuals with the lowest tertile of both, the
multivariable adjusted hazard ratios were 2.2 (95%CI:1.9-2.7) for
myocardial infarction, 1.9 (1.7-2.2) for ASCVD, and 1.4 (1.3-1.5) for
all-cause mortality. Corresponding values for only the highest tertile of
remnant cholesterol were 1.6 (1.5-1.8), 1.4 (1.3-1.5), and 1.1 (1.0-1.1),
and those for only the highest tertile of C-reactive protein were 1.7
(1.5-1.8), 1.6 (1.5-1.7), and 1.3 (1.3-1.4), respectively. There was no
statistical evidence for interaction between elevated remnant cholesterol
and elevated C-reactive protein on risk of myocardial infarction (p =
0.10), ASCVD (p = 0.40), or all-cause mortality (p = 0.74).
 Conclusion(s): Dual elevated remnant cholesterol and C-reactive
protein confers the highest risk of myocardial infarction, ASCVD, and
all-cause mortality, that is, compared to either of these two factors
individually. Copyright © 2023 The Authors

<130>
Accession Number
641382694
Title
Coronary revascularization for heart failure with coronary artery disease:
a systematic review and meta-analysis of randomized trials.
Source
European journal of heart failure. (no pagination), 2023. Date of
Publication: 22 May 2023.
Author
Iaconelli A.; Pellicori P.; Dolce P.; Busti M.; Ruggio A.; Aspromonte N.;
D'Amario D.; Galli M.; Princi G.; Caiazzo E.; Rezig A.O.M.; Maffia P.;
Pecorini G.; Crea F.; Cleland J.G.
Institution
(Iaconelli, Pellicori, Cleland) School of Cardiovascular and Metabolic
Health, University of Glasgow, Glasgow, United Kingdom
(Iaconelli, Ruggio, Aspromonte) Department of Cardiovascular Medicine,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
(Dolce) Department of Public Health, University of Naples Federico II,
Naples, Italy
(Busti, Princi, Crea) Department of Cardiovascular Sciences, Catholic
University of the Sacred Heart, Rome, Italy
(D'Amario) Department of Translational Medicine, University of Eastern
Piedmont, Novara, Italy
(D'Amario) Division of Cardiology, Azienda Ospedaliero Universitaria
"Maggiore Della Carita", Novara, Italy
(Galli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Caiazzo) Department of Pharmacy, School of Medicine and Surgery,
University of Naples Federico II, Naples, Italy
(Caiazzo, Rezig, Maffia) School of Infection and Immunity, College of
Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow,
United Kingdom
(Pecorini) Department of Cardiovascular Sciences, Cardiovascular Internal
Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS,
Roma, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: Coronary artery disease (CAD) is a common cause of
heart failure (HF). Whether coronary revascularisation improves outcomes
in patients with HF receiving guideline-recommended pharmacological
therapy (GRPT) remains uncertain; therefore, we conducted a systematic
review and meta-analysis of relevant randomized controlled trials (RCTs).
 METHOD(S): We searched in public databases for RCTs published between
1st January 2001 and 22nd November 2022, investigating the effects of
coronary revascularisation on morbidity and mortality in patients with
chronic HF due to CAD. All-cause mortality was the primary outcome.
 RESULT(S): We included five RCTs that enrolled, altogether, 2,842
patients (most aged <65years; 85% men; 67% with left ventricular ejection
fraction <=35%). Overall, compared to medical therapy alone, coronary
revascularisation was associated with a lower risk of all-cause mortality
(HR 0.88 [95% CI, 0.79-0.99]; p=0.0278) and cardiovascular mortality (HR
0.80 [95% CI, 0.70-0.93]; p=0.0024) but not the composite of
hospitalisation for HF or all-cause mortality (HR 0.87 [95% CI,
0.74-1.01]; p=0.0728). There were insufficient data to show whether the
effect of CABG or PCI were similar or differed. CONCLUSION(S): For
patients with chronic HF and CAD enrolled in RCTs, the effect of coronary
revascularization on all-cause mortality was statistically significant but
neither substantial (HR 0.88) nor robust (upper 95% CI close to 1.0). RCTs
were not blinded, which may bias reporting of the cause-specific reasons
for hospitalization and mortality. Further trials are required to
determine which patients with HF and CAD obtain a substantial benefit from
coronary revascularization by either CABG or PCI. This article is
protected by copyright. All rights reserved.

