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<1>
Accession Number
2025763651
Title
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid
Prescribing after Surgery (PRIOR): A Cluster Randomized Multiple Crossover
Trial.
Source
Anesthesiology. 139(2) (pp 186-196), 2023. Date of Publication: 01 Aug
2023.
Author
Rolfzen M.L.; Wick A.; Mascha E.J.; Shah K.; Krause M.;
Fernandez-Bustamante A.; Kutner J.S.; Ho P.M.; Sessler D.I.; Bartels K.
Institution
(Rolfzen, Bartels) Department of Anesthesiology, University of Nebraska
Medical Center, Omaha, NE, United States
(Wick) UCHealth, Pharmacy Analytics Core, Aurora, CO, United States
(Mascha) Departments of Quantitative Health Sciences Outcomes Research,
Cleveland Clinic, Cleveland, OH, United States
(Shah, Krause) Department of Anesthesiology, University of California San
Diego, San Diego, CA, United States
(Fernandez-Bustamante, Kutner) Department of Anesthesiology, University of
Colorado School of Medicine, Aurora, CO, United States
(Ho, Sessler) Department of Medicine, University of Colorado School of
Medicine, Aurora, CO, United States
(Sessler) Department of Outcomes Research, Cleveland Clinic, Outcomes
Research Consortium, Cleveland, OH, United States
(Sessler) Department of Anesthesiology, University of Colorado School of
Medicine, Aurora, CO, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Overprescription of opioids after surgery remains common.
Residual and unnecessarily prescribed opioids can provide a reservoir for
nonmedical use. This study therefore tested the hypothesis that a
decision-support tool embedded in electronic health records guides
clinicians to prescribe fewer opioids at discharge after inpatient
surgery. <br/>Method(s): This study included 21,689 surgical inpatient
discharges in a cluster randomized multiple crossover trial from July 2020
to June 2021 in four Colorado hospitals. Hospital-level clusters were
randomized to alternating 8-week periods during which an electronic
decision-support tool recommended tailored discharge opioid prescriptions
based on previous inpatient opioid intake. During active alert periods,
the alert was displayed to clinicians when the proposed opioid
prescription exceeded recommended amounts. No alerts were displayed during
inactive periods. Carryover effects were mitigated by including 4-week
washout periods. The primary outcome was oral morphine milligram
equivalents prescribed at discharge. Secondary outcomes included
combination opioid and nonopioid prescriptions and additional opioid
prescriptions until day 28 after discharge. A vigorous state-wide opioid
education and awareness campaign was in place during the trial.
<br/>Result(s): The total postdischarge opioid prescription was a median
[quartile 1, quartile 3] of 75 [0, 225] oral morphine milligram
equivalents among 11,003 patients discharged when the alerts were active
and 100 [0, 225] morphine milligram equivalents in 10,686 patients when
the alerts were inactive, with an estimated ratio of geometric means of
0.95 (95% CI, 0.80 to 1.13; P = 0.586). The alert was displayed in 28%
(3,074 of 11,003) of the discharges during the active alert period. There
was no relationship between the alert and prescribed opioid and nonopioid
combination medications or additional opioid prescriptions written after
discharge. <br/>Conclusion(s): A decision-support tool incorporated into
electronic medical records did not reduce discharge opioid prescribing for
postoperative patients in the context of vigorous opioid education and
awareness efforts. Opioid prescribing alerts might yet be valuable in
other contexts.(Anesthesiology 2023; 139:186-96).<br/>Copyright &#xa9;
2023 Lippincott Williams and Wilkins. All rights reserved.

<2>
Accession Number
2025708338
Title
Delayed renal infectious aneurysm 3 months after cardiac surgery for a
Streptococcus pyogenes infective endocarditis; case report and literature
review.
Source
Annales de Cardiologie et d'Angeiologie. 72(4) (no pagination), 2023.
Article Number: 101626. Date of Publication: October 2023.
Author
Boukobza M.; Cabrol X.; Laissy J.-P.
Institution
(Boukobza, Laissy) Department of Radiology, Bichat Hospital, Assistance
Publique-Hopitaux de Paris, 46 rue Henri Huchard, Paris 75018, France
(Cabrol) Department of Internal Medicine, Erasme Hospital, 808 Lennik
Road, Brussels 1070, Belgium
(Laissy) INSERM U1148, Paris, France
(Laissy) Paris University, Paris, France
Publisher
Elsevier Masson s.r.l.
Abstract
Infective endocarditis (IE) due to Streptococcus pyogenes (SP) (Group A
Streptococcus) is uncommon and infectious renal artery aneurysm (IRAA) is
an exceptional complication of IE, with few cases reported in the
literature. We describe a case of SP native mitral valve IE in a
58-year-old man, presenting with large valve vegetations, abscess and
severe regurgitation. Initial CT-angiography showed bilateral kidney and
splenic infarcts. He underwent successful emergent bioprosthetic valve
replacement. Antibiotic regimen consisted in linezolid and rifampicin for
8 weeks. Three months later, CT-angiography for feet gangrene revealed a
16mm aneurysm of the left intraparenchymal renal artery, which was
occluded by coil-embolization. This case shows that an infectious aneurysm
may develop several months after antibiotic treatment and emergent valve
replacement for IE.<br/>Copyright &#xa9; 2023 Elsevier Masson SAS

<3>
Accession Number
2025376633
Title
A Systematic Review and Meta-Analysis of Prevalence, Characteristics, and
Impact of Mitral Annular Calcification on Outcomes After Transcatheter
Aortic Valve Implantation.
Source
American Journal of Cardiology. 201 (pp 123-130), 2023. Date of
Publication: 15 Aug 2023.
Author
Moin A.; Lak H.M.; Zafar M.; Tariq R.; Shaikh F.H.; Mussa M.; Bansal A.;
Shekhar S.; Harb S.; Unai S.; Kapadia S.R.
Institution
(Moin, Zafar, Tariq, Mussa) Department of Internal Medicine, Dow Medical
College, Civil Hospital, Karachi, Pakistan
(Lak) Section of Clinical Cardiology, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio,
United States
(Shaikh) Department of Cardiology, Dow Medical College, Civil Hospital,
Karachi, Pakistan
(Bansal, Shekhar, Harb, Kapadia) Aortic Valve Center, Robert and Suzanne
Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller
Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland,
Ohio, United States
(Unai) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
There is a paucity of data on the prognostic impact of mitral annular
calcification (MAC) in patients who underwent transcatheter aortic valve
implantation (TAVI) with conflicting results being reported by the studies
that are published. Therefore, we performed a meta-analysis to assess the
short-term and long-term outcomes of MAC in patients after TAVI. Of 25,407
studies identified after the initial database search, 4 observational
studies comprising 2,620 patients (2,030 patients in the nonsevere MAC arm
and 590 patients in the severe MAC arm) were included in the final
analysis. Compared with patients with nonsevere MAC, the severe MAC group
was associated with significantly higher incidences of overall bleeding
(0.75 [0.57 to 0.98], p = 0.03, I² = 0%) at 30 days. However,
no significant difference was observed between the 2 groups for the rest
of the 30-day outcomes: all-cause mortality (0.79 [0.42 to 1.48], p =
0.46, I² = 9%), myocardial infarction (1.62 [0.37 to 7.04], p =
0.52, I² = 0%), cerebrovascular accident or stroke (1.22 [0.53
to 2.83], p = 0.64, I² = 0%), acute kidney injury (1.48 [0.64
to 3.42], p = 0.35, I² = 0%), and pacemaker implantation (0.70
[0.39 to 1.25], p = 0.23, I² = 68%). Similarly, follow-up
outcomes also showed no significant difference between the 2 groups:
all-cause mortality (0.69 [0.46 to 1.03], p = 0.07, I² = 44%),
cardiovascular mortality (0.52 [0.24 to 1.13], p = 0.10, I² =
70%) and stroke (0.83 [0.41 to 1.69], p = 0.61, I² = 22%). The
sensitivity analysis, however, demonstrated significant results for
all-cause mortality (0.57 [0.39 to 0.84], p = 0.005, I² = 7%)
by removing the study by Okuno et al⁵ and cardiovascular
mortality (0.41 [0.21 to 0.82], p = 0.01, I² = 66%) by removing
the study by Lak et al.⁷ In conclusion, our meta-analysis
corroborates the notion that isolated MAC is not an independent predictor
of long-term mortality after TAVI and determines severe MAC to be a
predictor of mortality at follow-up because of the higher incidence of
mitral valve dysfunction associated with it.<br/>Copyright &#xa9; 2023

<4>
Accession Number
2024818471
Title
Albumin Infusion and Blood Loss After Cardiac Surgery.
Source
Annals of Thoracic Surgery. 116(2) (pp 392-399), 2023. Date of
Publication: August 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

<5>
Accession Number
2024494734
Title
Cardioprotective effect of propofol in cardioplegia compared to systemic
propofol in heart valves surgery; a randomized controlled trial.
Source
Cardiothoracic Surgeon. 31(1) (no pagination), 2023. Article Number: 14.
Date of Publication: December 2023.
Author
Attia A.A.; Torky M.A.E.; Abo Elnasr M.M.; Wahby E.A.E.; Taha A.E.M.
Institution
(Attia, Torky, Abo Elnasr, Wahby, Taha) Cardiothoracic Surgery Department,
Faculty of Medicine, Tanta University, Tanta 31527, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Myocardial protection is still a focus of ongoing research.
Propofol is used widely during the induction of anaesthesia in cardiac
surgery. So, this triggers us to investigate the cardioprotective effect
of the propofol when added to the cardioplegia compared to systemic
propofol by measuring the troponin T level. <br/>Method(s): This clinical
randomized controlled trial was carried out on 150 patients operated for
elective valvular heart surgery. Patients were assigned into three equal
groups: Group 1: received propofol in the cardioplegia, Group 2: received
propofol injection in the aortic line before and after the aortic
cross-clamp, and Group 3 (control group): patients without propofol in the
cardioplegia or aortic line. All patients were subjected to full medical
histories, physical examinations, routine tests, and echocardiography.
Cardiac troponin T was measured before surgery and 4 times
postoperatively. <br/>Result(s): In group 1, there was a significant
improvement in troponin T level at the last reading compared with the
control group (mean +/- SD. of group 1 was 246.4 +/- 131.4, mean +/- SD.
of group 3 was 317.0 +/- 117.9, p = 0.031), denoting propofol's
cardioprotective effect when added as a cardioplegia additive. In group 2,
there was a significant improvement of troponin T level at the last
reading compared with the group 1 and control group (mean +/- SD. of group
2 was 202.54 +/- 156.03, mean +/- SD. of group 3 was 317.0 +/- 117.9, p <
0.001), denoting propofol's more cardioprotective effect when used
systemically during cardiopulmonary bypass than when added as a
cardioplegia additive. <br/>Conclusion(s): In valvular cardiac surgery,
propofol has an additional cardioprotective effect and a superior cardiac
outcome when administered systematically during cardiopulmonary bypass
rather than added to cardioplegia. Trial registration: Pan African
Clinical Trials Register PACTR201907764652028. Registered on 01 July 2019,
retrospectively registered, https://pactr.samrc.ac.za/
TrialDisplay.aspx?TrialID = 5726.<br/>Copyright &#xa9; 2023, The
Author(s).

<6>
Accession Number
2024384628
Title
Association of Preoperative Prognostic Nutritional Index with Risk of
Postoperative Acute Kidney Injury: A Meta-Analysis of Observational
Studies.
Source
Nutrients. 15(13) (no pagination), 2023. Article Number: 2929. Date of
Publication: July 2023.
Author
Liu C.-C.; Liu P.-H.; Chen H.-T.; Lee C.-W.; Cheng W.-J.; Chen J.-Y.; Hung
K.-C.
Institution
(Liu) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung City 82445, Taiwan (Republic of China)
(Liu) Department of Nursing, College of Medicine, I-Shou University,
Kaohsiung City 82445, Taiwan (Republic of China)
(Liu) School of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan
(Republic of China)
(Liu) Department of Anesthesiology, E-Da Dachang Hospital, I-Shou
University, Kaohsiung City 82445, Taiwan (Republic of China)
(Chen) Department of Chinese Medicine, Chi Mei Medical Center, Tainan City
71004, Taiwan (Republic of China)
(Chen) Division of Nephrology, Department of Internal Medicine, Chi Mei
Medical Center, Tainan City 71004, Taiwan (Republic of China)
(Chen) Department of Health and Nutrition, Chia Nan University of Pharmacy
and Science, Tainan City 71710, Taiwan (Republic of China)
(Lee) Department of Neurology, Chi Mei Medical Center, Tainan City 71004,
Taiwan (Republic of China)
(Cheng) Department of Anesthesiology, Chi Mei Medical Center, Liouying,
Tainan City 73657, Taiwan (Republic of China)
(Chen, Hung) Department of Anesthesiology, Chi Mei Medical Center, Tainan
City 71004, Taiwan (Republic of China)
(Chen, Hung) School of Medicine, College of Medicine, National Sun Yat-Sen
University, Kaohsiung City 80424, Taiwan (Republic of China)
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
This meta-analysis aimed to assess the clinical association of the
preoperative prognostic nutritional index (pre-PNI) with the risk of
postoperative acute kidney injury. Four databases (e.g., Medline) were
searched from inception to December 2022 to investigate the association
between pre-PNI (i.e., low vs. high) and PO-PNI as well as the correlation
between pre-PNI and other postoperative prognostic indices. Overall, 13
observational studies, including 9185 patients, were eligible for
analysis. A low PNI was related to increased risks of PO-AKI [odd ratio
(OR) = 1.65, p = 0.001, 3811 patients], postoperative infection (OR = 2.1,
p < 0.00001, 2291 patients), and mortality (OR = 1.93, p < 0.0001, 2159
patients). Albeit statistically nonsignificant, a trend was noted, linking
a low PNI to higher risks of postoperative bleeding (OR = 2.5, p = 0.12,
1157 patients) and stroke (OR = 1.62, p = 0.07, 2036 patients). Pooled
results revealed a prolonged intensive care unit (ICU) stay in patients
with low PNIs compared to those with high PNIs (MD: 0.98 days, p = 0.02,
2209 patients) without a difference in hospital stay between the two
groups (MD: 1.58 days, p = 0.35, 2249 patients). This meta-analysis
demonstrated an inverse correlation between PNI and the risks of PO-AKI,
postoperative infection, and mortality, as well as the length of ICU stay,
which warrants further investigations for verification.<br/>Copyright
&#xa9; 2023 by the authors.

<7>
Accession Number
2023648244
Title
Clinical characteristics and outcome of Mycobacterium chimaera infections
after cardiac surgery: systematic review and meta-analysis of 180
heater-cooler unit-associated cases.
Source
Clinical Microbiology and Infection. 29(8) (pp 1008-1014), 2023. Date of
Publication: August 2023.
Author
Wetzstein N.; Kohl T.A.; Diricks M.; Mas-Peiro S.; Holubec T.; Kessel J.;
Graf C.; Koch B.; Herrmann E.; Vehreschild M.J.G.T.; Hogardt M.; Niemann
S.; Stephan C.; Wichelhaus T.A.
Institution
(Wetzstein, Kessel, Vehreschild, Stephan) Department of Internal Medicine,
Infectious Diseases, University Hospital Frankfurt, Goethe University,
Frankfurt am Main, Germany
(Kohl, Diricks, Niemann) The German Centre for Infection Research (DZIF),
partner site Hamburg-Lubeck-Borstel-Riems, Germany
(Kohl, Diricks, Niemann) Research Centre Borstel, Molecular and
Experimental Mycobacteriology, Borstel, Germany
(Mas-Peiro) Department of Internal Medicine, University Hospital
Frankfurt, Goethe University, Cardiology, Frankfurt am Main, Germany
(Holubec) Department of Cardiovascular Surgery, University Hospital
Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
(Graf) Department of Internal Medicine, University Hospital Frankfurt,
Goethe University, Gastroenterology and Hepatology, Frankfurt am Main,
Germany
(Koch) Department of Internal Medicine, University Hospital Frankfurt,
Goethe University, Nephrology, Frankfurt am Main, Germany
(Herrmann) Institute of Biostatistics and Mathematical Modelling, Goethe
University, Frankfurt am Main, Germany
(Hogardt, Wichelhaus) Institute of Medical Microbiology and Infection
Control, University Hospital Frankfurt, Goethe University, Frankfurt am
Main, Germany
Publisher
Elsevier B.V.
Abstract
Objectives: Since 2013, heater-cooler unit (HCU) associated Mycobacterium
chimaera infections linked to a global outbreak have been described. These
infections were characterised by high morbidity and mortality due to
delayed diagnosis, as well as challenges in antimycobacterial and surgical
therapy. This study aimed to investigate the clinical characteristics and
outcome of published cases of HCU-associated M. chimaera infections.
<br/>Method(s): We searched PubMed and the Web of Science until 15 June
2022 for case reports, case series, and cohort studies, without language
restriction, on patients with M. chimaera infection and a prior history of
cardiac surgery. In this systematic review of case reports, no risk of
bias assessment could be performed. Clinical, microbiological, and
radiological features were recorded. Logistic regression and time-to-event
analyses were performed to identify the potential factors associated with
better survival. <br/>Result(s): One hundred eighty patients from 54
publications were included. Most patients underwent surgical aortic valve
(67.0%; 118/176 of patients with available data) or combined aortic valve
and root replacement (15.3%; 27/176). The median period between the time
point of surgery and the first symptoms was 17 months (interquartile range
13-26 months). The overall case fatality rate was 45.5% (80/176), with a
median survival of 24 months after the initiation of antimycobacterial
therapy or diagnosis. A reoperation (including the removal or exchange of
foreign material) was associated with better survival in multivariate
logistic regression (OR 0.32 for lethal events; 95% CI 0.12-0.79; p 0.015)
and in time-to-event analysis (p 0.0094). <br/>Discussion(s): This
systematic review and meta-analysis confirm the high overall mortality of
HCU -associated disseminated M. chimaera infections after cardiac surgery.
A reoperation seems to be associated with better survival. Physicians have
to stay aware of this infection, as patients might still be present today
due to the long latency period.<br/>Copyright &#xa9; 2023 European Society
of Clinical Microbiology and Infectious Diseases

<8>
Accession Number
2022877028
Title
Risk Factors for Ischemic Stroke After Revascularization Surgery in
Patients with Moyamoya Disease: An Age-Stratified Comparative
Meta-Analysis.
Source
World Neurosurgery. 173 (pp 146-157.e14), 2023. Date of Publication: May
2023.
Author
Pettersson S.D.; Olofsson H.K.L.; Ali S.; Szarek D.; Miekisiak G.; Ogilvy
C.S.
Institution
(Pettersson, Olofsson) Department of Neurosurgery, Medical University of
Gdansk, Gdansk, Poland
(Ali) Neurology Department, Mayo Clinic, Jacksonville, United States
(Szarek) Department of Neurosurgery, Lower Silesia Specialist Hospital of
T. Marciniak, Wroclaw, Poland
(Miekisiak) Institute of Medicine, Opole University, Opole, Poland
(Pettersson, Ogilvy) Neurosurgical Service, Beth Israel Deaconess Medical
Center, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients who undergo revascularization surgery for moyamoya
disease may develop postoperative ischemic stroke (pIS). Several studies
have sought to identify risk factors; however, the findings remain highly
inconsistent. <br/>Method(s): PubMed, Scopus, and Web of Science were used
to extract references. The first phase of screening required the studies
to be in English, involve patients surgically treated for moyamoya
disease, and report pIS. The second phase required the studies to provide
>=10 patients and include a control group. <br/>Result(s): All 22 studies
were rated as high quality. Univariate analysis identified pediatrics <3
years of age as a risk factor for pIS (odds ratio [OR], 7.60; P < 0.0001).
Among adult patients only, diabetes (OR, 2.10; P = 0.005), a Suzuki grade
greater than 3 (OR, 1.74; P = 0.005), mean intraoperative systolic blood
pressure (OR, 1.04; P < 0.0001), mean intraoperative diastolic blood
pressure (OR, 1.04; P = 0.002), and revascularization in the left
hemisphere (OR, 2.09; P = 0.001) were risk factors. Among both age groups,
preoperative ischemic stroke (OR, 2.59; P < 0.00001) was a risk factor for
pIS. Additionally, perioperative antiplatelet drug administration was a
protective factor for specifically acute postoperative white thrombus
among adult patients (OR, 0.35; P = 0.002). <br/>Conclusion(s): In
addition to the methods discussed that can mitigate the risk of pIS, the
risk factors identified in our analysis may be of great value among
surgeons for identifying high-risk patients in order to apply prophylactic
measures, as well as scheduling longer and more frequent follow-up
visits.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<9>
Accession Number
2021281992
Title
Effect of chest ultrasound compared with pericardial window for the
diagnosis of occult penetrating cardiac wounds in hemodynamically stable
subjects with penetrating thoracic trauma: A meta-analysis.
Source
International Wound Journal. 20(6) (pp 2483-2491), 2023. Date of
Publication: August 2023.
Author
Yan T.; Xie W.; Xu M.
Institution
(Yan, Xu) Department of Liver Surgery, West China Hospital, Sichuan
University, Chengdu, China
(Yan, Xie) Department of Emergency, People's Hospital of Deyang, Deyang,
China
Publisher
John Wiley and Sons Inc
Abstract
We conducted a meta-analysis to assess the diagnostic performance of chest
ultrasound compared with a pericardial window for the detection of occult
penetrating cardiac wounds in patients with penetrating thoracic trauma
who were hemodynamically stable. A systematic literature search up to
December 2022 was performed and 567 related studies were evaluated. The
chosen studies comprised 629 penetrating thoracic trauma subjects who
participated in the selected studies' baseline. Odds ratio (OR) with 95%
confidence intervals (CIs) were calculated to assess the effect of
different chest ultrasounds on wound infection after penetrating thoracic
trauma by the dichotomous methods with a random or fixed effect model. The
chest ultrasound resulted in significantly lower occult penetrating
cardiac wounds detection (OR, 0.02; 95% CI, 0.01-0.08, P < 0.001), higher
false positive (OR, 33.85; 95% CI, 9.21-124.39, P < 0.001), and higher
false negative (OR, 27.31; 95% CI, 7.62-97.86, P < 0.001) compared with
the pericardial window in penetrating thoracic trauma. The chest
ultrasound resulted in significantly lower occult penetrating cardiac
wound detection, higher false positives, and higher false negatives
compared with the pericardial window in penetrating thoracic trauma.
Although care should be taken when dealing with the results because all of
the studies had less than 200 subjects as a sample size.<br/>Copyright
&#xa9; 2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<10>
Accession Number
2020655150
Title
Comprehensive collection of COVID-19 related prosthetic valve failure: a
systematic review.
Source
Journal of Thrombosis and Thrombolysis. 55(3) (pp 474-489), 2023. Date of
Publication: April 2023.
Author
Trieu T.K.; Birkeland K.; Kimchi A.; Kedan I.
Institution
(Trieu) College of Medicine, California Northstate University, Elk Grove,
CA, United States
(Birkeland) Enterprise Data Intelligence, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Kimchi, Kedan) Smidt Heart Institute, Cedars-Sinai Hospital, 8501
Wilshire Blvd Suite 200, Beverly Hills, Los Angeles, CA, United States
Publisher
Springer
Abstract
Since the beginning of the SARS-CoV-2 (COVID-19) pandemic, correlation of
venous thromboembolism (VTE) and COVID-19 infection has been well
established. Increased inflammatory response in the setting of COVID-19
infection is associated with VTE and hypercoagulability. Venous and
arterial thrombotic events in COVID-19 infection have been well
documented; however, few cases have been reported involving cardiac valve
prostheses. In this review, we present a total of eight cases involving
COVID-19-related prosthetic valve thrombosis (PVT), as identified in a
systematic review. These eight cases describe valve position (mitral
versus aortic) and prosthesis type (bioprosthetic versus mechanical), and
all cases demonstrate incidents of PVT associated with simultaneous or
recent COVID-19 infection. None of these eight cases display obvious
non-adherence to anticoagulation; five of the cases occurred greater than
three years after the most recent valve replacement. Our review offers
insights into PVT in COVID-19 infected patients including an indication
for increased monitoring in the peri-infectious period. We explore valve
thrombosis as a mechanism for prosthetic valve failure. We describe
potential differences in antithrombotic strategies that may offer added
antithrombotic protection during COVID-19 infection. With the growing
population of valve replacement patients and recurring COVID-19 infection
surges, it is imperative to explore relationships between COVID-19 and
PVT.<br/>Copyright &#xa9; 2022, The Author(s).

<11>
Accession Number
2025903289
Title
Prognostic value of sarcopenia in older adults with transcatheter aortic
valve implantation: A systematic review and meta-analysis.
Source
Archives of Gerontology and Geriatrics. 115 (no pagination), 2023. Article
Number: 105125. Date of Publication: December 2023.
Author
Yang Y.-W.; Pan P.; Xia X.; Zhou Y.-W.; Ge M.-L.
Institution
(Yang, Pan, Zhou) The Emergency Department, West China Hospital, Sichuan
University, Sichuan, Chengdu 610041, China
(Xia, Ge) The Center of Gerontology and Geriatrics (National Clinical
Research Center for Geriatrics), West China Hospital, Sichuan University,
Sichuan, Chengdu 610041, China
Publisher
Elsevier Ireland Ltd
Abstract
Objective: We conducted this systematic review and meta-analysis to
summarize the prevalence of sarcopenia and its impact on mortality in
patients undergoing TAVI. <br/>Method(s): Medline, EMBASE, and PubMed were
searched from inception to October 14, 2022 to retrieve eligible studies
that assessed sarcopenia in patients undergoing TAVI. Pooled sarcopenia
prevalence was calculated with 95% confidence interval (CI), and
heterogeneity was estimated using the I² test. Associations of
sarcopenia with mortality of post-TAVI were expressed as hazard ratio (HR)
or odds ratios (OR) and 95% CI. <br/>Result(s): 13 studies involving 5248
patients (mean age from 78.1 to 84.9 years) undergoing TAVI were included.
There were eleven studies defined sarcopenia based on loss of skeletal
muscle mass index (SMI), while only two studies used low muscle mass plus
low muscle strength and/or low physical performance. Overall, the pooled
prevalence of sarcopenia in patients undergoing TAVI was 49% (95% CI
41%-58%). Sarcopenia was associated with an increased risk of long-term
(>=1 year) mortality in patients after TAVI (HR 1.57, 95% CI 1.33-1.85, P
< 0.001), with similar findings in the subgroups stratified by follow-up
time, definition of sarcopenia, study location, and study design.
Furthermore, the 1-, 2-, and 3-year cumulative probabilities of survival
in patients with sarcopenia were significantly lower than non-sarcopenia
(74.0% vs 91.0%, 68.3% vs 78.0%, and 72.6% vs 79.8%, all P < 0.05).
<br/>Conclusion(s): Although there are substantial differences in
diagnostic criteria, sarcopenia is highly prevalent in patients undergoing
TAVI and its linked to increased long-term mortality after
TAVI.<br/>Copyright &#xa9; 2023 The Author(s)

<12>
Accession Number
2024543853
Title
The efficacy of various Enoxaparin dosing regimens in general surgery
patients: A systematic review.
Source
Surgery (United States). 174(2) (pp 315-323), 2023. Date of Publication:
August 2023.
Author
Al Tannir A.H.; Biesboer E.A.; Pokrzywa C.J.; Figueroa J.; Harding E.; de
Moya M.A.; Morris R.S.; Murphy P.B.
Institution
(Al Tannir, Biesboer, Pokrzywa, Figueroa, Harding, de Moya, Morris,
Murphy) Division of Trauma and Acute Care Surgery, Department of Surgery,
Medical College of Wisconsin, Milwaukee, WI, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients undergoing surgical procedures are at an increased
risk of venous thromboembolism events. A fixed Enoxaparin dosing regimen
is the standard of care for chemoprophylaxis in most institutions;
however, breakthrough venous thromboembolism events are still reported. We
aimed to systematically review the literature to determine the ability of
various Enoxaparin dosing regimens to achieve adequate prophylactic
anti-Xa levels for venous thromboembolism prevention in hospitalized
general surgery patients. Additionally, we aimed to assess the correlation
between subprophylactic anti-Xa levels and the development of clinically
significant venous thromboembolism events. <br/>Method(s): A systematic
review was conducted using major databases from January 1, 1993, to
February 17, 2023. Two independent researchers screened titles and
abstracts, followed by a full-text review. Articles were included if
Enoxaparin dosing regimens were evaluated by anti-Xa levels. Exclusion
criteria included systematic reviews, pediatric population, nongeneral
surgery (defined as trauma, orthopedics, plastics, and neurosurgery), and
non-Enoxaparin chemoprophylaxis. The primary outcome was peak Anti-Xa
level measured at steady state concentration. The risk of bias was
assessed using the Risk of Bias in Nonrandomized studies-of Intervention
tool. <br/>Result(s): A total of 6,760 articles were extracted, of which
19 were included in the scoping review. Nine studies included bariatric
patients, whereas 5 studies explored abdominal surgical oncology patients.
Three studies assessed thoracic surgery patients, and 2 studies included
patients undergoing "general surgery" procedures. A total of 1,502
patients were included. The mean age was 47 years, and 38% were males. The
percentages of patients reaching adequate prophylactic anti-Xa levels were
39%, 61%, 15%, 50%, and 78% across the 40 mg daily, 40 mg twice daily, 30
mg twice daily, and weight-tiered, and body mass index-based groups,
respectively. The overall risk of bias was low to moderate.
<br/>Conclusion(s): Fixed Enoxaparin dosing regimens are not correlated
with adequate anti-Xa levels in general surgery patients. Additional
research is warranted to assess the efficacy of dosing regimens based on
novel physiologic parameters (such as estimated blood
volume).<br/>Copyright &#xa9; 2023 Elsevier Inc.

<13>
Accession Number
2022334563
Title
Is robotic assistance an added value in minimally invasive mitral valve
surgery? A meta-analysis from propensity score-matched series.
Source
Asian Cardiovascular and Thoracic Annals. 31(4) (pp 369-377), 2023. Date
of Publication: May 2023.
Author
Jegaden O.; Al Shamry A.; Ashafy S.; Mahdi A.; Eker A.
Institution
(Jegaden, Mahdi) Department of Cardiac Surgery, Mediclinic Middle East,
MBRU, AbuDhabi, United Arab Emirates
(Al Shamry) Department of Cardiac Surgery and ICU, Saudi German Hospital,
Dubai, United Arab Emirates
(Ashafy) Department of Cardiac Surgery, Zayed Military Hospital, AbuDhabi,
United Arab Emirates
(Eker) Department of Cardiac Surgery, Centre Cardio-Thoracic, Monaco,
Monaco
Publisher
SAGE Publications Inc.
Abstract
Objectives: There is still ongoing debate about the benefits of robotic
assistance (R-MVS) in comparison with video assistance (V-MVS) in
minimally invasive mitral valve surgery. This study aims to update the
current evidence. <br/>Method(s): Three propensity score-matched studies
published from 2011 to 2021 were included with a total of 1193 patients
operated on from 2005 (R-MVS: 536, V-MVS: 657). Data regarding early
mortality, postoperative event, and time-related outcomes were extracted
and submitted to a meta-analysis using weighted random-effects modeling.
<br/>Result(s): The incidence of early mortality, stroke, renal failure,
conversion, atrial fibrillation, and prolonged ventilation were similar,
all in the absence of heterogeneity. Reoperation for bleeding (odds ratio
[OR]: 0.36, 95% confidence interval [CI] 0.16-0.81, p = 0.01) and the need
for blood transfusion (OR: 0.30, 95% CI, 0.20-0.56, p = 0.001) were
significantly lower in V-MVS group. Regarding time-related outcomes, there
was evidence for important heterogeneity of treatment effect among the
studies. Operative times were longer in R-MVS: differences in means were
20.7 min for cross-clamp time (95% CI, 9.07-32.3, p = 0.001), 20.7 min for
cardiopulmonary bypass time (95% CI, 2.5-38.9, p = 0.03) and 40.2 min for
total operative time (95% CI, 24.5-55.8, p < 0.001). Intensive care unit
stay and hospital stay were reported in one study, and longer after R-MVS
compared to V-MVS; the differences in means were 0.17 days (p = 0.005) and
0.6 days (p = 0.017), respectively. Total cost of both procedures was
reported in an additional dedicated propensity score-matched series
including 448 patients; it was 21% higher for R-MVS than for V-MVS.
<br/>Conclusion(s): This meta-analysis showed excellent outcomes of both
video and robotic techniques with low incidence of morbidity and
mortality. However, there is no evidence for an added value of robotic
assistance in comparison with video assistance; the drawbacks of mini
access are reported higher regardless the induced over cost.<br/>Copyright
&#xa9; The Author(s) 2023.

<14>
[Use Link to view the full text]
Accession Number
2014921656
Title
Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and
Ischemia Severity.
Source
Circulation. 144(13) (pp 1024-1038), 2021. Date of Publication: 28 Sep
2021.
Author
Reynolds H.R.; Shaw L.J.; Min J.K.; Page C.B.; Berman D.S.; Chaitman B.R.;
Picard M.H.; Kwong R.Y.; O'Brien S.M.; Huang Z.; Mark D.B.; Nath R.K.;
Dwivedi S.K.; Smanio P.E.P.; Stone P.H.; Held C.; Keltai M.; Bangalore S.;
Newman J.D.; Spertus J.A.; Stone G.W.; Maron D.J.; Hochman J.S.
Institution
(Reynolds, Bangalore, Newman, Hochman) New York Universty Grossman, School
of Medicine, New York, NY, United States
(Shaw) Weill Cornell Medicine, New York Presbyterian Hospital, New York,
NY, United States
(Min) Cleerly Inc, New York, NY, United States
(Page, O'Brien, Huang, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Chaitman) St. Louis University, School of Medicine, Center for
Comprehensive Cardiovascular Care, MO, United States
(Picard) Massachusetts General Hospital and Harvard Medical School,
Boston, United States
(Kwong, Stone) Brigham and Women's Hospital, Boston, MA, United States
(Nath) Dr. Ram Manohar Lohia Hospital, New Delhi, India
(Dwivedi) King George's Medical University, Lucknow, India
(Smanio) Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e
Saude, Sao Paulo, Brazil
(Held) Department of Medical Sciences, Cardiology, Uppsala University and
Uppsala Clinical Research Center, Sweden
(Keltai) Semmelweis University, Budapest, Hungary
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri-Kansas City, United States
(Stone) Icahn School of Medicine at Mount Sinai, Cardiovascular Research
Foundation, New York, United States
(Maron) Department of Medicine, Stanford University, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) postulated that
patients with stable coronary artery disease (CAD) and moderate or severe
ischemia would benefit from revascularization. We investigated the
relationship between severity of CAD and ischemia and trial outcomes,
overall and by management strategy. <br/>Method(s): In total, 5179
patients with moderate or severe ischemia were randomized to an initial
invasive or conservative management strategy. Blinded, core
laboratory-interpreted coronary computed tomographic angiography was used
to assess anatomic eligibility for randomization. Extent and severity of
CAD were classified with the modified Duke Prognostic Index (n=2475, 48%).
Ischemia severity was interpreted by independent core laboratories
(nuclear, echocardiography, magnetic resonance imaging, exercise tolerance
testing, n=5105, 99%). We compared 4-year event rates across subgroups
defined by severity of ischemia and CAD. The primary end point for this
analysis was all-cause mortality. Secondary end points were myocardial
infarction (MI), cardiovascular death or MI, and the trial primary end
point (cardiovascular death, MI, or hospitalization for unstable angina,
heart failure, or resuscitated cardiac arrest). <br/>Result(s): Relative
to mild/no ischemia, neither moderate ischemia nor severe ischemia was
associated with increased mortality (moderate ischemia hazard ratio [HR],
0.89 [95% CI, 0.61-1.30]; severe ischemia HR, 0.83 [95% CI, 0.57-1.21];
P=0.33). Nonfatal MI rates increased with worsening ischemia severity (HR
for moderate ischemia, 1.20 [95% CI, 0.86-1.69] versus mild/no ischemia;
HR for severe ischemia, 1.37 [95% CI, 0.98-1.91]; P=0.04 for trend, P=NS
after adjustment for CAD). Increasing CAD severity was associated with
death (HR, 2.72 [95% CI, 1.06-6.98]) and MI (HR, 3.78 [95% CI, 1.63-8.78])
for the most versus least severe CAD subgroup. Ischemia severity did not
identify a subgroup with treatment benefit on mortality, MI, the trial
primary end point, or cardiovascular death or MI. In the most severe CAD
subgroup (n=659), the 4-year rate of cardiovascular death or MI was lower
in the invasive strategy group (difference, 6.3% [95% CI, 0.2%-12.4%]),
but 4-year all-cause mortality was similar. <br/>Conclusion(s): Ischemia
severity was not associated with increased risk after adjustment for CAD
severity. More severe CAD was associated with increased risk. Invasive
management did not lower all-cause mortality at 4 years in any ischemia or
CAD subgroup. Registration: URL: https://www.clinicaltrials.gov. Unique
identifier: NCT01471522.<br/>Copyright &#xa9; 2021 Lippincott Williams and
Wilkins. All rights reserved.

<15>
Accession Number
641751214
Title
Reply to Sethuraman.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 64(1) (no pagination),
2023. Date of Publication: 03 Jul 2023.
Author
Dusseaux M.-M.; Grego V.; Baste J.-M.; Selim J.
Institution
(Dusseaux, Grego, Selim) Department of Anaesthesiology and Critical Care,
CHU Rouen, Rouen F-76000, France
(Baste, Selim) Univ Rouen Normandy INSERM EnVI UMR 1096, Rouen, France
(Baste) Department of Thoracic Surgery, CHU Rouen F-76000, France
Publisher
NLM (Medline)

<16>
[Use Link to view the full text]
Accession Number
641547913
Title
Tricuspid valve repair concomitant with mitral valve surgery: a systematic
review and meta-analysis.
Source
International journal of surgery (London, England). 109(7) (pp 2082-2095),
2023. Date of Publication: 01 Jul 2023.
Author
Yi K.; Xu J.; Zhang X.; Wang W.; Liu C.; Li X.; You T.
Institution
(Yi, You) Department of Cardiovascular Surgery, Gansu Provincial Hospital
(Yi, Xu, Zhang, Wang, You) Gansu International Scientific and
Technological Cooperation Base of Diagnosis and Treatment of Congenital
Heart Disease, Gansu Province, Lanzhou, China
(Wang) Department of Cardiac Surgery, First Hospital of China Medical
University, Shenyang, Liaoning, China
(Xu) Evidence-Based Medicine Center, School of Basic Medical Sciences,
Lanzhou University
(Zhang, Wang) First School of Clinical Medicine of Gansu University of
Chinese Medicine, China
(Liu, Li) First Clinical Medical College of Lanzhou University, Lanzhou,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Uncertainties persist about whether to aggressively and
effectively treat tricuspid regurgitation (TR) during mitral valve (MV)
surgery. REVIEW METHODS: Systematic literature searches were performed in
five databases to collect all relevant studies published before May 2022
on whether the tricuspid valve was treated during MV surgery. Separate
meta-analyses were performed on data from unmatched studies and randomized
controlled trials (RCT)/adjusted studies. MAIN RESULTS: A total of 44
publications were included, of which eight were RCT studies and the rest
were retrospective studies. There was no difference in 30-day mortality
[odds ratio (OR): 1.00, 95% CI: 0.71-1.42, OR: 0.66, 95% CI: 0.30-1.41)]
or overall survival [hazard ratio (HR): 1.01, 95% CI: 0.85-1.19, HR: 0.77,
95% CI: 0.52-1.14] in unmatched studies and RCT/adjusted studies. Late
mortality (OR: 0.37, 95% CI: 0.21-0.64) and cardiac-related mortality (OR:
0.36, 95% CI: 0.21-0.62) were lower in the tricuspid valve repair (TVR)
group in the RCT/adjusted studies. In the unmatched studies, overall
cardiac mortality (OR: 0.48, 95% CI: 0.26-0.88) was lower in the TVR
group. In the late TR progression analysis, the late TR progression was
lower among patients in the concomitantly intervened tricuspid group, and
patients in the untreated tricuspid group were prone to TR progression in
both studies (HR: 0.30, 95% CI: 0.22-0.41, HR: 0.37, 95% CI: 0.23-0.58).
<br/>CONCLUSION(S): TVR concomitant with MV surgery is most effective in
patients with significant TR and dilated tricuspid annulus, especially
those with a significantly reduced risk of distant TR
progression.<br/>Copyright &#xa9; 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<17>
Accession Number
635098994
Title
Takayasu's arteritis presenting as acute myocardial infarction: Case
series and review of literature.
Source
Cardiology in the Young. 31(11) (pp 1866-1869), 2021. Date of Publication:
21 Nov 2021.
Author
Wilson L.; Chandran A.; Fudge J.C.; Moguillansky D.; Thatayatikom A.;
Philip J.; Jacobs J.P.; Bleiweis M.; Elder M.; Gupta D.
Institution
(Wilson, Chandran, Fudge, Moguillansky, Philip, Jacobs, Bleiweis, Gupta)
Congenital Heart Center, Department of Paediatrics, University of Florida,
Gainesville, FL, United States
(Thatayatikom, Elder) Division of Allergy, Immunology and Rheumatology,
Department of Paediatrics, University of Florida, Gainesville, FL, United
States
(Jacobs, Bleiweis) Division of Cardiovascular Surgery, Department of
Surgery, University of Florida, Gainesville, FL, United States
Publisher
Cambridge University Press
Abstract
This series describes three adolescent females who presented with chest
pain and ventricular dysfunction related to acute coronary ischemia
secondary to Takayasu's arteritis with varied courses of disease
progression leading to a diverse range of therapies including cardiac
transplantation. While Takayasu's arteritis is rare in childhood, it
should be strongly considered in any adolescent female presenting with
systemic inflammation and chest pain consistent with myocardial
infarction. A high index of suspicion can lead to early detection and
aggressive management of the underlying vasculitis reducing associated
morbidity and mortality. The purpose of this report is to describe the
challenges in the clinical diagnosis and management of Takayasu's
arteritis with myocardial infarction. We also seek to enhance awareness
about unique presentations of Takayasu's arteritis within the paediatric
community. <br/>Copyright &#xa9; The Author(s), 2021. Published by
Cambridge University Press.

