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<1>
Accession Number
368635604
Title
Psychological depression and cardiac surgery: A comprehensive review.
Source
Journal of Extra-Corporeal Technology. 44(4) (pp 224-232), 2012. Date of
Publication: December 2012.
Author
Tully P.J.
Institution
(Tully) Department of Surgery, Flinders Medical Centre, Flinders
University of South Australia, Bedford Park, SA, Australia
(Tully) The School of Psychology, The University of Adelaide, Adelaide,
SA, Australia
(Tully) The Discipline of Psychiatry, The University of Adelaide,
Adelaide, SA, Australia
(Tully) The Heart Failure Self Management Program, Ambulatory and Primary
Healthcare Directorate, Hampstead Rehabilitation Centre, Northfield,
Australia
Publisher
American Society of Extra-Corporeal Technology
Abstract
The psychological and neurological impact of cardiac surgery has been of
keen empirical interest for more than two decades although reports showing
the prognostic influence of depression on adverse outcomes lag behind the
evidence documented in heart failure, myocardial infarction, and unstable
angina. The paucity of research to date is surprising considering that
some pathophysiological mechanisms through which depression is
hypothesized to affect coronary heart disease (e.g., platelet activation,
the inflammatory system, dysrhythmias) are known to be substantially
influenced by the use of cardiopulmonary bypass. As such, cardiac surgery
may provide a suitable exemplar to better understand the psychiatric
mechanisms of cardiopathogenesis. The extant literature is comprehensively
reviewed with respect to the deleterious impact of depression on cardiac
and neuropsychological morbidity and mortality. Research to date indicates
that depression and major depressive episodes increase major
cardiovascular morbidity risk after cardiac surgery. The association
between depressive disorders and incident delirium is of particular
relevance to cardiac surgery staff. Contemporary treatment intervention
studies are also described along with suggestions for future cardiac
surgery research.

<2>
Accession Number
368635603
Title
Improvements in survival and neurodevelopmental outcomes in surgical
treatment of hypoplastic left heart syndrome: A meta-analytic review.
Source
Journal of Extra-Corporeal Technology. 44(4) (pp 216-223), 2012. Date of
Publication: December 2012.
Author
Sistino J.J.; Bonilha H.S.
Institution
(Sistino, Bonilha) College of Health Professions, Medical University of
South Carolina, Charleston, SC, United States
Publisher
American Society of Extra-Corporeal Technology
Abstract
The purpose of this study was to analyze the changes over the past two
decades in hospital survival and neurodevelopmental outcomes after
surgical treatment for hypoplastic left heart syndrome. The hypothesis for
this study is that increasing hospital survival following the Stage I
Norwood (S1N) procedure is associated with improvements in
neurodevelopmental outcomes. Studies included in the meta-analysis were
identified by searching Ovid MEDLINE from January 1980 to October 2010. A
total of 72 articles were identified. Fifteen single-center study articles
were appropriate for obtaining survival data and 14 were used for
neurodevelopmental outcomes. Wechsler Intelligence Test IQ scores and the
Bayley II Mental Development (MDI) and Psychomotor Development Indices
(PDI) were the primary neurodevelopmental outcomes included in this
meta-analysis. Metaregression analysis using a mixed-effects model
compared the percent survival and neurodevelopmental scores with the year
of surgery. Hospital survival for the S1N operation increased
significantly from 1996 to 2007 (p < .05). The overall mean survival
during this time period was 80.05% (95% confidence interval [CI],
76.4-84.0%). Standardized Wechsler IQ scores increased significantly from
1989 to 1999 (p < .05) and the mean IQ was 85.09 (95% CI, 82.3-89.5). The
Bayley II MDI increased significantly from 1998 to 2005 (p < .05) with
amean MDI of 86.9 (95% CI, 84.9-88.9). The Bayley II PDI increased
significantly from 1998 to 2005 (p < .05) with a mean PDI of 73.4 (95% CI,
71.2-75.5). Increased survival has been associated with improved but below
normal neurodevelopmental outcomes.

<3>
Accession Number
365367283
Title
A meta-analysis of renal benefits to pulsatile perfusion in cardiac
surgery.
Source
Journal of Extra-Corporeal Technology. 44(1) (pp 10-14), 2012. Date of
Publication: 2012.
Author
Sievert A.N.; Sistino J.
Institution
(Sievert, Sistino) Medical University of South Carolina, Charleston, SC,
United States
Publisher
American Society of Extra-Corporeal Technology
Abstract
Multiple studies have evaluated the efficacy of pulsatile flow during
cardiopulmonary bypass (CPB) showing controversial results. Suggested
benefits to pulsatile perfusion include reducing the systemic inflammatory
response syndrome associated with bypass, decreased need for inotropic
support, shortened hospital stay, and superior organ preservation. This
study aims to compare prior studies to determine if there is a significant
difference in post-operative renal function with pulsatile perfusion
compared to non-pulsatile perfusion during cardiac surgery. Studies
included in the analysis were identified by searching keywords - pulsatile
perfusion, pulse, pulsatile flow, cardiopulmonary bypass, and cardiac
surgery. To maintain a homogenous sample, manuscripts were included if
they met the following criteria: research was prospective in nature,
subjects were human, paper contained documented baseline demographics,
outcome data included markers of renal function. A meta-analysis was
performed to compare post-op renal function between pulsatile and
non-pulsatile perfusion groups. A total of 298 articles were screened. Ten
articles met the criteria, of these, 477 patients underwent non-pulsatile
perfusion while 708 received pulsatile perfusion during CPB. There was
insufficient evidence to show a difference in mean postoperative
creatinine or BUN between the groups, however, the pulsatile perfusion
group had significantly higher creatinine clearance (standardized
difference in means = 2.48, p =.004) and lower serum lactate levels
(standardized difference in means = -2.08, p =.012) in the intensive care
unit. This study found that there is great variability among pulsatile
perfusion research. The methods to create and assess effective pulsatility
on bypass varied widely among manuscripts. This analysis suggests that
pulsatile perfusion during CPB is beneficial in renal preservation and
should be considered. &#xa9; 2011 AmSECT.

<4>
Accession Number
365367282
Title
Impact of a Phosphorylcholine-Coated Cardiac Bypass Circuit on Blood Loss
and Platelet Function: A Prospective, Randomized Study.
Source
Journal of Extra-Corporeal Technology. 44(1) (pp 05-09), 2012. Date of
Publication: 2012.
Author
Marguerite S.; Levy F.; Quessard A.; Dupeyron J.-P.; Gros C.; Steib A.
Institution
(Marguerite, Levy, Quessard, Dupeyron, Gros, Steib) Department of Surgical
Anesthesia and Intensive Care, Civil Hospital, Strasbourg University
Hospital, Strasbourg, France
Publisher
American Society of Extra-Corporeal Technology
Abstract
Platelet dysfunction due to cardiopulmonary bypass (CPB) surgery increases
the risk of bleeding. This study analyzed the effect of a
phosphorylcholine (PC)-coated CPB circuit on blood loss, transfusion
needs, and platelet function. We performed a prospective, randomized study
at Strasbourg University Hospital, which included 40 adults undergoing
coronary artery bypass graft surgery (CABG) (n = 20) or mitral valve
repair (n = 20) using CPB. Patients were randomized either to PC-coated
CPB or uncoated CPB (10 CABG patients and 10 mitral valve repair patients
in each group). Blood loss and transfusion needs were evaluated intra- and
postoperatively. Markers of platelet activation and thrombin generation
were measured at anesthesia induction, at the beginning and end of CPB, on
skin closure, and on days 0, 1, and 5. Comparisons were made by Student's
t test or covariance analysis (significance threshold p .05). Blood loss
was significantly lower in the PC group during the first 6 postoperative
hours (171 +/- 102 vs. 285 +/- 193 mL, p =.024), at the threshold of
significance from 6- 24 hours (p =.052), and similar in both groups after
24 hours. During CPB, platelet count decreased by 48% in both groups.
There was no difference in markers of platelet activation, thrombin
generation, or transfusion needs between the two groups. Norepinephrine
use was more frequent in the control group (63% vs. 33%) but not
significantly. PC-coating of the CPB surface reduced early postoperative
bleeding, especially in CABG patients, but had no significant effect on
platelet function because of large interindividual variations that
prevented the establishment of a causal relationship. &#xa9; 2011 AmSECT.

<5>
Accession Number
365358695
Title
Randomized trial of the terumo capiox fx05 oxygenator with integral
arterial filter versus terumo capiox baby rx05 and terumo capiox af02
arterial filter in infants undergoing cardiopulmonary bypass.
Source
Journal of Extra-Corporeal Technology. 43(4) (pp 207-214), 2011. Date of
Publication: 2011.
Author
Nuszkowski M.M.; Deutsch N.; Jonas R.A.; Zurakowski D.; Montague E.; Holt
D.W.
Institution
(Nuszkowski, Deutsch, Jonas, Zurakowski, Montague, Holt) Children's
National Medical Center, Washington, DC, United States
Publisher
American Society of Extra-Corporeal Technology
Abstract
The purpose of this clinical trial was to evaluate the effect of the
Terumo Capiox FX05 oxygenator with integrated arterial filter during
cardiopulmonary bypass (CPB) compared with the Terumo Capiox RX05 Baby RX
and arterial filter on inflammatory mediators and blood product
utilization. Forty patients weighing less than 10 kg who underwent
congenital heart surgery utilizing cardiopulmonary bypass were randomized
into either oxygenator group. The endpoints included measuring
inflammatory markers at six different time points (preoperative baseline,
CPB circuit being primed, 15 minutes after CPB initiation, status post
protamine administration, prior to transport to intensive care unit, and
within 12 to 24 hours post surgery), blood product utilization, extubation
time, and days until discharge. The inflammatory mediators showed no
significant differences between oxygenators at any time points. However,
looking at the inflammatory mediators of both the FX and RX groups
combined, a statistically significant difference was seen in interleukin
(IL)-6 at 12/24 hour post surgery (p < .001) versus baseline and all other
time points. IL-8 at status post protamine (p < .001) and 12/24 hours post
surgery (p < .001) demonstrated significant differences versus all other
time points, and IL-10 at status post protamine (p < .001) and prior to
leaving the operating room (p < .001) were statistically different
compared to all other time points. Cardiopulmonary bypass stimulates the
systemic inflammatory response through various components of the
extracorporeal system. This investigation did not find significant
differences in cytokines interferon-g, IL-1b, IL-2, IL-4, IL-5, IL-6,
IL-8, IL-10, IL-12 p70, tumor necrosis factor (TNF)-alpha, and TNF-b when
comparing these two oxygenators. It is well known that various mechanisms
contribute to the levels of cytokines circulating in a patient's blood
volume and many manipulations throughout cardiac surgery have the ability
to demonstrate anti-inflammatory interventions. Further investigation is
needed as to how modification of the extracorporeal circuit may minimize
increases in inflammatory mediators.

<6>
Accession Number
358619357
Title
Evaluation of hemodynamic and regional tissue perfusion effects of
minimized extracorporeal circulation (MECC).
Source
Journal of Extra-Corporeal Technology. 42(1) (pp 30-39), 2010. Date of
Publication: March 2010.
Author
Bauer A.; Diez C.; Schubel J.; El-Shouki N.; Metz D.; Eberle T.; Hausmann
H.
Institution
(Bauer) Department of Cardiovascular Technology, MediClin Heart Center
Coswig, Lerchenfeld 1, 06869 Coswig, Sachsen-Anhalt, Germany
(Diez) Department of Cardiothoracic and Vascular Surgery, University
Hospital of Regensburg, Regensburg, Germany
(Schubel, El-Shouki, Metz, Hausmann) Department of Cardiovascular Surgery,
MediClin Heart Centre Coswig, Sachsen Anhalt, Germany
(Eberle) Department of Cardio - Anesthesiology, MediClin Heart Centre
Coswig, Sachsen Anhalt, Germany
Publisher
American Society of Extra-Corporeal Technology
Abstract
Minimized extracorporeal circulation (MECC , Maquet, Cardiopulmonary AG,
Hirrlingen, Germany) is an established procedure to perform coronary
revascularization. Studies showed positive effects of MECC compared to
conventional cardiopulmonary bypass (CCPB) procedures in terms of
transfusion requirements, less inflammation reactions, and neurological
impairments. Recent retrospective studies showed higher mean arterial
pressure (MAP) and a lower frequency of vasoactive drug use. We addressed
this issue in this study. The hypothesis was to find a higher MAP during
coronary bypass grafting surgery in patients treated with MECC systems .
We performed a prospective, controlled, randomized trial with 40 patients
either assigned to MECC ( n = 18) or CCPB ( n = 22) undergoing coronary
bypass grafting. Primary endpoints were the perioperative course of mean
arterial pressure, and the consumption of norepinephrine. Secondary
endpoints were the regional cerebral and renal oxygen saturation
(rSO<inf>2</inf>) as an indicator of area perfusion and the course of
hematocrit. Clinical and demographic characteristics did not significantly
differ between both groups. Thirty-day mortality was 0%. At four of five
time points during extracorporeal circulation (ECC) MAP values were
significantly higher in the MECC group compared to CCPB patients (after
starting the ECC 60 +/- 11 mmHg vs. 49 +/- 10 mmHg, p = .002). MECC
patients received significantly less norepinephrine (MECC 22.5 +/- 35 mug
vs. CCPB 60.5 +/- 75 mug, p = .045). The rSO<inf>2</inf> measured at right
and left forehead and the renal area was similar for both groups during
ECC and significantly higher at CCPB group 1 and 4 hours after termination
of CPB. Minimized extracorporeal circulation provides a higher mean
arterial pressure during ECC and we found a lower consumption of
vasoactive drugs in the MECC group. There was a decrease in regional
tissue saturation at 1 and 4 hours post bypass in the MECC group possibly
due to increased systemic inflammation and extravascular fluid shift in
the CCPB group.

<7>
Accession Number
358182848
Title
Anti-inflammatory effect of aprotinin: A meta-analysis.
Source
Journal of Extra-Corporeal Technology. 41(2) (pp 79-86), 2009. Date of
Publication: June 2009.
Author
Brown J.R.; Toler A.W.J.; Kramer R.S.; Clive Landis R.
Institution
(Brown, Toler) Dartmouth Institute for Health Policy and Clinical
Practice, Dartmouth Medical School, Lebanon, NH, United States
(Kramer) Division of Cardiothoracic Surgery, Maine Medical Center,
Portland, ME, United States
(Clive Landis) Edmund Cohen Laboratory for Vascular Research, University
of the West Indies, Barbados
Publisher
American Society of Extra-Corporeal Technology
Abstract
It is important to define the extent, and any limitations, of potential
anti-inflammatory regimens used in cardiac surgery to guide the rational
combination of drugs to suppress the systemic inflammatory response.
Aprotinin (Trasylol) is an anti-fibrinolytic agent with reported
anti-inflammatory properties. In this study, we investigated the published
data on aprotinin's effect on acute phase protein and cytokine levels in
cardiac surgery patients. Randomized placebo-controlled trials of
aprotinin published between 1985 and 2007, in adult cardiac surgery using
cardiopulmonary bypass, reporting tumor necrosis factor-alpha (TNF-alpha),
interleukin-6 (IL-6), IL-8, and IL-10 levels were included for review. Two
independent reviewers graded each paper and collected information on
inflammatory markers. RevMan 4.3 statistical software was used to
calculate and plot the weighted mean difference between placebo and
aprotinin groups. Thirteen studies met the review criteria. None of the
inflammatory markers were reduced by high-dose aprotinin treatment.
Low-dose aprotinin significantly reduced IL-10 levels after protamine
administration (?41.3 pg/ mL; 95% CI: ?59.5, ?23.1), but this result was
gone by the first post-operative day. These meta-analyses showed no
significant effect of aprotinin on acute phase proteins or systemic
cytokine markers of inflammation during clinical adult cardiac surgery
using cardiopulmonary bypass. While recognizing that other host defense
systems, such as coagulation and complement, contribute to the overall
systemic inflammatory response, the evidence presented here does not
support the clinical use of aprotinin as an anti-inflammatory agent on its
own.

<8>
Accession Number
2024817389
Title
A systematic review of biological changes in surgeons' acute stress levels
during surgery.
Source
Surgery in Practice and Science. 13 (no pagination), 2023. Article Number:
100174. Date of Publication: June 2023.
Author
Budden A.; Song S.; Henry A.; Wakefield C.E.; Abbott J.
Institution
(Budden, Song, Abbott) Gynaecological Research and Clinical Evaluation
(GRACE) Group, Royal Hospital for Women, Sydney, Australia
(Budden, Song, Henry, Wakefield, Abbott) School of Clinical Medicine,
UNSW, Sydney, Australia
(Henry) Department of Women's and Children's Health, St George Hospital,
Sydney, Australia
(Wakefield) Kids Cancer Centre, Sydney Children's Hospital, Sydney,
Australia
Publisher
Elsevier Ltd
Abstract
Background: While a degree of stress facilitates learning and task
performance, excessive stress in surgeons may lead to poor patient
outcomes, with maladaptive stress as a risk factor for surgeon burnout or
self-harm through mechanisms including substance abuse, and suicide. We
aim to systematically review publications investigating how measures of
surgeons' acute biological stress change during surgery. <br/>Method(s):
Medline, Embase, Cochrane library, and The United States, Australian, and
European clinical trials registries were searched using the terms stress;
surgeon; cortisol; skin conductance; and heart rate. Studies had to report
at least one measure of biological stress related to surgery or simulated
surgical exercise and have been published between January 1996 to June
2022. <br/>Result(s): Twenty-eight studies with a total of 433
participants met inclusion criteria with cortisol, heart rate, heart rate
variability, and electrodermal activity being reported. Salivary cortisol
was measured in four studies with conflicting directional changes
reported. Mean heart rate increased in nine studies (by 6-22
beats/minute), however the impact of the physical work of surgery was not
reported. Heart rate variability, as measured by low-frequency to
high-frequency ratio, was significantly increased in three of six studies.
One study measured electrodermal activity reporting significant increase
in skin conductance in a simulation setting. <br/>Conclusion(s): While
some biological measures appear able to detect changes in acute stress in
surgeons (particularly heart rate), appropriate measures of stress during
non-stressful and stressful surgery are yet to be fully identified.
Importantly, there are no current pathways for identifying surgeons at
risk of burnout or self-harm and this is a critical unmet research
need.<br/>Copyright &#xa9; 2023

<9>
Accession Number
2024788783
Title
Meta Analysis of Factors Which Influence Delirium Following Cardiac
Surgery.
Source
Pakistan Journal of Medical and Health Sciences. 17(2) (pp 852-864), 2023.
Date of Publication: March 2023.
Author
Mairajjudin; Tahir A.; Izhar N.; Ahmad S.; Shah J.Z.; Soomro A.A.
Institution
(Mairajjudin, Ahmad) Rawalpindi Institute of Cardiology, Pakistan
(Tahir) Farooq Teaching Hospital, Rawalpindi, Pakistan
(Izhar) Rawal Institute of Health Sciences, Islamabad, Pakistan
(Shah) Heart Hospital, Doha, Qatar
(Soomro) Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences
(PAQSJIMS ), Gambat, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Introduction: Delirium is a common postoperative complication following
cardiac surgery, and it can lead to a range of adverse outcomes, including
increased length of hospital stay, cognitive decline, and mortality.
<br/>Objective(s): The main objective of the study is to find the
meta-analysis of factors which influence delirium following cardiac
surgery. <br/>Material(s) and Method(s): The study is a systematic review
and meta-analysis of observational studies that investigate the potential
risk factors for delirium following cardiac surgery. A comprehensive
search of electronic databases such as PubMed, Embase, and Cochrane
Library was conducted to identify relevant studies published up to a
specific cut-off date. The search terms would include combinations of
relevant keywords such as "delirium," "postoperative," "cardiac surgery,"
and "risk factors." The search strategy included studies published in
English language journals from inception to the date of the search cutoff.
<br/>Result(s): The systematic review and meta-analysis included 20
observational studies with a total of 4,500 patients who underwent cardiac
surgery. The incidence of delirium ranged from 5% to 50% across studies.
Meta-analysis showed that several factors were significantly associated
with an increased risk of delirium following cardiac surgery. These
factors included advanced age (pooled OR 2.50, 95% CI 1.75-3.56),
pre-existing cognitive impairment (pooled OR 3.15, 95% CI 2.01-4.93),
longer cardiopulmonary bypass time (pooled OR 1.85, 95% CI 1.28-2.66), and
higher serum creatinine levels (pooled OR 2.10, 95% CI 1.47-3.01). The use
of benzodiazepines was also associated with an increased risk of delirium
(pooled OR 2.67, 95% CI 1.87-3.81). <br/>Conclusion(s): In conclusion, our
meta-analysis provides evidence that older age, pre-existing cognitive
impairment, longer bypass time, and depression are significant risk
factors for the development of delirium following cardiac surgery. These
findings have important implications for the management of patients
undergoing cardiac surgery, as identifying patients who are at higher risk
of developing delirium can help to prevent its occurrence and improve
patient outcomes.<br/>Copyright &#xa9; 2023 Lahore Medical And Dental
College. All rights reserved.

<10>
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.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<11>
Accession Number
2024029230
Title
The Effect of Inhalation Aromatherapy on Patients with Cardiovascular
Disease Seeking Pain Relief: A Systematic Review and Meta-analysis.
Source
Current Drug Therapy. 18(3) (pp 262-270), 2023. Date of Publication: 2023.
Author
Mohammadi-Dashtaki R.; Heidari-Soureshjani S.; Sherwin C.M.T.
Institution
(Mohammadi-Dashtaki) Research Center, Department of Medicine, Shahrekord
University of Medical Sciences, Shahrekord, Iran, Islamic Republic of
(Heidari-Soureshjani) Modeling in Health Research Center, Shahrekord
University of Medical Sciences, Shahrekord, Iran, Islamic Republic of
(Sherwin) Pediatric Clinical Pharma-cology, Department of Pediatrics,
Dayton Children's Hospital, Wright State University Boonshoft School of
Medicine, One Children's Plaza, Dayton, OH, United States
Publisher
Bentham Science Publishers
Abstract
Background: Untreated cardiovascular disease (CVD) can commonly cause
disability and morbidity and increase the mortality risk.
<br/>Objective(s): This systematic review and meta-analysis study aimed to
investigate the pain-relieving effects of aromatherapy with medicinal
plants on patients with cardiovascular diseases. <br/>Method(s): This
meta-analysis followed PRISMA guidelines. Several keywords were explored
using an extensive search of databases, including PubMed, Web of Science
(ISI), EMBASE, and Scopus, on May 15, 2022. In addition, an excel form was
designed for recording the data of the RCT studies. Standardized mean
difference (SMD) and their 95% confidence intervals (CI) were used to
estimate the overall effect size. The Cochran Q test and the statistic I2
were used to evaluate the heterogeneity of studies. Lastly, Egger's and
Begg's tests were used to assess potential publication bias.
<br/>Result(s): We included studies examining the effect of inhalation
aromatherapy on pain in patients with CVD after 5 minutes (five papers)
and 15-30 minutes (six papers) of intervention. The results showed a
significant decrease in pain in the intervention group compared to the
control group after 5 minutes (SMD =-2.25, 95% CI =-3.21 to-1.29, P <
0.001) and after 15-30 minutes (SMD =-3.22, 95% CI =-4.41 to-2.03, P <
0.001) of intervention in CVD patients. No publication bias was observed
related to the association between inhalation aromatherapy and pain
relief. <br/>Conclusion(s): In CVD patients, inhalation aromatherapy could
significantly reduce pain severity and can be used as a complementary
medicine for pain reduction.<br/>Copyright &#xa9; 2023 Bentham Science
Publishers.

<12>
Accession Number
2024028861
Title
Evaluation and comparison of two different combined regimens for
prophylaxis of nausea and vomiting after laparoscopic bariatric surgery: A
double-blinded randomized clinical trial.
Source
Acta Medica Iranica. 61(3) (pp 175-180), 2023. Date of Publication: 2023.
Author
Shahinpour S.; Momeni N.; Yaqubnejad M.; Khajavi M.; Pourfakhr P.
Institution
(Shahinpour, Momeni, Yaqubnejad, Khajavi, Pourfakhr) Department of
Anesthesiology, School of Medicine, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Khajavi, Pourfakhr) Anesthesiology, Critical Care, and Pain Management
Research Center, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Medical Sciences University of Teheran
Abstract
Postoperative Nausea and vomiting (PONV) are the most complications after
laparoscopic surgeries, especially laparoscopic bariatric surgeries. The
incidence of PONV has been estimated in over two-thirds of patients
undergoing laparoscopic bariatric surgeries. Prophylactic combined
antiemetic therapy is recommended for patients undergoing these surgeries.
This is a double-blinded randomized clinical trial. Eighty-three patients
of ASA physical status I and II undergoing elective bariatric laparoscopic
surgery were enrolled in this clinical trial and divided into two equal
groups through simple randomization using a random number table. One group
(group A) received a combination of ondansetron, dexamethasone, and
haloperidol (ODH); and the other group (group B) received a combination of
ondansetron, dexamethasone, and promethazine (ODP). The ODP group received
promethazine 25 mg IM 30 minutes before extubation and ODH group received
haloperidol 2 mg IM at the beginning of the surgery. Nausea and vomiting
were assessed in terms of severity and frequency in the recovery room, 6,
and 24 hours postoperatively in both groups using the Numeric Verbal
Rating Scale (NVRS). The frequency of PONV was significantly lower in the
ODH group compared to the ODP group in the recovery room (20% versus 40%).
PONV severity was lower in the ODH group compared to the ODP group. The
time to first rescue antiemetic prescription in the ODP group was more
than in the ODH group (7.2 h versus 2.6 h). In morbidly obese patients
undergoing laparoscopic bariatric surgery, both antiemetic combinations
decreased the incidence of PONV, but the combination of haloperidol,
dexamethasone, and ondansetron was more effective than promethazine,
dexamethasone, and ondansetron.<br/>Copyright &#xa9; 2023 Tehran
University of Medical Sciences.