<131>
Accession Number
641381585
Title
Development and Validation of a Nomogram for Predicting Heparin Resistance
in Neonates and Young Infants Undergoing Cardiac Surgery: A Retrospective
Study.
Source
Anesthesia and analgesia. (no pagination), 2023. Date of Publication: 22
May 2023.
Author
Gao P.; Zhang Y.; Jin Y.; Zhang P.; Wang W.; Liu J.
Institution
(Gao) From the Department of Anesthesiology, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Zhang) Department of Laboratory Medicine, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Jin, Zhang, Wang, Liu) Department of Cardiopulmonary Bypass, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Heparin resistance (HR) is a common finding in pediatric
cardiac surgery and generally refers to decreased sensitivity to heparin.
Antithrombin (AT) deficiency is considered the primary mechanism of HR;
however, the etiology of HR may be multifactorial. Early identification of
HR might help optimize heparin anticoagulation management. This study
aimed to develop a predictive nomogram for HR in neonates and young
infants undergoing cardiac surgery. METHOD(S): From January 2020 to
August 2022, a total of 296 pediatric patients 1 to 180 days of age were
included in this retrospective study. The patients were randomly divided
into development and validation cohorts in a 7:3 ratio. Univariable
logistic regression and the Least Absolute Shrinkage and Selection
Operator (LASSO) regularization were used for variable selection. A
multivariable logistic regression was performed to identify predictors and
establish a nomogram to predict HR risk. Discrimination, calibration, and
clinical usefulness were assessed in the development and validation
cohorts. RESULT(S): After the multistep variable selection, AT
activity, platelet count, and fibrinogen were predictors for HR in
neonates and young infants. The prediction model constructed using these 3
factors achieved an area under the receiver operating characteristic curve
(ROC-AUC) of 0.874 and 0.873 in the development and validation cohorts.
The Hosmer-Lemeshow test did not find evidence of a lack of fit (P =
.768). The calibration curve of the nomogram was close to the ideal
diagonal line. Furthermore, the model performed well in neonate and infant
subgroups. CONCLUSION(S): A nomogram based on preoperative variables
was developed to predict the HR risk in neonates and young infants
undergoing cardiac surgery. This provides clinicians with a simple tool
for the early prediction of HR, which may help optimize heparin
anticoagulation strategies in this vulnerable patient
population. Copyright © 2023 The Author(s). Published by Wolters
Kluwer Health, Inc. on behalf of the International Anesthesia Research
Society.

<132>
Accession Number
641381271
Title
Useful Respiratory Maneuvers Aiding Left Heart Cardiac Catheterization and
Intervention. A Comprehensive Review.
Source
Critical pathways in cardiology. (no pagination), 2023. Date of
Publication: 10 May 2023.
Author
Vakhshoori M.; Movahed M.R.
Institution
(Vakhshoori, Movahed) University of Arizona Sarver Heart Center, Tucson,
AZ, United States
(Movahed) University of Arizona, College of Medicine, Phoenix, AZ, United
States
Publisher
NLM (Medline)
Abstract
Left heart catheterizations, coronary angiography, and coronary
interventions are important common cardiac procedures. Performing a
successful cardiac catheterization and intervention and proper
catheterization and device delivery is not always without difficulties,
especially in the context of calcification or vessel tortuosity. Although
there are some techniques to overcome this issue, performing respiratory
maneuvers (inspiration or expiration) can be simply tried as the first
step to increasing successful procedures which is underreported and
underutilized. The goal of this manuscript is to review current literature
regarding useful respiratory maneuvers that can aid in successful left
heart cardiac catheterization, coronary angiography, and intervention for
a successful procedure. Copyright © 2023 Wolters Kluwer Health,
Inc. All rights reserved.

<133>
Accession Number
2024700620
Title
Use of Preoperative Natriuretic Peptide in Predicting Mortality After
Coronary Artery Bypass Grafting: A Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Comanici M.; Nadarajah D.; Katumalla E.; Cyclewala S.; Raja S.G.
Institution
(Comanici, Nadarajah, Katumalla, Cyclewala, Raja) Department of Cardiac
Surgery, Harefield Hospital, London, United Kingdom
Publisher
W.B. Saunders
Abstract
The objective of this systematic review was to evaluate the current
evidence on the utility of preoperative B-type natriuretic peptide (BNP)
and N-terminal-pro B-type natriuretic peptide (NT-proBNP) in predicting
short-term and long-term mortality after coronary artery bypass grafting
(CABG). OVID MEDLINE, EMBASE, SCOPUS, and PUBMED were searched from 1946
to August 2022 using the following terms: "coronary artery bypass
grafting" and "BNP" and "outcomes." Eligible studies included
observational studies reporting the association between preoperative BNP
and NT-proBNP levels and short- and long-term mortality after CABG.
Articles were selected systematically, assessed for bias, and, when
possible, meta-analyzed using a random effect model. After retrieving 53
articles, 11 were included for qualitative synthesis and 4 for
quantitative meta-analysis. Studies included in this review showed that
elevated preoperative natriuretic peptide levels, despite variable
cut-offs, have been consistently shown to be associated with short- and
long-term mortality after CABG. The median BNP cut-off value was 145.5
pg/mL (25th-75th percentile 95-324.25 pg/mL), and the mean NT-proBNP value
was 765 +/- 372 pg/mL. Compared to patients with normal natriuretic
peptide levels, patients with elevated BNP and NT-proBNP presented higher
mortality rates after CABG (odds ratio 3.96, 95% confidence interval
2.41-6.52; p < 0.00001). Preoperative BNP level is a powerful predictor of
mortality in patients undergoing CABG. The measurement of BNP can add
significant value to these patients' risk stratification and therapeutic
decision-making. Copyright © 2023 Elsevier Inc.

EPICORE Embase Updates

Saturday, June 3, 2023

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

No comments:

Post a Comment

Followers

Blog Archive

About Me