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<1>
Accession Number
2025493076
Title
The safety and efficacy of balloon-expandable versus self-expanding
trans-catheter aortic valve replacement in high-risk patients with severe
symptomatic aortic stenosis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1130354. Date of Publication: 2023.
Author
Senguttuvan N.B.; Bhatt H.; Balakrishnan V.K.; Krishnamoorthy P.; Goel S.;
Reddy P.M.K.; Subramanian V.; Claessen B.E.; Kumar A.; Majmundar M.; Ro
R.; Lerakis S.; Jayaraj R.; Kalra A.; Flather M.; Dangas G.; Tang G.H.L.
Institution
(Senguttuvan, Balakrishnan, Reddy, Subramanian) Department of Cardiology,
Sri Ramachandra Institute of Higher Education and Research, Chennai, India
(Senguttuvan, Bhatt, Claessen, Ro, Lerakis, Dangas) Department of
Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Bhatt, Krishnamoorthy, Goel) Department of Cardiology, Hackensack
Meridian Health, New Jersey, NJ, United States
(Claessen) Department of Cardiology, Amsterdam University Medical Centres,
Amsterdam, Netherlands
(Kumar, Kalra) Department of Internal Medicine, Cleveland Clinic Akron
General, Akron, OH, United States
(Majmundar) Department of Internal Medicine, New York Medical College,
Metropolitan Hospital, New York, NY, United States
(Jayaraj) Jindal Institute of Behavioral Sciences (JIBS), Jindal Global
Institution of Eminence Deemed to Be University, Sonipat, India
(Kalra) Department of Cardiovascular Medicine, Franciscan Health, Indiana,
IN, United States
(Flather) Cardiology, Norwich Medical School, University of East Anglia,
Norwich, United Kingdom
(Tang) Department of Cardiovascular Surgery, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Kalra) Kalra Hospitals, New Delhi, India
Publisher
Frontiers Media SA
Abstract
Aim: Transfemoral Trans-catheter Aortic Valve Replacement (TF-TAVR) is a
safe and effective therapy compared with surgical aortic valve replacement
(SAVR) in patients across all risk profiles using balloon-expandable
valves (BEV) and self-expanding valves (SEV). Our aim was to compare
safety and efficacy of BEV vs. SEV in high-risk patients undergoing
TF-TAVR. Methods and Results: We searched PubMed, EMBASE,
Clinicaltrials.gov, Scopus, and Web of sciences for studies on patients
with severe aortic stenosis undergoing TAVR. Primary outcome was 30-day
all-cause mortality. Secondary outcomes defined by Valve Academic Research
Consortium 2 (VARC-2) criteria were also examined. Six studies with 2,935
patients (1,439 to BEV and 1,496 to SEV) were included. BEV was associated
with lower risk of all-cause mortality (2.2% vs. 4.5%; RR: 0.51; 95% CI:
0.31-0.82; p < 0.006) and cardiovascular mortality [(2.5% vs. 4.3%; RR:
0.54; 95% CI: 0.32-0.90; p = 0.01) at 30 days compared with SEV.
Implantation of more than one valve per procedure (0.78% vs. 5.11%; RR:
0.15; 95% CI: 0.07-0.31; p < 0.00001), and moderate/severe AR/PVL (2.5%
vs. 9.01%; RR: 0.3; 95% CI: 0.17-0.48); p < 0.00001) were also lower in
the BEV arm. Conclusion(s): BEV TAVR is associated with reduced
all-cause mortality (High level of GRADE evidence), cardiovascular
mortality (very low level) at 30 days compared with SEV TAVR in high
surgical risk patients. Data are necessary to determine if the difference
in outcomes persists in longer-term and if the same effects are seen in
lower-risk patients. Systematic Review Registration: identifier,
CRD42020181190. Copyright 2023 Senguttuvan, Bhatt, Balakrishnan,
Krishnamoorthy, Goel, Reddy, Subramanian, Claessen, Kumar, Majmundar, Ro,
Lerakis, Jayaraj, Kalra, Flather, Dangas and Tang.

<2>
Accession Number
2024180281
Title
Effect of angiotensin receptor-neprilysin inhibitor treatment on erectile
dysfunction in heart failure with a reduced ejection fraction.
Source
Marmara Medical Journal. 36(1) (pp 99-104), 2023. Date of Publication: 31
Jan 2023.
Author
Sert S.; Karabay E.; Gungor B.; Yildirimturk O.
Institution
(Sert, Gungor, Yildirimturk) Department of Cardiology, Dr. Siyami Ersek
Thoracic and Cardiovascular Surgery Training and Research Hospital,
Istanbul, Turkey
(Karabay) Department of Urology, Acibadem Kadikoy Hospital, Istanbul,
Turkey
Publisher
Marmara University
Abstract
Objective: Erectile dysfunction (ED) is a common condition in patients
with heart failure (HF), which impairs quality of life. Our study aimed to
compare those patients, who received traditional treatment with a
diagnosis of HF and those who received angiotensin receptor-neprilysin
inhibitor (ARNI) treatment in addition to the current treatment, in terms
of ED at the end of 6 months. Patients and Methods: The study was
planned as a single-center, prospective study. The study included 200
patients with heart failure. The patients' demographic, clinical, and
echocardiographic characteristics were recorded, and an international ED
scoring questionnaire was applied. The participants in the study were
divided into two groups: those who received ARNI treatment and those who
did not. After 6 months, the ED questionnaire was applied to the patients
again and the groups were compared. Result(s): The median age of the
patients was 53 (years). The median ejection fraction (EF) value was
calculated to be 30% and no significant difference was found between the
groups (p: 0.122). It was found that N-terminal pro-brain natriuretic
peptide (NT-pro- BNP) levels measured at the end of the 6th month were
significantly lower in patients who had received ARNI treatment than in
those who had not (respectively, 245 pg/ml, 200 pg/ml; p: 0.003). In the
analysis performed to detect the presence of ED, it was discovered that
the ED score change was significantly higher in the group that had
received 6 months of ARNI treatment (p: 0.031) compared to that in the
group that had not (p: 0.031). When the ED sub-parameters were compared in
terms of the 6-month change rate, it was found that the ARNI group had a
significant increase in terms of ED and sexual satisfaction scores, but no
significant difference was found in the other parameters (p: 0.001, p:
0.029). Conclusion(s): Erectile dysfunction is more common in
patients with heart failure compared to the rest of society and impairs
quality of life. In our study, it was determined that ED complaints
decreased significantly in HF patients, who had received ARNI treatment
for 6 months than in patients who had not. Copyright © 2023,
Marmara University. All rights reserved.

<3>
Accession Number
2024022908
Title
The effect of applying telehealth education to home care of infants after
congenital heart disease surgery.
Source
International Journal for Quality in Health Care. 35(1) (no pagination),
2023. Article Number: mzac102. Date of Publication: 2023.
Author
Zhang Q.-L.; Lin S.-H.; Lin W.-H.; Chen Q.; Cao H.
Institution
(Zhang, Lin, Lin, Chen, Cao) Department of Cardiac Surgery, Fujian
Children's Hospital (Fujian Branch of Shanghai Children's Medical Center),
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
Fujian Medical University, No. 966 of Hengyu Road, Fujian, Fuzhou 350001,
China
Publisher
Oxford University Press
Abstract
Background: The purpose of this study was to investigate the effect of
applying telehealth education to home care of infants after congenital
heart disease (CHD) surgery. Method(s): A prospective randomized
controlled study was conducted from July 2020 to February 2021 in Fujian
Children's Hospital to compare the home care condition of infants after
CHD surgery between the intervention group and the control group.
 Result(s): At 3 months after discharge, parents' caring ability and
CHD knowledge in the intervention group were significantly better than
those in the control group and were significantly improved compared with
those at discharge time (P < 0.05). The parental care burden in the
intervention group was significantly lower than that in the control group
and was significantly lower than that at discharge time (P < 0.05). During
the follow-up period, the rate of loss of follow-up and complications in
the intervention group were significantly lower than those in the control
group (P < 0.05). Conclusion(s): Telehealth education via WeChat can
effectively improve the knowledge of disease and home care ability of
parents of infants after CHD surgery and reduce their home care burden,
which can effectively reduce the incidence of complications and lost to
follow-up rate after discharge. Copyright © 2023 The Author(s).

<4>
Accession Number
2023496585
Title
Effects of Combined Use of Salbutamol/Budesonide in Thoracic Surgery on
Postoperative Myocardial Injury (MINS) - A Prospective Randomized Clinical
Trial.
Source
Drug Design, Development and Therapy. 17 (pp 1025-1036), 2023. Date of
Publication: 2023.
Author
Lin S.; Zhang Y.; Huang X.; Liu J.; Zhang X.; Cheng E.; Zhou Z.
Institution
(Lin, Zhang, Huang, Liu, Zhang, Cheng) Department of Anesthesiology, The
Affiliated Hospital of Xuzhou Medical University, Jiangsu, Xuzhou, China
(Zhou) Department of Anesthesiology, The Affiliated Taian City Central
Hospital of Qingdao University, Shandong, Taian, China
(Liu) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical
University, Jiangsu, Xuzhou, China
(Liu) Jiangsu Province Key Laboratory of Anesthesia and Analgesia
Application Technology, Xuzhou Medical University, Jiangsu, Xuzhou, China
(Liu) NMPA Key Laboratory for Research and Evaluation of Narcotic and
Psychotropic Drugs, Xuzhou Medical University, Jiangsu, Xuzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aims to investigate whether the administration of
salbutamol/budesonide reduced the incidence of myocardial injury in
thoracic surgery. Method(s): The randomized controlled trial included
298 patients over 45 and at high-risk for cardiovascular complications
after lobectomy. Patients in the experimental group were treated with
salbutamol/budesonide after anesthesia induction with fiberoptic
bronchoscope. The primary outcome was the incidence rates of myocardial
injury, assessed before and three days after the operation. The secondary
outcome was respiratory function at each time point during the operation,
including lung compliance and arterial partial pressure of oxygen,
postoperative pulmonary and cardiovascular complications, hospital stay,
pain score, and analgesic dosage. Result(s): In the control group,
the incidence of myocardial injury was 57/150 (38%), while that in the
experimental group was 33/148 (22%); compared between the two groups, the
difference in the incidence of myocardial injury was statistically
significant. The dynamic compliance and static compliance at half an hour
after the start of surgery in the experimental group were significantly
improved. Before leaving the operating room, the difference in arterial
oxygen partial pressure between the two groups was statistically
significant. Conclusion(s): Intraoperative administration of
salbutamol/budesonide reduced the incidence of myocardial injury after
thoracic surgery, improved lung function, and reduced the incidence of
postoperative pulmonary complications. Copyright © 2023 Lin et
al.

<5>
Accession Number
2025692292
Title
Long-term outcomes of valve-sparing aortic root versus composite aortic
valve graft replacement for aortic root aneurysm: Meta-analysis of
reconstructed time-to-event data.
Source
American Journal of Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Chu D.; Serna-Gallegos D.;
Coselli J.S.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Coselli) Division of Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
(Coselli) Texas Heart Institute, Houston, TX, United States
(Coselli) CHI St Luke's-Baylor St. Luke's Medical Center, Houston, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background: We aimed to evaluate the long-term outcomes of valve-sparing
aortic root replacement (VSARR) versus composite aortic valve graft
replacement (CAVGR) for aortic root aneurysms. Method(s):
Meta-analysis of Kaplan-Meier-derived time-to-event data from studies with
follow-up including propensity-score matching or propensity-score
adjustment. Result(s): Six studies met our eligibility criteria,
comprising 3215 patients (1770 patients treated with VSARR and 1445
patients with CAVGR). We observed a statistically significant difference
for overall survival favoring VSARR (HR 0.63, 95%CI 0.49-0.82, P = 0.001),
but no statistically significant difference in the risk of reoperation (HR
0.77, 95%CI 0.51-1.14, P = 0.187) in the overall follow-up. Landmark
analyses revealed that, in the first 10 years after the procedure,
reoperation rates were comparable between VSARR and CAVGR (HR 0.96, 95%CI
0.62-1.48, p = 0.861), but the results beyond 10 years showed improved
rates of freedom from reoperation in patients undergoing VSARR (HR 0.10,
95%CI 0.01-0.78; p = 0.027). Conclusion(s): VSARR seems to confer
better long-term survival and lower risk of reoperation in the follow-up
of patients treated for aortic root aneurysm when compared with
CAVGR. Copyright © 2023 Elsevier Inc.

<6>
Accession Number
641657625
Title
Meta-Analysis of the Prognostic Significance of Carotid Artery Stenosis in
Patients Who Underwent Transcatheter Aortic Valve Implantation.
Source
The 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
NLM (Medline)
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. Copyright © 2023 The Author(s). Published by
Elsevier Inc. All rights reserved.

<7>
Accession Number
641765687
Title
SAFETY AND EFFICACY OF ANTIFIBRINOLYTICS IN COLORECTAL SURGERY: SYSTEMATIC
REVIEW AND META-ANALYSIS.
Source
Diseases of the Colon and Rectum. Conference: American Society of Colon
and Rectal Surgeons Annual Scientific Meeting, ASCRS 2023. Seattle, WA
United States. 66(6) (pp e444-e445), 2023. Date of Publication: June 2023.
Author
Park L.; Archer V.; McKechnie T.; Lee Y.; McIsaac D.; Eskicioglu C.; Moloo
H.
Institution
(Park, Archer, McKechnie, Lee, Eskicioglu) HamiltonONCanada
(McIsaac, Moloo) OttawaONCanada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose/Background: Perioperative bleeding and transfusion is a common
complication in colorectal surgeries, associated with significant
morbidity and mortality. Emerging evidence has demonstrated the safety and
efficacy of prophylactic antifibrinolytic use to decrease perioperative
bleeding. However, the role of TXA use in specific surgical subspecialty
contexts, including colorectal surgery, is unclear. The objective of this
study was to investigate the safety and efficacy of prophylactic
antifibrinolytic use in colorectal surgery patients.
Methods/Interventions: PRISMA and GRADE guidelines were followed. Medline,
Embase, and Cochrane Library databases were searched from inception to
October 2022. We included all comparative studies involving colorectal
surgery patients that studied the effects of intravenous antifibrinolytic
use on blood loss, allogenic red blood cell transfusion, anastomotic
leaks, venous thromboembolism (VTE), seizures, and other safety
parameters. A meta-analysis was performed using random effects models. The
Mantel-Haenszel method was used to report odds ratio (OR) values for
dichotomous variables, and inverse variance weighting was used to
calculate difference in means (MD) for continuous variables.
Results/Outcome(s): Five randomized controlled trials (RCT), a pilot RCT,
and 2 retrospective studies involving 550 colorectal surgery patients and
12632 non-cardiac surgery patients were identified for inclusion.
Meta-analysis demonstrated trends toward decreased perioperative
transfusion (OR 0.78 [0.20, 2.98], p=0.72, i2=42%, n=2 studies)
and decreased blood loss (MD -380.01ml [-1111.88, 351.87], p=0.31
i2=92%, n=2 studies) with TXA use. The use of antifibrinolytics
was associated with decreased rates of anastomotic leaks (OR 0.70 [0.43,
1.14], p=0.15, i2=0%, n= 3 studies). The meta-analyses did not
include the 12632 non-cardiac surgery patients because granular data
pertaining to colorectal surgery patients was not available. Safety
parameters including VTE and seizures could not be pooled, but there were
no differences in safety outcomes that were independently reported by the
included studies. Although the quality of quantitative evidence is low,
this review highlights the need for further study to determine safety and
efficacy of antifibrinolytic use in colorectal surgeries, as it may
improve surgical outcomes. Conclusions/Discussion: Current evidence
suggests no differences in perioperative transfusion, blood loss and
anastomotic leaks with prophylactic antifibrinolytic use in colorectal
surgery. However, considering the trends favouring antifibrinolytics, this
merits further investigation through larger studies dedicated to
colorectal surgery populations.

<8>
Accession Number
641769861
Title
The effect of self-affirmation on anxiety and perceived discomfort in
patients who have undergone open-heart surgery. A randomized controlled
trial.
Source
Applied nursing research : ANR. 72 (pp 151687), 2023. Date of Publication:
01 Aug 2023.
Author
Yildirim M.; Akbal S.; Turkoglu M.
Institution
(Yildirim) Research group on Methodology, Methods, Models and Outcomes of
Health and Social Sciences (M(3)O), Faculty of Health Science and Welfare,
Centre for Health and Social Care Research (CESS), University of
Vic-Central University of Catalonia (UVic-UCC), Vic 08500, Spain
(Akbal) Trakya University, Kesan Hakki Yoruk School of Health, Department
of Nursing, Yusuf Capraz Cad., Turkey
(Turkoglu) Istanbul Mehmet Akif Ersoy, Gogus Kalp ve Damar Cerrahisi
Egitim ve Arastirma Hastanesi, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Self-affirmations help one focus on positive outcomes and
adapt to new situations both psychologically and physiologically by the
repetition of positive affirmation sentences. This method, which has
promising results in symptom management, is predicted to have effective
results in the management of pain and discomfort in patients undergoing
open-heart surgery. AIM: To investigate the effect of self-affirmation on
anxiety and perceived discomfort in patients who have undergone open-heart
surgery. METHOD(S): This study adopted a randomized controlled
pretest-posttest follow-up research design. The study was conducted at a
public training and research hospital (Istanbul, Turkey) specialized in
thoracic and cardiovascular surgery. The sample consisted of 61 patients
randomized into two groups: intervention (n = 34) and control (n = 27).
The participants of the intervention group listened to a self-affirmation
audio recording for three days after surgery. Anxiety levels and perceived
discomfort regarding pain, dyspnoea, palpitations, fatigue and nausea were
measured daily. The State Trait Anxiety Inventory (STAI) was used to
measure the level of anxiety, meanwhile perceived discomfort regarding
pain, dyspnoea, palpitations, fatigue and nausea were measured by a 0 to
10 Numeric Rating Scale (NRS). RESULT(S): The control group had
significantly higher anxiety than the intervention group three days after
surgery (P < 0.001). The intervention group had less pain (P < 0.01),
dyspnoea (P < 0.01), palpitations (P < 0.01), fatigue (P < 0.001) and
nausea (P < 0.01) than the control group. CONCLUSION(S): Positive
self-affirmation helped reduce anxiety and perceived discomfort in
patients who underwent open-heart surgery. CLINICALTRIALS: gov Identifier:
NCT05487430. Copyright © 2023 The Authors. Published by Elsevier
Inc. All rights reserved.