<13>
Accession Number
2022492338
Title
A Double-Blinded Randomized Controlled Trial Comparing Eptifibatide Bolus
Only Versus Bolus Plus Infusion In Patients Undergoing Primary
Percutaneous Coronary Intervention For ST-Elevation Myocardial Infarction.
Source
Cardiovascular Revascularization Medicine. 51 (pp 1-7), 2023. Date of
Publication: June 2023.
Author
Mousavi M.; Sehati F.; Tayebi A.; Nayeri A.D.; Movahed M.R.
Institution
(Mousavi) Nipawin Hospital, Saskatchewan Health Authority, Niapwin, SK,
Canada
(Sehati, Tayebi, Nayeri) Shahid Rajaei Educational and Medical Center,
Shahid Rajaei Av, Karaj, Iran, Islamic Republic of
(Movahed) Division of Cardiology, University of Arizona College of
Medicine-, Tucson, AZ, United States
(Movahed) College of Medicine, University of Arizona, Phoenix, United
States
Publisher
Elsevier Inc.
Abstract
Backgrounds: The use of eptifibatide combined with heparin during
percutaneous coronary intervention (PCI) in patients presenting with
ST-elevation myocardial infarction (STEMI) is recommended to be followed
by continuous infusion. Recently, there are some suggestions that using
bolus only may be sufficient and cost-effective but randomized trials are
lacking. <br/>Aim(s): The goal of this study was to evaluate these two
approaches in a double-blinded randomized control trial. <br/>Method(s):
The primary PCI patients who received bolus eptifibatide were randomized
to 75 mg IV eptifibatide infusion or placebo blindly. The patients were
followed up for the primary outcome of vascular or bleeding complications
and secondary outcome of ischemic complications. <br/>Result(s): 330
patients (165 from each group) completed the study. The mean age was 57.67
+/- 11.53 years and 77.3 % were male. Major bleeding was seen in 1 patient
in each group. Hematoma occurred in 8.5 %. The relative risk of hematoma
and ecchymosis in bolus plus infusion group to bolus only group were 0.988
(95 % CI: 0.486-2.006) and 1.032 (95 % CI: 0.729-1.459). Multivariate
analysis confirmed no significant differences in the bleeding event.
Furthermore, there was no significant difference in in-hospital death or
any ischemic events. (Cath lab death: 1.4 % in bolus only vs zero % in the
control group, p = 0.217, stent thrombosis was seen in one patient in each
group). <br/>Conclusion(s): There were no differences in the risk of
access site ecchymosis, hematoma or major bleeding. Ischemic events and
stent thrombosis rates were also similar. Our study suggests that using
eptifibatide bolus only during PCI of patients with STEMI is safe and can
be cost-saving.<br/>Copyright &#xa9; 2023

<14>
Accession Number
641477286
Title
Off-pump injectable versus on-pump conventional tissue valves for
pulmonary valve replacement: the injectable valve implantation randomised
trial (INVITE).
Source
BMJ open. 13(6) (pp e065192), 2023. Date of Publication: 01 Jun 2023.
Author
Heys R.; Walker-Smith T.; Evans R.; Caputo M.; Culliford L.; Reeves B.;
Rogers C.; Turner M.; Hamilton M.; Sheehan K.; Viola N.; Stoica S.; Wright
K.; Angelini G.; Parry A.
Institution
(Heys, Walker-Smith, Evans, Culliford, Reeves, Rogers) Bristol Trials
Centre, Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Caputo, Turner, Hamilton, Stoica, Wright, Angelini, Parry) Bristol Heart
Institute, University of Bristol, Bristol, United Kingdom
(Sheehan) Bristol Royal Hospital for Children, University Hospitals
Bristol and Weston Foundation NHS Trust, Bristol, United Kingdom
(Viola) University Hospital Southampton NHS Foundation Trust, Southampton
General Hospital, Southampton, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To assess the effectiveness of injectable tissue pulmonary
valve compared with standard pulmonary valve in patients requiring
pulmonary valve replacement surgery. DESIGN: A multicentre, single-blind,
parallel two-group randomised controlled trial. Participants were blind to
their allocation. Follow-up continued for 6 months. Randomised allocations
were generated by a computer using block randomisation, stratified by
centre. SETTING: Two National Health Service secondary care centres in the
UK. PARTICIPANTS: People aged 12-80 years requiring pulmonary valve
replacement. INTERVENTIONS: Participants were randomly allocated (1:1
ratio) to injectable pulmonary valve replacement (IPVR) without
cardiopulmonary bypass (CPB) or standard pulmonary valve replacement
(SPVR) with CPB. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary
outcome was chest drainage volume over the first 24 hours after surgery.
Secondary outcomes included in-hospital clinical outcomes; valve and heart
function 6 months postsurgery and health-related quality of life 6 weeks
and 6 months postsurgery. <br/>RESULT(S): Nineteen participants agreed to
take part. Eleven were allocated to IPVR and eight to SPVR. The trial was
stopped before the target sample size of 60 participants was reached due
to challenges in recruitment. The primary analysis includes all randomised
participants; there were no withdrawals. Chest drain volume 24 hours after
surgery was on average 277.6mL lower with IPVR (IPVR mean 340.0mL; SPVR
mean 633.8mL; mean difference, -277.6; 95% CI, -484.0 to -71.2; p=0.005).
There were no statistically significant differences in time to readiness
for extubation (p=0.476), time to fitness for discharge (p=0.577) and time
to first discharge from the intensive care unit (p=0.209). Six
participants with IPVR required CPB. Safety profiles and quality of life
scores were similar. <br/>CONCLUSION(S): IPVR reduced chest drain volume
despite >50% of participants requiring CPB. There was no evidence of any
other benefit of IPVR. TRIAL REGISTRATION NUMBER:
ISRCTN23538073.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<15>
[Use Link to view the full text]
Accession Number
2024777718
Title
Transcatheter Repair for Patients with Tricuspid Regurgitation.
Source
New England Journal of Medicine. 388(20) (pp 1833-1842), 2023. Date of
Publication: 2023.
Author
Sorajja P.; Whisenant B.; Hamid N.; Naik H.; Makkar R.; Tadros P.; Price
M.J.; Singh G.; Fam N.; Kar S.; Schwartz J.G.; Mehta S.; Bae R.; Sekaran
N.; Warner T.; Makar M.; Zorn G.; Spinner E.M.; Trusty P.M.; Benza R.;
Jorde U.; McCarthy P.; Thourani V.; Tang G.H.L.; Hahn R.T.; Adams D.H.
Institution
(Sorajja, Hamid, Bae) Allina Health Minneapolis Heart Institute at Abbott
Northwestern Hospital, Minneapolis, United States
(Whisenant, Sekaran) Intermountain Medical Center, Murray, UT, United
States
(Naik, Warner) St. Josephs Hospital and Integrated Medical Services,
Phoenix, AZ, United States
(Makkar, Makar) Cedars Sinai Medical Center, Los Angeles, CA, United
States
(Price) Scripps Clinic Green Hospital, La Jolla, CA, United States
(Singh) UC Davis Medical Center, Sacramento, CA, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Spinner, Trusty) Abbott Structural Heart, Santa Clara, CA, United States
(Tadros, Zorn) Kansas University Medical Center, Kansas City, United
States
(Fam) St. Michaels Hospital, Toronto, Canada
(Mehta) McMaster University, Hamilton, ON, Canada
(Schwartz) Carolinas Medical Center, Charlotte, NC, United States
(Jorde) Ohio State University, Columbus, United States
(Tang, Adams) Montefiore Medical Center, Bronx, United States
(Hahn) Mount Sinai Health System and New York, Presbyterian Columbia
University Medical Center, New York, NY, United States
(McCarthy) Northwestern University, Chicago, United States
(Thourani) Marcus Valve Center, Piedmont Heart Institute, Atlanta, United
States
Publisher
Massachussetts Medical Society
Abstract
Abstract Background Severe tricuspid regurgitation is a debilitating
condition that is associated with substantial morbidity and often with
poor quality of life. Decreasing tricuspid regurgitation may reduce
symptoms and improve clinical outcomes in patients with this disease.
Methods We conducted a prospective randomized trial of percutaneous
tricuspid transcatheter edge-to-edge repair (TEER) for severe tricuspid
regurgitation. Patients with symptomatic severe tricuspid regurgitation
were enrolled at 65 centers in the United States, Canada, and Europe and
were randomly assigned in a 1:1 ratio to receive either TEER or medical
therapy (control). The primary end point was a hierarchical composite that
included death from any cause or tricuspid-valve surgery; hospitalization
for heart failure; and an improvement in quality of life as measured with
the Kansas City Cardiomyopathy Questionnaire (KCCQ), with an improvement
defined as an increase of at least 15 points in the KCCQ score (range, 0
to 100, with higher scores indicating better quality of life) at the
1-year follow-up. The severity of tricuspid regurgitation and safety were
also assessed. Results A total of 350 patients were enrolled; 175 were
assigned to each group. The mean age of the patients was 78 years, and
54.9% were women. The results for the primary end point favored the TEER
group (win ratio, 1.48; 95% confidence interval, 1.06 to 2.13; P=0.02).
The incidence of death or tricuspid-valve surgery and the rate of
hospitalization for heart failure did not appear to differ between the
groups. The KCCQ quality-of-life score changed by a mean (+/-SD) of
12.3+/-1.8 points in the TEER group, as compared with 0.6+/-1.8 points in
the control group (P<0.001). At 30 days, 87.0% of the patients in the TEER
group and 4.8% of those in the control group had tricuspid regurgitation
of no greater than moderate severity (P<0.001). TEER was found to be safe;
98.3% of the patients who underwent the procedure were free from major
adverse events at 30 days. Conclusions Tricuspid TEER was safe for
patients with severe tricuspid regurgitation, reduced the severity of
tricuspid regurgitation, and was associated with an improvement in quality
of life. (Funded by Abbott; TRILUMINATE Pivotal ClinicalTrials.gov number,
NCT03904147.) <br/>Copyright &#xa9; 2023 Massachusetts Medical Society.

<16>
Accession Number
2024777596
Title
Effect of glucagon-like peptide-1 receptor agonists administration during
coronary artery bypass grafting: a systematic review and meta-analysis of
randomized control trials.
Source
Future Cardiology. 19(2) (pp 105-115), 2023. Date of Publication: 01 Feb
2023.
Author
Watkins A.R.; Fialka N.; El-Andari R.; Kang J.J.H.; Bozso S.J.; Nagendran
J.
Institution
(Watkins, Fialka) Faculty of Medicine & Dentistry, University of Alberta,
Edmonton, AB T6G 2B7, Canada
(El-Andari, Kang, Bozso, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada
Publisher
Newlands Press Ltd
Abstract
Aim: To determine if glucagon-like peptide-1 receptor agonists (GLP-1 RAs)
can benefit patients receiving coronary artery bypass graft (CABG), GLP-1
RAs administration alongside standard insulin was compared with
perioperative insulin alone. <br/>Material(s) and Method(s): All articles
from Pubmed and Scopus databases that compared GLP-1 RA administration to
insulin alone during CABG were included for meta-analysis. Short-term
postoperative outcomes were analyzed between groups. <br/>Result(s):
Average postoperative blood glucose levels significantly favored GLP-1 RA
with a mean difference of -0.72 (p < 0.001). No other variables were
significantly different between GLP-1 RA and insulin alone.
<br/>Conclusion(s): GLP-1 RA is a safe option for perioperative care of
CABG patients that can potentially improve postoperative outcomes of CABG
patients by improving glycemic control and reducing hyperglycemic
episodes. <br/>Copyright &#xa9; 2023 Future Medicine Ltd.

<17>
Accession Number
2024765106
Title
Clinical factors affecting survival in patients with D-transposition of
the great arteries after atrial switch repair: A meta-analysis.
Source
Kardiologia Polska. 81(1) (pp 38-47), 2023. Date of Publication: 2023.
Author
Nartowicz S.A.; Jakielska E.; Cieplucha A.; Ratajczak P.; Grajek S.;
Lesiak M.; Trojnarska O.
Institution
(Nartowicz, Jakielska, Grajek, Lesiak, Trojnarska) Poznan University of
Medical Sciences, Poznan, Poland
(Cieplucha) 1st Department of Cardiology, Poznan University of Medical
Sciences, Poznan, Poland
(Ratajczak) Department of Pharmacoeconomics and Social Pharmacy, Poznan
University of Medical Sciences, Poznan, Poland
Publisher
Via Medica
Abstract
Background: Atrial switch repair (AtrSR) was the initial operation method
in patients with D-transposition of the great arteries (D-TGA)
constituting the right ventricle as a systemic one. Currently, it has been
replaced with arterial switch operation (ASO), but the cohort of adults
after AtrSR is still large and requires strict cardiological management of
late complications. For this reason, we aimed to evaluate potential
long-term mortality risk factors in patients with D-TGA after AtrSR
(either Mustard or Senning procedures) Methods: We searched the MEDLINE
database for suitable trials. We included 22 retrospective and prospective
cohort studies of patients with D-TGA with at least 5 years mean/median
follow-up time after Mustard or Senning procedures, with an endpoint of
non-sudden cardiac death (n-SCD) and sudden cardiac death (SCD) after at
least 30 days following surgery. <br/>Result(s): A total of 2912 patients
were enrolled, of whom 351 met the combined endpoint of n-SCD/SCD. The
long-term mortality risk factors were New York Heart Association (NYHA)
class >=III/heart failure hospitalization (odds ratio [OR], 7.25; 95%
confidence interval [CI], 2.67-19.7), tricuspid valve regurgitation (OR,
4.64; 95% CI, 1.95-11.05), Mustard procedure (OR, 2.15; 95% CI,
1.37-3.35), complex D-TGA (OR, 2.41; 95% CI, 1.31-4.43), and right
ventricular dysfunction (OR, 1.94; 95% CI, 0.99-3.79). Supraventricular
arrhythmia (SVT; OR, 2.07; 95% CI, 0.88-4.85) and pacemaker implantation
(OR, 2.37; 95% CI, 0.48-11.69) did not affect long-term survival in this
group of patients. In an additional analysis, SVT showed a statistically
significant impact on SCD (OR, 2.74; 95% CI, 1.36-5.53) but not on n-SCD
(OR, 1.5; 95% CI, 0.37-6.0). <br/>Conclusion(s): This meta-analysis
demonstrated that at least moderate tricuspid valve regurgitation, NYHA
class >=III/heart failure hospitalization, right ventricular dysfunction,
complex D-TGA, and Mustard procedure are risk factors for long-term
mortality in patients after AtrSR.<br/>Copyright by the Author(s), 2023.

<18>
Accession Number
2023533885
Title
Intracardiac thrombosis after congenital heart disease surgeries in
neonates: a report of two cases.
Source
BMC Pediatrics. 23(1) (no pagination), 2023. Article Number: 277. Date of
Publication: December 2023.
Author
Yang Y.; Lv J.; Li Y.; Gan C.; Ji P.
Institution
(Yang, Gan) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, No. 37 Guo Xue Alley, Wuhou District 610041, Sichuan
Province, Chengdu, China
(Lv) Anesthesia Operation Center, West China School of Nursing, West China
Hospital, Sichuan University, Sichuan Province, Chengdu, China
(Li) Department of Cardiology, West China Hospital, Sichuan University,
Sichuan Province, Chengdu, China
(Ji) Department of Critical Care Medicine, West China Hospital, Sichuan
University, No. 37 Guo Xue Alley, Wuhou District 610041, Sichuan Province,
Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: Intracardiac thrombosis (ICT) is a rare complication after the
cardiopulmonary surgery for interrupted aortic arch (IAA) or total
anomalous pulmonary venous connection (TAPVC) without previous records.
There are still no general guidelines regarding as the mechanism or
management of postoperative ICT in neonates and younger infants. Case
presentation: We reported the conservative and surgical therapies in two
neonates with intra-ventricular and intra-atrial thrombosis after the
anatomical repair for IAA and TAPVC, respectively. There were no risk
factors for ICT in both patients, except for the use of blood product and
prothrombin complex concentrate. The surgery was indicated after TAPVC
correction due to the worsening respiratory status and rapidly decreased
mixed venous saturation. Anticoagulation combined with antiplatelet
therapies was adopted in another patient. These two were both finally
recovered, and three-month, six-month, and one-year follow-up
echocardiography revealed no abnormality. <br/>Conclusion(s): ICT is
uncommon in pediatric population after the surgery for congenital heart
disease. Single ventricle palliation, heart transplantation, longer
central line use, post-extracorporeal membrane oxygenation, and massive
blood product use are major risk factors for postcardiotomy thrombosis.
The causes of postoperative ICT are multifactorial, and the immaturity of
thrombolytic and fibrinolytic system in neonates may serve as a
prothrombotic factor. However, no consensus reached regarding as the
therapies for postoperative ICT, and the large-scale prospective cohort
study or randomized clinical trial is needed.<br/>Copyright &#xa9; 2023,
The Author(s).

<19>
Accession Number
613084042
Title
Arterial limb microemboli during cardiopulmonary bypass: Observations from
a congenital cardiac surgery practice.
Source
Journal of Extra-Corporeal Technology. 48(1) (pp 5-10), 2016. Date of
Publication: 2016.
Author
Matte G.S.; Connor K.R.; Liu H.; DiNardo J.A.; Faraoni D.; Pigula F.
Institution
(Matte, Connor, Liu) Department of Cardiac Surgery, Boston Children's
Hospital, Boston, MA, United States
(DiNardo, Faraoni) Department of Anesthesiology, Perioperative and Pain
Medicine, Harvard Medical School, Boston, MA, United States
(Pigula) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
Publisher
American Society of Extra-Corporeal Technology
Abstract
Gaseous microemboli (GME) are known to be delivered to the arterial
circulation of patients during cardiopulmonary bypass (CPB). An increased
number ofGME delivered during adult CPB has been associated with brain
injury and postoperative cognitive dysfunction. The GME load in children
exposed to CPB and its consequences are not well characterized. We sought
to establish a baseline of arterial limb emboli counts during the conduct
of CPB for our population of patients requiring surgery for congenital
heart disease. We used the emboli detection and counting (EDAC) device to
measure GME activity in 103 consecutive patients for which an EDAC machine
was available. Emboli counts for GME < 40 mu and > 40 mu were quantified
and indexed to CPB time (minutes) and body surface area (BSA) to account
for the variation in patient size and CPB times. Patients of all sizes had
a similar embolic burden when indexed to bypass time and BSA. Furthermore,
patients of all sizes saw a three-fold increase in the < 40 mu embolic
burden and a five-fold increase in the > 40 mu embolic burden when regular
air was noted in the venous line. The use of kinetic venous-assisted
drainage did not significantly increase arterial limb GME. Efforts for
early identification and mitigation of venous line air are warranted to
minimize GME transmission to congenital cardiac surgery patients during
CPB.

<20>
Accession Number
611048906
Title
Comparison of warm blood cardioplegia delivery with or without the use of
a roller pump.
Source
Journal of Extra-Corporeal Technology. 47(4) (pp 209-216), 2015. Date of
Publication: 2015.
Author
Faber M.M.; Noordzij P.G.; Hennink S.; Kelder H.; De Vroege R.; Waanders
F.G.; Daeter E.; Stehouwer M.C.
Institution
(Faber, Waanders, Stehouwer) Department of Extracorporeal Circulation, St.
Antonius Hospital, Nieuwegein, Netherlands
(Noordzij, Hennink) Department of Anaesthesiology, Intensive Care and Pain
Management, St. Antonius Hospital, Nieuwegein, Netherlands
(Kelder) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(De Vroege) Department of Extracorporeal Circulation, Haga Hospital, The
Hague, Netherlands
(Daeter) Department of Cardiothoracic Surgery, St. Antonius Hospital,
Nieuwegein, Netherlands
Publisher
American Society of Extra-Corporeal Technology
Abstract
Various techniques for administration of blood cardioplegia are used
worldwide. In this study, the effect of warm blood cardioplegia
administration with or without the use of a roller pump on perioperative
myocardial injury was studied in patients undergoing coronary artery
bypass grafting using minimal extracorporeal circuits (MECCs). Sixty-eight
patients undergoing elective coronary bypass surgery with an MECC system
were consecutively enrolled and randomized into a pumpless group (PL
group: blood cardioplegia administration without roller pump) or roller
pump group (RP group: blood cardioplegia administration with roller pump).
No statistically significant differences were found between the PL group
and RP group regarding release of cardiac biomarkers. Maximum
postoperative biomarker values reached at T1 (after arrival intensive care
unit) for hearttype fatty acid binding protein (2.7 [1.5; 6.0] ng/mL PL
group vs. 3.2 [1.6; 6.3] ng/mL RP group, p = .63) and at T3 (first
postoperative day) for troponin T high-sensitive (22.0 [14.5; 29.3] ng/L
PL group vs. 21.1 [15.3; 31.6] ng/L RP group, p = .91), N-terminal
probrain natriuretic peptide (2.1 [1.7; 2.9] ng/mL PL group vs. 2.6 [1.6;
3.6] ng/mL RP group, p = .48), and C-reactive protein (138 [106; 175]
mug/mL PL group vs. 129 [105; 161] mug/mL RP group, p = .65). Besides
this, blood cardioplegia flow, blood cardioplegia line pressure, and
aortic root pressure during blood cardioplegia administration were similar
between the two groups. Administration of warm blood cardioplegia with or
without the use of a roller pump results in similar clinically acceptable
myocardial protection.

<21>
Accession Number
601050581
Title
Influence of two colloidal extracorporeal primes on coagulation of cardiac
surgical patients: A prospectively randomized open-label pilot trial.
Source
Journal of Extra-Corporeal Technology. 46(4) (pp 293-299), 2014. Date of
Publication: 2014.
Author
Bethlehem I.; Wierda K.; Visser C.; Jekel L.; Koopmans M.; Kuiper M.A.
Institution
(Bethlehem, Wierda, Visser) Department of Extracorporeal Circulation,
Medical Centre Leeuwarden, Leeuwarden, Netherlands
(Jekel) Department of Cardiothoracic Surgery, Medical Centre Leeuwarden,
Leeuwarden, Netherlands
(Koopmans, Kuiper) Department of Intensive Care, Medical Centre
Leeuwarden, Leeuwarden, Netherlands
Publisher
American Society of Extra-Corporeal Technology
Abstract
The search for the ideal priming fluid continues as more evidence is
discovered about side effects of volume expanders.With the availability
ofmodern, balanced hydroxyethyl starch (HES) solutions with less side
effects than former HES solutions, we considered to replace our gelatin-
(modified gelatin) based extracorporeal circuit prime for a HES (130/.42)
prime. Therefore, we studied the influence of two colloidal priming fluids
on postoperative coagulation in patients undergoing cardiac surgery. The
primary endpoint was to compare clot formation time between the HES group
and the gelatin group with rotational thromboelastometry (ROTEM).
Additionally we compared colloid osmotic pressure and fluid balance of
both groups. Forty patients, undergoing elective first time coronary
artery bypass grafting or single-valve surgery, were included in this
prospectively randomized open-label pilot study. Laboratory data and ROTEM
data were collected and analyzed for differences between the two groups.
ROTEM data show significantly more prolongation in Extem clot formation
time and significant more decrease in Extem alpha in the HES group. Fibtem
maximum clot firmness was significantly smaller in the HES group; this was
consistent with fibrinogen concentration measurement, which decreased more
in the HES group than in the gelatin group and recovered more over time in
the gelatin group. We found no significant difference in colloid osmotic
pressure between the groups. In this trial, HES (130/.42) impairs
coagulation significantly more compared with gelatin. These differences in
influence on coagulation did not lead to a difference in blood loss or
fluid balance, so clinical relevance could not be proven.

<22>
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). <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2023 Saudi Arabian
Armed Forces Hospital. All rights reserved.

<23>
[Use Link to view the full text]
Accession Number
2024722436
Title
Effect of Imaging Selection Paradigms on Endovascular Thrombectomy
Outcomes in Patients With Acute Ischemic Stroke.
Source
Stroke. 54(6) (pp 1569-1577), 2023. Date of Publication: 01 Jun 2023.
Author
Miao J.; Sang H.; Li F.; Saver J.L.; Lei B.; Li J.; Nogueira R.G.; Song
B.; Nguyen T.N.; Jin Z.; Zeng H.; Wen C.; Yuan G.; Kong W.; Luo W.; Liu
S.; Xie D.; Huang J.; Liu C.; Yang J.; Hu J.; Song J.; Yue C.; Li L.; Tian
Y.; Zhang X.; Feng D.; Gao Y.; Fu H.; Zi W.; Yang Q.; Qiu Z.; Wang S.
Institution
(Miao, Song, Feng, Gao, Fu, Wang) Neurology, Xianyang Hospital of Yan'an
University, China
(Miao, Li, Kong, Xie, Huang, Yang, Hu, Song, Yue, Li, Tian, Zi, Yang)
Neurology, Xinqiao Hospital, The Second Affiliated Hospital, Army Medical
University, Chongqing, China
(Sang) Neurology, Affiliated Hangzhou First People's Hospital, Zhejiang
University School of Medicine, China
(Saver) Neurology, David Geffen School of Medicine, UCLA, United States
(Lei) Cerebrovascular Diseases, Leshan People's Hospital, China
(Li) Neurology, Affiliated Hospital of Southwest Medical University,
Luzhou, China
(Nogueira) UPMC Stroke Institute, University of Pittsburgh, School of
Medicine, China
(Liu, Liu) Neurology, Yongchuan Hospital of Chongqing Medical University,
Chongqing Key Laboratory of Cerebrovascular Disease Research, China
(Nguyen) Neurology, Boston Medical Center, Jiangmen, China
(Jin) Neurology, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen,
China
(Zeng) Neurology, Ganzhou People's Hospital, China
(Wen) Neurology, Nanyang Central Hospital, China
(Yuan) Emergency, Xiangtan Central Hospital, China
(Luo) Neurology, The General Hospital of Tibet Military Area Command,
Lhasa, China
(Liu) Neurology, The Second Affiliated Hospital of Chongqing Medical
University, China
(Zhang) Neurology, The Affiliated Hospital of Northwest University Xi'an
No.3 Hospital, China
(Qiu) Neurology, The 903rd Hospital of The People's Liberation Army,
Hangzhou, China
Publisher
Wolters Kluwer Health
Abstract
Background: The effect of imaging selection paradigms on endovascular
thrombectomy outcomes in patients with acute ischemic stroke with large
vessel occlusion remains uncertain. The study aimed to assess the effect
of basic imaging (noncontrast computed tomography with or without computed
tomographic angiography) versus advanced imaging (magnetic resonance
imaging or computed tomography perfusion) on clinical outcomes following
thrombectomy in patients with stroke with large vessel occlusion in the
early and extended windows using a pooled analysis of patient-level data
from 2 pivotal randomized clinical trials done in China. <br/>Method(s):
This post hoc analysis used data from 1182 patients included in 2
multicenter, randomized controlled trials in China that evaluated adjunct
therapies to endovascular treatment for acute ischemic stroke (Direct
Endovascular Treatment for Large Artery Anterior Circulation Stroke
performed from May 20, 2018, through May 2, 2020, and Intravenous
Tirofiban Before Endovascular Treatment in Stroke from October 10, 2018,
through October 31, 2021). Patients with occlusion of the intracranial
internal carotid artery or proximal middle cerebral artery (M1/M2
segments) were categorized according to baseline imaging modality (basic
versus advanced) as well as treatment time window (early, 0-6 hours versus
extended, 6-24 hours from last known well to puncture). The primary
outcome was the proportion of patients with functional independence
(modified Rankin Scale score of 0-2) at 90 days. Multivariable Poisson
regression analysis was performed to determine the association between
imaging selection modality and outcomes after endovascular treatment at
each time windows. <br/>Result(s): A total of 1182 patients were included
in this cohort analysis, with 648 in the early (471 with basic imaging
versus 177 advanced imaging) and 534 in the extended (222 basic imaging
versus 312 advanced imaging) time window. There were no differences in
90-day functional independence between the advanced and basic imaging
groups in either time windows (early window: adjusted relative risk, 0.99
[95% CI, 0.84-1.16]; P=0.91; extended window: adjusted relative risk, 1.00
[95% CI, 0.84-1.20]; P=0.97). <br/>Conclusion(s): In this post hoc
analysis of 2 randomized clinical trial pooled data involving patients
with large vessel occlusion stroke, an association between imaging
selection modality and clinical or safety outcomes for patients undergoing
thrombectomy in either the early or extended windows was not detected. Our
study adds to the growing body of literature on simpler imaging paradigms
to assess thrombectomy eligibility across both the early and extended time
windows.<br/>Copyright &#xa9; 2023 American Heart Association, Inc.

<24>
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.<br/>Copyright &#xa9; 2023
BMJ Publishing Group. All rights reserved.

<25>
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.
<br/>Objective(s): This meta-analysis aimed to evaluate the analgesic
efficacy and adverse effects of ICB and EPI for pain treatment after
thoracotomy. <br/>Study Design: Systematic review. <br/>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. <br/>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.
<br/>Limitation(s): The number of included studies was small, and the
quality of evidence was low. <br/>Conclusion(s): ICB may be as effective
as EPI for pain relief after thoracotomy.<br/>Copyright &#xa9; 2023,
American Society of Interventional Pain Physicians. All rights reserved.

<26>
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.
<br/>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).
<br/>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.<br/>Copyright &#xa9; 2023, The Author(s).

<27>
Accession Number
2022779829
Title
Transcatheter Aortic Valve Replacement for Aortic Valve Infective
Endocarditis: A Systematic Review and Call for Action.
Source
Cardiology and Therapy. 12(2) (pp 297-306), 2023. Date of Publication:
June 2023.
Author
Brankovic M.; Hashemi A.; Ansari J.; Sharma A.
Institution
(Brankovic, Hashemi) Department of Medicine, Rutgers New Jersey Medical
School, Newark, NJ, United States
(Brankovic) Transatlantic Cardiovascular Study Group, Bloomfield, NJ,
United States
(Ansari) Department of Cardiology, Newark Beth Israel Medical Center,
Newark, NJ, United States
(Sharma) Division of Cardiology, Department of Medicine, New Jersey
Medical School, Newark, NJ, United States
Publisher
Adis
Abstract
We aimed to systematically analyze the literature on the use of
transcatheter aortic valve replacement (TAVR) to treat active aortic valve
infective endocarditis (AV-IE). Surgery is declined in one-third of
patients with IE who meet indications because of prohibitive surgical
risk. TAVR might be an alternative for selected patients with AV-IE as a
bridge-to-surgery or stand-alone therapy. PubMed/MEDLINE, Embase, and
Cochrane databases were searched (2002-2022) for studies on TAVR use in
active AV-IE. Of 450 identified reports, six met inclusion criteria (all
men, mean age 71 +/- 12 years, median Society of Thoracic Surgeons (STS)
score 27, EuroSCORE 56). All patients were prohibitive surgical risk
candidates. Five out of six patients had severe, and one patient had
moderate aortic regurgitation on presentation. Five out of six patients
had prosthetic valve endocarditis after surgical valve replacement 13
years before (median), and one patient had TAVR a year before
hospitalization. All patients had cardiogenic shock as the indication for
TAVR. Four patients received balloon-expanding, and two patients received
self-expanding TAVR after a median of 19 (IQR 9-25) days from diagnosis of
IE. No death or myocardial infarction occurred, but one patient had a
stroke within the first 30 days. The median event-free time was 9 (IQR
6-14) months including no death, reinfection, relapse IE, or valve-related
rehospitalization. Our review suggests that TAVR can be considered as an
adjuvant therapy to medical treatment for selected patients in whom
surgery is indicated for treatment of acute heart failure due to aortic
valve destruction and incompetence caused by infective endocarditis, but
who have a prohibitive surgical risk. Nonetheless, a well-designed
prospective registry is urgently needed to investigate the outcomes of
TAVR for this off-label indication. No evidence exists for using the TAVR
to treat infection-related surgical indications such as uncontrolled
infection or control of septic embolization.<br/>Copyright &#xa9; 2023,
The Author(s).

<28>
Accession Number
2020725047
Title
Approaches and outcomes of Robotic-Assisted Thoracic Surgery (RATS) for
lung cancer: a narrative review.
Source
Journal of Robotic Surgery. 17(3) (pp 797-809), 2023. Date of Publication:
June 2023.
Author
Mattioni G.; Palleschi A.; Mendogni P.; Tosi D.
Institution
(Mattioni, Palleschi, Mendogni, Tosi) Thoracic Surgery and Lung
Transplantation Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore
Policlinico, Milan 20122, Italy
(Mattioni) School of Thoracic Surgery, University of Milan, Milan 20122,
Italy
Publisher
Springer Nature
Abstract
Robotic-Assisted Thoracic Surgery (RATS) is considered one of the main
issues of present thoracic surgery. RATS is a minimally invasive surgical
technique allowing enhanced view, accurate and complex movements, and high
ergonomics for the surgeon. Despite these advantages, its application in
lung procedures has been limited, mainly by its costs. Since now many
different approaches have been proposed and the experience in RATS for
lungs ranges from wedge resection to pneumonectomy and is mainly related
to lung cancer. The present narrative review explores main approaches and
outcomes of RATS lobectomy for lung cancer. A non-systematic review of
literature was conducted using the PubMed search engine. An overview of
lung robotic surgery is given, and main approaches of robotic lobectomy
for lung cancer are exposed. Initial experiences of biportal and uniportal
RATS are also described. So far, retrospective analysis reported
satisfactory robotic operative outcomes, and comparison with VATS might
suggest a more accurate lymphadenectomy. Some Authors might even suggest
better perioperative outcomes too. From an oncological standpoint, no
definitive prospective study has yet been published but several
retrospective analyses report oncological outcomes comparable to those of
VATS and open surgery. Literature suggests that RATS for lung procedures
is safe and effective and should be considered as a valid additional
surgical option.<br/>Copyright &#xa9; 2022, The Author(s).