<18>
Accession Number
2025930919
Title
Language abilities in preschool children with critical CHD: A systematic
review.
Source
Cardiology in the Young. 32(5) (pp 683-693), 2022. Date of Publication: 05
May 2022.
Author
Turner T.; El Tobgy N.; Russell K.; Day C.; Cheung K.; Proven S.; Ricci
M.F.
Institution
(Turner, El Tobgy) University of Manitoba Advanced Degrees in Medicine
Program, Winnipeg, MB, Canada
(Russell, Ricci) Department of Pediatrics and Child Health, University of
Manitoba, Winnipeg, MB, Canada
(Russell, Ricci) Children's Hospital Research Institute of Manitoba,
Winnipeg, MB, Canada
(Day, Cheung, Proven, Ricci) Specialized Services for Children and Youth
(SSCY) Centre, Winnipeg, MB, Canada
(Cheung) Department of Clinical Health Psychology, University of Manitoba,
Winnipeg, MB, Canada
Publisher
Cambridge University Press
Abstract
Context: Children with critical CHD are at risk for neurodevelopmental
impairments, including delays in expressive and receptive language
development. However, no study has synthesised the literature regarding
language abilities in children with this condition. <br/>Objective(s): We
summarised the literature regarding expressive and receptive language in
preschool children with critical CHD. Data sources: MEDLINE, Embase,
Scopus, Child Development and Adolescent Studies, ERIC, PsycINFO, and
CINAHL. Study selection: We included studies published between January,
1990 and 1 July, 2021, focused on children aged <=5 years with critical
CHD requiring a complex cardiac procedure at age <1 year. Language ability
was documented using standardised, validated tools assessing both
expressive and receptive language outcomes. Data extraction: Data (study,
patient and language characteristics, and results) were extracted by two
reviewers. <br/>Result(s): Seventeen studies were included. Among children
2-5 years old with critical CHD, there were statistically significant
deficits in overall (standardised mean difference: -0.46; 95 % confidence
interval: -0.56, -0.35), expressive (standardised mean difference:
-0.45;95 % confidence interval: -0.54, -0.37), and receptive (standardised
mean difference: -0.32; 95 % confidence interval: -0.40, -0.23) language
compared to normative data. Results reported as medians were similar to
meta-analysis findings. Subgroup analysis showed that children with
univentricular physiology had lower language scores than children with
biventricular physiology. <br/>Conclusion(s): Preschool children with
critical CHD had statistically significantly lower language outcomes
compared to expected population norms. Healthcare professionals should
test early and often for language deficits, referring to individually
tailored supports. <br/>Copyright &#xa9; The Author(s), 2022. Published by
Cambridge University Press.

<19>
Accession Number
641861983
Title
Evaluation of clinical outcomes, complication rate, feasibility, and
applicability of transfacet pedicle-sparing approach in thoracic disc
herniation: a systematic review and meta-analysis.
Source
Journal of orthopaedic surgery and research. 18(1) (pp 516), 2023. Date of
Publication: 20 Jul 2023.
Author
Hamid S.; Moradi F.; Bagheri S.R.; Zarpoosh M.; Amirian P.; Ghasemi H.;
Alimohammadi E.
Institution
(Hamid) School of Medicine, Wayne State University, Detroit, MI, United
States
(Moradi, Bagheri) Department of Neurosurgery, Imam Reza Hospital,
Kermanshah University of Medical Sciences, Kermanshah, Iran, Islamic
Republic of
(Zarpoosh, Amirian) Imam Reza Hospital, Kermanshah University of Medical
Sciences, Kermanshah, Iran, Islamic Republic of
(Ghasemi) School of Nursing and Midwifery, Imam Reza Hospital, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
(Alimohammadi) Department of Neurosurgery, Imam Reza Hospital, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
OBJECTIVE: This study aimed to evaluate the clinical outcomes,
complication rate, feasibility, and applicability of transfacet
pedicle-sparing approach for treating thoracic disc herniation.
<br/>METHOD(S): We searched three databases including the Cochrane
Library, PubMed, and Embase for eligible studies until Dec 2022. The
quality of studies and their risk of bias were assessed using the
methodological index for non-randomized studies. We evaluated the
heterogeneity between studies using the I2 statistic and the P-value for
the heterogeneity. <br/>RESULT(S): A total of 328 patients described in 11
included articles were published from 2009 to 2022. Pain outcomes using
the visual analog scale (VAS score) were reported in four studies. The
standardized mean difference was reported as 0.749 (CI 95% 0.555-0.943).
The obtained result showed the positive effect of the procedure and the
improvement of patients' pain after the surgery. Myelopathy outcomes using
the Nurick score were reported in five studies. The standardized mean
difference was reported as 0.775 (CI 95% 0.479-1.071). The result showed
the positive effect of the procedure. Eight studies assessed postoperative
complications and neurological deterioration. The pooled overall
complication was 12.4% (32/258) and 3.5% (9/258) neurological worsening.
<br/>CONCLUSION(S): The results of this study demonstrated a positive
effect of the transfacet pedicle-sparing approach on the clinical outcomes
of patients with thoracic disc herniation surgery. The technique has been
shown to be safe and effective for the right patient. The technique is
associated with lower rates of complications and a shorter hospital stay
compared to other surgical approaches. This information can assist
clinicians in making informed decisions when selecting the most
appropriate surgical technique for their patients with thoracic disc
herniation.<br/>Copyright &#xa9; 2023. The Author(s).

<20>
Accession Number
2026005041
Title
Effect of bariatric surgery on cardio-psycho-metabolic outcomes in severe
obesity: A randomized controlled trial.
Source
Metabolism: Clinical and Experimental. 147 (no pagination), 2023. Article
Number: 155655. Date of Publication: October 2023.
Author
Koschker A.-C.; Warrings B.; Morbach C.; Seyfried F.; Jung P.; Dischinger
U.; Edelmann F.; Herrmann M.J.; Stier C.; Frantz S.; Malzahn U.; Stork S.;
Fassnacht M.
Institution
(Koschker, Dischinger, Stier, Fassnacht) Dept. Internal Medicine I,
Division of Endocrinology and Diabetology, University Hospital, University
of Wurzburg, Wurzburg, Germany
(Koschker, Warrings, Morbach, Herrmann, Frantz, Stork, Fassnacht) Dept.
Clinical Research & Epidemiology, Comprehensive Heart Failure Center,
University Hospital, University of Wurzburg, Wurzburg, Germany
(Warrings, Herrmann) Dept. Psychiatry, Psychosomatics, and Psychotherapy,
Center for Mental Health, University Hospital, University of Wurzburg,
Wurzburg, Germany
(Morbach, Frantz, Stork) Dept. of Internal Medicine I, Division of
Cardiology, University Hospital, University of Wurzburg, Wurzburg, Germany
(Seyfried, Stier) Dept. General, Visceral, Transplant, Vascular, and
Pediatric Surgery, University Hospital, University of Wurzburg, Wurzburg,
Germany
(Jung) Dept. Internal Medicine I, Division of Pneumology, University
Hospital, University of Wurzburg, Wurzburg, Germany
(Edelmann) Dept. Internal Medicine and Cardiology, Campus Virchow
Klinikum, Charite University Medicine Berlin, Berlin, Germany
(Edelmann) German Centre for Cardiovascular research (DZHK), Partner Site
Berlin, Germany
(Malzahn) Center for Clinical Trials, University Hospital Wurzburg,
Wurzburg, Germany
Publisher
W.B. Saunders
Abstract
Objective: Randomized evidence comparing the cardiovascular effects of
surgical and conservative weight management is lacking. Patients &
methods: In this single-center, open-label randomized trial, obese
patients with indication for Roux-en-Y gastric bypass (RYGB) and able to
perform treadmill cardiopulmonary exercise testing (CPET) were included.
After a 6-12 month run-in phase of multimodal anti-obesity treatment,
patients were randomized to RYGB or psychotherapy-enhanced lifestyle
intervention (PELI) and co-primary endpoints were assessed 12 months
later. Thereafter, PELI patients could opt for surgery and patients were
reassessed 24 months after randomization. Co-primary endpoints were mean
change (95 % confidence intervals) in peak VO<inf>2</inf> (ml/min/kg body
weight) in CPET and the physical functioning scale (PFS) of the Short Form
health survey (SF-36). <br/>Result(s): Of 93 patients entering the study,
60 were randomized. Among these (median age 38 years; 88 % women; mean BMI
48.2 kg/m²), 46 (RYGB: 22 and PELI: 24) were evaluated after 12
months. Total weight loss was 34.3 % after RYGB vs. 1.2 % with PELI, while
peak VO<inf>2</inf> increased by +4.3 ml/min/kg (2.7, 5.9) vs +1.1
ml/min/kg (-0.2, 2.3); p < 0.0001. Respective improvement in PFS score was
+40 (30, 49) vs +10 (1, 15); p < 0.0001. 6-minute walking distance also
favored the RYGB group: +44 m (17, 72) vs +6 m (-14, 26); p < 0.0001. Left
ventricular mass decreased after RYGB, but not with PELI: -32 g (-46, -17)
vs 0 g (-13,13); p < 0.0001. In the non-randomized follow-up, 34 patients
were assessed. Favorable changes were sustained in the RYGB group and were
repeated in the 15 evaluated patients that opted for surgery after PELI.
<br/>Conclusion(s): Among adults with severe obesity, RYGB in comparison
to PELI resulted in improved cardiopulmonary capacity and quality of life.
The observed effect sizes suggest that these changes are clinically
relevant.<br/>Copyright &#xa9; 2023 The Authors

<21>
Accession Number
2025963378
Title
Transcatheter Aortic Valve Replacement in Bicuspid Versus Tricuspid Aortic
Valve Stenosis: Meta-Analysis and Systemic Review.
Source
American Journal of Cardiology. 203 (pp 105-112), 2023. Date of
Publication: 15 Sep 2023.
Author
Saeed Al-Asad K.; Martinez Salazar A.; Radwan Y.; Wang E.; Salam M.F.;
Sabanci R.; Saeed M.; Halboni A.; Al-Abcha A.; Abela G.
Institution
(Saeed Al-Asad, Martinez Salazar, Radwan, Wang, Salam, Sabanci, Saeed)
Department of Internal Medicine, Michigan State University, East Lansing,
MI, United States
(Halboni) Department of Internal Medicine, Wayne State University,
Detroit, MI, United States
(Al-Abcha) Department of Cardiology, Mayo Clinic, Rochester, Minnesota,
United States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
Publisher
Elsevier Inc.
Abstract
Because of its anatomic and procedural complexities, bicuspid aortic valve
(BAV) has been excluded from previous trials investigating transcatheter
aortic valve replacement (TAVR). We aimed to compare the clinical outcomes
of TAVR in BAV and tricuspid aortic valve patients. We searched the
databases systematically from inception until March 2023 for studies that
reported the outcomes of TAVR in BAV and tricuspid aortic valve patients.
The primary focus was all-cause mortality at 1 year. Additional outcomes
included outcomes at 30-day follow-up. Secondary and subgroup analyses
were performed on propensity-matched patients, patients at low surgical
risk, and based on the type of transcatheter valve type. We included 30
studies with a total of 193,274 patients who underwent TAVR, of which
14,353 patients had BAV stenosis. The rate of 1-year mortality was lower
in the BAV group compared with the tricuspid group with the results
reaching statistical significance (odds ratio [OR] 0.86, 95% confidence
interval [CI] 0.75 to 0.98, p = 0.02). The rate of 30-day stroke, however,
was higher in patients with BAV who underwent TAVR (OR 1.24, 95% CI 1.08
to 1.43, p <0.05). Other 30-day clinical outcomes were similar between the
2 groups. Similar outcomes were observed in secondary analysis of matched
populations with less mortality and higher rate of stroke in patients with
BAV (OR 0.84, 95% CI 0.72 to 0.96, p = 0.01, and OR 1.38, 95% CI 1.09 to
1.75, p <0.05, respectively). Comparing the outcomes for self-expandable
and balloon-expandable valves resulted in similar results. Subgroup
analysis of low-surgical-risk patients similarly showed lower 1-year
mortality in patients with BAV (OR 0.67, 95% CI 0.50 to 0.91, p = 0.01),
without difference in 30-day stroke between the 2 groups (OR 1.24, 95% CI
0.83 to 1.88, p = 0.30). In conclusion, this report indicates that TAVR is
safe and feasible in patients with BAV, including patients at low surgical
risk. The higher rate of 30-day stroke, however, warrants caution when
pursuing TAVR in this population. More studies, specifically randomized
trials, are still warranted to further assess the safety and the long-term
outcomes in this group.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<22>
Accession Number
2024535476
Title
Multimodal prehabilitation in patients with non-small cell lung cancer
undergoing anatomical resection: protocol of a non-randomised feasibility
study.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 41.
Date of Publication: December 2023.
Author
Molenaar C.J.L.; Von Meyenfeldt E.M.; de Betue C.T.I.; van den Berg R.;
ten Cate D.W.G.; Schep G.; Youssef-El Soud M.; van Thiel E.; Rademakers
N.; Hoornweg S.C.; Slooter G.D.; van den Broek F.; Marres G.M.H.; van de
Voort L.; de Kort F.; de Jongh C.; van Erven C.; Staffeleu-Noodelijk M.;
Driessen E.; van de Wal M.; de Graaff N.; van Limpt A.; Scholten-Bakker M.
Institution
(Molenaar, ten Cate, Slooter, van den Broek) Department of Surgery, Maxima
MC, Veldhoven, Netherlands
(Von Meyenfeldt, de Betue, Marres) Department of Surgery, Albert
Schweitzer Hospital, Dordrecht, Netherlands
(van den Berg) Science Office, Albert Schweitzer Hospital, Dordrecht,
Netherlands
(Schep) Department of Sports Medicine, Maxima MC, Veldhoven, Netherlands
(Youssef-El Soud) Department of Pulmonology, Maxima MC, Veldhoven,
Netherlands
(van Thiel) Department of Pulmonology, Albert Schweitzer Hospital,
Dordrecht, Netherlands
(Rademakers) Physiotherapy Department, Maxima MC, Veldhoven, Netherlands
(Hoornweg) Physiotherapy Department, Albert Schweitzer Hospital,
Dordrecht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: The preoperative period can be used to enhance a patient's
functional capacity with multimodal prehabilitation and consequently
improve and fasten postoperative recovery. Especially, non-small cell lung
cancer (NSCLC) surgical patients may benefit from this intervention, since
the affected and resected organ is an essential part of the
cardiorespiratory fitness. Drafting a prehabilitation programme is
challenging, since many disciplines are involved, and time between
diagnosis of NSCLC and surgery is limited. We designed a multimodal
prehabilitation programme prior to NSCLC surgery and aimed to conduct a
study to assess feasibility and indicative evidence of efficacy of this
programme. Publication of this protocol may help other healthcare
facilities to implement such a programme. <br/>Method(s): The multimodal
prehabilitation programme consists of an exercise programme, nutritional
support, psychological support, smoking cessation, patient empowerment and
respiratory optimisation. In two Dutch teaching hospitals, 40 adult
patients with proven or suspected NSCLC will be included. In a
non-randomised fashion, 20 patients follow the multimodal prehabilitation
programme, and 20 will be assessed in the control group, according to
patient preference. Assessments will take place at four time points:
baseline, the week before surgery, 6 weeks postoperatively and 3 months
postoperatively. Feasibility and indicative evidence of efficacy of the
prehabilitation programme will be assessed as primary outcomes.
<br/>Discussion(s): Since the time between diagnosis of NSCLC and surgery
is limited, it is a challenge to implement a prehabilitation programme.
This study will assess whether this is feasible, and evidence of efficacy
can be found. The non-randomised fashion of the study might result in a
selection and confounding bias. However, the control group may help
putting the results of the prehabilitation group in perspective. By
publishing this protocol, we aim to facilitate others to evaluate and
implement a multimodal prehabilitation programme for surgical NSCLC
patients. Trial registration: The current study is registered as NL8080 in
the Netherlands Trial Register on the 10th of October 2019,
https://www.trialregister.nl/trial/8080 . Secondary identifiers: CCMO
(Central Committee on Research Involving Human Subjects) number
NL70578.015.19, reference number of the Medical Ethical Review Committee
of Maxima MC W19.045.<br/>Copyright &#xa9; 2023, The Author(s).

<23>
Accession Number
2025917499
Title
Quantitative flow ratio versus fractional flow reserve for guiding
percutaneous coronary intervention: design and rationale of the randomised
FAVOR III Europe Japan trial.
Source
EuroIntervention. 18(16) (pp E1357-E1364), 2023. Date of Publication:
April 2023.
Author
Andersen B.K.; Sejr-Hansen M.; Westra J.; Campo G.; Efterkhari A.; Tu S.;
Escaned J.; Koltowski L.; Stahli B.; Erglis A.; Jarusevicius G.; Ziubryte
G.; Ramunddal T.; Liu T.; Wijns W.; Landmesser U.; Maillard L.; Matsuo H.;
Christiansen E.H.; Holm N.R.
Institution
(Andersen, Sejr-Hansen, Westra, Christiansen, Holm) Department of
Cardiology, Aarhus University Hospital, Skejby, Denmark
(Campo) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Ferrara, Italy
(Campo) Maria Cecilia Hospital, GVM Care & Research, RA, Cotignola, Italy
(Efterkhari) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Tu) School of Biomedical Engineering, Shanghai Jiao Tong University,
Shanghai, China
(Escaned) Hospital Clinico San Carlos IdISSC, Complutense University of
Madrid, Madrid, Spain
(Koltowski) Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Stahli) Department of Cardiology, University Heart Center, University
Hospital Zurich, Zurich, Switzerland
(Erglis) Department of Cardiology, Riga Stradins University, Riga, Latvia
(Jarusevicius, Ziubryte) Department of Cardiology, Hospital of Lithuanian
University of Health Sciences Kauno Klinikos, Kaunas, Lithuania
(Jarusevicius, Ziubryte) Institute of Cardiology,, Lithuanian University
of Health Sciences, Kaunas, Lithuania
(Ramunddal) Department of Cardiology, Sahlgrenska University Hospital,
Goteborg, Sweden
(Liu) Department of Cardiology, HagaZiekenhuis, The Hague, Netherlands
(Wijns) The Lambe Institute for Translational Medicine and Curam, National
University of Ireland, Galway, Ireland
(Landmesser) Department of Cardiology (CBF), Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Maillard) GCS ES Axium Rambot, Clinique Axium, Aix-enProvence, France
(Matsuo) Department of Cardiovascular Medicine, Gifu Heart Center, Gifu,
Japan
Publisher
Europa Group
Abstract
Quantitative flow ratio (QFR) is a computation of fractional flow reserve
(FFR) based on invasive coronary angiographic images. Calculating QFR is
less invasive than measuring FFR and may be associated with lower costs.
Current evidence supports the call for an adequately powered randomised
comparison of QFR and FFR for the evaluation of intermediate coronary
stenosis. The aim of the FAVOR III Europe Japan trial is to investigate if
a QFR-based diagnostic strategy yields a non-inferior 12-month clinical
outcome compared with a standard FFR-guided strategy in the evaluation of
patients with intermediary coronary stenosis. FAVOR III Europe Japan is an
investigator-initiated, randomised, clinical outcome, non-inferiority
trial scheduled to randomise 2,000 patients with either 1) stable angina
pectoris and intermediate coronary stenosis, or 2) indications for
functional assessment of at least 1 non-culprit lesion after acute
myocardial infarction. Up to 40 international centres will randomise
patients to either a QFR-based or a standard FFR-based diagnostic
strategy. The primary endpoint of major adverse cardiovascular events is a
composite of all-cause mortality, any myocardial infarction, and any
unplanned coronary revascularisation at 12 months. QFR could emerge as an
adenosine- and wire-free alternative to FFR, making the functional
evaluation of intermediary coronary stenosis less invasive and more
cost-effective.<br/>Copyright &#xa9; 2023 Europa Group. All rights
reserved.

<24>
Accession Number
2025917490
Title
Routine cerebral embolic protection in transcatheter aortic valve
implantation: rationale and design of the randomised British Heart
Foundation PROTECT-TAVI trial.
Source
EuroIntervention. 18(17) (pp 1428-1435), 2023. Date of Publication: April
2023.
Author
Kharbanda R.K.; Perkins A.D.; Kennedy J.; Banning A.; Baumbach A.;
Blackman D.J.; Dodd M.; Evans R.; Hildick-Smith D.; Jamal Z.; Ludman P.;
Palmer S.; Stables R.; Clayton T.
Institution
(Kharbanda, Banning) NIHR Oxford Biomedical Research Centre, Oxford
University Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Kharbanda, Dodd, Evans, Jamal, Clayton) Department of Cardiovascular
Medicine, University of Oxford, Oxford, United Kingdom
(Perkins) Clinical Trials Unit, Department of Medical Statistics, London
School of Hygiene and Tropical Medicine, London, United Kingdom
(Kennedy) Acute Vascular Imaging Centre, Radcliffe Department of Medicine,
University of Oxford, Oxford, United Kingdom
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London, London, United
Kingdom
(Baumbach) Barts Heart Centre, London, United Kingdom
(Blackman) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Hildick-Smith) Cardiac Surgery, Cardiac Center, Royal Sussex County
Hospital, Brighton, United Kingdom
(Hildick-Smith) Sussex University Hospitals Trust, Brighton, United
Kingdom
(Ludman) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Palmer) Centre for Health Economics, University of York, York, United
Kingdom
(Stables) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool, United Kingdom
(Stables) Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
Publisher
Europa Group
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment
for aortic stenosis. Cerebral embolic protection (CEP) devices may impact
periprocedural stroke by capturing debris destined for the brain. However,
there is a lack of high-quality randomised trial evidence supporting the
use of CEP during TAVI. The British Heart Foundation (BHF) PROTECT-TAVI
trial will address whether the routine use of CEP reduces the incidence of
stroke in patients undergoing TAVI. BHF PROTECT-TAVI is a prospective,
open-label, outcome-adjudicated, multicentre randomised controlled trial.
The trial is open to all adult patients scheduled for TAVI at
participating specialist cardiac centres across the United Kingdom who are
able to receive the CEP device. The trial will recruit 7,730 participants.
Participants will be randomised in a 1:1 ratio to undergo TAVI with CEP or
TAVI without CEP (standard of care). The primary outcome is the incidence
of stroke at 72 hours post-TAVI. Key secondary outcomes include the
incidence of stroke and all-cause mortality up to 12 months post-TAVI,
disability and cognitive outcomes, stroke severity, access site
complications and a health economics analysis. The sample size of 7,730
participants has 80% power to detect a 33% relative risk reduction from a
3% incidence of the primary outcome in the controls. Trial recruitment
commenced in October 2020. As of October 2022, 3,068 patients have been
enrolled. BHF PROTECT-TAVI is designed to provide definitive evidence on
the clinical efficacy and cost-effectiveness of using routine CEP with the
SENTINEL device to reduce stroke in TAVI.<br/>Copyright &#xa9; Europa
Digital & Publishing 2023.

<25>
Accession Number
2025910924
Title
Early Supervised I ncremental Resistance Training (ESpIRiT) following
cardiac surgery via a median sternotomy: a study protocol of a multicentre
randomised controlled trial.
Source
BMJ Open. 13(7) (no pagination), 2023. Article Number: 067914. Date of
Publication: 14 Jul 2023.
Author
Md Ali N.A.; El-Ansary D.; Abdul Rahman M.R.; Ahmad S.; Royse C.; Huat
C.T.; Muhammad Nor M.A.; Dillon J.; Royse A.; Haron H.; Ismail M.I.; Abdul
Manaf M.R.; Katijjahbe M.A.
Institution
(Md Ali, Abdul Rahman, Haron, Ismail) Cardiothoracic Unit, Surgery
Department, Faculty of Medicine, UKM, Cheras, Kuala Lumpur, Malaysia
(Md Ali, Abdul Rahman, Ahmad, Haron, Ismail, Katijjahbe) Heart and Lung
Centre, Hospital Canselor Tuanku Muhriz, UKM, Cheras, Kuala Lumpur,
Malaysia
(El-Ansary) School of Biomedical and Health Sciences, RMIT, Melbourne,
VIC, Australia
(El-Ansary, Ahmad, Katijjahbe) Department of Physiotherapy, Hospital
Canselor Tunku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur,
Malaysia
(Royse, Royse) Department of Surgery, The University of Melbourne,
Melbourne, VIC, Australia
(Royse, Royse) Cardiothoracic Surgery, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Royse) Australian Director, Outcomes Research Consortium, Cleveland
Clinic, Cleveland, OH, United States
(Huat) Department of Surgery, Hospital Serdang, Cheras, Selangor, Malaysia
(Muhammad Nor) Cardiothoracic Surgery Department, Hospital Serdang,
Cheras, Selangor, Malaysia
(Dillon) Department of Cardiothoracic and Vascular Surgery, National
Institute Heart Centre, Kuala Lumpur, Malaysia
(Abdul Manaf) Department of Public Health Medicine, Faculty of Medicine,
Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Publisher
BMJ Publishing Group
Abstract
Introduction There is no consistency in current practice pertaining to the
prescription and progression of upper limb resistance exercise following
cardiac surgery via median sternotomy. The aim of this study is to
investigate whether less restrictive sternal precautions with the addition
of early-supervised resistance training exercise improves upper limb
function and facilitates recovery following median sternotomy. Methods and
analysis This is double-blind randomised controlled trial, with parallel
group, concealed allocation, blinding of patients and assessors, and
intention-to-treat analysis. 240 adult participants who had median
sternotomy from eight hospitals in Malaysia will be recruited. Sample size
calculations were based on the unsupported upper limb test. All
participants will be randomised to receive either standard or early
supervised incremental resistance training. The primary outcomes are upper
limb function and pain. The secondary outcomes will be functional
capacity, multidomain recovery (physical and psychological), length of
hospital stay, incidence of respiratory complications and quality of life.
Descriptive statistics will be used to summarise data. Data will be
analysed using the intention-to-treat principle. The primary hypothesis
will be examined by evaluating the change from baseline to the 4-week
postoperative time point in the intervention arm compared with the usual
care arm. For all tests to be conducted, a p value of <0.05 (two tailed)
will be considered statistically significant, and CIs will be reported.
The trial is currently recruiting participants. Ethics and dissemination
The study was approved by a central ethical committee as well as the local
Research Ethics Boards of the participating sites (UKM:JEP-2019-654;
Ministry of Health: NMMR-50763; National Heart Centre: IJNREC/501/2021).
Approval to start was given prior to the recruitment of participants
commencing at any sites. Process evaluation findings will be published in
peer-reviewed journals and presented at relevant academic conferences.
Trial registration number International Standard Randomised Controlled
Trials Number (ISRCTN17842822). <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.

<26>
Accession Number
641864614
Title
Concomitant tricuspid valve repair for mild-moderate tricuspid
regurgitation patients undergoing mitral valve surgery? A meta-analysis
and meta-regression.
Source
The Journal of cardiovascular surgery. (no pagination), 2023. Date of
Publication: 24 Jul 2023.
Author
Awad A.K.; Sayed A.; Elbadawy M.A.; Ahmed A.; Ming Wang T.K.; Elgharably
H.
Institution
(Awad) Faculty of Medicine, Ain-shams University, Cairo, Egypt
(Sayed, Elbadawy) Faculty of Medicine, Ain-shams University, Cairo, Egypt
(Ahmed) CUNY School of Medicine, New York, NY, USA
(Ming Wang) Department of Cardiovascular Medicine, Heart Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Elgharably) Department of Thoracic and Cardiovascular Surgery, Heart
Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
Publisher
NLM (Medline)
Abstract
The development of tricuspid regurgitation (TR) is a common complication
of mitral valve disease. Although severe TR is usually operated on at the
same time of mitral valve surgery (MVS), controversies remain regarding
whether mild to moderate TR patients should be operated. Concomitant
tricuspid valve repair with MVS for mild-moderate TR patients. Electronic
databases were searched from inception to November 20, 2022 to include any
observational or randomized controlled trials (RCT) that compare
concomitant tricuspid repair with MVS versus MVS alone. Mantel-Haenszel
method was used to pool study estimates and calculate odds ratios (OR)
with 95% confidence intervals (CI). A total of 9813 patients from 25
studies were included. Regarding primary outcomes, concomitant repair
group had significantly lower 30 days mortality (OR: 0.66; 95% CI 0.45 to
0.96), all-cause mortality-based on RCTs- (OR: 0.40; 95% CI 0.22 to 0.71),
cardiovascular mortality (OR: 0.53; 95% CI: 0.33 to 0.86) and heart
failure hospitalizations (OR: 0.41; 95% CI: 0.26 to 0.63). However, was
associated with higher permanent pacemaker implantation rates (OR: 2.09;
95% CI: 1.45 to 3.00). There were no significant differences in terms of
secondary outcomes: tricuspid valve reinterventions, stroke and acute
kidney injury. Furthermore, repair group showed lower risk for TR
progression degrees (OR 0.08; 95% CI 0.05 to 0.16) and decreased mean of
TR progression (MD -1.85; 95% CI -1.92 to -1.77). Concomitant tricuspid
valve repair in mild or moderate TR at time of MVS appears to reduce not
only 30 days but also long-term all-cause and cardiovascular mortality
weighed against the increased risk of pacemaker implantation.

<27>
Accession Number
641863917
Title
Evaluation of the efficacy and safety of robot-assisted and video assisted
thoracic surgery for early non-small cell lung cancer: A meta-analysis.
Source
Technology and health care : official journal of the European Society for
Engineering and Medicine. (no pagination), 2023. Date of Publication: 13
Jul 2023.
Author
Wang P.; Fu Y.-H.; Qi H.-F.; He P.; Wang H.-F.; Li C.; Liu X.-C.
Institution
(Wang, Qi, He, Wang, Li, Liu) Department of Cardiothoracic Surgery, 82nd
Group Military Hospital of PLA, Baoding, Hebei, China
(Fu) Department of Rheumatology and Immunology, Baoding Children's
Hospital, Baoding, Hebei, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Radical resection of lung cancer and chemotherapy are the main
methods for the treatment of early lung cancer, but surgical treatment is
still the key and preferred method. <br/>OBJECTIVE(S): To evaluate the
efficacy and safety of robotic-assisted thoracic surgery (RATS) and video
assisted thoracic surgery (VATS) for non-small cell lung cancer (NSCLC).
<br/>METHOD(S): The clinical cohort studies on the comparison of the
effects of RATS and VATS in the treatment of NSCLC published in Web of
Science, PubMed, The National Library of Medicine (NLM), China National
Knowledge Infrastructure (CNKI) and Wanfang database from January 1, 2015
to December 31, 2022 were searched. Two researchers independently screened
the literature, extracted the data, such as operation time, intraoperative
conversion rate, intraoperative blood loss, number of lymph nodes
dissected, and evaluated the quality of the included literature based on
the Newcastle-Ottawa Scale (NOS). RevMan 5.3 software was used for Meat
analysis. <br/>RESULT(S): A total of 18 articles and 21,802 subjects were
included. The results of the meta-analysis showed that the intraoperative
blood loss of RATS was significantly less than that of VAS, and the
difference was statistically significant [MD =-38.43 (95% CI: -57.71,
-19.15, P< 0.001)]. Compared with VATS, the number of lymph nodes
dissected in RATS was significantly higher [MD = 2.61 (95% CI: 0.47, 4.76,
P= 0.02)]. The rate of conversion to thoracotomy in RATS was lower, and
the difference was statistically significant [OR = 0.59 (95% CI: 0.50,
0.70, P< 0.001)]. There was no significant difference between RATS and
VATS in operation time [MD =-9.34 (95% CI: -28.72, 10.04, P= 0.34)],
postoperative thoracic drainage time [MD =-0.08 (95% CI: -0.42, 0.26, P=
0.64)], postoperative hospital stay [MD =-0.05 (95% CI: -0.19, 0.08, P=
0.42)], postoperative mortality [OR = 0.88 (95% CI: 0.56, 1.36, P= 0.56)]
and postoperative complications [OR = 1.03 (95% CI: 0.93, 1.13, P= 0.57)].
<br/>CONCLUSION(S): Compared with VATS, the number of lymph nodes
dissected in RATS was significantly more, and the removal of lesions and
lymph nodes was more thorough and accurate. More flexible and precise
operation avoids the injury of important blood vessels during operation,
effectively reduces the amount of blood loss during operation, shortens
the indwelling time of thoracic drainage tube, and is conducive to
postoperative rehabilitation of patients.

<28>
Accession Number
2025465321
Title
European Society of Cardiology quality indicators for the cardiovascular
pre-operative assessment and management of patients considered for
non-cardiac surgery. Developed in collaboration with the European Society
of Anaesthesiology and Intensive Care.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 9(4) (pp
331-341), 2023. Date of Publication: 01 Jun 2023.
Author
Gencer B.; Gale C.P.; Aktaa S.; Halvorsen S.; Beska B.; Abdelhamid M.;
Mueller C.; Tutarel O.; McGreavy P.; Schirmer H.; Geissler T.; Sillesen
H.; Niessner A.; Zacharowski K.; Mehilli J.; Potpara T.
Institution
(Gencer) Cardiology Division, Geneva University Hospitals, Geneva,
Switzerland
(Gencer) Institute of Primary Health Care (BIHAM), Bern University, Bern,
Switzerland
(Gale, Halvorsen) Leeds Institute of Cardiovascular and Metabolic
Medicine, University of Leeds, United Kingdom
(Gale, Beska) Leeds Institute for Data Analytics, University of Leeds,
Leeds, United Kingdom
(Gale, Aktaa, Beska) Department of Cardiology, Leeds Teaching Hospitals
Nhs Trust, Leeds, United Kingdom
(Aktaa) Department of Cardiology, Oslo University Hospital Ulleval, Oslo,
Norway
(Beska) Cardiology Department, Faculty of Medicine, Kase Al Ainy, Cairo
University, Cairo, Egypt
(Abdelhamid) Cardiovascular Research Institute Basel, University Heart
Center, University of Basel, University Hospital Basel, Basel, Switzerland
(Mueller) Department of Congenital Heart Disease and Paediatric
Cardiology, German Heart Centre Munich, Tum School of Medicine, Technical
University of Munich, Munich, Germany
(Tutarel) Patient Representatives, European Society of Cardiology (ESC),
France
(McGreavy) Department of Cardiology, Akershus University Hospital,
Lorenskog, Norway
(Schirmer) Institute of Clinical Medicine, Campus Ahus, University of
Oslo, Lorenskog, Norway
(Schirmer) Department of Cardiology and Angiology, University Hospital
Tubingen, Tubingen, Germany
(Geissler) Vascular Surgery, Rigshospitalet, University of Copenhagen,
Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
(Sillesen) Department of Internal Medicine Ii, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Niessner) Department Anaesthesiology, Intensive Care Medicine & Pain
Therapy, University Hospital Frankfurt, Goethe University, Frankfurt,
Germany
(Zacharowski) Department of Cardiology, Lmu University Hospital and German
Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart
Alliance, Munich, Germany
(Mehilli) Department of Cardiology, Medizinische Klinik I,
Landshut-Achdorf Hospital, Landshut, Germany
(Mehilli) Cardiology Clinic, University Clinical Centre of Serbia,
Belgrade, Serbia
(Potpara) School of Medicine, University of Belgrade, Belgrade, Serbia
Publisher
Oxford University Press
Abstract
Aims: To establish a set of quality indicators (QIs) for the
cardiovascular (CV) assessment and management of patients undergoing
non-cardiac surgery (NCS). <br/>Methods and Results: The Quality Indicator
Committee of the European Society of Cardiology (ESC) and European Society
of Anaesthesiology and Intensive Care (ESAIC) in collaboration with Task
Force members of the 2022 ESC Guidelines on CV assessment and management
of patients undergoing NCS followed the ESC methodology for QI
development. This included (1) identification, by constructing a
conceptual framework of care, of domains of the CV assessment, and
management of patients with risk factors or established cardiovascular
disease (CVD) who are considered for or undergoing NCS, (2) development of
candidate QIs following a systematic literature review, (3) selection of
the final set of QIs using a modified Delphi method, and (4) evaluation of
the feasibility of the developed QIs. In total, eight main and nine
secondary QIs were selected across six domains: (1) structural framework
(written policy), (2) patient education and quality of life (CV risk
discussion), (3) peri-operative risk assessment (indication for diagnostic
tests), (4) peri-operative risk mitigation (use of hospital therapies),
(5) follow-up (post-discharge assessment), and (6) outcomes (major CV
events). <br/>Conclusion(s): We present the 2022 ESC/ESAIC QIs for the CV
assessment and management of patients with risk factors or established CVD
who are considered for or are undergoing NCS y. These indicators are
supported by evidence from the literature, underpinned by expert
consensus, and align with the 2022 ESC Guidelines on CV assessment and
management of patients undergoing NCS.<br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Society of Cardiology.

<29>
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.

<30>
Accession Number
2024544679
Title
Clinical Outcomes in High-Gradient, Classical Low-Flow, Low-Gradient, and
Paradoxical Low-Flow, Low-Gradient Aortic Stenosis After Transcatheter
Aortic Valve Implantation: A Report From the SwissTAVI Registry.
Source
Journal of the American Heart Association. 12(12) (no pagination), 2023.
Article Number: e029489. Date of Publication: 20 Jun 2023.
Author
Wagener M.; Reuthebuch O.; Heg D.; Tuller D.; Ferrari E.; Grunenfelder J.;
Huber C.; Moarof I.; Muller O.; Nietlispach F.; Noble S.; Roffi M.;
Taramasso M.; Templin C.; Toggweiler S.; Wenaweser P.; Windecker S.;
Stortecky S.; Jeger R.
Institution
(Wagener, Reuthebuch, Jeger) University Hospital Basel, University of
Basel, Switzerland
(Wagener) University Hospital Galway, University of Galway, Ireland
(Heg) CTU Bern, University of Bern, Switzerland
(Tuller, Jeger) Triemli Hospital Zurich, Zurich, Switzerland
(Ferrari) Cardiocentro Ticino, Lugano, Switzerland
(Grunenfelder, Taramasso, Wenaweser) Hirslanden Hospital Zurich, Zurich,
Switzerland
(Huber, Noble, Roffi) University Hospital Geneva, University of Geneva,
Switzerland
(Moarof) Hirslanden Hospital Aarau, Aarau, Switzerland
(Muller) University Hospital Lausanne, University of Lausanne, Switzerland
(Nietlispach) Cardiovascular Center Zurich, Hirslanden Klinik Im Park,
Zurich, Switzerland
(Templin) University Hospital Zurich, University of Zurich, Switzerland
(Toggweiler) Cantonal Hospital Luzern, Switzerland
(Windecker, Stortecky) Department of Cardiology, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: In view of the rising global burden of severe symptomatic
aortic stenosis, its early recognition and treatment is key. Although
patients with classical low-flow, low-gradient (C-LFLG) aortic stenosis
have higher rates of death after transcatheter aortic valve implantation
(TAVI) when compared with patients with high-gradient (HG) aortic
stenosis, there is conflicting evidence on the death rate in patients with
severe paradoxical low-flow, low-gradient (P-LFLG) aortic stenosis.
Therefore, we aimed to compare outcomes in real-world patients with severe
HG, C-LFLG, and P-LFLG aortic stenosis undergoing TAVI. METHODS AND
RESULTS: Clinical outcomes up to 5 years were addressed in the 3 groups of
patients enrolled in the prospective, national, multicenter SwissTAVI
registry. A total of 8914 patients undergoing TAVI at 15 heart valve
centers in Switzerland were analyzed for the purpose of this study. We
observed a significant difference in time to death at 1 year after TAVI,
with the lowest observed in HG (8.8%) aortic stenosis, followed by P-LFLG
(11.5%; hazard ratio [HR], 1.35 [95% CI, 1.16-1.56]; P<0.001) and C-LFLG
(19.8%; HR, 1.93 [95% CI, 1.64-2.26]; P<0.001) aortic stenosis.
Cardiovascular death showed similar differences between the groups. At 5
years, the all-cause death rate was 44.4% in HG, 52.1% in P-LFLG (HR, 1.35
[95% CI, 1.23-1.48]; P<0.001), and 62.8% in C-LFLG aortic stenosis (HR,
1.7 [95% CI, 1.54-1.88]; P<0.001). <br/>CONCLUSION(S): Up to 5 years after
TAVI, patients with P-LFLG have higher death rates than patients with HG
aortic stenosis but lower death rates than patients with C-LFLG aortic
stenosis.<br/>Copyright &#xa9; 2023 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<31>
Accession Number
2024462655
Title
Effectiveness of a short-term multimodal prehabilitation program in adult
patients awaiting selective cardiac surgery: study protocol for an
open-label, pilot, randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1201737. Date of Publication: 2023.
Author
Gao W.; Li H.; Chen Y.; Zhang Y.; Zhang M.; Jin J.
Institution
(Gao, Zhang, Jin) Nursing Department, The Second Affiliated Hospital of
Zhejiang University School of Medicine, Hangzhou, China
(Gao, Zhang) Emergency Department, The Second Affiliated Hospital of
Zhejiang University School of Medicine, Hangzhou, China
(Li) Department of Rehabilitation, The Second Affiliated Hospital of
Zhejiang University School of Medicine, Hangzhou, China
(Chen) Department of Cardiovascular Surgery, The Second Affiliated
Hospital of Zhejiang University School of Medicine, Hangzhou, China
(Zhang, Jin) Key Laboratory of the Diagnosis, Treatment of Severe Trauma
and Burn of Zhejiang Province, Zhejiang University, Hangzhou, China
Publisher
Frontiers Media SA
Abstract
Background: Prehabilitation has been demonstrated to positively impact
postoperative recovery in patients undergoing selective cardiac surgery.
However, the optimal modules included in prehabilitation programs are yet
to be fully explored, as existing studies have primarily focused on
exercise. This study will explore the effectiveness of a three-arm
prehabilitation program among adult patients awaiting selective cardiac
surgery. Methods and analysis: A single-center, parallel-group randomized
controlled trial will be conducted at the Second Affiliated Hospital of
Zhejiang University School of Medicine (SAHZU). A total of 152 adult
patients scheduled for elective cardiac surgery (coronary artery bypass
grafting or valvular surgery) will be recruited from a tertiary teaching
hospital. The patients will be randomly assigned to either the control
group or the prehabilitation group. Patients assigned to the control group
will receive standard care, which includes patient education and
counseling as well as personal guidance on exercise, breathing, and
coughing. Patients in the intervention group will be provided a multimodal
prehabilitation program, including nutrition guidance, a diet journal,
mindfulness training, and exercise guidance. The interventions will begin
with home-based training and continue after hospital admission and before
surgery. The primary outcome will be the perioperative 6-minute walk
distance (6 MWD). The secondary outcomes will include preoperative
readiness, postoperative recovery, and patient experience with the
program. <br/>Discussion(s): The purpose of the study is to examine
whether a short-term multimodal prehabilitation program will be associated
with improved preoperative readiness and postoperative outcomes. The
findings of this study will provide evidence to support the development of
a perioperative program aimed at enhancing patient recovery. Clinical
Trial Registration: www.ClinicalTrials.gov; identifier:
NCT05503004.<br/>Copyright 2023 Gao, Li, Chen, Zhang, Zhang and Jin.