<9>
Accession Number
2025467999
Title
Effects of remote ischaemic preconditioning on myocardial injury after
major abdominal surgery in patients at high risk for cardiovascular
adverse events in China (RIPC-MAS): protocol for a randomised,
sham-controlled, observer-blinded trial.
Source
BMJ Open. 13(6) (no pagination), 2023. Article Number: e073038. Date of
Publication: 23 Jun 2023.
Author
Wang F.; Liang C.-J.; Shi J.-K.; Huang Q.-S.; Nassirou B.M.; Wang X.; Jin
S.-Q.; Zhao Y.
Institution
(Wang, Liang, Shi, Huang, Nassirou, Jin, Zhao) Department of Anaesthesia,
The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong,
Guangzhou, China
(Wang, Liang, Shi, Huang, Nassirou, Jin, Zhao) Biomedical Innovation
Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong,
Guangzhou, China
(Wang) Zhongshan School of Medicine, Sun Yat-sen University, Guangdong,
Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Myocardial injury after non-cardiac surgery (MINS) caused by
an ischaemic mechanism is common and is associated with adverse short-term
and long-term prognoses. However, MINS is a recent concept, and few
studies have prospectively used it as a primary outcome. Remote ischaemic
preconditioning (RIPC) is a non-invasive procedure that induces innate
cardioprotection and may reduce MINS. Methods and analysis This is a
multicentre, randomised, sham-controlled, observer-blinded trial. Patients
with a high clinical risk of cardiovascular events who are scheduled to
undergo major abdominal surgery will be enrolled. A total of 766
participants will be randomised (1:1 ratio) to receive RIPC or control
treatment before anaesthesia. RIPC will comprise four cycles of cuff
inflation for 5 min to 200 mm Hg and deflation for 5 min. In the controls,
an identical-looking cuff will be placed around the arm but will not be
actually inflated. The primary outcome will be MINS, defined as at least
one postoperative cardiac troponin (cTn) concentration above the 99th
percentile upper reference limit of the cTn assay as a result of a
presumed ischaemic mechanism. This trial will test the concentration of
high-sensitivity cardiac troponin T (hs-cTnT). The secondary outcomes will
be hs-cTnT levels reaching/above the prognostically important thresholds,
peak hs-cTnT and total hs-cTnT release during the initial 3 days after
surgery, length of hospital stay after surgery, length of stay in the
intensive care unit, myocardial infarction, major adverse cardiovascular
events, cardiac-related death, all-cause death within 30 days, 6 months, 1
year and 2 years after surgery, and postoperative complications and
adverse events within 30 days after surgery. Ethics and dissemination This
study protocol (version 5.0 on 7 April 2023) was approved by the Ethics
Committee of Sixth Affiliated Hospital of Sun Yat-sen University. The
findings will be published in peer-reviewed journals. Trial registration
number NCT05733208. Copyright © Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<10>
Accession Number
2025467954
Title
Change in cardiorespiratory parameters following surgical correction of
pectus excavatum: protocol for the historical-prospective HeartSoar
cohort.
Source
BMJ Open. 13(6) (no pagination), 2023. Article Number: e070891. Date of
Publication: 15 Jun 2023.
Author
Suehs C.M.; Molinari N.; Bourdin A.; Solovei L.
Institution
(Suehs) Respiratory Diseases, Medical Information, Univ Montpellier,
Centre Hospitalier Regional Universitaire de Montpellier, Montpellier,
France
(Molinari) Medical Information, Imag, Cnrs, Univ Montpellier, Centre
Hospitalier Regional Universitaire de Montpellier, Montpellier, France
(Bourdin) Respiratory Diseases, PhyMedExp, Cnrs, Inserm, Univ Montpellier,
Centre Hospitalier Regional Universitaire de Montpellier, Montpellier,
France
(Solovei) Thoracic Surgery, Univ Montpellier, Centre Hospitalier Regional
Universitaire de Montpellier, Montpellier, France
Publisher
BMJ Publishing Group
Abstract
Introduction How cardiorespiratory function changes following the surgical
correction of pectus excavatum (PE) often gives mixed results, with
meta-analyses demonstrating no benefit in terms of pulmonary function but
improvement in cardiac function. Functional responses may depend on type
of surgery, follow-up time and/or the patient's presurgical functional
status, and debate persists on the purely aesthetic nature of such
surgery. The aim of this protocol is to analyse data describing lung
function and incremental exercise testing before vs after the surgical
correction of PE. Methods and analysis A historical-prospective
before-after surgical correction of PE cohort will be constituted.
Historical inclusions are recruited during follow-up visits at
approximately 12, 24, 36 or 48 months following a prior surgery (with
presurgical data mined from patient records). Prospective inclusions are
recruited during presurgical work-ups and followed for 1 year following
surgery. The data collected include spirometry, incremental exercise
testing, body mass index, body composition, questionnaires targeting
general health status, self-esteem and body image. Any complications due
to surgery are also described. The primary outcome is oxygen pulse during
incremental exercise testing, and 44 data points are required to
demonstrate a moderate postsurgical change (ie, a Cohen's effect of
d=0.5). Wilcoxon signed-rank tests or t-tests for paired data will be used
for before-after comparisons (with false discovery rate corrections for
secondary analyses). Ethics and dissemination This study will be conducted
according to the principles of the Declaration of Helsinki (as revised in
2013) and was approved by a randomly assigned, independent, ethics
committee (Comite de Protection des Personnes Sud-Mediterranee II,
reference number: 218 B21) as per French law on 6 July 2018. Informed,
written consent for study participation is required of all study
candidates prior to enrolment. Results will be published in an
international peer-reviewed journal. Trial registration number
NCT03770390; Clinicaltrials.gov. Copyright © Author(s) (or their
employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<11>
Accession Number
2025467906
Title
Invasive acupuncture for gastroparesis after thoracic or abdominal
surgery: a systematic review and meta-analysis.
Source
BMJ Open. 13(6) (no pagination), 2023. Article Number: e068559. Date of
Publication: 26 Jun 2023.
Author
Fan Z.; Qiu Y.; Qi X.; Xu J.; Wan Y.; Hao Y.; Niu W.; Huang J.
Institution
(Fan, Qi, Xu, Wan, Huang) Department of Minimally Invasive Acupuncture
Oncology, Third Affiliated Hospital, Beijing University of Chinese
Medicine, Beijing, China
(Qiu) Department of Integrated Traditional Chinese and Western Medicine,
The First Affiliated Hospital of Chongqing Medical University, Chongqing,
China
(Hao) Oncology Department of Integrated Traditional Chinese and Western
Medicine, China-Japan Friendship Hospital, Beijing, China
(Niu) Center for Evidence-Based Medicine, Capital Institute of Pediatrics,
Beijing, China
Publisher
BMJ Publishing Group
Abstract
Objectives This meta-analysis aimed to systematically evaluate the
efficacy of acupuncture in treating postsurgical gastroparesis syndrome
(PGS) after thoracic or abdominal surgery. Design Systematic review and
meta-analysis. Data sources Twelve databases (PubMed, Embase, Cochrane
Library Cochrane Central Register of Controlled Trials (CENTRAL), Medline
(Ovid) (from 1946), Web of Science, EBSCO, Scopus, Open Grey, China
National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese
Scientific Journals Database (VIP) and China Biology Medicine disc (CBM))
and three registration websites (WHO International Clinical Trials
Registry Platform (ICTRP), ClinicalTrials.gov, and Chinese Clinical Trial
Registry (ChiCTR)) were searched from the inception to September 2022, and
citations of the included literature were screened. Eligibility criteria
All randomised controlled trials addressing invasive acupuncture for PGS.
Data extraction and synthesis Key information on the included studies was
extracted by two reviewers independently. Risk ratio (RR) with 95% CI was
used for categorical data, and mean difference with 95% CI for continuous
data. The quality of evidence was assessed using Grading of
Recommendations Assessment, Development and Evaluation. Outcomes were
conducted with trial sequential analysis (TSA). Results Fifteen studies
with 759 patients met the inclusion criteria. Subgroup analyses revealed
that compared with the drug group, the drug and acupuncture group had a
greater positive effect on the total effective rate (TER) (nine trials,
n=427; RR=1.20; 95% CI 1.08 to 1.32; P-heterogeneity=0.20, I 2 =28%,
p=0.0004) and the recovery rate (RCR) (six trials, n = 294; RR = 1.61; 95%
CI 1.30 to 1.98; P-heterogeneity=0.29, I 2 =19%, p<0.0001) of PGS after
abdominal surgery. However, acupuncture showed no significant advantages
in terms of the TER after thoracic surgery (one trial, p=0.13) or
thoracic/abdominal surgery-related PGS (two trials, n = 115; RR=1.18; 95%
CI 0.89 to 1.57; P-heterogeneity=0.08, I 2 =67%, p=0.24) and the RCR after
thoracic/abdominal surgery (two trials, n=115; RR=1.40; 95% CI 0.97 to
2.01; P-heterogeneity=0.96, I 2 =0%, p=0.07). The quality of evidence for
TER and RCR was moderate certainty. Only one study reported an
acupuncture-related adverse event, in the form of mild local subcutaneous
haemorrhage and pain that recovered spontaneously. TSA indicated that
outcomes reached a necessary effect size except for clinical symptom
score. Conclusion Based on subgroup analysis, compared with the drug
treatment, acupuncture combined drug has significant advantages in the
treatment of PGS associated with abdominal surgery, but not with thoracic
surgery. PROSPERO registration number CRD42022299189. Copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC
BY. Published by BMJ.

<12>
Accession Number
2024667724
Title
Effective Treatment Program for COPD Patients Undergoing Lung Surgery
Using Preoperative Pulmonary Rehabilitation.
Source
Latin American Journal of Pharmacy. 42(7) (pp 1471-1478), 2023. Date of
Publication: 2023.
Author
Cao Q.; Jia Y.; Zhao N.
Institution
(Cao, Jia, Zhao) Department of Respiratory Medicine, Shandong Provincial
Third Hospital, Shandong University, No. 11, Wuyingshan Middle Road,
Shandong Province, Jinan City 250031, China
Publisher
Colegio de Farmaceuticos de la Provincia de Buenos Aires
Abstract
Chronic obstructive pulmonary disease (COPD) patients are at higher risk
of adverse outcomes during lung cancer surgery due to the presence of
pre-existing lung damage. Preoperative intervention in the form of
rehabilitation program has been studied with mixed results. Hence, the
current study aims to find out the effect of preoperative pulmonary
rehabilitation amongst COPD patients during lung surgery. Systematic
search was done in Medline, CINAHL, Web of Science, Scopus, and Google
Scholar. The timepoint for search was from 1964 to January 2023. Pooled
meta-analysis findings were reported as standardised mean difference (SMD)
for continuous outcomes andrisk ratio (RR) for categorical outcome. Eleven
studies were included in the analysis. Most studies had higher risk of
bias.The estimated pooled SMD for forced expiratory volume-1 was 0.06 (95%
CI:-0.17 to 0.29); for 6-min walking distance, the pooled SMD was 0.42
(95% CI:-0.36 to 1.19); for length of hospital stay, pooled SMD was-0.60
(95% CI:-1.15 to-0.05). The pooled RR for postoperative pulmonary
complications was 0.42 (95% CI: 0.30-0.57). In summary, preoperative
pulmonary rehabilitation is effective in reducing the postoperative
pulmonary complications and shortens the length of hospital stay amongst
COPD patients undergoing thoracic surgery. Copyright © 2023,
Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights
reserved.

<13>
[Use Link to view the full text]
Accession Number
2025637014
Title
Pain Management Interventions for the Treatment of Chronic Low Back Pain:
A Systematic Review and Meta-Analysis.
Source
Clinical Journal of Pain. 39(7) (pp 349-364), 2023. Date of Publication:
24 Jul 2023.
Author
Mekhail N.; Eldabe S.; Templeton E.; Costandi S.; Rosenquist R.
Institution
(Mekhail, Templeton, Costandi) Evidence-Based Pain Management Research,
Cleveland Clinic, Cleveland, OH, United States
(Rosenquist) Department of Pain Management, Cleveland Clinic, United
States
(Eldabe) The James Cook University Hospital, Marton Road, Middlesbrough,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Determine the relative effectiveness and safety profiles of
percutaneous and minimally invasive interventions for chronic low back
pain. Method(s): A systematic search was performed for randomized
controlled trials published in the past 20 years reporting on
radiofrequency ablation of the basivertebral, disk annulus and facet nerve
structures, steroid injection of the disk, facet joint, and medial branch,
biological therapies, and multifidus muscle stimulation. Outcomes
evaluated included Visual Analog Scale (VAS) pain scores, Oswestry
Disability Index (ODI) scores, quality of life (SF-36 and EQ-5D) scores,
and serious adverse event (SAE) rates. Basivertebral nerve (BVN) ablation
was chosen as the subject of comparison to all other therapies using a
random-effects meta-analysis. Result(s): Twenty-seven studies were
included. BVN ablation was found to provide statistically significant
improvements in VAS and ODI scores for 6-, 12- and 24-month follow-up
(P<=0.05). Biological therapy and multifidus muscle stimulation were the
only 2 treatments with both VAS and ODI outcomes not significantly
different from BVN ablation at 6-, 12-, and 24-month follow-up. All
outcomes found to be statistically significant represented inferior
results to those of BVN ablation. Insufficient data precluded meaningful
comparisons of SF-36 and EQ-5D scores. The SAE rates for all therapies and
all reported time points were not significantly different from BVN
ablation except for biological therapy and multifidus muscle stimulation
at the 6-month follow-up. Conclusion(s): BVN ablation, biological
therapy, and multifidus stimulation all provide significant, durable
improvements in both pain and disability compared with other
interventions, which provided only short-term pain relief. Studies on BVN
ablation reported no SAEs, a significantly better result than for studies
of biological therapy and multifidus stimulation. Copyright ©
2023 Lippincott Williams and Wilkins. All rights reserved.

<14>
Accession Number
2025567479
Title
Long-term major adverse cardiovascular events following myocardial injury
after non-cardiac surgery: meta-analysis.
Source
BJS Open. 7(2) (no pagination), 2023. Article Number: zrad021. Date of
Publication: 01 Apr 2023.
Author
Strickland S.S.; Quintela E.M.; Wilson M.J.; Lee M.J.
Institution
(Strickland, Lee) Academic Directorate of General Surgery, Sheffield
Teaching Hospitals, Sheffield, United Kingdom
(Quintela, Wilson) Department of Anaesthesia, Sheffield Teaching
Hospitals, Sheffield, United Kingdom
(Quintela, Wilson) Centre for Urgent and Emergency Care Research, School
of Health and Related Research, University of Sheffield, Sheffield, United
Kingdom
(Lee) Department of Oncology and Metabolism, The Medical School,
University of Sheffield, Sheffield, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Myocardial injury after non-cardiac surgery is diagnosed
following asymptomatic troponin elevation in the perioperative interval.
Myocardial injury after non-cardiac surgery is associated with high
mortality rates and significant rates of major adverse cardiac events
within the first 30 days following surgery. However, less is known
regarding its impact on mortality and morbidity beyond this time. This
systematic review and meta-analysis aimed to establish the rates of
long-term morbidity and mortality associated with myocardial injury after
non-cardiac surgery. Method(s): MEDLINE, Embase and Cochrane CENTRAL
were searched, and abstracts screened by two reviewers. Observational
studies and control arms of trials, reporting mortality and cardiovascular
outcomes beyond 30 days in adult patients diagnosed with myocardial injury
after non-cardiac surgery, were included. Risk of bias was assessed using
the Quality in Prognostic Studies tool. A random-effects model was used
for the meta-analysis of outcome subgroups. Result(s): Searches
identified 40 studies. The meta-analysis of 37 cohort studies found a rate
of major adverse cardiac events-associated myocardial injury after
non-cardiac surgery of 21 per cent and mortality following myocardial
injury after non-cardiac surgery was 25 per cent at 1-year follow-up. A
non-linear increase in mortality rate was observed up to 1 year after
surgery. Major adverse cardiac event rates were also lower in elective
surgery compared with a subgroup including emergency cases. The analysis
demonstrated a wide variety of accepted myocardial injury after
non-cardiac surgery and major adverse cardiac events diagnostic criteria
within the included studies. Conclusion(s): A diagnosis of myocardial
injury after non-cardiac surgery is associated with high rates of poor
cardiovascular outcomes up to 1 year after surgery. Work is needed to
standardize diagnostic criteria and reporting of myocardial injury after
non-cardiac surgery-related outcomes. Registration: This review was
prospectively registered with PROSPERO in October 2021 (CRD42021283995).
 Copyright © 2023 The Author(s). Published by Oxford University
Press on behalf of BJS Society Ltd.

<15>
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. 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). 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). 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. Copyright
2023 Debreceni, Janosi, Bocz, Turcsan, Lukacs, Simor, Antolic, Vamos,
Komocsi and Kupo.

<16>
Accession Number
641766674
Title
Impact of early versus Class-I triggered surgery on postoperative survival
in severe aortic regurgitation: An observational study from the AVIATOR
registry.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2023. Date of Publication: 06 Jul 2023.
Author
Hanet V.; Schafers H.-J.; Lansac E.; de Kerchove L.; El Hamansy I.;
Vojacek J.; Contino M.; Pouleur A.-C.; Beauloye C.; Pasquet A.;
Vanoverschelde J.-L.; Vancraeynest D.; Gerber B.L.
Institution
(Hanet, de Kerchove, Pouleur, Beauloye, Pasquet, Vanoverschelde,
Vancraeynest, Gerber) Department of Cardiovascular Diseases, Cliniques
Universitaires St. Luc; Pole de Recherche Cardiovasculaire (CARD),
Institut de Recherche Experimentale et Clinique IREC UCLouvain, Brussels,
Belgium
(Schafers) Surgery Department, Homburg-Saarland University Medical Center,
Homburg, Germany
(Lansac) Surgery Department, Institut Mutualiste Montsouris, Paris, France
(El Hamansy) Surgery Department, Montreal Heart Institute, Montreal,
Canada
(Vojacek) Surgery Department, Charles University Hospital, Hradec Kralove,
Czechia
(Contino) Surgery Department, Socio Sanitaria Territoriale Universita
degli Studi di Milano, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND AND OBJECTIVES: Class I triggers for severe and chronic aortic
regurgitation (AR) surgery rely mainly on symptoms or systolic
dysfunction, resulting in a negative outcome despite surgical correction.
Therefore, US and European guidelines now advocate for earlier surgery. We
sought to determine whether earlier surgery leads to improved
postoperative survival. METHOD(S): We evaluated postoperative
survival of patients who underwent surgery for severe AR in the
international multicenter registry for aortic valve surgery, AVIATOR, over
a median follow-up of 37 months. RESULT(S): Among 1,899 patients
(49+/-15 years, 85% male), 83% and 84% had Class I indication according to
AHA and ESC, respectively, and most were offered repair surgery (92%).
Twelve patients (0.6%) died after surgery and 68 within 10 years after the
procedure. Heart failure symptoms (HR=2.60 [1.20,5.66], p=0.016), and
either left ventricular end-systolic diameter (LVESD)>50mm or LVESD index
(LVESDi)>25mm/m2 (HR=1.64 [1.05,2.55], p=0.030) predicted survival
independently over and above age, gender, and bicuspid phenotype.
Therefore, patients who underwent surgery based on any Class I trigger had
worse adjusted survival. However, patients who underwent surgery while
meeting early imaging triggers (LVESDi 20-25mm/m2 or left ventricular
ejection fraction [LVEF] 50-55%) had no significant outcome penalty.
 CONCLUSION(S): In this international registry of severe AR, surgery
when meeting Class I triggers led to postoperative outcome penalty,
compared with earlier triggers (LVESDi between 20-25mm/m2 or LVEF between
50-55%). This observation, which applies to expert centers where AV repair
is feasible, should encourage the global use of repair techniques and the
conduction of randomized trials. Copyright © 2023. Published by
Elsevier Inc.

<17>
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. (pp e029504), 2023. Date of
Publication: 08 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.