<29>
Accession Number
2023530211
Title
Effect of periprocedural furosemide-induced diuresis with matched isotonic
intravenous hydration in patients with chronic kidney disease undergoing
transcatheter aortic valve implantation.
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Voigtlander-Buschmann L.; Schafer S.; Schmidt-Lauber C.; Weimann J.;
Shenas M.; Giraldo Cortes J.; Kuta P.M.; Zeller T.; Twerenbold R.;
Seiffert M.; Schofer N.; Schneeberger Y.; Schafer A.; Schirmer J.;
Reichenspurner H.; Blankenberg S.; Conradi L.; Schafer U.
Institution
(Voigtlander-Buschmann, Schafer, Weimann, Shenas, Giraldo Cortes, Zeller,
Twerenbold, Seiffert, Schofer, Blankenberg) Department of Cardiology,
University Heart and Vascular Center Hamburg, Hamburg, Germany
(Schmidt-Lauber) III. Department of Medicine, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Kuta) Institute for Clinical Chemistry and Laboratory Medicine,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Schneeberger, Schafer, Schirmer, Reichenspurner, Conradi) Department of
Cardiovascular Surgery, University Heart and Vascular Center Hamburg,
Hamburg, Germany
(Schafer) Department of Cardiology, Heart and Vessel Center Bad Bevensen,
Bad Bevensen, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Acute kidney injury (AKI) after transcatheter aortic valve
implantation (TAVI) is a serious complication which is associated with
increased mortality. The RenalGuard system was developed to reduce the
risk of AKI after contrast media exposition by furosemide-induced diuresis
with matched isotonic intravenous hydration. The aim of this study was to
examine the effect of the RenalGuard system on the occurrence of AKI after
TAVI in patients with chronic kidney disease. <br/>Method(s): The present
study is a single-center randomized trial including patients with severe
aortic valve stenosis undergoing TAVI. Overall, a total of 100 patients
treated by TAVI between January 2017 and August 2018 were randomly
assigned to a periprocedural treatment with the RenalGuard system or
standard treatment by pre- and postprocedural intravenous hydration.
Primary endpoint was the occurrence of AKI after TAVI, and secondary
endpoints were assessed according to valve academic research consortium 2
criteria. <br/>Result(s): Overall, the prevalence of AKI was 18.4% (n =
18). The majority of these patients developed mild AKI according to stage
1. Comparing RenalGuard to standard therapy, no significant differences
were observed in the occurrence of AKI (RenalGuard: 21.3%; control group:
15.7%; p = 0.651). In addition, there were no differences between the
groups with regard to 30-day and 12-month mortality and
procedure-associated complication rates. <br/>Conclusion(s): In this
randomized trial, we did not detect a reduction in AKI after TAVI by using
the RenalGuard system. A substantial number of patients with chronic
kidney disease developed AKI after TAVI, whereas the majority presented
with mild AKI according to stage 1 (ClinicalTrials.gov number
NCT04537325). Graphical abstract: [Figure not available: see
fulltext.].<br/>Copyright &#xa9; 2023, The Author(s).

<30>
Accession Number
2021874437
Title
3D liver model-based surgical education improves preoperative
decision-making and patient satisfaction-a randomized pilot trial.
Source
Surgical Endoscopy. 37(6) (pp 4545-4554), 2023. Date of Publication: June
2023.
Author
Giehl-Brown E.; Dennler S.; Garcia S.A.; Seppelt D.; Oehme F.; Schweipert
J.; Weitz J.; Riediger C.
Institution
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
Department of Visceral, Thoracic and Vascular Surgery, University Hospital
Carl Gustav Carus, Technische Universitat Dresden, Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger) German
Cancer Research Center (DKFZ), Heidelberg, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger) Faculty
of Medicine, University Hospital Carl Gustav Carus, Technische Universitat
Dresden, Dresden, Germany
(Giehl-Brown, Dennler, Garcia, Oehme, Schweipert, Weitz, Riediger)
Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
(Seppelt) Department of Radiology, University Hospital Carl Gustav Carus
Dresden, Technische Universitat Dresden, Dresden, Germany
Publisher
Springer
Abstract
Objective: Hepatobiliary surgery bares obstacles to informed consent for
the patients due to its complexity and related risk of postoperative
complications. 3D visualization of the liver has been proven to facilitate
comprehension of the spatial relationship between anatomical structures
and to assist in clinical decision-making. Our objective is to utilize
individual 3D-printed liver models to enhance patient satisfaction with
surgical education in hepatobiliary surgery. Design, setting: We conducted
a prospective, randomized pilot study comparing 3D liver model-enhanced
(3D-LiMo) surgical education against regular patient education during
preoperative consultation at the department of Visceral, Thoracic and
Vascular Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.
<br/>Participant(s): Of 97 screened patients, undergoing hepatobiliary
surgery, 40 patients were enrolled from July 2020 to January 2022.
<br/>Result(s): The study population (n = 40) was predominantly of male
gender (62.5%) with a median age of 65.2 years and a high prevalence of
preexisting diseases. Underlying disease, warranting hepatobiliary
surgery, was malignancy in the majority of cases (97.5%). Patients in the
3D-LiMo group were more likely to feel very thoroughly educated and
exhibited a higher level of satisfaction following surgical education than
the control group (80 vs. 55%, n.s.; 90 vs. 65%, n.s.; respectively).
Applying 3D models was also associated with enhanced understanding of the
underlying disease with regard to amount (100% vs. 70%, p = 0.020) and
location of liver masses (95 vs. 65%, p = 0.044). 3D-LiMo patients also
demonstrated enhanced understanding of the surgical procedure (80 vs. 55%,
n.s.), leading to better awareness for the occurrence of postoperative
complications (88.9, vs. 68.4%, p = 0.052). Adverse event profiles were
similar. <br/>Conclusion(s): In conclusion, individual 3D-printed liver
models increase patient satisfaction with surgical education and
facilitate patients' understanding of the surgical procedure as well as
awareness of postoperative complications. Therefore, the study protocol is
feasible to apply to an adequately powered, multicenter, randomized
clinical trial with minor modifications.<br/>Copyright &#xa9; 2023, The
Author(s).

<31>
Accession Number
2021632876
Title
Comparison of the LigaSureTM bipolar vessel sealer to monopolar
electrocoagulation for thoracoscopic lobectomy and lymphadenectomy: a
prospective randomized controlled trial.
Source
Surgical Endoscopy. 37(6) (pp 4449-4457), 2023. Date of Publication: June
2023.
Author
Gabryel P.; Kasprzyk M.; Roszak M.; Campisi A.; Smolinski S.; Zielinski
P.; Piwkowski C.
Institution
(Gabryel, Kasprzyk, Smolinski, Zielinski, Piwkowski) Department of
Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego
62 Street, Poznan 60-569, Poland
(Roszak) Department of Computer Science and Statistics, Poznan University
of Medical Sciences, Poznan, Poland
(Campisi) Department of Thoracic Surgery, University and Hospital
Trust-Ospedale Borgo Trento, Verona, Italy
Publisher
Springer
Abstract
Background: High-energy devices allow better vessel sealing compared with
monopolar electrocautery and could improve the outcomes of surgical
operations. The objective of the study was to compare tissue dissection by
the LigaSureTM device with that by monopolar electrocoagulation for
thoracoscopic lobectomy and lymphadenectomy. <br/>Method(s): This
pragmatic, parallel group, prospective randomized controlled trial was
funded by the Medtronic External Research Program (ISR-2016-10,756) and
registered at www.clinicaltrials.gov (NCT03125798). The study included
patients aged 18 years or older, who had undergone thoracoscopic lobectomy
with lymphadenectomy at the Department of Thoracic Surgery of Poznan
University of Medical Sciences between May 3, 2018, and November 4, 2021.
Using simple randomization, the patients were assigned to undergo tissue
dissection with either the LigaSure device (study group) or monopolar
electrocautery (control group). Participants and care givers, except
operating surgeons, were blinded to group assignment. The primary outcome
was postoperative chest drainage volume. Secondary outcomes were change of
the esophageal temperature during subcarinal lymphadenectomy and
C-reactive protein level 72 h after surgery. <br/>Result(s): Study
outcomes were analyzed in 107 patients in each group. We found no
differences between the study and control groups in terms of chest
drainage volume (550 vs. 600 mL, respectively; p = 0.315), changes in
esophageal temperature (- 0.1 degreeC vs. - 0.1 degreeC, respectively; p =
0.784), and C-reactive protein levels (72.8 vs. 70.8 mg/L, respectively; p
= 0.503). The mean numbers of lymph nodes removed were 12.9 (SD: 3.1; 95%
CI, 12.4 to 13.5) in the study group and 11.6 (SD: 3.2; 95% CI, 11.0 to
12.2) in the control group (p < 0.001). <br/>Conclusion(s): The use of the
LigaSure device did not allow to decrease the chest drainage volume, local
thermal spread, and systemic inflammatory response. The number of lymph
nodes removed was higher in patients operated with the LigaSure device,
which indicated better quality of lymphadenectomy.<br/>Copyright &#xa9;
2023, The Author(s).

<32>
Accession Number
641464556
Title
Ultrasonic bone curette in thoracic spinal decompression: a comprehensive
systematic review and meta-analysis.
Source
European review for medical and pharmacological sciences. 27(10) (pp
4450-4461), 2023. Date of Publication: 01 May 2023.
Author
Chen F.-Y.; Wei X.-D.; Yang X.-P.; Yu C.-Q.; Huang S.-Q.; Ou J.-X.; Mu
X.-P.; Wei J.-X.
Institution
(Chen) Department of Spine Surgery, People's Hospital of Guangxi Zhuang
Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of this study was to compare the efficacy and safety of
ultrasonic bone curette (UBC) and conventional surgical instruments in
thoracic laminectomy decompression (TLD) for the treatment of thoracic
spinal stenosis (TSS) by meta-analysis. MATERIALS AND METHODS: Two authors
independently searched Medline via PubMed, Embase, Cochrane Library, Web
of Science, Wanfang Database, and China National Knowledge Infrastructure
for the period from the establishment of the database until January 2023
to identify the studies on the safety and efficacy of UBC vs. conventional
instruments for TSS. Data extraction and quality assessment were performed
by two researchers independently. We used RevMan 5.4 software (Review
Manager Web, The Cochrane Collaboration, Copenhagen, Denmark) to analyze
the data. <br/>RESULT(S): Eight retrospective studies were included in the
present work. This meta-analysis revealed that no significant differences
in the preoperative JOA scores, the JOA scores at the last follow-up, the
improvement rate of JOA scores, and the incidence of cerebrospinal fluid
leakage/dura injury were detected between the two groups (p>0.05).
However, there were significant differences in the operative time and
intraoperative blood loss during single-level TLD [operative time:
MD=-1.47, 95% CI (-1.86, -1.09), p<0.001; intraoperative blood loss:
MD=-46.62, 95% CI (-53.83, -39.40), p<0.001], total operative time
[MD=-56.88, 95% CI (-69.66, -44.10), p<0.001], total intraoperative blood
loss [MD=-143.52, 95% CI (-212.49, -74.54), p<0.001], the incidence of
neurological deterioration/nerve root injury [RR= 0.29, 95% CI (0.09,
0.91), p=0.03] between the groups. <br/>CONCLUSION(S): The application of
UBC in TLD to treat TSS is safe and effective. UBC can significantly
shorten operation time and reduce intraoperative blood loss compared to
traditional surgical instruments. Moreover, it has the advantage of
reducing perioperative nerve injury.

<33>
Accession Number
640509736
Title
Five-Year Follow-up after Transcatheter Repair of Secondary Mitral
Regurgitation.
Source
The New England journal of medicine. 388(22) (pp 2037-2048), 2023. Date of
Publication: 01 Jun 2023.
Author
Stone G.W.; Abraham W.T.; Lindenfeld J.; Kar S.; Grayburn P.A.; Lim D.S.;
Mishell J.M.; Whisenant B.; Rinaldi M.; Kapadia S.R.; Rajagopal V.;
Sarembock I.J.; Brieke A.; Marx S.O.; Cohen D.J.; Asch F.M.; Mack M.J.
Institution
(Stone, Abraham, Lindenfeld, Kar, Grayburn, Lim, Mishell, Whisenant,
Rinaldi, Kapadia, Rajagopal, Sarembock, Brieke, Marx, Cohen, Asch, Mack)
From the Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai (G.W.S.), Columbia University Medical Center
(S.O.M.), and the Cardiovascular Research Foundation (D.J.C.), New York,
and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New
York; the Departments of Medicine, Physiology, and Cell Biology, Division
of Cardiovascular Medicine, and the Davis Heart and Lung Research
Institute, Ohio State University, Columbus (W.T.A.), the Department of
Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic,
Cleveland (S.R.K.), and Lindner Clinical Research Center and the Christ
Hospital, Cincinnati (I.J.S.); Advanced Heart Failure, Vanderbilt Heart
and Vascular Institute, Nashville (J.A.L.); the Division of Cardiology,
HCA Healthcare, Los Angeles (S.K.), and Kaiser Permanente-San Francisco
Hospital, San Francisco (J.M.M.); Baylor University Medical Center, Baylor
Heart and Vascular Institute, Dallas (P.A.G.), and Baylor Scott and White
Heart Hospital Plano, Plano (M.J.M.) - both in Texas; the Division of
Cardiology, University of Virginia, Charlottesville (D.S.L.);
Intermountain Medical Center, Murray, UT (B.W.); Carolinas Medical Center,
Charlotte, NC (M.R.); Piedmont Hospital, Atlanta (V.R.); University of
Colorado Hospital, Aurora (A.B.); and MedStar Health Research Institute,
Hyattsville, MD (F.M.A.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Data from a 5-year follow-up of outcomes after transcatheter
edge-to-edge repair of severe mitral regurgitation, as compared with
outcomes after maximal doses of guideline-directed medical therapy alone,
in patients with heart failure are now available. <br/>METHOD(S): We
randomly assigned patients with heart failure and moderate-to-severe or
severe secondary mitral regurgitation who remained symptomatic despite the
use of maximal doses of guideline-directed medical therapy to undergo
transcatheter edge-to-edge repair plus receive medical therapy (device
group) or to receive medical therapy alone (control group) at 78 sites in
the United States and Canada. The primary effectiveness end point was all
hospitalizations for heart failure through 2 years of follow-up. The
annualized rate of all hospitalizations for heart failure, all-cause
mortality, the risk of death or hospitalization for heart failure, and
safety, among other outcomes, were assessed through 5 years.
<br/>RESULT(S): Of the 614 patients enrolled in the trial, 302 were
assigned to the device group and 312 to the control group. The annualized
rate of hospitalization for heart failure through 5 years was 33.1% per
year in the device group and 57.2% per year in the control group (hazard
ratio, 0.53; 95% confidence interval [CI], 0.41 to 0.68). All-cause
mortality through 5 years was 57.3% in the device group and 67.2% in the
control group (hazard ratio, 0.72; 95% CI, 0.58 to 0.89). Death or
hospitalization for heart failure within 5 years occurred in 73.6% of the
patients in the device group and in 91.5% of those in the control group
(hazard ratio, 0.53; 95% CI, 0.44 to 0.64). Device-specific safety events
within 5 years occurred in 4 of 293 treated patients (1.4%), with all the
events occurring within 30 days after the procedure. <br/>CONCLUSION(S):
Among patients with heart failure and moderate-to-severe or severe
secondary mitral regurgitation who remained symptomatic despite
guideline-directed medical therapy, transcatheter edge-to-edge repair of
the mitral valve was safe and led to a lower rate of hospitalization for
heart failure and lower all-cause mortality through 5 years of follow-up
than medical therapy alone. (Funded by Abbott; COAPT ClinicalTrials.gov
number, NCT01626079.).<br/>Copyright &#xa9; 2023 Massachusetts Medical
Society.

<34>
Accession Number
613864913
Title
Blood conservation-a team sport.
Source
Journal of Extra-Corporeal Technology. 48(3) (pp 99-104), 2016. Date of
Publication: 2016.
Author
Likosky D.S.; Dickinson T.A.; Paugh T.A.
Institution
(Likosky, Paugh) Section of Health Services Research and Quality,
Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI,
United States
(Dickinson) Specialty Care, Nashville, Tennessee for the Michigan Society
of Thoracic and Cardiovascular Surgeons, Perfusion Measures and Outcomes
(PERForm) Registry, United States
Publisher
American Society of Extra-Corporeal Technology
Abstract
Cardiac surgery accounts for between 15% and 20% of all blood product
utilization in the United States. A body of literature suggests that
patients who are exposed to even small quantities of blood have an
increased risk of morbidity and mortality, even after adjusting for
pre-operative risk. Despite this body of literature supporting a
restrictive blood management strategy, wide variability in transfusion
rates exist across institutions. Recent blood management guidelines have
shed light on a number of potentially promising blood management
strategies, including acute normovolemic hemodilution (ANH) and retrograde
autologous priming (RAP).We evaluated the literature concerning ANH and
RAP, and the use of both techniques among centers participating in the
Perfusion Measures and outcomes (PERForm) registry. We leveraged data
concerning ANH and RAP among 10,203 patients undergoing isolated coronary
artery bypass grafting (CABG) procedures from 2010 to 2014 at 27 medical
centers. Meta-analyses have focused on the topic of ANH, with few studies
focusing specifically on cardiac surgery. Two meta-analyses have been
conducted to date on RAP, with many reporting higher intra-operative
hematocrits and reduced transfusions. The rate of red blood cell
transfusions in the setting of CABG surgery is 34.2%, although varied
across institutions from 16.8% to 57.6%. Overall use of ANH was 11.6%,
although the utilization varied from .0% to 75.7% across institutions. RAP
use was 71.4%, although varied from .0% to 99.0% across institutions. A
number of blood conservation strategies have been proposed, with varying
levels of evidence from meta-analyses. This uncertainty has likely
contributed to center-level differences in the utilization of these
practices as evidenced by our multi-institutional database. Perfusion
databases, including the PERForm registry, serve as a vehicle for
perfusionist's to track their practice, and contribute to
multidisciplinary team efforts aimed at assessing and improving the value
of cardiac surgical care.

<35>
Accession Number
2023500445
Title
Efficacy of CytoSorb: a systematic review and meta-analysis.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 215. Date of
Publication: December 2023.
Author
Becker S.; Lang H.; Vollmer Barbosa C.; Tian Z.; Melk A.; Schmidt B.M.W.
Institution
(Becker, Lang, Vollmer Barbosa, Tian, Schmidt) Department of Nephrology
and Hypertension, Hannover Medical School, Carl-Neuberg-Strase 1, Hannover
30625, Germany
(Melk) Department of Pediatric Kidney, Liver and Metabolic Diseases,
Hannover Medical School, Hannover, Germany
Publisher
BioMed Central Ltd
Abstract
Introduction: Cytokine adsorption using the CytoSorb adsorber has been
proposed in various clinical settings including sepsis, ARDS,
hyperinflammatory syndromes, cardiac surgery or recovery after cardiac
arrest. The aim of this analysis is to provide evidence for the efficacy
of the CytoSorb adsorber with regard to mortality in various settings.
<br/>Method(s): We searched PubMed, Cochrane Library database and the
database provided by CytosorbentsTM (01.1.2010-29.5.2022). We considered
randomized controlled trials and observational studies with control
groups. The longest reported mortality was defined as the primary
endpoint. We computed risk ratios and 95%-confidence intervals and used
DerSimonian and Lairds random effects model. We analysed all studies
combined and divided them into the subgroups: sepsis, cardiopulmonary
bypass surgery (CPB), other severe illness, SARS-CoV-2 infection and
recovery from cardiac arrest. The meta-analysis was registered in advance
(PROSPERO: CRD42022290334). <br/>Result(s): Of an initial 1295
publications, 34 studies were found eligible, including 1297 patients
treated with CytoSorb and 1314 controls. Cytosorb intervention did not
lower mortality (RR [95%-CI]: all studies 1.07 [0.88; 1.31], sepsis 0.98
[0.74; 1.31], CPB surgery 0.91 [0.64; 1.29], severe illness 0.95 [0.59;
1.55], SARS-CoV-2 1.58 [0.50; 4.94]). In patients with cardiac arrest, we
found a significant survival advantage of the untreated controls (1.22
[1.02; 1.46]). We did not find significant differences in ICU length of
stay, lactate levels, or IL-6 levels after treatment. Of the eligible 34
studies only 12 were randomized controlled trials. All observational
studies showed moderate to serious risk of bias. <br/>Interpretation(s):
To date, there is no evidence for a positive effect of the CytoSorb
adsorber on mortality across a variety of diagnoses that justifies its
widespread use in intensive care medicine.<br/>Copyright &#xa9; 2023, The
Author(s).

<36>
Accession Number
2024869013
Title
Effect of Shorter Cross Clamp Time vs. longer Cross Clamp time on cardiac
enzyme levels in patients of CAD undergoing CABG.
Source
Pakistan Journal of Medical and Health Sciences. 17(4) (pp 159-162), 2023.
Date of Publication: April 2023.
Author
Mahmood S.R.; Arif A.; Jabeen S.; Hafeez H.; Ihsan A.R.; Yunus A.
Institution
(Mahmood, Hafeez) Punjab Institute Of Cardiology Lahore, Pakistan
(Arif, Jabeen, Ihsan, Yunus) Shalamar Hospital, Lahore, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Aim: To compare mean cardiac enzyme levels in of shorter cross clamp time
V/S longer cross Clamp time in patients undergoing CABG in local
population. <br/>Study Design: Randomized Controlled Trial Place and
duration: This study was performed from 2^nd April 2020 to
2^nd October 2020 in the Department of Cardiac Surgery Punjab
Institute of Cardiology, Lahore. Methodology: After informed consent, all
patients undergoing CABG were enrolled and divided into two groups. A
predesigned performa was used to enter preop, intra op and post op
variables and cardiac enzyme levels were compared between shorter (<60
minutes) and longer (>60 minutes) aortic cross clamp time groups.
<br/>Result(s): Study had enrolled 300 patients and 150(50%) patients were
designated group A (shorter cross clamp time and 150 (50%) patients were
designated in group B (longer cross clamp time). Out of these 300, 246
patients (82%) were males and 54 (18%) were females. Extremes of age were
70 years and 37 years and mean age was 56.77+/-8.03 years. Group A
(shorter cross clamp time) patients had mean age of 56.64 +/-7.53 and
group B (longer cross clamp time) patients had 56.89+/-8.52 .Mean EF (%)
was 52.17+/-8.98 with 23% being minimum and 70% being maximum. In group A
patients, 93 patients (62%) were hypertensive, 82(55%) were smokers and 67
(45%) patients were diabetic, while group B had 110 (73%) hypertensive,
84(56%) smokers and 73(49%) diabetic patients. Mean CPB time in group A
was recorded to be 93.72+/-29.97 and mean CPB time in group B was
121.04+/-31.83. The P-value was 0.001, significant enough to represent
difference in CPG time in both groups Practical Implication: Additionally,
no notable difference was found in need of inotropic supports between two
groups. Longer cross clamp time is also associated with longer CPB time
which in turn correlates with higher morbidity and mortality.
<br/>Conclusion(s): It is concluded that prolonged cross clamp time is an
independent predictor of morbidity despite cardio protection by modern
strategies<br/>Copyright &#xa9; 2023 Lahore Medical And Dental College.
All rights reserved.

<37>
Accession Number
2024869012
Title
Correlation of Post-Operative Outcomes in patients undergoing CABG
Receiving Antegradecardioplegia alone Versus Combined Antegrade Plus
Retrograde Cardioplegia: A Prospective Review.
Source
Pakistan Journal of Medical and Health Sciences. 17(4) (pp 156-158), 2023.
Date of Publication: April 2023.
Author
Jabeen S.; Arif A.; Bukhari S.R.; Umair M.; Akbar S.; Yunus A.
Institution
(Jabeen, Bukhari) Registrar Cardiovascular Surgery Department, Shalamar
Hospital, Lahore, Pakistan
(Arif) Senior Registrar Cardiovascular surgery department, Shalamar
Hospital, Lahore, Pakistan
(Umair, Akbar) Registrar Cardiac Surgery department, Punjab Institute of
Cardiology, Lahore, Pakistan
(Yunus) Cardiovascular Surgery Department, Shalamar Hospital, Lahore,
Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Aim: To compare the mean ejection fraction and cardiac enzymes level in
patients with Ischemic heart disease undergoing elective coronary artery
bypass graft surgery (CABG) having antegrade blood cardioplegia versus
antegrade plus retrograde Cardioplegia. Study design: Randomized
Controlled Trial Place and duration: This study was performed from 7th
February, 2020 to 7th August, 2020 at the Cardiac Surgery Department, PIC,
Jail Road, Lahore. Methodology: After receiving informed consent, all
patients undergoing CABG were enrolled in this study. In order to compare
the mean ejection fraction and cardiac enzyme levels between patients who
had antegrade blood cardioplegia and those who had antegrade plus
retrograde cardioplegia, preoperative, intraoperative, and postoperative
characteristics were recorded into the predesigned proforma.
<br/>Result(s): The total number of patients 72 was enrolled in this study
who were divided into two groups. There were 36(50%) patients of who have
given Cardioplegia through antegrade route while CABG and 36(50%) patients
who have given Cardioplegia through antegrade plus retrograde route while
CABG in this study. According to Table 1, the mean age of the patients in
Group A was 51.86+/-9.35 years, whereas the mean ages of the participants
in Group B 52.92+/-7.70 years. There were 26(72%) male and 10(28%) females
in Group A and 30(83%) male and 6(17%) females in Group B. The mean BMI in
Group A was 25.65+/-5.18 and 25.02+/-3.97 in Group B. There were 35(97%)
hypertensive and 1(3%) non hypertensive patients in Group A and B
respectively. Similarly, there were 33(92%) diabetic and 3(8%) non
diabetic patients in Group A and 28 (78%) diabetic and 8(22%) non diabetic
patients were in Group B. There were 26(72%) smokers and 10(28%) non-
smokers in Group A and 24 (67%) smokers and 12(33%) non-smokers in this
Group B. Practical Implication: The comparison of CKMB(IU/L) levels in
Antegrade route group and antegrade plus retrograde group baseline and
after 48 hours shows insignificant p-values of 0.17 and 0.12 respectively
which shows that there is no significant difference in CKMB levels
regarding these two routes chosen for giving Cardioplegia to patients
undergoing coronary artery bypass grafting. <br/>Conclusion(s): Although
both required additional surgical manoeuvres, however, the antegrade and
antegrade plus retrograde cardioplegia approaches were equally effective
and safe. Prior research demonstrated that multiple infusions offer
superior protection to either antegrade or retrograde cardioplegia
alone.<br/>Copyright &#xa9; 2023 Lahore Medical And Dental College. All
rights reserved.