<32>
Accession Number
2024258620
Title
Effect of superficial and deep parasternal blocks on recovery after
cardiac surgery: study protocol for a randomized controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 444. Date of
Publication: December 2023.
Author
Jeanneteau A.; Demarquette A.; Blanchard-Daguet A.; Fouquet O.; Lasocki
S.; Riou J.; Rineau E.; Leger M.
Institution
(Jeanneteau, Demarquette, Blanchard-Daguet, Lasocki, Rineau, Leger)
Departement d'Anesthesie Reanimation, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet) Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Riou) Departement de Biostatistiques Et Methodologie, Centre Hospitalier
Universitaire d'Angers, Angers, France
(Leger) INSERM UMR 1246, SPHERE, Nantes University, Tours University,
France
Publisher
BioMed Central Ltd
Abstract
Background: Pain is frequent after cardiac surgery and source of multiple
complications that can impair postoperative recovery. Regional anesthesia
seems to be an interesting technique to reduce the pain in this context,
but its effectiveness in improving recovery has been poorly studied so
far. The objective of this study is to compare the effectiveness of two of
the most studied chest wall blocks in cardiac surgery, i.e., the
superficial and the deep parasternal intercostal plane blocks (SPIP and
DPIP respectively), in addition to standard care, versus the standard care
without regional anesthesia, on the quality of postoperative recovery
(QoR) after cardiac surgery with sternotomy. <br/>Method(s): This is a
single-center, single-blind, controlled, randomized trial with a 1:1:1
ratio. Patients (n = 254) undergoing cardiac surgery with sternotomy will
be randomized into three groups: a control group with standard care and no
regional anesthesia, a SPIP group with standard care and a SPIP, and a
DPIP with standard care and a DPIP. All groups will receive the usual
analgesic protocol. The primary endpoint is the value of the QoR evaluated
by the QoR-15 at 24 h after the surgery. <br/>Discussion(s): This study
will be the first powered trial to compare the SPIP and the DPIP on global
postoperative recovery after cardiac surgery with sternotomy. Trial
registration: ClinicalTrials.gov NCT05345639. Registered on April 26,
2022.<br/>Copyright &#xa9; 2023, The Author(s).

<33>
Accession Number
2023715901
Title
Transcutaneous Electrical Acupoint Stimulation for Preventing
Postoperative Delirium: A Meta-Analysis.
Source
Neuropsychiatric Disease and Treatment. 19 (pp 907-920), 2023. Date of
Publication: 2023.
Author
Guo F.; Yan Y.; Sun L.; Han R.; Zheng L.; Qin Y.; Wang S.; Sun X.; Ji Z.;
Gao C.
Institution
(Guo, Yan, Sun, Han, Zheng, Qin, Wang, Sun, Gao) Department of
Anesthesiology, Second Affiliated Hospital of Air Force Medical
University, Xi'an 710038, China
(Ji) Department of Epidemiology, School of Public Health, Ministry of
Education Key Laboratory of Hazard Assessment and Control in Special
Operational Environment, Air Force Medical University, Xi'an 710032, China
Publisher
Dove Medical Press Ltd
Abstract
Objective: This meta-analysis of randomized controlled trials (RCTs) aims
to evaluate the efficacy and safety of transcutaneous electrical acupoint
stimulation (TEAS) for postoperative delirium (POD) in surgical patients.
<br/>Method(s): Based on database searches of the Wanfang, China National
Knowledge Infrastructure (CNKI), VIP, Chinese Biology Medicine (CBM),
PubMed, Cochrane Library, and Web of Science, relevant RCTs published
before December 30, 2022, were extracted. Outcome indicators included the
incidence of POD, changes in Confusion Assessment Method (CAM) scores,
Visual Analogue Scale (VAS) scores, and the intraoperative consumption of
anesthetics. Data were pooled and analyzed by Review Manager 5.3, and
publication bias detection was conducted using Stata 17.0. <br/>Result(s):
A meta-analysis containing 715 experimental and 717 control participants
from 12 RCTs was performed. The overall results showed that TEAS had
obvious superiority with a lower incidence of POD on any day during the
postoperative 1 week. In subgroup analyses, the CAM scores on the third
postoperative day were significantly lower in the TEAS group than in the
control group (MD = -0.52, 95% CI: -1.02 to -0.03, P = 0.04), the VAS
scores on the first postoperative day were significantly lower in the TEAS
group than in the control group (MD = -0.19, 95% CI: -0.36 to -0.02, P =
0.03), the consumption of propofol and remifentanil were both
significantly lower in the TEAS group compared with the control group (MD
= -23.1, 95% CI: -37.27 to -8.94, P = 0.001; MD = -105.69, 95% CI: -174.20
to -37.19, P = 0.002). No serious adverse events of TEAS were reported in
any of the referenced studies. <br/>Conclusion(s): TEAS has an obvious
curative effect in preventing POD and pain in the earlier stage of
surgical patients. It could be a promising assisted anesthesia technique
in the future.<br/>Copyright &#xa9; 2023 Guo et al.

<34>
Accession Number
2023180193
Title
The Uncomfortable Truth: Open Thoracotomy versus Minimally Invasive
Surgery in Lung Cancer: A Systematic Review and Meta-Analysis.
Source
Cancers. 15(9) (no pagination), 2023. Article Number: 2630. Date of
Publication: May 2023.
Author
Kim D.; Woo W.; Shin J.I.; Lee S.
Institution
(Kim) Department of Thoracic and Cardiovascular Surgery, College of
Medicine, Chungbuk National University Hospital, Chungbuk National
University, Cheongju 28644, South Korea
(Woo, Lee) Department of Thoracic and Cardiovascular Surgery, Gangnam
Severance Hospital, Yonsei University College of Medicine, Seoul 03722,
South Korea
(Shin) Department of Pediatrics, Yonsei University College of Medicine, 50
Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
For decades, lung surgery in thoracic cancer has evolved in two ways:
saving more parenchyma and being minimally invasive. Saving parenchyma is
a fundamental principle of surgery. However, minimally invasive surgery
(MIS) is a matter of approach, so it has to do with advances in surgical
techniques and tools. For example, MIS has become possible with the
introduction of VATS (video-assisted thoracic surgery), and the
development of tools has extended the indication of MIS. Especially, RATS
(robot-assisted thoracic surgery) improved the quality of life for
patients and the ergonomics of doctors. However, the dichotomous idea that
the MIS is new and right but the open thoracotomy is old and useless may
be inappropriate. In fact, MIS is exactly the same as a classic
thoracotomy in that it removes the mass/parenchyma containing cancer and
mediastinal lymph nodes. Therefore, in this study, we compare
randomized-controlled trials about open thoracotomy and MIS to find out
which surgical method is more helpful.<br/>Copyright &#xa9; 2023 by the
authors.

<35>
Accession Number
2023093019
Title
Unusual causes for meralgia paresthetica: systematic review of the
literature and single center experience.
Source
Neurosurgical Review. 46(1) (no pagination), 2023. Article Number: 107.
Date of Publication: December 2023.
Author
de Ruiter G.C.W.; Oosterhuis J.W.A.; Vissers T.F.H.; Kloet A.
Institution
(de Ruiter, Kloet) Department of Neurosurgery, Haaglanden Medical Center,
Lijnbaan 32, CK, The Hague 2501, Netherlands
(Oosterhuis) Department of Surgery, Haaglanden Medical Center, The Hague,
Netherlands
(Vissers) Medical Library, Haaglanden Medical Center, The Hague,
Netherlands
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Meralgia paresthetica is often idiopathic, but sometimes symptoms may be
caused by traumatic injury to the lateral femoral cutaneous nerve (LFCN)
or compression of this nerve by a mass lesion. In this article the
literature is reviewed on unusual causes for meralgia paresthetica,
including different types of traumatic injury and compression of the LFCN
by mass lesions. In addition, the experience from our center with the
surgical treatment of unusual causes of meralgia paresthetica is
presented. A PubMed search was performed on unusual causes for meralgia
paresthetica. Specific attention was paid to factors that may have
predisposed to LFCN injury and clues that may have pointed at a mass
lesion. Moreover, our own database on all surgically treated cases of
meralgia paresthetica between April 2014 and September 2022 was reviewed
to identify unusual causes for meralgia paresthetica. A total of 66
articles was identified that reported results on unusual causes for
meralgia paresthetica: 37 on traumatic injuries of the LFCN and 29 on
compression of the LFCN by mass lesions. Most frequent cause of traumatic
injury in the literature was iatrogenic, including different procedures
around the anterior superior iliac spine, intra-abdominal procedures and
positioning for surgery. In our own surgical database of 187 cases, there
were 14 cases of traumatic LFCN injury and 4 cases in which symptoms were
related to a mass lesion. It is important to consider traumatic causes or
compression by a mass lesion in patients that present with meralgia
paresthetica.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<36>
Accession Number
2022867908
Title
Evaluation of levosimendan as treatment option in a large case-series of
preterm infants with cardiac dysfunction and pulmonary hypertension.
Source
European Journal of Pediatrics. 182(7) (pp 3165-3174), 2023. Date of
Publication: July 2023.
Author
Schroeder L.; Holcher S.; Leyens J.; Geipel A.; Strizek B.; Dresbach T.;
Mueller A.; Kipfmueller F.
Institution
(Schroeder, Holcher, Leyens, Dresbach, Mueller, Kipfmueller) Department of
Neonatology and Pediatric Intensive Care Medicine, University Children's
Hospital Bonn, Venusberg-Campus 1, Bonn D-53127, Germany
(Geipel, Strizek) Department of Obstetrics and Prenatal Medicine,
University Hospital Bonn, Bonn, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Levosimendan as a calcium-sensitizer is a promising innovative
therapeutical option for the treatment of severe cardiac dysfunction (CD)
and pulmonary hypertension (PH) in preterm infants, but no data are
available analyzing levosimendan in cohorts of preterm infants. The
design/setting of the evaluation is in a large case-series of preterm
infants with CD and PH. Data of all preterm infants (gestational age (GA)
< 37 weeks) with levosimendan treatment and CD and/or PH in the
echocardiographic assessment between 01/2018 and 06/2021 were screened for
analysis. The primary clinical endpoint was defined as echocardiographic
response to levosimendan. Preterm infants (105) were finally enrolled for
further analysis. The preterm infants (48%) were classified as extremely
low GA newborns (ELGANs, < 28 weeks of GA) and 73% as very low birth
weight infants (< 1500 g, VLBW). The primary endpoint was reached in 71%,
without difference regarding GA or BW. The incidence of moderate or severe
PH decreased from baseline to follow-up (24 h) in about 30%, with a
significant decrease in the responder group (p < 0.001). The incidence of
left ventricular dysfunction and bi-ventricular dysfunction decreased
significantly from baseline to follow-up (24 h) in the responder-group (p
= 0.007, and p < 0.001, respectively). The arterial lactate level
decreased significantly from baseline (4.7 mmol/l) to 12 h (3.6 mmol/l, p
< 0.05), and 24 h (3.1 mmol/l, p < 0.01). <br/>Conclusion(s): Levosimendan
treatment is associated with an improvement of both CD and PH in preterm
infants, with a stabilization of the mean arterial pressure during the
treatment and a significant decrease of arterial lactate levels. Future
prospective trials are highly warranted.What is Known:* Levosimendan as a
calcium-sensitizer and inodilator is known to improve the low cardiac
output syndrome (LCOS), and improves ventricular dysfunction, and PH, both
in pediatric as well as in adult populations. Data related to critically
ill neonates without major cardiac surgery and preterm infants are not
available.What is New:* This study evaluated the effect of levosimendan on
hemodynamics, clinical scores, echocardiographic severity parameters, and
arterial lactate levels in a case-series of 105 preterm infants for the
first time. Levosimendan treatment in preterm infants is associated with a
rapid improvement of CD and PH, an increase of the mean arterial pressure,
and a significant decrease in arterial lactate levels, as surrogate marker
for a LCOS.* How this study might affect research, practice, or policy. As
no data are available regarding the use of levosimendan in this
population, our results hopefully animate the research community to
conduct future prospective trails analyzing levosimendan in randomized
controlled trials (RCT) and observational control studies. Additionally,
our results potentially motivate clinicians to introduce levosimendan as
second second-line therapy in cases of severe CD and PH in preterm infants
without improvement using standard treatment strategies.<br/>Copyright
&#xa9; 2023, The Author(s).

<37>
Accession Number
2022486704
Title
A river runs through it: Reflections of blood flow, teams, and lives.
Source
Transfusion. 63(5) (pp 908-911), 2023. Date of Publication: May 2023.
Author
Bracey A.
Institution
(Bracey) Department of Cardiology, CHI St. Luke's Health-Baylor St. Luke's
Medical Center, Houston, TX, United States
Publisher
John Wiley and Sons Inc

<38>
Accession Number
2017986908
Title
Aggressive intraoperative warming versus routine thermal management during
non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority
trial.
Source
The Lancet. 399(10337) (pp 1799-1808), 2022. Date of Publication: 07 May
2022.
Author
Sessler D.I.; Pei L.; Li K.; Cui S.; Chan M.T.V.; Huang Y.; Wu J.; He X.;
Bajracharya G.R.; Rivas E.; Lam C.K.M.; Sun H.; Hu Z.; Li W.; Han W.; Zhao
P.; Ye H.; Chen P.; Zhu Z.; Dai W.; Jin L.; Bian W.; Liu Y.; Fung B.B.Y.;
Lee E.; Hui K.Y.; Choi G.Y.S.; Wong W.T.; Chan C.S.; Xiao Y.; Wu B.; Kang
W.; Lan L.; Sun C.; Qiu Y.; Tang W.; Zhang Y.; Huang Q.; Lu X.; Li T.; Yu
Q.; Yu J.; Wang R.; Chang H.; Zuo Y.; Sun Z.; Hou W.; Pan C.; Liu X.;
Zhang X.; Wang S.; Kang Y.; Ma Z.; Gu X.; Miao C.; Bravo M.; Kurz A.;
Turan A.; Ruetzler K.; Maheshwari K.; Mao G.; Han Y.; Yamak Altinpulluk
E.; Montalvo Compana M.; Almonacid-Cardenas F.; Leung S.M.; Hanline C.K.;
Chelnick D.M.; Tanios M.; Walters M.; Rosen M.J.; Ezoke S.; Mascha E.J.;
Cheng B.C.P.; Yip R.P.L.; Devereaux P.J.
Institution
(Sessler, Bajracharya, Rivas) Department of Outcomes Research,
Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States
(Sessler) Population Health Research Institute, McMaster University, ON,
Canada
(Pei, Huang) Department of Anesthesiology, Peking Union Medical College
Hospital, Beijing, China
(Li, Cui) China-Japan Union Hospital of Jilin University, Jilin, China
(Chan) The Chinese University of Hong Kong, Hong Kong Special
Administrative Region, China
(Wu) Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai,
China
(He) West China Hospital, Sichuan University, Sichuan, China
(Rivas) Department of Anesthesia, Hospital Clinic of Barcelona, IDIBAPS,
Universidad de Barcelona, Barcelona, Spain
(Lam) Tuen Mun Hospital, Hong Kong Special Administrative Region, China
Publisher
Elsevier B.V.
Abstract
Background: Moderate intraoperative hypothermia promotes myocardial
injury, surgical site infections, and blood loss. Whether aggressive
warming to a truly normothermic temperature near 37degreeC improves
outcomes remains unknown. We aimed to test the hypothesis that aggressive
intraoperative warming reduces major perioperative complications.
<br/>Method(s): In this multicentre, parallel group, superiority trial,
patients at 12 sites in China and at the Cleveland Clinic in the USA were
randomly assigned (1:1) to receive either aggressive warming to a target
core temperature of 37degreeC (aggressively warmed group) or routine
thermal management to a target of 35.5degreeC (routine thermal management
group) during non-cardiac surgery. Randomisation was stratified by site,
with computer-generated, randomly sized blocks. Eligible patients (aged
>=45 years) had at least one cardiovascular risk factor, were scheduled
for inpatient non-cardiac surgery expected to last 2-6 h with general
anaesthesia, and were expected to have at least half of the anterior skin
surface available for warming. Patients requiring dialysis and those with
a body-mass index exceeding 30 kg/m² were excluded. The primary
outcome was a composite of myocardial injury (troponin elevation,
apparently of ischaemic origin), non-fatal cardiac arrest, and all-cause
mortality within 30 days of surgery, as assessed in the modified
intention-to-treat population. This study is registered with
ClinicalTrials.gov, NCT03111875. <br/>Finding(s): Between March 27, 2017,
and March 16, 2021, 5056 participants were enrolled, of whom 5013 were
included in the intention-to-treat population (2507 in the aggressively
warmed group and 2506 in the routine thermal management group). Patients
assigned to aggressive warming had a mean final intraoperative core
temperature of 37.1degreeC (SD 0.3) whereas the routine thermal management
group averaged 35.6degreeC (SD 0.3). At least one of the primary outcome
components (myocardial injury after non-cardiac surgery, cardiac arrest,
or mortality) occurred in 246 (9.9%) of 2497 patients in the aggressively
warmed group and in 239 (9.6%) of 2490 patients in the routine thermal
management group. The common effect relative risk of aggressive versus
routine thermal management was an estimated 1.04 (95% CI 0.87-1.24,
p=0.69). There were 39 adverse events in patients assigned to aggressive
warming (17 of which were serious) and 54 in those assigned to routine
thermal management (30 of which were serious). One serious adverse event,
in an aggressively warmed patient, was deemed to be possibly related to
thermal management. <br/>Interpretation(s): The incidence of a 30-day
composite of major cardiovascular outcomes did not differ significantly in
patients randomised to 35.5degreeC and to 37degreeC. At least over a
1.5degreeC range from very mild hypothermia to full normothermia, there
was no evidence that any substantive outcome varied. Keeping core
temperature at least 35.5degreeC in surgical patients appears sufficient.
<br/>Funding(s): 3M and the Health and Medical Research Fund, Food and
Health Bureau, Hong Kong. Translation: For the Chinese translation of the
abstract see Supplementary Materials section.<br/>Copyright &#xa9; 2022
Elsevier Ltd

<39>
Accession Number
2025866366
Title
Impact of obstructive sleep apnea in cardiovascular risk in the pediatric
population: A systematic review.
Source
Sleep Medicine Reviews. 71 (no pagination), 2023. Article Number: 101818.
Date of Publication: October 2023.
Author
Castillo-Garcia M.; Solano-Perez E.; Coso C.; Romero-Peralta S.;
Garcia-Borreguero D.; Izquierdo J.L.; Mediano O.
Institution
(Castillo-Garcia, Solano-Perez, Coso, Romero-Peralta, Izquierdo, Mediano)
Pneumology Department, Hospital Universitario de Guadalajara, Sleep Unit,
Guadalajara, Spain
(Castillo-Garcia, Romero-Peralta) Predoctoral Student in Universidad de
Alcala, Madrid, Spain
(Castillo-Garcia, Romero-Peralta, Garcia-Borreguero) Sleep Research
Institute, Madrid, Spain
(Solano-Perez, Coso, Mediano) Centro de Investigacion Biomedica en Red de
Enfermedades Respiratorias (CIBERES), Madrid, Spain
(Izquierdo, Mediano) Medicine Department, Universidad de Alcala, Madrid,
Spain
Publisher
W.B. Saunders Ltd
Abstract
While the association of obstructive sleep apnea (OSA) with an increased
cardiovascular risk (CVR) in the adult population is well known, there is
insufficient evidence to affirm something similar in the pediatric
population. On the other hand, adenotonsillectomy has been shown to be an
effective treatment. Our objective was to evaluate the association of
sleep respiratory disorders in children with increased CVR and the impact
of adenotonsillectomy in the literature. To this aim, a literature search
was conducted, between 2002 to the present. After carrying out a
systematic review, the following results were provided: thoracic
echocardiography after surgery found improvements in terms of cardiac
function and structure; blood pressure (BP) measurement, verified a
tendency to higher BP values in the OSA pediatric population, which
improved after surgery; different biomarkers of CVR, were increased in OSA
patients and improved after treatment and finally; some studies found
endothelial dysfunction in pediatric OSA, a measurement of vascular system
function, was reversible with adenotonsillectomy. Increases in BP
parameters, biological markers related to CVR and alterations in cardiac
function structure, have been reported in pediatric patients with OSA. At
least, some of these parameters would be reversible after
adenotonsillectomy, reflecting a possible reduction in CVR.<br/>Copyright
&#xa9; 2023 Elsevier Ltd

<40>
Accession Number
2025324608
Title
Delirium in older patients given propofol or sevoflurane anaesthesia for
major cancer surgery: a multicentre randomised trial.
Source
British Journal of Anaesthesia. 131(2) (pp 253-265), 2023. Date of
Publication: August 2023.
Author
Cao S.-J.; Zhang Y.; Zhang Y.-X.; Zhao W.; Pan L.-H.; Sun X.-D.; Jia Z.;
Ouyang W.; Ye Q.-S.; Zhang F.-X.; Guo Y.-Q.; Ai Y.-Q.; Zhao B.-J.; Yu
J.-B.; Liu Z.-H.; Yin N.; Li X.-Y.; Ma J.-H.; Li H.-J.; Wang M.-R.;
Sessler D.I.; Ma D.; Wang D.-X.
Institution
(Cao, Zhang, Zhang, Ma, Wang) Department of Anesthesiology, Peking
University First Hospital, Beijing, China
(Zhang) Clinical Research Institute, Shenzhen Peking University-The Hong
Kong University of Science and Technology Medical Center, Guangdong,
Shenzhen, China
(Zhao) Department of Anesthesiology, The Fourth Hospital of Hebei Medical
University, Hebei, Shijiazhuang, China
(Pan) Department of Anesthesiology, Guangxi Medical University Cancer
Hospital, Guangxi Zhuang Autonomous Region, Nanning, China
(Sun) Department of Anesthesiology, Tangdu Hospital, Air Force Medical
University (Fourth Military Medical University), Shaanxi, Xi'an, China
(Jia) Department of Anesthesiology, Affiliated Hospital of Qinghai
University, Qinghai, Xining, China
(Ouyang) Department of Anesthesiology, The Third Xiangya Hospital, Central
South University, Hunan, Changsha, China
(Ye) Department of Anesthesiology, People's Hospital of Ningxia Hui
Autonomous Region, Ningxia Hui Autonomous Region, Yinchuan, China
(Zhang) Department of Anesthesiology, Guizhou Provincial People's
Hospital, Guizhou, Guiyang, China
(Guo) Department of Anesthesiology, Shanxi Provincial People's Hospital,
Shanxi, Taiyuan, China
(Ai) Department of Anesthesiology, Pain and Perioperative Medicine, The
First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China
(Zhao) Department of Anesthesiology, Beijing Shijitan Hospital, Capital
Medical University, Beijing, China
(Yu) Department of Anesthesiology and Critical Care Medicine, Tianjin
Nankai Hospital, Tianjin Medical University, Tianjin, China
(Liu) Department of Anesthesiology, Shenzhen Second People's Hospital, The
First Affiliated Hospital of Shenzhen University, Health Science Center,
Guangdong, Shenzhen, China
(Yin) Department of Anesthesiology, Zhongda Hospital, Medical School of
Southeast University, Jiangsu, Nanjing, China
(Yin) Department of Anesthesiology, Sir Run Run Hospital, Nanjing Medical
University, Jiangsu, Nanjing, China
(Li) Department of Biostatistics, Peking University First Hospital,
Beijing, China
(Li, Wang) Peking University Clinical Research Institute, Peking
University Health Science Center, Beijing, China
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Sessler, Wang) Outcomes Research Consortium, Cleveland, OH, United States
(Ma) Division of Anesthetics, Pain Medicine and Intensive Care, Department
of Surgery and Cancer, Faculty of Medicine, Imperial College London,
Chelsea and Westminster Hospital, London, United Kingdom
(Ma) The Children's Hospital, Zhejiang University School of Medicine,
National Clinical Research Center for Child Health, Hangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Delirium is a common and disturbing postoperative complication
that might be ameliorated by propofol-based anaesthesia. We therefore
tested the primary hypothesis that there is less delirium after
propofol-based than after sevoflurane-based anaesthesia within 7 days of
major cancer surgery. <br/>Method(s): This multicentre randomised trial
was conducted in 14 tertiary care hospitals in China. Patients aged 65-90
yr undergoing major cancer surgery were randomised to either
propofol-based anaesthesia or to sevoflurane-based anaesthesia. The
primary endpoint was the incidence of delirium within 7 postoperative
days. <br/>Result(s): A total of 1228 subjects were enrolled and
randomised, with 1195 subjects included in the modified intention-to-treat
analysis (mean age 71 yr; 422 [35%] women); one subject died before
delirium assessment. Delirium occurred in 8.4% (50/597) of subjects given
propofol-based anaesthesia vs 12.4% (74/597) of subjects given
sevoflurane-based anaesthesia (relative risk 0.68 [95% confidence interval
{CI}: 0.48-0.95]; P=0.023; adjusted relative risk 0.59 [95% CI:
0.39-0.90]; P=0.014). Delirium reduction mainly occurred on the first day
after surgery, with a prevalence of 5.4% (32/597) with propofol
anaesthesia vs 10.7% (64/597) with sevoflurane anaesthesia (relative risk
0.50 [95% CI: 0.33-0.75]; P=0.001). Secondary endpoints, including ICU
admission, postoperative duration of hospitalisation, major complications
within 30 days, cognitive function at 30 days and 3 yr, and safety
outcomes, did not differ significantly between groups. <br/>Conclusion(s):
Delirium was a third less common after propofol than sevoflurane
anaesthesia in older patients having major cancer surgery. Clinicians
might therefore reasonably select propofol-based anaesthesia in patients
at high risk of postoperative delirium. Clinical trial registration:
Chinese Clinical Trial Registry (ChiCTR-IPR-15006209) and
ClinicalTrials.gov (NCT02662257).<br/>Copyright &#xa9; 2023 The Authors

<41>
Accession Number
641846926
Title
Complete Revascularization and Angina-Related Health Status in the
ISCHEMIA Trial.
Source
Journal of the American College of Cardiology. 82(4) (pp 295-313), 2023.
Date of Publication: 25 Jul 2023.
Author
Mavromatis K.; Jones P.G.; Ali Z.A.; Stone G.W.; Rhodes G.M.; Bangalore
S.; O'Brien S.; Genereux P.; Horst J.; Dressler O.; Goodman S.; Alexander
K.; Mathew A.; Chen J.; Bhargava B.; Uxa A.; Boden W.E.; Mark D.B.;
Reynolds H.R.; Maron D.J.; Hochman J.S.; Spertus J.A.
Institution
(Mavromatis) Emory University, Atlanta VA Healthcare System, Atlanta, GA,
United States
(Jones, Spertus) Saint Luke's Mid America Heart Institute/University of
Missouri - Kansas City (UMKC), Kansas City, MO, United States
(Ali) St Francis Hospital and Heart Center, Roslyn, New York, USA;
Cardiovascular Research Foundation, New York, New York, USA
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
(Rhodes, O'Brien, Alexander, Mark) Duke Clinical Research Institute,
Durham, NC, United States
(Bangalore, Reynolds, Hochman) NYU Grossman School of Medicine, NY, United
States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Horst, Dressler) Cardiovascular Research Foundation, NY, United States
(Goodman) St Michael's Hospital, University of Toronto, the Canadian Heart
Research Centre, Toronto, ON, Canada
(Mathew) University of Alberta Hospital, Edmonton, AB, Canada
(Chen) Guangdong Provincial People's Hospital, Guangdong, China
(Bhargava) All India Institute of Medical Science, New Delhi, India
(Uxa) University of Toronto and University Health Network/Mount Sinai
Hospital, Toronto, ON, Canada
(Boden) VA New England Healthcare System, Bedford, MA, United States
(Maron) Department of Medicine, Stanford University, Stanford, CA, United
States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The impact of complete revascularization (CR) on
angina-related health status (symptoms, function, quality of life) in
chronic coronary disease (CCD) has not been well studied.
<br/>OBJECTIVE(S): Among patients with CCD randomized to invasive (INV) vs
conservative (CON) management in ISCHEMIA (International Study of
Comparative Health Effectiveness with Medical and Invasive Approaches), we
compared the following: 1) the impact of anatomic and functional CR on
health status compared with incomplete revascularization (ICR); and 2) the
predicted impact of achieving CR in all INV patients compared with CON.
<br/>METHOD(S): Multivariable regression adjusting for patient
characteristics was used to compare 12-month health status after
independent core laboratory-defined CR vs ICR in INV patients who
underwent revascularization. Propensity-weighted modeling was then
performed to estimate the treatment effect had CR or ICR been achieved in
all INV patients, compared with CON. <br/>RESULT(S): Anatomic and
functional CR were achieved in 43.3% and 57.8% of 1,641 INV patients,
respectively. Among revascularized patients, CR was associated with
improved Seattle Angina Questionnaire Angina Frequency compared with ICR
after adjustment for baseline differences. After modeling CR and ICR in
all INV patients, patients with CR and ICR each had greater improvements
in health status than CON, with better health status with CR than ICR. The
projected benefits of CR were most pronounced in patients with baseline
daily/weekly angina and not seen in those with no angina.
<br/>CONCLUSION(S): Among patients with CCD in ISCHEMIA, health status
improved more with CR compared with ICR or CON, particularly in those with
frequent angina. Anatomic and functional CR provided comparable
improvements in quality of life. (International Study of Comparative
Health Effectiveness With Medical and Invasive Approaches [ISCHEMIA];
NCT01471522).<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation. Published by Elsevier Inc. All rights reserved.

<42>
Accession Number
641840848
Title
Transcatheter Valve Replacement in Patients with Aortic Valve Stenosis: An
Overview of Systematic Reviews and Meta-Analysis with Different
Populations.
Source
Arquivos brasileiros de cardiologia. 120(7) (pp e20220701), 2023. Date of
Publication: 01 Jun 2023.
Author
Diegoli H.; Alves M.R.D.; Okumura L.M.; Kroll C.; Silveira D.; Furlan
L.H.P.
Institution
(Diegoli) Academia VBHC Educacao e Consultoria Ltda, Sao Paulo, Brazil
(Alves, Silveira) Edwards Lifesciences Corporation, Sao Paulo, Brazil
(Okumura) Universidade de York, York - Reino Unido
(Kroll) Universidade da Regiao de Joinville, SC - Brasil, Joinville,
Brazil
(Furlan) Unimed do Parana, Curitiba, Brazil
Publisher
NLM (Medline)

<43>
Accession Number
2025906839
Title
Predictors of Major Adverse Cardiovascular Events in Patients with
Moderate Aortic Stenosis: Implications for Aortic Valve Replacement.
Source
Circulation: Cardiovascular Imaging. 16(7) (pp 557-565), 2023. Date of
Publication: 01 Jul 2023.
Author
Howard T.; Majmundar M.; Sarin S.; Kumar A.; Ajay A.; Krishnaswamy A.;
Reed G.W.; Harb S.C.; Harmon E.; Dykun I.; Ghandakly E.; Kapadia S.R.;
Kalra A.; Puri R.
Institution
(Howard, Kumar, Ajay, Krishnaswamy, Reed, Harb, Harmon, Ghandakly,
Kapadia, Kalra, Puri) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH, United States
(Majmundar) Department of Cardiovascular Medicine, University of Kansas
Medical Center, Kansas City, United States
(Sarin) Case Western Reserve University, School of Medicine, Cleveland,
OH, United States
(Dykun) Department of Cardiology and Vascular Medicine, West German Heart
and Vascular Center, University of Duisburg-Essen, Germany
(Kumar) Franciscan Health, Lafayette, IN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Although the prognosis and management of severe aortic
stenosis has been extensively studied, the risk stratification and
outcomes of patients with moderate aortic stenosis remain elusive.
<br/>METHOD(S): This study included 674 patients from the Cleveland Clinic
Health System with moderate aortic stenosis (aortic valve area, 1-1.5
cm²; mean gradient, 20-40 mm Hg; and peak velocity <4 m/s) and
an NT-proBNP (N-terminal pro-B-type natriuretic peptide) level within 3
months of index diagnosis. The primary outcome of major adverse
cardiovascular events (defined as the composite outcome of progression to
severe aortic stenosis requiring aortic valve replacement, heart failure
hospitalization, or death) was extracted from the electronic medical
record. <br/>RESULT(S): The mean age was 75.3+/-12 years, and 57% were
men. During a median follow-up of 316 days, the composite end point
occurred in 305 patients. There were 132 (19.6%) deaths, 144 (21.4%) heart
failure hospitalizations, and 114 (16.9%) patients underwent aortic valve
replacement. Elevated NT-proBNP (1.41 [95% CI, 1.01-1.95]; P=0.048),
diabetes (1.46 [95% CI, 1.08-1.96]; P=0.01), elevated averaged mitral
valve E/e' ratio (hazard ratio, 1.57 [95% CI, 1.18-2.10]; P<0.01), and
presence atrial fibrillation at the time of index echocardiogram (hazard
ratio, 1.83 [95% CI, 1.15-2.91]; P=0.01) were each independently
associated with an increased hazard for the composite outcome and when
taken collectively, each of these factors incrementally increased risk.
<br/>CONCLUSION(S): These results further elucidate the relatively poor
short-medium term outcomes and risk stratification of patients with
moderate aortic stenosis, supporting randomized trials assessing the
efficacy of transcatheter aortic valve replacement in this
population.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All
rights reserved.

<44>
Accession Number
2025878274
Title
Serratus anterior plane block versus thoracic epidural block in patients
undergoing thoracotomy: a randomized double-blind trial.
Source
Anaesthesia, Pain and Intensive Care. 27(3) (pp 389-395), 2023. Date of
Publication: June 2023.
Author
Gamal R.M.; Bossily S.S.; Ali A.R.; Samy S.F.; Seif N.E.; Ahmed H.I.
Institution
(Gamal, Bossily, Samy) National Cancer Institute, Cairo University, Cairo,
Egypt
(Ali, Seif, Ahmed) Cairo University, Cairo, Egypt
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & Objective: Standard pain management technique after thoracic
surgery is thoracic epidural analgesia, parentral analgesics and nerve
blocks. Thoracic epidural analgesia (TEA) has many known complications,
including respiratory depression and urinary retention. Serratus anterior
plane block (SAPB) is a simple procedure, which provides postoperative
pain relief by blocking the lateral cutaneous branches of T2-T9 spinal
neurons. We compared the analgesic efficacy of both of these techniques in
thoracotomy patients in this randomized trial. Methodology: The study
involved 74 cancer patients scheduled for thoracotomy. The patients were
randomly divided into two groups. The patients in Group SAPB underwent
ultrasound-guided serratus anterior plan block (SAPB) with catheter
insertion. The second group (Group TEA) underwent TEA with preoperative
indwelling catheter insertion. In both groups blocks were activated before
induction of routine general anesthesia (GA) by a bupivacaine bolus dose,
then continued as bupivacaine infusion in ICU for postoperative analgesia.
Hemodynamic monitoring was started. Intraoperative fentanyl consumption,
postoperative morphine consumption, and time to first request for
analgesic were noted including MAP in the two groups. <br/>Result(s): Both
groups were statistically comparable regarding intraoperative fentanyl
consumption, postoperative morphine consumption, and time to first request
for analgesia in the two groups. Hypotensive episodes were significantly
more frequent (P < 0.001) in the TEA group (n = 17; 45.9%) compared to the
Group SAPB (n = 2; 5.4%). Ramsey sedation scores (RSS) were comparable in
the two groups immediately postoperatively and after 2 h. After 4 h after
recovery all patients in both groups had an RSS of 2. <br/>Conclusion(s):
Ultrasound-guided serratus anterior plane block is associated with reduced
intraoperative and postoperative fentanyl consumption, but the Ramsey
sedation scores were equivalent in the two groups after recovery and upto
4h.<br/>Copyright &#xa9; 2023 Faculty of Anaesthesia, Pain and Intensive
Care, AFMS. All rights reserved.

<45>
Accession Number
2024123314
Title
Safety and efficacy of cerebral embolic protection devices for patients
undergoing transcatheter aortic valve replacement: An updated
meta-analysis.
Source
Health Science Reports. 6(7) (no pagination), 2023. Article Number: e1391.
Date of Publication: July 2023.
Author
Shrestha D.B.; Shtembari J.; Lamichhane S.; Baniya A.; Shahi M.; Dhungel
S.; Pant K.; Sutton N.R.; Villablanca P.; Mungee S.
Institution
(Shrestha, Shtembari) Department of Internal Medicine, Mount Sinai
Hospital, Chicago, IL, United States
(Lamichhane, Baniya, Shahi) Department of Internal Medicine, Chitwan
Medical College Teaching Hospital, Bharatpur, Nepal
(Dhungel) Division of Cardiovascular Medicine, Department of Internal
Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL,
United States
(Pant, Mungee) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Illinois College of Medicine, OSF Healthcare,
Peoria, IL, United States
(Sutton) Division of Cardiovascular Medicine, Department of Internal
Medicine, Vanderbilt University Medical Center, Nashville, TN, United
States
(Sutton) Department of Biomedical Engineering, Vanderbilt University,
Nashville, TN, United States
(Villablanca) Division of Interventional Cardiology and Structural Heart
Disease, Department of Internal Medicine, The Center for Structural Heart
Disease Henry Ford Hospital, Detroit, MI, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: Cerebral embolic protection (CEP) devices are
employed to capture embolic debris and reduce the risk of stroke during
transcatheter aortic valve replacement (TAVR). Evidence is mixed regarding
the safety and efficacy of CEP. We aimed to summarize the safety and
effectiveness of CEP use during TAVR. <br/>Method(s): Electronic
databases, including PubMed, PubMed Central, Scopus, Cochrane Library, and
Embase, were searched using relevant search terms for articles relating to
CEP. All relevant data from 20 studies were extracted into a standardized
form. Statistical analyses were performed using Revman 5.4. Odds ratio
(OR) or mean differences (MDs) were used to estimate the desired outcome
with a 95% confidence interval (CI). <br/>Result(s): Twenty studies (eight
randomized controlled trials [RCTs]) involving 210,871 patients (19,261 in
the CEP group and 191,610 in TAVR without the CEP group) were included.
The use of CEP was associated with a lower odds of 30-day mortality by 39%
(OR: 0.61, 95% CI: 0.53-0.70) and stroke by 31% (OR: 0.69, 95% CI:
0.52-0.92). Comparing devices, benefit in terms of mortality and stroke
was observed with the use of the Sentinel device (Boston Scientific), but
not among other devices. No differences were observed in the outcomes of
acute kidney injury, major or life-threatening bleeding events, or major
vascular complications between groups. When only RCTs were included, there
were no observed differences in the primary or secondary outcomes for CEP
versus no CEP use during TAVR. <br/>Conclusion(s): The totality of
evidence suggests a net benefit for the use of CEP, weighted by studies in
which the Sentinal device was used. However, given the RCT subanalysis,
additional evidence is needed to identify patients at the highest risk of
stroke for optimal decision-making.<br/>Copyright &#xa9; 2023 The Authors.
Health Science Reports published by Wiley Periodicals LLC.