<18>
Accession Number
641766583
Title
Midterm Outcomes of Endovascular Versus Medical Therapy for Uncomplicated
Type B Aortic Dissection: Meta-Analysis of Reconstructed Time to Event
Data.
Source
European journal of vascular and endovascular surgery : the official
journal of the European Society for Vascular Surgery. (no pagination),
2023. Date of Publication: 06 Jul 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Chu D.; Serna-Gallegos D.; Singh
M.J.; Chaer R.A.; Sultan I.
Institution
(Sa) Department of Cardiothoracic Surgery, University of Pittsburgh,
Pittsburgh, PA, USA; UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:
michel_pompeu@yahoo.com.br
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, USA; UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
(Singh, Chaer) UPMC Heart and Vascular Institute, University of Pittsburgh
Medical Center, Pittsburgh, PA, USA; Division of Vascular Surgery,
University of Pittsburgh Medical Centre, Pittsburgh, PA, USA
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate outcomes of thoracic endovascular aortic repair
(TEVAR) versus medical therapy in uncomplicated type B aortic dissections
(TBAD). DATA SOURCES: PubMed/MEDLINE, EMBASE, SciELO, LILACS,
CENTRAL/CCTR, Google Scholar, and reference lists of relevant articles.
REVIEW METHODS: This was a pooled meta-analysis of time to event data
extracted from studies published by December 2022 for the following
outcomes: all cause mortality, aortic related mortality, and late aortic
interventions. Certainty of evidence was evaluated through the Grading of
Recommendations, Assessment, Development and Evaluations (GRADE) tool.
 RESULT(S): Ten studies met the eligibility criteria (eight
observational; two randomised trials), comprising 17 906 patients (2 332
patients in the TEVAR groups and 15 574 patients in the medical therapy
group). Compared with patients who received medical therapy, patients who
underwent TEVAR had a statistically significantly lower risk of all cause
death (HR 0.79, 95% CI 0.72 - 0.87, p < .001; GRADE certainty: low) and
lower risk of aortic related death (HR 0.43, 95% CI 0.30 - 0.62, p < .001;
GRADE certainty: low) without statistically significant difference in the
risk of late aortic interventions (HR 1.05, 95% CI 0.88 - 1.26, p = .56;
GRADE certainty: low). In the subgroup analyses, TEVAR was associated with
lower risk of all cause death when randomised controlled trials only were
pooled (HR 0.44, 95% CI 0.23 - 0.83, p = .012; GRADE certainty: moderate),
younger patients only (HR 0.56, 95% CI 0.47 - 0.67, p < .001; GRADE
certainty: low), Western populations only (HR 0.85, 95% CI 0.77 - 0.93, p
= .001; GRADE certainty: low) and non-Western populations only (HR 0.47,
95% CI 0.35 - 0.62, p < .001; GRADE certainty: low). For all cause
mortality and aortic related mortality, restricted mean survival time was
overall 396 days and 398 days greater with TEVAR (p < .001), respectively,
which means that TEVAR was associated with lifetime gain.
 CONCLUSION(S): TEVAR may be associated with better midterm survival
and lower risk of aortic related death in the follow up of patients
treated for uncomplicated TBAD when compared with medical therapy;
however, randomised controlled trials with larger sample sizes and longer
follow up are still warranted. Copyright © 2023 European Society
for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

<19>
Accession Number
2025247497
Title
Efficacy of Local Hemostatic Management in Implant Surgery in
Anticoagulated Patients on Warfarin: A Randomized Clinical Study.
Source
International Journal of Oral and Maxillofacial Implants. 38(3) (pp
545-552), 2023. Date of Publication: 2023.
Author
Vassallo M.; Zamberlin J.; Roig M.D.; Macchi R.; Aguilar J.E.
Institution
(Vassallo, Zamberlin, Roig, Macchi, Aguilar) Masters Program in Dental
Implantology, School of Dentistry, Salvador University /Argentine Dental
Association (USAL/AOA), Buenos Aires, Argentina
Publisher
Quintessence Publishing Co. Inc.
Abstract
Purpose: To compare the frequency of immediate/short-term postoperative
bleeding and occurrence of hematomas using tranexamic acid (TXA), bismuth
subgallate (BS), or dry gauze (DG) as a local hemostatic agent, and to
explore the relation between short-term bleeding and occurrence of
intraoral and extraoral hematomas and length of incision, duration of
surgery, and alveolar ridge recontouring in patients who were continued on
oral anticoagulation therapy. Material(s) and Method(s): Eighty
surgical procedures performed in 71 patients were assigned to one of four
groups (20 each): control group (patients not on oral anticoagulant
therapy) and three experimental groups (patients on oral anticoagulation
therapy managed with local hemostatic measures): TXAg, BSg, or DGg.
Studied variables were length of incision, duration of surgery, and
alveolar ridge recontouring. Short-term bleeding episodes and occurrence
of intraoral and extraoral hematomas were recorded. Result(s): A
total of 111 implants were placed. No significant differences in mean
international normalized ratio, duration of surgery, and length of
incision were observed among groups (P >.05). Short-term bleeding and
intraoral and extraoral hematomas were observed in 2, 2, and 14 surgical
procedures, respectively, and did not differ significantly among groups.
Overall relation between variables showed no association between extraoral
hematomas and duration of surgery/length of incision (P >.05). Association
between extraoral hematomas and alveolar ridge recontouring was
statistically significant (OR = 26.72). Association with short-term
bleeding and intraoral hematomas was not studied due to the small number
of events. Conclusion(s): Implant placement in warfarin
anticoagulated patients without withdrawing oral anticoagulation therapy
is a safe and predictable procedure, and different local hemostatic agents
(TXA, BS, and DG) are effective in managing postoperative bleeding.
Development of hematomas may be higher in patients undergoing alveolar
ridge recontouring. Further studies are necessary to confirm these
results. Copyright © 2023 by Quintessence Publishing Co Inc.

<20>
Accession Number
2024656805
Title
Effects of Using Intravenous Lidocaine on Reducing the Complications of
Tracheal Tube Removal After Cardiac Surgery: A Randomized Clinical Trial.
Source
Iranian Heart Journal. 24(3) (pp 45-53), 2023. Date of Publication: July
2023.
Author
Azarfarin R.; Ferastkish R.; Totonchi Z.; Dayani A.; Tatari H.; Amniati S.
Institution
(Azarfarin) Cardio-Oncology Research Center, Rajaie Cardiovascular,
Medical, and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Ferastkish, Totonchi, Dayani, Tatari) Rajaie Cardiovascular Medical and
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Amniati) Rasool Akarm Hospital, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Coughing during anesthesia or extubation is a probable event
that can cause hemodynamic changes due to an increase in chest pressure or
the stimulation of the adrenergic system. We aimed to compare the effects
of IV lidocaine with those of IV normal saline (as a placebo) on
diminishing the incidence of coughs and sore throats, laryngospasms, and
hemodynamic changes during tracheal extubation in the ICU after cardiac
surgery. Method(s): The present randomized clinical trial assigned 50
candidates for simple cardiac valve or coronary bypass surgery to 2 groups
(each group =25) to receive IV lidocaine or a placebo before tracheal tube
removal after cardiac surgery in the ICU. Hemodynamic changes, the level
of consciousness-restlessness (RASS), and the incidence of coughs were
evaluated in both study groups. Four patients in the lidocaine group and 5
in the control group were lost to follow-up. Finally, 21 patients in the
lidocaine group and 20 patients in the control group were analyzed.
 Result(s): The rates of hemodynamic changes in the 2 groups were not
statistically different. The changes in the level of consciousness based
on the RASS were not significant in the 2 groups. The incidence of coughs
based on the mentioned 3 criteria showed a statistically significant
difference between the lidocaine and placebo groups. Conclusion(s):
IV lidocaine after cardiac surgery can be part of the weaning and
extubation process without hemodynamic complications to reduce the
incidence of coughs. Copyright © 2023, Iranian Heart Association.
All rights reserved.

<21>
Accession Number
2024656795
Title
Effects of Dexmedetomidine on Endogenous Antioxidant Levels and Clinical
Outcomes Among Patients Undergoing Coronary Artery Bypass Grafting: A
Randomized Clinical Trial.
Source
Iranian Heart Journal. 24(3) (pp 24-31), 2023. Date of Publication: July
2023.
Author
Kachoueian N.; Totonchi Z.; Barari M.; Fazli A.; Pazhoha M.; Toloueitabar
Y.; Jadbabaie A.; Tirgarfakheri K.; Shams S.; Mortazian M.
Institution
(Kachoueian) Department of Cardiac Surgery, Imam Hossein Educational
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Totonchi, Toloueitabar, Jadbabaie, Tirgarfakheri, Shams) Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Barari) Pharmacology and Toxicology Department, Faculty of Pharmacy and
Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University,
Iran, Islamic Republic of
(Fazli, Pazhoha) Mazandaran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Mortazian) AJA University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Iranian Heart Association
Abstract
Background: Dexmedetomidine reduces perioperative catecholamine
concentrations and confers hemodynamic and sympathetic stability. It
adjusts coronary blood flow and is known as one of the ideal anesthetic
drugs, especially for patients undergoing coronary artery bypass graft
surgery (CABG). The present study was performed to evaluate the potential
of dexmedetomidine to protect against oxidative stress during CABG.
 Method(s): The present double-blinded randomized clinical trial was
performed on 58 patients undergoing CABG at Rajaie Cardiovascular Medical
and Research Center. After anesthesia induction, the patients were
allocated to the trial (dexmedetomidine) and control (normal saline
solution) groups. Total antioxidant capacity and malondialdehyde were
measured in samples obtained from arterial catheters before the
intervention, after pump weaning, and 24 hours after intensive care unit
(ICU) admission. Result(s): Only total antioxidant capacity and
malondialdehyde at the third measurement point at the ICU were lower in
the trial group than in the control group. The levels of circulatory
antioxidants were higher in the trial group than in the control group
before the intervention and after pump weaning. No significant differences
were observed regarding circulatory antioxidant levels between the trial
and control groups. Conclusion(s): Dexmedetomidine infusion before
and during CABG might improve endocardial blood flow and hemodynamic
stability among patients undergoing CABG. (Iranian Heart Journal 2023;
24(3): 24-31). Copyright © 2023, Iranian Heart Association. All
rights reserved.

<22>
Accession Number
2024656793
Title
Comparison of the Effects Between Ringer's and Ringer's Lactate
Administration as the Prime Solution on Perioperative Acid-Base Status in
Pediatric Patients With Non-Cyanotic Diseases Undergoing Cardiac
Surgeries.
Source
Iranian Heart Journal. 24(3) (pp 6-14), 2023. Date of Publication: July
2023.
Author
Omrani G.; Gholampour-Dehaki M.; Totonchi Z.; Hadipourzadeh F.; Samiei D.;
Jamalian J.; Ramezan-Sikaroudi M.
Institution
(Omrani, Gholampour-Dehaki) Cardiac Surgery Department, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Totonchi, Hadipourzadeh, Jamalian) Cardiac Anesthesia Department, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Samiei, Ramezan-Sikaroudi) Rajaie Cardiovascular Medical and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Iranian Heart Association
Abstract
Background: The solutions used to prepare the cardiopulmonary bypass (CPB)
circuit are known to constitute some of the potential causes of metabolic
acidosis at the onset of CPB. Solutions containing lactate, acetate, and
other anions have a buffering effect owing to the metabolism of these
anions into bicarbonate ions. Hence, the administration of
lactate-containing solutions to children may lead to elevated serum
lactate levels. Method(s): The present double-blind randomized
clinical trial evaluated 50 non-cyanotic pediatric patients (2 groups of
25 cases) aged between 12 and 48 months undergoing cardiac surgeries.
Ringer's solution and Ringer's lactate solution were each used in 1 study
group as the CPB prime solution. The levels of pH, bicarbonate, base
excess (BE), lactate, calcium, glucose, chloride, and arterial blood gas
were measured at 4 different time points: before the initiation of CPB
(T0) and then 5 (T1), 30 (T2), and 60 (T3) minutes after bypass
commencement. Result(s): The levels of pH at T1 and T2 were
statistically different between the 2 groups (P=0.029 and P=0.001,
respectively). The 2 groups were also statistically meaningfully different
concerning T2 BE (P<0.0001). The mean HCO-3 levels at T2 and T3
were statistically different between the groups (P<0.0001 and P=0.039,
respectively). Lactate levels at T1 and T2 statistically significantly
differed between the 2 groups (P<0.0001 and P=0.017, respectively).
 Conclusion(s): The current study showed that Ringer's lactate
solution as the CPB prime solution was more effective than Ringer's
solution in reducing CPB-induced acidosis without increasing the
circulatory lactate level. Copyright © 2023, Iranian Heart
Association. All rights reserved.

<23>
Accession Number
2023896074
Title
Venous External Support in Coronary Artery Bypass Surgery: A Systematic
Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101687. Date of Publication: July 2023.
Author
Gemelli M.; Gallo M.; Addonizio M.; Pahwa S.; Van den Eynde J.; Trivedi
J.; Slaughter M.S.; Gerosa G.
Institution
(Gemelli, Addonizio, Gerosa) Cardiac Surgery Unit, Department of Cardiac,
Thoracic, Vascular Sciences and Public Health, University of Padua, Italy
(Gallo, Pahwa, Trivedi, Slaughter) Department of Cardiothoracic Surgery,
University of Louisville, Louisville, KY
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Neointimal hyperplasia and lumen irregularities are major contributors to
vein graft failure and the use of VEST(R) should prevent this.
In this review, we aim to evaluate the angiographic outcomes of externally
supported vein grafts. Medline, Embase and Cochrane Library were
systematically reviewed for randomized clinical trials published by August
2022. The primary outcome was graft failure. Secondary outcomes included
graft ectasia, intimal hyperplasia area and thickness, and graft
nonuniformity. Odds ratios (OR) for dichotomous variables and mean
difference (MD) for continuous variables with 95% confidence intervals
(CI) were pooled using a fixed-effects model. Three randomized controlled
trials with a total of 437 patients were included with follow-up ranging
from 1 to 2 years. The odds of graft failure were similar in the 2 groups
(OR 1.22; 95%CI 0.88-1.71; I2 = 0%). Intimal hyperplasia area [MD -0.77
mm2; 95%CI -1.10 to -0.45; I2 = 0%] and thickness
[MD -0.06 mm; 95% CI -0.08 to -0.04; I2=0%] were significantly
lower in the VEST group. Fitzgibbon Patency Scale of II or III
(representing angiographic conduit nonuniformity; OR 0.67; 95%CI
0.48-0.94; I2 = 0%) and graft ectasia (OR 0.53; 95%CI
0.32-0.88; I2 = 33%) were also significantly lower in the VEST
group. At short-term follow-up, VEST does not seem to reduce the incidence
of graft failure, although it is associated with attenuation of intimal
hyperplasia and nonuniformity. Longer angiographic follow-up is warranted
to determine whether these positive effects might translate into a
positive effect in graft failure and in long-term clinical
outcomes. Copyright © 2023 Elsevier Inc.

<24>
Accession Number
2022785041
Title
Evidence base for exercise prehabilitation suggests favourable outcomes
for patients undergoing surgery for non-small cell lung cancer despite
being of low therapeutic quality: a systematic review and meta-analysis.
Source
European Journal of Surgical Oncology. 49(5) (pp 879-894), 2023. Date of
Publication: May 2023.
Author
Voorn M.J.J.; Franssen R.F.W.; Hoogeboom T.J.; van Kampen-van den Boogaart
V.E.M.; Bootsma G.P.; Bongers B.C.; Janssen-Heijnen M.L.G.
Institution
(Voorn, Franssen, Janssen-Heijnen) Department of Clinical Epidemiology,
VieCuri Medical Centre, Venlo, Netherlands
(Voorn) Adelante Rehabilitation Centre, Venlo, Netherlands
(Voorn, Franssen, Janssen-Heijnen) Department of Epidemiology, GROW School
for Oncology and Reproduction, Faculty of Health, Medicine and Life
Sciences, Maastricht University, Maastricht, Netherlands
(Franssen) Department of Clinical Physical Therapy, VieCuri Medical
Centre, Venlo, Netherlands
(Hoogeboom) Radboud Institute for Health Sciences, IQ Healthcare,
Radboudumc, Nijmegen, Netherlands
(van Kampen-van den Boogaart) Department of Pulmonology, VieCuri Medical
Centre, Venlo, Netherlands
(Bootsma) Department of Pulmonology, Zuyderland Medical Centre, Heerlen,
Netherlands
(Bongers) Department of Nutrition and Movement Sciences, School for
Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of
Health, Medicine and Life Sciences, Maastricht University, Maastricht,
Netherlands
(Bongers) Department of Surgery, School for Nutrition and Translational
Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life
Sciences, Maastricht University, Maastricht, Netherlands
Publisher
W.B. Saunders Ltd
Abstract
Objective: The aim of this systematic review was to evaluate whether
exercise prehabilitation programs reduce postoperative complications,
postoperative mortality, and length of hospital stay (LoS) in patients
undergoing surgery for non-small cell lung cancer (NSCLC), thereby
accounting for the quality of the physical exercise program.
 Method(s): Two reviewers independently selected randomized controlled
trials (RCTs) and observational studies and assessed them for
methodological quality and therapeutic quality of the exercise
prehabilitation program (i-CONTENT tool). Eligible studies included
patients with NSCLC performing exercise prehabilitation and reported the
occurrence of 90-day postoperative complications, postoperative mortality,
and LoS. Meta-analyses were performed and the certainty of the evidence
was graded (Grading of Recommendations Assessment, Development and
Evaluation (GRADE)) for each outcome. Result(s): Sixteen studies,
comprising 2,096 patients, were included. Pooled analyses of RCTs and
observational studies showed that prehabilitation reduces postoperative
pulmonary complications (OR 0.45), postoperative severe complications (OR
0.51), and LoS (mean difference -2.46 days), but not postoperative
mortality (OR 1.11). The certainty of evidence was very low to moderate
for all outcomes. Risk of ineffectiveness of the prehabilitation program
was high in half of the studies due to an inadequate reporting of the
dosage of the exercise program, inadequate type and timing of the outcome
assessment, and low adherence. Conclusion(s): Although risk of
ineffectiveness was high for half of the prehabilitation programs and
certainty of evidence was very low to moderate, prehabilitation seems to
result in a reduction of postoperative pulmonary and severe complications,
as well as LoS in patients undergoing surgery for NSCLC. Copyright
© 2023 The Authors

<25>
Accession Number
2020930749
Title
Assessing the impact of publications: A bibliometric analysis of the
top-cited articles from The Journal of Thoracic and Cardiovascular
Surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(5) (pp 1901-1916),
2023. Date of Publication: May 2023.
Author
Castro-Varela A.; Schaff H.V.
Institution
(Castro-Varela, Schaff) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minn, United States
Publisher
Elsevier Inc.
Abstract
Objective: After 90 years, The Journal of Thoracic and Cardiovascular
Surgery (JTCVS) remains one of the most influential and widely read
journals in our specialty. This study analyzes the characteristics of its
top-cited articles over the past 6 decades. Method(s): Using
Elsevier's Scopus database, we identified all papers published in JTCVS
since 1959. After exclusion of expert consensus guidelines, articles were
grouped by decade and ranked by the total number of citations. We included
the field-weighted citation impact (FWCI) when available. We analyzed the
characteristics of the 10 most cited documents overall and per decade.
 Result(s): The Journal published a total of 32,335 papers, of which
14,052 were published between 2010 and 2021. The order of the top-cited
articles differs when ranked by citations versus FWCI. During the last 6
decades, the 10 most cited articles per decade have a mean number of 604
citations (range, 240-1670) and a mean FWCI of 13.1 (range, 4.3-24.7).
There is no overlap in positions when articles are ranked by citations
versus FWCI. The majority of the 60 top 10 cited articles over the past 6
decades were presented at a major meeting (n = 38, 63%), most commonly the
Annual Meeting of the American Association for Thoracic Surgery. Topics in
adult cardiac surgery and general thoracic surgery predominated among the
most-cited papers, which originated most often from the United States
followed by Japan, Canada, France, England, and Germany.
 Conclusion(s): JTCVS continues to provide a global platform to share
impactful knowledge related to surgery for thoracic diseases. The use of
citations to determine an article's impact has limitations and
nontraditional metrics may prove to be an excellent complementary tool for
more equitable evaluations. Copyright © 2022 The American
Association for Thoracic Surgery