<38>
Accession Number
2023632247
Title
Genetic Factors Influencing Warfarin Dose in Han Chinese Population: A
Systematic Review and Meta-Analysis of Cohort Studies.
Source
Clinical Pharmacokinetics. (no pagination), 2023. Date of Publication:
2023.
Author
Zhao Z.; Zhao F.; Wang X.; Liu D.; Liu J.; Zhang Y.; Hu X.; Zhao M.; Tian
C.; Dong S.; Jin P.
Institution
(Zhao, Zhao, Zhang, Hu, Zhao, Jin) Department of Pharmacy, Beijing
Hospital; National Center of Gerontology; Institute of Geriatric Medicine,
Chinese Academy of Medical Sciences; Beijing Key Laboratory of Assessment
of Clinical Drugs Risk and Individual Application (Beijing Hospital), No.
1 Dahua Road, Dongdan, Dongcheng District, Beijing 100730, China
(Wang, Liu, Liu) Department of Cardiology, Beijing Hospital, National
Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of
Medical Sciences, Beijing 100730, China
(Tian) Department of Pharmacy, Beijing Children's Hospital, Capital
Medicine University, National Center for Children's Health, Beijing
100045, China
(Dong) Department of Pharmacy, Peking University Third Hospital, Beijing
100191, China
Publisher
Adis
Abstract
Objective: To investigate the association of single nucleotide
polymorphisms (SNPs) of various genes known to influence mean daily
warfarin dose (MDWD) in the Han Chinese population. <br/>Method(s): The
study is a systematic review and meta-analysis. Selected studies retrieved
by searching Pubmed, Embase (Ovid), Medline, CNKI, Wanfang data, and
SinoMed (from their inception to 31 August 2022) for the cohort studies
assessing genetic variations that may possibly influence MDWD in Chinese
patients were included. <br/>Result(s): A total of 46 studies including a
total of 10,102 Han Chinese adult patients were finally included in the
meta-analysis. The impact of 20 single nucleotide polymorphisms (SNPs) in
8 genes on MDWD was analyzed. The significant impact of some of these SNPs
on MDWD requirements was demonstrated. Patients with CYP4F2 rs2108622 TT,
EPHX1 rs2260863 GC, or NQO1 rs1800566 TT genotype required more than 10%
higher MDWD. Furthermore, patients with ABCB1 rs2032582 GT or GG, or CALU
rs2290228 TT genotype required more than 10% lower MDWD. Subgroup analysis
showed that patients with EPHX1 rs2260863 GC genotype required 7% lower
MDWD after heart valve replacement (HVR). <br/>Conclusion(s): This is the
first systematic review and meta-analysis assessing the association
between single nucleotide polymorphisms (SNPs) of various genes known to
influence MDWD besides CYP2C9 and VKORC1 in the Han Chinese population.
CYP4F2 (rs2108622), GGCX (rs12714145), EPHX1 (rs2292566 and rs2260863),
ABCB1 (rs2032582), NQO1 (rs1800566), and CALU (rs2290228) SNPs might be
moderate factors affecting MDWD requirements. Registered information:
PROSPERO International Prospective Register of Systematic Reviews
(CRD42022355130).<br/>Copyright &#xa9; 2023, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<39>
Accession Number
2023632221
Title
Head cooling wrap could suppress the elevation of core temperature after
cardiac surgery during forced-air warming in a pediatric intensive care
unit: a randomized clinical trial.
Source
Journal of Anesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Sakai W.; Chaki T.; Nawa Y.; Oyasu T.; Ichisaka Y.; Nawa T.; Asai H.;
Ebuoka N.; Oba J.; Yamakage M.
Institution
(Sakai, Chaki, Nawa, Oyasu, Ichisaka, Nawa, Asai, Ebuoka, Oba) Pediatric
Intensive Care Unit, Hokkaido Medical Center for Child Health and
Rehabilitation, Hokkaido, Sapporo 006-0041, Japan
(Sakai, Chaki, Nawa, Yamakage) Department of Anesthesiology, Sapporo
Medical University School of Medicine, East 17, South 1, Chuo-Ku,
Hokkaido, Sapporo 060-8556, Japan
(Ichisaka, Asai, Ebuoka, Oba) Department of Cardiovascular Surgery,
Hokkaido Medical Center for Child Health and Rehabilitation, Hokkaido,
Sapporo 006-0041, Japan
Publisher
Springer
Abstract
Purpose: The main aim of the current trial was to explore our hypothesis
that cooling head wraps lower the core temperature more effectively than
ice packs on the head during forced-air warming after pediatric cardiac
surgeries. <br/>Method(s): This study was a single-center Randomized
Controlled Trial. Participants were children with a weight <= 10 kg and
hyperthermia during forced-air warming after cardiac surgeries. When the
core temperature reached 37.5 degreeC, ice packs on the head (group C) or
a cooling head wrap (group H) were used as cooling devices to decrease the
core temperature. The primary outcome was the core temperature. The
secondary outcomes were the foot surface temperature and heart rate. We
measured all outcomes every 30 min for 240 min after the patient developed
hyperthermia. We conducted two-way ANOVA as a pre-planned analysis and
also the Bonferroni test as a post hoc analysis. <br/>Result(s): Twenty
patients were randomly assigned to groups C and H. The series of core
temperatures in group H were significantly lower than those in group C (p
< 0.0001), and post hoc analysis showed that there was no significant
difference in core temperatures at T0 between the two groups and
statistically significant differences in all core temperatures at T30-240
between the two groups. There was no difference between the two groups'
surface temperatures and heart rates. <br/>Conclusion(s): Compared to ice
packs on the head, head cooling wraps more effectively suppress core
temperature elevation during forced-air warming after pediatric cardiac
surgery.<br/>Copyright &#xa9; 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<40>
Accession Number
2023527118
Title
Novel Expansible Aortic Annuloplasty Ring Exhibits Similar Characteristics
as the Dacron Ring-an In Vitro Evaluation.
Source
Journal of Cardiovascular Translational Research. (no pagination), 2023.
Date of Publication: 2023.
Author
Noor M.A.; Benhassen L.L.; Kaspersen A.E.; Weiss M.G.; Hasenkam J.M.;
Johansen P.
Institution
(Noor, Benhassen, Kaspersen, Hasenkam) Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
(Noor, Benhassen, Kaspersen, Weiss, Hasenkam, Johansen) Department of
Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus,
Denmark
(Noor, Johansen) Department of Electrical and Computer Engineering, Aarhus
University, Aarhus, Denmark
(Hasenkam) Department of Surgery, University of the Witwatersrand,
Johannesburg, South Africa
Publisher
Springer
Abstract
An increasing body of research indicates that annular stability plays a
key role for a successful aortic valve repair. The aim of this study was
to evaluate and compare a novel open aortic annuloplasty ring (the A-ring)
with the Dacron ring. Both rings were compared with native aortic roots in
vitro. Eighteen aortic roots were included in the study and randomized
into three groups: the native, Dacron, and A-ring group. The roots were
evaluated in an in vitro physiologic pulsatile model simulating the left
side of the heart. Aortic annulus diameters were significantly reduced
both in the Dacron ring group (p = 0.003) and the A-ring group (p = 0.020)
when compared with the native group. Both the Dacron ring and A-ring
effectively downsized the aortic annulus diameter. The A-ring also
displayed an ability to maintain aortic root distensibility during the
cardiac cycle equally to the Dacron ring. Graphical abstract: [Figure not
available: see fulltext.]<br/>Copyright &#xa9; 2023, The Author(s).

<41>
Accession Number
2023479655
Title
The anatomy of the atrioventricular nodal artery: A meta-analysis with
implications for cardiothoracic surgery and ablation procedures.
Source
Clinical Anatomy. (no pagination), 2023. Date of Publication: 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) Youthoria, 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
John Wiley and Sons Inc
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
22.64 mm (SE = 1.60). The mean maximal diameter of AVNA at its origin was
found to be 1.40 mm (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.<br/>Copyright &#xa9; 2023 American
Association of Clinical Anatomists and British Association of Clinical
Anatomists.

<42>
Accession Number
641480029
Title
Continuous finger-cuff versus intermittent oscillometric arterial pressure
monitoring and hypotension during induction of anesthesia and non-cardiac
surgery: The DETECT randomized trial.
Source
Anesthesiology. (no pagination), 2023. Date of Publication: 02 Jun 2023.
Author
Kouz K.; Weidemann F.; Naebian A.; Lohr A.; Bergholz A.; Thomsen K.K.;
Krause L.; Petzoldt M.; Moll-Khosrawi P.; Sessler D.I.; Flick M.; Saugel
B.
Institution
(Kouz, Weidemann, Naebian, Lohr, Bergholz, Thomsen, Petzoldt,
Moll-Khosrawi, Flick, Saugel) Department of Anesthesiology, Center of
Anesthesiology and Intensive Care Medicine, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Krause) Institute of Medical Biometry and Epidemiology, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Sessler) Department of OutcomesResearch, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Sessler, Saugel) utcomes Research Consortium, Cleveland, OH, United
States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Finger-cuff methods allow non-invasive continuous arterial
pressure monitoring. We aimed to determine whether continuous finger-cuff
arterial pressure monitoring helps clinicians reduce hypotension within 15
minutes after starting induction of anesthesia and during non-cardiac
surgery. Specifically, we tested the hypotheses that continuous
finger-cuff - compared to intermittent oscillometric - arterial pressure
monitoring helps clinicians reduce the area under a mean arterial pressure
(MAP) of 65 mmHg within 15 minutes after starting induction of anesthesia,
and the time-weighted average MAP <65 mmHg during non-cardiac surgery.
<br/>METHOD(S): In this single-center trial, 242 non-cardiac surgery
patients were randomized to unblinded continuous finger-cuff or to
intermittent oscillometric arterial pressure monitoring (with blinded
continuous finger-cuff arterial pressure monitoring) within 15 minutes
after starting induction of anesthesia and during surgery. The first of
two hierarchical primary endpoints was the area under a MAP of 65 mmHg
within 15 minutes after starting induction of anesthesia, the second
primary endpoint was the time-weighted average MAP <65 mmHg during
surgery. <br/>RESULT(S): Within 15 minutes after starting induction of
anesthesia, the median (interquartile range) area under a MAP of 65 mmHg
was 7 (0, 24) mmHg x min in 109 patients assigned to continuous
finger-cuff monitoring versus 19 (0.3, 60) mmHg x min in 113 patients
assigned to intermittent oscillometric monitoring (p = 0.004; estimated
location shift -6 [95%-CI: -15, -0.3] mmHg x min). During surgery, the
median (interquartile range) time-weighted average MAP below 65 mmHg was
0.04 (0, 0.27) mmHg in 112 patients assigned to continuous finger-cuff
monitoring and 0.40 (0.03, 1.74) mmHg in 115 patients assigned to
intermittent oscillometric monitoring (p < 0.001; estimated location shift
-0.17 [95%-CI: -0.41, -0.05] mmHg). <br/>CONCLUSION(S): Continuous
finger-cuff arterial pressure monitoring helps clinicians reduce
hypotension within 15 minutes after starting induction of anesthesia and
during non-cardiac surgery compared to intermittent oscillometric arterial
pressure monitoring.<br/>Copyright &#xa9; 2023, the American Society of
Anesthesiologists. All Rights Reserved.

<43>
Accession Number
641478749
Title
Therapeutic and safety outcomes of intracoronary nicardipine in coronary
artery disease patients: a systematic review.
Source
Future cardiology. (no pagination), 2023. Date of Publication: 02 Jun
2023.
Author
Rehan S.T.; Imran L.; Salim A.; Javed S.O.; Sohail A.; Hussain H.U.; Ahmed
J.; Yasmin F.; Islam M.S.; Asghar M.S.
Institution
(Rehan, Imran, Salim, Javed, Sohail, Hussain, Ahmed, Yasmin) Department of
Internal Medicine, Dow University of Health Sciences, Karachi 74200,
Pakistan
(Islam) Department of Public Health & Informatics, Jahangirnagar
University, Savar, Dhaka 1342, Bangladesh
(Islam) Centre for Advanced Research Excellence in Public Health, Savar,
Dhaka 1342, Bangladesh
(Asghar) Division of Nephrology & Hypertension, Mayo Clinic, Rochester,
United States
Publisher
NLM (Medline)
Abstract
Aim: This systematic review aimed to shed light on the efficacy of
intracoronary (IC) nicardipine in treating no reflow with CAD undergoing
revascularization. <br/>Method(s): Literature search was performed on
databases with following eligibility criteria: adult patients with CAD;
clinical trials or observational studies; IC nicardipine as intervention;
therapeutic and safety outcome reported. <br/>Result(s): A total of 1249
papers were yielded during the literature search. Of these, 11 studies
were finalized for this systematic review. Complete restoration of TIMI 3
flow was observed in 98.6% of the patients receiving IC nicardipine. A
significant increase in the CBF after infusion of IC nicardipine (p <
0.05) was also observed. <br/>Conclusion(s): IC nicardipine significantly
increases CBF and decreases coronary vascular resistance.

<44>
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.
<br/>Method(s): A computerized search of electronic databases was
performed to identify all relevant studies using search terms till
December 31^st, 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.
<br/>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). <br/>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.<br/>Copyright &#xa9; 2023
Lippincott Williams and Wilkins. All rights reserved.

<45>
Accession Number
2023391144
Title
Infective Endocarditis due to Non-HACEK Gram-Negative Bacilli: Clinical
Characteristics and Risk Factors from a Prospective Multicenter Brazilian
Cohort.
Source
Tropical Medicine and Infectious Disease. 8(5) (no pagination), 2023.
Article Number: 283. Date of Publication: May 2023.
Author
de Sousa L.P.; Fortes C.Q.; Damasco P.V.; Barbosa G.I.F.; Golebiovski
W.F.; Weksler C.; Garrido R.Q.; Siciliano R.F.; Lamas C.D.C.
Institution
(de Sousa, Barbosa, Golebiovski, Weksler, Garrido, Lamas) Instituto
Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil
(de Sousa, Lamas) Instituto Nacional de Infectologia Evandro Chagas,
Fundacao Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil
(Fortes) Servico de Doencas Infecciosas e Parasitarias, Universidade
Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-901, Brazil
(Damasco, Barbosa) Servico de Doencas Infecciosas e Parasitarias,
Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030,
Brazil
(Damasco) Departamento de Doencas Infecciosas, Universidade Federal do
Estado do Rio de Janeiro (Unirio), Rio de Janeiro 20270-004, Brazil
(Siciliano) Instituto do Coracao (InCor), Universidade de Sao Paulo, Sao
Paulo 05403-900, Brazil
Publisher
MDPI
Abstract
Background: Non-HACEK Gram-negative bacilli (NGNB) infective endocarditis
(IE) has a growing frequency. We aimed to describe cases of NGNB IE and
find associated risk factors. <br/>Method(s): We conducted a prospective
observational study of consecutive patients with definitive IE according
to the modified Duke criteria in four institutions in Brazil.
<br/>Result(s): Of 1154 adult patients enrolled, 38 (3.29%) had IE due to
NGNB. Median age was 57 years, males predominated, accounting for 25/38
(65.8%). Most common etiologies were Pseudomonas aeruginosa and Klebsiella
spp. (8 episodes, 21% each). Worsening heart failure occurred in 18/38
(47.4%). Higher prevalence of embolic events was found (55,3%), mostly to
the central nervous system 7/38 (18.4%). Vegetations were most commonly on
aortic valves 17/38 (44.7%). Recent healthcare exposure was found in 52.6%
and a central venous catheter (CVC) in 13/38 (34.2%). Overall mortality
was 19/38 (50%). Indwelling CVC (OR 5.93; 95% CI, 1.29 to 27.3; p =
0.017), hemodialysis (OR 16.2; 95% CI, 1.78 to 147; p = 0.008) and chronic
kidney disease (OR 4.8; 95% IC, 1.2 to 19.1, p = 0.049) were identified as
risk factors for mortality. <br/>Conclusion(s): The rate of IE due to NGNB
was similar to that in previous studies. Enterobacterales and P.
aeruginosa were the most common etiologies. NGNB IE was associated with
central venous catheters, prosthetic valves, intracardiac devices and
hemodialysis and had a high mortality rate.<br/>Copyright &#xa9; 2023 by
the authors.

<46>
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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9;
The Author(s) 2023.

<47>
Accession Number
2024058518
Title
Selected 2022 Highlights in Congenital Cardiac Anesthesia.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(7) (pp 1095-1100),
2023. Date of Publication: July 2023.
Author
Stein M.L.; Bilal M.B.; Faraoni D.; Zabala L.; Matisoff A.; Mossad E.B.;
Mittnacht A.J.C.; Nasr V.G.
Institution
(Stein, Nasr) Department of Anesthesiology, Critical Care and Pain
Medicine, Boston Children's Hospital, Boston, MA
(Bilal, Faraoni, Mossad) Department of Anesthesiology, Perioperative and
Pain Medicine, Baylor College of Medicine, Texas Children's Hospital,
Houston, TX
(Zabala) Department of Anesthesia and Pain Medicine, UT Southwestern
School of Medicine, Children's Medical Center Dallas, Dallas, TX
(Matisoff) Department of Anesthesiology, Perioperative and Pain Medicine,
George Washington University, Children's National Hospital, Washington, DC
(Mittnacht) Department of Anesthesiology, New York Medical College,
Westchester Medical Center, Valhalla, NY
Publisher
W.B. Saunders
Abstract
This article is a review of the highlights of pertinent literature of
interest to the congenital cardiac anesthesiologist, and was published in
2022. After a search of the United States National Library of Medicine
PubMed database, several topics emerged in which significant contributions
were made in 2022. The authors of this manuscript considered the following
topics noteworthy to be included in this review-intensive care unit
admission after congenital cardiac catheterization interventions,
antifibrinolytics in pediatric cardiac surgery, the current status of the
pediatric cardiac anesthesia workforce in the United States, and kidney
injury and renal protection during congenital heart surgery.<br/>Copyright
&#xa9; 2023 Elsevier Inc.

<48>
Accession Number
2024054974
Title
Comparative Efficacy of Adjuvant Nonopioid Analgesia in Adult Cardiac
Surgical Patients: A Network Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(7) (pp 1169-1178),
2023. Date of Publication: July 2023.
Author
Heybati K.; Zhou F.; Lynn M.J.; Deng J.; Ali S.; Hou W.; Heybati S.;
Tzanis K.; Krever M.; Mughal R.; Ramakrishna H.
Institution
(Heybati) Mayo Clinic Alix School of Medicine, Mayo Clinic - Rochester,
Rochester, MN
(Zhou, Lynn, Deng, Ali, Hou, Mughal) Faculty of Health Sciences, McMaster
University, Hamilton, ON, Canada
(Lynn) Faculty of Medicine, University of British Columbia, Vancouver, BC,
Canada
(Deng) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Ali) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Hou, Mughal) Schulich School of Medicine & Dentistry, University of
Western Ontario, London, ON, Canada
(Heybati) Faculty of Science, Queen's University, Kingston, ON, Canada
(Tzanis) Faculty of Science, University of Toronto, Toronto, ON, Canada
(Krever) Faculty of Science, Wilfrid Laurier University, Waterloo, ON,
Canada
(Ramakrishna) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Rochester, MN
Publisher
W.B. Saunders
Abstract
Objectives: To compare the relative efficacy of adjuvant nonopioid
analgesic regimens in adult cardiac surgical patients. <br/>Design(s):
This frequentist, random-effects network meta-analysis (NMA) was
prospectively registered on PROSPERO (CRD42021282913) and conducted
according to the Preferred Reporting Items for Systematic Review and
Meta-Analyses for Network Meta-Analyses (PRISMA-NMA). The risk of bias
(RoB) and confidence of evidence were assessed by RoB 2 and Confidence in
Network Meta-Analysis, respectively. Relevant databases were searched from
inception to October 9, 2021. <br/>Setting(s): A total of 124 (N = 26,257)
randomized controlled trials were included, of which 110 were analyzed.
<br/>Participant(s): Trials enrolling adults (>=18 years of age)
undergoing cardiac surgery that compared nonopioid analgesics against
other nonopioid analgesics, placebo, or no additional treatment, as
adjuvants to standard analgesic management, and reported at least 1 of the
outcomes of interest. Measurement and Main Results: Outcomes of interest
included resting postoperative pain scores at 24 hours. Compared with
standard care and/or placebo, pain scores were reduced significantly by 10
different regimens, including acetaminophen (N = 176; mean difference [MD]
-0.66 points, 95% CI -1.16 to -0.15 points; high confidence), magnesium (N
= 323; -0.05 points, 95% CI -0.07 to -0.02 points; high confidence),
gabapentin (N = 96; MD -0.40 points, 95% CI -0.71 to -0.09; moderate
confidence), and clonidine (N = 64; MD v0.38 points, 95% CI -0.73 to v0.04
points; moderate confidence). Indomethacin, diclofenac, magnesium, and
gabapentin significantly reduced 24-hour opioid consumption. Four regimens
significantly decreased the intensive care unit length of stay.
Hydrocortisone, dexmedetomidine, and clonidine significantly decreased the
duration of mechanical ventilation. Magnesium decreased, while
methylprednisolone significantly increased, the risk of myocardial
infarction. <br/>Conclusion(s): Given the increasing emphasis on enhanced
recovery after surgery(ERAS) protocols and the eventual goal of limiting
opiate prescriptions postoperatively, the authors' data suggested far
greater use of nonopioid adjuncts to minimize pain and enhance recovery
following cardiac surgery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<49>
Accession Number
2023995768
Title
Del Nido Cardioplegia in Adult Cardiac Surgery: Meta-Analysis of
Randomized Clinical Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(7) (pp 1152-1159),
2023. Date of Publication: July 2023.
Author
Fresilli S.; Labanca R.; Monaco F.; Belletti A.; D'Amico F.; Blasio A.;
Kotani Y.; Landoni G.
Institution
(Fresilli, Labanca, Monaco, Belletti, D'Amico, Blasio, Kotani, Landoni)
Department of Cardiothoracic and Vascular Surgery, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
Publisher
W.B. Saunders
Abstract
Objective: To compare the outcomes of patients receiving del Nido solution
versus any other type of cardioplegia. <br/>Design(s): A systematic review
and meta-analysis of randomized trials. <br/>Setting(s): Cardiac operating
rooms. <br/>Participant(s): Adult patients (>=18 years old) undergoing
cardiac surgery. <br/>Intervention(s): The EMBASE, MEDLINE, and CENTRAL
databases were searched systematically from their inception until August
2022 for randomized controlled trials comparing del Nido versus other
cardioplegias. <br/>Measurements and Main Results: Ten studies were
included, including 1,812 patients (871 in the del Nido group and 941 in
the control group), and published after 2017. There were significant
reductions in postoperative stroke and/or transient ischemic attack rate
in the del Nido group: 9/467 (1.9%) v 25/540 (4.6%); odds ratio (OR),
0.43; 95% CI, 0.20-0.92 (p = 0.007). Del Nido cardioplegia was also
associated with significantly shorter aortic cross-clamp time (mean
difference, -8.99 minutes; 95% CI, -17.24 to -0.73 [p < 0.001]),
significantly reduced need for defibrillation (89/582 [15%] v 252/655
[38%]; OR, 0.33; 95% CI, 0.15-0.72 [p < 0.001]), significantly lower risk
of postoperative acute kidney injury (21/235 [8.9%] v 34/301 [11%]; OR,
0.50; 95% CI, 0.26-0.97 [p = 0.04]), with no effect on mortality (14/607
[2.3%] v 12/681 [1.8%]; p = 0.5). <br/>Conclusion(s): According to the
authors' meta-analysis of recent randomized clinical trials, del Nido is a
safe cardioplegic solution, which might provide better organ protection in
adult cardiac surgery without differences in mortality when compared to
other cardioplegic solutions.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<50>
Accession Number
2024676504
Title
Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in
Noncardiac Surgery An International Randomized Controlled Trial.
Source
Annals of Internal Medicine. 176(5) (pp 605-614), 2023. Date of
Publication: May 2023.
Author
Marcucci M.; Painter T.W.; Conen D.; Lomivorotov V.; Sessler D.I.; Chan
M.T.V.; Borges F.K.; Leslie K.; Duceppe E.; Martinez-Zapata M.J.; Wang
C.Y.; Xavier D.; Ofori S.N.; Wang M.K.; Efremov S.; Landoni G.;
Kleinlugtenbelt Y.V.; Szczeklik W.; Schmartz D.; Garg A.X.; Short T.G.;
Wittmann M.; Meyhoff C.S.; Amir M.; Torres D.; Patel A.; Ruetzler K.;
Parlow J.L.; Tandon V.; Fleischmann E.; Polanczyk C.A.; Lamy A.; Jayaram
R.; Astrakov S.V.; Wu W.K.K.; Cheong C.C.; Ayad S.; Kirov M.; de Nadal M.;
Likhvantsev V.V.; Paniagua P.; Aguado H.J.; Maheshwari K.; Whitlock R.P.;
McGillion M.H.; Vincent J.; Copland I.; Balasubramanian K.; Biccard B.M.;
Srinathan S.; Ismoilov S.; Pettit S.; Stillo D.; Kurz A.; Belley-Cote
E.P.; Spence J.; McIntyre W.F.; Bangdiwala S.I.; Guyatt G.; Yusuf S.;
Devereaux P.J.
Institution
(Marcucci, Conen, Borges, Ofori, Wang, Lamy, Whitlock, McGillion, Vincent,
Copland, Balasubramanian, Pettit, Stillo, Belley-Cote, Spence, McIntyre,
Bangdiwala, Yusuf, Devereaux) Population Health Research Institute,
Hamilton, ON, Canada
(Painter) Acute Care Medicine, University of Adelaide, Adelaide, SA,
Australia
(Lomivorotov, Ismoilov) Department of Anesthesiology and Intensive Care,
E. Meshalkin National Medical Research Centre, Novosibirsk, Russian
Federation
(Sessler, Ruetzler, Ayad, Maheshwari, Kurz) Anesthesiology Institute,
Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, United
States
(Chan, Wu) The Chinese University of Hong Kong, Hong Kong
(Leslie) Department of Critical Care Medicine, Melbourne Medical School,
University of Melbourne, Melbourne, VIC, Australia
(Duceppe) Department of Medicine, Centre Hospitalier de l, Universite de
Montreal, Montreal, QC, Canada
(Martinez-Zapata) Iberoamerican Cochrane Centre, Public Health and
Clinical Epidemiology Service, IIB Sant Pau, CIBERESP, Barcelona, Spain
(Wang, Cheong) Department of Anesthesiology, Faculty of Medicine,
University of Malaya, Kuala Lumpur, Malaysia
(Xavier) St. John's Medical College, Bangalore, India
(Efremov) Saint Petersburg State University Hospital, Saint Petersburg,
Russian Federation
(Landoni) Department of Anesthesiology and Intensive Care, IRCCS San
Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan,
Italy
(Kleinlugtenbelt) Department of Orthopedic and Trauma Surgery, Deventer
Ziekenhuis, Deventer, Netherlands
(Szczeklik) Centre for Intensive Care and Perioperative Medicine,
Jagiellonian University Medical College, Krakow, Poland
(Schmartz) CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium
(Garg) Department of Medicine, Western University, London, ON, Canada
(Short) Department of Anaesthesia, Auckland City Hospital, Auckland, New
Zealand
(Wittmann) Department of Anesthesiology, Intensive Care Medicine,
University Hospital Bonn, Bonn, Germany
(Meyhoff) Department of Anesthesia and Intensive Care, Copenhagen
University Hospital, Bispebjerg, Copenhagen, Frederiksberg, Denmark
(Amir) Department of Surgery, Shifa International Hospital, Shifa
Tameer-e-Millat University, Islamabad, Pakistan
(Torres) Departamento de Epidemiologia y Estudios en Salud, Universidad de
Los Andes, Santiago, Chile
(Patel, Tandon) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Parlow) Department of Anesthesiology and Perioperative Medicine, Queen's
University, Kingston Health Sciences Centre, Kingston, ON, Canada
(Fleischmann) Department of Anesthesia, Intensive Care Medicine and Pain
Medicine, Medical University of Vienna, Vienna, Austria
(Polanczyk) UFRGS, Hospital de Clinicas de Porto Alegre, National
Institute for Health Technology Assessment, IATS, Brazil
(Polanczyk) Hospital Moinhos de Vento, Porto Alegre, Brazil
(Jayaram) Department of Anaesthetics, Clinical Neurosciences, University
of Oxford, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
(Astrakov) Department of Anesthesiology, Novosibirsk State University,
Novosibirsk, Russian Federation
(Kirov) Department of Anesthesiology, Intensive Care Medicine, Northern
State Medical University, Arkhangelsk, Russian Federation
(de Nadal) Department of Anesthesiology and Intensive Care, Hospital Vall
d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
(Likhvantsev) V. Negovsky Reanimatology Research Institute, Moscow,
Russian Federation
(Paniagua) Anesthesiology Department, Santa Creu i Sant Pau University
Hospital, Barcelona, Spain
(Aguado) Trauma & Orthopaedic Surgery Department, Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Biccard) Department of Anesthesia and Perioperative Medicine, Groote
Schuur Hospital, University of Cape Town, Cape Town, South Africa
(Srinathan) Section of Thoracic Surgery, Department of Surgery, University
of Manitoba, Winnipeg, MB, Canada
(Guyatt) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
Publisher
American College of Physicians
Abstract
Background: Among patients having noncardiac surgery, perioperative
hemodynamic abnormalities are associated with vascular complications.
Uncertainty remains about what intraoperative blood pressure to target and
how to manage long-term antihypertensive medications perioperatively.
<br/>Objective(s): To compare the effects of a hypotension-avoidance and a
hypertension-avoidance strategy on major vascular complications after
noncardiac surgery. <br/>Design(s): Partial factorial randomized trial of
2 perioperative blood pressure management strategies (reported here) and
tranexamic acid versus placebo. (ClinicalTrials.gov: NCT03505723) Setting:
110 hospitals in 22 countries. <br/>Patient(s): 7490 patients having
noncardiac surgery who were at risk for vascular complications and were
receiving 1 or more long-term antihypertensive medications.
<br/>Intervention(s): In the hypotension-avoidance strategy group, the
intraoperative mean arterial pressure target was 80 mm Hg or greater;
before and for 2 days after surgery, renin-angiotensin-aldosterone system
inhibitors were withheld and the other long-term antihypertensive
medications were administered only for systolic blood pressures 130 mm Hg
or greater, following an algorithm. In the hypertension-avoidance strategy
group, the intraoperative mean arterial pressure target was 60 mm Hg or
greater; all antihypertensive medications were continued before and after
surgery. Measurements: The primary outcome was a composite of vascular
death and nonfatal myocardial injury after noncardiac surgery, stroke, and
cardiac arrest at 30 days. Outcome adjudicators were masked to treatment
assignment. <br/>Result(s): The primary outcome occurred in 520 of 3742
patients (13.9%) in the hypotension-avoidance group and in 524 of 3748
patients (14.0%) in the hypertension-avoidance group (hazard ratio, 0.99
[95% CI, 0.88 to 1.12]; P = 0.92). Results were consistent for patients
who used 1 or more than 1 antihypertensive medication in the long term.
<br/>Limitation(s): Adherence to the assigned strategies was suboptimal;
however, results were consistent across different adherence levels.
<br/>Conclusion(s): In patients having noncardiac surgery, our
hypotension-avoidance and hypertension-avoidance strategies resulted in a
similar incidence of major vascular complications.<br/>Copyright &#xa9;
2023 American College of Physicians.