<46>
Accession Number
641859026
Title
Renin-angiotensin-aldosterone system dynamics after targeted blood
pressure control using angiotensin II or norepinephrine in cardiac
surgery: mechanistic randomised controlled trial.
Source
British journal of anaesthesia. (no pagination), 2023. Date of
Publication: 20 Jul 2023.
Author
Coulson T.G.; Miles L.F.; Zarbock A.; Burrell L.M.; Patel S.K.; von Groote
T.; Pilcher D.; Weinberg L.; Landoni G.; Bellomo R.
Institution
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred
Health and Monash University, Melbourne, VIC, Australia; Department of
Critical Care, University of Melbourne, Melbourne, VIC, Australia
(Miles, Weinberg) Department of Critical Care, University of Melbourne,
Melbourne, VIC, Australia; Department of Anaesthesia and Pain Medicine,
Austin Health, Melbourne, VIC, Australia
(Zarbock, von Groote) Department of Anaesthesiology, Intensive Care and
Pain Medicine, University Hospital Munster, Munster, Germany
(Burrell) Department of Medicine, Austin Health, University of Melbourne,
Heidelberg, VIC, Australia; Department of Cardiology, Austin Health,
Heidelberg, VIC, Australia; The Institute for Breathing and Sleep,
Heidelberg, VIC, Australia
(Patel) Department of Medicine, Austin Health, University of Melbourne,
Heidelberg, VIC, Australia
(Pilcher) Department of Intensive Care, Alfred Hospital, Melbourne, VIC,
Australia; Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
(Landoni) Department of Anaesthesia, IRCCS San Raffaele Scientific
Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia; Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia; Department of Intensive
Care, Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of
Intensive Care, Austin Hospital, Melbourne, VIC, Australia; Data Analytics
Research and Evaluation Centre, Austin Hospital, Melbourne, VIC, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: The role of the renin-angiotensin-aldosterone axis in
vasoplegia after cardiac surgery remains unclear. We tested the hypothesis
that, compared with norepinephrine, infusion of angiotensin II titrated to
achieve similar mean arterial pressure (MAP) would suppress plasma renin
concentration (PRC) while maintaining aldosterone levels. <br/>METHOD(S):
In a double-blind, randomised controlled trial, subjects received either
an infusion of angiotensin II or norepinephrine to maintain MAP 70-80 mm
Hg from induction of anaesthesia. We compared PRC, aldosterone, dipeptidyl
peptidase-3, and angiotensin-converting enzyme 2 activity between
treatment groups, before surgery, on ICU admission, and 24 h after
surgery. <br/>RESULT(S): In 60 patients (11.7% female; mean age 68 yr [11
yr]), norepinephrine increased median PRC at ICU admission (median
difference [MD] 46 [inter-quartile range, IQR, 3-88] muU ml-1; P<0.001)
but angiotensin II did not (MD -3 [IQR -62 to 35] muU ml-1; P=0.36).
Aldosterone levels increased with both. The aldosterone:PRC ratio did not
change with norepinephrine (MD -0.01 [IQR -0.14 to 0.03] muU ml-1 per ng
dl-1, P=0.76) but increased with angiotensin II (MD 0.05 [IQR 0.004-0.26]
muU ml-1 per ng dl-1, P<0.001). The upper quartile of PRC before surgery
was associated with higher vasopressor requirements when norepinephrine
was used to maintain MAP, but not angiotensin II. Dipeptidyl peptidase-3
levels and angiotensin-converting enzyme 2 activities were similar at all
time points. <br/>CONCLUSION(S): Angiotensin II suppressed renin release
while maintaining aldosterone levels compared with norepinephrine. Higher
plasma renin concentration before surgery was associated with greater
vasopressor requirement for norepinephrine, but not angiotensin II.
CLINICAL TRIAL REGISTRATION: Australian and New Zealand Clinical Trials
Registry-ACTRN12621000195853 23/02/2021.<br/>Copyright &#xa9; 2023 British
Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

<47>
Accession Number
641856939
Title
Therapeutic Outcomes Following Isolated Transcatheter Tricuspid Valve
Repair: A Systematic Review and Meta-analysis.
Source
Current problems in cardiology. (pp 101985), 2023. Date of Publication:
19 Jul 2023.
Author
Siddiqui H.F.; Khan A.B.; Nasir M.M.; Latif F.; Siddiqui A.F.; Akhtar P.;
Hamza M.; Barmanwalla A.
Institution
(Siddiqui, Khan, Nasir, Latif) Department of Internal Medicine, Dow
University of Health Sciences, Karachi, Pakistan
(Siddiqui) Department of Internal Medicine, Aga Khan University Hospital,
Karachi, Pakistan
(Akhtar) Department of Cardiology, National Institute of Cardiovascular
Diseases, Karachi, Pakistan
(Hamza) Department of Internal Medicine, Albany Medical Center
(Barmanwalla) MD Brigham & Women's Hospital and Cape Cod Hospital
Publisher
NLM (Medline)
Abstract
BACKGROUND: Tricuspid regurgitation (TR) is traditionally treated
surgically, but isolated transcatheter tricuspid valve repair (ITTVR)
offers a less invasive option. <br/>OBJECTIVE(S): This study conducts a
meta-analysis and systematic review to evaluate ITTVR outcomes in patients
with TR. METHODOLOGY: Database searches until March 2023 identified
studies assessing ITTVR safety and efficacy in moderate/severe TR
patients. Primary outcomes analyzed were severe TR, NYHA functional class
improvement, and 6-minute walking distance. Meta-analyses used Risk ratio
(RR) or mean difference with a random effects model. <br/>RESULT(S): The
review included 25 studies with 2,421 patients. ITTVR improved NYHA
functional class (RR: 3.262), reduced TR severity (RR: 0.303), and
enhanced 6-minute walking distance (MD: +47.077 m). Echocardiographic
parameters improved, including reductions in TR vena contracta, TR EROA,
septolateral tricuspid annular diameter, RVEDD, RV FAC, and TAPSE. LVEF
and PASP showed no significant changes. <br/>CONCLUSION(S): ITTVR improves
functional outcomes and echocardiographic parameters in TR
patients.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<48>
Accession Number
641855936
Title
Platelet Transfusion in Cardiac Surgery: An Entropy-Balanced, Weighted,
Multicenter Analysis.
Source
Anesthesia and analgesia. (no pagination), 2023. Date of Publication: 21
Jul 2023.
Author
Fletcher C.M.; Hinton J.V.; Xing Z.; Perry L.A.; Greifer N.; Karamesinis
A.; Shi J.; Penny-Dimri J.C.; Ramson D.; Liu Z.; Williams-Spence J.; Segal
R.; Smith J.A.; Coulson T.G.; Bellomo R.
Institution
(Fletcher, Coulson) From the Department of Anaesthesiology and
Perioperative Medicine, Alfred Hospital, Melbourne, VIC, Australia
(Hinton, Xing, Perry, Karamesinis, Shi, Liu, Segal, Coulson) Department of
Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC,
Australia
(Perry, Segal, Bellomo) Department of Critical Care, University of
Melbourne, Parkville, VIC, Australia
(Greifer) Harvard University Institute for Quantitative Social Science,
Cambridge, MA, United States
(Penny-Dimri, Ramson, Smith) Department of Surgery, School of Clinical
Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
(Williams-Spence) Department of Epidemiology and Preventive Medicine,
Monash University, Melbourne, VIC, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Clayton,
United States
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Monash
University, Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne, VIC,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, United Kingdom
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Platelet transfusion is common in cardiac surgery, but some
studies have suggested an association with harm. Accordingly, we
investigated the association of perioperative platelet transfusion with
morbidity and mortality. <br/>METHOD(S): We conducted a retrospective
analysis of prospectively collected data from the Australian Society of
Cardiac and Thoracic Surgeons National Cardiac Surgery Database. We
included consecutive adults from 2005 to 2018 across 40 centers. We used
inverse probability of treatment weighting via entropy balancing to
investigate the association of perioperative platelet transfusion with our
2 primary outcomes, operative mortality (composite of both 30-day and
in-hospital mortality) and 90-day mortality, as well as multiple other
clinically relevant secondary outcomes. <br/>RESULT(S): Among 119,132
eligible patients, 25,373 received perioperative platelets and 93,759 were
considered controls. After entropy balancing, platelet transfusion was
associated with reduced operative mortality (odds ratio [OR], 0.63; 99%
confidence interval [CI], 0.47-0.84; P < .0001) and 90-day mortality (OR,
0.66; 99% CI, 0.51-0.85; P < .0001). Moreover, it was associated with
reduced odds of deep sternal wound infection (OR, 0.57; 99% CI, 0.36-0.89;
P = .0012), acute kidney injury (OR, 0.84; 99% CI, 0.71-0.99; P = .0055),
and postoperative renal replacement therapy (OR, 0.71; 99% CI, 0.54-0.93;
P = .0013). These positive associations were observed despite an
association with increased odds of return to theatre for bleeding (OR,
1.55; 99% CI, 1.16-2.09; P < .0001), pneumonia (OR, 1.26; 99% CI,
1.11-1.44; P < .0001), intubation for longer than 24 hours postoperatively
(OR, 1.13; 99% CI, 1.03-1.24; P = .0012), inotrope use for >4 hours
postoperatively (OR, 1.14; 99% CI, 1.11-1.17; P < .0001), readmission to
hospital within 30 days of surgery (OR, 1.22; 99% CI, 1.11-1.34; P <
.0001), as well as increased drain tube output (adjusted mean difference,
89.2 mL; 99% CI, 77.0 mL-101.4 mL; P < .0001). <br/>CONCLUSION(S): In
cardiac surgery patients, perioperative platelet transfusion was
associated with reduced operative and 90-day mortality. Until randomized
controlled trials either confirm or refute these findings, platelet
transfusion should not be deliberately avoided when considering odds of
death.<br/>Copyright &#xa9; 2023 International Anesthesia Research
Society.

<49>
Accession Number
641853957
Title
Effect of prehabilitation-related DIETary protein intake on Quality of
Recovery after elective cardiac surgery (DIETQoR) study: protocol of a
randomised controlled trial.
Source
BMJ open. 13(7) (pp e069528), 2023. Date of Publication: 20 Jul 2023.
Author
Cheung H.H.T.; Yau D.K.W.; Chiu L.C.S.; Wong M.K.H.; Yeung S.S.Y.;
Underwood M.J.; Wong R.H.L.; Joynt G.M.; Lee A.
Institution
(Cheung, Yau, Chiu, Wong, Joynt, Lee) Anaesthesia and Intensive Care,
Chinese University of Hong Kong, Hong Kong, China
(Yeung) Medicine and Therapeutics, Chinese University of Hong Kong, Hong
Kong, China
(Underwood) Cardiovascular Services, Auckland City Hospital, Auckland, New
Zealand
(Wong) Division of Cardiothoracic Surgery, Chinese University of Hong
Kong, Hong Kong, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Protein malnutrition is associated with higher risks of
postoperative complications, mortality, prolonged postoperative stays in
hospital, slower physical and mental recovery after surgery and lower
subsequent health-related quality of life. To reduce the risk of
postoperative morbidity and mortality, nutritional prehabilitation
programmes have been developed recently to build up patient's nutritional
reserve to withstand the stress of surgery. The intervention involves
nutritional screening and counselling, and increasing dietary protein
intake in protein-malnourished patients in the several weeks before
surgery. However, there are few well-conducted preoperative studies to
examine the effect of increasing dietary protein intake on the quality of
recovery of malnourished patients after elective cardiac surgery. METHOD
AND ANALYSIS: This randomised controlled trial of malnourished patients
undergoing major elective cardiac surgery will compare the quality of
postoperative recovery in patients with or without nutritional
prehabilitation. One hundred and thirty-two patients will be randomised to
receive nutritional prehabilitation (target-adjusted whey protein powder
supplementation and an individualised 1hour session/week counselling by a
dietician 1month before operation date) or standard care (no nutritional
prehabilitation). Primary outcomes will be the quality of recovery after
surgery (15-item Quality of Recovery) on the third postoperative day.
Secondary outcomes will include days (alive and) at home within 30 days,
changes in the WHO Disability Assessment Schedule 2.0, changes in
health-related quality of life (EQ-5D) and Cardiac Postoperative Morbidity
Survey. An outcomes assessor will be blinded to the treatment allocation.
Appropriate univariate analyses, generalised estimating equations and
multiple regressions will be performed for intention-to-treat and
per-protocol analyses. ETHICS AND DISSEMINATION: The Joint CUHK-NTEC
Clinical Research Ethics Committee approved the study protocol (CREC Ref.
No.: 2021.703T). The findings will be presented at scientific meetings,
peer-reviewed journals and to study participants. TRIAL REGISTRATION
NUMBER: ChiCTR2200057463.<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.

<50>
Accession Number
641852049
Title
5-years hemodynamic performance of three aortic bioprostheses. A
randomized clinical trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 20 Jul 2023.
Author
Montero Cruces L.; Carnero Alcazar M.; Perez Camargo D.; Cobiella Carnicer
J.; Campelos Fernandez P.; Reguillo Lacruz F.J.; Maroto Castellanos L.C.
Institution
(Montero Cruces, Carnero Alcazar, Perez Camargo, Cobiella Carnicer,
Campelos Fernandez, Reguillo Lacruz, Maroto Castellanos) Department of
Cardiovascular Surgery, Clinico San Carlos Hospital. Madrid
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Carpentier Perimount Magna EaseTM (CPME), Crown PRTTM, and
TrifectaTM bovine pericardial valves have been widely used worldwide. The
primary end-point was to compare the haemodynamic performance quantified
by in vivo echocardiogram of these 3 aortic prostheses. <br/>METHOD(S):
The "BEST-VALVE" (Comparison of 3 contemporary cardiac bioprosthesis:
mid-term valve haemodynamic performance) was a single center randomized
clinical trial to compare the haemodynamic and clinical outcomes of the
aforementioned bioprostheses. 5year results are assessed in this
manuscript. <br/>RESULT(S): 154 patients were included. CPMETM (n=48,
31.2%), Crown PRTTM (n=51, 32.1%) and TrifectaTM (n=55, 35.7%).
Significant differences were observed between the three bioprostheses
5-years after the procedure. These haemodynamic differences were found
between CPMETM and Crown PRTTM bioprostheses (Mean aortic gradient:
12.3mmHg (IQR 7.8-17.5) for CPMETM vs 15mmHg (IQR 10.8 - 31.9) for Crown
PRTTM, p<0.001) and between CPMETM and TrifectaTM prostheses (Mean aortic
gradient: 12.3mmHg (IQR 7.8-17.5) for CPMETM vs 14.7mmHg (IQR 8.2-55) for
TrifectaTM, p<0.001), with a better haemodynamic performance of CPMETM.
The cumulative incidence of severe structural valve degeneration was 9.5%
in the TrifectaTM group at 6years of follow-up. The 1-, 3- and 5-years
survival from all-cause mortality was 91.5%, 83.5% and 74.8%, respectively
(Log Rank p=0.440). Survival from the composite event at 1-, 3- and
5-years follow-up was 92.8%, 74.6% and 59%, respectively (Log Rank
p=0.299). <br/>CONCLUSION(S): We detected significant differences between
the three bioprosthesis having CPMETM the best haemodynamic performance at
5years follow-up. CLINICAL REGISTRATION NUMBER: EudraTC (European Database
of Clinical Trials): 2018-001658-87.
https://eudract.ema.europa.eu.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<51>
Accession Number
641851987
Title
Clinical outcomes following tricuspid transcatheter edge-to-edge repair
with PASCAL: A meta-analysis.
Source
International journal of cardiology. (pp 131194), 2023. Date of
Publication: 18 Jul 2023.
Author
Badwan O.; Mirzai S.; Skoza W.; Hawk F.; Braghieri L.; Persits I.;
Krishnaswamy A.; Puri R.; Kapadia S.R.
Institution
(Badwan, Mirzai, Skoza, Braghieri, Persits) Department of Internal
Medicine, Cleveland Clinic, Cleveland, OH, United States
(Hawk) Division of Cardiovascular Medicine, University of South Florida
College of Medicine, Tampa, FL, United States
(Krishnaswamy, Puri) Department of Cardiovascular Medicine, Heart,
Vascular, Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
(Kapadia) Department of Cardiovascular Medicine, Heart, Vascular, Thoracic
Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with severe tricuspid regurgitation (TR) exhibit high
morbidity and mortality. Tricuspid transcatheter edge-to-edge repair
(T-TEER) is a rapidly evolving strategy to address the unmet clinical need
of severe TR therapies. <br/>OBJECTIVE(S): Organize the current body of
evidence on outcomes following use of the PASCAL (Edwards Lifesciences)
system for T-TEER. <br/>METHOD(S): For this meta-analysis, we searched the
MEDLINE/PubMed, Embase, and Cochrane databases for keywords ["tricuspid"]
and ["transcatheter" or "edge-to-edge"] and ["PASCAL" or "leaflet repair"
or "valve repair"] from the database inception until January 11, 2023.
Primary outcomes of interest were procedural success, mortality, New York
Heart Association (NYHA) functional class, 6-min walking distance (6MWD),
and TR severity. <br/>RESULT(S): A total of 549 patients undergoing PASCAL
or PASCAL Ace T-TEER were included. The mean age ranged from 71.0 to
80.3years, with 25.0 to 63.6% females. The follow-up duration ranged from
30days to 1year. The success rate was 83.5% (409/490). There was
improvement in symptoms based on NYHA classification (at 1- to 6-months;
NYHA >=3 RR 0.27 [95% CI 0.19-0.39]; p<0.001) and 6MWD (at 1-month; 50.96
[95% CI 32.34-69.59]; p<0.001) post-procedure. On imaging, there was
improvement in TR severity post-procedure (at 1- to 12-months;>=severe TR
0.21 [95% CI 0.14-0.31]; p<0.001), which remained significant with each
study removed. <br/>CONCLUSION(S): PASCAL for T-TEER is associated with
high procedural success rates along with improvements in NYHA functional
class, TR severity, 6MWD, and patient-reported outcomes.<br/>Copyright
&#xa9; 2023. Published by Elsevier B.V.

<52>
Accession Number
641851679
Title
Clinical Outcomes of Transcatheter Aortic Valve Replacement with and
without Percutaneous Coronary Intervention - An Updated Meta-Analysis and
Systematic Review.
Source
Current problems in cardiology. (pp 101980), 2023. Date of Publication:
18 Jul 2023.
Author
Yassen M.; Moustafa A.; Venkataramany B.; Schodowski E.; Royfman R.;
Eltahawy E.
Institution
(Yassen) University of Toledo Medical Center, Department of Internal
Medicine
(Moustafa, Eltahawy) University of Toledo Medical Center, Division of
Cardiovascular Medicine
(Venkataramany, Schodowski, Royfman) University of Toledo, College of
Medicine and Life Sciences
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is indicated for
high-risk patients with severe degenerative aortic stenosis (AS). Given
the shared risk factors and coexistence of obstructive coronary artery
disease (CAD) and AS, there is inconsistent clinical data regarding
potential survival benefits of paired percutaneous coronary intervention
(PCI) with TAVR procedures. <br/>METHOD(S): We performed a literature
search using PubMed, Embase, and Cochrane Library from inception through
June 2023 assessing the impact of concomitant PCI in patients with
obstructive CAD undergoing TAVR. The primary outcomes were 30-day
all-cause mortality, 30-day cardiovascular mortality, and 6 months-1 year
all-cause mortality. Secondary outcomes included 30-day myocardial
infarction, stroke, major bleeding complications, and acute kidney injury
(AKI). <br/>RESULT(S): 11 studies involving 2804 patients were included in
the final analysis. Compared to patients undergoing TAVR alone, the
TAVR+PCI group showed no significant difference in 30-day all-cause
mortality (RR 0.90, CI 0.66, 1.22, p =0.49), 30-day cardiovascular
mortality (RR 0.71 CI 0.44, 1.14, p =0.16), or 6 months-1 year all-cause
mortality (RR 0.94, CI 0.75, 1.18, p =0.57). Regarding secondary outcomes,
30-day myocardial infarction was higher in the TAVR+PCI group (RR 3.09, CI
1.26, 7.57, p =0.01), with no significant differences noted in rates of
30-day stroke (RR 1.14, CI 0.56, 2.33, p =0.72), major bleeding/vascular
complications (RR 1.11, CI 0.79, 1.56, p =0.55), and AKI (RR 1.07, CI
0.75, 1.54, p =0.71). <br/>CONCLUSION(S): Concomitant PCI does not confer
any mortality benefit in patients with obstructive CAD and high-grade AS
undergoing TAVR. Further trials are needed to confirm our
findings.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<53>
Accession Number
2024226824
Title
Influence of Gender on Transcatheter Aortic Valve Implantation: A
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(4) (no pagination), 2023. Article
Number: 116. Date of Publication: April 2023.
Author
Lang Z.; Zhu Y.; Jiang G.; Ji P.; Zhang X.; Zhang Y.; Sun X.; Bai M.
Institution
(Lang, Zhang) The First Clinical Medical College of Lanzhou University,
Gansu, Lanzhou 730000, China
(Zhu, Jiang, Bai) The First Hospital of Lanzhou University, Heart Center,
Gansu Provincial Cardiovascular Disease Clinical Medical Research Center,
Gansu Provincial Key Laboratory of Cardiovascular Disease, Gansu, Lanzhou
730000, China
(Ji, Zhang, Sun) The Second Clinical Medical College of Lanzhou
University, Gansu, Lanzhou 730000, China
Publisher
IMR Press Limited
Abstract
Background: To assess whether there are differences in common
postoperative complications and survival between men and women after
transcatheter aortic valve implantation. <br/>Method(s): We searched the
Cochrane Library, PubMed, Embase, and the Web of Science from January 2000
to August 2022. Gender-related articles reporting complications and
mortality after transcatheter aortic valve implantation were identified.
The primary outcomes were the thirty-day mortality, one-year mortality and
perivalvular leakage. The secondary outcomes were conversion to open heart
surgery during operation, ejection fraction after operation,
reintervention and other common postoperative complications. Data were
pooled using the risk ratio or standardized mean difference with 95%
confidence interval. Subgroup analysis, meta-regression, sensitivity
analysis, egger's test and begg's test were performed. The original study
protocol was registered prospectively with PROSPERO (CRD42021245858).
<br/>Result(s): There were 24 studies, a total of 92,499 patients,
enrolled in our systematic review and meta-analysis, including 43,948 men
and 48,551 women. Comprehensive analysis showed significant differences in
gender in postoperative complications and survival after transcatheter
aortic valve implantation. Men had a significantly higher risk of
perivalvular leakage (risk ratio (RR) = 1.42; 95% CI: 1.15 to 1.75; p =
0.001; I² = 68%), but lower risk in bleeding (RR = 0.69; 95%
CI: 0.61 to 0.79; p < 0.00001; I² = 82%), vascular
complications (RR = 0.56; 95% CI: 0.52 to 0.61; p < 0.00001; I²
= 48%), and stroke (RR = 0.86; 95% CI: 0.80 to 0.93; p < 0.00001;
I² = 12%). The thirty-day mortality of men is slightly lower
than that of women (RR = 0.87; 95% CI: 0.81 to 0.93; p = 0.0001;
I² = 47%), the difference in one-year mortality was also
significant (RR = 1.20; 95% CI: 1.08 to 1.33; p = 0.0008; I² =
59%). Univariate meta-regression analyses showed that pulmonary
hypertension is the major source of heterogeneity in bleeding.
<br/>Conclusion(s): Men after transcatheter aortic valve implantation have
a lower risk of related postoperative complications, but a higher risk of
paravalvular leak and no advantage in medium-term survival.<br/>Copyright:
&#xa9; 2023 The Author(s). Published by IMR Press.

<54>
Accession Number
2024226820
Title
Intravenous Tranexamic Acid Reduces Post-Operative Bleeding and Blood
Transfusion in Patients Undergoing Aortic Surgery: A PRISMA-Compliant
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(4) (no pagination), 2023. Article
Number: 120. Date of Publication: April 2023.
Author
Zhang B.; He L.-X.; Yao Y.-T.
Institution
(Zhang) Department of Anesthesiology, Tianjin Union Medical Center,
Tianjin 300121, China
(He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Yunnan, Kunming 650000, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing 100037, China
Publisher
IMR Press Limited
Abstract
Background: Tranexamic acid (TXA), an antifibrinolytic agent, has been
demonstrated to reduce blood loss and transfusion requirements in both
cardiac and non-cardiac surgery. However, the evidence regarding the
efficacy of intravenous TXA in aortic surgery has been seldomly analyzed.
Therefore, the current study was performed to address this question.
<br/>Method(s): Searches of PubMed, EMBASE, OVID, Cochrane Library and
CNKI were conducted comprehensively for randomized controlled trials
(RCTs) comparing intravenous TXA versus no-TXA. Independently and in
duplicate, we reviewed titles, abstracts and full-text articles, extracted
data and evaluated bias risks. A random effect or fixed effect model was
utilized to pool data. <br/>Result(s): The database search yielded 4 RCTs
involving 273 patients. Meta-analysis revealed that, there was a
significant reduction in bleeding volume within the first 4 hours
post-operatively [(weighted mean difference (WMD) = -74.33; 95% confidence
interval (CI): -133.55 to -15.11; p = 0.01)], and the first 24 hours
post-operatively [(WMD = -228.91; 95% CI: -352.60 to -105.23; p =
0.0003)], post-operative red blood cell (RBC) transfusion volume [(WMD =
-420.00; 95% CI: -523.86 to -316.14; p < 0.00001)], fresh frozen plasma
(FFP) transfusion volume [(WMD = -360.35; 95% CI: -394.80 to -325.89; p <
0.00001)] and platelet concentrate (PC) transfusion volume [(WMD = -1.27;
95% CI: -1.47 to -1.07; p < 0.0001)] following intravenous TXA
administration. In addition, intravenous TXA administration significantly
decreased the incidence of postoperative complications (53/451 (8.2%) vs.
75/421 (13.9%); odds ratio (OR) = 0.47; 95% CI: 0.30 to 0.75; p = 0.001),
according to this present meta-analysis. <br/>Conclusion(s): The current
study preliminarily demonstrated that, TXA significantly reduced
postoperative bleeding, blood transfusion requirements and postoperative
complications among patients undergoing aortic surgery. More well-designed
studies are warrant to confirm the efficacy and safety of intravenous TXA
in patients undergoing aortic surgery.<br/>Copyright: &#xa9; 2023 The
Author(s). Published by IMR Press.

<55>
Accession Number
2023127528
Title
Pharmacological options for Candida albicans Endocarditis at the roadblock
with irrecoverable prosthetics and drug interactions: a case report and
review of literature.
Source
BMC Infectious Diseases. 23(1) (no pagination), 2023. Article Number: 304.
Date of Publication: December 2023.
Author
Sahra S.; Javed A.; Jahangir A.; Thind S.K.
Institution
(Sahra, Thind) Department of Infectious Diseases, Veterans Affairs Medical
Center, Oklahoma City, OK 73104, United States
(Sahra, Thind) Department of Infectious Diseases, The University of
Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK 73104, United
States
(Javed) Department of Internal Medicine, Staten Island University
Hospital, Staten Island, NY 10305, United States
(Jahangir) Department of Critical Care, Veterans Affairs Medical Center,
Oklahoma City, OK 73104, United States
Publisher
BioMed Central Ltd
Abstract
Background: Candidemia is the fourth most common nosocomial bloodstream
infection. Endocarditis from candidemia is a rare but possibly fatal
complication. The efficacy of amphotericin and echinocandins for induction
and azoles for suppression has been well studied. Source control of
infection, including removal of foreign bodies, remains the cornerstone
for the success of any antifungal therapy. Case Presentation: We are
describing a case of a 63-years old patient with multiple comorbidities
who developed candidemia secondary to Candida albicans. The prospect of
curing the fungemia was made difficult by prosthetic devices, including
prosthetic heart valves, intracardiac defibrillator, and inferior vena
filter, which could not be extracted due to poor cardiovascular status and
higher postoperative mortality risk. Combination therapy with amphotericin
and 5-Flucytosine (5FC) was used with the first recurrence. Suppression
with fluconazole was contraindicated due to prolonged corrected QT (QTc)
interval. Isavuconazole was employed for chronic lifelong suppression.
<br/>Conclusion(s): Retaining prosthetics in higher surgical risk patients
presents us with unique clinical and pharmacological challenges regarding
breakthrough infections, drug interaction, and side effects from prolonged
suppressive therapies.<br/>Copyright &#xa9; 2023, The Author(s).

<56>
Accession Number
2022466783
Title
Impact of coronary artery disease on clinical outcomes after TAVR:
Insights from the BRAVO-3 randomized trial.
Source
Catheterization and Cardiovascular Interventions. 101(6) (pp 1134-1143),
2023. Date of Publication: 01 May 2023.
Author
Feldman D.; Cao D.; Sartori S.; Zhang Z.; Hengstenberg C.; Tron C.;
Anthopoulos P.; Widder J.D.; Meneveau N.; Stella P.R.; Ferrari M.; Jeger
R.; Violini R.; Dumonteil N.; Chen S.; Yan R.; Nicolas J.; Razuk V.;
Spirito A.; Vogel B.; Mehran R.; Dangas G.
Institution
(Feldman, Cao, Sartori, Zhang, Chen, Yan, Nicolas, Razuk, Spirito, Vogel,
Mehran, Dangas) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Feldman, Razuk) Department of Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Cao) Department of Biomedical Sciences, Humanitas University, Milan,
Italy
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Tron) Division of Cardiology, Rouen University Hospital, Rouen, France
(Anthopoulos) European Medical, Arena Pharmaceuticals Inc, Zurich,
Switzerland
(Widder) Department of Medicine, Cardiology and Angiology, Municipial
Hospital Karlsruhe, Karlsruhe, Germany
(Meneveau) Department of Cardiology, University Hospital Jean Minjoz,
Besancon, France
(Stella) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Ferrari) Division of Interventional Cardiology, Helios Dr. Horst Schmidt
Kliniken Wiesbaden, Wiesbaden, Germany
(Jeger) Department of Cardiology, Triemli Hospital, Zurich, Switzerland
(Jeger) Department of Cardiology, University Hospital Basel, Basel,
Switzerland
(Violini) Department of Interventional Cardiology, Azienda Ospedaliera
S.Camillo Forlanini, Rome, Italy
(Dumonteil) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
Publisher
John Wiley and Sons Inc
Abstract
Objective: To determine the prognostic impact of coronary artery disease
(CAD) in patients randomized to bivalirudin or unfractionated heparin
(UFH) during transcatheter aortic valve replacement (TAVR).
<br/>Background(s): CAD is a common comorbidity among patients undergoing
TAVR and studies provide conflicting data on its prognostic impact.
<br/>Method(s): The Bivalirudin on Aortic Valve Intervention Outcomes-3
(BRAVO-3) randomized trial compared the use of bivalirudin versus UFH in
802 high-surgical risk patients undergoing transfemoral TAVR for severe
symptomatic aortic stenosis. Patients were stratified according to the
presence or absence of history of CAD as well as periprocedural
anticoagulation. The coprimary endpoints were net adverse cardiac events
(NACE; a composite of all-cause mortality, myocardial infarction, stroke,
or major bleeding) and major Bleeding Academic Research Consortium (BARC)
bleeding >=3b at 30 days postprocedure. <br/>Result(s): Among 801
patients, 437 (54.6%) had history of CAD of whom 223 (51.0%) received
bivalirudin. There were no significant differences in NACE (adjusted odds
ratio [OR]: 1.04; 95% confidence interval [CI]: 0.69-1.58) or BARC >= 3b
bleeding (adjusted OR: 0.84; 95% CI: 0.51-1.39) in patients with vs
without CAD at 30 days. Among CAD patients, periprocedural use of
bivalirudin was associated with similar NACE (OR: 0.80; 95% CI: 0.47-1.35)
and BARC >= 3b bleeding (OR: 0.64; 95% CI: 0.33-1.25) compared with UFH,
irrespective of history of CAD (p-interaction = 0.959 for NACE;
p-interaction = 0.479 for major bleeding). <br/>Conclusion(s): CAD was not
associated with a higher short-term risk of NACE or major bleeding after
TAVR. Periprocedural anticoagulation with bivalirudin did not show any
advantage over UFH in patients with and without CAD.<br/>Copyright &#xa9;
2023 Wiley Periodicals LLC.

<57>
Accession Number
2020363365
Title
Prevalence and factors associated with pressure injury in patients
undergoing open heart surgery: A systematic review and meta-analysis.
Source
International Wound Journal. 20(6) (pp 2321-2333), 2023. Date of
Publication: August 2023.
Author
Taghiloo H.; Ebadi A.; Saeid Y.; Jalali Farahni A.; Davoudian A.
Institution
(Taghiloo) Department of Operating Room and Anesthesiology, School of
Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan,
Iran, Islamic Republic of
(Ebadi) Behavioral Sciences Research Centre, Life Style Institute, School
of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Saeid) Trauma Research Center and Faculty of Nursing, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Jalali Farahni) Atherosclerosis Research Center, Baqiyatallah University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Davoudian) Deputy of Research and Technology, Zanjan University of
Medical Sciences, Zanjan, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Pressure injuries (PIs) are one of the major and costliest medical
problems with severe implications for patients. Cardiovascular surgery
patients are at the higher risk of developing surgery-related PIs. So this
study was conducted with the aim of investigating the prevalence and
factors associated with PIs in patients undergoing open heart surgery. We
identified articles through electronic databases such as Web of Science,
Scopus, PubMed, ProQuest; and Persian Databases: SID, Magiran and Irandoc
without restriction on language or publication period (from inception
through June 2022). Finally, 17 studies that fulfilled eligibility
criteria were included in final systematic review and meta-analysis. Data
analyses were conducted using STATA version 14. The pooled prevalence of
PI in patients undergoing open heart surgery was 24.06% (95% CI:
17.85-30.27). High heterogeneity was observed across the included studies
(I² = 96.0, P < 0.000). The prevalence by gender was reported
as 25.19% (95% CI: 13.45-36.93) in men and 33.36% (95 CI%: 19.99-46.74) in
women. The result showed there was statistically significant association
between PI and Female sex (Pooled Est: 1.551, 95% CI: 1.199-2.006, z =
3.345, P = 0.001), diabetes (Pooled Est: 1.985, 95% CI: 1.383-2.849, z =
3.719, P = 0.000), advanced age (SMD: 0.33 years; 95% CI: 0.09-0.57),
Duration of surgery (SMD: 0.47; 95% CI: 0.19-0.75) and preoperative serum
albumin level (SMD: 0.56; 95% CI: 0.14-0.98). The relatively high PIs
incidence among patients undergoing open heart surgery suggests that
typical PI prevention methods are insufficient for this population.
Targeted prevention measures must be developed and
implemented.<br/>Copyright &#xa9; 2022 The Authors. International Wound
Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons
Ltd.

<58>
Accession Number
2024912093
Title
Serratus anterior and pectoralis plane blocks for robotically assisted
mitral valve repair: a randomised clinical trial. Comment on Br J Anaesth
2023; 130: 786-794.
Source
British Journal of Anaesthesia. 131(2) (pp e49-e50), 2023. Date of
Publication: August 2023.
Author
Coppens S.; Hoogma D.; Rex S.; Wolmarans M.; Merjavy P.
Institution
(Coppens, Hoogma, Rex) University Hospitals of Leuven, Department of
Anesthesiology, Leuven, Belgium
(Coppens, Hoogma, Rex) University of Leuven, Biomedical Sciences Group,
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Merjavy) Department of Anaesthesia, Craigavon Area University Teaching
Hospital, Northern Ireland, Craigavon, United Kingdom
(Wolmarans, Merjavy) Norwich Medical School, University of East Anglia,
Norwich, United Kingdom
(Wolmarans) Department of Anaesthesia, Norfolk & Norwich University
Hospital, Norwich, United Kingdom
Publisher
Elsevier Ltd

<59>
Accession Number
2017549955
Title
Identification of research priorities in CHD: Empowering patients and
families through participation in the development of formal research
agendas.
Source
Cardiology in the Young. 33(2) (pp 288-293), 2023. Date of Publication: 24
Feb 2023.
Author
Burns J.; Basken A.; Acosta R.; Garnier-Villarreal M.; Kulkarni A.; Hayes
D.A.
Institution
(Burns) Cohen Children's Medical Center, Queens, NY, United States
(Basken) Conquering CHD, Madison, WI, United States
(Acosta) A+J Patient Advocacy, LLC, Las Vegas, NV, United States
(Garnier-Villarreal) Department of Sociology, Vrije Universiteit
Amsterdam, Amsterdam, Netherlands
(Kulkarni, Hayes) Department of Pediatric Cardiology, Cohen Children's
Medical Center, Queens, NY, United States
Publisher
Cambridge University Press
Abstract
Background: Conquering CHD, formerly known as the Pediatric Congenital
Heart Association (PCHA), is the leading congenital heart disease (CHD)
patient advocacy organisation in the United States of America, and places
high priority on patient engagement in the research process. Participatory
design is an approach to problem-solving that utilises the knowledge and
opinions of groups of people to generate plans and new ideas. Utilising
this mode of patient engagement, patients and families engaged with
Conquering CHD assisted in developing a list of research priorities which
was then distributed to the larger membership with instructions to rank
the priorities in order of importance. Upon completion, these items were
compared to the current scientific literature to assess correlation with
current publications. This cross-sectional study and literature review
aimed to assess the priorities of patients and families in CHD research
and to determine the reflection of these areas in the current body of
scientific literature. <br/>Method(s): This cross-sectional study utilised
a survey asking participants to rank the importance of research items
within categories including Technology Advances, Genetic and Cellular
Research, Broad Understanding of CHD, and Psychosocial Outcomes which was
distributed through social media and email to 43,168 accounts across all
platforms. Respondents were asked to place each item in a ranked order in
each category, with the value 1 representing the most preferred for each
participant. Anyone engaged with Conquering CHD was eligible to complete
the study, including patients and families. Subsequently, a literature
review of the largest medical databases including PubMed, Scopus, and
ScienceDirect was undertaken to determine the number of articles published
per each topic which was then assessed to determine if there is a
correlation between patient-ranked priorities and the current body of
literature. <br/>Result(s): The study generated a total response of 527
participants. Regarding Technology Advances, valve replacement was the
preferred topic (mean rank 2.07, IQR 2). Stem cell research was the
favoured topic in Genetic and Cellular Research (mean rank 2.53, IQR 2).
Access to care was the priority in the Broadening Understanding of CHD
(mean rank 1.24, IQR 1). Pertaining to Psychosocial Outcomes,
psychological/emotional effects was the highest ranked topic (mean rank
1.46, IQR 1). The literature review returned a total of 135,672 articles
in the areas of interest. For Valve Replacement, 8361 articles resulted
reflecting a proportion of 0.097 of total articles. For Stem Cell
Research, 9921 articles resulted reflecting a proportion of 0.115 of total
articles. For Access to Care, 7845 articles resulted reflecting a
proportion of 0.091 of total articles. For Psychological/Emotional
Effects, 6422 articles resulted reflecting a proportion of 0.074 of total
articles. A Spearman's correlation demonstrated no correlation between the
preferred domain of CHD research and the number of articles published for
that domain (rs = 0.02, p = 0.94). <br/>Conclusion(s): This process
demonstrates the effectiveness of participatory design, using a patient
and family network to determine the research items of concern to those
affected by CHD. The cross-sectional survey was effective in assessing
patient and family priorities but was limited by access to reliable
internet and delivery only in English. Though the study had a large
response rate, it was limited to patients already engaged with Conquering
CHD. For these reasons, it may not completely reflect the opinions of the
total population affected by CHD. However, this offers valuable insight
into patient-determined priorities and reveals that the current scientific
literature does not correlate with these items. These data serve to inform
individual and institutional research agendas to better reflect the needs
and desires of this population. <br/>Copyright &#xa9; The Author(s), 2022.
Published by Cambridge University Press.

<60>
Accession Number
2024453299
Title
Randomized study for the optimal treatment of symptomatic patients with
low gradient severe aortic valve stenosis and preserved left ventricular
ejection fraction (ROTAS trial).
Source
Archives of Cardiovascular Diseases Supplements. Conference: Printemps de
la cardiologie 2023. Marseille France. 15(3) (pp 245-246), 2023. Date of
Publication: June 2023.
Author
Galli E.; Coisne A.; Le Ven F.; Sportuch C.; Lairez O.; Bernard A.; Oger
E.; Le Pabic E.; Donal E.
Institution
(Galli, Oger, Le Pabic, Donal) CHU de Rennes, Rennes, France
(Coisne) CHU de Lille, Lille, France
(Le Ven) CHU de Brest, Brest, France
(Sportuch) Clinique du millenaire, Montpellier, France
(Lairez) CHU de Toulouse-Rangueil, Toulouse, France
(Bernard) CHU de Tours, Tours, France
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Background: the best management of symptomatic patients with
low gradient (LG) severe aortic stenosis (AS) and preserved left
ventricular ejection fraction (LVEF) has not been established in
randomized controlled trials. The ROTAS trial aimed to assess the
superiority of aortic valve replacement (AVR) versus optimized medical
therapy (OMT) in symptomatic patients with LG severe AS and preserved
LVEF. <br/>Method(s): Fifty-two patients (age 79 +/- 7 years; males 46%,
mean aortic gradient: 31 +/- 5 mmHg; aortic surface: 0.8 +/- 0.1
cm²) who were randomized 1:1 to AVR or OMT. The follow-up
lasted 14 +/- 7 months. The study was interrupted early because of the low
inclusion rate during the COVID-2019 pandemic. The AS severity was
confirmed by a multimodality approach including dobutamine stress
echocardiography and/or aortic calcium score. The primary end-point
(overall death and/or hospitalisation for heart failure) occurred in 13
(25%) patients. <br/>Result(s): Patients undergoing AVR showed a similar
recurrence of events (overall death, heart failure hospitalisation)
compared to patients receiving OMT (5 vs. 8 events). Patients receiving
OMT did not experience worse survival compared to patients receiving AVR
(HR 1.57, 95% CI: 0.51-4.83, P = 0.4275). Kaplan-Meier curves showed
similar event-free survival (logrank P = 0.4236) among the 2 groups (Fig.
1). <br/>Conclusion(s): In the randomized ROTAS trial, AVR is not
associated with a better prognosis in symptomatic patients with LG severe
AS and preserved LVEF.<br/>Copyright &#xa9; 2023

<61>
Accession Number
641849180
Title
Effect of preoperative ivabradine on hemodynamics during elective off-pump
CABG.
Source
Annals of cardiac anaesthesia. 26(3) (pp 260-267), 2023. Date of
Publication: 01 Jul 2023.
Author
Virmani S.; Mallik I.; Mohire V.B.; Geelani M.A.; Minhas H.S.
Institution
(Virmani) Department of Anaesthesiology and Intensive Care, B Pant
Institute of Postgraduate Medical Education and Research, J L Nehru Marg,
New Delhi, India
(Mallik) Department of Cardiac Anaesthesia, Haryana, India
(Mohire) Department of Cardiac Anaesthesia, Superspeciality Hospital, NSCB
Medical College, Jabalpur, India
(Geelani, Minhas) Department of Cardiothoracic Surgery, B Pant Institute
of Postgraduate Medical Education and Research, J L Nehru Marg, New Delhi,
India
Publisher
NLM (Medline)
Abstract
Background: Ivabradine is a specific heart rate (HR)-lowering agent which
blocks the cardiac pacemaker If channels. It reduces the HR without
causing a negative inotropic or lusitropic effect, thus preserving
ventricular contractility. The authors hypothesized that its usefulness in
lowering HR can be utilized in patients undergoing off-pump coronary
artery bypass (OPCAB) surgery. <br/>Objective(s): To study the effects of
preoperative ivabradine on hemodynamics (during surgery) in patients
undergoing elective OPCAB surgery. <br/>Method(s): Fifty patients, New
York Heart Association (NYHA) class I and II, were randomized into group I
(control, n = 25) and group II (ivabradine group, n = 25). In group I,
patients received the usual anti-anginal medications in the preoperative
period, as per the institutional protocol. In group II, patients received
ivabradine 5 mg twice daily for 3 days before surgery, in addition to the
usual anti-anginal medications. Anesthesia was induced with fentanyl,
thiopentone sodium, and pancuronium bromide as a muscle relaxant and
maintained with fentanyl, midazolam, pancuronium bromide, and isoflurane.
The hemodynamic parameters [HR and mean arterial pressure (MAP)] and
pulmonary artery (PA) catheter-derived data were recorded at the baseline
(before induction), 3 min after the induction of anesthesia at 1 min and 3
min after intubation and at 5 min and 30 min after protamine
administration. Intraoperatively, hemodynamic data (HR and MAP) were
recorded every 10 min, except during distal anastomosis of the coronary
arteries when it was recorded every 5 min. Post-operatively, at 24 hours,
the levels of troponin T and brain natriuretic peptide (BNP) were
measured. This trial's CTRI registration number is CTRI/005858.
<br/>Result(s): The HR in group II was lower when compared to group I
(range 59.6-72.4 beats/min and 65.8-80.2 beats/min, respectively)
throughout the study period. MAP was comparable [range (78.5-87.8 mm Hg)
vs. (78.9-88.5 mm Hg) in group II vs. group I, respectively] throughout
the study period. Intraoperatively, 5 patients received metoprolol in
group I to control the HR, whereas none of the patients in group II
required metoprolol. The incidence of preoperative bradycardia (HR <60
beats/min) was higher in group II (20%) vs. group I (8%). There was no
difference in both the groups in terms of troponin T and BNP level after
24 hours, time to extubation, requirement of inotropes, incidence of
arrhythmias, in-hospital morbidity, and 30-day mortality.
<br/>Conclusion(s): Ivabradine can be safely used along with other
anti-anginal agents during the preoperative period in patients undergoing
OPCAB surgery. It helps to maintain a lower HR during surgery and reduces
the need for beta-blockers in the intraoperative period, a desirable and
beneficial effect in situations where the use of beta-blockers may be
potentially harmful. Further studies are needed to evaluate the beneficial
effects of perioperative Ivabradine in patients with moderate-to-severe
left ventricular dysfunction.