<26>
Accession Number
2016913342
Title
Unilateral versus bilateral anterograde cerebral perfusion in acute type A
aortic dissection repair: A systematic review and meta-analysis.
Source
Perfusion (United Kingdom). 38(5) (pp 931-938), 2023. Date of Publication:
July 2023.
Author
Tasoudis P.T.; Varvoglis D.N.; Vitkos E.; Ikonomidis J.S.; Athanasiou T.
Institution
(Tasoudis, Varvoglis) Department of Cardiothoracic Surgery, Faculty of
Medicine, School of Health Sciences, University of Thessaly, Athens,
Greece
(Vitkos) Surgery Working Group, Society of Junior Doctors, Athens, Greece
(Ikonomidis) Department of Surgery, School of Medicine, University of
North Carolina at Chapel Hill Chapel HillUniversity, NC, United States
(Athanasiou) Department of Surgery and Cancer, Imperial College London, St
Mary's Hospital, London, United Kingdom
(Athanasiou) Department of Cardiothoracic Surgery, University Hospital of
Larissa, Greece
Publisher
SAGE Publications Ltd
Abstract
Objectives: The aim of the study is to compare the safety and efficacy of
unilateral anterograde cerebral perfusion (UACP) and bilateral anterograde
cerebral perfusion (BACP) for acute type A aortic dissection (ATAAD).
 Method(s): A systematic review of the MEDLINE (PubMed), Scopus, and
Cochrane Library databases (last search: August 7th, 2021) was performed
according to the PRISMA statement. Studies directly comparing UACP versus
BACP for ATAAD were included. Random-effects meta-analyses were performed.
 Result(s): Eight retrospective cohort studies were identified,
incorporating 2416 patients (UACP: 843, BACP: 1573). No statistically
significant difference was observed regarding in-hospital mortality (odds
ratio [OR]:1.05 [95% Confidence Interval (95% CI):0.70-1.57]), permanent
neurological deficit (PND) (OR: 0.94 [95% CI: 0.52-1.70]), transient
neurological deficit (TND) (OR: 1.37 [95% CI: 0.98-1.92]), renal failure
(OR: 0.96 [95% CI: 0.70-1.32]), and re-exploration for bleeding (OR: 0.77
[95% CI: 0.48-1.22]). Meta-regression analysis revealed that PND and TND
were not influenced by differences in rates of total arch repair, Bentall
procedure, and concomitant CABG in UACP and BACP groups. Cardiopulmonary
bypass time (Standard Mean Difference [SMD]: -0.11 [95% CI: -0.22, 0.44]),
Cross clamp time (SMD: -0.04 [95% CI: -0.38, 0.29]), and hypothermic
circulatory arrest time (SMD: -0.12 [95% CI: -0.55, 0.30]) were comparable
between UACP and BACP. Intensive care unit stay was shorter in BACP arm
(SMD:0.16 [95% CI: 0.01, 0.31]); however, length of hospital stay was
shorter in UACP arm (SMD: -0.25 [95% CI: -0.45, -0.06]).
 Conclusion(s): UACP and BACP had similar results in terms of
in-hospital mortality, PND, TND, renal failure, and re-exploration for
bleeding rate in patients with ATAAD. ICU stay was shorter in the BACP arm
while LOS was shorter in the UACP arm. Copyright © The Author(s)
2022.

<27>
Accession Number
2025551143
Title
Topical vancomycin for sternal wound infection prophylaxis. A systematic
review and updated meta-analysis of over 40,000 cardiac surgery patients.
Source
Surgery (United States). (no pagination), 2023. Date of Publication:
2023.
Author
Kowalewski M.; Pasierski M.; Makhoul M.; Comanici M.; Dabrowski E.J.;
Matteucci M.; Litwinowicz R.; Kowalowka A.; Wanha W.; Jiritano F.; Fina
D.; Martucci G.; Raffa G.M.; Malvindi P.G.; Kuzma L.; Suwalski P.; Lorusso
R.; Meani P.; Lazar H.
Institution
(Kowalewski, Pasierski, Suwalski) Department of Cardiac Surgery and
Transplantology, National Medical Institute of the Ministry of Interior,
Warsaw, Poland
(Kowalewski, Lorusso) Cardio-Thoracic Surgery Department, Heart and
Vascular Centre, Maastricht University Medical Centre and Cardiovascular
Research Institute Maastricht, Netherlands
(Kowalewski, Pasierski, Makhoul, Matteucci, Litwinowicz, Kowalowka, Wanha,
Jiritano, Fina, Martucci, Raffa, Malvindi, Suwalski, Meani) Thoracic
Research Centre, Collegium Medicum Nicolaus Copernicus University,
Innovative Medical Forum, Bydgoszcz, Poland
(Makhoul, Comanici) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
(Matteucci) Cardiac Surgery Unit, Azienda Socio Sanitaria Territoriale dei
Sette Laghi, Department of Medicine and Surgery, University of Insubria,
Varese, Italy
(Dabrowski, Kuzma) Department of Invasive Cardiology, Medical University
of Bialystok, Poland
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Upper-Silesian Heart Center,
Medical University of Silesia, Faculty of Medical Sciences, Katowice,
Poland
(Wanha) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, School of Medicine in Katowice, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
(Fina, Meani) Department of Cardiothoracic and Vascular Anesthesia and
Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientific
Policlinico, San Donato Milanese, Milan, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo per i trapianti e Terapie ad alta specializzazione, Palermo,
Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Istituto Mediterraneo per i trapianti
e Terapie ad alta specializzazione, Palermo, Italy
(Malvindi) Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali
Riuniti delle Marche, Polytechnic University of Marche, Ancona, Italy
(Lazar) Boston University School of Medicine, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Despite guideline recommendations, routine application of
topical antibiotic agents to sternal edges after cardiac surgery is seldom
done. Recent randomized controlled trials have also questioned the
effectiveness of topical vancomycin in sternal wound infection
prophylaxis. Method(s): We screened multiple databases for
observational studies and randomized controlled trials assessing the
effectiveness of topical vancomycin. Random effects meta-analysis and
risk-profile regression were performed, and randomized controlled trials
and observational studies were analyzed separately. The primary endpoint
was sternal wound infection; other wound complications were also analyzed.
Risk ratios served as primary statistics. Result(s): Twenty studies
(N = 40,871) were included, of which 7 were randomized controlled trials
(N = 2,187). The risk of sternal wound infection was significantly reduced
by almost 70% in the topical vancomycin group (risk ratios [95% confidence
intervals]: 0.31 (0.23-0.43); P < .00001) and was comparable between
randomized controlled trials (0.37 [0.21-0.64]; P < .0001) and
observational studies (0.30 [0.20-0.45]; P < .00001; P<inf>subgroup</inf>
= .57). Topical vancomycin significantly reduced the risk of superficial
sternal wound infections (0.29 [0.15-0.53]; P < .00001) and deep sternal
wound infections (0.29 [0.19-0.44]; P < .00001). A reduction in the risk
of mediastinitis and sternal dehiscence risks was also demonstrated. Risk
profile meta-regression showed a significant relationship between a higher
risk of sternal wound infection and a higher benefit accrued with topical
vancomycin (s-coeff. = -0.00837; P < .0001). The number needed to treat
was 58.2. A significant benefit was observed in patients with diabetes
mellitus (risk ratios 0.21 [0.11-0.39]; P < .00001). There was no evidence
of vancomycin or methicillin resistance; on the contrary, the risk of
gram-negative cultures was reduced by over 60% (risk ratios 0.38
[0.22-0.66]; P = .0006). Conclusion(s): Topical vancomycin
effectively reduces the risk of sternal wound infection in cardiac surgery
patients. Copyright © 2023 Elsevier Inc.

<28>
Accession Number
2024272698
Title
Ultrasound-guided erector spinae plane block in coronary artery bypass
surgery: the role of local anesthetic volume-a prospective, randomized
study.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2023. Date
of Publication: 2023.
Author
Demir Z.A.; Aydin M.E.; Balci E.; Ozay H.Y.; Ozgok A.; Ahiskalioglu A.
Institution
(Demir, Balci, Ozay, Ozgok) Anesthesiology Department, Ankara City
Hospital, Health Sciences University, Ankara, Turkey
(Aydin, Ahiskalioglu) Department of Anaesthesiology and Reanimation,
Ataturk University School of Medicine, Erzurum 25070, Turkey
(Aydin, Ahiskalioglu) Clinical Research, Development and Design
Application and Research Center, Ataturk University School of Medicine,
Erzurum 25240, Turkey
Publisher
Springer
Abstract
Background: Erector spinae plane block has been shown to help with pain
management in different regions and many areas with different indications.
However, the effectiveness of this block in cardiac surgery has been shown
in the literature, the optimal volume remains unclear. The aim of this
study is to determine the analgesic efficacy of two different volumes of
local anesthetic injection used in ultrasound-guided bilateral-thoracic
erector spinae plane block in patients undergoing coronary artery bypass
graft. Method(s): This study was conducted on adult patients
undergoing surgery with coronary artery bypass graft, and 70 patients were
analyzed in each group. Group 20 received erector spinae plane block with
20 ml of 0.25% bupivacaine, Group 30 received 30 ml of 0.25% bupivacaine
bilaterally. Postoperative sternotomy and chest tube-related pain were
evaluated using the numerical rating scale (NRS) at rest and during
movement. Result(s): There were significant differences between the
groups regarding rescue tramadol consumption was higher in Group 20 than
in Group 30 (25/35 vs. 2/35, p < 0.001). In addition, there were
substantial differences between the two groups concerning the time of the
first-rescue analgesic requirement. The mean time +/- standard deviation
was 11.26 +/- 9.57 h and 24.03 +/- 4.12 h in Groups 20 and 30 (p < 0.001).
The median scores, both at sternotomy and chest tubes, were significantly
lower in Group 30 than in Group 20 at the different time points after the
surgery (p < 0.05). Conclusion(s): In coronary artery bypass graft
surgery, erector spinae plane block performed with 30 ml instead of 20 ml
on each side resulted in less pain in the sternum and chest tube region,
less need for rescue analgesics, and delayed first-rescue analgesic
requirement. Copyright © 2023, The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<29>
Accession Number
2024272696
Title
Bioprosthetic versus mechanical valves for mitral valve replacement in
patients < 70 years: an updated pairwise meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2023. Date
of Publication: 2023.
Author
Ahmed A.; Awad A.K.; Varghese K.S.; Sehgal V.S.; Hisham K.; George J.;
Pandey R.; Vega E.; Polizzi M.; Mathew D.M.
Institution
(Ahmed, Varghese, Sehgal, Pandey, Vega, Polizzi, Mathew) CUNY School of
Medicine, 1589 Amsterdam Avenue, New York, NY 10031, United States
(Awad, Hisham) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
Publisher
Springer
Abstract
Background: The ideal conduit for mitral valve replacement (MVR) remains
elusive, particularly among younger patients due to increased life
expectancy. We perform a pairwise meta-analysis comparing the use of
bioprosthetic valves (BPV) and mechanical mitral valves (MMV) in patients
< 70 years old undergoing MVR. Method(s): We comprehensively searched
medical databases to identify studies comparing the use of BPV and MMV in
patients < 70 years old undergoing MVR. Pairwise meta-analysis was
performed using the Mantel-Haenszel method in R version 4.0.2. Outcomes
were pooled using the random effect model as risk ratios (RR) with their
95% confidence intervals (95% CI). Result(s): 16,879 patients from 15
studies were pooled. Compared to MMV, BPV was associated with
significantly higher rates of 30-day mortality (RR 1.53, p = 0.0006) but
no difference in 30-day stroke (RR 0.70, p = 0.43). At a weighted mean
follow-up duration of 14.1 years, BPV was associated with higher rates of
long-term mortality (RR 1.28, p = 0.0054). No difference was seen between
the two groups for risk of long-term stroke (RR 0.92, p = 0.67),
reoperation(RR 1.72, p = 0.12), or major-bleeding (RR 0.57, p = 0.10) at a
weighted mean follow-up duration of 11.7, 11.3, and 11.9 years,
respectively. Conclusion(s): The use of MMV in patients < 70
undergoing MVR is associated with lower rates of 30-day/long-term
mortality compared to BPV. No significant differences were observed for
risk of 30-day/long-term stroke, long-term reoperation, and long-term
major bleeding. These findings support the use of MMV in younger patients,
although prospective, randomized trials are still needed. Copyright
© 2023, The Author(s), under exclusive licence to The Japanese
Association for Thoracic Surgery.

<30>
Accession Number
2023310325
Title
Cost Effectiveness of Strategies to Manage Atrial Fibrillation in Middle-
and High-Income Countries: A Systematic Review.
Source
PharmacoEconomics. 41(8) (pp 913-943), 2023. Date of Publication: August
2023.
Author
Okafor C.; Byrnes J.; Stewart S.; Scuffham P.; Afoakwah C.
Institution
(Okafor, Byrnes, Scuffham, Afoakwah) Centre for Applied Health Economics,
School of Medicine and Dentistry, Griffith University, 170 Kessels Road,
Nathan, QLD 4111, Australia
(Okafor, Byrnes, Stewart, Scuffham, Afoakwah) Menzies Health Institute
Queensland, Griffith University, Southport, QLD, Australia
(Stewart) Institute for Health Research, University of Notre Dame
Australia, Freemantle, WA, Australia
Publisher
Adis
Abstract
Background: Atrial fibrillation (AF) remains the most common form of
cardiac arrhythmia. Management of AF aims to reduce the risk of stroke,
heart failure and premature mortality via rate or rhythm control. This
study aimed to review the literature on the cost effectiveness of
treatment strategies to manage AF among adults living in low-, middle- and
high-income countries. Method(s): We searched MEDLINE (OvidSp),
Embase, Web of Science, Cochrane Library, EconLit and Google Scholar for
relevant studies between September 2022 and November 2022. The search
strategy involved medical subject headings or related text words. Data
management and selection was performed using EndNote library. The titles
and abstracts were screened followed by eligibility assessment of full
texts. Selection, assessment of the risk of bias within the studies, and
data extraction were conducted by two independent reviewers. The
cost-effectiveness results were synthesised narratively. The analysis was
performed using Microsoft Excel 365. The incremental cost effectiveness
ratio for each study was adjusted to 2021 USD values. Result(s):
Fifty studies were included in the analysis after selection and risk of
bias assessment. In high-income countries, apixaban was predominantly cost
effective for stroke prevention in patients at low and moderate risk of
stroke, while left atrial appendage closure (LAAC) was cost effective in
patients at high risk of stroke. Propranolol was the cost-effective choice
for rate control, while catheter ablation and the convergent procedure
were cost-effective strategies in patients with paroxysmal and persistent
AF, respectively. Among the anti-arrhythmic drugs, sotalol was the
cost-effective strategy for rhythm control. In middle-income countries,
apixaban was the cost-effective choice for stroke prevention in patients
at low and moderate risk of stroke while high-dose edoxaban was cost
effective in patients at high risk of stroke. Radiofrequency catheter
ablation was the cost-effective option in rhythm control. No data were
available for low-income countries. Conclusion(s): This systematic
review has shown that there are several cost-effective strategies to
manage AF in different resource settings. However, the decision to use any
strategy should be guided by objective clinical and economic evidence
supported by sound clinical judgement. Registration:
CRD42022360590. Copyright © 2023, The Author(s).

<31>
Accession Number
641751050
Title
Analgesic Efficacy of Combined Thoracic Paravertebral Block and Erector
Spinae Plane Block for Video-Assisted Thoracic Surgery: A Prospective
Randomized Clinical Trial.
Source
Medical science monitor : international medical journal of experimental
and clinical research. 29 (pp e940247), 2023. Date of Publication: 06 Jul
2023.
Author
Zhang L.; Hu Y.; Liu H.; Qi X.; Chen H.; Cao W.; Wang L.; Zhang Y.; Wu Y.
Institution
(Zhang, Hu, Qi, Chen, Zhang, Wu) Department of Anesthesiology and
Perioperative Medicine, Second Affiliated Hospital of Anhui Medical
University, Hefei, Anhui, China
(Liu) Department of Anesthesiology and Perioperative Medicine, University
of California Davis Health, Sacramento, CA, United States
(Cao) Department of Cardiothoracic Surgery, Second Affiliated Hospital of
Anhui Medical University, Hefei, Anhui, China
(Wang) Department of Radiology, Second Affiliated Hospital of Anhui
Medical University, Hefei, Anhui, China
Publisher
NLM (Medline)
Abstract
BACKGROUND Thoracic paravertebral block (TPVB) and erector spinae plane
block (ESPB) are widely used in video-assisted thoracic surgery (VATS).
However, they have corresponding adverse effects, including hypotension
for TPVB and unpredictable injectate spread in ESPB. An optimal
perioperative analgesic strategy remains controversial. We investigated
the effect of ultrasound-guided combined TPVB and ESPB (CTEB) for VATS.
MATERIAL AND METHODS A total of 120 patients scheduled for thoracic
surgery were randomized to receive either ultrasound-guided TPVB, ESPB, or
CTEB preoperatively. Postoperative analgesia was achieved with sufentanil
patient-controlled intravenous analgesia. The primary outcome was the
static pain score at 2 h after surgery. RESULTS The static pain score 2 h
postoperatively was significantly different among the 3 groups. This
difference was statistically significant for Group ESPB vs Group TPVB
(P=0.004), but not for Group ESPB vs Group CTEB (P=0.767), or Group TPVB
vs Group CTEB (P=0.117). Group TPVB exhibited the highest incidence of
hypotension among the 3 groups. More patients experienced a sensory loss
in Groups TPVB and CTEB 30 min after the block performance. Patients
receiving CTEB exhibited a lower incidence of chronic pain 6 months
postoperatively than those in Group ESPB. CONCLUSIONS CTEB does not
enhance the analgesic effect of ESPB in patients undergoing VATS; however,
it may induce a faster sensory loss after nerve block and reduce the
incidence of postoperative chronic pain compared with ESPB. CTEB may also
help to reduce the incidence of intraoperative hypotension compared with
TPVB.

<32>
[Use Link to view the full text]
Accession Number
641751029
Title
del Nido versus blood cardioplegia in adult cardiac surgery: a
meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 24(8) (pp 522-529),
2023. Date of Publication: 01 Aug 2023.
Author
Malvindi P.G.; Tian D.H.; Bifulco O.; Berretta P.; Alfonsi J.; Cefarelli
M.; Yan T.D.; Di Eusanio M.
Institution
(Malvindi, Bifulco, Berretta, Alfonsi, Cefarelli, Di Eusanio) Cardiac
Surgery Unit, Lancisi Cardiovascular Center, Ospedali Riuniti delle
Marche, Polytechnic University of Marche, Ancona, Italy
(Tian) Department of Anaesthesia and Perioperative Medicine, Westmead
Hospital
(Tian) Critical Care Division, George Institute for Global Health, Sydney,
Australia
(Tian) Department of Surgery, University of Melbourne, Melbourne,
Australia
(Bifulco) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, University of Padua, Padova, Italy
(Yan) Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital
(Yan) Sydney Medical School, Sydney University, Sydney, Australia
Publisher
NLM (Medline)
Abstract
AIMS: Initially developed for myocardial protection in immature
cardiomyocytes, del Nido cardioplegia has been increasingly used over the
past decade in adult patients. Our aim is to analyse the results from
randomized controlled trials and observational studies comparing early
mortality and postoperative troponin release in patients who underwent
cardiac surgery using del Nido solution and blood cardioplegia.
 METHOD(S): A literature search was performed through three online
databases between January 2010 and August 2022. Clinical studies providing
early mortality and/or postoperative troponin evaluation were included. A
random-effects meta-analysis with a generalized linear mixed model,
incorporating random study effects, was implemented to compare the two
groups. RESULT(S): Forty-two articles were included in the final
analysis for a total of 11 832 patients, 5926 of whom received del Nido
solution and 5906 received blood cardioplegia. del Nido and blood
cardioplegia populations had comparable age, gender distribution, history
of hypertension and diabetes mellitus. There was no difference in early
mortality between the two groups. There was a trend towards lower 24 h
[mean difference -0.20; 95% confidence interval (CI) -0.40 to 0.00; I2 =
89%; P = 0.056] and lower peak postoperative troponin levels (mean
difference -0.10; 95% CI -0.21 to 0.01; I2 = 0.87; P = 0.087) in the del
Nido group. CONCLUSION(S): del Nido cardioplegia can be safely used
in adult cardiac surgery. The use of del Nido solution was associated with
similar results in terms of early mortality and postoperative troponin
release when compared with blood cardioplegia myocardial
protection. Copyright © 2023 Italian Federation of Cardiology -
I.F.C. All rights reserved.