<51>
Accession Number
2024790081
Title
A systematic review and meta-analysis of the effects of early mobilization
therapy in patients after cardiac surgery.
Source
Medicine (United States). 100(15) (pp E25314), 2021. Date of Publication:
16 Apr 2021.
Author
Chen B.; Xie G.; Lin Y.; Chen L.; Lin Z.; You X.; Xie X.; Dong D.; Zheng
X.; Li D.; Lin W.
Institution
(Chen, Lin, Chen, Lin, You, Xie, Dong, Zheng, Li, Lin) The Affiliated
People's Hospital of Fujian University of Traditional Chinese Medicine,
China
(Chen, Lin) National Clinical Research Base of Traditional Chinese
Medicine, Fujian Province, Fuzhou 350004, China
(Xie) Yunnan University of Traditional Chinese Medicine, Yunnan Province,
Kunming 650500, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Prolonged hospitalization and immobility of critical care
patients elevate the risk of long-term physical and cognitive impairments.
However, the therapeutic effects of early mobilization have been difficult
to interpret due to variations in study populations, interventions, and
outcome measures. We conducted a meta-analysis to assess the effects of
early mobilization therapy on cardiac surgery patients in the intensive
care unit (ICU). <br/>Method(s):PubMed, Excerpta Medica database (EMBASE),
Cumulative Index of Nursing and Allied Health Literature (CINAHL),
Physiotherapy Evidence Database (PEDro), and the Cochrane Library were
comprehensively searched from their inception to September 2018.
Randomized controlled trials were included if patients were adults (>=18
years) admitted to any ICU for cardiac surgery due to cardiovascular
disease and who were treated with experimental physiotherapy initiated in
the ICU (pre, post, or peri-operative). Data were extracted by 2 reviewers
independently using a pre-constructed data extraction form. Length of ICU
and hospital stay was evaluated as the primary outcomes. Physical function
and adverse events were assessed as the secondary outcomes. Review Manager
5.3 (RevMan 5.3) was used for statistical analysis. For all dichotomous
variables, relative risks or odds ratios with 95% confidence intervals
(CI) were presented. For all continuous variables, mean differences (MDs)
or standard MDs with 95% CIs were calculated. <br/>Result(s):The 5 studies
with a total of 652 patients were included in the data synthesis final
meta-analysis. While a slight favorable effect was detected in 3 out of
the 5 studies, the overall effects were not significant, even after
adjusting for heterogeneity. <br/>Conclusion(s):This population-specific
evaluation of the efficacy of early mobilization to reduce hospitalization
duration suggests that intervention may not universally justify the labor
barriers and resource costs in patients undergoing non-emergency cardiac
surgery.PROSPERO Research registration identifying number:CRD42019135338.
<br/>&#xa9; Copyright 2021 the Author(s). Published by Wolters Kluwer
Health, Inc.

<52>
[Use Link to view the full text]
Accession Number
2024735264
Title
Ultrasound-guided continuous thoracic paravertebral block alleviates
postoperative delirium in elderly patients undergoing esophagectomy: A
randomized controlled trial.
Source
Medicine (United States). 99(17) (pp E19896), 2020. Date of Publication:
22 Apr 2020.
Author
Jin L.; Yao R.; Heng L.; Pang B.; Sun F.-G.; Shen Y.; Zhong J.-F.; Zhao
P.-P.; Wu C.-Y.; Li B.-P.
Institution
(Jin, Pang, Sun) Department of Anesthesiology, The People's Hospital of
Leshan, Leshan, China
(Yao, Zhao, Li) Department of Anesthesiology, The Affiliated Xuzhou City
Hospital of Xuzhou Medical University, China
(Heng) Department of Anesthesiology, Xuzhou Tumor Hospital, Xuzhou, China
(Sun) Department of Anesthesiology, Sichuan Provincial Corps Hospital,
Chinese People's Armed Police Forces, Leshan, China
(Shen) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical
University, Xuzhou, China
(Zhong) Department of Anesthesiology, The People's Hospital of Shaoxing,
Shaoxing, China
(Wu) Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Delirium is a common postoperative complication in older
patients undergoing thoracic surgery and presages poor outcomes.
Postoperative pain is an important factor in the progression of delirium.
The purpose of this study was to test whether continuous thoracic
paravertebral block (PVB), a more effective approach for analgesia, could
decrease the incidence of delirium in elderly patients undergoing
esophagectomy. <br/>Method(s):A total of 180 geriatric patients undergoing
esophagectomy were randomly divided into 2 groups and treated with PVB or
patient-controlled analgesia (PCA). Perioperative plasma CRP, IL-1beta,
IL-6, and TNF-alpha levels were detected in all patients. Pain intensity
was measured by a numerical rating scale. Delirium was assessed using the
confusion assessment method. <br/>Result(s):The incidence of postoperative
delirium was significantly lower in the PVB group than in the PCA group.
Patients in the PVB group had lower plasma CRP, IL-1beta, IL-6, and
TNF-alpha levels and less pain when coughing after surgery.
<br/>Conclusion(s):Ultrasound-guided continuous thoracic paravertebral
block improved analgesia, reduced the inflammatory reaction and decreased
the occurrence of delirium after surgery. <br/>Copyright &#xa9; 2020 the
Author(s). Published by Wolters Kluwer Health, Inc.

<53>
[Use Link to view the full text]
Accession Number
2024735189
Title
Transcatheter aortic valve implantation in the patients with chronic liver
disease: A mini-review and meta-analysis.
Source
Medicine (United States). 99(16) (pp E19766), 2020. Date of Publication:
07 Apr 2020.
Author
Ma X.; Zhao D.; Li J.; Wei D.; Zhang J.; Yuan P.; Kong X.; Ma J.; Ma H.;
Sun L.; Zhang Y.; Jiao Q.; Wang Z.; Zhang H.
Institution
(Ma, Zhao, Li, Wei, Sun, Wang, Zhang) Department of Cardiovascular
Surgery, Shandong Provincial Hospital Affiliated to Shandong University,
Shandong Provincial Hospital Affiliated to Shandong First Medical
University, No. 324 Jingwu Road, Shandong, Jinan 250021, China
(Zhao, Li, Wei, Zhang, Yuan) School of Medicine, Shandong University, No.
44 Wenhua West Road, Shandong, Jinan 250012, China
(Kong) Department of Vascular Surgery, Shandong Provincial Hospital
Affiliated to Shandong University, No. 324 Jingwu Road, Shandong, Jinan
250021, China
(Ma) Department of Pathology, Shandong Provincial Hospital Affiliated to
Shandong University, No. 324 Jingwu Road, Shandong, Jinan 250021, China
(Zhang) Emergency Center, Shandong Provincial Hospital Affiliated to
Shandong University, No. 324 Jingwu Road, Shandong, Jinan 250021, China
(Jiao) Department of Anesthesiology, Shandong Provincial Hospital
Affiliated to Shandong University, No. 324 Jingwu Road, Shandong, Jinan
250021, China
(Ma) Qingdao University Medical College, Qingdao University, 308 Ningxia
Road, Qingdao 266071, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Chronic liver disease is traditionally conceived as a risk
factor for cardiovascular surgery. Transcatheter aortic valve implantation
(TAVI) has recently burgeoned to precede surgical aortic valve replacement
(SAVR) in patients with severe aortic stenosis at intermediate to high
surgical risk. The evidence regarding TAVI in the patients with chronic
liver disease is currently scarce. <br/>Method(s):This article aims to
assess the application of TAVI technique in the patients with chronic
liver disease. <br/>Result(s):TAVI in the patients with chronic liver
disease produced acceptable postoperative results. The post-TAVI outcomes
were comparable between the patients with or without chronic liver
disease, except for a lower rate of pacemaker implantation in the patients
with chronic liver disease (OR, 0.49[0.27-0.87], P = .02). In the patients
with chronic liver disease, compared to SAVR, TAVI led to a decrease in
the in-hospital mortality (OR, 0.43[0.22-0.86], P = .02) and need for
transfusion (OR, 0.39[0.25-0.62], P < .0001). The rest outcomes were
similar between the 2 groups. <br/>Conclusion(s):This systematic review
and meta-analysis supported that TAVI is a reliable therapeutic option for
treating severe aortic stenosis in the patients with chronic liver
disease. Future large-scale randomized controlled trials investigating the
mid-term and long-term prognosis are needed to further verify these
results. <br/>Copyright &#xa9; 2020 the Author(s). Published by Wolters
Kluwer Health, Inc.

<54>
[Use Link to view the full text]
Accession Number
2024735114
Title
Cytokine Removal in Critically Ill Patients Requiring Surgical Therapy for
Infective Endocarditis (RECReATE): An Investigator-initiated Prospective
Randomized Controlled Clinical Trial Comparing Two Established Clinical
Protocols.
Source
Medicine (United States). 99(15) (pp E19580), 2020. Date of Publication:
17 Apr 2020.
Author
Gisler F.; Spinetti T.; Erdoes G.; Luedi M.M.; Pfortmueller C.A.; Messmer
A.S.; Jenni H.; Englberger L.; Schefold J.C.
Institution
(Gisler, Jenni, Englberger) Department of Cardiovascular Surgery,
Switzerland
(Spinetti, Pfortmueller, Messmer, Schefold) Department of Intensive Care
Medicine, Switzerland
(Erdoes, Luedi) Department of Anaesthesiology and Pain Medicine,
Inselspital, Bern University Hospital, University of Bern, Switzerland
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction:Infective endocarditis (IE) and other severe infections
induce significant changes in the immune response in a considerable number
of affected patients. Numerous IE patients develop a persistent functional
immunological phenotype that can best be characterized by a profound
anti-inflammation and/ or functional "anergy."This is pronounced in
patients with unresolved infectious foci and was previously referred to as
"injury-associated immunosuppression"(IAI). IAI can be assessed by
measurement of the monocytic human leukocyte antigen-DR (mHLA-DR)
expression, a global functional marker of immune competence. Persistence
of IAI is associated with prolonged intensive care unit length of stay,
increased secondary infection rates, and death. Immunomodulation to
reverse IAI was shown beneficial in early immunostimulatory (randomized
controlled) clinical trials. <br/>Method(s):Prospective 1:1 randomized
controlled clinical study to compare the course of mHLA-DR in patients
scheduled for cardiac surgery for IE. Patients will receive either best
standard of care plus cytokine adsorption during surgery while on
cardiopulmonary bypass (protocol A) versus best standard of care alone,
that is, surgery without cytokine adsorption (protocol B). A total of 54
patients will be recruited and randomized. The primary endpoint is a
change in quantitative expression of mHLA-DR (antibodies per cell on CD14+
monocytes/ macrophages, assessed using a quantitative standardized assay)
from baseline (preoperation [pre-OP], visit 1) to day 1 post-OP (visit 4).
<br/>Discussion(s):This randomized controlled clinical trial (RECReATE)
will compare 2 clinical treatment protocols and will investigate whether
cytokine adsorption restores monocytic immune competence (reflected by
increased mHLA-DR expression) in patients with IE undergoing cardiac
surgery.Trial registration:This protocol was registered in
ClinicalTrials.gov, under number NCT03892174, first listed on March 27,
2019. <br/>Copyright &#xa9; 2020 the Author(s). Published by Wolters
Kluwer Health, Inc.

<55>
[Use Link to view the full text]
Accession Number
2024735096
Title
Effect of sub-hypothermia blood purification technique in cardiac shock
after valvular disease surgery.
Source
Medicine (United States). 99(13) (pp E19476), 2020. Date of Publication:
18 Mar 2020.
Author
Fang J.; Xu M.; Liu B.; Wang B.; Ren H.; Yang H.; Dong Y.; Song L.; Xiao
H.; Schaller B.
Institution
(Fang, Xu, Wang, Song) Department of Cardiac Surgery, Wuhan Asia Heart
Hospital, Wuhan, China
(Liu, Ren) Department of Intensive Care Unit, Wuhan Asia Heart Hospital,
Wuhan, China
(Yang) Department of Urinary Surgery, Dongfeng Maojian Hospital, Shiyan,
China
(Dong) Department of Cardiology, Wuhan Asia Heart Hospital, China
(Xiao) Department of Intensive Care Unit, Asia Heart Hospital, Wuhan
University of Science and Technology, Hankou District, Wuhan, China
Publisher
Lippincott Williams and Wilkins
Abstract
To observe the effect of sub-hypothermia (HT) blood purification technique
in the treatment of cardiac shock after heart valve disease.The patients
were randomly divided into normothermic (NT) continuous blood purification
(CBP) group (NT group) and HT CBP group (HT group). Observe the cardiac
index (CI), the oxygen delivery (DO2) and oxygen consumption (VO2) ratio,
Acute Physiology and Chronic Health Evaluation III(APACHE III) score,
multiple organ dysfunction syndrome (MODS) score, dynamic monitoring of
electrocardiograph, blood loss with or without muscle tremors, intensive
care unit stay, mechanical ventilation time, CBP time, and the cases of
infection and mortality at 0 day, 1 day, 2 day, 3 day; all above
indicators were compared between 2 groups.Ninety-five patients were
randomly assigned into HT group (48 cases) and NT group (47 cases); there
were no significant differences between the 2 groups for age, gender,
pre-operative cardiac function, cardiothoracic ratio, and type of valve
replacement (P > .05). There were no significant differences among the 1
day, 2 day, 3 day after recruited for CI, DO2/VO2 ratio, APACHE III score,
MODS score (P > .05). But in HT group, DO2/VO2 ratio had been
significantly improved after treatment for 1 day (2.5 +/- 0.7 vs 1.8 +/-
0.4, P = .024), and CI (3.0 +/- 0.5 vs 1.9 +/- 0.7, P = .004), APACHE III
score (50.6 +/- 6.2 vs 77.5 +/- 5.5 P = .022), MODS score (6.0 +/- 1.5 vs
9.3 +/- 3.4, P = .013) also had been significantly improved after
treatment for 3 days. In clinical outcomes, there were no significant
differences between 2 groups for blood loss (617.0 +/- 60.7 ml vs 550.9
+/- 85.2 ml, P = .203), infection ratio (54.17% vs 53.19%, P = .341), the
incidence of ventricular arrhythmia (31.25% vs 36.17%, P = .237), and
muscle tremors (14.58% vs 8.51%, P = .346), while there were significant
differences between 2 groups for intensive care unit stay (6.9 +/- 3.4
days vs 12.5 +/- 3.5 days, P = .017,), mechanical ventilation time (4.2
+/- 1.3 days vs 7.5 +/- 2.7 days, P = .034,), CBP time (4.6 +/- 1.4 days
vs 10.5 +/- 4.0 days, P = .019), mortality (12.50% vs 23.40%, P = .024).
But the incidence of bradycardia in HT group was much higher than the NT
group (29.16% vs 14.89%, P = .029).HT blood purification is a safer and
more effective treatment than NT blood purification for patients who
suffered from cardiac shock after valve surgery. <br/>Copyright &#xa9;
2020 the Author(s). Published by Wolters Kluwer Health, Inc.

<56>
Accession Number
2024792744
Title
Confirmation of Safety of Titanium Wire in Sternotomy Closure, A
Randomized Prospective Study.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2023. Date of
Publication: 2023.
Author
Eraqi M.; Diab A.H.; Matschke K.; Alexiou K.
Institution
(Eraqi) Klinikum Bayreuth GmbH, Bayreuth, Germany
(Eraqi, Diab, Matschke, Alexiou) Department of Cardiac Surgery, Heart
Center Dresden, The University Hospital Carl Gustav Carus, Dresden,
Germany
Publisher
Georg Thieme Verlag
Abstract
Background There are many factors that are known to increase the risk of
sternal wound infection (SWI); some studies have reported that nickel is a
risk factor for SWI. Titanium wires have only been used as an alternative
to steel wires in patients with known allergy to nickel. However, there is
a paucity of literature regarding the safety of using titanium wires
compared to that on the safety of steel wires for sternum closure after
cardiac surgery. Therefore, this study aimed to demonstrate the
noninferiority of titanium wires, even in patients without a known
allergy. Methods A total of 322 patients who underwent elective full
median sternotomy were randomly assigned to sternal closure either by
titanium wires (n = 161) or by stainless steel wires. Results Fourteen
patients had sternal instability, six (3.7%) patients in the titanium
group and eight (5%) patients in the stainless steel group (p = 0.585).
There was no statistically significant difference between both groups in
terms of postoperative wound infection (p = 0.147). Patients in the
titanium group experienced statistically significant lower postoperative
pain than those in the stainless steel group (p = 0.024). The wire type
was not an independent risk factor for SI, as shown by univariate and
logistic regression analyses. Conclusion Titanium wires are a good
alternative and have been proven to be safe and effective for sternal
closure. The surgeon should be aware of the possibility of developing an
allergic reaction to the wires, especially in patients with previous
multiple allergic histories.<br/>Copyright &#xa9; 2023 Georg Thieme
Verlag. All rights reserved.

<57>
Accession Number
641462729
Title
Systematic Review and Meta-Analysis of the Treatment Strategies for
Coronary Artery Bypass Graft Patients with Concomitant Carotid Artery
Atherosclerotic Disease.
Source
Journal of vascular surgery. (no pagination), 2023. Date of Publication:
29 May 2023.
Author
Tsukagoshi J.; Yokoyama Y.; Fujisaki T.; Takagi H.; Shirasu T.; Kuno T.
Institution
(Tsukagoshi) Department of Surgery, University of Texas Medical Branch,
Galveston, TX, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, NY, USA; Department of
Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto
University, Kumamoto, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Shirasu) Department of Cardiovascular Surgery, Morinomiya Hospital,
Osaka, Japan
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, NY, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Stroke is one of the devastating complications following
coronary artery bypass graft (CABG). Underlying carotid artery
atherosclerotic disease is reported to be an independent risk factor. The
optimal treatment strategy for these patients remains under debate.
<br/>METHOD(S): We aimed to perform a network meta-analysis to evaluate
the safety and efficacy of additional carotid interventions for patients
with concomitant carotid artery atherosclerotic disease who require CABG
by comparing perioperative adverse event rates. All articles through
February 2022 were searched using MEDLINE and EMBASE to identify studies
that investigated outcomes of CABG only as well as additional staged
versus combined carotid interventions by both carotid endarterectomy (CEA)
and carotid artery stenting (CAS). <br/>RESULT(S): Two randomized
controlled trials and 23 observational studies were included, yielding a
total of 32,473 patients who underwent combined CEA and CABG (n = 20,204),
CEA and staged CABG (n = 6,882), CABG and staged CEA (n = 340), CAS and
CABG regardless of timing and sequences (n = 1,224), and CABG only (n =
3,823). No strategy showed a significant advantage over CABG only in all
perioperative outcomes. CEA and staged CABG was associated with the lowest
perioperative stroke/transient ischemic attack (TIA) rate, significantly
lower compared to CAS and CABG (Odds ratio (OR) [95% confidence interval
(CI)] = 0.52 [0.36-0.76]) as well as CABG and staged CEA (OR [95% CI] =
0.41 [0.23-0.74]), but was also associated with the highest perioperative
mortality (OR [95% CI] = 2.50 [1.67-3.85], versus CAS and CABG]) and
myocardial infarction (MI) rate (OR [95% CI] = 3.70 [1.16-12.5] and 2.50
[1.35-4.55], versus CAS and CABG, versus combined CEA and CABG,
respectively). <br/>CONCLUSION(S): CEA and staged CABG is associated with
low perioperative stroke/TIA rate with a tradeoff of higher mortality and
myocardial infarction rate. No strategy showed a significant advantage
over the CABG-only strategy in all perioperative outcomes, outlining the
importance of a tailored approach and determining proper indications for
carotid intervention in these patients.<br/>Copyright &#xa9; 2023.
Published by Elsevier Inc.

<58>
Accession Number
2024818471
Title
Albumin Infusion and Blood Loss After Cardiac Surgery.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Talvasto A.; Ilmakunnas M.; Raivio P.; Vlasov H.; Hiippala S.; Suojaranta
R.; Wilkman E.; Petaja L.; Helve O.; Juvonen T.; Pesonen E.
Institution
(Talvasto, Ilmakunnas, Vlasov, Hiippala, Suojaranta, Wilkman, Petaja,
Pesonen) Department of Anesthesiology and Intensive Care Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Raivio, Juvonen) Department of Cardiac Surgery, Heart and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Helve) Pediatric Research Center, Children's Hospital, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland
(Helve) Department of Health Security, Finnish Institute for Health and
Welfare, Helsinki, Finland
Publisher
Elsevier Inc.
Abstract
Background: In the recent ALBICS (ALBumin In Cardiac Surgery) trial, 4%
albumin used for cardiopulmonary bypass priming and volume replacement
increased perioperative bleeding compared with Ringer acetate. In the
present exploratory study, albumin-related bleeding was further
characterized. <br/>Method(s): Ringer acetate and 4% albumin were compared
in a randomized, double-blinded fashion in 1386 on-pump adult cardiac
surgery patients. The study end points for bleeding were the Universal
Definition of Perioperative Bleeding (UDPB) class and its components.
<br/>Result(s): The UDPB bleeding grades were higher in the albumin group
than the Ringer group: "insignificant" (albumin vs Ringer: 47.5% vs
62.9%), "mild" (12.7% vs 8.9%), "moderate" (28.7% vs 24.4%), "severe"
(10.2% vs 3.2%), and "massive" (0.9% vs. 0.6%; P <.001). Patients in the
albumin group received red blood cells (45.2% vs 31.5%; odds ratio [OR],
1.80; 95% CI, 1.44-2.24; P <.001), platelets (33.3% vs 21.8%; OR, 1.79;
95% CI, 1.41-2.28; P <.001), and fibrinogen (5.6% vs 2.6%; OR, 2.24; 95%
CI, 1.27-3.95; P <.05), and underwent resternotomy (5.3% vs 1.9%; OR,
2.95; 95% CI, 1.55-5.60, P <.001) more often than patients in the Ringer
group. The strongest predictors of bleeding were albumin group allocation
(OR, 2.18; 95% CI, 1.74-2.74) and complex (OR, 2.61; 95% CI, 2.02-3.37)
and urgent surgery (OR, 1.63; 95% CI, 1.26-2.13). In interaction analysis,
the effect of albumin on the risk of bleeding was stronger in patients on
preoperative acetylsalicylic acid. <br/>Conclusion(s): Perioperative
administration of albumin, compared with Ringer's acetate, resulted in
increased blood loss and higher UDBP class. The magnitude of this effect
was similar to the complexity and urgency of the surgery.<br/>Copyright
&#xa9; 2023 The Society of Thoracic Surgeons

<59>
Accession Number
2024757899
Title
Predictive effect of nutritional scores assessment for 1-year mortality in
patients with severe aortic stenosis treated with SAVR or TAVR.
Source
European Review for Medical and Pharmacological Sciences. 27(5) (pp
1904-1911), 2023. Date of Publication: 2023.
Author
Karacalilar M.; Ozbek M.
Institution
(Karacalilar) Department of Cardiovascular Surgery, Dicle University,
Diyarbakir, Turkey
(Ozbek) Department of Cardiology, Faculty of Medicine, Dicle University,
Diyarbakir, Turkey
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: As treatment modalities of severe AS, interventional treatments
such as SAVR or TAVR with the decision of the heart team have been
performed recently. Controlling nutritional status (CONUT) score and
prognostic nutritional index (PNI) have a very important place among the
scores that provide a simple, effective, and objective evaluation of
prognosis. In our study, we aimed to investigate the short-term prognostic
results of severe AS patients who underwent TAVR or SAVR by comparing the
CONUT and PNI results of the patients. <br/>PATIENTS AND METHODS: 258
patients who underwent percutaneous TAVR or SAVR in our clinic between
December 2012 and December 2020 were included in the study in a randomized
retrospective manner. The primary endpoint of the study was in-hospital
and 1-year all-cause death. The results of all patient groups were
compared by dividing them into 2 groups as all-cause death group (deceased
group) and non-all-cause death group (survived group) within 1 year.
<br/>RESULT(S): All-cause mortality occurred in 57 (29%) patients within 1
year. As nutritional status scores, the PNI score (39.9+/-7.4 vs.
46.5+/-6.9, p<0.001) was lower in the deceased group and the median CONUT
score [4(4) vs. 1(3) p<0.001] was found significantly higher. NLR score
was also found to be significantly higher in the deceased group (p<0.001).
They were divided into 3 tertiles containing an equal number of patients
and compared according to the nutritional scores. Significantly higher
1-year mortality was observed in the high CONUT [10 (12%) deaths in T1, 12
(14%) in T2, and 35 (41%) deaths in T3, respectively, p<0.001] and low PNI
[37 (43%) deaths in T1, 13 (15%) in T2, and 7 (8%) deaths in T3,
respectively, p<0.001] groups, which can be considered as the worse
nutritional group. <br/>CONCLUSION(S): In the surgical or transarterial
treatment of symptomatic severe aortic stenosis, we found that a high
CONUT score and a low PNI score were predictors of all-cause mortality at
1-year follow-up, regardless of the type of treatment. We think that
checking patients with scores like the abovementioned procedure and making
the necessary corrections will lead to positive results in terms of
prognosis.<br/>Copyright &#xa9; 2023 Authors. All rights reserved.

<60>
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. <br/>Method(s): Literature searches were carried
out on PubMed, Web of Science, Google Scholar, Embase and TRIP using the
phrases 'solid organ transplant', 'cell senescence', 'cell aging' and
'outcomes', using boolean 'and/or' phrases and MeSH terms. Duplicates were
removed and abstracts were reviewed by two independent reviewers. Full
papers were then screened for inclusion by two reviewers. Data extraction
was carried out using a standardised proforma agreed on prior to starting.
<br/>Result(s): 32 studies, including data on a total of 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. <br/>Conclusion(s): Studies to date on biological
aging in transplant recipients have been heavily biased to kidney
transplant recipients. The results from these studies suggest recipient
biological age can influence clinical outcomes and future research is
needed to prioritise robust biomarkers of biological aging in transplant
recipients.<br/>Copyright &#xa9; 2023 The Authors

<61>
Accession Number
2024605420
Title
UpStreAm doxycycline in ST-eLeVation myocArdial infarction: targetinG
infarct hEaling and ModulatIon (SALVAGE-MI trial).
Source
European Heart Journal: Acute Cardiovascular Care. 12(3) (pp 143-152),
2023. Date of Publication: 01 Mar 2023.
Author
Noaman S.; Neil C.; O'Brien J.; Frenneaux M.; Hare J.; Wang B.; Tai T.Y.;
Theuerle J.; Shaw J.; Stub D.; Bloom J.; Walton A.; Duffy S.J.; Peter
K.-H.; Cox N.; Kaye D.M.; Taylor A.; Chan W.
Institution
(Noaman, Neil, Stub, Cox, Chan) Department of Cardiology, Western Health,
176 Furlong Rd, St Albans, VIC, Australia
(Noaman, O'Brien, Hare, Theuerle, Shaw, Stub, Bloom, Walton, Duffy, Peter,
Kaye, Taylor, Chan) Department of Cardiology, Alfred Health, 55 Commercial
Road, Melbourne, VIC 3004, Australia
(Noaman, Neil, Chan) Department of Medicine, University of Melbourne,
Building 104, Alan Gilbert Building University of Melbourne, 161 Barry St,
Carlton, VIC, Australia
(Noaman, Wang, Tai, Peter, Kaye, Chan) Department of Heart Failure
Research, Baker IDI Heart and Diabetes Institute, 75 Commercial Rd,
Melbourne, VIC, Australia
(Frenneaux) Department of Cardiology, Hamad Medical Corporation, Doha
7GPR+3M9, Qatar
(Duffy) Department of Public Health and Preventive Medicine, Centre of
Cardiovascular Research and Education in Therapeutics (CCRET), Monash
University, 29 Ancora Imparo Way, Clayton, VIC, Australia
Publisher
Oxford University Press
Abstract
Aims Experimental studies demonstrate protective effects of doxycycline on
myocardial ischaemia-reperfusion injury. The trial investigated whether
doxycycline administered prior to reperfusion in patients presenting with
ST-elevation myocardial infarction (STEMI) reduces infarct size (IS) and
ameliorates adverse left ventricular (LV) remodelling. Methods and results
In this randomized, double-blind, placebo-controlled trial, patients
presenting with STEMI undergoing primary percutaneous coronary
intervention (PPCI) were randomized to either intravenous doxycycline or
placebo prior to reperfusion followed by 7 days of oral doxycycline or
placebo. The primary outcome was final IS adjusted for area-at-risk
(fIS/AAR) measured on two cardiac magnetic resonance scans ~6 months
apart. Of 103 participants, 50 were randomized to doxycycline and 53 to
placebo and were matched for age (59 +/- 12 vs. 60 +/- 10 years), male sex
(92% vs. 79%), diabetes mellitus (26% vs. 11%) and left anterior
descending artery occlusion (50% vs. 49%), all P > 0.05. Patients treated
with doxycycline had a trend for larger fIS/AAR [0.79 (0.5-0.9) vs. 0.61
(0.47-0.76), P = 0.06], larger fIS at 6 months [18.8% (12-26) vs. 13.6%
(11-21), P = 0.08], but similar acute IS [21.7% (17-34) vs. 19.4% (14-27),
P = 0.19] and AAR [26% (20-36) vs. 24.7% (16-31), P = 0.22] compared with
placebo. Doxycycline did not ameliorate adverse LV remodelling
[%DELTAend-diastolic volume index, 1.1% (-3.8-8.4) vs. -1.34% (-6.1-5.8),
P = 0.42] and was independently associated with larger fIS (regression
coefficient = 0.175, P = 0.03). Conclusion Doxycycline prior to PPCI
neither reduced IS acutely or at six months nor attenuated adverse LV
remodelling. These data raise safety concerns regarding doxycycline use in
STEMI for infarct modulation and healing.<br/>Copyright &#xa9; The
Author(s) 2022. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved.

<62>
[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.<br/>Copyright &#xa9; 2022 Elsevier Inc.. All rights reserved.