<62>
Accession Number
641849088
Title
Impact of ketamine versus propofol for anesthetic induction on cognitive
dysfunction, delirium, and acute kidney injury following cardiac surgery
in elderly, high-risk patients.
Source
Annals of cardiac anaesthesia. 26(3) (pp 274-280), 2023. Date of
Publication: 01 Jul 2023.
Author
Wittwer E.D.; Cerhan J.H.; Schroeder D.R.; Schaff H.V.; Mauermann W.J.
Institution
(Wittwer, Mauermann) Department of Anesthesiology and Perioperative
Medicine, Surgery, Mayo Clinic, Rochester, MN, United States
(Cerhan) Department of Psychiatry and Psychology, Surgery, Mayo Clinic,
Rochester, MN, United States
(Schroeder) Department of Health Sciences Research, Surgery, Mayo Clinic,
Rochester, MN, United States
(Schaff) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN,
United States
Publisher
NLM (Medline)
Abstract
Objective: Evaluate the effects of ketamine versus propofol when used for
induction of anesthesia in elderly, high-risk cardiac surgical patients on
postoperative complications including cognitive dysfunction, delirium, and
acute kidney injury. <br/>Method(s): Prospective, randomized study
performed at a tertiary medical center. A total of 52 patients aged >=70
and older presenting for complex cardiac surgery were randomized to
receive either ketamine or propofol for induction of anesthesia. Patients
underwent a battery of cognitive testing preoperatively and
postoperatively and the incidence of delirium and acute kidney injury were
measured. Norepinephrine (NEE) equivalents following induction were
assessed for each group. <br/>Result(s): A total of 49 patients were
included, 25 in the ketamine group and 24 in the propofol group with 3
patients excluded from the analysis. No difference was found between
groups in either postoperative cognitive dysfunction or delirium
incidence. Acute kidney injury occurred in 6 (24%) patients in the
ketamine group in 12 (50%) patients in the propofol group, but the
difference did not meet statistical significance (P = 0.08; Relative Risk
= 2.1, 95% CI 0.9-4.7). NEE equivalents were lower in the ketamine group,
9.6 +/- 22.2 versus 32.7 +/- 46.0, P < 0.03. <br/>Conclusion(s): The use
of ketamine versus propofol for induction of anesthesia did not impact the
incidence of postoperative cognitive dysfunction or delirium. Twice as
many patients in the propofol group developed acute kidney injury,
although not reaching statistical significance and warranting further
investigation. In elderly, high-risk patients, ketamine was associated
with a significantly reduced need for vasopressor support following
induction.

<63>
Accession Number
641848810
Title
Erector spinae plane block for postoperative analgesia in cardiac
surgeries- A systematic review and meta-analysis.
Source
Annals of cardiac anaesthesia. 26(3) (pp 247-259), 2023. Date of
Publication: 01 Jul 2023.
Author
Nair A.; Saxena P.; Borkar N.; Rangaiah M.; Arora N.; Mohanty P.K.
Institution
(Nair) Department of Anaesthesiology, Ibra Hospital, Ministry of
Health-Oman, Ibra 414, Oman
(Saxena, Mohanty) Department of Cardiac Anesthesia, National Heart Center,
Royal Hospital, Muscat, Oman
(Borkar) Department of Pediatric Surgery, All India Institute of Medical
Sciences, Raipur, Chhattisgarh, India
(Rangaiah) Department of Anaesthetics and Pain Management, Walsall Manor
Hospital, Moat Rd, Walsall WS2 9PS, United Kingdom
(Arora) Department of Anaesthesiology, Kings College Hospital, NHS
Foundation Trust, London, United Kingdom
Publisher
NLM (Medline)
Abstract
Ultrasound-guided erector spinae plane block (ESPB) has been used in many
studies for providing opioid-sparing analgesia after various cardiac
surgeries. We performed a systematic review and meta-analysis of
randomized controlled trials to assess the efficacy of ESPB in cardiac
surgeries. We searched PubMed, Embase, Cochrane Central Register of
Controlled Trials (CENTRAL), and Google Scholar to identify the studies in
which ESPB was compared with the control group/sham block in patients
undergoing cardiac surgeries. The primary outcomes were postoperative
opioid consumption and postoperative pain scores. The secondary outcomes
were intraoperative opioid consumption, ventilation time, time to the
first mobilization, length of ICU and hospital stay, and adverse events.
Out of 607 studies identified, 16 studies (n = 1110 patients) fulfilled
inclusion criteria and were used for qualitative and quantitative
analysis. Although, 24-hr opioid consumption were comparable in both
groups group (MD, -18.74; 95% CI, -46.85 to 9.36, P = 0.16), the 48-hr
opioid consumption was significantly less in ESPB group than control ((MD,
-11.01; 95% CI, -19.98 to --2.04, P = 0.02). The pain scores at various
time intervals and intraoperative opioid consumption were significantly
less in ESPB group. Moreover, duration of ventilation, time to the first
mobilization, and length of ICU and hospital were also less in ESPB group
(P < 0.00001, P < 0.00001, P < 0.00001, and P < 0.0001, respectively).
This systematic review and meta-analysis demonstrated that ESPB provides
opioid-sparing perioperative analgesia, facilitates early extubation and
mobilization, leads to early discharge from ICU and hospital, and has
lesser pruritus when compared to control in patients undergoing cardiac
surgeries.

<64>
Accession Number
641848673
Title
Low-Dose vasopressin and renal perfusion in pediatric cardiac surgery.
Source
Annals of cardiac anaesthesia. 26(3) (pp 309-317), 2023. Date of
Publication: 01 Jul 2023.
Author
Kumar A.; Ghotra G.S.; Raj S.; Tiwari N.; Ramamurthy H.R.
Institution
(Kumar, Raj) Department of Anaesthesia and Critical Care, Army Hospital
(Research and Referral), Delhi Cantt, New Delhi, India
(Ghotra) Department of Anaesthesia and Critical Care, Army Institute of
Cardiothoracic Sciences, Pune, Maharashtra, India
(Tiwari) Department of Cardiothoracic Surgery, Army Hospital (Research and
Referral), Delhi Cantt, New Delhi, India
(Ramamurthy) Department of Paediatrics, Army Hospital (Research and
Referral), Delhi Cantt, New Delhi, India
Publisher
NLM (Medline)
Abstract
Background: Congenital heart surgeries are associated with post-bypass
renal and cardiac dysfunctions. The use of low-dose vasopressin has been
found to be beneficial in adult cardiac surgeries. <br/>Objective(s): To
assess the hemodynamic and renal effects of patients undergoing on-pump
pediatric cardiac surgery under general anesthesia (GA) with low-dose
vasopressin infusion. <br/>Design(s): Prospective randomized controlled
study. <br/>Setting(s): Operation room and ICU, tertiary care teaching
hospital. <br/>Patient(s): Fifty-five pediatric cardiac patients
undergoing repair for congenital heart diseases (CHD).
<br/>Intervention(s): Low-dose vasopressin infusion in the study group and
placebo in the control group. <br/>Measurements and Main Results: Renal
near-infrared spectroscopy (NIRS), serum NGAL, and inflammatory
mediators-IL6 and IL8 along with other renal and hemodynamic parameters in
the perioperative period were recorded. Diastolic blood pressure (DBP) and
cardiac index were significantly higher in the vasopressin group.
Inflammatory markers were significantly high in the immediate
postoperative period in all patients which later stabilized in the next 48
h but showed similar trends in both groups. Low-dose vasopressin infusion
did not improve either renal perfusion or function. The duration of
mechanical ventilation and length of hospital stay, the incidence of AKI
development, and transfusion requirements were marginally lower in the
vasopressin group, although not significant. <br/>Conclusion(s): Low-dose
vasopressin infusion improved hemodynamics and showed a decreased
incidence of complications. However, it failed to show any benefit of
renal function and overall outcome in pediatric cardiac surgery.

<65>
Accession Number
641848433
Title
Comparative efficacy of serratus anterior plane block (SAPB) and fentanyl
for postoperative pain management and stress response in patients
undergoing minimally invasive cardiac surgery (MICS).
Source
Annals of cardiac anaesthesia. 26(3) (pp 268-273), 2023. Date of
Publication: 01 Jul 2023.
Author
Saikat S.; Shweta S.; Somalia M.; Dibyendu K.; Sushan M.
Institution
(Saikat) Senior Consultant Anesthesiologist, Apollo Multispeciality
Hospital, Kolkata, West Bengal, India
(Shweta) Resident, Department of Anesthesiology, Apollo Multispeciality
Hospital, Kolkata, West Bengal, India
(Somalia) Senior Registrar, Apollo Multispeciality Hospital, Kolkata, West
Bengal, India
(Dibyendu) Consultant Cardiac Anesthesiologist, Apollo Multispeciality
Hospital, Kolkata, West Bengal, India
(Sushan) Consultant Cardiac Surgeon, Apollo Multispeciality Hospital,
Kolkata, West Bengal, India
Publisher
NLM (Medline)
Abstract
Background: Fast-tracking plays a significant role in reducing
perioperative morbidity and postoperative hospital stay by facilitating
early extubation and optimal pain control. Attenuating the stress response
to surgery also has a crucial function in enhancing recovery. Serratus
anterior plane block (SAPB) is a recently described technique for chest
wall analgesia. More data is required to find out the effectiveness of
analgesia by SAPB for minimally invasive cardiac surgery (MICS).
<br/>Aim(s): The study aimed to assess the efficacy and safety of
ultrasound-guided SAPB compared to fentanyl for controlling
post-thoracotomy pain and stress response in patients undergoing MICS.
Setting and Design: Time framed comparative, prospective, and
observational study. <br/>Material(s) and Method(s): Patients undergoing
MICS for coronary artery bypass grafting under general anesthesia were
randomly assigned into two groups. SAPB group (Group A) patients were
given 0.2% of 20 ml ropivacaine followed by catheter insertion for
continuous infiltration at the end of the procedure. Fentanyl group (Group
B) patients were given fentanyl infusion for postoperative analgesia. The
primary outcome measured changes in visual analog scale (VAS) score (pain)
and cortisol levels (for stress response) in both groups. <br/>Result(s):
VAS score was significantly low in Group A when compared to Group B (P <
0.0001). Cortisol levels were also lower in the SAPB group. Hemodynamic
parameters (systolic blood pressure, diastolic blood pressure, pulse rate,
and oxygen saturation) were more stable in Group A with a lesser
requirement of top-up analgesics. <br/>Conclusion(s): SAPB was more
effective than fentanyl in managing post-thoracotomy pain after MICS.
Cortisol level was lower in the group that received SAPB.

<66>
Accession Number
2025885861
Title
Alirocumab effect on preventing periprocedural ischaemic events in
coronary heart disease patients undergoing coronary stenting (APPEASE
trial): Study protocol of a multicentre, open-label, randomised controlled
trial.
Source
BMJ Open. 13(7) (no pagination), 2023. Article Number: e072541. Date of
Publication: 11 Jul 2023.
Author
Huang Z.; Zhuang X.; Zhang S.; Huang Y.; Yuan L.; Lin A.; Tang L.; Xiong
Z.; Christopher O.; Chen Y.; Wu B.; Ling Y.; Li S.; Jie Q.; Xiong L.; Qian
X.; Liao X.; Liu J.
Institution
(Huang, Tang, Chen, Wu, Ling, Li, Qian, Liu) Department of Cardiovascular
Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangdong,
Guangzhou, China
(Huang, Zhuang, Zhang, Huang, Xiong, Christopher, Liao) Cardiology
Department, First Affiliated Hospital of Sun Yat-sen University,
Guangdong, Guangzhou, China
(Huang, Zhuang, Zhang, Huang, Xiong, Christopher, Liao) NHC Key Laboratory
of Assisted Circulation, Sun Yat-Sen University, Guangdong, Guangzhou,
China
(Yuan) Department of Science and Research, Third Affiliated Hospital of
Sun Yat-Sen University, Guangdong, Guangzhou, China
(Lin, Jie) Department of Cardiology, Cardiovascular Institute of Panyu
District, Guangzhou Panyu Central Hospital, Guangdong, Guangzhou, China
(Xiong) Department of Cardiology, Second Affiliated Hospital of Guangzhou
Medical University, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Percutaneous coronary intervention (PCI)-related myocardial
infarction (type 4a MI) and major periprocedural myocardial injury have
been demonstrated leading to poor prognosis of patients with coronary
heart disease (CHD) undergoing elective PCI and still remain high
occurrence even after the therapy of dual antiplatelet agents and statins.
Proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab has
been shown to be effectively in reducing the risk of acute MI (AMI).
However, the effect of alirocumab on preventing PCI-related MI or major
periprocedural myocardial injury in patients with CHD undergoing elective
PCI remains uncertain. Methods and analysis Alirocumab effect on
Preventing Periprocedural ischaemic Events in coronary heart diseAse
patients undergoing coronary StEnting trial is a multicentre, open-label,
randomised controlled trial aiming to determine whether alirocumab could
reduce the incidence of type 4a MI or major periprocedural myocardial
injury in patients with CHD undergoing elective PCI. In total, 422 non-AMI
CHD patients planned to undergo elective PCI will be randomly assigned to
receive standard pharmacotherapy of CHD (control group) or additional use
of subcutaneous alirocumab 75 mg 1 day before procedure (alirocumab
group). The primary outcome is type 4a MI or major periprocedural
myocardial injury defined as high-sensitivity cardiac troponin elevating
above 5x99 th percentile upper reference limit in 48 hours after PCI.
Patients will continue receiving standard pharmacotherapy or additional
biweekly subcutaneous alirocumab 75 mg for 3 months according to the
initial randomisation group. We will follow up for 3 months and record all
the major adverse cardiovascular events (MACEs). Incidence of PCI-related
MI or major periprocedural myocardial injury, and MACE in 3 months after
PCI will be compared between control group and alirocumab group. Ethics
and dissemination Ethics approval has been obtained from the Medical
Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen
University with approval number: (2022)02-140-01. The results of this
study will be reported through peer-reviewed journals and conference
presentations. Trial registration number ChiCTR2200063191. <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.

<67>
Accession Number
2025859001
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. 8(7) (pp 631-639), 2023. Date of Publication: 12 Jul
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
(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, New York, NY, United States
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
(O'Gara, Sabatine) JAMA Cardiology, United States
Publisher
American Medical Association
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.<br/>Copyright &#xa9; 2023 American Medical Association. All
rights reserved.

<68>
Accession Number
2025848949
Title
Would the Actigraph Always be Sufficient for Sleep Analysis in
Exercise-Based Studies? A Case Report of Negative Response of Sleep to
Exercise.
Source
Sleep Science. 16(2) (pp 265-270), 2023. Date of Publication: 2023.
Author
Atef H.; Gaber M.
Institution
(Atef) School of Allied Health Professions (SAHP), Keele University,
Staffordshire ST5 5BG, United Kingdom
(Atef) Faculty of Physical Therapy, Cairo University, Cairo, Egypt
(Gaber) Medical Research Institute, Alexandria University, Alexandria,
Egypt
Publisher
Brazilian Association of Sleep and Latin American Federation of Sleep
Societies
Abstract
Introduction Sleep deprivation is common after coronary artery bypass
grafting (CABG). It is mostly managed well by exercise. The number of
reported post-CABG cases that respond negatively to exercise is scanty.
The etiology is usually associated with the underlying sleep pathology,
and how it responds to exercise. Cases with undiagnosed central sleep
apnea post CABG have not been reported before. Case description A
medically stable male patient, 63 years old, hypertensive, but not
diabetic, had entered coronary artery bypass grafting (CABG) 8 weeks
before attending the outpatient cardiac rehabilitation unit and was
referred for a cardiac rehabilitation program at this time. He entered a
study in the cardiac rehabilitation center utilizing either aerobic or
combined aerobic and resistance training for 10 weeks to improve sleep
architecture and functional capacity post-CABG. After randomization, he
entered the group doing combined aerobic and resistance exercises. All of
the patients in this group improved except him, his sleep quality
worsened, but his functional capacity improved. After a complete analysis
of sleep on polysomnography, it was revealed that the patient had central
sleep apnea that was mostly worsened by resistance training. The patient
was withdrawn from the study by the 8th week, and his sleep condition
improved gradually. After then, he was asked to attend the cardiac
rehabilitation center again to share in aerobic exercise, having evidence
that central sleep apnea does not respond negatively to this form of
training. After 12 months of follow-up, the patient still shows no signs
of sleep deprivation. Conclusion Sleep deprivation is prevalent in
post-CABG patients, but with different presentations and it can generally
improve by exercise. Identification of the underlying cause of the
sleeping difficulty is a cornerstone of targeted treatment.<br/>Copyright
&#xa9; 2023. Brazilian Sleep Association. All rights reserved.

<69>
Accession Number
2024563486
Title
Ross procedure versus pulmonary homograft versus mechanical valve versus
bioprosthetic valve versus Ozaki procedure for surgical aortic valve
replacement: a frequentist network meta-analysis.
Source
Egyptian Heart Journal. 75(1) (no pagination), 2023. Article Number: 64.
Date of Publication: December 2023.
Author
Mathew D.M.; Fusco P.J.; Varghese K.S.; Abdel-Nasser O.; Awad A.K.;
Giannaris P.; Mathew S.M.; Ahmed A.
Institution
(Awad, Abdel-Nasser) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Mathew, Fusco, Varghese, Giannaris, Mathew, Ahmed) City University of New
York School of Medicine, 1589 Amsterdam Avenue, New York, NY 10031, United
States
(Awad) Faculty of Medicine, El-Galala University, Suez, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: There has been a resurgence in interest regarding the Ross
procedure due to recent publications detailing positive long-term
outcomes. Conversely, surgical aortic valve replacement (SAVR) with a
pulmonary homograft (PH), mechanical (MV), bioprosthetic (BV), or the
Ozaki procedure each has its own technical advantages and disadvantages.
Therefore, we performed a network meta-analysis (NMA) comparing other
alternatives to Ross procedure. <br/>Method(s): Medical databases were
comprehensively searched for studies comparing the Ross procedure with AVR
using a PH, MV, BV, or the Ozaki procedure. Outcomes were pooled as risk
ratios (RR) with their 95% confidence intervals (95% CI). <br/>Result(s):
A total of 7816 patients were pooled for our NMA from 24 studies. Compared
to Ross procedure, both BV and MV were associated with significantly
higher rates of 30-day mortality of RR (2.37, 95% CI 1.20-4.67) and (1.88
95% CI 1.04-3.40), respectively, with no significant difference regarding
PH or Ozaki. However, only MV was associated with a higher risk of 30-day
stroke (RR 8.42, 95% CI 1.57-45.23) with no significant difference in the
other alternatives, as well as 30-day MI which showed no significant
differences between any of the aortic conduits compared to the Ross
procedure. Regarding 30-day major bleeding, MV was associated with a
higher when compared to the Ross procedure RR (4.58, 95% CI 1.94-10.85),
PH was associated with a lower risk of major bleeding with RR (0.35, 95%
CI 0.17-0.71), and BV showed no significant difference. With a mean
follow-up duration of 8.5 years compared to the Ross procedure, BV, PH,
and MV were associated with a higher risk of long-term mortality with RR
(1.89, 95% CI 1.38-2.58), (1.38, 95% CI 1.0-1.87), and (1.94, 95% CI
1.52-2.47), respectively, with the Ozaki procedure showed no significant
difference. Regarding long-term stroke-with a mean of 6.3-year follow-up
duration-there were no significant differences between any of the aortic
conduits compared to the Ross procedure. Nevertheless, long-term need for
reintervention-with a mean follow-up duration of 17.5 years-was
significant of higher risk with both BV and PH with RR (3.28, 95% CI
1.21-8.84) and (2.42, 95% CI 1.05-5.58), respectively, compared to Ross
procedure with MV and Ozaki having no significant difference.
<br/>Conclusion(s): The Ross procedure is a viable treatment option for
patients undergoing SAVR, showing promising outcomes at short- and
long-term follow-ups.<br/>Copyright &#xa9; 2023, The Author(s).

<70>
Accession Number
2024536797
Title
The added value of remote technology and the background factors explaining
the changes in biopsychosocial functioning in cardiac rehabilitation:
cluster randomised controlled trial.
Source
European Journal of Physiotherapy. (no pagination), 2023. Date of
Publication: 2023.
Author
Sinkkonen E.; Korpi H.; Sjogren T.
Institution
(Sinkkonen, Korpi, Sjogren) Faculty of Sports and Health Sciences,
University of Jyvaskyla, Jyvaskyla, Finland
Publisher
Taylor and Francis Ltd.
Abstract
Purpose This study aimed to explore added value of mcoach app and activity
bracelet in 12-month cardiac rehabilitation on changes in rehabilitee's
biopsychosocial functioning: cardiorespiratory fitness, depressive
symptoms and social quality of life compared to similar rehabilitation
without remote technology. Additionally, the study explored the factors
explaining changes of biopsychosocial functioning. Materials and methods
Six groups of coronary rehabilitees were cluster-randomised to
experimental (n = 30) or control group (n = 29). Parametric and
nonparametric statistical analyses and linear regression analyses were
used. Results No differences between the groups regarding changes in
VO<inf>2</inf>max (p = 0.474), DEPS (p = 0.315) or social quality of life
(p = 0.592) were observed. Positive changes in the whole study population
in VO<inf>2</inf>max were explained with shorter time from last cardiac
operation and higher light activity at the baseline (R ² =
0.309). Smaller increase in DEPS was explained with positive changes in
different aspects of social quality of life (R ² = 0.562).
Conclusions Remote technology had no added value for rehabilitation, but
the results confirmed the importance of early rehabilitation, maintenance
of socially meaningful life and the use of biopsychosocial and
multidisciplinary approaches. Research defining the needs and types of
technology, their timing, to whom and to what extent the remote technology
would be most beneficial, is still needed.<br/>Copyright &#xa9; 2023
Informa UK Limited, trading as Taylor & Francis Group.

<71>
Accession Number
641846940
Title
Platelet activation and endothelial dysfunction biomarkers in acute
coronary syndrome: the impact of PCSK9 inhibition.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2023. Date of Publication: 19 Jul 2023.
Author
Ziogos E.; Chelko S.P.; Harb T.; Engel M.; Vavuranakis M.A.; Landim-Vieira
M.; Walsh E.M.; Lai S.; Halushka M.K.; Gerstenblith G.; Leucker T.M.
Institution
(Ziogos, Chelko, Harb, Vavuranakis, Gerstenblith, Leucker) Division of
Cardiology, Department of Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, Liberia
(Chelko, Engel, Landim-Vieira) Department of Biomedical Sciences, College
of Medicine, Florida State University, Tallahassee, FL, Puerto Rico
(Walsh, Halushka) Department of Pathology, Johns Hopkins University School
of Medicine, Baltimore, MD, Liberia
(Walsh) Department of Genetic Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, Liberia
(Lai) Institute of Human Virology, University of Maryland School of
Medicine, Baltimore, MD, Liberia
Publisher
NLM (Medline)
Abstract
AIMS: Platelet activation and endothelial dysfunction contribute to
adverse outcomes in patients with acute coronary syndromes (ACS). The
goals of this study were to assess the impact of proprotein convertase
subtilisin/kexin type 9 (PCSK9) inhibition on markers of platelet
activation and endothelial dysfunction in ACS patients and the interaction
among PCSK9, platelets, and endothelial cells (ECs) on left internal
mammary artery (LIMA) vascular endothelium using specimens obtained during
coronary artery bypass surgery (CABG). METHODS AND RESULTS: ACS patients
enrolled in the Evolocumab in Acute Coronary Syndrome trials were
randomized to placebo or a single dose of 420 mg evolocumab within 24
hours of hospitalization. Serum samples for analysis of platelet factor 4
(PF4) and P-selectin, markers of platelet activation, and von Willebrand
factor (vWF), a marker of endothelial dysfunction, were obtained at
baseline and 30 days. Additionally, LIMA segments obtained during CABG
from patients who were and were not receiving evolocumab were
immunostained with PCSK9; CD61, a platelet-specific marker; and CD31, an
endothelial cell-specific marker. Forty-six participants were randomized
to placebo or to evolocumab. Controlling for baseline levels, PF4 and vWF
were significantly lower in the evolocumab, than in the placebo, group at
30 days. Immunostaining of LIMA specimens from twelve participants
undergoing CABG revealed colocalization of PCSK9, CD61, and CD31 at the
vascular endothelium. Administration of evolocumab was associated with
decreased overlap of PCSK9, CD61, and CD31. <br/>CONCLUSION(S): PCSK9
inhibition decreases markers of platelet activation and endothelial
dysfunction in ACS patients. PCSK9 is associated with platelets and
vascular ECs in LIMA segments and PCSK9 inhibition decreases that
interaction.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<72>
Accession Number
2025468110
Title
Single-injection serratus anterior plane block for cardiothoracic surgery
via thoracotomy in children: A systematic review and meta-analysis of
randomised controlled trials.
Source
BMJ Paediatrics Open. 7(1) (no pagination), 2023. Article Number: e001912.
Date of Publication: 14 Jun 2023.
Author
He Y.; Li Z.; Xu M.; Du B.; Zuo Y.
Institution
(He, Xu, Du, Zuo) Department of Anesthesiology, West China Hospital,
Sichuan University, The Research Units of West China (2018RU012), Chinese
Academy of Medical Sciences, Sichuan University West China Hospital,
Sichuan, Chengdu, China
(Li) Department of Critical Care Medicine, Cheng du Shang Jin Nan Fu
Hospital, Sichuan University West China Hospital, Sichuan, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Background Serratus anterior plane block (SAPB) has gained popularity in
cardiothoracic surgery due to its feasibility and simplicity. However, the
efficacy of ultrasound-guided single-injection SAPB in the paediatric
population has not been well evaluated, as only a few studies with small
sample sizes are available. Methods We searched PubMed, Embase (Ovid),
Cochrane Central Register of Controlled Trials, Wanfang databases and
China National Knowledge Infrastructure from their inception to 31
September 2022 for randomised comparative clinical trials that compared
single-injection SAPB with systemic analgesia or different forms of
regional analgesia in children. The primary outcomes included
postoperative opioid consumption and pain scores within 24 hours. The
secondary outcomes included postoperative adverse events, the need for
rescue analgesia and the time from the end of surgery to endotracheal tube
removal. Results Five randomised controlled trials with 418 children
meeting the inclusion criteria were included. SAPB markedly reduced
postoperative opioid consumption up to 24 hours compared with controls
(mean difference (MD): -0.29 mg/kg, 95% CI -0.38 to -0.20, I 2 =67%]. The
postoperative pain scores were reduced compared with controls: 1 hour (MD
-0.6, 95% CI -1.17 to -0.04, I 2 =92%), 4-6 hours (MD -1.16, 95% CI -1.87
to -0.45, I 2 =90%) and 12 hours (MD -0.71, 95% CI -1.35 to -0.08, I 2
=86%). The incidence of postoperative nausea and vomiting was comparable
between SAPB and controls. One trial suggested that the analgesic effect
of SAPB was comparable to that of ICNB (intercostal nerve block).
Conclusion Single-injection SAPB is associated with a reduction in opioid
consumption and pain intensity after cardiothoracic surgery via
thoracotomy in children. Due to the high heterogeneity, the Grading of
Recommendations Assessment, Development and Evaluation scores were low.
Clinical trials with rigorous methodological approaches as well as safety
endpoints are needed to confirm these preliminary findings. PROSPERO
registration number CRD42021241691.<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.

<73>
Accession Number
2024349343
Title
Effect of Colchicine on the Risk of Perioperative Acute Kidney Injury:
Clinical Protocol of a Substudy of the Colchicine for the Prevention of
Perioperative Atrial Fibrillation Randomized Clinical Trial.
Source
Canadian Journal of Kidney Health and Disease. 10 (no pagination), 2023.
Date of Publication: January-December 2023.
Author
Garg A.X.; Cuerden M.; Cata J.; Chan M.T.V.; Devereaux P.J.; Fleischmann
E.; Grande A.M.; Kabon B.; Landoni G.; Maziak D.E.; McLean S.; Parikh C.;
Popova E.; Reimer C.; Trujillo Reyes J.C.; Roshanov P.; Sessler D.I.;
Srinathan S.; Sontrop J.M.; Gonzalez Tallada A.; Wang M.K.; Wells J.R.;
Conen D.
Institution
(Garg, Cuerden, Roshanov, Sontrop) London Health Sciences Centre, ON,
Canada
(Cata) MD Anderson Cancer Center, Houston, TX, United States
(Chan) The Chinese University of Hong Kong, Shatin, China
(Devereaux) McMaster University, Hamilton, ON, Canada
(Fleischmann, Kabon) Medical University of Vienna, Austria
(Grande) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Landoni) IRCCS San Raffaele Scientific Institute, Milan, Italy
(Maziak) University of Ottawa, ON, Canada
(McLean) Vancouver Acute Department of Anesthesiology, Vancouver General
Hospital, BC, Canada
(Parikh) Johns Hopkins School of Medicine, Baltimore, MD, United States
(Popova) Institut d'Investigacio Biomedica Sant Pau, Barcelona, Spain
(Reimer) Kingston Health Sciences Centre, ON, Canada
(Trujillo Reyes) Department of Thoracic Surgery, Hospital de la Santa Creu
i Sant Pau, Barcelona, Spain
(Roshanov) Division of Nephrology, Department of Medicine, Western
University, London, ON, Canada
(Roshanov) Department of Epidemiology and Biostatistics, Western
University, London, ON, Canada
(Roshanov, Wang, Wells, Conen) Population Health Research Institute,
Hamilton, ON, Canada
(Sessler) Department of Outcomes Research, Cleveland Clinic, OH, United
States
(Srinathan) Department of Surgery, University of Manitoba, Winnipeg,
Canada
(Gonzalez Tallada) Hospital Universitari Vall d'Hebron, Barcelona, Spain
Publisher
SAGE Publications Ltd
Abstract
Background: Inflammation during and after surgery can lead to organ damage
including acute kidney injury. Colchicine, an established inexpensive
anti-inflammatory medication, may help to protect the organs from
pro-inflammatory damage. This protocol describes a kidney substudy of the
colchicine for the prevention of perioperative atrial fibrillation
(COP-AF) study, which is testing the effect of colchicine versus placebo
on the risk of atrial fibrillation and myocardial injury among patients
undergoing thoracic surgery. <br/>Objective(s): Our kidney substudy of
COP-AF will determine whether colchicine reduces the risk of perioperative
acute kidney injury compared with a placebo. We will also examine whether
colchicine has a larger absolute benefit in patients with pre-existing
chronic kidney disease, the most prominent risk factor for acute kidney
injury. Design and Setting: Randomized, superiority clinical trial
conducted in 40 centers in 11 countries from 2018 to 2023.
<br/>Patient(s): Patients (~3200) aged 55 years and older having major
thoracic surgery. <br/>Intervention(s): Patients are randomized 1:1 to
receive oral colchicine (0.5 mg tablet) or a matching placebo, given twice
daily starting 2 to 4 hours before surgery for a total of 10 days.
Patients, health care providers, data collectors, and outcome adjudicators
will be blinded to the randomized treatment allocation. <br/>Method(s):
Serum creatinine concentrations will be measured before surgery and on
postoperative days 1, 2, and 3 (or until hospital discharge). The primary
outcome of the substudy is perioperative acute kidney injury, defined as
an increase (from the prerandomization value) in serum creatinine
concentration of either >=26.5 mumol/L (>=0.3 mg/dL) within 48 hours of
surgery or >=50% within 7 days of surgery. The primary analysis
(intention-to-treat) will examine the relative risk of acute kidney injury
in patients allocated to receive colchicine versus placebo. We will repeat
the primary analysis using alternative definitions of acute kidney injury
and examine effect modification by pre-existing chronic kidney disease,
defined as a prerandomization estimated glomerular filtration rate (eGFR)
<60 mL/min per 1.73 m². <br/>Limitation(s): The substudy will
be underpowered to detect small effects on more severe forms of acute
kidney injury treated with dialysis. <br/>Result(s): Substudy results will
be reported in 2024. <br/>Conclusion(s): This substudy will estimate the
effect of colchicine on the risk of perioperative acute kidney injury in
older adults undergoing major thoracic surgery. Clinical trial
registration number: NCT03310125<br/>Copyright &#xa9; The Author(s) 2023.

<74>
[Use Link to view the full text]
Accession Number
2024265632
Title
The Lymphatic Vasculature in Cardiac Development and Ischemic Heart
Disease.
Source
Circulation Research. 132(9) (pp 1246-1253), 2023. Date of Publication: 28
Apr 2023.
Author
Liu X.; Oliver G.
Institution
(Liu) Department of Cardiovascular Sciences, Lemole Center for Integrated
Lymphatics Research, Lewis Katz School of Medicine, Temple University,
Philadelphia, PA, United States
(Oliver) Center for Vascular and Developmental Biology, Feinberg
Cardiovascular and Renal Research Institute, Feinberg School of Medicine,
Northwestern University, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
In recent years, the lymphatic system has received increasing attention
due to the fast-growing number of findings about its diverse novel
functional roles in health and disease. It is well documented that the
lymphatic vasculature plays major roles in the maintenance of tissue-fluid
balance, the immune response, and in lipid absorption. However, recent
studies have identified an additional growing number of novel and
sometimes unexpected functional roles of the lymphatic vasculature in
normal and pathological conditions in different organs. Among those,
cardiac lymphatics have been shown to play important roles in heart
development, ischemic cardiac disease, and cardiac disorders. In this
review, we will discuss some of those novel functional roles of cardiac
lymphatics, as well as the therapeutic potential of targeting lymphatics
for the treatment of cardiovascular diseases.<br/>Copyright &#xa9; 2023
Lippincott Williams and Wilkins. All rights reserved.

<75>
Accession Number
2024226823
Title
The Prognostic Value of Biomarkers in Non-ST-Elevation Acute Coronary
Syndrome Patients that are Treated by an Early Invasive Strategy: Insights
from the OPTIMA-2 Trial.
Source
Reviews in Cardiovascular Medicine. 24(4) (no pagination), 2023. Article
Number: 117. Date of Publication: April 2023.
Author
Fagel N.D.; Vink M.A.; Heestermans A.A.C.M.; Riezebos R.K.
Institution
(Fagel, Vink, Riezebos) Heart Center, OLVG Hospital, Amsterdam 1091 AC,
Netherlands
(Heestermans) Heart Center, NWZ Hospital, Alkmaar 1815 JD, Netherlands
Publisher
IMR Press Limited
Abstract
Background: Patients with non-ST-elevation acute coronary syndrome
(NSTE-ACS) consists of a heterogenic population and improvement in
identification of a specific risk profile is needed. In this study we
aimed to obtain better insight in the role of different biomarkers for
patients undergoing a routine invasive diagnostic strategy within 24 hours
after admission. <br/>Method(s): An Immediate or Early Invasive Strategy
in Non-ST-Elevation Acute Coronary Syndrome (OPTIMA-2) study was a
randomized controlled prospective open-label multicentre trial,
randomizing NSTE-ACS patients. An invasive strategy was either immediate
(<3 hours) or early (12-24 hours). Peak high-sensitive TroponinT (hsTropT)
value was determined within the first 48 hours of admission. N-terminal
proB-type natriuretic peptide (NTpro-BNP) and high-sensitivity C-reactive
protein (hsCRP) values were determined at admission and at discharge.
These biomarkers were then divided into tertiles and related to clinical
outcomes up to one year. The relation between these biomarkers and
myocardial function recovery established by echocardiography was analyzed
as a secondary endpoint. <br/>Result(s): The OPTIMA-2 study included 249
patients. Overall, there was no significant increase in the risk of
developing an adverse cardiovascular event in the first year if biomarker
tertiles at admission were compared. However, mean NT-proBNP levels at
admission were higher for patients that experienced all-cause death
withing the first year (1.93 +/- 0.49 vs 1.42 +/- 0.58, p = 0.05). Also,
peak hs-cTnT (232.0 +/- 2846.0 vs 71.5 +/- 1152.0, p = 0.06) values at
baseline were higher in patients experiencing a myocardial infarction
within 1-year. NT-proBNP levels at admission and at discharge correlated
with recovery of the left ventricular (LV) function at 30 days
(coefficient 0.021 (95% CI = 0.009-0.033) and coefficient 0.016 (95% CI =
0.005-0.027)). <br/>Conclusion(s): In NSTE-ACS patients treated by an
early invasive strategy and administration of modern anticoagulant and
antiplatelet therapy, multiple biomarker measurements during admission
could not predict the occurrence of recurrent cardiovascular events within
the first year of follow-up.<br/>Copyright: &#xa9; 2023 The Author(s).
Published by IMR Press.