<33>
Accession Number
638718162
Title
Efficacy of non-pharmacological interventions in pain relief and opioid
consumption after cardiac surgery: A systematic review and Bayesian
network meta-analysis.
Source
Journal of clinical nursing. 32(15-16) (pp 4626-4637), 2023. Date of
Publication: 01 Aug 2023.
Author
Liu M.; Ni R.; Huang S.; Yang X.; Lin Q.; Lin P.; Yang J.
Institution
(Liu, Ni, Huang, Yang, Yang) Department of Pharmacy, Fujian Medical
University Union Hospital, Fuzhou, China
(Liu, Ni, Huang, Yang, Yang) College of Pharmacy, Fujian Medical
University, Fuzhou, China
(Lin) Department of Nursing, Fujian Medical University Union Hospital,
Fuzhou, China
(Lin) Department of Anesthesiology, Fujian Medical University Union
Hospital, Fuzhou, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate and rank the evidence for the efficacy of
non-pharmacological interventions in relieving pain after cardiac surgery
using comprehensive comparisons. BACKGROUND: Although several previous
systematic reviews and meta-analyses showed that non-pharmacological
interventions effectively control and reduce pain after cardiac surgery,
none quantitatively compared the effect of these different types of
interventions. DESIGN: Systematic review and Bayesian network
meta-analysis based on the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses for Network Meta-Analysis guidelines.
 METHOD(S): Six databases were searched from inception to April 2021
to collect all published evidence from randomised clinical trials. One
author extracted the relevant information from the eligible trials; a
second author independently reviewed the data. Before analysing the
extracted data, two investigators independently assessed the quality of
the included studies. Conventional meta-analysis was conducted using
either fixed- or random-effects models according to statistical
heterogeneity. The Bayesian network meta-analysis was conducted using the
consistency model. RESULT(S): We identified 42 randomised clinical
trials comparing 14 groups with 4253 patients. Transcutaneous electrical
nerve stimulation, acupressure, music and massage were effective for pain
relief, with transcutaneous electrical nerve stimulation being associated
with the best probability of successful pain relief after cardiac surgery
(cumulative ranking curve surface, 0.97; probability, 77.03%). Acupressure
(cumulative ranking curve surface, 0.79; probability, 30.69%) was the
second-best option. However, there was no evidence that any pair-up
intervention significantly reduced opioid use or anxiety.
 CONCLUSION(S): These findings suggest that transcutaneous electrical
nerve stimulation, acupressure, music and massage may effectively
alleviate postoperative cardiac pain, with transcutaneous electrical nerve
stimulation representing the best choice for pain relief. RELEVANCE TO
CLINICAL PRACTICE: The results of this network meta-analysis can guide
patients after cardiac surgery and healthcare providers to make optimal
decisions in managing postoperative cardiac pain. TRIAL REGISTRATION:
PROSPERO CRD42021246183. Copyright © 2022 John Wiley & Sons Ltd.

<34>
Accession Number
2025626114
Title
Diagnostic accuracy of brain natriuretic peptide and N-terminal-pro brain
natriuretic peptide to detect complications of cardiac transplantation in
adults: A systematic review and meta-analysis.
Source
Transplantation Reviews. 37(3) (no pagination), 2023. Article Number:
100774. Date of Publication: July 2023.
Author
Zhu V.; Perry L.A.; Plummer M.; Segal R.; Smith J.; Liu Z.
Institution
(Zhu, Perry, Segal, Liu) Department of Anaesthesia, Royal Melbourne
Hospital, Parkville, Australia
(Zhu, Perry, Plummer, Segal, Liu) Department of Critical Care, Melbourne
Medical School, Faculty of Medicine, Dentistry and Health Sciences,
University of Melbourne, Parkville, Australia
(Plummer) Department of Intensive Care Medicine, Royal Adelaide Hospital,
Adelaide, Australia
(Smith) Department of Surgery, Monash University, Clayton, Australia
Publisher
Elsevier Inc.
Abstract
Background: We aimed to evaluate the utility of BNP and NT-proBNP in
identifying adverse recipient outcomes following cardiac transplantation.
 Method(s): We searched MEDLINE (Ovid), Embase (Ovid), and the
Cochrane Library from inception to February 2023. We included studies
reporting associations between BNP or NT-proBNP and adverse outcomes
following cardiac transplantation in adults. We calculated standardised
mean differences (SMD) with 95% confidence intervals (CI); or confusion
matrices with sensitivities and specificities. Where meta-analysis was
inappropriate, studies were analysed descriptively. Result(s):
Thirty-two studies involving 2,297 cardiac transplantation recipients were
included. We report no significant association between BNP or NT-proBNP
and significant acute cellular rejection of grade 3A or higher (SMD 0.40,
95% CI -0.06-0.86) as defined by the latest 2004 International Society for
Heart and Lung Transplantation Guidelines. We also report no strong
associations between BNP or NT-proBNP and cardiac allograft vasculopathy
or antibody mediated rejection. Conclusion(s): In isolation, serum
BNP and NT-proBNP lack sufficient sensitivity and specificity to reliably
predict adverse outcomes following cardiac transplantation. Copyright
© 2023 Elsevier Inc.

<35>
Accession Number
2025523247
Title
The left atrial appendage closure by surgery-2 (LAACS-2) trial protocol
rationale and design of a randomized multicenter trial investigating if
left atrial appendage closure prevents stroke in patients undergoing
open-heart surgery irrespective of preoperative atrial fibrillation status
and stroke risk.
Source
American Heart Journal. 264 (pp 133-142), 2023. Date of Publication:
October 2023.
Author
Madsen C.L.; Park-Hansen J.; Irmukhamedov A.; Carranza C.L.; Rafiq S.;
Rodriguez-Lecoq R.; Palmer-Camino N.; Modrau I.S.; Hansson E.C.; Jeppsson
A.; Hadad R.; Moya-Mitjans A.; Greve A.M.; Christensen R.; Carstensen
H.G.; Host N.B.; Dixen U.; Torp-Pedersen C.; Kober L.; Gogenur I.;
Truelsen T.C.; Kruuse C.; Sajadieh A.; Dominguez H.
Institution
(Madsen, Hadad, Carstensen, Host, Sajadieh, Dominguez) Department of
Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg,
Copenhagen, Denmark
(Madsen, Dominguez) Department of Biomedical Science, University of
Copenhagen, Copenhagen, Denmark
(Irmukhamedov) Department of Heart, Lung, and Vascular Surgery, Odense
University Hospital, Odense, Denmark
(Carranza, Rafiq) Department of Cardio-Thoracic Surgery, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Rodriguez-Lecoq, Palmer-Camino) Department of Cardiac Surgery, Hospital
Vall d'Hebron, Barcelona, Spain
(Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Skejby, Denmark
(Modrau) Institute of Clinical Medicine, Aarhus University, Aarhus,
Denmark
(Hansson, Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Hansson, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Moya-Mitjans) Department of Cardiology, Hospital Vall d'Hebron,
Barcelona, Spain
(Greve) Department of Clinical Biochemistry, Copenhagen University
Hospital, Rigshospitalet, Copenhagen, Denmark
(Christensen) Section for Biostatistics and Evidence-Based Research, The
Parker Institute, Copenhagen University Hospital, Bispebjerg and
Frederiksberg, Copenhagen, Denmark
(Christensen) Department of Clinical Research, Research Unit of
Rheumatology, University of Southern Denmark, Odense University Hospital,
Odense, Denmark
(Park-Hansen, Dixen) Department of Cardiology, Copenhagen University
Hospital, Amager and Hvidovre, Hvidovre, Denmark
(Torp-Pedersen) Department of Cardiology, Copenhagen University Hospital,
North Zealand, Hilleroed, Denmark
(Kober) Department of Cardiology, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
(Gogenur) Department of Surgery, Zealand University Hospital, Koge,
Denmark
(Truelsen) Department of Neurology, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
(Kruuse) Department of Neurology, Neurovascular Research Unit, Copenhagen
University Hospital, Herlev and Gentofte, Herlev, Denmark
Publisher
Elsevier Inc.
Abstract
Background: Current recommendations regarding the use of surgical left
atrial appendage (LAA) closure to prevent thromboembolisms lack high-level
evidence. Patients undergoing open-heart surgery often have several
cardiovascular risk factors and a high occurrence of postoperative atrial
fibrillation (AF)-with a high recurrence rate-and are thus at a high risk
of stroke. Therefore, we hypothesized that concomitant LAA closure during
open-heart surgery will reduce mid-term risk of stroke independently of
preoperative AF status and CHA<inf>2</inf>DS<inf>2</inf>-VASc score.
 Method(s): This protocol describes a randomized multicenter trial.
Consecutive participants >=18 years scheduled for first-time planned
open-heart surgery from cardiac surgery centers in Denmark, Spain, and
Sweden are included. Both patients with a previous diagnosis of paroxysmal
or chronic AF, as well as those without AF, are eligible to participate,
irrespective of their CHA<inf>2</inf>DS<inf>2</inf>-VASc score. Patients
already planned for ablation or LAA closure during surgery, with current
endocarditis, or where follow-up is not possible are considered
noneligible. Patients are stratified by site, surgery type, and
preoperative or planned oral anticoagulation treatment. Subsequently,
patients are randomized 1:1 to either concomitant LAA closure or standard
care (ie, open LAA). The primary outcome is stroke, including transient
ischemic attack, as assigned by 2 independent neurologists blinded to the
treatment allocation. To recognize a 60% relative risk reduction of the
primary outcome with LAA closure, 1,500 patients are randomized and
followed for 2 years (significance level of 0.05 and power of 90%).
 Conclusion(s): The LAACS-2 trial is likely to impact the LAA closure
approach in most patients undergoing open-heart surgery. Trial
registration: NCT03724318. Copyright © 2023 Elsevier Inc.

<36>
Accession Number
2024235558
Title
Influenza vaccination and cardiovascular events in patients with ischaemic
heart disease and heart failure: A meta-analysis.
Source
European Journal of Heart Failure. (no pagination), 2023. Date of
Publication: 2023.
Author
Modin D.; Lassen M.C.H.; Claggett B.; Johansen N.D.; Keshtkar-Jahromi M.;
Skaarup K.G.; Nealon J.; Udell J.A.; Vardeny O.; Solomon S.D.; Gislason
G.; Biering-Sorensen T.
Institution
(Modin, Lassen, Johansen, Skaarup, Gislason, Biering-Sorensen) Department
of Cardiology, Copenhagen University Hospital - Herlev & Gentofte,
Copenhagen, Denmark
(Claggett, Solomon) Cardiovascular Medicine Division, Department of
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Keshtkar-Jahromi) Division of Infectious Diseases, Department of
Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Nealon) School of Public Health, Li Ka Shing Faculty of Medicine, The
University of Hong Kong, Hong Kong
(Udell) Cardiovascular Division, Department of Medicine, Women's College
Hospital, Toronto, ON, Canada
(Vardeny) Department of Medicine, University of Minnesota, Minneapolis,
MN, United States
(Gislason) Institute of Clinical Medicine, Faculty of Health Sciences,
University of Copenhagen, Copenhagen, Denmark
(Biering-Sorensen) Department of Biomedical Sciences, Faculty of Health
and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Randomized controlled trials (RCTs) enrolling patients at high
cardiovascular risk have found that influenza vaccination may reduce the
incidence of cardiovascular events. We performed an updated meta-analysis
assessing the effect of influenza vaccination on the incidence of
cardiovascular events in patients with ischaemic heart disease or heart
failure. Methods and Results: We searched PubMed, EMBASE and other
sources to identify RCTs examining the effect of influenza vaccination on
the incidence of cardiovascular events assessed as efficacy outcomes in
patients with ischaemic heart disease or heart failure. Eligible studies
followed patients for at least one influenza season, defined as a minimum
duration of 6 months. The primary endpoint was a composite of
cardiovascular death, acute coronary syndrome, stent thrombosis or
coronary revascularization, stroke or heart failure hospitalization. The
secondary endpoints were cardiovascular death and all-cause death. Two
investigators independently identified and extracted data from studies.
Results were compared using hazard ratios (HRs) in both random effects and
fixed effects models. We included five peer-reviewed and one non
peer-reviewed RCTs for a total of 9340 patients. Five trials included
patients with ischaemic heart disease (n = 4211) and one trial included
patients with heart failure (n = 5129). Influenza vaccination was
associated with a reduced incidence of the primary composite endpoint
(random effects HR [rHR] 0.74, 95% confidence interval [CI] 0.63-0.88, p <
0.001, I2 = 52%), cardiovascular death (rHR 0.63, 95% CI
0.42-0.95, p = 0.028, I2 = 58%) and all-cause death (rHR 0.72,
95% CI 0.54-0.95, p = 0.0227, I2 = 52%). Results were similar
when non peer-reviewed data were excluded. Conclusion(s): In this
meta-analysis of available RCTs in patients at high cardiovascular risk,
influenza vaccination was associated with a reduced incidence of
cardiovascular events, cardiovascular death and all-cause death as
compared to placebo or no treatment. Copyright © 2023 European
Society of Cardiology.

<37>
Accession Number
641759541
Title
Final 3-Year Outcomes of a Randomized Trial Comparing a Self-Expanding to
a Balloon-Expandable Transcatheter Aortic Valve.
Source
Circulation. Cardiovascular interventions. (pp e012873), 2023. Date of
Publication: 07 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, S.S., S.W., Switzerland
(Mollmann) Department of Internal Medicine I, St-Johannes-Hospital,
Germany (H.M.), Dortmund, Germany
(Kim) Department of Cardiology, Kerckhoff Heart and Thorax Center, Germany
(W.-K.K.), Bad Nauheim, Germany
(Burgdorf) Heart and Vascular Center, Germany (C.B.), Bad Bevensen,
Germany
(Linke) Department of Internal Medicine and Cardiology, Heart Center
Dresden, Germany (A.L.), Technische Universitat Dresden
(Redwood, Prendergast) Department of Cardiology, United Kingdom (S.R., St
Thomas' Hospital, London, United Kingdom
(Hilker) Department of Cardiothoracic Surgery, University Medical Center,
Germany (M.H.), Regensburg, Germany
(Joner) German Heart Centre, Technical University of Munich, Germany
(M.J.), Germany
(Thiele) Heart Center Leipzig at University of Leipzig, Germany (H.T.),
Germany
(Conzelmann) Department of Cardiac Surgery, Helios Klinik, Germany (L.
Conzelmann), Karlsruhe, Germany
(Conradi) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Germany (L. Conradi), Germany
(Kerber) Department of Cardiology, Cardio-vascular Center Bad Neustadt,
Germany (S.K.), Germany
(Thilo) Department of Internal Medicine I, RoMed Klinikum Rosenheim,
Germany (C.T.), Germany
(Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Lucerne,
Switzerland
(Husser) Department of Cardiology and Intensive Care Medicine, Augustinum
Klinik Munich (O.H.)
(Deckarm, Kunzi, Heg) Clinical Trials Unit Bern, University of Bern, A.K
(Walther) Department of Cardiac and Vascular Surgery, University Hospital
Frankfurt, Germany (T.W.), Germany
Publisher
NLM (Medline)
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. 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. 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). 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.

<38>
Accession Number
641757963
Title
Sutureless valves versus aortic root enlargement for aortic valve
replacement in small aortic annulus: A systematic review and pooled
analysis.
Source
Asian cardiovascular & thoracic annals. (pp 2184923231187055), 2023. Date
of Publication: 07 Jul 2023.
Author
Agarwal R.; Arnav A.; Ranjan A.; Mudgal S.; Singh D.
Institution
(Agarwal) Department of Cardiothoracic Surgery, All India Institute of
Medical Sciences (AIIMS), Jharkhand, India
(Arnav) Department of Surgical Oncology, All India Institute of Medical
Sciences (AIIMS), Jharkhand, India
(Ranjan) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jharkhand, India
(Mudgal) College of Nursing, All India Institute of Medical Sciences
(AIIMS), Jharkhand, India
(Singh) Department of Radiotherapy, All India Institute of Medical
Sciences (AIIMS), Jharkhand, India
Publisher
NLM (Medline)
Abstract
BACKGROUND: Very few studies provide direct comparisons between aortic
root enlargement and sutureless valve implantation in patients with a
small aortic annulus who underwent aortic valve replacement. This study
aims to provide comparative outcomes between the two in such a subset of
patients, through a systematic review and pool analysis. METHOD(S):
The PubMed, Scopus and Embase databases were searched using the
appropriate terms. The data from original articles mentioning aortic root
enlargement and sutureless valves in a single or comparative study with
another group of patients with a small aortic annulus were pooled and
analyzed using descriptive statistics. RESULT(S): Both
cardiopulmonary bypass (68.4 vs. 125.03 min, p<0.001) and aortic
cross-clamp times were significantly shorter in the sutureless valve
group, along with a concomitantly higher number of minimally invasive
surgeries. The incidence of permanent pacemaker implantation (9.76% vs.
3.16%, p<0.00001), patient prosthesis mis-match and paravalvular leak was
significantly higher in the sutureless valve group. In comparison, the
incidence of re-exploration for bleeding was higher in the aortic root
enlargement group (5.27% vs. 3.16%, p<0.02). The two groups had no
differences in the duration of hospital stays or mortality.
 CONCLUSION(S): Sutureless valves demonstrated a comparable
hemodynamic outcome with aortic root enlargement in patients with a small
aortic annulus. In addition to this, it greatly facilitated minimally
invasive surgery. However, the high incidence of pacemaker implantation is
still a concern for the widespread recommendation of sutureless valves,
especially in young patients with a small aortic annulus.