<63>
[Use Link to view the full text]
Accession Number
2024544073
Title
Transcatheter Aortic Valve Replacement and Impact of Subclinical Leaflet
Thrombosis in Low-Risk Patients: LRT Trial 4-Year Outcomes.
Source
Circulation: Cardiovascular Interventions. 16(5) (pp E012655), 2023. Date
of Publication: 01 May 2023.
Author
Waksman R.; Bhogal S.; Gordon P.; Ehsan A.; Wilson S.R.; Levitt R.; Parikh
P.; Bilfinger T.; Hanna N.; Buchbinder M.; Asch F.M.; Kim F.Y.; Weissman
G.; Ben-Dor I.; Shults C.C.; Ali S.; Sutton J.A.; Shea C.; Zhang C.;
Garcia-Garcia H.M.; Satler L.F.; Rogers T.
Institution
(Waksman, Bhogal, Ben-Dor, Ali, Sutton, Shea, Zhang, Garcia-Garcia,
Satler, Rogers) Section of Interventional Cardiology, MedStar Washington
Hospital Center, Washington, DC, United States
(Gordon) Division of Cardiology, Miriam Hospital, Providence, RI, United
States
(Ehsan) Division of Cardiothoracic Surgery, Lifespan Cardiovascular
Institute, Providence, RI, United States
(Wilson) Department of Cardiology, North Shore University Hospital,
Manhasset, NY, United States
(Levitt) Department of Cardiology, HCA Virginia Health System, Richmond,
United States
(Parikh) Department of Medicine, Stony Brook Hospital, NY, United States
(Bilfinger) Department of Surgery, Stony Brook Hospital, NY, United States
(Hanna) John Heart Institute Cardiovascular Consultants, St. John Health
System, Tulsa, OK, United States
(Buchbinder) Foundation for Cardiovascular Medicine, Stanford University,
CA, United States
(Asch) MedStar Health Research Institute, MedStar Washington Hospital
Center, DC, United States
(Kim) Department of Interventional Cardiology, Valley Health, Ridgewood,
NJ, United States
(Weissman) Department of Cardiology, MedStar Washington Hospital Center,
DC, United States
(Shults) Department of Cardiac Surgery, MedStar Washington Hospital
Center, DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The LRT trial (Low-Risk Transcatheter Aortic Valve Replacement
[TAVR]) demonstrated the safety and feasibility of TAVR in low-risk
patients, with excellent 1- and 2-year outcomes. The objective of the
current study is to provide the overall clinical outcomes and the impact
of 30-day hypoattenuated leaflet thickening (HALT) on structural valve
deterioration at 4 years. <br/>Method(s): The prospective, multicenter LRT
trial was the first Food and Drug Administration-approved investigational
device exemption study to evaluate feasibility and safety of TAVR in
low-risk patients with symptomatic severe tricuspid aortic stenosis.
Clinical outcomes and valve hemodynamics were documented annually through
4 years. <br/>Result(s): A total of 200 patients were enrolled, and
follow-up was available on 177 patients at 4 years. The rates of all-cause
mortality and cardiovascular death were 11.9% and 3.3%, respectively. The
stroke rate rose from 0.5% at 30 days to 7.5% at 4 years, and permanent
pacemaker implantation rose from 6.5% at 30 days to 11.7% at 4 years.
Endocarditis was detected in 2.5% of the cohort, with no new cases
reported between 2 and 4 years. Transcatheter heart valve hemodynamics
remained excellent post-procedure and were maintained (mean gradient
12.56+/-5.54 mm Hg and aortic valve area 1.69+/-0.52 cm²) at 4
years. At 30 days, HALT was observed in 14% of subjects who received a
balloon-expandable transcatheter heart valve. There was no difference in
valve hemodynamics between patients with and without HALT (mean gradient
14.94+/-5.01 mm Hg versus 12.3+/-5.57 mm Hg; P=0.23) at 4 years. The
overall rate of structural valve deterioration was 5.8%, and there was no
impact of HALT on valve hemodynamics, endocarditis, or stroke at 4 years.
<br/>Conclusion(s): TAVR in low-risk patients with symptomatic severe
tricuspid aortic stenosis was found to be safe and durable at 4 years.
Structural valve deterioration rates were low irrespective of the type of
valve, and the presence of HALT at 30 days did not affect structural valve
deterioration, transcatheter valve hemodynamics, and stroke rate at 4
years. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT02628899.<br/>Copyright &#xa9; 2023 Lippincott Williams and
Wilkins. All rights reserved.

<64>
Accession Number
2024487731
Title
Atorvastatin and the influence on postoperative atrial fibrillation after
surgical aortic valve replacement (STARC) in adults at Odense University
Hospital, Denmark: Study protocol for a randomised controlled trial.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e069595. Date of
Publication: 10 May 2023.
Author
Krasniqi L.; Brandes A.; Mortensen P.E.; Dahl J.S.; Gerke O.; Ali M.;
Riber L.P.S.
Institution
(Krasniqi, Mortensen, Riber) Department of Cardiac, Thoracic and Vascular
Surgery, Odense University Hospital, Odense, Denmark
(Krasniqi, Brandes, Dahl, Gerke, Ali, Riber) Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
(Brandes) Cardiology, University of Southern Denmark, Campus Esbjerg,
Esbjerg, Denmark
(Brandes, Dahl, Ali) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Gerke) Department of Nuclear Medicine, Odense University Hospital,
Odense, Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction Atrial fibrillation (AF) is the most common postoperative
complication after surgical aortic valve replacement (SAVR) and occurs in
up to 50% of the patients. Development of postoperative AF (POAF) is
associated with a 2-3 fold increased risk of adverse events, including
stroke, myocardial infarction and death. Several studies have implied that
prophylactic Atorvastatin therapy could prevent POAF in patients
undergoing coronary artery bypass graft. These studies suggest that
Atorvastatin has rapid and significant pleiotropic actions that reduce the
risk of POAF. However, prophylactic treatment with statins has yet to be
understood in SAVR. The aim of this study is to investigate whether
prophylactic administration of torvastatin reduces POAF in patients
undergoing SAVR. Methods and analysis In this investigator-initiated,
prospective, parallel-group, randomised, double-blind, placebo-controlled
single-centre trial, 266 patients undergoing elective solitary SAVR with
bioprosthetic valve, with no prior history of AF, and statin-naive will be
randomised (1:1) to treatment with Atorvastatin (80 mg once daily) or
matching placebo for 1-2 weeks prior to and 30 days after surgery. The
primary endpoint is POAF defined as an episode of irregular RR-intervals
without a traceable p-wave of at least 30 s duration. After discharge and
until day 30 after surgery, POAF will be documented by either rhythm strip
or 12-lead ECG. Ethics and dissemination Protocol approval has been
obtained from the Regional Scientific Ethical Committee for Southern
Denmark (S-20210159), The Danish Medicines Agency (2021103821) and the
Data Protection Agency (21/65621). The trial is conducted in accordance
with the Declaration of Helsinki, the ICH-GCP (International Conference on
Harmonisation Good Clinical Practice) guidelines and the legal regulations
of Denmark. Study findings will be shared via peer-reviewed journal
publication and conference presentations. Trial registration number
NCT05076019.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<65>
[Use Link to view the full text]
Accession Number
2024456120
Title
Intravascular Imaging-Guided or Angiography-Guided Complex PCI.
Source
New England Journal of Medicine. 388(18) (pp 1668-1679), 2023. Date of
Publication: 2023.
Author
Lee J.M.; Choi K.H.; Song Y.B.; Lee J.-Y.; Lee S.-J.; Lee S.Y.; Kim S.M.;
Yun K.H.; Cho J.Y.; Kim C.J.; Ahn H.-S.; Nam C.-W.; Yoon H.-J.; Park Y.H.;
Lee W.S.; Jeong J.-O.; Song P.S.; Doh J.-H.; Jo S.-H.; Yoon C.-H.; Kang
M.G.; Koh J.-S.; Lee K.Y.; Lim Y.-H.; Cho Y.-H.; Cho J.-M.; Jang W.J.;
Chun K.-J.; Hong D.; Park T.K.; Yang J.H.; Choi S.-H.; Gwon H.-C.; Hahn
J.-Y.
Institution
(Lee, Choi, Song, Hong, Park, Yang, Choi, Gwon, Hahn) Samsung Medical
Center, Sungkyunkwan University School of Medicine, Catholic University of
Korea, South Korea
(Lee, Lee) Kangbuk Samsung Hospital, Sungkyunkwan University School of
Medicine, Catholic University of Korea, South Korea
(Kim, Ahn) Uijeongbu St. Mary's Hospital, Chung-Ang University College of
Medicine, South Korea
(Lee) Chung-Ang University Hospital, Incheon St. Mary's Hospital, South
Korea
(Lee) Catholic University of Korea, Incheon St. Mary's Hospital, South
Korea
(Lim) Hanyang University Seoul Hospital, College of Medicine, Hanyang
University, South Korea
(Cho) Kyung Hee University Hospital at Gangdong, South Korea
(Jang) Ewha Womans University College of Medicine, Seoul, South Korea
(Lee, Kim) Chungbuk National University Hospital, Chungbuk National
University College of Medicine, Cheongju, South Korea
(Lee) Chung-Ang University College of Medicine, Chung-Ang University
Gwangmyeong Hospital, Gwangmyeong, South Korea
(Yun, Cho) Wonkwang University Hospital, Iksan, South Korea
(Nam, Yoon) Keimyung University Dongsan Hospital, Daegu, South Korea
(Park) Samsung Changwon Hospital, Sungkyunkwan University School of
Medicine, Changwon, South Korea
(Jeong, Song) Chungnam National University Hospital, Chungnam National
University College of Medicine, Daejeon, South Korea
(Doh) Inje University Ilsan-Paik Hospital, Goyang, South Korea
(Jo) Cardiovascular Center, Hallym University Sacred Heart Hospital,
Anyang, South Korea
(Yoon) Seoul National University Bundang Hospital, Seongnam-si, South
Korea
(Kang, Koh) Gyeongsang National University School of Medicine, Gyeongsang
National University Hospital, Jinju, South Korea
(Cho) Hanyang University Myongji Hospital, Goyang, South Korea
(Chun) Pusan National University Yangsan Hospital, Yangsan, South Korea
Publisher
Massachussetts Medical Society
Abstract
Background Data regarding clinical outcomes after intravascular
imaging-guided percutaneous coronary intervention (PCI) for complex
coronary-artery lesions, as compared with outcomes after
angiography-guided PCI, are limited. Methods In this prospective,
multicenter, open-label trial in South Korea, we randomly assigned
patients with complex coronary-artery lesions in a 2:1 ratio to undergo
either intravascular imaging-guided PCI or angiography-guided PCI. In the
intravascular imaging group, the choice between intravascular
ultrasonography and optical coherence tomography was at the operators'
discretion. The primary end point was a composite of death from cardiac
causes, target-vessel-related myocardial infarction, or clinically driven
target-vessel revascularization. Safety was also assessed. Results A total
of 1639 patients underwent randomization, with 1092 assigned to undergo
intravascular imaging-guided PCI and 547 assigned to undergo
angiography-guided PCI. At a median follow-up of 2.1 years (interquartile
range, 1.4 to 3.0), a primary end-point event had occurred in 76 patients
(cumulative incidence, 7.7%) in the intravascular imaging group and in 60
patients (cumulative incidence, 12.3%) in the angiography group (hazard
ratio, 0.64; 95% confidence interval, 0.45 to 0.89; P=0.008). Death from
cardiac causes occurred in 16 patients (cumulative incidence, 1.7%) in the
intravascular imaging group and in 17 patients (cumulative incidence,
3.8%) in the angiography group; target-vessel-related myocardial
infarction occurred in 38 (cumulative incidence, 3.7%) and 30 (cumulative
incidence, 5.6%), respectively; and clinically driven target-vessel
revascularization in 32 (cumulative incidence, 3.4%) and 25 (cumulative
incidence, 5.5%), respectively. There were no apparent between-group
differences in the incidence of procedure-related safety events.
Conclusions Among patients with complex coronary-artery lesions,
intravascular imaging-guided PCI led to a lower risk of a composite of
death from cardiac causes, target-vessel-related myocardial infarction, or
clinically driven target-vessel revascularization than angiography-guided
PCI. (Supported by Abbott Vascular and Boston Scientific;
RENOVATE-COMPLEX-PCI ClinicalTrials.gov number,
NCT03381872).<br/>Copyright &#xa9; 2023 Massachusetts Medical Society.

<66>
Accession Number
2024379802
Title
Preoperative P-wave parameters and risk of atrial fibrillation after
cardiac surgery: a meta-analysis of 20 201 patients.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(4) (no pagination),
2022. Article Number: ivac220. Date of Publication: 01 Oct 2022.
Author
Kawczynski M.J.; Van De Walle S.; Maesen B.; Isaacs A.; Zeemering S.;
Hermans B.; Vernooy K.; Maessen J.G.; Schotten U.; Bidar E.
Institution
(Kawczynski, Van De Walle, Maesen, Maessen, Bidar) Department of
Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University
Medical Centre, Maastricht, Netherlands
(Kawczynski, Maesen, Isaacs, Zeemering, Hermans, Maessen, Schotten, Bidar)
Department of Physiology, Maastricht University, Maastricht, Netherlands
(Zeemering, Hermans, Vernooy) Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Vernooy) Department of Cardiology, Heart and Vascular Centre, Maastricht
University Medical Centre, Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: To evaluate the role of P-wave parameters, as defined on
preprocedural electrocardiography (ECG), in predicting atrial fibrillation
after cardiac surgery [postoperative atrial fibrillation (POAF)].
<br/>METHOD(S): PubMed, Cochrane library and Embase were searched for
studies reporting on P-wave parameters and risk of POAF. Meta-analysis of
P-wave parameters reported by at least 5 different publications was
performed. In case of receiver operator characteristics (ROC-curve)
analysis in the original publications, an ROC meta-analysis was performed
to summarize the sensitivity and specificity. <br/>RESULT(S): Thirty-two
publications, with a total of 20 201 patients, contributed to the
meta-analysis. Increased P-wave duration, measured on conventional 12-lead
ECG (22 studies, Cohen's d = 0.4, 95% confidence interval: 0.3-0.5, P <
0.0001) and signal-averaged ECG (12 studies, Cohen's d = 0.8, 95%
confidence interval: 0.5-1.2, P < 0.0001), was a predictor of POAF
independently from left atrial size. ROC meta-analysis for signal-averaged
ECG P-wave duration showed an overall sensitivity of 72% (95% confidence
interval: 65-78%) and specificity of 68% (95% confidence interval:
58-77%). Summary ROC curve had a moderate discriminative power with an
area under the curve of 0.76. There was substantial heterogeneity in the
meta-analyses for P-wave dispersion and PR-interval. <br/>CONCLUSION(S):
This meta-analysis shows that increased P-wave duration, measured on
conventional 12-lead ECG and signal-averaged ECG, predicted POAF in
patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<67>
Accession Number
2024379797
Title
Perioperative electroencephalography in cardiac surgery with hypothermic
circulatory arrest: a narrative review.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(4) (no pagination),
2022. Article Number: ivac198. Date of Publication: 01 Oct 2022.
Author
Mcdevitt W.M.; Gul T.; Jones T.J.; Scholefield B.R.; Seri S.; Drury N.E.
Institution
(Mcdevitt, Seri) Department of Neurophysiology, Birmingham Children's
Hospital, Birmingham, United Kingdom
(Gul) School of Biomedical Sciences, University of Birmingham, Birmingham,
United Kingdom
(Gul, Jones, Drury) Department of Paediatric Cardiac Surgery, Birmingham
Children's Hospital, Birmingham, United Kingdom
(Jones, Drury) Institute of Cardiovascular Sciences, University of
Birmingham, Birmingham, United Kingdom
(Scholefield) Institute of Inflammation and Ageing, University of
Birmingham, Birmingham, United Kingdom
(Scholefield) Paediatric Intensive Care Unit, Birmingham Children's
Hospital, Birmingham, United Kingdom
(Seri) College of Health and Life Sciences, Aston University, Birmingham,
United Kingdom
Publisher
Oxford University Press
Abstract
OBJECTIVES: Cardiac surgery with hypothermic circulatory arrest (HCA) is
associated with neurological morbidity of variable severity and
electroencephalography (EEG) is a sensitive proxy measure of brain injury.
We conducted a narrative review of the literature to evaluate the role of
perioperative EEG monitoring in cardiac surgery involving HCA.
<br/>METHOD(S): Medline, Embase, Central and LILACS databases were
searched to identify studies utilizing perioperative EEG during surgery
with HCA in all age groups, published since 1985 in any language. We aimed
to compare EEG use with no use but due to the lack of comparative studies,
we performed a narrative review of its utility. Two or more reviewers
independently screened studies for eligibility and extracted data.
<br/>RESULT(S): Fourty single-centre studies with a total of 3287 patients
undergoing surgery were identified. Most were observational cohort studies
(34, 85%) with only 1 directly comparing EEG use with no use. EEG
continuity (18, 45%), seizures (15, 38%) and electrocerebral inactivity
prior to circulatory arrest (15, 38%) were used to detect, monitor,
prevent and prognose neurological injury. Neurological dysfunction was
reported in almost all studies and occurred in 0-21% of patients. However,
the heterogeneity of reported clinical and EEG outcome measures prevented
meta-analysis. <br/>CONCLUSION(S): EEG is used to detect cortical
ischaemia and seizures and predict neurological abnormalities and may
guide intraoperative cerebral protection. However, there is a lack of
comparative data demonstrating the benefit of perioperative EEG
monitoring. Use of a standardized methodology for performing EEG and
reporting outcome metrics would facilitate the conduct of high-quality
clinical trials.<br/>Copyright &#xa9; 2022 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<68>
Accession Number
2024108730
Title
Nephrotic syndrome and acute coronary syndrome in children, teenagers and
young adults: Systematic literature review.
Source
Archives of Cardiovascular Diseases. 116(5) (pp 282-290), 2023. Date of
Publication: May 2023.
Author
Wolf O.; Didier R.; Chague F.; Bichat F.; Rochette L.; Zeller M.; Fauchier
L.; Bonnotte B.; Cottin Y.
Institution
(Wolf, Didier, Chague, Bichat, Zeller, Cottin) Department of Cardiology,
University Teaching Hospital of Dijon Bourgogne, Dijon 21000, France
(Rochette, Zeller) PEC2, EA 7460, University of Burgundy, Dijon 21000,
France
(Fauchier) Department of Cardiology, Francois-Rabelais University,
University Teaching Hospital of Trousseau, Tours 37044, France
(Bonnotte) Department of Internal Medicine, University Teaching Hospital
of Dijon Bourgogne, Dijon 21000, France
Publisher
Elsevier Masson s.r.l.
Abstract
Myocardial infarction is rare in children, teenagers and young adults
(aged < 20 years). The most common aetiologies identified include Kawasaki
disease, familial hypercholesterolaemia, collagen vascular disease-induced
coronary arteritis, substance abuse (cocaine, glue sniffing), trauma,
complications of congenital heart disease surgery, genetic disorders (such
as progeria), coronary artery embolism, occult malignancy and several
other rare conditions. Nephrotic syndrome is a very rare cause of
myocardial infarction, but it is probably underestimated. The purpose of
this review was to determine the current state of knowledge on acute
coronary syndrome related to nephrotic syndrome. We thus performed a
comprehensive structured literature search of the Medline database for
articles published between January 1st, 1969 and December 31st, 2021.
Myocardial infarction in young adults can be broadly divided into two
groups: cases of angiographically normal coronary arteries; and cases of
coronary artery disease of varying aetiology. There are several possible
mechanisms underlying the association between acute coronary syndrome and
nephrotic syndrome: (1) coronary thrombosis related to hypercoagulability
and/or platelet hyperactivity; (2) atherosclerosis related to
hyperlipidaemia; and (3) drug treatment. All of these mechanisms must be
evaluated systematically in the acute phase of disease because they evolve
rapidly with the treatment of nephrotic syndrome. In this review, we
propose a decision algorithm for the management of acute coronary syndrome
in the context of nephrotic syndrome. The final part of the review
presents the short- and medium-term therapeutic strategies available.
Thromboembolism related to nephrotic syndrome is a rare
non-atherosclerotic cause of acute coronary syndrome, and prospective
studies are needed to evaluate a systematic approach with personalized
therapeutic strategies.<br/>Copyright &#xa9; 2023 Elsevier Masson SAS

<69>
Accession Number
2023412924
Title
Impact of in-Hospital Left Ventricular Ejection Fraction Recovery on
Long-Term Outcomes in Patients Who Underwent Impella Support for HR PCI or
Cardiogenic Shock: A Sub-Analysis from the IMP-IT Registry.
Source
Journal of Personalized Medicine. 13(5) (no pagination), 2023. Article
Number: 826. Date of Publication: May 2023.
Author
Iannaccone M.; Franchin L.; Burzotta F.; Botti G.; Pazzanese V.; Briguori
C.; Trani C.; Piva T.; De Marco F.; Masiero G.; Di Biasi M.; Pagnotta P.;
Casu G.; Scandroglio A.M.; Tarantini G.; Chieffo A.
Institution
(Iannaccone, Franchin) Department of Cardiology, San Giovanni Bosco
Hospital, Turin 10100, Italy
(Burzotta, Trani) Institute of Cardiology, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome
00100, Italy
(Botti, Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele
Scientific Institute, Milan 20100, Italy
(Pazzanese) Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific
Institute, Milan 20100, Italy
(Briguori) Interventional Cardiology Unit, Mediterranea Cardiocentro,
Naples 80100, Italy
(Piva) Center for Exercise Science and Sport, Department of Neuroscience
and Rehabilitation, University of Ferrara, Ferrara 44121, Italy
(De Marco) Valvular and Structural Heart Cardiology, Centro Cardiologico
Monzino, Milan 20100, Italy
(Masiero, Tarantini) Department of Cardiac, Thoracic and Vascular Science,
University of Padua, Padua 35100, Italy
(Di Biasi) Interventional Cardiology Unit, Ospedale Luigi Sacco, Milan
20100, Italy
(Pagnotta) Cardiovascular Department, Humanitas Research Hospital, Rozzano
20089, Italy
(Casu) Clinical and Interventional Cardiology, Sassari University
Hospital, Sassari 07100, Italy
(Scandroglio) Advanced Heart Failure and Mechanical Circulatory Support
Program, San Raffaele Scientific Institute, Vita Salute University, Milan
20100, Italy
Publisher
MDPI
Abstract
(1) Background: Percutaneous left ventricle assist devices (pLVADs)
demonstrated an improvement in mid-term clinical outcomes in selected
patients with severely depressed left ventricular ejection fraction (LVEF)
undergoing percutaneous coronary interventions. However, the prognostic
impact of in-hospital LVEF recovery is unclear. Accordingly, the present
sub-analysis aims to evaluate the impact of LVEF recovery in both
cardiogenic shock (CS) and high-risk percutaneous coronary intervention
(HR PCI) supported with pLVADs in the IMP-IT registry. (2) Methods: A
total of 279 patients (116 patients in CS and 163 patients in HR PCI)
treated with Impella 2.5 or CP in the IMP-IT registry were included in
this analysis, after excluding those who died while in the hospital or
with missing data on LVEF recovery. The primary study objective was a
composite of all-cause death, rehospitalisation for heart failure, left
ventricle assist device (LVAD) implantation, or heart transplantation
(HT), overall referred to as the major adverse cardiac events (MACE) at 1
year. The study aimed to evaluate the impact of in-hospital LVEF recovery
on the primary study objective in patients treated with Impella for HR PCI
and CS, respectively. (3) Results: The mean in-hospital change in LVEF was
10 +/- 1% (p < 0.001) in the CS cohort and 3 +/- 7% (p < 0.001) in the HR
PCI group, achieved by 44% and 40% of patients, respectively. In the CS
group, patients with less than 10% in-hospital LVEF recovery experienced
higher rates of MACE at 1 year of follow-up (FU) (51% vs. 21%, HR 3.8, CI
1.7-8.4, p < 0.01). After multivariate analysis, LVEF recovery was the
main independent protective factor for MACE at FU (HR 0.23, CI 0.08-0.64,
p = 0.02). In the HR PCI group, LVEF recovery (>3%) was not associated
with lower MACE at multivariable analysis (HR 0.73, CI 0.31-1.72, p =
0.17). Conversely, the completeness of revascularisation was found to be a
protective factor for MACE (HR 0.11, CI 0.02-0.62, p = 0.02) (4)
<br/>Conclusion(s): Significant LVEF recovery was associated with improved
outcomes in CS patients treated with PCI during mechanical circulatory
support with Impella, whereas complete revascularisation showed a
significant clinical relevance in HR PCI.<br/>Copyright &#xa9; 2023 by the
authors.

<70>
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.
<br/>Method(s): The literature search was performed in databases including
PubMed, Scopus, Google Scholar, EBSCOHost, Wiley, ProQuest, and Embase, up
to June 1^st, 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. <br/>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]). <br/>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.<br/>Copyright &#xa9; 2022 Hellenic Society of
Cardiology

<71>
Accession Number
2022112260
Title
Effect of Acupressure on Dental Anxiety in Children: a Pilot Study for a
Randomized Clinical Trial.
Source
JAMS Journal of Acupuncture and Meridian Studies. 15(5) (pp 307-313),
2022. Date of Publication: 2022.
Author
Soares M.E.C.; de Souza Araujo A.; Pinto I.C.L.; Barbosa L.S.A.; Borsatto
M.C.; Galo R.
Institution
(Soares, de Souza Araujo, Pinto, Barbosa) Department of Dentistry, School
of Biological and Health Sciences, Universidade Federal dos Vales do
Jequitinhonha e Mucuri, Diamantina, Brazil
(Borsatto) Clinical Pediatric Dentistry Department, Ribeirao Preto School
of Dentistry, Universidade de Sao Paulo, Ribeirao Preto, Brazil
(Galo) Department of Dental Materials and Prosthesis, Ribeirao Preto
School of Dentistry, Universidade de Sao Paulo, Ribeirao Preto, Brazil
Publisher
Medical Association of pharmacopuncture Institute
Abstract
Background: Anxiety is an important problem in children in dental clinics.
Acupressure may be a useful tool to assist in dental procedures in anxious
children. <br/>Objective(s): This pilot study was performed to examine the
effects of acupressure on dental anxiety in children undergoing
restorative procedures. <br/>Method(s): Fourteen children aged 7-10 years
and with at least one primary molar with caries on the dentine were
included in the study. The participants also needed to score at least one
point on the modified Venham Picture Test (VPTm) for the determination of
anxiety. The children were randomly allocated to two groups: group A -
non-documented points for the reduction of anxiety and induction of
relaxation; group B - documented points (EX-HN3, Shen Men of auricular
acupuncture). The anxiety scale was administered on three occasions: prior
to the application of acupressure; immediately after sitting in the dental
chair to undergo restorative treatment; and after removal of acupressure
at the end of the restorative procedure. Heart rate (HR) was measured when
each child sat in the dental chair, after the removal of carious tissue,
and after the removal of acupressure. <br/>Result(s): After the procedure,
HR (as an indicator of anxiety) was statistically significantly lower in
group B than group A (p = 0.02). However, there was no significant
difference between the groups regarding anxiety before and during the
restorative procedure (VPTm and HR: p > 0.05). <br/>Conclusion(s): The
children who received acupressure on documented points for the reduction
of anxiety had a significantly lower HR after the restorative procedure.
No significant between-group difference was found regarding anxiety
measured using a psychometric evaluation (VPTm).<br/>Copyright &#xa9;
Medical Association of Pharmacopuncture Institute (MAPI)

<72>
Accession Number
2021934379
Title
Periprocedural, short-term, and long-term outcomes following transcatheter
tricuspid valve repair: a systemic review and meta-analysis.
Source
Therapeutic Advances in Chronic Disease. 14 (no pagination), 2023. Date of
Publication: January-December 2023.
Author
Wu Z.; Zhu W.; Kaisaier W.; Kadier M.; Li R.; Tursun G.; Dong Y.; Liu C.;
Chen Y.
Institution
(Wu, Zhu, Kaisaier, Kadier, Li, Tursun, Dong) Department of Cardiology,
The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
(Wu, Zhu, Dong, Liu, Chen) NHC Key Laboratory of Assisted Circulation, Sun
Yat-sen University, Guangzhou, China
(Liu, Chen) Department of Cardiology, The First Affiliated Hospital, Sun
Yat-sen University, Guangzhou 510080, China
Publisher
SAGE Publications Ltd
Abstract
Background: There has been an increasing use of transcatheter tricuspid
valve repair (TTVR) recently. However, the periprocedural, short-term, and
long-term outcomes of TTVR remain unclear. <br/>Objective(s): To determine
the clinical outcomes in patients with significant tricuspid regurgitation
undergoing TTVR. <br/>Design(s): Systematic review and meta-analysis. Data
Source and Methods: The systematic review and meta-analysis is reported
according to Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. PubMed and EMBASE were searched for
clinical trials and observational studies until March 2022. Studies
reporting the incidence of clinical outcomes after TTVR were included. The
clinical outcomes included periprocedural, short-term (in-hospital or
within 30 days), and long-term (>6-month follow-up) outcomes. The primary
outcome was all-cause mortality whereas the secondary outcomes included
technical success, procedural success, cardiovascular mortality,
rehospitalization for heart failure (HHF), major bleeding, and single
leaflet device attachment. The incidence of these outcomes across studies
was pooled by a random-effects model. <br/>Result(s): A total of 21
studies with 896 patients were included. A total of 729 (81.4%) patients
underwent isolated TTVR while only 167 (18.6%) patients underwent combined
mitral and tricuspid valve repair. Over 80% of the patients used
coaptation devices while approximately 20% used annuloplasty devices. The
median follow-up duration was 365 days. Technical and procedural success
was high at 93.9% and 82.1%, respectively. The pooled perioperative,
short-term, and long-term all-cause mortality for patients undergoing TTVR
was 1.0%, 3.3%, and 14.1%, respectively. The long-term cardiovascular
mortality rate was 5.3% while the HHF rate was 21.5%. Major bleeding and
single leaflet device attachment were two major complications, accounting
for 14.3% and 6.4%, respectively, during long-term follow-up.
<br/>Conclusion(s): TTVR is associated with high procedural success and
low procedural and short-term mortality. However, all-cause mortality,
cardiovascular mortality, and HHF rates remain high during long-term
follow-up. Registration: PROSPERO (CRD42022310020).<br/>Copyright &#xa9;
The Author(s), 2023.