<76>
Accession Number
2024200779
Title
Platelet and Monocyte Activation After Transcatheter Aortic Valve
Replacement (POTENT-TAVR): A Mechanistic Randomized Trial of Ticagrelor
Versus Clopidogrel.
Source
Structural Heart. 7(4) (no pagination), 2023. Article Number: 100182. Date
of Publication: July 2023.
Author
Zidar D.A.; Al-Kindi S.; Longenecker C.T.; Parikh S.A.; Gillombardo C.B.;
Funderburg N.T.; Juchnowski S.; Huntington L.; Jenkins T.; Nmai C.; Osnard
M.; Shishebhor M.; Filby S.; Tatsuoka C.; Lederman M.M.; Blackstone E.;
Attizzani G.; Simon D.I.
Institution
(Zidar, Al-Kindi, Longenecker, Gillombardo, Juchnowski, Huntington,
Jenkins, Osnard, Shishebhor, Filby, Tatsuoka, Lederman, Attizzani, Simon)
Department of Medicine, Case Western Reserve University, Cleveland, OH,
United States
(Zidar, Juchnowski, Huntington) Louis Stokes Cleveland Veterans Affairs
Medical Center, Cleveland, OH, United States
(Zidar, Al-Kindi, Longenecker, Gillombardo, Juchnowski, Huntington,
Jenkins, Shishebhor, Filby, Attizzani, Simon) Harrington Heart & Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Parikh) Division of Cardiology, Center for Interventional Vascular
Therapy, Columbia University Irving Medical Center, New York, NY, United
States
(Funderburg) Division of Medical Laboratory Science, School of Health and
Rehabilitations Sciences, Ohio State University, Columbus, OH, United
States
(Nmai) New York University Grossman School of Medicine, New York, NY,
United States
(Blackstone) Department of Population Health and Quantitative Health
Sciences, Cleveland Clinic Foundation, Cleveland, OH, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Inflammation and thrombosis are often linked mechanistically
and are associated with adverse events after transcatheter aortic valve
replacement (TAVR). High residual platelet reactivity (HRPR) is especially
common when clopidogrel is used in this setting, but its relevance to
immune activation is unknown. We sought to determine whether residual
activity at the purinergic receptor P2Y12 (P2Y12) promotes prothrombotic
immune activation in the setting of TAVR. <br/>Method(s): This was a
randomized trial of 60 patients (enrolled July 2015 through December 2018)
assigned to clopidogrel (300mg load, 75mg daily) or ticagrelor (180mg
load, 90 mg twice daily) before and for 30 days following TAVR. Co-primary
endpoints were P2Y12-dependent platelet activity (Platelet Reactivity
Units; VerifyNow) and the proportion of inflammatory (cluster of
differentiation [CD] 14+/CD16+) monocytes 1 day after TAVR.
<br/>Result(s): Compared to clopidogrel, those randomized to ticagrelor
had greater platelet inhibition (median Platelet Reactivity Unit
[interquartile range]: (234 [170.0-282.3] vs. 128.5 [86.5-156.5], p <
0.001), but similar inflammatory monocyte proportions (22.2% [18.0%-30.2%]
vs. 25.1% [22.1%-31.0%], p = 0.201) 1 day after TAVR. Circulating
monocyte-platelet aggregates, soluble CD14 levels, interleukin 6 and 8
levels, and D-dimers were also similar across treatment groups. HRPR was
observed in 63% of the clopidogrel arm and was associated with higher
inflammatory monocyte proportions. Major bleeding events, pacemaker
placement, and mortality did not differ by treatment assignment.
<br/>Conclusion(s): Residual P2Y12 activity after TAVR is common in those
treated with clopidogrel but ticagrelor does not significantly alter
biomarkers of prothrombotic immune activation. HRPR appears to be an
indicator (not a cause) of innate immune activation in this
setting.<br/>Copyright &#xa9; 2023

<77>
Accession Number
2024160454
Title
Early anticoagulation after aortic valve replacement with porcine
bioprosthesis randomized control trial (ANTIPRO).
Source
European Journal of Cardio-thoracic Surgery. 63(1) (no pagination), 2023.
Article Number: ezac507. Date of Publication: 01 Jan 2023.
Author
Fernandez A.; Loza G.; Parma G.; Florio L.; Estigarribia J.; Soca G.;
Robaina R.; Duran A.; Brusich D.; Dayan V.
Institution
(Fernandez, Estigarribia, Soca, Robaina, Dayan) Instituto Nacional de
Cirugia Cardiaca, Montevideo, Uruguay
(Loza, Parma, Florio, Duran, Brusich, Dayan) Centro Cardiovascular
Universitario, Universidad de la Republica del Uruguay, Montevideo,
Uruguay
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Most evidence for anticoagulation (AC) in aortic bioprosthesis
is centred on embolic events, bleeding and reintervention risk. The effect
of AC on haemodynamics has not been previously assessed. Our hypothesis
was that patients with early AC after aortic valve replacement (AVR) with
porcine bioprosthesis have better haemodynamics at 1 year of follow-up.
<br/>METHOD(S): Prospective, randomized, open-label trial conducted at 2
cardiac surgery centres. All patients undergoing AVR with porcine
bioprosthesis were consecutively recruited. The anticoagulated group
received warfarin + aspirin and the non-anticoagulated (control) only
aspirin. The primary outcome was mean gradient after 1 year of AVR and
change in New York Heart Association class. Secondary outcomes were major
and minor bleeding, embolic events and prosthetic leak. <br/>RESULT(S): Of
140 participants in the study, 71 were assigned to the anticoagulated
group and 69 to the control group. The mean age of the overall population
was 72.4 (SD: 7.1) years. Global EuroSCORE was 7.65 (SD: 5.73). At 1 year,
the mean gradient was similar between both groups [18.6 (SD: 1.1 mmHg) and
18.1 (SD: 1.0 mmHg) in the control and anticoagulated groups,
respectively, P = 0.701]. No differences in functional class at 3 months
or 1 year were found among groups. No differences were found among groups
in the secondary outcomes. <br/>CONCLUSION(S): The addition of 3 months of
oral AC to anti-aggregation treatment was not detected to affect
bioprosthetic haemodynamics nor functional class at 1 year after AVR.
Likewise, AC does not lead to the higher incidence of
complications.<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<78>
Accession Number
2024104606
Title
Zero fluoroscopy catheter ablation for atrial fibrillation: a systematic
review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1178783. Date of Publication: 2023.
Author
Debreceni D.; Janosi K.; Bocz B.; Turcsan M.; Lukacs R.; Simor T.; Antolic
B.; Vamos M.; Komocsi A.; Kupo P.
Institution
(Debreceni, Janosi, Bocz, Turcsan, Lukacs, Simor, Komocsi, Kupo) Heart
Institute, Medical School, University of Pecs, Pecs, Hungary
(Antolic) Department of Cardiology, University Medical Center Ljubljana,
Ljubljana, Slovenia
(Vamos) Cardiac Electrophysiology Division, Department of Internal
Medicine, University of Szeged, Szeged, Hungary
Publisher
Frontiers Media SA
Abstract
Introduction: Catheter ablation for atrial fibrillation (AF) is the most
frequently performed cardiac ablation procedure worldwide. The majority of
ablations can now be performed safely with minimal radiation exposure or
even without the use of fluoroscopy, thanks to advances in 3-dimensional
electroanatomical mapping systems and/or intracardiac echocardiography.
The aim of this study was to conduct a meta-analysis to compare the
effectiveness of zero fluoroscopy (ZF) versus non-zero fluoroscopy (NZF)
strategies for AF ablation procedures. <br/>Method(s): Electronic
databases were searched and systematically reviewed for studies comparing
procedural parameters and outcomes of ZF vs. NZF approaches in patients
undergoing catheter ablation for AF. We used a random-effects model to
derive the mean difference (MD) and risk ratios (RR) with a 95% confidence
interval (CI). <br/>Result(s): Our meta-analysis included seven studies
comprising 1,593 patients. The ZF approach was found to be feasible in
95.1% of patients. Compared to the NZF approach, the ZF approach
significantly reduced procedure time [mean difference (MD): -9.11 min (95%
CI: -12.93 to -5.30 min; p < 0.01)], fluoroscopy time [MD: -5.21 min (95%
CI: -5.51 to -4.91 min; p < 0.01)], and fluoroscopy dose [MD: -3.96 mGy
(95% CI: -4.27 to -3.64; p < 0.01)]. However, there was no significant
difference between the two groups in terms of total ablation time [MD:
-104.26 s (95% CI: -183.37 to -25.14; p = 0.12)]. Furthermore, there was
no significant difference in the acute [risk ratio (RR): 1.01, 95% CI:
1.00-1.02; p = 0.72] and long-term success rates (RR: 0.96, 95% CI:
0.90-1.03; p = 0.56) between the ZF and NZF methods. The complication rate
was 2.76% in the entire study population and did not differ between the
groups (RR: 0.94, 95% CI: 0.41-2.15; p = 0.89). <br/>Conclusion(s): The ZF
approach is a feasible method for AF ablation procedures. It significantly
reduces procedure time and radiation exposure without compromising the
acute and long-term success rates or complication rates.<br/>Copyright
2023 Debreceni, Janosi, Bocz, Turcsan, Lukacs, Simor, Antolic, Vamos,
Komocsi and Kupo.

<79>
Accession Number
2023870412
Title
Role of patient selection and trial stimulation for spinal cord
stimulation therapy for chronic non-cancer pain: A comprehensive narrative
review.
Source
Regional Anesthesia and Pain Medicine. 48(6) (pp 251-272), 2023. Date of
Publication: 01 Jun 2023.
Author
Shanthanna H.; Eldabe S.; Provenzano D.A.; Chang Y.; Adams D.; Kashir I.;
Goel A.; Tian C.; Couban R.J.; Levit T.; Hagedorn J.M.; Narouze S.
Institution
(Shanthanna, Couban) Anesthesia, McMaster University, Hamilton, ON, Canada
(Eldabe) James Cook University Hospital, Middlesbrough, United Kingdom
(Provenzano) Pain Diagnostics and Interventional Care, Sewickley, PA,
United States
(Chang) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Adams, Narouze) Center for Pain Medicine, Summa Western Reserve Hospital,
Cuyahoga Falls, OH, United States
(Kashir) University of Waterloo, Waterloo, ON, Canada
(Goel, Tian) Anesthesiology and Pain Medicine, University of Toronto,
Toronto, ON, Canada
(Levit) Michael G DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Hagedorn) Anesthesiology and Perioperative Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
BMJ Publishing Group
Abstract
Background/importance Patient selection for spinal cord stimulation (SCS)
therapy is crucial and is traditionally performed with clinical selection
followed by a screening trial. The factors influencing patient selection
and the importance of trialing have not been systematically evaluated.
Objective We report a narrative review conducted to synthesize evidence
regarding patient selection and the role of SCS trials. Evidence review
Medline, EMBASE and Cochrane databases were searched for reports (any
design) of SCS in adult patients, from their inception until March 30,
2022. Study selection and data extraction were carried out using
DistillerSR. Data were organized into tables and narrative summaries,
categorized by study design. Importance of patient variables and trialing
was considered by looking at their influence on the long-term therapy
success. Findings Among 7321 citations, 201 reports consisting of 60
systematic reviews, 36 randomized controlled trials (RCTs), 41
observational studies (OSs), 51 registry-based reports, and 13 case
reports on complications during trialing were included. Based on RCTs and
OSs, the median trial success rate was 72% and 82%, and therapy success
was 65% and 61% at 12 months, respectively. Although several psychological
and non-psychological determinants have been investigated, studies do not
report a consistent approach to patient selection. Among psychological
factors, untreated depression was associated with poor long-term outcomes,
but the effect of others was inconsistent. Most RCTs except for chronic
angina involved trialing and only one RCT compared patient selection with
or without trial. The median (range) trial duration was 10 (0-30) and 7
(0-56) days among RCTs and OSs, respectively. Conclusions Due to lack of a
consistent approach to identify responders for SCS therapy, trialing
complements patient selection to exclude patients who do not find the
therapy helpful and/or intolerant of the SCS system. However, more
rigorous and large studies are necessary to better evaluate its
role.<br/>Copyright &#xa9; American Society of Regional Anesthesia & Pain
Medicine 2023. No commercial re-use. See rights and permissions. Published
by BMJ.

<80>
Accession Number
2023751246
Title
An Updated Meta-Analysis on Cerebral Embolic Protection in Patients
Undergoing Transcatheter Aortic Valve Intervention Stratified by Baseline
Surgical Risk and Device Type.
Source
Structural Heart. 7(4) (no pagination), 2023. Article Number: 100178. Date
of Publication: July 2023.
Author
Khan S.U.; Zahid S.; Alkhouli M.A.; Akbar U.A.; Zaid S.; Arshad H.B.;
Little S.H.; Reardon M.J.; Kleiman N.S.; Goel S.S.
Institution
(Khan, Zaid, Arshad, Little, Kleiman, Goel) Department of Cardiology,
Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United
States
(Zahid) Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, United States
(Alkhouli) Division of Interventional Cardiology, Mayo Clinic, Rochester,
MN, United States
(Akbar) Department of Medicine, North Shore University Hospital, New York,
NY, United States
(Reardon) Department of Cardiovascular Surgery, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Transcatheter aortic valve intervention (TAVI) can lead to the
embolization of debris. Capturing the debris by cerebral embolic
protection (CEP) devices may reduce the risk of stroke. New evidence has
allowed us to examine the effects of CEP in patients undergoing TAVI. We
aimed to assess the effects of CEP overall and stratified by the device
used (SENTINEL or TriGuard) and the surgical risk of the patients.
<br/>Method(s): We selected randomized controlled trials using electronic
databases through September 17, 2022. We estimated random-effects risk
ratios (RR) with (95% confidence interval) and calculated absolute risk
differences at 30 days across baseline surgical risks derived from the
TAVI trials for any stroke (disabling and nondisabling) and all-cause
mortality. <br/>Result(s): Among 6 trials (n = 3921), CEP vs. control did
not reduce any stroke [RR: 0.95 (0.50-1.81)], disabling [RR: 0.75
(0.18-3.16)] or nondisabling [RR: 0.99 (0.65-1.49)] strokes, or all-cause
mortality [RR: 1.23 (0.55-2.77)]. However, when analyzed by device,
SENTINEL reduced disabling stroke [RR: 0.46 (0.22-0.95)], translating into
6 fewer per 1000 in high-risk, 3 fewer per 1000 in intermediate-risk, and
1 fewer per 1000 in low surgical-risk patients. CEP vs. control did not
reduce the risk of any bleeding [RR: 1.03 (0.44-2.40)], major vascular
complications [RR: 1.41 (0.57-3.48)], or acute kidney injury [RR: 1.36
(0.57-3.28)]. <br/>Conclusion(s): This updated meta-analysis showed that
SENTINEL CEP might reduce disabling stroke in patients undergoing TAVI.
Patients with high and intermediate surgical risks were most likely to
derive benefits.<br/>Copyright &#xa9; 2023 The Authors

<81>
Accession Number
2023541735
Title
Posttransplant Diabetes Mellitus (PTDM) Following Solid Organ
Transplantation-Systematic Analysis of Prevalence and Total Mortality and
Meta-Analysis of Randomized Interventional Studies Aimed at Lowering Blood
Glucose.
Source
Current Diabetes Reviews. 19(7) (no pagination), 2023. Article Number:
e071122210692. Date of Publication: 2023.
Author
Almdal K.; Hornum M.; Almdal T.
Institution
(Almdal, Almdal) Department of Endocrinology PE, Rigshospitalet,
Copenhagen, Denmark
(Hornum) Department of Nephrology P, Rigshospitalet, Copenhagen, Denmark
(Hornum) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Almdal) Department of Microbiology and Immunology, University of
Copenhagen, Copenhagen, Denmark
Publisher
Bentham Science Publishers
Abstract
Objective: A systematic review of the prevalence and prognosis of
posttransplant diabetes mellitus (PTDM) following the transplantation of
heart, lung, liver and kidney and a meta-analysis of randomised studies of
glucose-lowering treatment is reported. <br/>Method(s): We searched for
publications on solid organ transplants and PTDM in relation to the risk
and total mortality of PTDM and randomized controlled trials aiming at
reducing glucose levels. <br/>Result(s): PTDM prevalence one year after
transplantation was reported to be 9-40%. Ten years after transplantation,
60-85% of people without PTDM and 30-76% of people with PTDM were alive.
Following kidney transplantation, we identified six randomized controlled
trials on the treatment of PTDM. Intervention ranged from 3 to 12 months.
Four studies used intervention with oral glucose-lowering drugs, one used
dietician appointments and exercise, and one used insulin treatment. Among
the intermediate results reported, a reduction in HbA1c of 2.7 mmol/mol,
and an increase in the odds ratio of serious adverse events of 3.0 was
significant. <br/>Conclusion(s): In conclusion, information on the
prevalence and effect on survival of PTDM is het-erogeneous, and the
randomized studies on the effect of treatment available are short and lack
information on clinically important endpoints, such as mortality or
morbidity.<br/>Copyright &#xa9; 2023 Bentham Science Publishers.

<82>
Accession Number
2021080771
Title
A meta-analysis examined the effect of topical vancomycin application in
decreasing sternal wound infections post cardiac surgery.
Source
International Wound Journal. 20(6) (pp 2068-2074), 2023. Date of
Publication: August 2023.
Author
Zhang Y.; Zhang P.; Li H.; Chi H.; Zheng N.; Pan X.; Tang C.
Institution
(Zhang, Zhang, Li, Chi, Zheng, Pan, Tang) Department of Cardiovascular
Surgery, Sixth Medical Center, General Hospital of the Chinese People's
Liberation Army, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
To assess the impact of topical vancomycin (TV) application in decreasing
sternal wound infections (SWIs) post cardiac surgery (CS), we lead a
meta-analysis. Twenty-three thousand seven hundred and forty five
participants had CS at the outset of the investigations, according to a
thorough evaluation of the literature done up to November 2022; 8730 of
them used TV, while 15 015 were controls. To assess the effectiveness of
TV application in lowering SWIs following CS, odds ratios (OR) with 95%
confidence intervals (CIs) were computed with dichotomous technique with a
fixed- or random-effect model. The TV had significantly lower SWIs post CS
(OR, 0.34; 95% CI, 0.20-0.57; P <.001), and deep SWIs post CS (OR, 0.26;
95% CI, 0.11-0.65; P =.004) compared with control as shown in Figures 2
and 3. Yet, there was no significant difference found amongst TV and
control in superficial SWIs post CS (OR, 0.30; 95% CI, 0.07-1.30; P
=.011). The TV had significantly lower SWIs, and deep SWIs post CS, and no
significant difference was found in superficial SWIs post CS compared with
control. The low number of included studies in this meta-analysis for
superficial SWIs calls for precaution when analysing the
outcomes.<br/>Copyright &#xa9; 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons
Ltd.

<83>
Accession Number
2025474473
Title
Continuous Ultrafiltration Enhances Recovery After Adult Cardiac Surgery
With Cardiopulmonary Bypass: A Systematic Review and Meta-analysis.
Source
CJC Open. 5(7) (pp 494-507), 2023. Date of Publication: July 2023.
Author
Bierer J.; Horne D.; Stanzel R.; Henderson M.; Boulos L.; Hayden J.A.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Department of Surgery,
Dalhousie University, Halifax, NS, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Halifax, NS, Canada
(Boulos) Maritime SPOR SUPPORT Unit, Halifax, NS, Canada
(Hayden) Department of Community Health & Epidemiology, Dalhousie
University, Halifax, NS, Canada
Publisher
Elsevier Inc.
Abstract
Background: Cardiac surgery with cardiopulmonary bypass is associated with
systemic inflammation. Ultrafiltration used throughout the cardiopulmonary
bypass time, continuously, is hypothesized to be an immunomodulatory
therapy. <br/>Method(s): A systematic review and meta-analysis of
randomized trials investigating continuous forms of ultrafiltration during
adult cardiac surgery (CRD42020219309) was conducted and is reported
following PRISMA guidelines. MEDLINE, Embase, CENTRAL, and Scopus were
searched on November 3, 2021. The primary endpoint was operative
mortality, and secondary outcomes included intensive care unit length of
stay (ICU LOS), ventilation time, acute kidney injury or renal failure,
and pneumonia. Each study was assessed for risk of bias using the Cochrane
Risk-of Bias-Tool for Randomized Trials (RoB2) instrument. Outcomes were
analyzed with inverse variance random-effects models and assessed for
GRADE quality of evidence. <br/>Result(s): Twelve randomized trials
consisting of 989 adult patients undergoing coronary, valvular, or
concomitant cardiac procedures were included. Compared to controls,
patients receiving continuous ultrafiltration had no statistical
difference in operative mortality; risk ratio of 0.32 (95% confidence
interval [CI]: 0.10-1.03; P = 0.06). Reductions occurred in ICU LOS, by
7.01 hours (95% CI: 1.86-12.15; P = 0.008); ventilation time, by 2.11
hours (95% CI: 0.71-3.51; P = 0.003); and incidence of pneumonia, with a
risk ratio of 0.33 (95% CI: 0.15-0.75; P = 0.008). There wasno difference
in renal injury. The GRADE quality of evidence for these outcomes ranged
from very low to low. <br/>Conclusion(s): Continuous forms of
ultrafiltration enhance recovery after adult cardiac surgery by reducing
ICU LOS, ventilation time, and incidence of pneumonia. A multicentre
randomized trial could confirm and generalize these
findings.<br/>Copyright &#xa9; 2023 The Authors

<84>
Accession Number
641766656
Title
Incidence, Predictors, and Outcomes Associated With Worsening Renal
Function in Patients With Heart Failure and Secondary Mitral
Regurgitation: The COAPT Trial.
Source
Journal of the American Heart Association. 12(14) (pp e029504), 2023. Date
of Publication: 18 Jul 2023.
Author
Kong J.; Zaroff J.G.; Ambrosy A.P.; Fitzpatrick J.K.; Ku I.A.; Mishell
J.M.; Kotinkaduwa L.N.; Redfors B.; Beohar N.; Ailawadi G.; Lindenfeld J.;
Abraham W.T.; Mack M.J.; Kar S.; Lim D.S.; Whisenant B.K.; Stone G.W.
Institution
(Kong, Zaroff, Ambrosy, Fitzpatrick, Ku, Mishell) Kaiser Permanente
Department of Cardiology San Francisco CA USA
(Ambrosy) Division of Research Kaiser Permanente Northern California
Oakland CA USA
(Kotinkaduwa, Redfors) Clinical Trials Center Cardiovascular Research
Foundation New York City NY USA
(Redfors) NewYork-Presbyterian Hospital/Columbia University Medical Center
New York NY USA
(Redfors) Department of Cardiology Sahlgrenska University Hospital
Gothenburg Sweden, Sweden
(Beohar) Mount Sinai Medical Center Columbia University Division of
Cardiology Miami Beach FL USA
(Ailawadi) Department of Cardiac Surgery University of Michigan Ann Arbor
MI USA
(Lindenfeld) Vanderbilt University Division of Cardiology Nashville TN USA
(Abraham) Division of Cardiovascular Medicine The Ohio State University
Columbus OH USA
(Mack) Baylor Scott and White Healthcare Dallas TX USA
(Kar) Cardiovascular Institute Los Robles Health System Thousand Oaks CA
USA
(Lim) Division of Cardiology University of Virginia Charlottesville VA USA
(Whisenant) Intermountain Medical Center Murray UT USA
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai New York NY USA
Publisher
NLM (Medline)
Abstract
Background The incidence and implications of worsening renal function
(WRF) after mitral valve transcatheter edge-to-edge repair (TEER) in
patients with heart failure (HF) are unknown. Therefore, the aim of this
study was to determine the proportion of patients with HF and secondary
mitral regurgitation who develop persistent WRF within 30days following
TEER, and whether this development portends a worse prognosis. Methods and
Results In the COAPT (Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients With Functional Mitral
Regurgitation) trial, 614 patients with HF and severe secondary mitral
regurgitation were randomized to TEER with the MitraClip plus
guideline-directed medical therapy (GDMT) versus GDMT alone. WRF was
defined as serum creatinine increase >=1.5x or >=0.3mg/dL from baseline
persisting to day 30 or requiring renal replacement therapy. All-cause
death and HF hospitalization rates between 30days and 2years were compared
in patients with and without WRF. WRF at 30days was present in 11.3% of
patients (9.7% in the TEER plus GDMT group and 13.1% in the GDMT alone
group; P=0.23). WRF was associated with all-cause death (hazard ratio
[HR], 1.98 [95% CI, 1.3-3.03]; P=0.001) but not HF hospitalization (HR,
1.47 [ 95% CI, 0.97-2.24]; P=0.07) between 30days and 2years. Compared
with GDMT alone, TEER reduced both death and HF hospitalization
consistently in patients with and without WRF (Pinteraction=0.53 and 0.57,
respectively). Conclusions Among patients with HF and severe secondary
mitral regurgitation, the incidence of WRF at 30days was not increased
after TEER compared with GDMT alone. WRF was associated with greater
2-year mortality but did not attenuate the treatment benefits of TEER in
reducing death and HF hospitalization compared with GDMT alone.
Registration URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01626079.

<85>
Accession Number
641122990
Title
Paravertebral block combined with serratus anterior plane block after
video-assisted thoracic surgery: a prospective randomized controlled
trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 64(1) (no pagination),
2023. Date of Publication: 03 Jul 2023.
Author
Dusseaux M.-M.; Grego V.; Baste J.-M.; Besnier E.; Boujibar F.; Koscianski
G.; Ben Yahia M.M.; Compere V.; Clavier T.; Vannier M.; Selim J.
Institution
(Dusseaux, Grego, Besnier, Koscianski, Ben Yahia, Compere, Clavier, Selim)
Department of Anaesthesiology and Critical Care, CHU Rouen, Rouen F-76000,
France
(Baste, Besnier, Boujibar, Clavier, Selim) Univ Rouen Normandy INSERM EnVI
UMR 1096, Rouen F-76000, France
(Baste, Boujibar) Department of Thoracic Surgery, CHU Rouen, Rouen
F-76000, France
(Vannier) Department of Biostatistics, Rouen University Hospital, Rouen
F-76000, France
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Adequate pain management after thoracoscopic surgery is a
major issue in the prevention of respiratory complications. The
combination of the paravertebral block (PVB) with the serratus anterior
plane block (SAPB) may decrease postoperative pain. The objective of this
study was to evaluate the impact of the combination of PVB and SAPB on the
consumption of morphine and pain after video- or robot-assisted thoracic
surgery. <br/>METHOD(S): The main objective of this randomized controlled
trial was to compare the cumulative postoperative morphine consumption at
24 h between a group having PVB (PVB group) and a group having PVB and
SAPB (PV-SAPB group). Postoperative pain at 6 and 24 h and
morphine-related complications were also assessed. <br/>RESULT(S): A total
of 112 patients were included with 56 in each group. There was no
difference in median cumulative morphine consumption at 24 h between the 2
groups (P=0.1640). At 6 h, the median postoperative pain was higher in the
PVB group compared to the PV-SAPB group (3 [0; 4] vs 2 [0; 3], P=0.0231).
There were no differences between the 2 groups for pain at 24 h and
morphine-related complications. <br/>CONCLUSION(S): We did not find any
difference in morphine consumption between the 2 groups. Our results
suggest that the combination of PVB and SAPB for video-assisted thoracic
surgery or robot-assisted thoracic surgery is safe effective and reliable
and could be an alternative to PVB alone in certain
indications.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<86>
Accession Number
2025886908
Title
Application of topical pharyngeal anesthesia to reduce adverse reactions
during painless gastroscopy: A prospective randomized study.
Source
Technology and Health Care. 31(4) (pp 1245-1251), 2023. Date of
Publication: 2023.
Author
Sun H.; Lin X.; Liu Y.; Hu S.; Yu Y.; Song C.
Institution
(Lin, Sun, Lin, Liu, Hu, Yu, Song) Department of Gastroenterology, The
Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University,
Wenzhou People's Hospital, Zhejiang, Wenzhou, China
Publisher
IOS Press BV
Abstract
Background: Studies have reported that certain adverse reactions can occur
during painless gastroscopy examination. Knowing how to decrease the risks
and incidence of adverse reactions is of great importance.
<br/>Objective(s): To investigate whether topical pharyngeal anesthesia
combined with intravenous anesthesia is superior to intravenous anesthesia
alone in patients undergoing painless gastroscopy and to determine whether
this combined approach had any additional benefits. <br/>Method(s): Three
hundred patients undergoing painless gastroscopy were randomly assigned to
either the control group or the experimental group. In the control group,
patients were anesthetized with propofol, while patients in the
experimental group received propofol combined with 2% lidocaine spray for
topical pharyngeal anesthesia. Hemodynamic parameters before and after the
procedure, including the heart rate (HR), mean arterial pressure (MAP),
and pulse oxygen saturation (SPO2) were recorded. Any adverse reactions
experienced by the patient, including choking and respiratory depression,
and the total dosage of propofol required during each procedure were also
documented. <br/>Result(s): Compared with pre-anesthetic data, the HR,
MAP, and SPO2 were reduced after the completion of the painless
gastroscopy procedure in both groups. However, the HR, MAP, and SPO2
measurements taken after the gastroscopy were significantly lower in the
control group than those of the experimental group (P< 0.05); thus, the
hemodynamic parameters of the experimental group were more stable.
Compared with the control group, there was significant reduction in the
total amount of propofol administered in the experimental group (P< 0.05).
The incidence of adverse reactions, including choking and respiratory
depression, was significantly lower in the experimental group (P< 0.05).
<br/>Conclusion(s): The results demonstrated that the application of
topical pharyngeal anesthesia in painless gastroscopy can significantly
reduce the incidence of adverse reactions. Thus, the combination of
topical pharyngeal and intravenous anesthesia is worthy of clinical
application and promotion. <br/>Copyright &#xa9; 2023 - IOS Press. All
rights reserved.

<87>
Accession Number
2025851145
Title
Comparison of the Effect of Inhalation and Intermittent
Inhalation-Exhalation Incentive Spirometry on Dyspnea Severity and
Atelectasis in Patients undergoing Coronary Artery Bypass Graft.
Source
Iranian Red Crescent Medical Journal. 25(3) (no pagination), 2023. Article
Number: e1918. Date of Publication: 2023.
Author
Sabziani Z.; Khalili Z.; Borzou S.R.; Tapak L.; Shams A.
Institution
(Sabziani) School of Nursing and Midwifery, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Khalili, Borzou) Faculty Member, Chronic Disease (Home Care) Research
Center, Department of Medical Surgical Nursing, School of Nursing and
Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
(Tapak) Department of Biostatistics, School of Public Health and Modeling
of Noncommunicable Diseases Research Center, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Shams) Department of Cardiac Surgery, Medical Faculty, Hamadan University
of Medical Sciences, Hamadan, Iran, Islamic Republic of
Publisher
ZamenPub
Abstract
Background: Dyspnea and atelectasis after Coronary Artery Bypass Graft
(CABG) are common and need nursing attention. Inhalation and exhalation
incentive spirometry is recommended for preventing alveolar collapse and
atelectasis. <br/>Objective(s): This study aimed to compare different
methods of incentive spirometry on dyspnea severity and atelectasis of the
patients undergoing CABG. <br/>Method(s): This randomized clinical trial
study was conducted on 66 patients undergoing CABG admitted to the
Intensive Care Unit (ICU) of Cardiac Surgery Department in Hamadan, Iran,
in 2020. The patients were selected through convenient sampling and were
divided into two groups through block permutation: inhalation incentive
spirometry and intermittent inhalation-exhalation spirometry. Both groups
performed incentive spirometry according to the instructions they had
received for four days. Then, they were examined for dyspnea and
atelectasis using the Borg scale and chest x-ray, respectively.
<br/>Result(s): During the intervention, dyspnea significantly decreased
in the intermittent inhalation-exhalation group relative to the inhalation
group (P<0.05). Most patients in both inhalation (63.6%) and intermittent
inhalation-exhalation (65.6%) groups had atelectasis; however, no
significant differences were observed between the two groups (P=0.867).
<br/>Conclusion(s): Incentive spirometry via intermittent
inhalation-exhalation method was more effective on dyspnea compared to the
inhalation method. Therefore, this method is recommended to patients and
nurses to reduce pulmonary complications after CABG.<br/>Copyright &#xa9;
2023, Author(s).

<88>
Accession Number
2025863627
Title
Final 3-Year Outcomes of a Randomized Trial Comparing a Self-Expanding to
a Balloon-Expandable Transcatheter Aortic Valve.
Source
Circulation: Cardiovascular Interventions. 16(7) (pp E012873), 2023. Date
of Publication: 01 Jul 2023.
Author
Lanz J.; Mollmann H.; Kim W.-K.; Burgdorf C.; Linke A.; Redwood S.; Hilker
M.; Joner M.; Thiele H.; Conzelmann L.; Conradi L.; Kerber S.; Thilo C.;
Toggweiler S.; Prendergast B.; Husser O.; Stortecky S.; Deckarm S.; Kunzi
A.; Heg D.; Walther T.; Windecker S.; Pilgrim T.
Institution
(Lanz, Stortecky, Windecker, Pilgrim) Department of Cardiology,
Inselspital, Bern University Hospital, Switzerland
(Mollmann) Department of Internal Medicine I, St-Johannes-Hospital,
Dortmund, Germany
(Kim) Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad
Nauheim, Germany
(Burgdorf) Heart and Vascular Center, Bad Bevensen, Germany
(Linke) Department of Internal Medicine and Cardiology, Heart Center
Dresden, Technische Universitat Dresden, Germany
(Redwood, Prendergast) Department of Cardiology, St Thomas' Hospital,
London, United Kingdom
(Hilker) Department of Cardiothoracic Surgery, University Medical Center,
Regensburg, Germany
(Joner) German Heart Centre, Technical University of Munich, Germany
(Thiele) Heart Center Leipzig, University of Leipzig, Germany
(Conzelmann) Department of Cardiac Surgery, Helios Klinik, Karlsruhe,
Germany
(Conradi) Department of Cardiovascular Surgery, University Heart and
Vascular Center, Hamburg, Germany
(Kerber) Department of Cardiology, Cardio-vascular Center Bad Neustadt,
Germany
(Thilo) Department of Internal Medicine I, RoMed Klinikum Rosenheim,
Germany
(Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Lucerne,
Switzerland
(Husser) Department of Cardiology and Intensive Care Medicine, Augustinum
Klinik Munich, Germany
(Deckarm, Kunzi, Heg) Clinical Trials Unit Bern, University of Bern,
Switzerland
(Walther) Department of Cardiac and Vascular Surgery, University Hospital
Frankfurt, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the SCOPE I trial (Safety and Efficacy of the Symetis
ACURATE Neo/TF Compared to the Edwards SAPIEN 3 Bioprosthesis),
transcatheter aortic valve implantation with the self-expanding ACURATE
neo (NEO) did not meet noninferiority compared with the balloon-expandable
SAPIEN 3 (S3) device regarding a composite end point at 30 days due to
higher rates of prosthetic valve regurgitation and acute kidney injury.
Data on long-term durability of NEO are scarce. Here, we report whether
early differences between NEO and S3 translate into differences in
clinical outcomes or bioprosthetic valve failure 3 years after
transcatheter aortic valve implantation. <br/>METHOD(S): Patients with
severe aortic stenosis were randomized to transfemoral transcatheter
aortic valve implantation with NEO or S3 at 20 European centers. Clinical
outcomes at 3 years are compared using Cox proportional or Fine-Gray
subdistribution hazard models by intention-to-treat. Bioprosthetic valve
failure is reported for the valve-implant cohort. <br/>RESULT(S): Among
739 patients, 84 of 372 patients (24.3%) had died in the NEO and 85 of 367
(25%) in the S3 group at 3 years. Comparing NEO with S3, the 3-year rates
of all-cause death (hazard ratio, 0.98 [95% CI, 0.73-1.33]), stroke
(subhazard ratio, 1.04 [95% CI, 0.56-1.92]), and hospitalization for
congestive heart failure (subhazard ratio, 0.74 [95% CI, 0.51-1.07]) were
similar between the groups. Aortic valve reinterventions were required in
4 NEO and 3 S3 patients (subhazard ratio, 1.32 [95% CI, 0.30-5.85]). New
York Heart Association functional class <=II was observed in 84% (NEO) and
85% (S3), respectively. Mean gradients remained lower after NEO at 3 years
(8 versus 12 mm Hg; P<0.001). <br/>CONCLUSION(S): Early differences
between NEO and S3 did not translate into significant differences in
clinical outcomes or bioprosthetic valve failure throughout 3 years.
REGISTRATION: URL: https://clinicaltrials.gov, Unique identifier:
NCT03011346.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<89>
Accession Number
2025863626
Title
Predicting 1-Year Mortality in Outpatients with Heart Failure with Reduced
Left Ventricular Ejection Fraction: Do Empiric Models Outperform Physician
Intuitive Estimates? A Multicenter Cohort Study.
Source
Circulation: Heart Failure. 16(7) (pp E010312), 2023. Date of Publication:
01 Jul 2023.
Author
Alba A.C.; Buchan T.A.; Saha S.; Fan S.; Demers C.; Poon S.; Mak S.;
Al-Hesayen A.; Toma M.; Zieroth S.; Anderson K.; Porepa L.; Chih S.;
Giannetti N.; Rac V.; Levy W.C.; Ross H.J.; Guyatt G.H.
Institution
(Alba, Buchan, Saha, Fan, Ross) Peter Munk Cardiac Centre, Ted Rogers
Center for Heart Research, University Health Network, Toronto, ON, Canada
(Alba, Buchan, Demers, Guyatt) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Poon) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Mak) Mount Sinai Hospital, Toronto, ON, Canada
(Al-Hesayen) Saint Michael's Hospital, Toronto, ON, Canada
(Toma) Providence Health Care, Vancouver, BC, Canada
(Zieroth) St. Boniface General Hospital, Winnipeg, MB, Canada
(Anderson) QEII Halifax Infirmary, Nova Scotia Health Authority, Halifax,
NS, Canada
(Porepa) Southlake Regional Health Centre, Newmarket, ON, Canada
(Chih) Ottawa Heart Institute, ON, Canada
(Giannetti) McGill University, Montreal, QC, Canada
(Rac) Institute of Health Policy, Management and Evaluation, Dalla Lana
School of Public Health, University of Toronto, ON, Canada
(Levy) University of Washington, Seattle, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Many studies have demonstrated that physicians often err in
estimating patient prognosis. No studies have directly compared physician
to model predictive performance in heart failure (HF). We aimed to compare
the accuracy of physician versus model predictions of 1-year mortality.
<br/>METHOD(S): This multicenter prospective cohort study on 11 HF clinics
in 5 provinces in Canada included consecutive consented outpatients with
HF with reduced left ventricular ejection fraction (<40%). By collecting
clinical data, we calculated predicted 1-year mortality using the Seattle
HF Model (SHFM), the Meta-Analysis Global Group in Chronic HF score, and
the HF Meta-Score. HF cardiologists and family doctors, blinded to model
predictions, estimated patient 1-year mortality. During 1-year follow-up,
we recorded the composite end point of mortality, urgent ventricular
assist device implant, or heart transplant. We compared physicians and
model discrimination (C statistic), calibration (observed versus predicted
event rate), and risk reclassification. <br/>RESULT(S): The study included
1643 patients with ambulatory HF with a mean age of 65 years, 24% female,
and mean left ventricular ejection fraction of 28%. Over 1-year follow-up,
9% had an event. The SHFM had the best discrimination (SHFM C statistic
0.76; HF Meta-Score 0.73; Meta-Analysis Global Group in Chronic Heart
Failure 0.70) and calibration. Physicians' discrimination differed little
(0.75 for HF cardiologists and 0.73 for family doctors) but both physician
groups substantially overestimated risk by >10% in both low- and high-risk
patients (poor calibration). In risk reclassification analysis, among
patients without events, the SHFM better classified 51% in comparison to
HF cardiologists and 43% in comparison to family doctors. In patients with
events, the SHFM erroneously assigned lower risk to 44% in comparison to
HF cardiologists and 34% in comparison to family doctors.
<br/>CONCLUSION(S): Family doctors and HF cardiologists showed adequate
risk discrimination, with however substantial overestimation of absolute
risk. Predictive models showed higher accuracy. Incorporating models in
family and HF cardiology practices may improve patient care and resource
use in HF with reduced left ventricular ejection fraction. REGISTRATION:
URL: https://www.clinicaltrials.gov; Unique identifier:
NCT04009798.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<90>
Accession Number
2025931418
Title
Cost effectiveness and long-term outcomes of dexamethasone administration
in major non-cardiac surgery.
Source
Journal of Clinical Anesthesia. 90 (no pagination), 2023. Article Number:
111218. Date of Publication: November 2023.
Author
Bouras M.; Clement A.; Schirr-Bonnans S.; Mauduit N.; Pere M.; Roquilly
A.; Riche V.-P.; Asehnoune K.
Institution
(Bouras, Clement, Roquilly, Asehnoune) Nantes Universite, CHU Nantes,
Service d'Anesthesie Reanimation Chirurgicale, INSERM CIC 0004 Immunologie
et Infectiologie, Nantes F-44093, France
(Schirr-Bonnans, Riche) Nantes Universite, CHU Nantes, Service Evaluation
Economique et Developpement des Produits de Sante, Direction de la
Recherche et de l'Innovation, Nantes, France
(Mauduit) Department of Medical Information, Nantes University Hospital, 1
Place Alexis-Ricordeau, Nantes 44000, France
(Pere) CHU de Nantes, Direction de la Recherche et de l'Innovation,
Plateforme de Methodologie et Biostatistique, Nantes, France
Publisher
Elsevier Inc.
Abstract
Study objectives: Postoperative administration of dexamethasone has been
proposed to reduce morbidity and mortality in patients undergoing major
non-cardiac surgery. In this ancillary study of the PACMAN trial, we aimed
to evaluate the cost effectiveness of dexamethasone in patients undergoing
major non-cardiac surgery. <br/>Method(s): Patients included in the
multicentric randomized double-blind, placebo-controlled PACMAN trial were
followed up for 12 months after their surgical procedure. Patients were
randomized to receive either dexamethasone (0.2 mg/kg immediately after
the surgical procedure, and on day 1) or placebo. Cost effectiveness
between the dexamethasone and placebo groups was assessed for the 12-month
postoperative period from a health payer perspective. <br/>Result(s): Of
1222 randomized patients in PACMAN, 137 patients (11%) were followed up
until 12 months after major surgery (71 in the DXM group and 66 in the
placebo group). Postoperative dexamethasone administration reduced costs
per patient at 1 year by 358.06 (95%CI -1519.99 to 803.87). The
probability of dexamethasone being cost effective was between 12% and 22%
for a willingness to pay of 100,000 to 150,000 per life-year, which is the
threshold that is usually used in France and was 52% for willingness to
pay of 50,000 per life-year (threshold in USA). At 12 months, 9 patients
(13.2%) in the DXM group and 10 patients (16.1%) in the placebo group had
died. In conclusion, our study does not demonstrate the cost effectiveness
of perioperative administration of DXM in major non-cardiac
surgery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<91>
Accession Number
2025825831
Title
Statin loading before coronary artery bypass grafting: a randomized trial.
Source
European Heart Journal. 44(25) (pp 2322-2331), 2023. Date of Publication:
01 Jul 2023.
Author
Liakopoulos O.J.; Kuhn E.W.; Hellmich M.; Schlomicher M.; Strauch J.;
Reents W.; Diegeler A.; Thielmann M.; Wendt D.; Borgermann J.; Gummert
J.F.; Stoppe C.; Goetzenich A.; Martens S.; Reichenspurner H.; Wippermann
J.; Reuter H.; Choi Y.-H.; Wahlers T.
Institution
(Liakopoulos, Kuhn, Choi, Wahlers) Department of Cardiothoracic Surgery,
University Hospital Cologne, Kerpener Str. 62, Cologne 50937, Germany
(Liakopoulos, Choi) Department of Cardiac Surgery, Kerckhoff-Clinic,
Justus-Liebig-University of Giessen, Campus Kerckhoff, Benekestr. 2-8, Bad
Nauheim 61231, Germany
(Hellmich) Institute of Medical Statistics and Computational Biology,
University Hospital Cologne, Cologne, Germany
(Schlomicher, Strauch) Department of Cardiothoracic Surgery,
Ruhr-University Hospital Bergmannsheil, Bochum, Germany
(Reents, Diegeler) Department of Cardiac Surgery, Bad Neustadt a. d.
Saale, Germany
(Thielmann, Wendt) Department of Thoracic and Cardiovascular Surgery, West
German Heart and Vascular Center Essen, University Hospital Essen, Essen,
Germany
(Borgermann, Gummert) Clinic for Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum,
Bad Oeynhausen, Germany
(Stoppe, Goetzenich) Department of Thoracic and Cardiovascular Surgery,
University Hospital Aachen, Aachen, Germany
(Martens) Department of Cardiac and Thoracic Surgery, University Hospital
Munster, Munster, Germany
(Reichenspurner) Department of Cardiovascular Surgery, University Heart
Center Hamburg, Hamburg, Germany
(Wippermann) Department of Cardiothoracic Surgery, Otto-von Guericke
University, Magdeburg, Germany
(Reuter) Department of Cardiology, University Hospital Cologne, Cologne,
Germany
Publisher
Oxford University Press
Abstract
Aims: Evidence suggests that a high-dose statin loading before a
percutaneous coronary revascularization improves outcomes in patients
receiving long-term statins. This study aimed to analyse the effects of
such an additional statin therapy before surgical revascularization.
<br/>Methods and Results: This investigator-initiated, randomized,
double-blind, and placebo-controlled trial was conducted from November
2012 to April 2019 at 14 centres in Germany. Adult patients (n = 2635)
with a long-term statin treatment (>=30 days) who were scheduled for
isolated coronary artery bypass grafting (CABG) were randomly assigned to
receive a statin-loading therapy or placebo at 12 and 2 h prior to surgery
using a web-based system. The primary outcome of major adverse cardiac and
cerebrovascular events (MACCE) was a composite consisting of all-cause
mortality, myocardial infarction (MI), and a cerebrovascular event
occuring within 30 days after surgery. Key secondary endpoints included a
composite of cardiac death and MI, myocardial injury, and death within 12
months. Non-statistically relevant differences were found in the modified
intention-to-treat analysis (2406 patients; 1203 per group) between the
statin (13.9%) and placebo groups (14.9%) for the primary outcome [odds
ratio (OR) 0.93, 95% confidence interval (CI) 0.74-1.18; P = 0.562] or any
of its individual components. Secondary endpoints including cardiac death
and MI (12.1% vs. 13.5%; OR 0.88, 95% CI 0.69-1.12; P = 0.300), the area
under the troponin T-release curve (median 0.398 vs. 0.394 ng/ml, P =
0.333), and death at 12 months (3.1% vs. 2.9%; P = 0.825) were comparable
between treatment arms. <br/>Conclusion(s): Additional statin loading
before CABG failed to reduce the rate of MACCE occuring within 30 days of
surgery. <br/>Copyright &#xa9; 2023 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<92>
[Use Link to view the full text]
Accession Number
2025890207
Title
Epidemiology of infective endocarditis in transcatheter aortic valve
replacement: systemic review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 21(10) (pp 790-801), 2020. Date of
Publication: 01 Oct 2020.
Author
Prasitlumkum N.; Vutthikraivit W.; Thangjui S.; Leesutipornchai T.;
Kewcharoen J.; Riangwiwat T.; Dworkin J.
Institution
(Prasitlumkum, Kewcharoen, Dworkin) Department of Internal Medicine,
University of Hawaii Internal Medicine Residency Program, Honolulu, HI,
United States
(Vutthikraivit) Department of Internal Medicine, Texas Tech University
Health Sciences Center, Lubbock, TX, United States
(Thangjui, Leesutipornchai) Department of Internal Medicine, Faculty of
Medicine, Chulalongkorn University, Bangkok, Thailand
(Riangwiwat) Cardiology Department, Geisinger Medical Center, Danville,
PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
IntroductionInfective endocarditis following transcatheter aortic valve
replacement (TAVR) is an emerging problem, with a high rate of morbidity
and mortality. However, little is known about the burden of disease, and
data on infective endocarditis incidence are scarce. This study aimed to
evaluate the incidence of infective endocarditis in TAVR by performing a
systematic review and meta-analysis of the literature.MethodsWe
comprehensively searched the databases of MEDLINE and EMBASE from
inception to October 2019. Included studies were prospective or
retrospective cohort studies that reported the event rate of infective
endocarditis in patients who underwent TAVR. Data from each study were
combined using the random-effects method to calculate pooled incidence
with 95% confidence intervals (CIs).ResultsA total of 30 studies
consisting of 73780 patients undergoing TAVR were included in this
meta-analysis. Overall, the pooled estimated incidence of infective
endocarditis following TAVR was 7 in 1000 patients (95% CI: 0.5-1%). For
early infective endocarditis, the pooled estimated incidence was 8 per
1000 patients (95% CI: 0.5-1.1%). For late infective endocarditis, the
pooled estimated incidence was 2 in 1000 patients (95% CI: 0.1-0.4%).
Significantly, the overall pooled infective endocarditis mortality rate
was 39% (95% CI: 28.7-49.4%).ConclusionThe current study demonstrates the
incidence of overall, early, and late infective endocarditis following
TAVR, ranging from 2 to 8 per 1000 patients. Although it remains a rare
event, infective endocarditis following TAVR is associated with high
mortality.<br/>Copyright &#xa9; 2020 Lippincott Williams and Wilkins. All
rights reserved.