<39>
Accession Number
641757486
Title
Invited commentary on Kowalewski M, Pasierski M, Makhoul M, et al. Topical
vancomycin for sternal wound infection prophylaxis. A systematic review
and updated meta-analysis of over 40,000 cardiac surgery patients.
Source
Surgery. (no pagination), 2023. Date of Publication: 04 Jul 2023.
Author
Sellke F.W.
Institution
(Sellke) Division of Cardiothoracic Surgery, Alpert Medical School of
Brown University and Rhode Island Hospital, Providence, RI, United States
Publisher
NLM (Medline)

<40>
Accession Number
2024543520
Title
Risk of parenterally transmitted hepatitis following exposure to invasive
procedures in Italy: SEIEVA surveillance 2000-2021.
Source
Journal of Hepatology. 79(1) (pp 61-68), 2023. Date of Publication: July
2023.
Author
Caminada S.; Mele A.; Ferrigno L.; Alfonsi V.; Crateri S.; Iantosca G.;
Sabato M.; Tosti M.E.
Institution
(Caminada, Mele, Sabato) Sapienza University of Rome, Department of Public
Health and Infectious Diseases, Rome, Italy
(Mele) Prevention Department - Health Local Unit Lecce, Italy
(Ferrigno, Crateri, Iantosca, Tosti) Istituto Superiore di Sanita,
National Centre for Global Health, Rome, Italy
(Alfonsi) Sant'Andrea Hospital, University La Sapienza, Rome, Italy
Publisher
Elsevier B.V.
Abstract
Background & Aims: Surgical interventions and invasive
diagnostic/therapeutic procedures are known routes of transmission of
viral hepatitis. Using data from the Italian surveillance system for acute
viral hepatitis (SEIEVA), the aim of this study was to investigate the
association between specific types of invasive procedures and the risk of
acute HBV and HCV infections. Method(s): Data from SEIEVA (period
2000-2021) were used. The association between acute HBV and HCV infection
and potential risk factors, i.e. surgical interventions and
diagnostic/therapeutic procedures (given according to the ICD-9-CM
classification), was investigated in comparison to age-matched hepatitis A
cases, used as controls, by conditional multiple logistic regression
analysis. Result(s): A total of 8,176 cases with acute HBV, 2,179
with acute HCV, and the respective age-matched controls with acute HAV
infection were selected for the main analysis. Most of the procedures
evaluated were associated with the risk of acquiring HBV or HCV. The
strongest associations for HBV infection were: gynaecological surgery
(odds ratio [OR] 5.19; 95% CI 1.12-24.05), otorhinolaryngological surgery
(OR 3.78; 95% CI 1.76-8.09), and cardiac/thoracic surgery (OR 3.52; 95% CI
1.34-9.23); while for HCV infection, they were: neurosurgery (OR 11.88;
95% CI 2.40-58.85), otorhinolaryngological surgery (OR 11.54; 95% CI
2.55-52.24), and vascular surgery (OR 9.52; 95% CI 3.25-27.87). Hepatitis
C was also strongly associated with ophthalmological surgery (OR 8.32; 95%
CI 2.24-30.92). Biopsy and/or endoscopic procedures were significantly
associated with both HCV (OR 3.84; 95% CI 2.47-5.95) and, to a lesser
extent, HBV infection (OR 1.48; 95% CI 1.16-1.90). Conclusion(s):
Despite the progress made in recent years, invasive procedures still
represent a significant risk factor for acquiring parenterally transmitted
hepatitis viruses, thus explaining the still numerous and unexpected cases
diagnosed among the elderly population in Italy. Our results underline the
importance of observing universal precautions to control the iatrogenic
transmission of hepatitis viruses. Impact and implications: Cases of
parenterally transmitted acute viral hepatitis in the elderly population,
that are difficult to explain based on the most widely recognised risk
factors, continue to be diagnosed in Italy. Based on the Italian SEIEVA
surveillance of acute viral hepatitis data, this study highlights an
increased risk of acquiring hepatitis B and C following exposure to
invasive procedures, which might explain the observed cases in elderly
individuals. Furthermore, this finding emphasises the need to observe
universal precautions strictly, in healthcare settings, including in the
case of minor surgical procedures. Copyright © 2023 The Authors

<41>
Accession Number
2023949983
Title
Perioperative Management of Vitamin K Antagonists and Direct Oral
Anticoagulants: A Systematic Review and Meta-analysis.
Source
Chest. 163(5) (pp 1245-1257), 2023. Date of Publication: May 2023.
Author
Shah S.; Nayfeh T.; Hasan B.; Urtecho M.; Firwana M.; Saadi S.; Abd-Rabu
R.; Nanaa A.; Flynn D.N.; Rajjoub N.S.; Hazem W.; Seisa M.O.; Hassett
L.C.; Spyropoulos A.C.; Douketis J.D.; Murad M.H.
Institution
(Shah, Nayfeh, Hasan, Urtecho, Firwana, Saadi, Abd-Rabu, Nanaa, Rajjoub,
Hazem, Seisa, Murad) Evidence-Based Practice Center, Mayo Clinic,
Rochester, MN, United States
(Shah, Nayfeh, Hasan, Urtecho, Firwana, Saadi, Abd-Rabu, Nanaa, Rajjoub,
Hazem, Seisa, Murad) Robert D. and Patricia E. Kern Center for the Science
of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
(Hassett) Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
(Flynn) School of Medicine, University of North Carolina at Chapel Hill,
Chapel Hill, NC, United States
(Spyropoulos) Institute of Health Systems Science-Feinstein Institutes for
Medical Research and The Donald and Barbara Zucker School of Medicine at
Hofstra/Northwell, and Department of Medicine, Anticoagulation and
Clinical Thrombosis Services, Northwell Health at Lenox Hill Hospital, New
York, NY, United States
(Douketis) Department of Medicine, McMaster University, Hamilton, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: The management of patients who are receiving chronic oral
anticoagulation therapy and require an elective surgery or an invasive
procedure is a common clinical scenario. Research Question: What is the
best available evidence to support the development of American College of
Chest Physicians guidelines on the perioperative management of patients
who are receiving long-term vitamin K agonist (VKA) or direct oral
anticoagulant (DOAC) and require elective surgery or procedures? Study
Design and Methods: A literature search including multiple databases from
database inception through July 16, 2020, was performed. Meta-analyses
were conducted when appropriate. Result(s): In patients receiving VKA
(warfarin) undergoing elective noncardiac surgery, shorter (< 3 days) VKA
interruption is associated with an increased risk of major bleeding. In
patients who required VKA interruption, heparin bridging (mostly with
low-molecular-weight heparin [LMWH]) was associated with a statistically
significant increased risk of major bleed, representing a very low
certainty of evidence (COE). Compared with DOAC interruption 1 to 4 days
before surgery, continuing DOACs may be associated with higher risk of
bleeding demonstrated in some, but not all studies. In patients who needed
DOAC interruption, bridging with LMWH may be associated with a
statistically significant increased risk of bleeding, representing a low
COE. Interpretation(s): The certainty in the evidence supporting the
perioperative management of anticoagulants remains limited. No
high-quality evidence exists to support the practice of heparin bridging
during the interruption of VKA or DOAC therapy for an elective surgery or
procedure, or for the practice of interrupting VKA therapy for minor
procedures, including cardiac device implantation, or continuation of a
DOAC vs short-term interruption of a DOAC in the perioperative
period. Copyright © 2022 American College of Chest Physicians

<42>
Accession Number
2025293858
Title
Outcomes of SAPIEN 3 Transcatheter Aortic Valve Replacement Compared With
Surgical Valve Replacement in Intermediate-Risk Patients.
Source
Journal of the American College of Cardiology. 82(2) (pp 109-123), 2023.
Date of Publication: 11 Jul 2023.
Author
Madhavan M.V.; Kodali S.K.; Thourani V.H.; Makkar R.; Mack M.J.; Kapadia
S.; Webb J.G.; Cohen D.J.; Herrmann H.C.; Williams M.; Greason K.; Pibarot
P.; Hahn R.T.; Jaber W.; Xu K.; Alu M.; Smith C.R.; Leon M.B.
Institution
(Madhavan, Kodali, Hahn, Alu, Smith, Leon) Columbia University Irving
Medical Center and NewYork-Presbyterian Hospital, New York, NY, United
States
(Madhavan, Cohen, Hahn, Alu, Leon) Cardiovascular Research Foundation, New
York, NY, United States
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Kapadia, Jaber) Cleveland Clinic, Cleveland, OH, United States
(Webb) St Paul's Hospital, Vancouver, BC, Canada
(Cohen) St Francis Hospital, Roslyn, NY, United States
(Herrmann) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
(Williams) New York University Langone Medical Center, New York, NY,
United States
(Greason) Mayo Clinic, Rochester, MN, United States
(Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec City,
QC, Canada
(Xu) Edwards Lifesciences, Irvine, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Previous studies demonstrated transcatheter aortic valve
replacement (TAVR) with an earlier generation balloon-expandable valve to
be noninferior to surgical aortic valve replacement (SAVR) for death and
disabling stroke in intermediate-risk patients with symptomatic, severe
aortic stenosis at 5 years. However, limited long-term data are available
with the more contemporary SAPIEN 3 (S3) bioprosthesis. Objective(s):
The aim of this study was to compare 5-year risk-adjusted outcomes in
intermediate-risk patients undergoing S3 TAVR vs SAVR. Method(s):
Propensity score matching was performed to account for baseline
differences in intermediate-risk patients undergoing S3 TAVR in the
PARTNER 2 (Placement of Aortic Transcatheter Valves) S3 single-arm study
and SAVR in the PARTNER 2A randomized clinical trial. The primary
composite endpoint consisted of 5-year all-cause death and disabling
stroke. Result(s): A total of 783 matched pairs of intermediate-risk
patients with severe aortic stenosis were studied. There were no
differences in the primary endpoint between S3 TAVR and SAVR at 5 years
(40.2% vs 42.7%; HR: 0.87; 95% CI: 0.74-1.03; P = 0.10). The incidence of
mild or greater paravalvular regurgitation was more common after S3 TAVR.
There were no differences in structural valve deterioration-related stage
2 and 3 hemodynamic valve deterioration or bioprosthetic valve failure.
 Conclusion(s): In this propensity-matched analysis of
intermediate-risk patients, 5-year rates of death and disabling stroke
were similar between S3 TAVR and SAVR. Rates of structural valve
deterioration-related hemodynamic valve deterioration were similar, but
paravalvular regurgitation was more common after S3 TAVR. Longer-term
follow-up is needed to further evaluate differences in late adverse
clinical events and bioprosthetic valve durability. (PII S3i [PARTNER II
Trial: Placement of Aortic Transcatheter Valves II - S3 Intermediate],
NCT03222128; PII A (PARTNER II Trial: Placement of Aortic Transcatheter
Valves II - XT Intermediate and High Risk], NCT01314313) Copyright
© 2023

<43>
Accession Number
2025069933
Title
HEART Score Recalibration Using Higher Sensitivity Troponin T.
Source
Annals of Emergency Medicine. (no pagination), 2023. Date of Publication:
2023.
Author
Khand A.U.; Backus B.; Campbell M.; Frost F.; Mullen L.; Fisher M.;
Theodoropoulos K.C.; Obeidat M.; Batouskaya K.; Carlton E.W.; Van Meerten
K.; Neoh K.; Dakshi A.; Mumma B.E.
Institution
(Khand, Campbell, Fisher, Obeidat, Batouskaya, Neoh, Dakshi) Liverpool
University Hospital, Liverpool, United Kingdom
(Khand, Mullen, Fisher, Theodoropoulos) Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Khand, Frost) Liverpool Centre for Cardiovascular Diseases, University of
Liverpool, Liverpool, United Kingdom
(Backus) Erasmus Medical Center, Rotterdam, Netherlands
(Carlton) North Bristol NHS Trust, Bristol, United Kingdom
(Van Meerten) Albert Schweitzer Hospital, Dordrecht, Netherlands
(Mumma) Department of Emergency Medicine, University of California, Davis
School of Medicine, Sacramento, CA, United States
Publisher
Elsevier Inc.
Abstract
Study objective: We examined the diagnostic performance of a recalibrated
History, Electrocardiogram, Age, Risk factors, Troponin (HEART), and
Thrombolysis in Myocardial Infarction (TIMI) score in patients with
suspected acute cardiac syndrome (ACS). Recalibration of troponin
thresholds was performed, including shifting from the 99th percentile to
the limit of detection (LOD) or to the limit of quantification (LOQ) We
compared the discharge potential and safety of the recalibrated composite
scores using a single presentation high-sensitivity cardiac troponin
(hs-cTn) T to the conventional scores and with a LOD/LOQ troponin strategy
alone. Method(s): We undertook a 2-center prospective cohort study in
the United Kingdom (UK) (2018) (Clinicaltrials.gov NCT03619733) to
specifically assess recalibrated risk scores (shifting the troponin subset
scoring from 99th percentile to LOD [UK]) and combined the results of this
with secondary analyses of 2 prospective cohort studies in the UK (2011)
and the United States (2018, using LOQ rather than LOD). The primary
outcome was major adverse cardiovascular events (MACE), defined as
adjudicated type 1 myocardial infarction (MI), urgent coronary
revascularization, and all-cause death, at 30 days. We evaluated the
original scores using hs-cTn below the 99th percentile and recalibrated
scores using hs-cTn <LOD/LOQ and compared these composite scores with a
single hs-cTnT less than LOD/LOQ combined with a nonischemic ECG. For each
discharge strategy, an assessment of clinical effectiveness was also made,
defined as the proportion of patients eligible for discharge from the
emergency department without the need for further inpatient testing.
 Result(s): We studied 3,752 patients (3,003 in the UK and 749 in the
United States). Median age was 58 years, and 48% were female. At 30 days,
330/3,752 (8.8%) experienced MACE. The sensitivities of the original HEART
less or equal to 3 and recalibrated HEART less or equal to 3 scores for
rule-out were 96.1% (95% confidence interval [CI], 93.4 to 97.9) and 98.6%
(95% CI, 96.5 to 99.5) respectively; the original TIMI less or equal to 1
and recalibrated TIMI less or equal to 1 scores' sensitivities were 79.7%
(95% CI, 74.9 to 83.9) and 96.1% (95% CI, 93.4 to 97.9) respectively; and
nonischemic ECG with hs-cTn T below the 99th percentile and hs-cTn T less
than LOD/LOQ was 79.7% (95%CI, 0.749 to 0.839) and 99.1% (95% CI, 0.974 to
0.998), respectively. Recalibrated HEART less or equal to 3 was projected
to discharge 14% more patients than hs-cTn T less than LOD/LOQ. The
improved sensitivity of rule-out for recalibrated HEART less than or equal
to 3 came at the cost of reduced specificity (50.8% versus 53.8% for
recalibrated HEART and conventional HEART respectively).
 Conclusion(s): This study indicates that recalibrated HEART score of
less or equal to 3 is a feasible and safe early discharge strategy using a
single presentation hs-cTnT. This finding should be further tested using
competitor hs-cTn assays in independent prospective cohorts before
implementation. Copyright © 2023 American College of Emergency
Physicians

<44>
Accession Number
2024162281
Title
The Effects of Peroxisome Proliferator-Activated Receptor-Delta Modulator
ASP1128 in Patients at Risk for Acute Kidney Injury Following Cardiac
Surgery.
Source
Kidney International Reports. 8(7) (pp 1407-1416), 2023. Date of
Publication: July 2023.
Author
van Till J.W.O.; Nojima H.; Kameoka C.; Hayashi C.; Sakatani T.; Washburn
T.B.; Molitoris B.A.; Shaw A.D.; Engelman D.T.; Kellum J.A.
Institution
(van Till) Mitobridge Inc., Cambridge, MA, United States
(Nojima, Hayashi) Astellas Pharma Global Development Inc., Northbrook, IL,
United States
(Kameoka, Sakatani) Astellas Pharma Inc, Development, Tokyo, Japan
(Washburn) Department of Thoracic Surgery, Heart Center, Huntsville, AL,
United States
(Molitoris) Division of Nephrology, Indiana University School of Medicine,
Indianapolis, IN, United States
(Shaw) Department of Intensive Care and Resuscitation, Cleveland Clinic,
Cleveland, OH, United States
(Engelman) Heart and Vascular Program, Baystate Health and University of
Massachusetts Medical School-Baystate, Springfield, MA, United States
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,
United States
Publisher
Elsevier Inc.
Abstract
Introduction: Peroxisome proliferator-activated receptor delta (PPARdelta)
plays a central role in modulating mitochondrial function in
ischemia-reperfusion injury. The novel PPARdelta modulator, ASP1128, was
evaluated. Method(s): A randomized, double-blind, placebo-controlled,
biomarker assignment-driven, multicenter study was performed in adult
patients at risk for acute kidney injury (AKI) following cardiac surgery,
examining efficacy and safety of a 3-day, once-daily intravenous dose of
100 mg ASP1128 versus placebo (1:1). AKI risk was based on clinical
characteristics and postoperative urinary biomarker (TIMP2)*(IGFBP7). The
primary end point was the proportion of patients with AKI based on serum
creatinine within 72 hours postsurgery (AKI-SCr72h). Secondary endpoints
included the composite end point of major adverse kidney events (MAKE:
death, renal replacement therapy, and/or >=25% reduction of estimated
glomerular filtration rate [eGFR]) at days 30 and 90). Result(s): A
total of 150 patients were randomized and received study medication (81
placebo, 69 ASP1128). Rates of AKI-SCr72h were 21.0% and 24.6% in the
placebo and ASP1128 arms, respectively (P = 0.595). Rates of
moderate/severe AKI (stage 2/3 AKI-SCr and/or stage 3 AKI-urinary output
criteria) within 72 hours postsurgery were 19.8% and 23.2%, respectively
(P = 0.609). MAKE occurred within 30 days in 11.1% and 13.0% in the
placebo and ASP1128 arms (P = 0.717), respectively; and within 90 days in
9.9% and 15.9% in the placebo and ASP1128 arms (P = 0.266), respectively.
No safety issues were identified with ASP1128 treatment, but rates of
postoperative atrial fibrillation were lower (11.6%) than in the placebo
group (29.6%). Conclusion(s): ASP1128 was safe and well-tolerated in
patients at risk for AKI following cardiac surgery, but it did not show
efficacy in renal endpoints. Copyright © 2023 International
Society of Nephrology

<45>
Accession Number
2023313674
Title
Percutaneous treatment of left circumflex coronary artery injury related
to mitral valve surgery: Case series and systematic review of the
literature.
Source
Catheterization and Cardiovascular Interventions. 102(1) (pp 121-137),
2023. Date of Publication: 01 Jul 2023.
Author
Benedetti A.; Castaldi G.; Poletti E.; Moroni A.; Scott B.; Convens C.;
Verheye S.; Vermeersch P.; Agostoni P.; Zivelonghi C.
Institution
(Benedetti, Castaldi, Poletti, Moroni, Scott, Convens, Verheye,
Vermeersch, Agostoni, Zivelonghi) HartCentrum, Ziekenhuis Netwerk
Antwerpen (ZNA) Middelheim, Antwerp, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Left circumflex coronary artery (LCx) injury related to mitral valve
surgery is a rare complication. The best treatment option is not defined,
and percutaneous coronary intervention (PCI) may represent an effective
treatment to avoid prolonged myocardial ischemia. To evaluate feasibility
and efficacy of PCI treatment, all records of LCx injury related to mitral
valve surgery and treated with PCI were included after a systematic PubMed
searching. Moreover, we retrospectively analyzed our single-center PCI
database and patients fulfilling the inclusion criteria were included.
Patients undergoing transcatheter mitral valve intervention, non-mitral
valve surgery, conservatively or surgically treated after LCx injury were
excluded. Data about patient characteristics, procedural details, PCI
success, and in-hospital mortality were collected. Fifty-six patients were
included, 58.9% were male (n = 33) and the median age was 60.5 years (IQR
= 21.75). The majority had left dominant or codominant coronary system
(62.2%, n = 28 and 15.6%, n = 7, respectively). Clinical manifestations
ranged from hemodynamic stability (21.1%, n = 8) to hemodynamic
instability (42.1%, n = 16) and cardiac arrest (18.4%, n = 7). On ECG,
23.5% of patients (n = 12) presented ST-segment depression, 58.8% (n = 30)
ST-segment elevation, 7.8% (n = 4) atrioventricular block, and 29.4% (n =
15) ventricular arrhythmias. Left ventricle dysfunction was present in
52.3% (n = 22) of patients and wall motion abnormalities in 71.4% (n =
30). PCI success rate was 82.1% (n = 46) and in-hospital mortality 4.5% (n
= 2). LCx injury related to mitral surgery is a rare complication
characterized by an increased risk of mortality. PCI seems a feasible
treatment option, still burdened by suboptimal results, probably related
to the technical challenges posed by the surgical failure. Copyright
© 2023 Wiley Periodicals LLC.