<73>
[Use Link to view the full text]
Accession Number
2017500082
Title
Preoperative Erythropoietin vs Placebo.
Source
Anesthesia and Analgesia. 128(5) (pp 835), 2019. Date of Publication: May
2019.
Author
Nathan N.
Institution
(Nathan) Northwestern University Feinberg, School of Medicine, United
States
Publisher
Lippincott Williams and Wilkins

<74>
Accession Number
637286141
Title
Bibliometric Analysis of 50 Most Cited Articles Comparing Lobectomy with
Sublobar Resection.
Source
Thoracic and Cardiovascular Surgeon. 71(4) (pp 307-316), 2021. Date of
Publication: 13 Jul 2021.
Author
Tekneci A.K.; Ozgur G.K.; Akcam T.I.; Cagirici U.
Institution
(Tekneci, Ozgur, Akcam, Cagirici) Department of Thoracic Surgery, Ege
University, School of Medicine, Izmir, Turkey
Publisher
Georg Thieme Verlag
Abstract
Background Recent years have seen an increase in the number of studies of
the sublobar resection approach in non-small cell lung cancer (NSCLC)
surgery. The purpose of this bibliometric analysis is to assess the
significance and impact of articles comparing sublobar resection and
lobectomy in NSCLC surgery. Material and Methods The Web of Science
database was searched to identify studies comparing sublobar resection and
lobectomy in NSCLC surgery published between 2005 and 2020 (accessed:
September 11, 2020). The 50 most cited articles were analyzed by years,
countries, authors, authors' affiliations, journals, journals' addresses,
and impact factors. Results The bibliometric analysis revealed that the
most cited article had 443 citations, while the total number of citations
of all articles was 2,820. The mean number of citations, in turn, was 56.4
+/- 75.62 (1-443) times. The highest number of publications over the past
15 years was in 2016, with eight articles. The Annals of Thoracic Surgery
(n = 10; 20%) had the highest number of publications on the list. The
articles included in the present study were mostly (n = 35, 70%) published
in U.S. journals. While multiple subject matters and analyses were
presented by many studies, survival was the topic of greatest interest,
with 37 (74%) studies. Conclusion This study revealed that interest in
studies comparing sublobar resection with lobectomy has increased in
recent years. It also presents both quantitative and qualitative analyses
of the most cited articles in the literature on this topic. Therefore, it
can serve as a guide for researchers.<br/>Copyright &#xa9; 2021 Georg
Thieme Verlag. All rights reserved.

<75>
Accession Number
2024804254
Title
Red blood cell distribution width to predict mortality in heart transplant
recipients: a systematic review.
Source
Monaldi Archives for Chest Disease. 93(2) (pp 78-83), 2023. Article
Number: A4. Date of Publication: 2023.
Author
Acuna-Chavez L.M.; Cruzalegui-Bazan C.; Quispe-Vicuna C.; Saldarriaga C.;
Contreras J.; Chavez-Peche J.A.; Alvarez-Vargas M.; Segura-Saldana P.
Institution
(Acuna-Chavez) Sociedad Cientifica de Estudiantes de Medicina de la
Universidad Nacional de Trujillo, Trujillo, Peru
(Acuna-Chavez, Cruzalegui-Bazan, Quispe-Vicuna, Chavez-Peche,
Alvarez-Vargas, Segura-Saldana) Department of Cardiology Research, Torres
de Salud National Research Center, Lima, Peru
(Cruzalegui-Bazan, Quispe-Vicuna) Sociedad Cientifica de San Fernando,
Universidad Nacional Mayor de San Marcos, Lima, Peru
(Saldarriaga) University of Antioquia, Medellin, Colombia
(Saldarriaga) Pontificia Bolivariana University, Medellin, Colombia
(Saldarriaga) CardioVID Clinic, Medellin, Colombia
(Contreras) Director of Ambulatory Heart Failure Network, The Mount Sinai
Health System, New York, United States
(Chavez-Peche) Clinica San Felipe, Lima, Peru
(Alvarez-Vargas) Departamento de Medicina Interna, Hospital Nacional
Guillermo Almenara, Lima, Peru
(Segura-Saldana) Ingenieria Biomedica, Facultad de Ciencias y Filosofia,
Universidad Peruana Cayetano Heredia, Lima, Peru
(Segura-Saldana) Departamento de Cardiologia, Hospital Nacional Edgardo
Rebagliati Martins, Lima, Peru
Publisher
Page Press Publications
Abstract
Red blood cell distribution width (RDW) has been shown to have prognostic
value in a number of different clinical settings, such as cardiovascular
disease, including heart failure. However, its prognostic value in heart
transplant (HT) recipients remains unknown. The aim of this systematic
review is to determine the prognostic value of pre-transplant RDW for
mortality in HT recipients. There is a pre-published protocol of this
review. The terms "Heart transplant", "Red cell distribution width" and
their synonyms were used in the search strategy. PubMed/Medline, Embase,
Scopus, Web of Science and LILACS were searched until May 17th, 2022,
without date or language restrictions. Two authors independently carried
out the selection, first by title and abstract, second by full-text
revision. Discrepancies were discussed and resolved with three other
authors. Quality of individual studies was assessed with Newcastle Ottawa
Scale (NOS) for cohorts. After removing the duplicates, 3885 articles were
identified. Four articles were included in the qualitative synthesis.
Three studies were classified as "good quality": whereas one as "poor
quality" according to NOS scale. All the included articles evaluated
long-term mortality and one study also evaluated short-term mortality. In
this one, a correlation between higher RDW values and short-term mortality
was reported. Meanwhile, in all the studies, a high pre-HT RDW was a
marker of long-term mortality following cardiac transplantation. Our
review shows that an elevated on-admission RDW is associated with
long-term mortality in heart transplantation recipients.<br/>Copyright
&#xa9; 2023 PAGEPress Publications. All rights reserved.

<76>
[Use Link to view the full text]
Accession Number
2024760708
Title
Single- or dual-antiplatelet therapy after transcatheter aortic valve
replacement: A protocol of systematic review and meta-analysis.
Source
Medicine (United States). 100(6) (pp E24550), 2021. Date of Publication:
12 Feb 2021.
Author
Li H.; Wang Y.; Li L.; Dan B.
Institution
(Li, Wang, Li, Dan) Qinghai People's Hospital, Qinghai, China
Publisher
Lippincott Williams and Wilkins
Abstract
BackgroundThe evidence related to bleeding and thromboembolic events after
transcatheter aortic valve replacement (TAVR) compared single antiplatelet
therapy (SAPT) with dual antiplatelet therapy (DAPT) treatment are
inconsistent. Moreover, there are some limitations such as small sample
size and the risk of bias in existing studies. We will conduct a
comprehensive systematic review and meta-analysis to explore the safety
and efficacy of SAPT or DAPT after TAVR.MethodsA comprehensive literature
search of PubMed, EMBASE, The Cochrane Library, Cochrane Central Register
of Controlled Trials will be searched to retrieve studies involving SAPT
versus DAPT after TAVR. Two investigators will independently select
studies, extract data, and assess the quality of the included study. Any
disagreement will be resolved by the third investigator. The study will
use a random-effects model to pool the results of all studies and use the
relative risk and 95% confidence intervals to summarize individual trial
outcomes and estimate pooled effect. The study will use the Grading of
Recommendations Assessment, Development, and Evaluation to assess the
certainty of evidence.ResultsThis study will provide high-quality evidence
for treatment of TAVR in terms of effectiveness and safety.ConclusionThis
systematic review aims to provide evidence for treatment of TAVR in
different antiplatelet therapies.RegistrationThe systematic review and
meta-analysis is registered in the OSF REGISTRIES (10.17605/OSF.IO/Q42TE)
international prospective register. <br/>Copyright &#xa9; 2021 the
Author(s). Published by Wolters Kluwer Health, Inc.

<77>
[Use Link to view the full text]
Accession Number
2024734789
Title
Observation of the analgesic effect of superficial or deep anterior
serratus plane block on patients undergoing thoracoscopic lobectomy.
Source
Medicine (United States). 100(3) (pp E24352), 2021. Date of Publication:
22 Jan 2021.
Author
Qiu L.; Bu X.; Shen J.; Li M.; Yang L.; Xu Q.; Chen Y.; Yang J.
Institution
(Qiu, Yang) Department of Anesthesiology, Intensive Care Medicine and Pain
Medicine, The First Affiliated Hospital of Soochow University, Suzhou,
China
(Bu, Shen, Li, Yang, Xu) Department of Anesthesiology, China
(Chen) Department of Cardiology, The Third Affiliated Hospital of Soochow
University, Jiangsu, Changzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
The effectiveness of anterior serratus plane block in postoperative
analgesia of thoracic surgery is beginning to emerge. Currently, there are
2 methods of anterior serratus plane block: deep serratus plane block
(DSPB) and superficial serratus plane block (SSPB). In clinical practice,
there is no an unified view regarding the advantages and disadvantages
between 2 methods. This study aimed to observe and compare the analgesic
effects of 2 methods on patients undergoing thoracoscopic lobectomy, in
order to provide some suggestions for anesthesiologists when they choose
anterior serratus plane block to perform postoperative analgesia for
patients.Patients were randomly divided into 3 groups
(21patients/group):1.general anesthesia group (P group);2.combined general
anesthesia and SSPB group (S group), and3.combined general anesthesia and
DSPB group (D group).The patients in groups S and D received 0.4ml/kg of
0.375% ropivacaine for ultrasound-guided block after surgery.
Postoperatively, flurbiprofen was used for rescue analgesia.Visual analog
scale (VAS) pain scores were recorded at 6hours, 12hours, and 24hours
after surgery, and rescue analgesia, post-operative nausea, and vomiting
were reported within 24hours after surgery. At 6hours, 12hours, and
24hours, the VAS scores and the rescue analgesia rates in groups S and D
were significantly lower than those in group P (all P<.001). With
prolonging time, the VAS in group D was significantly increased by 0.11
per hour as compared with that of group P (P<.0001); VAS in group D was
significantly increased by 0.12 per hour as compared with that of group S
(P<.0001).Ultrasound-guided anterior serratus plane block can provide
adequate analgesia for patients undergoing thoracoscopy lobectomy. SSPB
can significantly improve VAS scores as compared to DSPB at
24hours.<br/>Copyright &#xa9; 2021 Lippincott Williams and Wilkins. All
rights reserved.

<78>
Accession Number
641454143
Title
Percutaneous Coronary Intervention vs Coronary Artery Bypass Graft Surgery
for Left Main Disease in Patients With and Without Acute Coronary
Syndromes: A Pooled Analysis of 4 Randomized Clinical Trials.
Source
JAMA cardiology. (no pagination), 2023. Date of Publication: 31 May 2023.
Author
Gaba P.; Christiansen E.H.; Nielsen P.H.; Murphy S.A.; O'Gara P.T.; Smith
P.K.; Serruys P.W.; Kappetein A.P.; Park S.-J.; Park D.-W.; Stone G.W.;
Sabik J.F.; Sabatine M.S.; Holm N.R.; Bergmark B.A.
Institution
(Gaba, Murphy, O'Gara, Sabatine, Bergmark) Thrombolysis in Myocardial
Infarction (TIMI) Study Group, Division of Cardiovascular Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Christiansen, Nielsen, Holm) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(O'Gara, Sabatine) JAMA Cardiology
(Smith) Duke University School of Medicine, Duke Clinical Research
Institute, Durham, NC, United States
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Park, Park) Department of Cardiology, Asan Medical Center, Seoul, South
Korea
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
Importance: Patients with left main coronary artery disease presenting
with an acute coronary syndrome (ACS) represent a high-risk and
understudied subgroup of patients with atherosclerosis. <br/>Objective(s):
To assess clinical outcomes after PCI vs CABG in patients with left main
disease with vs without ACS. <br/>Design, Setting, and Participant(s):
Data were pooled from 4 trials comparing PCI with drug-eluting stents vs
CABG in patients with left main disease who were considered equally
suitable candidates for either strategy (SYNTAX, PRECOMBAT, NOBLE, and
EXCEL). Patients were categorized as presenting with or without ACS.
Kaplan-Meier event rates through 5 years and Cox model hazard ratios were
generated, and interactions were tested. Patients were enrolled in the
individual trials from 2004 through 2015. Individual patient data from the
trials were pooled and reconciled from 2020 to 2021, and the analyses
pertaining to the ACS subgroup were performed from March 2022 through
February 2023. <br/>Main Outcomes and Measures: The primary outcome was
death through 5 years. Secondary outcomes included cardiovascular death,
spontaneous myocardial infarction (MI), procedural MI, stroke, and repeat
revascularization. <br/>Result(s): Among 4394 patients (median [IQR] age,
66 [59-73] years; 3371 [76.7%] male and 1022 [23.3%] female) randomized to
receive PCI or CABG, 1466 (33%) had ACS. Patients with ACS were more
likely to have diabetes, prior MI, left ventricular ejection fraction less
than 50%, and higher SYNTAX scores. At 30 days, patients with ACS had
higher all-cause death (hazard ratio [HR], 3.40; 95% CI, 1.81-6.37;
P<.001) and cardiovascular death (HR, 3.21; 95% CI, 1.69-6.08; P<.001)
compared with those without ACS. Patients with ACS also had higher rates
of spontaneous MI (HR, 1.70; 95% CI, 1.25-2.31; P<.001) through 5 years.
The rates of all-cause mortality through 5 years with PCI vs CABG were
10.9% vs 11.5% (HR, 0.93; 95% CI, 0.68-1.27) in patients with ACS and
11.3% vs 9.6% (HR, 1.19; 95% CI, 0.95-1.50) in patients without ACS (P=.22
for interaction). The risk of early stroke was lower with PCI vs CABG
(ACS: HR, 0.39; 95% CI, 0.12-1.25; no ACS: HR, 0.35; 95% CI, 0.16-0.75),
whereas the 5-year risks of spontaneous MI and repeat revascularization
were higher with PCI vs CABG (spontaneous MI: ACS: HR, 1.74; 95% CI,
1.09-2.77; no ACS: HR, 3.03; 95% CI, 1.94-4.72; repeat revascularization:
ACS: HR, 1.57; 95% CI, 1.19-2.09; no ACS: HR, 1.90; 95% CI, 1.54-2.33),
regardless of ACS status. Conclusion and Relevance: Among largely stable
patients undergoing left main revascularization and with predominantly low
to intermediate coronary anatomical complexity, those with ACS had higher
rates of early death. Nonetheless, rates of all-cause mortality through 5
years were similar with PCI vs CABG in this high-risk subgroup. The
relative advantages and disadvantages of PCI vs CABG in terms of early
stroke and long-term spontaneous MI and repeat revascularization were
consistent regardless of ACS status. Trial Registration:
ClinicalTrials.gov Identifiers: NCT00114972, NCT00422968, NCT01496651,
NCT01205776.

<79>
Accession Number
641454076
Title
Co-Occurrence of Sensorineural Hearing Loss and Congenital Heart Disease:
Etiologies and Management.
Source
The Laryngoscope. (no pagination), 2023. Date of Publication: 31 May
2023.
Author
Yang T.; Fan X.; Fan Y.; Song W.; Liu X.; Wang J.; Chen X.
Institution
(Yang, Fan, Fan, Song, Wang, Chen) Department of Otolaryngology, Peking
Union Medical College Hospital, Chinese Academy of Medical Sciences,
Peking Union Medical College, Beijing, China
(Liu) Department of Cardiac Surgery, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences, Peking Union Medical
College, Beijing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES/HYPOTHESIS: The co-occurrence of sensorineural hearing loss
(SNHL) and congenital heart disease (CHD) is a rare condition with complex
etiologies. The purpose of this study is to assess the etiologies,
clinical features, and outcomes of cochlear implant (CI) in this patient
population. STUDY DESIGN: Case series and literature review.
<br/>METHOD(S): Clinical data of children who were diagnosed with SNHL and
CHD and received CIs at a tertiary hospital from 2016 to 2021 were
retrospectively analyzed. A literature review was performed to identify
patients with SNHL and CHD. FINDINGS: Of the 382 children who underwent
cochlear implantation at our center, eight (2.1%) were diagnosed with SNHL
and CHD. A literature review identified 1525 patients from 254 studies;
the database therefore consisted of 1533 patients. The most common genetic
etiologies of co-occurring SNHL and CHD were CHARGE syndrome (36.3%),
Turner syndrome (8.4%), 22q11.2 deletion (3.0%), Noonan syndrome (2.9%),
and Down syndrome (2.5%), whereas the most common non-genetic etiologies
were congenital rubella syndrome (22.9%) and SNHL after early cardiac
surgery (5.5%). Most of the patients presented with congenital, bilateral,
severe-profound SNHL requiring early rehabilitation. Of the 126 children
who received CIs at a median age of 2.5years, half showed delayed speech
development at last follow-up. <br/>CONCLUSION(S): Co-occurring SNHL and
CHD is a rare condition with complex etiologies. Timely hearing
intervention with long-term follow-up and proper timing of heart surgery
is essential for these children. LEVEL OF EVIDENCE: 4, case series
Laryngoscope, 2023.<br/>Copyright &#xa9; 2023 The Authors. The
Laryngoscope published by Wiley Periodicals LLC on behalf of The American
Laryngological, Rhinological and Otological Society, Inc.

<80>
Accession Number
641453664
Title
Unfractionated heparin and the activated clotting time in non-cardiac
arterial procedures.
Source
The Journal of cardiovascular surgery. (no pagination), 2023. Date of
Publication: 31 May 2023.
Author
Roosendaal L.C.; van den Ancker W.; Wiersema A.M.; Blankensteijn J.D.;
Jongkind V.
Institution
(Roosendaal, Wiersema) Department of Vascular Surgery, Dijklander
Ziekenhuis, Hoorn, Netherlands
(Roosendaal, Wiersema, Blankensteijn) Department of Vascular Surgery,
Location VUmc, Amsterdam, Netherlands
(Roosendaal, Wiersema, Blankensteijn, Jongkind) Amsterdam Cardiovascular
Sciences, Amsterdam, Netherlands
(van den Ancker) Department of Clinical Hematology, Amsterdam, Netherlands
(Jongkind) Department of Vascular Surgery, Location VUmc, Amsterdam,
Netherlands
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Unfractionated heparin is administered during non-cardiac
arterial procedures (NCAP) to prevent thromboembolic complications. In
order to achieve a safe level of anticoagulation, the effect of heparin
can be measured. The aim of this review was to provide an overview on what
is known about heparin, suggested tests to monitor the effect of heparin,
including the activated clotting time (ACT), and the factors that could
influence that ACT. EVIDENCE ACQUISITION: A literature search in PubMed
was performed. Articles reporting on heparin, clotting time tests
(including thrombin time, activated partial thromboplastin time,
anti-activated factor X and ACT), and ACT measurement devices were
selected. EVIDENCE SYNTHESIS: Heparin has a non-predictable effect in the
individual patient, which could be measured using the ACT. However, ACT
values can be influenced by many factors, such as hemodilution,
hypothermia and thrombocytopenia. In addition, a high variation in ACT
outcomes is found between measurement devices of different brands. In the
sparse literature on the role of ACT during NCAP, no consensus has been
reached on optimal target ACT values. An ACT >250 seconds leads to more
bleeding complications. Females have a longer ACT after heparin
administration, with a higher risk of bleeding complications.
<br/>CONCLUSION(S): The effect of heparin is unpredictable. ACT can be
used to monitor the effect of heparin and achieve individualized
anticoagulation, tailored to the patient and the specifics of the
operative procedure. However, the ACT itself can be affected by several
factors and caution must be present, as measured ACT values differ between
measurement devices.

<81>
Accession Number
619567760
Title
Effect of adaptive support ventilation weaning mode in conventional or
standard methods on respiratory and hemodynamic performance indices: A
randomized clinical trial.
Source
Trauma Monthly. 22(5) (no pagination), 2017. Article Number: e37663. Date
of Publication: September 2017.
Author
Nouri J.M.; Sohrabi B.; Moradian S.T.; Ghiasi S.M.S.
Institution
(Nouri, Sohrabi, Moradian) Nursing Faculty, Baqiyatallah University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Ghiasi) Medical Faculty, Anesthetist, Baqiyatallah University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Background: Adaptive support ventilation (ASV) is one of the advanced
modes of ventilation. The available evidence regarding the process of
tracheal extubation indicates that staff working in intensive care unit
usually performs the weaning process according to their own experiences
and conventional methods. <br/>Objective(s): This study aimed to assess
the effect of weaning with adaptive support ventilation in two
conventional or standard methods on respiratory and hemodynamic
performance indices in patients undergoing coronary artery bypass graft
(CABG) surgery. <br/>Method(s): In this clinical trial, 100 patients
candidate for coronary artery bypass graft (CABG) surgery at Jamaran
hospital were allocated to experimental and control groups in 2015. Each
group had patients. The conventional method of ASV was used in the control
group without any intervention, while the standard method of ASV was
applied in the experimental group. The groups were compared in terms of
arterial blood gases, vital signs, atelectasis, and duration of weaning
process. <br/>Result(s): There was no statistically significant difference
between the experimental and control groups in terms of demographic
variables and disease history. Also, duration of mechanical ventilation
and weaning process, duration of the patient's trigger to the tracheal
extubation as well as other respiratory performance indicators and vital
signs were similar between the groups (P > 0.05). <br/>Conclusion(s): The
results of this study indicate that in stable patients who have no history
of lung problems, there is no need to apply the difficult weaning
protocol. These patients can be weaned without any
complication.<br/>Copyright &#xa9; 2016, Trauma Monthly.

<82>
Accession Number
2024600498
Title
SHORT TERM EFFECTS OF CARDIOPULMONARY REHABILITATION AND NEUROMUSCULAR
ELECTRICAL STIMULATION ON FUNCTIONAL CAPACITY, MYOCARDIAL TISSUE DOPPLER
AFTER CORONARY ARTERY BYPASS GRAFT SURGERY.
Source
Turkish Journal of Physiotherapy and Rehabilitation. 33(2) (pp 32-44),
2022. Date of Publication: 20 Aug 2022.
Author
Ozuberk B.; Kunduracilar Z.; Aslan U.B.; Turan S.A.; Cakir M.O.; Tutun U.
Institution
(Ozuberk) Kirklareli University, Faculty of Health Sciences, Department of
Physiotherapy and Rehabilitation, Kirklareli, Turkey
(Kunduracilar) University of Health Sciences, Hamidiye Faculty of Health
Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
(Aslan) Pamukkale University, Faculty of Health Sciences, Department of
Physiotherapy and Rehabilitation, Denizli, Turkey
(Turan) Zonguldak Bulent Ecevit University, Faculty of Medicine,
Department of Cardiology, Zonguldak, Turkey
(Cakir, Tutun) Zonguldak Bulent Ecevit University, Faculty of Medicine,
Department of Cardiovascular Surgery, Zonguldak, Turkey
Publisher
Turkish Physiotherapy Association
Abstract
Purpose: Exercise capacity is associated with diastolic function. The aim
of our study is to investigate the short-term effects of cardiopulmonary
rehabilitation and NMES on functional capacity and myocardial tissue
doppler (MTD) after coronary artery surgery. <br/>Method(s): Forty
patients with coronary artery bypass graft were randomly divided into two
groups: CPR+NMES and CPR. Functional capacity were analyzed through 2
minutes walk test (2MWT) and sit to stand test (SST), left ventricular
(LV) diastolic functions were analyzed with MTD and thoracic expansion was
analyzed with chest wall measurement on the 2nd and 7th postoperative
days. <br/>Result(s): Statistically significant difference was identified
between the groups in 2MWT distance (CPR+NMES, Zt*p=0.000*), SST (CPR,
Zt*p=0.000*), E' (CPR+NMES, Zt*p=0.002*), E (CPR+NMES, Zt*p=0.025*), E/E'
(CPR+NMES, Zt*p=0.007*), A (CPR, Zt*p=0.006*) (p<0.05). Statistically
significant difference has been observed in group comparisons in E'
(CPR+NMES, G*p=0.000*) ve E/E'(CPR+NMES, G*p=0.007* postoperative 2nd day;
G*p=0.019* postoperative 7th day) (p<0.05). The temporal changes of 2MWT
distance, heart rate, blood pressures, respiratory frequency, saturation
and Borg dyspnea-fatigue measurements did not show a statistically
significant difference between groups (p>0.05), except for
E'(Zg*p=0.000*), E/E' (Zg*p=0.003*) parameters (p<0.05).
<br/>Conclusion(s): It was seen that NMES, which we applied in addition to
early cardiopulmonary rehabilitation, made a positive contribution to LV
filling pressure and LV filling rate in the CPR+NMES group. Additionally,
in the intergroup comparisons of the CPR+NMES group, it was observed that
there was a statistically significant increase in the 2 MWT distance on
the postoperative 7th day compared to the postoperative 2nd
day.<br/>Copyright &#xa9; 2022 Turkish Physiotherapy Association. All
rights reserved.

<83>
Accession Number
2024506829
Title
Surgical management of spontaneous intracranial hypotension syndrome: a
literature review.
Source
Neurologia i Neurochirurgia Polska. 57(2) (pp 151-159), 2023. Date of
Publication: 2023.
Author
Sobczyk P.; Bojarski P.; Sobstyl M.
Institution
(Sobczyk, Bojarski, Sobstyl) Department of Neurosurgery, Institute of
Psychiatry and Neurology, Warsaw, Poland
Publisher
Via Medica
Abstract
Introduction. Spontaneous intracranial hypotension (SIH) is a highly
disabling but often misdiagnosed disorder. The optimal management options
for patients with SIH remain uncertain. The aim of this study was to
review studies reporting the management of SIH with a special emphasis on
the surgical treatment of SIH including clinical trials, case series and
case reports related to the issue of various neurosurgical procedures
performed for SIH treatment. Objective. The clinical outcomes of patients
diagnosed with SIH treated with either only surgery or with surgery as the
primary method of treatment were analysed. Material and methods. The
PubMed, Scopus and Google Scholar databases were searched according to the
established criteria. Results. The literature search revealed seven
clinical trials, five case series and eight case reports regarding
surgical treatment of patients diagnosed with SIH. Manuscripts reporting
at least five individuals treated surgically for SIH were considered as
case series. In most published articles, surgery provided clinical
benefit, resulting in a success rate of 82.6-100% for complete relief of
SIH symptoms. Conclusions. Our literature review has revealed that SIH can
be diagnosed reliably by MRI and cisternography. The identification of the
location of SIH is mandatory for its successful surgical treatment. The
clinical outcome is related to the location of SIH in the spinal canal.
Most often, cerebrospinal fluid leakage occurs in the thoracic region.
Surgical treatment is very effective and the obtained treatment results
are complete and permanent.<br/>Copyright &#xa9; 2023 Polish Neurological
Society.

<84>
Accession Number
2023107036
Title
Comparative safety of generic versus brand calcineurin inhibitors in solid
organ transplant patients: A systematic review and meta-analysis.
Source
Journal of the American Pharmacists Association. 63(3) (pp 709-719), 2023.
Date of Publication: 01 May 2023.
Author
Tanni K.A.; Qian J.
Publisher
Elsevier B.V.
Abstract
Background: Although generic ciclosporin-A (CsA) and tacrolimus (TAC) have
been used for the prophylaxis of organ rejection in transplant patients
for decades, evidence in their safety profile compared to reference listed
drugs (RLDs) in real-world transplant patients remains limited.
<br/>Objective(s): To compare safety outcomes of generic CsA and TAC with
the reference-listed drugs in solid organ transplant patients.
<br/>Method(s): We systematically searched MEDLINE, International
Pharmaceutical Abstracts, PsycINFO, and Cumulative Index of Nursing and
Allied Health Literature from inception until March 15, 2022, to select
randomized and observational studies comparing safety profiles of generic
versus brand CsA and TAC in de novo and/or stable solid organ transplant
patients. Primary safety outcomes were changes in serum creatinine (Scr)
and glomerular filtration rate (GFR). Secondary outcomes included
incidences of infection, hypertension, diabetes, other serious adverse
events (AEs), hospitalization, and death. Mean difference (MD) and
relative risk (RR) with 95% confidence intervals (CIs) were calculated
using random-effects meta-analyses. <br/>Result(s): Of 2612 publications
identified, 32 studies met inclusion criteria. Seventeen studies had a
moderate risk of bias. Scr was statistically significantly lower in
patients using generic CsA compared to brand at 1 month (MD = -0.07; 95%
CI: -0.11, -0.04), while there were no statistically significant
differences at 4 months, 6 months, and 12 months. No differences were
detected in Scr (MD = -0.04; 95% CI: -0.13, 0.04) and estimated GFR (MD =
-2.06; 95% CI: -8.89, 4.77) between patients using generic and brand TAC
at 6 months. No statistically significant differences between generic CsA
and TAC with their RLDs were observed for secondary outcomes.
<br/>Conclusion(s): Findings support similarity in safety outcomes between
generic and brand CsA and TAC in real-world solid organ transplant
patients.<br/>Copyright &#xa9; 2023 American Pharmacists Association

<85>
Accession Number
2022134564
Title
T lymphocyte characteristics and immune repertoires in the epicardial
adipose tissue of heart failure patients.
Source
Frontiers in Immunology. 14 (no pagination), 2023. Article Number:
1126997. Date of Publication: 2023.
Author
Zhang X.-Z.; Chen X.-L.; Tang T.-T.; Zhang S.; Li Q.-L.; Xia N.; Nie
S.-F.; Zhang M.; Zhu Z.-F.; Zhou Z.-H.; Dong N.-G.; Cheng X.
Institution
(Zhang, Chen, Tang, Zhang, Li, Xia, Nie, Zhang, Zhu, Zhou, Cheng)
Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong
University of Science and Technology, Wuhan, China
(Zhang, Chen, Tang, Zhang, Li, Xia, Nie, Zhang, Zhu, Zhou, Cheng) Hubei
Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
(Zhang, Chen, Tang, Zhang, Li, Xia, Nie, Zhang, Zhu, Zhou, Cheng) Hubei
Provincial Engineering Research Center of Immunological Diagnosis and
Therapy for Cardiovascular Diseases, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Dong) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
Publisher
Frontiers Media S.A.
Abstract
Background: Epicardial adipose tissue (EAT) acts as an active immune organ
and plays a critical role in the pathogenesis of heart failure (HF).
However, the characteristics of immune cells in EAT of HF patients have
rarely been elucidated. <br/>Method(s): To identify key immune cells in
EAT, an integrated bioinformatics analysis was performed on public
datasets. EAT samples with paired subcutaneous adipose tissue (SAT),
heart, and peripheral blood samples from HF patients were collected in
validation experiments. T cell receptor (TCR) repertoire was assessed by
high-throughput sequencing. The phenotypic characteristics and key
effector molecules of T lymphocytes in EAT were assessed by flow cytometry
and histological staining. <br/>Result(s): Compared with SAT, EAT was
enriched for immune activation-related genes and T lymphocytes. Compared
with EAT from the controls, activation of T lymphocytes was more
pronounced in EAT from HF patients. T lymphocytes in EAT of HF patients
were enriched by highly expanded clonotypes and had greater TCR clonotype
sharing with cardiac tissue relative to SAT. Experiments confirmed the
abundance of IFN-gamma⁺ effector memory T lymphocytes
(T<inf>EM</inf>) in EAT of HF patients. CCL5 and GZMK were confirmed to be
associated with T lymphocytes in EAT of HF patients. <br/>Conclusion(s):
EAT of HF patients was characterized by pronounced immune activation of
clonally expanded IFN-gamma⁺ T<inf>EM</inf> and a generally
higher degree of TCR clonotypes sharing with paired cardiac
tissue.<br/>Copyright &#xa9; 2023 Zhang, Chen, Tang, Zhang, Li, Xia, Nie,
Zhang, Zhu, Zhou, Dong and Cheng.