<93>
Accession Number
2025811220
Title
Acute Glycemic Variability and Early Outcomes After Cardiac Surgery: A
Meta-Analysis.
Source
Hormone and Metabolic Research. (no pagination), 2023. Date of
Publication: 2023.
Author
Chang S.; Xu M.; Wang Y.; Zhang Y.
Institution
(Chang, Zhang) Surgery ICU, Cardiac surgery, Fuwai Hospital State Key
Laboratory of Cardiovascular Disease, Beijing, China
(Xu, Wang) Surgery ICU, Cardiac surgery, Fuwai Yunnan Cardiovascular
Hospital, Kunming, China
Publisher
Georg Thieme Verlag
Abstract
The influence of acute glycemic variability (GV) on early outcomes of
patients after cardiac surgery remains not fully determined. We performed
a systematic review and meta-analysis to evaluate the association between
acute GV and in-hospital outcomes of patients after cardiac surgery.
Relevant observational studies were obtained by search of electronic
databases including Medline, Embase, Cochrane Library, and Web of Science.
A randomized-effects model was selected to pool the data by incorporating
the influence of potential heterogeneity. Nine cohort studies involving 16
411 patients after cardiac surgery were included in this meta-analysis.
Pooled results showed that a high acute GV was associated with an
increased risk of major adverse events (MAE) during hospitalization for
patients after cardiac surgery [odds ratio [OR]: 1.29, 95% CI: 1.15 to
1.45, p<0.001, I22=38%]. Sensitivity analysis limited to studies of
on-pump surgery and GV evaluated by coefficient of variation of blood
glucose showed similar results. Subgroup analysis suggested that a high
acute GV was related to an increased incidence of MAE in patients after
coronary artery bypass graft, but not for those after isolated valvular
surgery (p=0.04), and the association was weakened after adjustment of
glycosylated hemoglobin (p=0.01). Moreover, a high acute GV was also
related to an increased risk of in-hospital mortality (OR: 1.55, 95% CI:
1.15 to 2.09, p=0.004; I22=0%). A high acute GV may be associated with
poor in-hospital outcomes in patients after cardiac surgery.<br/>Copyright
&#xa9; 2023 Georg Thieme Verlag. All rights reserved.

<94>
Accession Number
2025579437
Title
Meta-Analysis of the Prognostic Significance of Carotid Artery Stenosis in
Patients Who Underwent Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 200 (pp 225-231), 2023. Date of
Publication: 01 Aug 2023.
Author
Vella A.; Roux O.; Antiochos P.; Monney P.; Maurizi N.; Skalidis I.;
Fournier S.; Eeckhout E.; Roguelov C.; Oestreicher S.; Kirsch M.; Muller
O.; Lu H.
Institution
(Vella) Service of Cardiology, Geneva University Hospital and University
of Geneva, Geneva, Switzerland
(Roux) HerzHirslanden Group, Herzzentrum im Park AG, Zurich, Switzerland
(Antiochos, Monney, Maurizi, Skalidis, Fournier, Eeckhout, Roguelov,
Muller, Lu) Service of Cardiology, Lausanne University Hospital and
University of Lausanne, Lausanne, Switzerland
(Oestreicher) Service of Internal Medicine, Lausanne University Hospital
and University of Lausanne, Lausanne, Switzerland
(Kirsch) Service of Cardiovascular Surgery, Lausanne University Hospital
and University of Lausanne, Lausanne, Switzerland
Publisher
Elsevier Inc.
Abstract
Stroke is a known complication of both transcatheter aortic valve
implantation (TAVI) and carotid artery stenosis (CAS). Whether CAS is a
predictor of worse prognosis after TAVI is unclear. We performed a
meta-analysis to assess the impact of CAS on the incidence of
neurovascular complications and mortality after TAVI. We searched
PubMed/MEDLINE and EMBASE databases from inception to January 2023. CAS
was defined by >=50% stenosis of at least 1 carotid artery. Studies
comparing CAS versus non-CAS TAVI populations were included. Patients'
baseline characteristics and 30-day clinical outcomes were extracted. End
points included the 30-day incidence of neurovascular complications
(stroke or transient ischemic attack) and 30-day all-cause mortality. We
identified six studies, totaling 6,763 patients in the CAS group and
23,861 patients in the non-CAS group. Patients with CAS had a higher
prevalence of hypertension, diabetes mellitus, dyslipidemia, previous
myocardial infarction, coronary artery bypass graft, peripheral artery
disease, previous neurovascular disease, and chronic kidney disease. There
was no significant difference in the rates of 30-day neurovascular
complications between CAS and non-CAS groups (relative risk 1.23, 95%
confidence interval 0.63 to 2.40, p = 0.54). CAS was associated with a
higher risk of 30-day all-cause mortality (relative risk 1.28, 95%
confidence interval 1.12 to 1.47, p <0.001), not found in a sensitivity
analysis. In conclusion, patients with CAS presented with a significantly
higher co-morbidity burden. CAS was not associated with an increased risk
of 30-day neurovascular complications. 30-day mortality was higher in the
CAS group but that may be a surrogate of the heavy co-morbidity burden of
patients with CAS.<br/>Copyright &#xa9; 2023 The Author(s)

<95>
Accession Number
2024465334
Title
Rhythm vs. Rate Control in Patients with Postoperative Atrial Fibrillation
after Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(13) (no pagination), 2023. Article
Number: 4534. Date of Publication: July 2023.
Author
Ahmed M.; Belley-Cote E.P.; Qiu Y.; Belesiotis P.; Tao B.; Wolf A.; Kaur
H.; Ibrahim A.; Wong J.A.; Wang M.K.; Healey J.S.; Conen D.; Devereaux
P.J.; Whitlock R.P.; Mcintyre W.F.
Institution
(Ahmed, Belley-Cote, Belesiotis, Kaur, Wong, Wang, Healey, Conen,
Devereaux, Whitlock, Mcintyre) Faculty of Health Sciences, McMaster
University, Hamilton, ON L8L 2X2, Canada
(Qiu) Ottawa Heart Institute, University of Ottawa, Ottawa, ON K1Y 4W7,
Canada
(Tao) Department of Medicine, University of British Columbia, Vancouver,
BC V6T 1Z1, Canada
(Wolf, Ibrahim) Department of Medicine, Western University, Hamilton, ON
N6A 5C1, Canada
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
complication after cardiac surgery; it is associated with morbidity and
mortality. We undertook this review to compare the effects of rhythm vs.
rate control in this population. <br/>Method(s): We searched MEDLINE,
Embase and CENTRAL to March 2023. We included randomized trials and
observational studies comparing rhythm to rate control in cardiac surgery
patients with POAF. We used a random-effects model to meta-analyze data
and rated the quality of evidence using GRADE. <br/>Result(s): From 8,110
citations, we identified 8 randomized trials (990 patients). Drug regimens
used for rhythm control included amiodarone in four trials, other class
III anti-arrhythmics in one trial, class I anti-arrhythmics in four trials
and either a class I or III anti-arrhythmic in one trial. Rhythm control
compared to rate control did not result in a significant difference in
length of stay (mean difference -0.8 days; 95% CI -3.0 to +1.4,
I² = 97%), AF recurrence within 1 week (130 events; risk ratio
[RR] 1.1; 95%CI 0.6-1.9, I² = 54%), AF recurrence up to 1 month
(37 events; RR 0.9; 95%CI 0.5-1.8, I² = 0%), AF recurrence up
to 3 months (10 events; RR 1.0; 95%CI 0.3-3.4, I² = 0%) or
mortality (25 events; RR 1.6; 95%CI 0.7-3.5, I² = 0%). Effect
measures from seven observational studies (1428 patients) did not differ
appreciably from those in randomized trials. <br/>Conclusion(s): Although
atrial fibrillation is common after cardiac surgery, limited low-quality
data guide its management. Limited available evidence suggests no clear
advantage to either rhythm or rate control. A large-scale randomized trial
is needed to inform this important clinical question.<br/>Copyright &#xa9;
2023 by the authors.

<96>
Accession Number
2024436115
Title
The impact of semi-upright position on severity of sleep disordered
breathing in patients with obstructive sleep apnea: a two-arm,
prospective, randomized controlled trial.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 236. Date
of Publication: December 2023.
Author
Lukachan G.A.; Yadollahi A.; Auckley D.; Gavrilovic B.; Matelski J.; Chung
F.; Singh M.
Institution
(Lukachan) Department of Anesthesia, Believers Church Medical College
Hospital, Kerala, Thiruvalla, India
(Yadollahi, Gavrilovic) KITE - Toronto Rehabilitation Institute,
University Health Network, University of Toronto, Toronto, ON, Canada
(Auckley) Division of Pulmonary, Critical Care and Sleep Medicine,
MetroHealth Medical Center, Case Western Reserve University, Cleveland,
OH, United States
(Matelski) Biostatistics Research Unit, University Health Network,
Toronto, ON, Canada
(Chung, Singh) Department of Anesthesia, Toronto Western Hospital,
University Health Network, University of Toronto, 399 Bathurst Street, McL
2-405, Toronto, ON M5T 2S8, Canada
Publisher
BioMed Central Ltd
Abstract
Background: The severity of sleep-disordered breathing is known to worsen
postoperatively and is associated with increased cardio-pulmonary
complications and increased resource implications. In the general
population, the semi-upright position has been used in the management of
OSA. We hypothesized that the use of a semi-upright position versus a
non-elevated position will reduce postoperative worsening of OSA in
patients undergoing non-cardiac surgeries. <br/>Method(s): This study was
conducted as a prospective randomized controlled trial of perioperative
patients, undergoing elective non-cardiac inpatient surgeries. Patients
underwent a preoperative sleep study using a portable polysomnography
device. Patients with OSA (apnea hypopnea index (AHI) > 5 events/hr),
underwent a sleep study on postoperative night 2 (N2) after being
randomized into an intervention group (Group I): semi-upright position (30
to 45 degrees incline), or a control group (Group C) (zero degrees from
horizontal). The primary outcome was postoperative AHI on N2. The
secondary outcomes were obstructive apnea index (OAI), central apnea index
(CAI), hypopnea index (HI), obstructive apnea hypopnea index (OAHI) and
oxygenation parameters. <br/>Result(s): Thirty-five patients were
included. Twenty-one patients were assigned to the Group 1 (females-14
(67%); mean age 65 +/- 12) while there were fourteen patients in the Group
C (females-5 (36%); mean age 63 +/- 10). The semi-upright position
resulted in a significant reduction in OAI in the intervention arm (Group
C vs Group I postop AHI: 16.6 +/- 19.0 vs 8.6 +/- 11.2 events/hr; overall
p = 0.01), but there were no significant differences in the overall AHI or
other parameters between the two groups. Subgroup analysis of patients
with "supine related OSA" revealed a decreasing trend in postoperative AHI
with semi-upright position, but the sample size was too small to evaluate
statistical significance. <br/>Conclusion(s): In patients with newly
diagnosed OSA, the semi-upright position resulted in improvement in
obstructive apneas, but not the overall AHI. Trial registration: This
trial was retrospectively registered in clinicaltrials.gov NCT02152202 on
02/06/2014.<br/>Copyright &#xa9; 2023, The Author(s).

<97>
Accession Number
2024436113
Title
Analgesic effectiveness of serratus anterior plane block in patients
undergoing video-assisted thoracoscopic surgery: a systematic review and
updated meta-analysis of randomized controlled trials.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 235. Date
of Publication: December 2023.
Author
Li J.; Wang X.; Wang Y.; Zhang W.
Institution
(Li, Wang, Wang, Zhang) Department of Anesthesiology, Yuncheng Central
Hospital, Shanxi Medical University, Shanxi Province, Yuncheng 044000,
China
Publisher
BioMed Central Ltd
Abstract
Background: Serratus anterior plane block (SAPB) is a promising regional
technique for analgesia in thoracic surgery. Till now, several randomized
controlled trials (RCTs) have explored the effectiveness of SAPB for
postoperative pain control in patients undergoing video-assisted
thoracoscopic surgery (VATS), but the sample sizes were small and
conclusions remained in controversy. Therefore, we conducted the present
systematic review and meta-analysis. <br/>Method(s): RCTs evaluating the
analgesic performance of SAPB, comparing to control methods (no block,
placebo or local infiltration anesthesia), in patients undergoing VATS
were searched in PubMed, EMBASE, Web of Science and Cochrane Library from
inception to December 31, 2022. Mean difference (MD) and corresponding 95%
confidence interval (95%CI) were calculated for postoperative pain scores
at various time points, postoperative opioid consumption and length of
hospital stay. Pooled relative risk (RR) with 95%CI were calculated for
the risk of postoperative nausea and vomiting (PONV) and dizziness. A
random-effect model was applied. <br/>Result(s): A total of 12 RCTs (837
participants) were finally included. Compared to control group, SAPB had
significant reductions of postoperative pain scores at 2 h (MD = -1.58,
95%CI: -1.86 to -1.31, P < 0.001), 6 h (MD = -2.06, 95%CI: -2.74 to -1.38,
P < 0.001), 12 h (MD = -1.72, 95%CI: -2.30 to -1.14, P < 0.001) and 24 h
(MD = -1.03, 95%CI: -1.55 to -0.52, P < 0.001), respectively. Moreover,
SAPB conferred a fewer postoperative opioid consumption (MD = -7.3 mg of
intravenous morphine equivalent, 95%CI: -10.16 to -4.44, P < 0.001) and
lower incidence of PONV (RR = 0.56, 95%CI: 0.41 to 0.77, P < 0.001). There
was no difference between both groups regarding length of hospital stay
and risk of dizziness. <br/>Conclusion(s): SAPB shows an excellent
performance in postoperative pain management in patients undergoing VATS
by reducing pains scores, postoperative opioid consumption and incidence
of PONV. However, due to huge heterogeneity, more well-designed,
large-scale RCTs are needed to verify these findings in the
future.<br/>Copyright &#xa9; 2023, The Author(s).

<98>
Accession Number
2024436013
Title
Effects of penehyclidine hydrochloride combined with dexmedetomidine on
pulmonary function in patients undergoing heart valve surgery: a
double-blind, randomized trial.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 237. Date
of Publication: December 2023.
Author
He F.; Lu Y.; Mao Q.; Zhou L.; Chen Y.; Xie Y.
Institution
(He, Lu, Mao, Zhou, Chen, Xie) Department of Anesthesiology, The First
Affiliated Hospital of Guangxi Medical University, Nanning, China
(Xie) Guangxi Key Laboratory of Enhanced Recovery After Surgery for
Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical
University, Nanning, China
Publisher
BioMed Central Ltd
Abstract
Aim: To investigate the effects of penehyclidine hydrochloride combined
with dexmedetomidine on pulmonary function in patients undergoing heart
valve surgery with cardiopulmonary bypass (CPB). <br/>Method(s): A total
of 180 patients undergoing elective heart valve surgery with CPB were
randomly divided into four groups: 45 in group P (intravenous
penehyclidine hydrochloride 0.02 mg/kg 10 min before anesthesia induction
and at the beginning of CPB, total 0.04 mg/kg); 43 in group D
(dexmedetomidine 0.5 mug/kg/h after induction of anesthesia until the end
of anesthesia); 44 in group PD (penehyclidine hydrochloride 0.04 mg/kg
combined with dexmedetomidine 0.5 mug/kg/h intravenously during
anesthesia); and 43 in group C (same amount of normal saline 10 min before
and after anesthesia induction, to the end of anesthesia, and at the
beginning of CPB). The main outcomes were the incidence and severity of
postoperative pulmonary complications (PPCs). The secondary outcomes were:
(1) extubation time, length of stay in intensive care, and postoperative
hospital stay, and adverse events; and (2) pulmonary function evaluation
indices (oxygenation index and respiratory index) and plasma inflammatory
factor concentrations (tumor necrosis factor-alpha, interleukin-6,
C-reactive protein and procalcitonin) during the perioperative period.
<br/>Result(s): The incidence of PPCs in groups P, D and PD after CPB was
lower than that in group C (P < 0.05), and the incidence in group PD was
significantly lower than that in groups P and D (P < 0.05). The scores for
PPCs in groups P, D and PD were lower than those in group C (P < 0.05).
<br/>Conclusion(s): Combined use of penehyclidine hydrochloride and
dexmedetomidine during anesthesia reduced the occurrence of postoperative
pulmonary dysfunction, and improved the prognosis of patients undergoing
heart valve surgery with CPB. Trial registration: The trial was registered
in the Chinese Clinical Trial Registry on 3/11/2020 (Registration No.:
ChiCTR2000039610).<br/>Copyright &#xa9; 2023, The Author(s).

<99>
Accession Number
2024383089
Title
Effects of intraoperative inspired oxygen fraction (FiO<inf>2</inf> 0.3 vs
0.8) on patients undergoing off-pump coronary artery bypass grafting: the
CARROT multicenter, cluster-randomized trial.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 286. Date of
Publication: December 2023.
Author
Nam K.; Nam J.-S.; Kim H.-B.; Chung J.; Hwang I.E.; Ju J.-W.; Bae J.; Lee
S.; Cho Y.J.; Shim J.-K.; Kwak Y.-L.; Chin J.-H.; Choi I.-C.; Lee E.-H.;
Jeon Y.
Institution
(Nam, Chung, Hwang, Ju, Bae, Lee, Cho, Jeon) Department of Anesthesiology
and Pain Medicine, Seoul National University Hospital, Seoul National
University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080,
South Korea
(Nam, Chin, Choi, Lee) Department of Anesthesiology and Pain Medicine,
Asan Medical Center, University of Ulsan College of Medicine, 88
Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
(Kim, Shim, Kwak) Department of Anesthesiology and Pain Medicine,
Severance Hospital, Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Chung) Medical Service Corps of the First Logistics Support Command,
Gangwon State, Wonju, South Korea
(Bae) Department of Anesthesiology and Pain Medicine, Ajou University
Medical Center, Ajou University School of Medicine, Gyeonggi Province,
Suwon, South Korea
(Lee) Hana Anesthesia Clinic, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: To maintain adequate oxygenation is of utmost importance in
intraoperative care. However, clinical evidence supporting specific oxygen
levels in distinct surgical settings is lacking. This study aimed to
compare the effects of 30% and 80% oxygen in off-pump coronary artery
bypass grafting (OPCAB). <br/>Method(s): This multicenter trial was
conducted in three tertiary hospitals from August 2019 to August 2021.
Patients undergoing OPCAB were cluster-randomized to receive either 30% or
80% oxygen intraoperatively, based on the month when the surgery was
performed. The primary endpoint was the length of hospital stay.
Intraoperative hemodynamic data were also compared. <br/>Result(s): A
total of 414 patients were cluster-randomized. Length of hospital stay was
not different in the 30% oxygen group compared to the 80% oxygen group
(median, 7.0 days vs 7.0 days; the sub-distribution hazard ratio, 0.98;
95% confidence interval [CI] 0.83-1.16; P = 0.808). The incidence of
postoperative acute kidney injury was significantly higher in the 30%
oxygen group than in the 80% oxygen group (30.7% vs 19.4%; odds ratio,
1.94; 95% CI 1.18-3.17; P = 0.036). Intraoperative time-weighted average
mixed venous oxygen saturation was significantly higher in the 80% oxygen
group (74% vs 64%; P < 0.001). The 80% oxygen group also had a
significantly greater intraoperative time-weighted average cerebral
regional oxygen saturation than the 30% oxygen group (56% vs 52%; P =
0.002). <br/>Conclusion(s): In patients undergoing OPCAB, intraoperative
administration of 80% oxygen did not decrease the length of hospital stay,
compared to 30% oxygen, but may reduce postoperative acute kidney injury.
Moreover, compared to 30% oxygen, intraoperative use of 80% oxygen
improved oxygen delivery in patients undergoing OPCAB. Trial registration
ClinicalTrials.gov (NCT03945565; April 8, 2019).<br/>Copyright &#xa9;
2023, The Author(s).

<100>
Accession Number
2025680574
Title
Randomized Comparison of the Outcome of Single Versus Multiple Arterial
Grafts trial (ROMA):Women-a trial dedicated to women to improve coronary
bypass outcomes.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Gaudino M.; Bairey Merz C.N.; Sandner S.; Creber R.M.; Ballman K.V.;
O'Brien S.M.; Harik L.; Perezgrovas-Olaria R.; Mehran R.; Safford M.M.;
Fremes S.E.
Institution
(Gaudino, Harik, Perezgrovas-Olaria) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Bairey Merz) Barbra Streisand Women's Heart Center, Cedars-Sinai Medical
Center, Smidt Heart Institute, Los Angeles, Calif, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Creber) Columbia University School of Nursing, New York, NY, United
States
(Ballman) Alliance Statistics and Data Center, Weill Medical College of
Cornell University, New York, NY, United States
(O'Brien) Duke Clinical Research Institute, Durham, NC, United States
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Safford) Department of Medicine, Weill Cornell Medicine, New York, NY,
United States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Canada
Publisher
Elsevier Inc.

<101>
Accession Number
2024482927
Title
Prognostic role of CA-125 in patients undergoing transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Clinical Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Diaz-Arocutipa C.; Saucedo-Chinchay J.; Mamas M.A.
Institution
(Diaz-Arocutipa) Vicerrectorado de Investigacion, Universidad San Ignacio
de Loyola, Lima, Peru
(Saucedo-Chinchay) Department of Cardiology, Hospital Nacional Edgardo
Rebagliati Martins, Lima, Peru
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Keele, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) has become a widely used
therapy for patients with severe aortic stenosis. Carbohydrate antigen 125
(CA-125) is a promising biomarker in some cardiovascular diseases. This
systematic review aims to assess the prognostic role of CA-125 in patients
undergoing TAVR. We searched electronic databases from inception to March
2023 to include cohort studies evaluating the association between
preprocedural CA-125 levels and mortality or heart failure (HF)
readmission at 12 months in patients undergoing TAVR. We pooled crude
(cHR) and adjusted hazard ratios (aHR) with their 95% confidence interval
(CI) using a random-effects model. The risk of bias was evaluated using
the QUIPS tool. The certainty of the evidence was assessed using the GRADE
approach. We included five cohort studies involving 1594 patients. Higher
levels of CA-125 were significantly associated with an increased risk of
mortality or HF readmission using crude (cHR 2.79, 95% CI 1.45-5.36,
I² = 72%) and adjusted (aHR 3.27, 95% CI 2.07-5.18,
I² = 0%, high certainty) effect estimates compared with lower
levels. Similarly, there was also associated with increased mortality
using crude (cHR 2.68, 95% CI 1.99-3.60, I² = 0%) and adjusted
(aHR 2.17, 95% CI 1.54-3.07, I² = 0%, high certainty) effect
estimates. The risk of bias varied between low to moderate across studies.
Our meta-analysis suggests that CA-125 has incremental prognostic value in
patients undergoing TAVR. Further studies are needed to determine the
clinical utility of CA-125 in guiding treatment decisions in this
population.<br/>Copyright &#xa9; 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<102>
Accession Number
2025698323
Title
Is the folk medicine known as "the Secret" efficient in reducing bleeding
after percutaneous coronary procedures?: A double-blinded, randomised
trial.
Source
Open Heart. 9(2) (no pagination), 2022. Article Number: e002134. Date of
Publication: 20 Dec 2022.
Author
Ferry C.; Puricel S.; Lehmann S.; Rickard K.; Meier P.; Togni M.; Diego
A.; Cook S.
Institution
(Ferry, Puricel, Lehmann, Meier, Togni, Diego, Cook) Cardiology,
University of Fribourg, Fribourg, Switzerland
(Rickard) Economics, United Nations Unversity (UNU-WIDER), Helsinki,
Finland
Publisher
BMJ Publishing Group
Abstract
Aim Percutaneous coronary interventions require an arterial approach and
administration of antithrombotic drugs. This may lead to bleeding
complications. The aim of this study was to test whether "The Secret"- a
pagan prayer - is effective in reducing post-interventional bleeding.
Design Randomised controlled trial. Setting Monocentric, tertiary care
centre. Participants From January to July 2022, 200 patients (aged >18
years) undergoing elective coronary angiography were included in the
study. Intervention The intervention group received "The Secret"in
addition to the normal procedure. The control group was treated according
to standard practice. Main outcome measures The primary outcome was the
rate of in-hospital bleeding according to the Bleeding Academic Research
Consortium (BARC) consensus definition. Results The rate of bleeding was
similar in both groups ("The Secret"group vs control group) with 16%
versus 14% (p=0.69) of BARC 1, 12% versus 13% (p=0.81) of BARC 2, and 0%
versus 0% of BARC 3 and 5 (p=1.00). Most (76%) of the participants
believed that "The Secret"would be efficient in preventing bleeding.
Conclusions This study demonstrates no effect on bleeding after
percutaneous coronary procedures. A large majority of our study population
believe that "The Secret"can have a positive effect on their hospital
care.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2022. Re-use
permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<103>
Accession Number
2025606807
Title
Pci does not improve outcomes for patients with ischemic heart disease
andlvef of less than 35%.
Source
American Family Physician. 107(5) (pp 551A-551B), 2023. Date of
Publication: 01 May 2023.
Author
Ebell M.H.
Institution
(Ebell) Professor, University of Georgia, Athens, GA, United States
Publisher
American Academy of Family Physicians

<104>
Accession Number
2024311908
Title
Analgesic efficacy of pre-emptive ultrasound-guided mid-point transverse
process to pleura block for patients undergoing posterolateral thoracotomy
incisions: Randomized controlled trial.
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 538-545), 2023. Date of
Publication: 2023.
Author
Mohammed H.A.; Belal A.M.; Elkalla R.S.; Soliman S.M.
Institution
(Mohammed, Belal, Elkalla, Soliman) Anesthesiology, Surgical Intensive
Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta,
Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: For anesthesiologists, managing pain during and after thoracic
surgery remains a significant challenge. This research aims to assess the
safety and efficacy of ultrasound (US)-guided pre-emptive mid-point
transverse process to pleura (MTP) block for posterolateral thoracotomy.
<br/>Method(s): This prospective randomized, double-blind clinical trial
was conducted on 70 patients scheduled for a posterolateral thoracotomy
operation under general anesthesia (GA). Patients were classified randomly
and equally into Group I (MTP group) received MTP blocks, and Group II
(sham block) received 2 ml of saline solution. The blocks were done after
induction of GA but before the skin incision. <br/>Result(s): Numerical
rating scale (NRS) at rest and cough, total morphine consumption, the
incidence of chronic pain at 3 months, and undesirable side effects
(nausea, vomiting, respiratory depression) were significantly lower in MTP
block than in sham block. Oxygen saturation and
SpO<inf>2</inf>/FiO<inf>2</inf> raised significantly in the MTP block than
in the sham block (P < 0.001). <br/>Conclusion(s): The US-guided MTP block
provided effective analgesia with a lower pain score, lesser rescue
analgesics consumption, and reduced risk of developing chronic pain
posterolateral thoracotomy.<br/>Copyright &#xa9; 2023 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<105>
Accession Number
2024160484
Title
The full bi-atrial lesion pattern in the Cox-maze procedure: a concept
rather than a technique.
Source
European Journal of Cardio-thoracic Surgery. 63(1) (no pagination), 2023.
Article Number: ezac579. Date of Publication: 01 Jan 2023.
Author
Garcia-Villarreal O.A.
Institution
(Garcia-Villarreal) Mexican College of Cardiovascular and Thoracic
Surgery, Mexico City, Mexico
Publisher
European Association for Cardio-Thoracic Surgery

<106>
Accession Number
2024160478
Title
Do all roads lead to Rome? Critical reassessment of the individual patient
meta-analysis on bypass grafts by Gaudino et al.
Source
European Journal of Cardio-thoracic Surgery. 63(1) (no pagination), 2023.
Article Number: ezac564. Date of Publication: 01 Jan 2023.
Author
Freemantle N.; Myers P.O.; Siepe M.
Institution
(Freemantle) Institute for Clinical Trials and Methodology, University
College London, London, United Kingdom
(Myers) Division of Cardiac Surgery, CHUV, Lausanne University Hospital,
Switzerland
(Myers) La Tour Hospital, Geneva, Switzerland
(Siepe) Department of Cardiac Surgery, University Hospital Bern,
University of Bern, Bern, Switzerland
Publisher
European Association for Cardio-Thoracic Surgery

<107>
Accession Number
2022856309
Title
The changing spectrum of cardiovascular emergencies during the COVID-19
pandemic.
Source
Herz. 48(3) (pp 218-222), 2023. Date of Publication: June 2023.
Author
Thiele H.; Zeymer U.
Institution
(Thiele) Heart Center Leipzig, Department of Internal Medicine/Cardiology,
University of Leipzig, Strumpellstrase 39, Leipzig 04289, Germany
(Zeymer) Institut fur Herzinfarktforschung, Klinikum Ludwigshafen,
Bremserstrase 79, Ludwigshafen 67063, Germany
Publisher
Springer Medizin
Abstract
The outbreak of the COVID-19 pandemic in March 2020 influenced treatment
strategies and behaviors, particularly cardiovascular emergencies, which
may have led to cardiovascular collateral damage. This review article
covers aspects of the changing spectrum of cardiac emergencies with a
focus on acute coronary syndrome rates and cardiovascular mortality and
morbidity based on a selected literature review including the most recent
comprehensive meta-analyses.<br/>Copyright &#xa9; 2023, The Author(s),
under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von
Springer Nature.

<108>
Accession Number
2022489959
Title
Effect of Perioperative Oral Vitamin C Supplementation on In-Hospital
Postoperative Medication Costs for Cardiac Surgery Patients: A
Prospective, Single-Centre, Randomised Clinical Trial.
Source
PharmacoEconomics - Open. 7(4) (pp 655-663), 2023. Date of Publication:
July 2023.
Author
Heerman J.; Boydens C.; Allaert S.; Cathenis K.; Deryckere K.;
Vanoverschelde H.
Institution
(Heerman, Boydens, Allaert, Vanoverschelde) Department of Anaesthesia and
Intensive Care, AZ Maria Middelares Hospital, Buitenring Sint-Denijs 30,
Ghent 9000, Belgium
(Cathenis) Department of Cardiac Surgery, AZ Maria Middelares Hospital,
Buitenring Sint-Denijs 30, Ghent 9000, Belgium
(Deryckere) Department of Pharmaceutics, AZ Maria Middelares Hospital,
Buitenring Sint-Denijs 30, Ghent 9000, Belgium
Publisher
Adis
Abstract
Background: Due to its antioxidant properties, vitamin C might be a
promising and effective strategy for preventing postoperative atrial
fibrillation (POAF) after cardiac surgery. This study was aimed at
evaluating whether vitamin C supplementation is effective in reducing the
cost of in-hospital postoperative medication used for patients undergoing
coronary artery bypass (CABG) or valve surgery (+/-CABG).
<br/>Objective(s): The primary goal of this study was to evaluate the
impact of perioperative vitamin C supplementation in patients undergoing
cardiac surgery on in-hospital postoperative medication costs, while
secondary endpoints were the effects on length of stay (LOS) in both the
intensive care unit (ICU) and the hospital, and the incidence of POAF.
<br/>Material(s) and Method(s): From November 2018 to January 2021, 253
patients planned for CABG or valve surgery (+/-CABG) in AZ Maria
Middelares, Ghent, Belgium, and who met the inclusion criteria (>=18 years
of age, all having cardiac sinus rhythm, and who provided written informed
consent) were randomised into a placebo group or vitamin C group. The
medication was administered orally (1 g twice daily), starting from 5 days
preoperatively until 10 days postoperatively. The medication used, LOS in
the hospital/ICU, and development of clinically relevant POAF in the ICU
were registered. <br/>Result(s): Mean medication costs were 264.6 +/- 98.1
for patients in the vitamin C group and 294.9 +/- 267.3 for patients in
the placebo group. When stratifying according to the type of surgery (CABG
or valve surgery [+/-CABG]), these costs did not significantly differ.
There was no significant difference in LOS or the incidence of clinically
relevant POAF. <br/>Conclusion(s): Our data did not identify any
short-term financial impact on postoperative medication costs after oral
perioperative vitamin C supplementation (1 g twice daily) for patients
undergoing a CABG procedure or valve surgery (+/-CABG). No effect was
found on the LOS or the incidence of clinically relevant POAF. Potential
effects in the longer term, after intravenous administration of vitamin C
or in other types of (cardiac) surgery, are still to be investigated.
Clinical Trials registration number: NCT03592680.<br/>Copyright &#xa9;
2023, The Author(s).

<109>
Accession Number
2020021062
Title
Patient-centered care in Coronary Heart Disease: what do you want to
measure? A systematic review of reviews on patient-reported outcome
measures.
Source
Quality of Life Research. 32(5) (pp 1405-1425), 2023. Date of Publication:
May 2023.
Author
Pardo Y.; Garin O.; Oriol C.; Zamora V.; Ribera A.; Ferrer M.
Institution
(Pardo, Garin, Zamora, Ribera, Ferrer) CIBER Epidemiologia y Salud Publica
(CIBERESP), Dr. Aiguader 88, Barcelona 08003, Spain
(Pardo, Garin, Zamora, Ferrer) Health Services Research Group, IMIM
(Hospital del Mar Medical Research Institute), Barcelona, Spain
(Pardo) Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
(Garin, Zamora, Ferrer) Universitat Pompeu Fabra (UPF), Barcelona, Spain
(Oriol) Unitat de Suport a la Recerca Metropolitana Nord, Institut
Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi
Gol), Mataro, Spain
(Ribera) Cardiovascular Epidemiology and Research Unit, University
Hospital and Research Institute Vall d'Hebron (VHIR), Barcelona, Spain
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The number of published articles on Patient-Reported Outcomes
Measures (PROMs) in Coronary Heart Disease (CHD), a leading cause of
disability-adjusted life years lost worldwide, has been growing in the
last decades. The aim of this study was to identify all the
disease-specific PROMs developed for or used in CHD and summarize their
characteristics (regardless of the construct), to facilitate the selection
of the most adequate one for each purpose. <br/>Method(s): A systematic
review of reviews was conducted in MEDLINE, Scopus, and the Cochrane
Database of Systematic Reviews. PROQOLID and BiblioPRO libraries were also
checked. PROMs were classified by construct and information was extracted
from different sources regarding their main characteristics such as aim,
number of items, specific dimensions, original language, and metric
properties that have been assessed. <br/>Result(s): After title and
abstract screening of 1224 articles, 114 publications were included for
full text review. Finally, we identified 56 PROMs: 12 symptoms scales, 3
measuring functional status, 21 measuring Health-Related Quality of Life
(HRQL), and 20 focused on other constructs. Three of the symptoms scales
were specifically designed for a study (no metric properties evaluated),
and only five have been included in a published study in the last decade.
Regarding functional status, reliability and validity have been assessed
for Duke Activity Index and Seattle Angina Questionnaire, which present
multiple language versions. For HRQL, most of the PROMs included physical,
emotional, and social domains. Responsiveness has only been evaluated for
10 out the 21 HRQL PROMs identified. Other constructs included
psychological aspects, self-efficacy, attitudes, perceptions, threats and
expectations about the treatment, knowledge, adjustment, or limitation for
work, social support, or self-care. <br/>Conclusion(s): There is a wide
variety of instruments to assess the patients' perspective in CHD,
covering several constructs. This is the first systematic review of
specific PROMs for CHD including all constructs. It has practical
significance, as it summarizes relevant information that may help
clinicians, researchers, and other healthcare stakeholders to choose the
most adequate instrument for promoting shared decision making in a trend
towards value-based healthcare.<br/>Copyright &#xa9; 2022, The Author(s).

<110>
Accession Number
2025143269
Title
Effectiveness and quality of life in lung cancer, pre-, post- and
perioperative rehabilitation - A review.
Source
Physiology International. 110(2) (pp 89-107), 2023. Date of Publication:
June 2023.
Author
Abidi Y.; Fekete M.; Farkas A.; Horvath A.; Varga J.T.
Institution
(Abidi, Varga) Department of Pulmonology, Semmelweis University, Budapest
H-1083, Hungary
(Fekete) Department of Public Health, Faculty of Medicine, Semmelweis
University, Budapest, Hungary
(Farkas) Centre for Energy Research, Budapest H-1121, Hungary
(Horvath) Chiesi Hungary Kft., Budapest H-1138, Hungary
(Varga) Department of Pulmonary Rehabilitation, National Koranyi Institute
of Pulmonology, Budapest H-1122, Hungary
Publisher
Akademiai Kiado ZRt.
Abstract
Functional conditions like lung function and exercise capacity are
important limiting factors of chest surgery in lung cancer with
co-morbidities (chronic obstructive pulmonary disease (COPD) and other
chronic respiratory diseases). Pulmonary rehabilitation has a favourable
effect on the cardiovascular system, metabolism, respiratory and
peripheral muscles and lung mechanics. Our aim was to assess the role of
pre-, post- and peri-operative pulmonary rehabilitation in lung cancer in
this review. We sought to size up the importance of pulmonary
rehabilitation in patients undergoing surgery with or without
(neo)adjuvant treatment, radiotherapy, chemotherapy, chemoradiotherapy,
major physiological impairments and complications. Searches were performed
in PubMed and ClinicalTrials.gov databases using the terms "exercise",
"rehabilitation", "small cell lung cancer", "non-small cell lung cancer",
"exercise capacity", "chest surgery"and "quality of life"from inception to
February 7th, 2022. Pulmonary rehabilitation has been recognized as an
effective intervention to reduce lung cancer related symptoms and improve
the pulmonary function, lung mechanics, chest kinematics, respiratory- and
peripheral muscle function, physical activity and quality of life (QoL) of
the patients. In conclusion, this review shows positive, highly
encouraging and effective results of pulmonary rehabilitation in terms of
the patients' lung function, functional mobility and quality of life. The
tools for complex pulmonary rehabilitation have evolved considerably over
the past two decades, thus this research has been conducted on a variety
of studies about this subject and serves as a synthesis of the systematic
and meta-analytic reviews. <br/>Copyright &#xa9; 2023 The Author(s).