<46>
Accession Number
2023174570
Title
Mild aortic insufficiency following transcatheter aortic valve
replacement: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 102(1) (pp 166-175),
2023. Date of Publication: 01 Jul 2023.
Author
Hameed I.; Ahmed A.; Kumar A.; Li E.; Candelario K.; Khan S.; Kannan A.;
Latif N.; Amabile A.; Geirsson A.; Williams M.L.
Institution
(Hameed, Ahmed, Li, Candelario, Khan, Kannan, Latif, Amabile, Geirsson,
Williams) Section of Cardiac Surgery, Department of Surgery, Yale School
of Medicine, New Haven, CT, United States
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Post-procedural aortic insufficiency (AI) continues to be
prevalent following transcatheter aortic valve replacement (TAVR). While
several studies have assessed the outcomes of moderate-severe AI following
TAVR, the incidence, predictors, and outcomes of mild AI remain unclear.
 Method(s): A systematic literature review was performed to identify
studies reporting on mild AI following TAVR. The primary outcome was
pooled incidence of post-TAVR mild AI. Secondary outcomes included pooled
incidence of mild AI at 30 days and long term. The pooled incidence of
midterm mortality in patients with post-TAVR mild AI was also evaluated.
The random effect generalized linear mixed-effects model with
logit-transformed proportions and Hartung-Knapp adjustment was used to
calculate pooled incidence rates. Meta-regression was performed to
identify predictors of mild AI. Result(s): The pooled analysis
included 19,241 patients undergoing TAVR across 50 studies. The mean age
of patients ranged from 73 to 85 years, and female patients ranged from
20.0% to 83.3%. The overall pooled incidence of post-TAVR mild AI was
56.1% (95% confidence interval [CI] 0.31-0.64). The pooled incidence of
mild AI at 30 days was 33.7% (95% CI 0.12-0.37). At mean follow-up of 1.15
years, the pooled incidence of mild AI was 37.0% (95% CI 0.16-0.45). The
overall pooled incidence of Midterm mortality (mean follow-up 1.22 years)
in patients with mild AI was 14.8% (95% CI 0.10-0.25). At meta-regression,
none of the explored variables correlated with a difference in mild AI
incidence. Conclusion(s): In published studies to date, 50% of
patients undergoing TAVR develop mild AI postoperatively. In 37% of
patients, this persists in long term. Though the incidence of AI is likely
improving with newer generation TAVR valves, the prevalence and outcomes
of mild AI should be closely monitored as TAVR volume and indications
expand to younger patients with long life expectancy. The long-term
outcomes of mild AI remain unclear. Further dedicated studies on post-TAVR
mild AI are needed. Copyright © 2023 Wiley Periodicals LLC.

<47>
Accession Number
2023132741
Title
Transcatheter edge-to-edge mitral valve repair for post-myocardial
infarction papillary muscle rupture and acute heart failure: A systematic
review.
Source
Catheterization and Cardiovascular Interventions. 102(1) (pp 138-144),
2023. Date of Publication: 01 Jul 2023.
Author
Cali F.; Pagnesi M.; Pezzola E.; Montisci A.; Metra M.; Adamo M.
Institution
(Cali, Pagnesi, Pezzola, Metra, Adamo) Department of Medical and Surgical
Specialties, Radiological Sciences, and Public Health, Division of
Cardiology, ASST Spedali Civili di Brescia, University of Brescia,
Brescia, Italy
(Montisci) Division of Cardiothoracic Intensive Care, ASST Spedali Civili
di Brescia, Brescia, Italy
Publisher
John Wiley and Sons Inc
Abstract
Papillary muscle rupture (PMR) is a rare complication of acute myocardial
infarction (AMI) associated with high mortality and morbidity. Surgery is
the gold-standard treatment for these patients, but it is burdened by a
high perioperative risk due to hemodynamic instability. Mitral
transcatheter edge-to-edge repair (M-TEER) was reported to be safe and
effective in unstable patients with significant mitral regurgitation.
However, data in patients with post-AMI PMR are limited to a few case
reports. In this review, we summarized all data available regarding
percutaneous treatment of post-AMI PMR. These results show that M-TEER is
safe and effective in this setting with low in-hospital mortality and
complications and high rate of significant mitral regurgitation
reduction. Copyright © 2023 Wiley Periodicals LLC.

<48>
Accession Number
641747870
Title
The Predictive Ability of MAGGIC Score After Coronary Artery Bypass
Grafting: A Comparative Study.
Source
Brazilian journal of cardiovascular surgery. 38(4) (pp e20220355), 2023.
Date of Publication: 04 Jul 2023.
Author
Ozcan S.; Donmez E.; Ziyrek M.; Mert B.; Sahin I.; Okuyan E.; Ozkaynak B.
Institution
(Ozcan, Donmez, Ziyrek, Sahin, Okuyan) Department of Cardiology, Bagcilar
Training and Research Hospital, Istanbul, Turkey
(Mert, Ozkaynak) Department of Cardiovascular Surgery, Bagcilar Training
and Research Hospital, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The European System for Cardiac Operative Risk Evaluation
(EuroSCORE) II and the Society of Thoracic Surgeons (STS) are validated
scoring systems for short-term risk estimation after coronary artery
bypass grafting (CABG). The Meta-Analysis Global Group in Chronic Heart
Failure (MAGGIC) risk score is originally aimed to estimate mortality in
heart failure patients; however, it has showed a similar power to predict
mortality after heart valve surgery. In this study, we sought to evaluate
whether MAGGIC score may predict short and long-term mortality after CABG
and to compare its power with EuroSCORE II and STS scoring systems.
 METHOD(S): Patients who underwent CABG due to chronic coronary
syndrome at our institution were included in this retrospective study.
Follow-up data were used to define the predictive ability of MAGGIC and to
compare it with STS and EuroSCORE-II for early, one-year, and up to
10-year mortality. RESULT(S): MAGGIC, STS, and EuroSCORE-II scores
had good prognostic power, moreover MAGGIC was better for predicting
30-day (area under the curve [AUC]: 0.903; 95% confidence interval [CI]:
0.871-0.935), one-year (AUC: 0.931; 95% CI: 0.907-0.955), and 10-year
(AUC: 0.923; 95% CI: 0.893-0.954) mortality. MAGGIC was found to be an
independent predictor to sustain statistically significant association
with mortality in follow-up. CONCLUSION(S): MAGGIC scoring system had
a good predictive accuracy for early and long-term mortality in patients
undergoing CABG when compared to EuroSCORE-II and STS scores. It requires
limited variables for calculation and still yields better prognostic power
in determining 30-day, one-year, and up to 10-year mortality.

<49>
Accession Number
641747796
Title
Adaptation And Use of the Papworth Haemostasis Checklist - Clinical
Outcomes Analysis at Hospital Estadual Mario Covas.
Source
Brazilian journal of cardiovascular surgery. 38(4) (pp e20220305), 2023.
Date of Publication: 04 Jul 2023.
Author
Poltronieri P.B.; Freitas A.C.O.; Batista C.H.R.; Luz J.L.R.D.; Barbosa
M.B.; Goncalves R.S.; Smanio M.C.M.; Pires A.C.
Institution
(Poltronieri, Batista, Smanio) Faculdade de Medicina, Centro Universitario
FMABC, Santo Andre, Sao Paulo, Brazil
(Freitas, Luz, Barbosa, Goncalves) Centro de Cirurgia Cardiovascular,
Hospital Estadual Mario Covas, Santo Andre, Sao Paulo, Brazil
(Barbosa, Goncalves) Cardiovascular Surgery Department, Faculdade de
Medicina, Centro Universitario FMABC, Santo Andre, Sao Paulo, Brazil
(Pires) Cardiothoracic Surgery Department, Faculdade de Medicina, Centro
Universitario FMABC, Santo Andre, Sao Paulo, Brazil
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Postoperative bleeding is one of the main causes of
complications in cardiovascular surgery, which highlights the importance
of ensuring adequate intraoperative hemostasis, providing a better patient
outcome. This study aimed to improve the prevention of postoperative
bleeding in the Cardiovascular Surgery Department of the Hospital Estadual
Mario Covas (Santo Andre, Brazil) using an adapted version of the Papworth
Haemostasis Checklist to assess the impact of this standardization on
bleeding rate, postoperative complications, reoperation, and mortality.
 METHOD(S): This is a non-randomized controlled clinical trial, whose
non-probabilistic sample consisted of patients undergoing cardiac surgery
in the abovementioned service within a two-year interval. The Papworth
Haemostasis Checklist was adapted to the Brazilian laboratory parameters
and the questions were translated into Portuguese. This checklist was used
before the surgeon started the chest wall closure. Patients were followed
up until 30 days after surgery. A P-value < 0.05 was considered
statistically relevant. RESULT(S): This study included 200 patients.
After the checklist, a reduction in 24-hour drain output, postoperative
complications, and reoperation was observed, although statistical
significance was not reached. Finally, there was a significant reduction
in the number of deaths (8 vs. 2; P=0.05). CONCLUSION(S): The use of
the adapted checklist in our hospital proved to be an effective
intervention to improve the prevention of postoperative bleeding, with a
direct impact in the number of deaths in the study period. The reduction
in deaths was possible thanks to the reduction in the bleeding rate,
postoperative complications, and reoperations for bleeding.

<50>
Accession Number
641747118
Title
Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular
Septal Rupture: A Systematic Review and Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. 38(4) (pp e20220417), 2023.
Date of Publication: 04 Jul 2023.
Author
Wu X.; Wang C.; Du X.; Li Y.; He F.; Zhao Q.; Mao Y.
Institution
(Wu, Li, He, Zhao, Mao) Department of Cardiac Surgery, Lanzhou University
Second Hospital, Lanzhou University, Lanzhou, Gansu, China
(Wang) Health Science Center of Lanzhou University, Lanzhou University,
Lanzhou, Gansu, China
(Du) Tianjin University of Traditional Chinese Medicine, Tianjin, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Ventricular septal rupture is an important high-mortality
complication in the scope of myocardial infarctions. The effectiveness of
different treatment modalities is still controversial. This meta-analysis
compares the efficacy of percutaneous closure vs. surgical repair for the
treatment of postinfarction ventricular septal rupture (PI-VSR).
 METHOD(S): A meta-analysis was performed on relevant studies found
through PubMed, Embase, Web of Science, Cochrane Library, China National
Knowledge Infrastructure (or CNKI), Wanfang Data, and VIP databases
searching. The primary outcome was a comparison of in-hospital mortality
between the two treatments, and the secondary outcome was documentation of
one-year mortality, postoperative residual shunts, and postoperative
cardiac function. Differences were expressed as odds ratios (ORs) with 95%
confidence intervals (CIs) to assess the relationships between predefined
surgical variables and clinical outcomes. RESULT(S): Qualified
studies (742 patients from 12 trials) were found and investigated for this
meta-analysis (459 patients in the surgical repair group, 283 patients in
the percutaneous closure group). When comparing surgical repair to
percutaneous closure, it was found that the former significantly reduced
in-hospital mortality (OR: 0.67, 95% CI 0.48-0.96, P=0.03) and
postoperative residual shunts (OR: 0.03, 95% CI 0.01-0.10, P<0.00001).
Surgical repair also improved postoperative cardiac function overall (OR:
3.89, 95% CI 1.10-13.74, P=0.04). However, there was no statistically
significant difference in one-year mortality between the two surgical
strategies (OR: 0.58, 95% CI 0.24-1.39, P=0.23). CONCLUSION(S): We
found that surgical repair appears to be a more effective therapeutic
option than percutaneous closure for PI-VSR.

<51>
Accession Number
641743544
Title
Outcomes of valve-sparing aortic root replacement in patients with
bicuspid aortic valve and tricuspid aortic valve: a systematic review and
meta-analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 206), 2023. Date of
Publication: 03 Jul 2023.
Author
Zuo Y.; Tan R.; Qin C.
Institution
(Zuo, Tan) Department of Anesthesia, West China Hospital, Sichuan
University, Chengdu 610041, China
(Qin) Department of Cardiovascular Surgery and Cardiovascular Surgery
Research Laboratory, West China Hospital, Sichuan University, 37th Guoxue
Road, Chengdu 610041, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Valve-sparing aortic root replacement (VSARR) is a safe and
effective surgical procedure to treat aortic root aneurysm. This
meta-analysis aimed to investigate how this procedure might differ in
patients with bicuspid aortic valve (BAV) and tricuspid aortic valve
(TAV). DESIGN: Meta-analysis with meta-regression and systematic review.
SETTING: Systematic search in the following databases: PubMed, Cochrane
Central Register of Controlled Trials, and Embase. INTERVENTIONS: All
observational studies of VSARR in patients with BAV or TAV were included
in our study. Studies were included without any restrictions on language
or publication date. A trial sequential analysis and a post-hoc
meta-regression was performed on the main outcomes. RESULT(S): Eleven
articles met the inclusion criteria. A total of 1138 patients in BAV
group, and 2125 patients in TAV group. No significant differences in
gender and age were observed between BAV and TAV patients. BAV and TAV
patients showed no differences in in-hospital mortality rate [0.00% vs.
1.93%; RR (95% CI) 0.33 (0.09, 1.26), I2=0%, P=0.11] and the rate of
in-hospital reoperation [5.64% vs. 5.99%; RR (95% CI) 1.01(0.59, 1.73),
I2=33%, P=0.98]. The overall long-term mortality rate of BAV patients was
better than that of TAV patients [1.63% vs. 8.15%; RR (95% CI) 0.34 (0.13,
0.86), I2=0%, P=0.02]. During the follow-up observation period, patients
in TAV group showed small but no statistic advantage in 3-year, 5-year,
and over 10-year incidences of reintervention. Regarding the secondary
endpoints, the two groups showed similar aortic cross-clamping time and
total cardiopulmonary bypass time. CONCLUSION(S): The VSARR
techniques yielded similar clinical outcomes in both BAV and TAV patients.
Although patients with BAV might have a higher incidence of
reinterventions after initial VSARR, it is still a safe and effective
approach to treat aortic root dilation with or without aortic valve
insufficiency. TAV patients showed small but no statistic advantage in
long-term (over 10 years) reintervention rate, which means, patients with
BAV may face a higher risk of reintervention in the clinic. Copyright
© 2023. The Author(s).

<52>
Accession Number
641634237
Title
Safety and efficacy of colchicine for the prevention of post-operative
atrial fibrillation in patients undergoing cardiac surgery: a
meta-analysis of randomized controlled trials.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. 25(7)
(no pagination), 2023. Date of Publication: 04 Jul 2023.
Author
Agarwal S.; Beard C.W.; Khosla J.; Clifton S.; Anwaar M.F.; Ghani A.;
Farhat K.; Pyrpyris N.; Momani J.; Munir M.B.; DeSimone C.V.; Deshmukh A.;
Stavrakis S.; Jackman W.M.; Po S.; Asad Z.U.A.
Institution
(Agarwal, Beard, Khosla, Anwaar, Ghani, Farhat, Stavrakis, Jackman, Po,
Asad) Department of Medicine, University of Oklahoma Health Sciences
Center, 800 Stanton L Young Blvd, Oklahoma City, OK 73104, United States
(Clifton) Robert M Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Pyrpyris) First Department of Cardiology, School of Medicine, National
and Kapodistrian University of Athens, Hippokration Hospital, Athens,
Greece
(Momani) Department of Internal Medicine, Alfaisal University, Riyadh,
Saudi Arabia
(Munir) Division of Cardiovascular Medicine, University of California
Davis, Sacramento, CA, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: Colchicine is an anti-inflammatory drug that may
prevent post-operative atrial fibrillation (POAF). The effect of this drug
has been inconsistently shown in previous clinical trials. We aimed to
compare the efficacy and safety of colchicine vs. placebo to prevent POAF
in patients undergoing cardiac surgery. METHODS AND RESULTS: A systematic
search of EMBASE, MEDLINE, SCOPUS, ClinicalTrials.gov, and the Cochrane
Library for randomized controlled trials (RCTs) was conducted from
inception till April 2023. The primary outcome was the incidence of POAF
after any cardiac surgery. The secondary outcome was the rate of drug
discontinuation due to adverse events and adverse gastrointestinal events.
Risk ratios (RR) were reported using the Mantel Haenszel method. A total
of eight RCTs comprising 1885 patients were included. There was a
statistically significant lower risk of developing POAF with colchicine
vs. placebo (RR: 0.70; 95% CI: 0.59-0.82; P < 0.01, I2 = 0%), and this
effect persisted across different subgroups. There was a significantly
higher risk of adverse gastrointestinal events (RR: 2.20; 95% CI:
1.38-3.51; P < 0.01, I2 = 55%) with no difference in the risk of drug
discontinuation in patients receiving colchicine vs. placebo (RR: 1.33;
95% CI: 0.93-1.89; P = 0.11, I2 = 0%). CONCLUSION(S): This
meta-analysis of eight RCTs shows that colchicine is effective at
preventing POAF, with a significantly higher risk of adverse
gastrointestinal events but no difference in the rate of drug
discontinuation. Future studies are required to define the optimal
duration and dose of colchicine for the prevention of POAF. Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<53>
Accession Number
2025522471
Title
Use of a mixed reality system for navigational mapping during cardiac
electrophysiological testing does not prolong case duration: A subanalysis
from the Cardiac Augmented REality study.
Source
Cardiovascular Digital Health Journal. (no pagination), 2023. Date of
Publication: 2023.
Author
Bloom D.; Catherall D.; Miller N.; Southworth M.K.; Glatz A.C.; Silva
J.R.; Avari Silva J.N.
Institution
(Bloom, Glatz, Avari Silva) Department of Pediatrics, Division of
Cardiology, Washington University in St. Louis, School of Medicine, St.
Louis, Missouri, United States
(Catherall) School of Medicine, Washington University School of Medicine,
St. Louis, Missouri, United States
(Miller) Pediatric Cardiology/Electrophysiology, St. Louis Children's
Hospital, St. Louis, Missouri, United States
(Southworth, Silva, Avari Silva) SentiAR, Inc., St. Louis, Missouri,
United States
(Silva, Avari Silva) Department of Biomedical Engineering. Washington
University in St. Louis, McKelvey School of Engineering, St. Louis,
Missouri, United States
Publisher
Elsevier Inc.
Abstract
Background: CommandEPTM is a mixed reality (MXR) system for cardiac
electrophysiological (EP) procedures that provides a real-time
3-dimensional digital image of cardiac geometry and catheter locations. In
a previous study, physicians using the system demonstrated improved
navigational accuracy. This study investigated the impact of the CommandEP
system on EP procedural times compared to the standard-of-care
electroanatomic mapping system (EAMS) display. Objective(s): The
purpose of this retrospective case-controlled analysis was to evaluate the
impact of a novel MXR interface on EP procedural times compared to a
case-matched cohort. Method(s): Cases from the Cardiac Augmented
REality (CARE) study were matched for diagnosis and weight using a
contemporary cohort. Procedural time was compared from the roll-in and
full implementation cohort. During routine EP procedures, operators
performed tasks during the postablation waiting phase, including creation
of cardiac geometry and 5-point navigation under 2 conditions: (1) EAMS
first; and (2) CommandEP. Result(s): From a total of 16 CARE study
patients, the 10 full implementation patients were matched to a cohort of
20 control patients (2 controls:1 CARE, matched according to pathology and
age/weight). No statistical difference in total case times between CARE
study patients vs control group (118 +/- 29 minutes vs 97 +/- 20 minutes;
P = .07) or fluoroscopy times (6 +/- 4 minutes vs 7 +/- 6 minutes; P =
.9). No significant difference in case duration for CARE study patients
comparing roll-in vs full-implementation cohort (121 +/- 26 minutes vs 118
+/- 29 minutes; P = .96). CommandEP wear time during cases was
significantly longer in full implementation cases (53 +/- 24 minutes vs 24
+/- 5 minutes; P = .0009). During creation of a single cardiac geometry,
no significant time difference was noted between CommandEP vs EAMS (284
+/- 45 seconds vs 268 +/- 43 seconds; P = .1) or fluoroscopy use (9 +/- 19
seconds vs 6 +/- 18 seconds; P = .25). During point navigation tasks,
there was no difference in total time (CommandEP 31 +/- 14 seconds vs EAMS
28 +/- 15 seconds; P = .16) or fluoroscopy time (CommandEP 0 second vs
EAMS 0 second). Conclusion(s): MXR did not prolong overall procedural
time compared to a matched cohort. There was no prolongation in study task
completion time. Future studies with experienced CommandEP users directly
assessing procedural time and task completion time in a randomized study
population would be of interest. Copyright © 2023