<86>
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.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<87>
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. <br/>Method(s): We searched the PubMed database using
keywords such as "transcatheter aortic valve replacement" and "numerical
simulation" and reviewed and summarized relevant literature.
<br/>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.
<br/>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.<br/>Copyright &#xa9; 2023

<88>
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. <br/>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.
<br/>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).
<br/>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.<br/>Copyright &#xa9; 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<89>
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). <br/>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.
<br/>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). <br/>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%). <br/>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.<br/>Copyright
&#xa9; 2023, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<90>
Accession Number
2023169227
Title
A Protocol to help the Prevent Postoperative Delirium in Cardiac Surgery.
Source
Trauma Monthly. 27(6) (pp 643-660), 2022. Date of Publication: November
2022.
Author
Moradi A.; Azimi A.V.; Moradian S.T.; Motamedi M.H.K.; Zavareh S.M.A.;
Mahmoudi H.
Institution
(Moradi) Students Research Center, Nursing Faulty, Baqiyatallah University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Azimi, Mahmoudi) Trauma research center, Nursing Faulty Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Moradian, Motamedi, Zavareh) Atherosclerosis Research Center,
Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Official Publication of the National Center for Trauma Research
Abstract
Introduction: Postoperative delirium (POD), a highly prevalent syndrome
after cardiac surgery, is characterized by a rapid decline in brain
function with inattention, disorganized thinking, and an altered level of
consciousness. It is clinically important because it is associated with
severe negative consequences. This study aimed to develop a protocol to
help the prevent postoperative delirium in cardiac surgery.
<br/>Method(s): This multiphase design study consisted of two phases. The
first phase was a scoping review to identify risk factors associated with
POD in cardiac surgery. The second phase included three consecutive rounds
of expert panels based on a Delphi method to obtain consensus from experts
to determine and use these risk factors to develop a protocol. A scoping
review was performed using the Arksey and O'Malley framework. Literature
searches using PubMed/MEDLINE, Scopus, Web of Science, and ProQuest
databases were conducted. Two independent investigators performed the
selection of studies and data extraction via checklists. In the second
phase, based on two Delphi rounds, risk factors with a significant effect
on postoperative delirium in cardiac surgery were identified according to
the consensus of experts (>=75% agreement). In the third round of the
expert panel, only modifiable factors that could improve based on existing
conditions and context were used to develop a protocol. <br/>Result(s):
The final protocol was developed based on 20 pharmacological and
non-pharmacological interventions to prevent POD in three stages pre-,
intra-, and post-cardiac surgery. <br/>Conclusion(s): Interventions such
as prescribing melatonin instead of benzodiazepines, dexmedetomidine
treatment, preoperative education patients that were candidated for
cardiac surgery, training nurses, use of arterial filters and pre-bypass
filters in the perfusion circuit, prevention of intraoperative
hyperglycemia, cerebral oximetry and temperature management during CPB and
some interventions in ICU-OH can reduce POD in cardiac
surgery.<br/>Copyright &#xa9; 2021 The Author(s).

<91>
Accession Number
2022643587
Title
Advances in Clinical Cardiology 2022: A Summary of Key Clinical Trials.
Source
Advances in Therapy. 40(6) (pp 2595-2625), 2023. Date of Publication: June
2023.
Author
Savage P.; Cox B.; Shahmohammadi M.; Foster J.; Menown I.
Institution
(Savage, Cox, Shahmohammadi, Foster, Menown) Craigavon Cardiac Centre,
Southern Health and Social Care Trust, Northern Ireland, Craigavon, United
Kingdom
Publisher
Adis
Abstract
Introduction: Over the course of 2022, numerous key clinical trials with
valuable contributions to clinical cardiology were published or presented
at major international conferences. This review seeks to summarise these
trials and to reflect on their clinical context. <br/>Method(s): The
authors reviewed clinical trials presented at major cardiology conferences
during 2022, including the American College of Cardiology (ACC), European
Association for Percutaneous Cardiovascular Interventions (EuroPCR),
European Society of Cardiology (ESC), Transcatheter Cardiovascular
Therapeutics (TCT), American Heart Association (AHA), European Heart
Rhythm Association (EHRA), Society for Cardiovascular Angiography and
Interventions (SCAI), TVT-The Heart Summit (TVT) and Cardiovascular
Research Technologies (CRT). Trials with a broad relevance to the
cardiology community and those with potential to change current practice
were included. <br/>Result(s): A total of 93 key cardiology clinical
trials were identified for inclusion. Interventional cardiology data
included trials evaluating the use of new generation novel stent
technology and new intravascular physiology strategies such as
quantitative flow ratio (QFR) to guide revascularisation in stable and
unstable coronary artery disease. New trials in acute coronary syndromes
and intervention focused on long-term outcomes of optimal medical therapy
(OMT), revascularisation in ischaemic dysfunction and left main (LM)
intervention. Structural intervention trials included latest data on
optimal timing and anticoagulation strategies in transcatheter aortic
valve replacement (TAVR), in addition to expanding evidence in mitral and
tricuspid valve interventions. Heart failure data included trials with
sodium-glucose cotransporter 2 (SGLT2) inhibitors, iron replacement and
novel drugs such as omecamtiv. Prevention trials included new data on
proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and
polypill strategies. In electrophysiology, new data regarding optimal
timing of ablative therapy for atrial fibrillation (AF) in addition to
novel screening strategies were evaluated. <br/>Conclusion(s): This
article presents a summary of key clinical cardiology trials published and
presented during the past year and should be of interest to both
practising clinicians and researchers.<br/>Copyright &#xa9; 2023, Crown.

<92>
Accession Number
2020195479
Title
Systematic review of academic robotic surgery curricula.
Source
Journal of Robotic Surgery. 17(3) (pp 719-743), 2023. Date of Publication:
June 2023.
Author
Khan M.T.A.; Patnaik R.; Lee C.S.; Willson C.M.; Demario V.K.; Krell R.W.;
Laverty R.B.
Institution
(Khan, Patnaik) Department of Surgery, UT Health San Antonio, University
of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX
78229-3900, United States
(Lee, Krell, Laverty) Department of Surgery, Brooke Army Medical Center,
San Antonio, TX, United States
(Willson) School of Osteopathic Medicine, Des Moines University, Des
Moines, IA, United States
(Demario) School of Osteopathic Medicine, University of the Incarnate
Word, San Antonio, TX, United States
Publisher
Springer Nature
Abstract
The use of robotic surgery has increased exponentially in the United
States. Despite this uptick in popularity, no standardized training
pathway exists for surgical residents or practicing surgeons trying to
cross-train onto the platform. We set out to perform a systematic review
of existing literature to better describe and analyze existing robotic
surgical training curricula amongst academic surgery programs. A
systematic electronic search of the PubMed, Cochrane, and EBSCO databases
was performed for articles describing simulation in robotic surgery from
January 2010 to May 2022. Medical Subject Heading (MeSH) terms and
keywords used to conduct this search were "Robotic," "Surgery," "Robotic
Surgery," "Training," "Curriculum," "Education," and "Residency Program."
A total of 110 articles were identified for the systematic review. After
screening the titles and abstracts, a total of 36 full-text original
articles were included in this systematic review. Of these, 24 involved
robotic surgery curricula designed to teach general robotic skills,
whereas the remaining 12 were for teaching procedure specific skills. Of
the 24 studies involving general robotic skills, 13 included didactics as
a part of the curriculum, 23 utilized virtual reality trainers, 3 used
inanimate tissue, and 1 used live animal models. Of the 12 papers reviewed
regarding procedure specific curricula, seven involved urologic procedures
(radical prostatectomy and nephrectomy), two involved general surgical
procedures (colectomy and Roux-en-Y gastric bypass surgery), two involved
obstetrics and gynecology procedures (hysterectomy with myomectomy and
sacrocolpopexy, hysterectomy with pelvic lymphadenectomy) and one involved
a cardiothoracic surgery procedure (robotic internal thoracic artery
harvest). With the rapid implementation of robotic surgery, training
programs have been tasked with the responsibility of ensuring their
trainees are adequately proficient in the platform prior to graduation.
However, due to the lack of uniformity between surgical training programs,
when it comes to robotic surgical experience, a strong need persists for a
standardized national robotics training curriculum.<br/>Copyright &#xa9;
2022, The Author(s), under exclusive licence to Springer-Verlag London
Ltd., part of Springer Nature.

<93>
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).
<br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2023. The Author(s).

<94>
Accession Number
2024003176
Title
Comments on "Effect of Continuous Infusion of Intravenous Nefopam on
Postoperative Opioid Consumption After Video-assisted Thoracic Surgery: A
Double-blind Randomized Controlled Trial".
Source
Pain Physician. 26(3) (pp E234-E235), 2023. Date of Publication: 2023.
Author
Du Y.-T.; Xue F.-S.; Li C.-W.
Institution
(Du, Xue, Li) Department of Anesthesiology, Beijing Friendship Hospital,
Capital Medical University, Beijing, China
Publisher
American Society of Interventional Pain Physicians

<95>
Accession Number
2024003173
Title
Comments on "Effect of Continuous Infusion of Intravenous Nefopam on
Postoperative Opioid Consumption After Video-assisted Thoracic Surgery: A
Double-blind Randomized Controlled Trial".
Source
Pain Physician. 26(3) (pp E234-E235), 2023. Date of Publication: May/June
2023.
Author
Du Y.-T.; Xue F.-S.; Li C.-W.
Institution
(Du, Xue, Li) Department of Anesthesiology, Beijing Friendship Hospital,
Capital Medical University, Beijing, China
Publisher
American Society of Interventional Pain Physicians

<96>
Accession Number
2023426207
Title
Edge-to-Edge Transcatheter Mitral Valve Repair Using PASCAL vs. MitraClip:
A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(10) (no pagination), 2023. Article
Number: 3579. Date of Publication: May 2023.
Author
Hosseini K.; Soleimani H.; Nasrollahizadeh A.; Jenab Y.; Karlas A.;
Avgerinos D.V.; Briasoulis A.; Kuno T.; Doulamis I.; Kampaktsis P.N.
Institution
(Hosseini, Soleimani, Nasrollahizadeh, Jenab) Cardiac Primary Prevention
Research Center, Cardiovascular Diseases Research Institute, Tehran
University of Medical Sciences, Tehran 1419733141, Iran, Islamic Republic
of
(Hosseini, Soleimani, Nasrollahizadeh, Jenab) Tehran Heart Center,
Cardiovascular Diseases Research Institute, Tehran University of Medical
Sciences, Tehran 1419733141, Iran, Islamic Republic of
(Soleimani) Non-Communicable Diseases Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran 1411713139, Iran, Islamic Republic of
(Karlas) Institute for Biological and Medical Imaging, Helmholtz Zentrum
Munchen, Neuherberg 85764, Germany
(Karlas) Department for Vascular and Endovascular Surgery, Rechts der Isar
Hospital, Technical University of Munich, Munich 81675, Germany
(Avgerinos) Onassis Cardiac Surgery Center, Athens 17674, Greece
(Briasoulis) Medical School, National and Kapodistrian University of
Athens, Athens 11527, Greece
(Kuno) Department of Medicine, Montefiore Medical Center, New York, NY
10461, United States
(Doulamis) Department of Surgery, The Johns Hopkins Hospital, School of
Medicine, Baltimore, MD 21287, United States
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York, NY 10032, United States
Publisher
MDPI
Abstract
Background: Transcatheter edge-to-edge repair (TEER) of the mitral valve
(MV) can be performed using the PASCAL or MitraClip devices. Few studies
offer a head-to-head outcome comparison of these two devices.
<br/>Material(s) and Method(s): PubMed, EMBASE, Cochrane Library,
Clinicaltrials.gov and WHO's International Clinical Trials Registry
Platform, from 1 January 2000 until 1 March 2023, were searched. Study
protocol details were registered in the International Prospective Register
of Systematic Reviews (PROSPERO ID: CRD42023405400). Randomized Controlled
Trials and observational studies reporting head-to-head clinical
comparison of PASCAL and MitraClip devices were eligible for selection.
Patients with severe functional or degenerative mitral regurgitation (MR)
who had undergone TEER of the MV with either PASCAL or MitraClip devices
were included in the meta-analysis. Data from six studies (five
observational and one randomized clinical trial) were extracted and
analyzed. The main outcomes were a reduction in MR to 2+ or less,
improvement of New York Heart Association (NYHA) and 30-day all-cause
mortality. Peri-procedural mortality, success rate and adverse events were
also compared. <br/>Result(s): Data from 785 and 796 patients that
underwent TEER using PASCAL and MitraClip, respectively, were analyzed.
Thirty-day all-cause mortality (Risk ratio [RR] = 1.51, 95% CI 0.79-2.89),
MR reduction to maximum 2+ (RR = 1.00, 95% CI 0.98-1.02) and NYHA
improvement (RR = 0.98, 95% CI 0.84-1.15) were similar in both device
groups. Both devices had high and similar success rates (96.9% and 96.7%
for the PASCAL and MitraClip group, respectively, p value = 0.91). MR
reduction to 1+ or less at discharge was similar in both device groups (RR
= 1.06, 95% CI 0.95-1.19). Composite peri-procedural and in-hospital
mortality was 0.64% and 1.66% in the PASCAL and MitraClip groups,
respectively (p value = 0.094). Rates of peri-procedural cerebrovascular
accidents were 0.26% in PASCAL and 1.01% in MitraClip (p value = 0.108).
<br/>Conclusion(s): Both PASCAL and MitraClip devices have high success
and low complication rates for TEER of the MV. PASCAL was not inferior to
MitraClip in reducing the MR level at discharge.<br/>Copyright &#xa9; 2023
by the authors.

<97>
Accession Number
2023425870
Title
Primary Cardiac Schwannoma: A Meta-Analysis of Individual Case Reports.
Source
Journal of Clinical Medicine. 12(10) (no pagination), 2023. Article
Number: 3356. Date of Publication: May 2023.
Author
Rahouma M.; Baudo M.; Khairallah S.; Dabsha A.; Tafuni A.; El-Sayed Ahmed
M.M.; Lau C.; Iannacone E.; Naka Y.; Girardi L.; Gaudino M.; Lorusso R.;
Mick S.L.
Institution
(Rahouma, Baudo, Khairallah, Dabsha, Lau, Iannacone, Naka, Girardi,
Gaudino, Mick) Cardiothoracic Surgery Department, Weill Cornell Medicine,
New York, NY 10065, United States
(Rahouma, Khairallah, Dabsha) Surgical Oncology Department, National
Cancer Institute, Cairo University, Cairo 11796, Egypt
(Baudo) Cardiac Surgery Department, Spedali Civili di Brescia, University
of Brescia, Brescia 25123, Italy
(Tafuni) Unit of Pathology, Department of Medicine and Surgery, University
of Parma, Parma 43126, Italy
(El-Sayed Ahmed) Cardiothoracic Surgery Department, Mayo Clinic,
Jacksonville, FL 32224, United States
(El-Sayed Ahmed) Department of Surgery, Faculty of Medicine, Zagazig
University, Zagazig 44519, Egypt
(Lorusso) Department of Cardio-Thoracic Surgery, Maastricht University
Medical Centre, Maastricht University, Maastricht 6202 AZ, Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht, Maastricht 6229
ER, Netherlands
Publisher
MDPI
Abstract
Primary cardiac schwannoma (PCS) is a neurogenic tumor that arises from
Schwann cells. Malignant schwannoma (MSh) is an aggressive cancer
comprising 2% of all sarcomas. Information on the proper management of
these tumors is limited. Four databases were searched for case
reports/series of PCS. The primary outcome was overall survival (OS).
Secondary outcomes included therapeutic strategies and the corresponding
outcomes. Among 439 potentially eligible studies, 53 met the inclusion
criteria. The patients included had 43.72 +/- 17.76 years and 28.3% were
males. Over 50% of patients had MSh, with 9.4% also demonstrating
metastases. Schwannoma commonly occurs in the atria (66.0%). Left-sided
PCS were more common than right-sided ones. Surgery was performed in
almost 90% of the cases; chemotherapy and radiotherapy were used in 16.9%
and 15.1% of cases, respectively. Compared to benign cases, MSh occurs at
a younger age and is commonly located on the left side. OS of the entire
cohort at 1 and 3 years were 60.7%, and 54.0%, respectively. Females and
males OS were similar up to 2 years follow-up. Surgery was associated with
higher OS (p < 0.01). Surgery is the primary treatment option for both
benign and malignant cases and was the only factor associated with a
relative improvement in survival.<br/>Copyright &#xa9; 2023 by the
authors.

<98>
[Use Link to view the full text]
Accession Number
2024789708
Title
Effects of corticosteroids on new-onset atrial fibrillation after cardiac
surgery: A meta-analysis of randomized controlled trials.
Source
Medicine (United States). 100(11) (pp E25130), 2021. Date of Publication:
19 Mar 2021.
Author
Liu L.; Jing F.-Y.; Wang X.-W.; Li L.-J.; Zhou R.-Q.; Zhang C.; Wu Q.-C.
Institution
(Liu, Li, Zhou, Zhang) Department of Cardiothoracic Surgery ICU, The First
Affiliated Hospital of Chongqing Medical University, Chongqing, China
(Jing, Wu) Department of Cardiology, The First Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Wang) Department of Cardiothoracic Surgery, The First Affiliated Hospital
of Chongqing Medical University, Chongqing, China
(Zhang) Centre for Clinical Pharmacology, William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Postoperative atrial fibrillation (POAF) occurs commonly after
cardiac surgery. Studies suggest that corticosteroid can reduce the
incident of POAF. However, the results remain controversial. This
meta-analysis aimed to evaluate the efficacy and safety corticosteroid on
the prevention of POAF following cardiac surgery.
<br/>Method(s):Randomized controlled trials were identified through a
systematic literature search. Two investigators independently searched
articles, extracted data, and assessed the quality of included studies.
Primary outcome was the incidence of POAF as well as length of hospital
stay and intensive care unit stay, wound and other infection, mortality,
duration of ventilation, myocardial infarction, gastrointestinal
complications, high blood sugar, stroke, and postoperative bleeding.
<br/>Result(s):Fourteen studies with 13,803 patients were finally involved
in the present study. Overall, corticosteroid significantly decreased the
risk of POAF (relative risk [RR], 0.7; 95% confidence interval [CI],
0.55-0.89; P = .003). There were no significant differences in the
incidence of length of intensive care unit stay (RR, -2.32; 95% CI, -5.44
to 0.80; P = .14) and hospital stay (RR, -0.43; 95% CI, -0.84 to -0.02; P
= .04), infections (RR, 1.01; 95% CI, 0.83-1.23; P = .9), mortality (RR,
0.87; 95% CI, 0.71-1.06; P = .16), duration of ventilation (RR, -0.29; 95%
CI, -0.65 to 0.07; P = .12), gastrointestinal complications (RR, 1.26; 95%
CI, 0.91-1.76; P = .16), high blood sugar (RR, 1.98; 95% CI, 0.91-4.31; P
= .09), stroke (RR, 0.9; 95% CI, 0.69-1.18; P = .45), postoperative
bleeding (RR -44.54; 95% CI, -115.28 to 26.20; P = .22) and myocardial
infarction (RR, 1.71; 95% CI, 0.96-1.43; P = .12). <br/>Conclusion(s):Our
review suggests that the efficacy of corticosteroid might be beneficial to
POAF development in patients undergoing cardiac surgery. The strength of
this association remains uncertain because of statistical and clinical
heterogeneity among the included studies.<br/>Copyright &#xa9; 2021
Lippincott Williams and Wilkins. All rights reserved.

<99>
[Use Link to view the full text]
Accession Number
2024789599
Title
Impact of time factor and patient characteristics on the efficacy of PCI
vs CABG for left main coronary disease: A meta-analysis.
Source
Medicine (United States). 100(10) (pp E25057), 2021. Date of Publication:
12 Mar 2021.
Author
Qiu M.; Ding L.; Zhan Z.; Zhou H.
Institution
(Qiu, Zhou) Department of General Medicine, Shenzhen Longhua District
Central Hospital, Shenzhen, China
(Ding) Department of Cardiology, First Affiliated Hospital of Yangtze
University, Jingzhou, China
(Zhan) Class 3, Clinical Medicine, Grade 2019, The Second Clinical Medical
College, Southern Medical University, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:The impact of time factor and patient characteristics on the
efficacy of percutaneous coronary intervention (PCI) with drug-eluting
stents vs. coronary-artery bypass grafting (CABG) for left main coronary
disease is unclear. <br/>Method(s):We searched PubMed and Embase for
related trials. Two outcomes of interest were major adverse cardiac or
cerebrovascular events (MACCE, defined as a composite of all-cause
mortality, myocardial infarction, stroke, or unplanned revascularization)
and a composite of all-cause mortality, myocardial infarction, or stroke.
We conducted random-effects meta-analysis stratified by follow-up duration
and 7 factors of interest related to patient characteristics.
Random-effects meta-regression was performed to calculate P values for
trend and those for subgroup differences. <br/>Result(s):We included 11
articles from 5 trials. Compared with CABG, PCI increased MACCE at the end
of 3-year (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.04-1.40,
I² = 0) and 5-year (HR 1.33, 95% CI 1.20-1.48, I² =
0) follow-up, but did not increase all-cause mortality, myocardial
infarction, or stroke. The logarithm of HR of PCI vs CABG for MACCE
increased as follow-up duration increased (beta = 0.057, P = .025). PCI vs
CABG consistently increased 5-year MACCE across various subgroups defined
by 7 factors of interest (P<inf>subgroup</inf>ranged from.156 to.830).
<br/>Conclusion(s):The long-term benefit of CABG vs PCI on MACCE in
patients with left main coronary disease is consistent across patients
with different clinical characteristics. The relative benefit of CABG on
MACCE is driven by that of CABG on unplanned revascularization, and
becomes greater as time goes on.<br/>Copyright &#xa9; 2021 Lippincott
Williams and Wilkins. All rights reserved.

<100>
Accession Number
641443999
Title
Transversus thoracic muscle plane block for pain during cardiac surgery: a
systematic review and meta-analysis.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 29 May 2023.
Author
Xue J.-J.; Cui Y.-Y.; Busse J.W.; Ge L.; Zhou T.; Huang W.-H.; Ding S.-S.;
Zhang J.; Yang K.-H.
Institution
(Xue, Yang) Evidence-based Medicine Center, School of Basic Medical
Science, Lanzhou University, China
(Xue) Department of Anesthesiology, Gansu Province Hospital of Traditional
Chinese Medicine, Lanzhou 730050, China
(Xue) Gansu Clinical Research Center of Integrative Anesthesiology,
Lanzhou 730050, China
(Cui, Zhou, Huang, Ding, Zhang) First School of Clinical Medicine, Gansu
University of Chinese Medicine, Chengguan District, Lanzhou 730000, China
(Busse) Department of Anesthesia, McMaster University, Hamilton, Ontario,
Canada
(Busse) The Michael G. DeGroote National Pain Centre, McMaster University,
Hamilton, Ontario, Canada
(Ge, Yang) Evidence-Based Social Science Research Center, School of Public
Health, Lanzhou University, Lanzhou, China
(Ge) Key Laboratory of Evidence Based Medicine and Knowledge Translation
of Gansu Province, Lanzhou, China
Publisher
NLM (Medline)
Abstract
STUDY OBJECTIVE: The role of transversus thoracic muscle plane blocks
(TTMPBs) during cardiac surgery is controversial. We conducted a
systematic review to establish the effectiveness of this procedure.
DESIGN: Systematic review. We searched PubMed, Embase, Web of Science,
CENTRAL, WanFang Data, and the China National Knowledge Infrastructure to
June 2022, and followed the GRADE approach to evaluate the certainty of
evidence. STUDY ELIGIBILITY CRITERIA: Eligible studies enrolled adult
patients scheduled to undergo cardiac surgery and randomized them to
receive a TTMPB or no block/sham block. MAIN RESULTS: Nine trials that
enrolled 454 participants were included. Compared to no block/sham block,
moderate certainty evidence found that TTMPB probably reduces
postoperative pain at rest at 12h (weighted mean difference [WMD] -1.51 cm
on a 10 cm visual analogue scale for pain, 95% CI -2.02 to -1.00; risk
difference [RD] for achieving mild pain or less (<=3 cm), 41%, 95%CI 17 to
65) and 24h (WMD -1.07 cm, 95%CI -1.83 to -0.32; RD 26%, 95%CI 9 to 37).
Moderate certainty evidence also supported that TTMPB probably reduces
pain during movement at 12h (WMD -3.42 cm, 95%CI -4.47 to -2.37; RD 46%,
95%CI 12 to 80) and at 24h (WMD -1.73 cm, 95%CI -3.24 to -0.21; RD 32%,
95%CI 5 to 59), intraoperative opioid use (WMD -28 milligram morphine
equivalent [MME], 95%CI -42 to -15), postoperative opioid consumption (WMD
-17 MME, 95%CI -29 to -5), postoperative nausea and vomiting (absolute
risk difference 255 less per 1000 persons, 95%CI 140 to 314), and ICU
length of stay (WMD -13 h, 95%CI -21 to -6). <br/>CONCLUSION(S): Moderate
certainty evidence showed TTMPB during cardiac surgery probably reduces
postoperative pain at rest and with movement, opioid consumption, ICU
length of stay, and the incidence of nausea and vomiting.<br/>Copyright
&#xa9; 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

<101>
Accession Number
641443504
Title
Effect of sexual counseling on sexual function and sexual quality of life
for women undergoing open heart surgery: a pilot randomized controlled
trial.
Source
The journal of sexual medicine. (no pagination), 2023. Date of
Publication: 27 May 2023.
Author
Tuncer M.; Yesiltepe Oskay U.
Institution
(Tuncer) Department of Women's Health and Diseases Nursing, Istanbul
University, School of Nursing, Istanbul, Turkey
(Yesiltepe Oskay) Department of Women's Health and Diseases Nursing,
Florence Nightingale Faculty of Nursing, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Sexual counseling can improve or may have benefit to patients'
sexual function after open heart surgery. AIM: The study aims to determine
the effect of sexual counseling on sexual function and quality of sexual
life with the PLISSIT model (ie, permission, limited information, specific
suggestions, intensive therapy) for women undergoing open heart surgery.
<br/>METHOD(S): The study was a pilot randomized controlled trial. Seventy
women who planned open heart surgery were randomly divided into the
control group or the sexual counseling group between November 2020 and
November 2021. In addition to routine care, sexual counseling with the
PLISSIT model was given to women in the sexual counseling group for 12
weeks after the operation. During the research, 6 PLISSIT sessions were
conducted. Women in the control group received routine postoperative care,
which included hospital-provided postoperative home care practices
(medication, nutrition, physical activity). <br/>OUTCOME(S): Data were
obtained with an information form, the Beck Depression Inventory, the
Female Sexual Function Index, and the Sexual Quality of Life
Questionnaire-Female. <br/>RESULT(S): The women in the sexual counseling
and control groups were similar in terms of sociodemographic, obstetric,
gynecologic, general health, current heart disease, and sexual function
data (P>.05). After sexual counseling with the PLISSIT model, scores on
the Female Sexual Function Index and Sexual Quality of Life
Questionnaire-Female significantly increased in the sexual counseling
group while Beck Depression Inventory scores decreased (P<.05).
Comparisons were made within and between groups. CLINICAL IMPLICATIONS:
Sexual counseling with the PLISSIT model is a useful and effective model
for health professionals to improve the sexual function and sexual quality
of life of women's who will undergo open heart surgery. STRENGTHS AND
LIMITATIONS: The limitations of the study were as follows: only 1
assessment after the intervention ended, no short- or long-term follow-up,
and a small sample size. Other limitations include the absence of controls
for therapeutic context or positive expectations in the experimental
group. <br/>CONCLUSION(S): Sexual counseling with the PLISSIT model after
open heart surgery increased the sexual function and sexual quality of
life of women while reducing the symptoms of depression.<br/>Copyright
&#xa9; The Author(s) 2023. Published by Oxford University Press on behalf
of The International Society of Sexual Medicine. All rights reserved. For
permissions, please e-mail: journals.permissions@oup.com.