<111>
Accession Number
2024317233
Title
Hybrid Ablation Versus Repeated Catheter Ablation in Persistent Atrial
Fibrillation: A Randomized Controlled Trial.
Source
JACC: Clinical Electrophysiology. Part 2. 9(7) (pp 1013-1023), 2023. Date
of Publication: July 2023.
Author
van der Heijden C.A.J.; Weberndorfer V.; Vroomen M.; Luermans J.G.;
Chaldoupi S.-M.; Bidar E.; Vernooy K.; Maessen J.G.; Pison L.; van Kuijk
S.M.J.; La Meir M.; Crijns H.J.G.M.; Maesen B.
Institution
(van der Heijden, Bidar, Maessen, La Meir, Maesen) Department of
Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht,
Netherlands
(Weberndorfer, Vroomen, Luermans, Chaldoupi, Vernooy, Crijns) Department
of Cardiology, Maastricht University Medical Center, Maastricht,
Netherlands
(Weberndorfer, Luermans, Chaldoupi, Bidar, Vernooy, Maessen, Crijns,
Maesen) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Vroomen) Department of Cardiac Surgery, Robert Bosch Hospital, Stuttgart,
Germany
(Pison) Department of Cardiology, Hospital Oost Limburg, Genk, Belgium
(van Kuijk) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Centre, Maastricht, Netherlands
(La Meir) Department of Cardiac Surgery, UZ Brussel, Brussels, Belgium
Publisher
Elsevier Inc.
Abstract
Background: Although catheter ablation (CA) is successful for the
treatment of paroxysmal atrial fibrillation (AF), results are less
satisfactory in persistent AF. Hybrid ablation (HA) results in better
outcomes in patients with persistent atrial fibrillation (persAF), as it
combines a thoracoscopic epicardial and transvenous endocardial approach
in a single procedure. <br/>Objective(s): The purpose of this study was to
compare the effectiveness and safety of HA with CA in a prospective,
superiority, unblinded, randomized controlled trial. <br/>Method(s):
Forty-one ablation-naive patients with (long-standing)-persAF were
randomized to HA (n = 19) or CA (n = 22) and received pulmonary vein
isolation, posterior left atrial wall isolation and, if needed, a
cavotricuspid isthmus ablation. The primary efficacy endpoint was freedom
from any atrial tachyarrhythmia >5 minutes off antiarrhythmic drugs after
12 months. The primary and secondary safety endpoints included major and
minor complications and the total number of serious adverse events.
<br/>Result(s): After 12 months, the freedom of atrial tachyarrhythmias
off antiarrhythmic drugs was higher in the HA group compared with the CA
group (89% vs 41%, P = 0.002). There was 1 pericarditis requiring
pericardiocentesis and 1 femoral arteriovenous-fistula in the HA group. In
the CA arm, 1 bleeding from the femoral artery occurred. There were no
deaths, strokes, need for pacemaker implantation, or conversions to
sternotomy, and the number of (serious) adverse events was comparable
between groups (21% vs 14%, P = 0.685). <br/>Conclusion(s): Hybrid AF
ablation is an efficacious and safe procedure and results in better
outcomes than catheter ablation for the treatment of patients with
persistent AF. (Hybrid Versus Catheter Ablation in Persistent AF
[HARTCAP-AF]; NCT02441738)<br/>Copyright &#xa9; 2023 The Authors

<112>
Accession Number
2023727262
Title
Interventional Cardio-Oncology: Unique Challenges and Considerations in a
High-Risk Population.
Source
Current Treatment Options in Oncology. 24(8) (pp 1071-1087), 2023. Date of
Publication: August 2023.
Author
Leiva O.; Alam U.; Bohart I.; Yang E.H.
Institution
(Leiva) Division of Cardiology, Department of Medicine, New York
University Grossman School of Medicine, New York, NY, United States
(Alam, Bohart) Department of Medicine, New York University Grossman School
of Medicine, New York, NY, United States
(Yang) Division of Cardiology, Department of Medicine, UCLA
Cardio-Oncology Program, University of California at Los Angeles, 100
Medical Plaza, Suite 630, Los Angeles, CA 90095, United States
Publisher
Springer
Abstract
Patients with cancer are at risk of developing cardiovascular disease
(CVD) including atherosclerotic heart disease (AHD), valvular heart
disease (VHD), and atrial fibrillation (AF). Advances in percutaneous
catheter-based treatments, including percutaneous coronary intervention
(PCI) for AHD, percutaneous valve replacement or repair for VHD, and
ablation and left atrial appendage occlusion devices (LAAODs) for AF, have
provided patients with CVD significant benefit in the recent decades.
However, trials and registries investigating outcomes of these procedures
often exclude patients with cancer. As a result, patients with cancer are
less likely to undergo these therapies despite their benefits. Despite the
inclusion of cancer patients in randomized clinical trial data, studies
suggest that cancer patients derive similar benefits of percutaneous
therapies for CVD compared with patients without cancer. Therefore,
percutaneous interventions for CVD should not be withheld in patients with
cancer, as they may still benefit from these procedures.<br/>Copyright
&#xa9; 2023, The Author(s).

<113>
Accession Number
2016536944
Title
Outcomes of cardiac surgical procedures performed by trainees versus
consultants: A systematic review with meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(2) (pp 612-627.e35),
2023. Date of Publication: August 2023.
Author
Escorel Neto A.C.; Sa M.P.; Van den Eynde J.; Rotbi H.; Do-Nguyen C.C.;
Olive J.K.; Cavalcanti L.R.P.; Torregrossa G.; Sicouri S.; Ramlawi B.;
Hussein N.
Institution
(Escorel Neto, Cavalcanti) Division of Cardiovascular Surgery of Pronto
Socorro Cardiologico de Pernambuco - PROCAPE, Recife, Brazil
(Escorel Neto, Cavalcanti) University of Pernambuco - UPE, Recife, Brazil
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Main Line Health, Wynnewood, PA, United States
(Sa, Sicouri, Ramlawi) Department of Cardiac Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, PA, United States
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Radboud Institute for Health Sciences, Department of Physiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Do-Nguyen) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich, United States
(Olive) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
(Hussein) Department of Congenital Cardiac Surgery, Yorkshire Heart
Centre, Leeds General Infirmary, Leeds, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objectives: Cardiac surgery is highly demanding and the ideal teaching
method to reach competency is widely debated. Some studies have shown that
surgical trainees can safely perform full operations with equivocal
outcomes compared with their consultant colleagues while under
supervision. We aimed to compare outcomes after cardiac surgery with
supervised trainee involvement versus consultant-led procedures.
<br/>Method(s): We systematically reviewed databases (PubMed/MEDLINE,
Embase, the Cochrane Central Register of Controlled Trials,
ClinicalTrials.gov, Google Scholar) and reference lists of relevant
articles for studies that compared outcomes of cardiac surgery performed
by trainees versus consultants. Primary end points included: operative
mortality, coronary events, neurological/renal complications, reoperation,
permanent pacemaker implantation, and sternal complications. Secondary
outcomes included cardiopulmonary bypass and aortic cross-clamp times and
intensive care/in-hospital length of stay. Random effects meta-analysis
was performed. <br/>Result(s): Thirty-three observational studies that
reported on a total of 81,616 patients (trainee: 20,154; consultant:
61,462) were included. There was a difference favoring trainees in terms
of operative mortality in the main analysis and in an analysis restricted
to propensity score-matched samples, whereas other outcomes were not
consistently different in both analyses. Overall cardiopulmonary bypass
and aortic cross-clamp times were longer in the trainee group but did not
translate in longer intensive care unit or hospital stay.
<br/>Conclusion(s): In the right conditions, good outcomes are possible in
cardiac surgery with trainee involvement. Carefully designed training
programs ensuring graduated hands-on operative exposure as primary
operator with appropriate supervision is fundamental to maintain
high-quality training in the development of excellent cardiac
surgeons.<br/>Copyright &#xa9; 2021

<114>
Accession Number
640694639
Title
Posterior pericardiotomy for the prevention of atrial fibrillation after
cardiac surgery: a systematic review and meta-analysis of 25 randomised
controlled trials.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
19(4) (pp e305-e317), 2023. Date of Publication: 17 Jul 2023.
Author
Abdelaziz A.; Hafez A.H.; Elaraby A.; Roshdy M.R.; Abdelaziz M.; Eltobgy
M.A.; Elsayed H.; El-Samahy M.; Elbehbeh N.A.; Philip K.G.; Abdelaty A.M.;
Rizk M.A.; Al-Tawil M.; AboElfarh H.E.; Ramadan A.; Ghaith H.S.; Wahsh
E.A.; Abdelazeem B.; Fayed B.
Institution
(Abdelaziz, Hafez, Elaraby, Roshdy, Abdelaziz, Eltobgy, Elsayed,
El-Samahy, Elbehbeh, Philip, Abdelaty, Rizk, Al-Tawil, AboElfarh, Ramadan,
Ghaith, Wahsh, Abdelazeem) Medical Research Group of Egypt (MRGE), Cairo,
Egypt
(Abdelaziz, Hafez, Elaraby, Abdelaziz, Ghaith) Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Roshdy, Philip) Faculty of Medicine, Sohag University, Sohag, Egypt
(Eltobgy) Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
(Elsayed, El-Samahy, Elbehbeh, Abdelaty, Rizk) Faculty of Medicine,
Zagazig University, Zagazig, Egypt
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(AboElfarh) Mansoura Manchester Programme for Medical Education, Faculty
of Medicine, Mansoura University, Mansoura, Egypt
(Ramadan) Faculty of Medicine, South Valley University, Egypt
(Wahsh) Department of Clinical Pharmacy, Faculty of Pharmacy, October 6
University, Giza, Egypt
(Abdelazeem) McLaren Flint Hospital, Flint, MI, United States
(Abdelazeem) Michigan State University, East Lansing, MI, United States
(Fayed) Cardiothoracic Surgery Department, Faculty of Medicine, Port Said
University, Port Said, Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial fibrillation (AF) associated with postoperative
pericardial effusion is the most commonly reported adverse event after
cardiac surgery. AIMS: We aimed to determine the role of posterior
pericardiotomy in preventing postoperative AF (POAF). <br/>METHOD(S): We
searched PubMed, Scopus, Web of Science, Ovid, and EBSCO from inception
until 30 June 2022. We included randomised clinical trials (RCTs) that
compared posterior pericardiotomy (PP) versus control (no PP) in patients
undergoing cardiac surgery. The primary endpoint was the incidence of POAF
after cardiac surgery. The secondary endpoints were supraventricular
arrhythmias, early/late pericardial effusion, pericardial tamponade,
pleural effusion, length of hospital/intensive care unit stay,
intra-aortic balloon pump use, revision surgery for bleeding, and
mortality. <br/>RESULT(S): Twenty-five RCTs comprising 4,467 patients were
included in this systematic review and meta-analysis. The overall
incidence rate of POAF was 11.7% in the PP group compared with 23.67% in
the no PP or control group, with a significant decrease in the risk of
POAF following PP (odds ratio [OR] 0.49, 95% confidence interval [CI]:
0.38-0.61). Compared with the control group, the risk of supraventricular
tachycardia (OR 0.66, 95% CI: 0.43-0.89), early pericardial effusion (OR
0.32, 95% CI: 0.22-0.46), late pericardial effusion (OR 0.15, 95% CI:
0.09-0.25), and pericardiac tamponade (OR 0.18, 95% CI: 0.10-0.33) were
lower in the PP group. <br/>CONCLUSION(S): PP is an effective intervention
for reducing the risk of POAF after cardiac surgery. Also, PP is
economically efficient in terms of decreasing the length of hospital stay.

<115>
Accession Number
2024464921
Title
Intramyocardial Stem Cell Transplantation during Coronary Artery Bypass
Surgery Safely Improves Cardiac Function: Meta-Analysis of 20 Randomized
Clinical Trials.
Source
Journal of Clinical Medicine. 12(13) (no pagination), 2023. Article
Number: 4430. Date of Publication: July 2023.
Author
Soetisna T.W.; Thamrin A.M.H.; Permadijana D.; Ramadhani A.N.E.; Sugisman;
Santoso A.; Mansyur M.
Institution
(Soetisna, Thamrin, Permadijana, Ramadhani, Sugisman) Adult Cardiac
Surgery Division, Department of Thoracic and Cardiovascular Surgery,
Harapan Kita National Cardiovascular Center Hospital, Jakarta 11420,
Indonesia
(Soetisna, Sugisman) Department of Thoracic and Cardiovascular Surgery,
Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia
(Thamrin) Faculty of Medicine, Syarif Hidayatullah State Islamic
University, Haji Hospital, Jakarta 13560, Indonesia
(Santoso) Department of Cardiology and Vascular Medicine, Harapan Kita
National Cardiovascular Center Hospital, Jakarta 11420, Indonesia
(Santoso) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, University of Indonesia, Jakarta 10430, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
University of Indonesia, Jakarta 10430, Indonesia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
IMSC transplantation during CABG is considered one of the most promising
methods to effectively deliver stem cells and has been widely studied in
many trials. But the results of outcomes and safety of this modality still
vary widely. We conducted this meta-analysis of randomized controlled
trials (RCTs) to evaluate not only the outcome but also the safety of this
promising method. A meta-analysis was performed according to Preferred
Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)
guidelines. A comprehensive literature search was undertaken using the
PubMed, Scopus, and Cochrane databases. Articles were thoroughly evaluated
and analyzed. Twenty publications about IMSC during CABG were included.
Primary outcomes were measured using LVEF, LVESV, LVESVI, LVESD, LVEDV,
LVEDVI, LVEDD, WMSI, and 6-MWT. Safety measures were depicted by total
deaths, MACE, CRD, CVA, myocardial infarction, ventricular arrhythmia, and
cardiac-related readmission. IMSC transplantation during CABG
significantly improved LVEF (MD = 3.89%; 95% CI = 1.31% to 6.46%; p =
0.003) and WMSI (MD = 0.28; 95% CI = 0.01-0.56; p = 0.04). Most of the
other outcomes showed favorable results for the IMSC group but were not
statistically significant. The safety analysis also showed no significant
risk difference for IMSC transplantation compared to CABG alone. IMSC
during CABG can safely improve cardiac function and tend to improve
cardiac volumes and dimensions. The analysis and application of
influencing factors that increase patients' responses to IMSC
transplantation are important to achieve long-term
improvement.<br/>Copyright &#xa9; 2023 by the authors.

<116>
Accession Number
2025858889
Title
Bempedoic Acid for Primary Prevention of Cardiovascular Events in
Statin-Intolerant Patients.
Source
JAMA. 330(2) (pp 131-140), 2023. Date of Publication: 11 Jul 2023.
Author
Nissen S.E.; Menon V.; Nicholls S.J.; Brennan D.; Laffin L.; Ridker P.;
Ray K.K.; Mason D.; Kastelein J.J.P.; Cho L.; Libby P.; Li N.; Foody J.;
Louie M.J.; Lincoff A.M.
Institution
(Nissen, Menon, Brennan, Laffin, Mason, Cho, Lincoff) Cleveland Clinic,
Cleveland, OH, United States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Ridker, Libby) Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Ray) Imperial College London, London, United Kingdom
(Kastelein) University of Amsterdam, Academic Medical Center, Amsterdam,
Netherlands
(Li, Foody, Louie) Esperion Therapeutics Inc, Ann Arbor, MI, United States
Publisher
American Medical Association
Abstract
Importance: The effects of bempedoic acid on cardiovascular outcomes in
statin-intolerant patients without a prior cardiovascular event (primary
prevention) have not been fully described. <br/>Objective(s): To determine
the effects of bempedoic acid on cardiovascular outcomes in primary
prevention patients. <br/>Design, Setting, and Participant(s): This
masked, randomized clinical trial enrolled 13970 statin-intolerant
patients (enrollment December 2016 to August 2019 at 1250 centers in 32
countries), including 4206 primary prevention patients.
<br/>Intervention(s): Participants were randomized to oral bempedoic acid,
180 mg daily (n = 2100), or matching placebo (n = 2106). <br/>Main Outcome
Measure(s): The primary efficacy measure was the time from randomization
to the first occurrence of any component of a composite of cardiovascular
death, nonfatal myocardial infarction (MI), nonfatal stroke, or coronary
revascularization. <br/>Result(s): Mean participant age was 68 years, 59%
were female, and 66% had diabetes. From a mean baseline of 142.2 mg/dL,
compared with placebo, bempedoic acid reduced low-density lipoprotein
cholesterol levels by 30.2 mg/dL (21.3%) and high-sensitivity C-reactive
protein levels by 0.56 mg/L (21.5%), from a median baseline of 2.4 mg/L.
Follow-up for a median of 39.9 months was associated with a significant
risk reduction for the primary end point (111 events [5.3%] vs 161 events
[7.6%]; adjusted hazard ratio [HR], 0.70 [95% CI, 0.55-0.89]; P =.002) and
key secondary end points, including the composite of cardiovascular death,
MI, or stroke (83 events [4.0%] vs 134 events [6.4%]; HR, 0.64 [95% CI,
0.48-0.84]; P <.001); MI (29 events [1.4%] vs 47 events [2.2%]; HR, 0.61
[95% CI, 0.39-0.98]); cardiovascular death (37 events [1.8%] vs 65 events
[3.1%]; HR, 0.61 [95% CI, 0.41-0.92]); and all-cause mortality (75 events
[3.6%] vs 109 events [5.2%]; HR, 0.73 [95% CI, 0.54-0.98]). There was no
significant effect on stroke or coronary revascularization. Adverse
effects with bempedoic acid included a higher incidence of gout (2.6% vs
2.0%), cholelithiasis (2.5% vs 1.1%), and increases in serum creatinine,
uric acid, and hepatic enzyme levels. <br/>Conclusion(s): In a subgroup of
high-risk primary prevention patients, bempedoic acid treatment was
associated with reduced major cardiovascular events. Trial Registration:
ClinicalTrials.gov Identifier: NCT02993406.<br/>Copyright &#xa9; 2023
American Medical Association. All rights reserved.

<117>
Accession Number
2025823388
Title
Effects of high-intensity interval training on cardiac remodelling,
function and coronary microcirculation in de novo heart transplant
patients: a substudy of the HITTS randomised controlled trial.
Source
BMJ Open Sport and Exercise Medicine. 9(3) (no pagination), 2023. Article
Number: e001331. Date of Publication: 09 Jul 2023.
Author
Rafique M.; Solberg O.G.; Gullestad L.; Bendz B.; Murbraech K.; Nytroen
K.; Rolid K.; Lunde K.
Institution
(Rafique, Solberg, Gullestad, Bendz, Murbraech, Lunde) Department of
Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
(Rafique, Bendz, Nytroen, Rolid) Institute of Clinical Medicine, Faculty
of Medicine, University of Oslo, Oslo, Norway
(Gullestad) Kg Jebsen Center for Cardiac Research, University of Oslo,
Oslo, Norway
(Gullestad) Center for Heart Failure Research, Oslo University Hospital,
Oslo, Norway
Publisher
BMJ Publishing Group
Abstract
Objectives High-intensity interval training (HIT) improves peak oxygen
consumption (VO2peak) in de novo heart transplant (HTx) recipients. It
remains unclear whether this improvement early after HTx is solely
dependent on peripheral adaptations, or due to a linked chain of central
and peripheral adaptations. The objective of this study was to determine
whether HIT results in structural and functional adaptations in the
cardiovascular system. Methods Eighty-one de novo HTx recipients were
randomly assigned to participate in either 9 months of supervised HIT or
standard care exercise-based rehabilitation. Cardiac function was assessed
by echocardiogram and the coronary microcirculation with the index of
microcirculatory resistance (IMR) at baseline and 12 months after HTx.
Results Cardiac function as assessed by global longitudinal strain was
significantly better in the HIT group than in the standard care group
(16.3+/-1.2% vs 15.6+/-2.2%, respectively, treatment effect = -1.1% (95%
CI -2.0% to -0.2%), p=0.02), as was the end-diastolic volume (128.5+/-20.8
mL vs 123.4+/-15.5 mL, respectively, treatment effect=4.9 mL (95% CI 0.5
to 9.2 mL), p=0.03). There was a non-significant tendency for IMR to
indicate improved microcirculatory function (13.8+/-8.0 vs 16.8+/-12.0,
respectively, treatment effect = -4.3 (95% CI -9.1 to 0.6), p=0.08).
Conclusion When initiated early after HTx, HIT leads to both structural
and functional cardiovascular adaptations. Trial registration number
NCT01796379. <br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<118>
Accession Number
2025763645
Title
Patient-, Clinician-, and Institution-level Variation in Inotrope Use for
Cardiac Surgery: A Multicenter Observational Analysis.
Source
Anesthesiology. 139(2) (pp 122-141), 2023. Date of Publication: 01 Aug
2023.
Author
Mathis M.R.; Janda A.M.; Kheterpal S.; Schonberger R.B.; Pagani F.D.;
Engoren M.C.; Mentz G.B.; Shook D.C.; Muehlschlegel J.D.; Cassidy R.;
Clark D.J.; Colquhoun D.A.; Freundlich R.E.; Jewell E.S.
Institution
(Mathis, Janda, Kheterpal, Engoren, Mentz, Colquhoun, Freundlich, Jewell)
Department of Anesthesiology, University of Michigan Medical School, Ann
Arbor, MI, United States
(Mathis) Department of Computational Bioinformatics, University of
Michigan Medical School, Ann Arbor, MI, United States
(Schonberger) Department of Anesthesiology, Yale School of Medicine, New
Haven, CT, United States
(Pagani) Department of Cardiac Surgery, University of Michigan Medical
School, Ann Arbor, MI, United States
(Shook, Muehlschlegel) Department of Anesthesiology, Perioperative, Pain
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Cassidy) Department of Anesthesiology, University of Michigan Medical
School, United States
(Clark) Department of Anesthesiology, Stanford University, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Conflicting evidence exists regarding the risks and benefits
of inotropic therapies during cardiac surgery, and the extent of variation
in clinical practice remains understudied. Therefore, the authors sought
to quantify patient-, anesthesiologist-, and hospital-related
contributions to variation in inotrope use. <br/>Method(s): In this
observational study, nonemergent adult cardiac surgeries using
cardiopulmonary bypass were reviewed across a multicenter cohort of
academic and community hospitals from 2014 to 2019. Patients who were
moribund, receiving mechanical circulatory support, or receiving
preoperative or home inotropes were excluded. The primary outcome was an
inotrope infusion (epinephrine, dobutamine, milrinone, dopamine)
administered for greater than 60 consecutive min intraoperatively or
ongoing upon transport from the operating room. Institution-, clinician-,
and patient-level variance components were studied. <br/>Result(s): Among
51,085 cases across 611 attending anesthesiologists and 29 hospitals,
27,033 (52.9%) cases received at least one intraoperative inotrope,
including 21,796 (42.7%) epinephrine, 6,360 (12.4%) milrinone, 2,000
(3.9%) dobutamine, and 602 (1.2%) dopamine (non-mutually exclusive).
Variation in inotrope use was 22.6% attributable to the institution, 6.8%
attributable to the primary attending anesthesiologist, and 70.6%
attributable to the patient. The adjusted median odds ratio for the same
patient receiving inotropes was 1.73 between 2 randomly selected
clinicians and 3.55 between 2 randomly selected institutions. Factors most
strongly associated with increased likelihood of inotrope use were
institutional medical school affiliation (adjusted odds ratio, 6.2; 95%
CI, 1.39 to 27.8), heart failure (adjusted odds ratio, 2.60; 95% CI, 2.46
to 2.76), pulmonary circulation disorder (adjusted odds ratio, 1.72; 95%
CI, 1.58 to 1.87), loop diuretic home medication (adjusted odds ratio,
1.55; 95% CI, 1.42 to 1.69), Black race (adjusted odds ratio, 1.49; 95%
CI, 1.32 to 1.68), and digoxin home medication (adjusted odds ratio, 1.48;
95% CI, 1.18 to 1.86). <br/>Conclusion(s): Variation in inotrope use
during cardiac surgery is attributable to the institution and to the
clinician, in addition to the patient. Variation across institutions and
clinicians suggests a need for future quantitative and qualitative
research to understand variation in inotrope use affecting outcomes and
develop evidence-based, patient-centered inotrope therapies.<br/>Copyright
&#xa9; 2023 Lippincott Williams and Wilkins. All rights reserved.

<119>
Accession Number
2025693385
Title
Anticoagulant therapy during cardiovascular implantable electronic device
procedures.
Source
Postepy w Kardiologii Interwencyjnej. 19(2) (pp 99-112), 2023. Date of
Publication: 2023.
Author
Daubaraite A.; Marinskis G.; Rackauskas G.
Institution
(Daubaraite) Faculty of Medicine, Vilnius University, Vilnius, Lithuania
(Marinskis, Rackauskas) Centre of Cardiology and Angiology, Vilnius
University Hospital Santaros Klinikos, Vilnius, Lithuania
Publisher
Termedia Publishing House Ltd.
Abstract
Aim: The objective of the study is to systematically evaluate the safety
and efficacy of peri-procedural utilization of anticoagulation therapy
during cardiovascular implantable electronic device procedures.
<br/>Material(s) and Method(s): The review materials were based on
comprehensive retrieval of randomized controlled trials and observational
studies published until April 2023. Studies which compared different
management strategies of long-term anticoagulation therapy during
peri-procedural cardiac rhythm device implantation and compared the
complications of bleeding and/or thromboembolic events were selected and
reviewed. <br/>Result(s): Studies analysing non-vitamin K oral
anticoagulants interruption versus continuation during peri-procedural
implantable cardiac device surgery found no statistically significant
difference in bleeding or thromboembolic complications between these
strategies. Studies comparing non-vitamin K oral anticoagulants with
vitamin K antagonists also showed no statistically significant difference.
One study comparing uninterrupted warfarin with interrupted warfarin with
heparin bridging reported a reduced incidence of clinically significant
device pocket haematoma in patients with continued warfarin treatment
(relative risk = 0.19; 95% confidence interval: 0.10 to 0.36; p < 0.001).
A sub-analysis of one study comparing dabigatran versus warfarin with
heparin bridging and without bridging reported a lower risk of pocket
haematoma with dabigatran when compared to warfarin with heparin bridging
(risk difference: -8.62%, 95% confidence interval: -24.15 to -0.51%; p =
0.034). Both bleeding and thromboembolic complications were rare.
<br/>Conclusion(s): The traditional method of vitamin K antagonists
interruption with heparin bridging is less safe than continuing vitamin K
antagonists at therapeutic levels. Both continuation and interruption
strategies of non-vitamin K anticoagulants during cardiac device surgery
seem to be safe and appropriate.<br/>Copyright &#xa9; 2023 Termedia
Publishing House Ltd.. All rights reserved.

<120>
Accession Number
2025638898
Title
Percutaneous Left Atrial Appendage Occlusion Therapy: Past, Present, and
Future.
Source
Cardiovascular Innovations and Applications. 8 (no pagination), 2023.
Article Number: 16. Date of Publication: 2023.
Author
Han X.; Dong J.; Benditt D.G.
Institution
(Han) Indiana University School of Medicine, Cardiology Division, Reid
Health, Richmond, IN 47374, United States
(Dong) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing 100029, China
(Dong) Department of Cardiology, The First Affiliated Hospital, Zhengzhou
University, Zhengzhou 450052, China
(Benditt) Cardiac Arrhythmia Center, Cardiovascular Division, Department
of Medicine, University of Minnesota Medical School, Minneapolis, MN
55455, United States
Publisher
Compuscript Ltd
Abstract
Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is
increasing in incidence and prevalence worldwide. AF significantly
increases the risk of intracardiac thrombus formation and, if left
untreated, ischemic stroke. In patients with nonvalvular AF (NVAF), the
left atrial appendage (LAA) has been determined to be the source of
thrombus development in 91% to 99% of cases. In this regard, oral
anticoagulants (OACs) have become the standard treatment for stroke
prevention in most patients with AF; however, OACs are associated with a
risk of bleeding complications, and their efficacy depends on optimal
patient compliance. Among alternative approaches to embolic stroke
prevention, surgical LAA excision for stroke prevention for valvular AF
was attempted as early as the late 1940s. LAA excision remains recommended
in surgical guidelines for patients with NVAF requiring open-heart
coronary bypass or valvular replacement/repair surgeries. However, owing
to the traumatic/invasive nature and suboptimal outcomes of conventional
surgical LAA intervention, clinical application of this approach is
limited in current cardiology practice. Percutaneous LAA occlusion (LAAO)
is increasingly being performed as an alternative to OAC for stroke
prevention, particularly in patients with elevated bleeding risk.
Substantial progress has been made in percutaneous LAAO therapy since its
inception approximately 20 years ago. This article systematically reviews
the literature leading to the development of LAAO and the evidence-based
clinical experience supporting the application of this treatment strategy
for NVAF, with a focus on recently published critical evaluations of US
FDA and CE mark approved LAAO devices. Future perspectives regarding
knowledge and technology gaps are also discussed, recognizing the many
ongoing clinical trials that are likely to be transformative and the
critical unanswered questions regarding LAAO therapy.<br/>Copyright &#xa9;
2023 Cardiovascular Innovations and Applications. Creative Commons
Attribution-NonCommercial 4.0 International License

<121>
Accession Number
2025804793
Title
Prediction of adverse outcomes in nonischemic dilated cardiomyopathy: A
CMR-based nomogram.
Source
International Journal of Cardiology. (no pagination), 2023. Article
Number: 131136. Date of Publication: 2023.
Author
Xiang X.; Zhao K.; Chen X.; Song Y.; Yang K.; Yu S.; Yang S.; Wang J.;
Dong Z.; Lu M.; Ma L.; Zhao S.
Institution
(Xiang, Chen, Song, Yang, Yu, Yang, Wang, Dong, Lu, Zhao) MR Center, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing 100037, China
(Zhao) Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen
Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen
518055, China
(Ma) First Affiliated Hospital of USTC, Division of Life Sciences and
Medicine, University of Science and Technology of China, Anhui 230036,
China
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: To develop and validate a novel nomogram score to predict
outcomes in patients with nonischemic dilated cardiomyopathy (NIDCM) over
a long follow-up period. <br/>Method(s): A total of 335 consecutive NIDCM
patients who underwent cardiac magnetic resonance (CMR) imaging were
retrospectively enrolled. Comprehensive clinical evaluation and imaging
investigation were obtained, including measurements of late gadolinium
enhancement (LGE) and feature tracking (FT) images. All patients were
followed up for a composite endpoint of major adverse cardiac events
(MACE) including all-cause mortality and heart transplantation. These
patients were randomly divided into development and validation cohorts
(7:3). <br/>Result(s): MACE occurred in 87 (37.2%) out of 234 patients in
the development cohort, and in 31 (30.7%) out of 101 patients in the
validation cohort. Five variables including NYHA class III-IV, NT-proBNP,
beta-blocker medication, LGE presence, and LV global longitudinal strain
(GLS) were found to be significantly associated with MACE and were used
for constructing the nomogram. The nomogram achieved good discrimination
with C-indexes in development and validation cohorts respectively. The
calibration curve for 1-, 3-, and 5-year survival probability also showed
high coherence between the predicted and actual probability of MACE.
Decision curve analysis identified the model was significantly better net
benefit in predicting MACE. <br/>Conclusion(s): A novel nomogram score of
a predictive model that incorporates clinical factors and imaging features
was constructed, which could be conveniently used to facilitate risk
evaluation in patients with NIDCM.<br/>Copyright &#xa9; 2023

<122>
Accession Number
641827930
Title
Intercostal Nerve Cryoablation for Postoperative Pain Control in Pediatric
Thoracic Surgery: A Scoping Review.
Source
Journal of laparoendoscopic & advanced surgical techniques. Part A. (no
pagination), 2023. Date of Publication: 18 Jul 2023.
Author
Lai K.; Eldredge R.S.; Zobel M.; Hargis-Villanueva A.; Ostlie A.; Padilla
B.E.
Institution
(Lai, Eldredge, Hargis-Villanueva, Padilla) Division of Pediatric Surgery,
Phoenix Children's Hospital, Phoenix, AZ, United States
(Zobel) Division of Pediatric Surgery, University of California San
Francisco, San Francisco, United States
(Ostlie, Padilla) Department of Child Health, University of Arizona School
of Medicine, Tucson, AZ, United States
Publisher
NLM (Medline)
Abstract
Background: Cryoanalgesia uses the application of cold temperatures to
temporarily disrupt peripheral sensory nerve function for pain control.
This review outlines the principles of cryoablation, clinical
applications, and clinical data for its use in pediatric thoracic surgery.
<br/>Method(s): A comprehensive PubMed search was performed using the
principal terms and combinations of cryoablation, cryoanalgesia, Nuss,
Nuss repair, pectus, pectus excavatum, thoracic surgery, thoracotomy, and
chest wall. Pediatric articles were reviewed and included if relevant.
Adult articles were reviewed for supporting information as needed.
Reference lists of included articles were reviewed for possible additional
sources. <br/>Discussion(s): The scientific and clinical principles of
cryoablation are outlined, followed by a focused review of current
clinical application and outcome data. <br/>Conclusion(s): Postoperative
pain is a major challenge following thoracic surgery. Cryoanalgesia is
emerging as an adjunct in pediatric thoracic surgery, particularly for the
Nuss procedure or minimally invasive repair of pectus excavatum. It
effectively controls pain, decreasing postoperative opioid use and
hospital length of stay with few short-term complications. Although more
long-term studies are needed, early evidence suggests there is reliable
return of sensation to the chest wall and long-term neuropathic pain is
rare.

<123>
Accession Number
641825670
Title
Pharmacologic interventions for the therapy of postanesthetic shivering in
adults: a systematic review and network meta-analysis.
Source
Minerva anestesiologica. (no pagination), 2023. Date of Publication: 17
Jul 2023.
Author
Dinges H.-C.; Al-Dahna T.; Rucker G.; Wulf H.; Eberhart L.; Wiesmann T.;
Schubert A.-K.
Institution
(Dinges) Department of Anesthesia and Intensive Care, University Hospital
Marburg, Marburg, Germany
(Al-Dahna, Wulf, Eberhart, Wiesmann, Schubert) Department of Anesthesia
and Intensive Care, University Hospital Marburg, Marburg, Germany
(Rucker) Faculty of Medicine and Medical Center, Institute of Medical
Biometry and Statistics, University of Freiburg, Freiburg, Germany
(Wiesmann) Department of Anesthesiology and Intensive Care Medicine,
Schwabisch-Hall, Germany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Shivering is a common side effect after general anesthesia.
Risk factors are hypothermia, young age and postoperative pain. Severe
complications of shivering are rare but can occur due to increased oxygen
consumption. Previous systematic reviews are outdated and have summarized
the evidence on the topic using only pairwise comparisons. The objective
of this manuscript was a quantitative synthesis of evidence on
pharmacological interventions to treat postanesthetic shivering. EVIDENCE
ACQUSITION: Systematic review and frequentist network meta-analysis using
the R package netmeta. Endpoints were the risk ratio (RR) of persistent
shivering at 1, 5 and 10 minutes after treatment with saline/placebo as
the comparator. Data were retrieved from Medline, Embase, Central and Web
of Science up to January 2022. Eligibility criteria were: randomized,
controlled, and blinded trials comparing pharmacological interventions to
treat shivering after general anesthesia. Studies on shivering during or
after any type of regional anesthesia were excluded as well as sedated
patients after cardiac surgery. EVIDENCE SYNTHESIS: Thirty-two trials were
eligible for data synthesis, including 28 pharmacological interventions.
The largest network included 1431 patients. The network geometry was
two-centered with most comparisons linked to saline/placebo or pethidine.
The best interventions were after 1 minute: doxapram 2 mg/kg, tramadol 2
mg/kg and nefopam 10 mg, after 5 minutes: tramadol 2 mg/kg, nefopam 10 mg
and clonidine 150 microg and after 10 minutes: nefopam 10 mg,
methylphenidate 20 mg and tramadol 1 mg/kg, all reaching statistical
significance. Pethidine 25 mg and clonidine 75 microg also performed well
and with statistical significance in all networks. <br/>CONCLUSION(S):
Nefopam, tramadol, pethidine and clonidine are the most effective
treatments to stop postanesthetic shivering. The efficacy of doxapram is
uncertain since different doses showed contradictory effects and the
evidence for methylphenidate is based on a single comparison in only one
network. Furthermore, both lack data on side effects. Further studies are
needed to clarify the efficacy of dexmedetomidine to treat postanesthetic
shivering.

<124>
Accession Number
641825657
Title
The effect of peridevice leaks on ischemic stroke/TIA/SE after left atrial
appendage closure: A systematic review and meta-analysis.
Source
Cardiology. (no pagination), 2023. Date of Publication: 17 Jul 2023.
Author
He Y.-G.; Yang S.-H.; Xu L.; Wang Y.; Qin X.-T.; Chen P.-P.; Zhao Y.-J.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Left atrial appendage closure (LAAC) is a safe and effective
method for preventing embolic events in patients with nonvalvular atrial
fibrillation (NVAF). However, peridevice leaks (PDLs) are sometimes
unavoidable. Controversy exists regarding whether PDLs lead to embolic
events. <br/>OBJECTIVE(S): This study aimed to explore the association
between PDLs and embolic events, including ischaemic stroke, transient
ischaemic attacks (TIA), and systemic embolism (SE). <br/>METHOD(S): We
conducted a systematic search of the PubMed, Web of Science, MEDLINE, and
Cochrane Library databases for studies published up to September 25, 2022,
to compare the rate of ischaemic stroke/TIA/SE between the PDL group and
the non-PDL group after LAAC. <br/>RESULT(S): Thirteen studies comprising
54,405 patients were included in the meta-analysis. The PDL group detected
by transoesophageal echocardiography (TEE) had a significantly higher rate
of ischaemic stroke/TIA/SE than the non-PDL group (OR: 1.20, 95% CI:
1.08-1.33, P=0.0009). However, no difference in ischaemic stroke/TIA/SE
was found between the PDL and non-PDL subgroups of the cardiac computed
tomography angiography (CCTA) group (OR: 1.12, 95% CI: 0.51-2.50, P=0.77).
CCTA and TEE showed different rates of PDL detection, with the CCTA group
having a higher rate of PDL detection (P<0.0001), especially for trivial
leaks. <br/>CONCLUSION(S): PDL detected by TEE increases the risk of
embolic events after LAAC. However, no association was found between PDL
and ischaemic stroke/TIA/SE in the CCTA group, which showed a higher rate
of PDL detection than TEE, particularly for trivial leaks. In the future,
CCTA may be used to explore the relationship between PDL size and
ischaemic stroke/TIA/SE.<br/>Copyright S. Karger AG, Basel.

<125>
Accession Number
641825168
Title
Wearable cardiac rhythm monitoring device for detection of post-operative
atrial fibrillation.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 15 Jul 2023.
Author
Hibino M.; Pandey A.K.; Verma S.; Puar P.; Teoh H.; Quan A.; Verma R.; Yau
T.M.; Bisleri G.; Yanagawa B.; Mazer C.D.; Verma A.; Ha A.C.T.
Institution
(Hibino) Division of Cardiothoracic Surgery, Emory University School of
Medicine, Atlanta, GA, United States
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Verma, Bisleri, Yanagawa) Division of Cardiac Surgery, St. Michael's
Hospital of Unity Health Toronto, University of Toronto, Toronto, ON,
Canada;; Division of Cardiovascular Surgery, Department of Surgery,
University of Toronto, Toronto, ON
(Puar, Quan) Division of Cardiac Surgery, St. Michael's Hospital of Unity
Health Toronto, University of Toronto, Toronto, ON, Canada
(Teoh) Division of Cardiac Surgery, St. Michael's Hospital of Unity Health
Toronto, University of Toronto, Toronto, ON, Canada;; Division of
Endocrinology and Metabolism, St. Michael's Hospital of Unity Health
Toronto, Toronto, ON, Canada
(Verma) Royal College of Surgeons in Ireland, Dublin, Ireland
(Yau) Division of Cardiovascular Surgery, Department of Surgery,
University of Toronto, Toronto, ON; Peter Munk Cardiac Centre, University
Health Network, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital of Unity Health
Toronto, Toronto, ON, Canada
(Verma) Division of Cardiology, McGill University, Montreal, QC, Canada
(Ha) Peter Munk Cardiac Centre, University Health Network, Toronto, ON,
Canada;
Publisher
NLM (Medline)
Abstract
PURPOSE: We evaluated the use of a wearable, patch-based cardiac rhythm
monitoring device in detecting post-operative atrial fibrillation (POAF)
among cardiac surgical patients within 30 days after hospital discharge.
DESCRIPTION: From the SEARCH-AF CardioLink-1 trial, we examined rates of
POAF according to surgery type and the incremental value of continuous
cardiac rhythm monitoring among patients who underwent valve surgery. The
primary outcome was cumulative atrial fibrillation/flutter (AF/AFL)
lasting for >=6 minutes detected by continuous monitoring or AF/AFL
documented by a 12-lead electrocardiogram within 30 days of randomization.
EVALUATION: The primary outcome occurred in 8.2%, 13.5%, and 21.2%
patients who underwent isolated CABG, isolated valve surgery, and combine
CABG and valve surgery. Relative to patients who underwent isolated CABG,
those who had valve surgery were more likely to experience POAF. A higher
diagnostic yield was obtained when the patch-based cardiac rhythm monitor
was applied for patients who underwent valve surgery. <br/>CONCLUSION(S):
Use of a wearable, patch-based cardiac monitoring device was an effective
detection strategy among patients undergoing valve surgery given their
higher risk of developing POAF.<br/>Copyright &#xa9; 2023. Published by
Elsevier Inc.