<54>
Accession Number
2025519691
Title
The incidence of surgical site infections in China.
Source
Journal of Hospital Infection. (no pagination), 2023. Date of
Publication: 2023.
Author
Lin J.; Peng Y.; Guo L.; Tao S.; Li S.; Huang W.; Yang X.; Qiao F.; Zong
Z.
Institution
(Lin, Zong) Center of Infectious Diseases, West China Hospital, Sichuan
University, Chengdu, China
(Lin, Peng, Guo, Tao, Li, Huang, Qiao) Department of Infectious Control,
West China Hospital, Sichuan University, Chengdu, China
(Yang) Southern Central Hospital of Yunnan Province, Honghe, China
(Zong) Center for Pathogen Research, West China Hospital, Sichuan
University, Chengdu, China
Publisher
W.B. Saunders Ltd
Abstract
Surgical site infections (SSIs) are a common type of healthcare-associated
infection. We performed a literature review to demonstrate the incidence
of SSIs in mainland China based on studies since 2010. We included 231
eligible studies with >=30 postoperative patients, comprising 14 providing
overall SSI data regardless of surgical sites and 217 reporting SSIs for a
specific site. We found that the overall SSI incidence was 2.91% (median;
interquartile range: 1.05%, 4.57%) or 3.18% (pooled; 95% confidence
interval: 1.85%, 4.51%) and the SSI incidence varied remarkably according
to the surgical site between the lowest (median, 1.00%; pooled, 1.69%) in
thyroid surgeries and the highest (median, 14.89%; pooled, 12.54%) in
colorectal procedures. We uncovered that Enterobacterales and
staphylococci were the most common types of micro-organisms associated
with SSIs after various abdominal surgeries and cardiac or neurological
procedures, respectively. We identified two, nine, and five studies
addressing the impact of SSIs on mortality, the length of stay (LOS) in
hospital, and additional healthcare-related economic burden, respectively,
all of which demonstrated increased mortality, prolonged LOS, and elevated
medical costs associated with SSIs among affected patients. Our findings
illustrate that SSIs remain a relatively common, serious threat to patient
safety in China, requiring more action. To tackle SSIs, we propose to
establish a nationwide network for SSI surveillance using unified criteria
with the aid of informatic techniques and to tailor and implement
countermeasures based on local data and observation. We highlight that the
impact of SSIs in China warrants further study. Copyright © 2023
The Healthcare Infection Society

<55>
Accession Number
2024189834
Title
External stenting for saphenous vein grafts in coronary artery bypass
grafting: A meta-analysis.
Source
European Journal of Clinical Investigation. (no pagination), 2023. Date
of Publication: 2023.
Author
Chen H.; Si K.; Wu X.; Ni H.; Tang Y.; Liu W.; Wang Z.
Institution
(Chen, Wang, Wang) Department of Neurosurgery & Brain and Nerve Research
Laboratory, The First Affiliated Hospital of Soochow University, Jiangsu
Province, China
(Chen) Department of Neurology, The First Affiliated Hospital of Soochow
University, Suzhou, China
(Si) Department of Cardiovascular Surgery, The First Affiliated Hospital
of Soochow University, Suzhou, China
(Wu, Ni, Tang) Suzhou Medical College of Soochow University, Suzhou, China
(Liu) Department of Medicine, The Tianjin North China Hospital, Tianjin,
China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Autologous saphenous vein grafts (SVGs) are the most commonly
used bypass conduits in coronary artery bypass grafting (CABG) with
multivessel coronary artery disease. Although external support devices for
SVGs have shown promising outcomes, the overall efficacy and safety
remains controversial. We aimed to evaluate external stenting for SVGs in
CABG versus non-stented SVGs. Method(s): MEDLINE, EMBASE, Cochrane
Library and clinicaltrails.gov were searched for randomized controlled
trials (RCTs) to evaluate external-stented SVGs versus non-stented SVGs in
CABG up to 31 August 2022. The risk ratio and mean difference with 95%
confidence interval were analysed. The primary efficacy outcomes included
intimal hyperplasia area and thickness. The secondary efficacy outcomes
were graft failure (>=50% stenosis) and lumen diameter uniformity.
 Result(s): We pooled 438 patients from three RCTs. The external
stented SVGs group showed significant reductions in intimal hyperplasia
area (MD: -0.78, p < 0.001, I2 = 0%) and thickness (MD: -0.06,
p < 0.001, I2 = 0%) compared to the non-stented SVGs group.
Meanwhile, external support devices improved lumen uniformity with
Fitzgibbon I classification (risk ratio (RR):1.1595, p = 0.05,
I2 = 0%). SVG failure rates were not increased in the external
stented SVGs group during the short follow-up period (RR: 1.14, p = 0.38,
I2 = 0%). Furthermore, the incidences of mortality and major
cardiac and cerebrovascular events were consistent with previous reports.
 Conclusion(s): External support devices for SVGs significantly
reduced the intimal hyperplasia area and thickness, and improved the lumen
uniformity, assessed with the Fitzgibbon I classification. Meanwhile, they
did not increase the overall SVG failure rate. Copyright © 2023
Stichting European Society for Clinical Investigation Journal Foundation.
Published by John Wiley & Sons Ltd.

<56>
Accession Number
641751607
Title
Natural history and clinical burden of moderate aortic stenosis: a
systematic review and explorative meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). (no pagination),
2023. Date of Publication: 27 Jun 2023.
Author
Morelli M.; Galasso M.; Esposito G.; Soriano F.S.; Nava S.; Da Pozzo C.;
Bossi I.; Piccaluga E.; Bruschi G.; Maloberti A.; Oliva F.; Oreglia J.A.;
Giannattasio C.; Montalto C.
Institution
(Morelli, Galasso, Maloberti, Giannattasio) School of Medicine and
Surgery, University of Milano-Bicocca
(Esposito, Soriano, Nava, Bossi, Piccaluga, Oliva, Oreglia, Montalto)
Interventional Cardiology, Division of Cardiology, De Gasperis Cardio
Center, Niguarda Hospital
(Da Pozzo) School of Medicine and Surgery, University of Milan
(Bruschi) Department of Cardiac Surgery
(Maloberti, Giannattasio) Division of Cardiology, De Gasperis Cardio
Center, Niguarda Hospital, Milan, Italy
Publisher
NLM (Medline)
Abstract
AIMS: The mortality risk of patients with moderate aortic stenosis is not
well known, but recent studies suggested that it might negatively affect
prognosis. We aimed to assess the natural history and clinical burden of
moderate aortic stenosis and to investigate the interaction of patients'
baseline characteristics with prognosis. METHOD(S): Systematic
research was conducted on PubMed. The inclusion criteria were inclusion of
patients with moderate aortic stenosis; and report of the survival at
1-year follow-up (minimum). Incidence ratios related to all-cause
mortality in patients and controls of each study were estimated and then
pooled using a fixed effects model. All patients with mild aortic stenosis
or without aortic stenosis were considered controls. Meta-regression
analysis was performed to assess the impact of left ventricular ejection
fraction and age on the prognosis of patients with moderate aortic
stenosis. RESULT(S): Fifteen studies and 11 596 patients with
moderate aortic stenosis were included. All-cause mortality was
significantly higher among patients with moderate aortic stenosis than in
controls in all timeframes analysed (all P < 0.0001). Left ventricular
ejection fraction and sex did not significantly impact on the prognosis of
patients with moderate aortic stenosis (P = 0.4584 and P = 0.5792), while
increasing age showed a significant interaction with mortality (estimate =
0.0067; 95% confidence interval: 0.0007-0.0127; P = 0.0323).
 CONCLUSION(S): Moderate aortic stenosis is associated with reduced
survival. Further studies are necessary to confirm the prognostic impact
of this valvulopathy and the possible benefit of aortic valve
replacement. Copyright © 2023 Italian Federation of Cardiology -
I.F.C. All rights reserved.

<57>
Accession Number
641751214
Title
Paravertebral block combined with serratus anterior plane block after
video-assisted thoracic surgery: a prospective randomized controlled
trial-Response.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 06 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 F-76000,
France
(Baste) Department of Thoracic Surgery, CHU Rouen, Rouen F-76000, France
Publisher
NLM (Medline)

<58>
Accession Number
641750958
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in dialysis-dependent patients: a meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). (no pagination),
2023. Date of Publication: 30 May 2023.
Author
Burton S.; Reynolds A.; King N.; Modi A.; Asopa S.
Institution
(Burton) Faculty of Medicine and Dentistry, University of Plymouth,
Plymouth, United Kingdom
(Reynolds) Swansea University Medical School, Wales, United Kingdom
(King) Faculty of Health, University of Plymouth, Plymouth, United Kingdom
(Modi) Wessex Cardiac Centre, Southampton, Bermuda
(Asopa) Southwest Cardiothoracic Centre, Plymouth, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This meta-analysis aims to compare the clinical outcomes of
transcatheter aortic valve implantation (TAVI) versus aortic valve
replacement (AVR) for aortic stenosis in dialysis-dependent patients.
 METHOD(S): Literature searches employed PubMed, Web of Science,
Google Scholar and Embase to identify relevant studies. Bias-treated data
were prioritized, isolated and pooled for analysis; raw data were utilized
where bias-treated data were unavailable. Outcomes were analysed to assess
for study data crossover. RESULT(S): Literature search identified 10
retrospective studies; following data source analysis, five studies were
included. Upon pooling of bias-treated data, TAVI was significantly
favoured in early mortality [odds ratio (OR), 0.42; 95% confidence
interval (95% CI), 0.19-0.92; I2 = 92%; P = 0.03], 1-year mortality (OR,
0.88; 95% CI 0.80-0.97; I2 = 0%; P = 0.01), rates of
stroke/cerebrovascular events (OR, 0.71; 95% CI 0.55-0.93; I2 = 0%; P =
0.01) and blood transfusions (OR, 0.36; 95% CI 0.21-0.62; I2 = 86%; P =
0.0002). Pooling demonstrated fewer new pacemaker implantations in the AVR
group (OR, 3.33; 95% CI 1.94-5.73; I2 = 74%; P <= 0.0001) and no
difference in the rate of vascular complications (OR, 2.27; 95% CI
0.60-8.59; I2 = 83%; P = 0.23). Analysis including raw data revealed the
length of hospital stay to favour TAVI with a mean difference of -9.20
days (95% CI -15.58 to -2.82; I2 = 97%; P = 0.005). CONCLUSION(S):
Bias-treated meta-analysis comparing surgical AVR and TAVI favoured TAVI
in early mortality, 1-year mortality, rates of stroke/cerebrovascular
events and blood transfusions. There was no difference in the rates of
vascular complications; however, TAVI required more pacemaker
implantations. Data pooling including raw data revealed that the length of
hospital admission favours TAVI. Copyright © 2023 Italian
Federation of Cardiology - I.F.C. All rights reserved.

<59>
Accession Number
641749186
Title
Reviewing the Impact of Topical and Intravenous Tranexamic Acid Use in
Breast Plastic Surgery.
Source
Annals of plastic surgery. (no pagination), 2023. Date of Publication: 05
Jul 2023.
Author
Parmeshwar N.; Mehta S.R.; Piper M.
Institution
(Parmeshwar) From the Division of Plastic and Reconstructive Surgery,
University of California San Francisco, San Francisco, CA, United States
(Mehta) Wright State University, School of Medicine, Fairborn, OH, United
States
(Piper) University of California San Francisco, San Francisco, CA, United
States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Topical and intravenous uses of tranexamic acid (TXA) have
been shown to reduce bleeding and ecchymosis in various surgical fields.
However, there is a lack of data evaluating the efficacy of TXA in breast
surgery. This systematic review evaluates the impact of TXA on hematoma
and seroma incidence in breast plastic surgery. METHOD(S): A
systematic review of the literature was performed for all studies that
evaluated the use of TXA in breast surgery including reduction
mammoplasty, gynecomastia surgery, masculinizing chest surgery, or
mastectomy. Outcomes of interest included rate of hematoma, seroma, and
drain output. RESULT(S): Thirteen studies met the inclusion criteria
with a total of 3297 breasts, of which 1656 were treated with any TXA, 745
with topical TXA, and 1641 were controls. There was a statistically
significant decrease in hematoma formation seen in patients who received
any form of TXA compared with control (odds ratio [OR], 0.37; P < 0.001),
and a similar tendency toward decreased hematoma with topically treated
TXA (OR, 0.42; P = 0.06). There was no significant difference in seroma
formation with any TXA (OR, 0.84; P = 0.33) or topical TXA (OR, 0.91; P =
0.70). When stratified by surgery, there was a 75% decrease in the odds of
hematoma formation with any TXA compared with the control for oncologic
mastectomy (OR, 0.25; P = 0.003) and a 56% decrease in nononcologic breast
surgery (OR, 0.44; P = 0.003). CONCLUSION(S): This review suggests
that TXA may significantly reduce hematoma formation in breast surgery and
may also decrease seroma and drain output. Future high-quality prospective
studies are required to evaluate the utility of topical and intravenous
TXA in decreasing hematoma, seroma, and drain output in breast surgery
patients. Copyright © 2023 Wolters Kluwer Health, Inc. All rights
reserved.

<60>
Accession Number
641748065
Title
A randomised controlled trial of prehabilitation in patients undergoing
elective cardiac surgery.
Source
Anaesthesia. (no pagination), 2023. Date of Publication: 04 Jul 2023.
Author
Akowuah E.F.; Wagnild J.M.; Bardgett M.; Prichard J.G.; Mathias A.;
Harrison S.L.; Ogundimu E.O.; Hancock H.C.; Maier R.H.
Institution
(Akowuah, Maier) Academic Cardiovascular Unit, South Tees Hospitals NHS
Foundation Trust, Middlesbrough, United Kingdom
(Akowuah) Translational and Clinical Research Institute, Newcastle
University, Newcastle Upon Tyne, United Kingdom
(Wagnild) Department of Anthropology, Durham University, Durham, United
Kingdom
(Bardgett, Prichard, Mathias, Hancock) Newcastle Clinical Trials Unit,
Newcastle University, Newcastle Upon Tyne, United Kingdom
(Harrison) Centre for Rehabilitation, School of Health and Life Sciences,
Teesside University, Middlesborough, United Kingdom
(Ogundimu) Durham Biostatistics Unit, Department of Mathematical Sciences,
Durham University, Durham, United Kingdom
Publisher
NLM (Medline)
Abstract
The feasibility, safety and efficacy of prehabilitation in adult patients
awaiting elective cardiac surgery are unknown. A total of 180 participants
undergoing elective cardiac surgery were allocated randomly to receive
either standard pre-operative care or prehabilitation, consisting of
pre-operative exercise and inspiratory muscle training. The primary
outcome was change in six-minute walk test distance from baseline to
pre-operative assessment. Secondary outcomes included change in
inspiratory muscle strength (maximal inspiratory pressure); sarcopenia
(handgrip strength); quality of life and compliance. Safety outcomes were
pre-specified surgical and pulmonary complications and adverse events. All
outcomes were assessed at baseline; at pre-operative assessment; and 6 and
12weeks following surgery. Mean (SD) age was 64.7 (10.2) years; 33/180
(18%) were women. In total, 65/91 (71.4%) participants who were allocated
to prehabilitation attended at least four of eight supervised in-hospital
exercise classes; participants aged >50years were more likely than younger
participants to attend (odds ratio (95%CI) of 4.6 (1.0-25.1)). Six-minute
walk test was not significantly different between groups (mean difference
(95%CI) -7.8m (-30.6-15.0), p=0.503) in the intention-to-treat analysis.
Subgroup analyses based on tests for interaction indicated improvements in
six-minute walk test distance were larger amongst sarcopenic patients in
the prehabilitation group (p=0.004). Change in maximal inspiratory
pressure from baseline to all time-points was significantly greater in the
prehabilitation group, with the greatest mean difference (95%CI) observed
12weeks after surgery (10.6 cmH2 O (4.6-16.6) cmH2 O, p<0.001). There were
no differences in handgrip strength or quality of life up to 12weeks after
surgery. There was no significant difference in postoperative mortality
(one death in each group), surgical or pulmonary complications. Of 71
pre-operative adverse events, six (8.5%) were related to prehabilitation.
The combination of exercise and inspiratory muscle training in a
prehabilitation intervention before cardiac surgery was not superior to
standard care in improving functional exercise capacity measured by
six-minute walk test distance pre-operatively. Future trials should target
patients living with sarcopenia and include inspiratory muscle strength
training. Copyright © 2023 The Authors. Anaesthesia published by
John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

<61>
Accession Number
641747658
Title
Culprit vessel only versus complete revascularization following
thrombolysis in patients with ST elevation myocardial infraction and
multivessel coronary artery disease - A prospective study.
Source
Indian heart journal. (no pagination), 2023. Date of Publication: 02 Jul
2023.
Author
Jain C.; Dash P.K.; Iyer V.R.; Deshmukh R.
Institution
(Jain, Dash, Iyer, Deshmukh) Department of Cardiology, Sri Satya Sai
General Hospital, Puttaparthi, Andhra Pradesh 515134, India
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The present study compares the treatment outcomes of only
culprit vessel PCI and complete revascularization in patients with STEMI
and multivessel disease (MVD) following thrombolysis. METHOD(S): This
was a single-center, prospective randomized study including total 108
patients at a tertiary care center within 3-24 h post-thrombolysis and
undergoing pharmacoinvasive PCI, were enrolled and randomized into two
groups: complete revascularization PCI group and culprit only PCI group.
The primary outcomes were evaluated by cardiac mortality, repeat
myocardial infarction (MI)/acute coronary syndrome (ACS) and refractory
angina. The secondary outcomes include repeat revascularization and safety
outcomes namely contrast induced nephropathy (CIN), cerebrovascular
accident (CVA) and major bleeding were compared among both the groups at
one year follow-up. RESULT(S): Complete revascularization PCI group
and culprit only PCI group had 54 patients in each group. Left ventricular
ejection fraction did not show significant difference at discharge (p = 1)
but was significantly improved in complete revascularization PCI group (p
= 0.001) at one year follow-up. Reduced number of outcomes with a
significant difference in both the groups were seen in the primary
outcomes such as cardiac mortality (p = 0.01), repeat MI/ACS (p = 0.01)
and refractory angina (p = 0.038) along with repeat revascularization (p =
0.001) at one year follow-up. Complete revascularization did not show any
statistically significant difference in CIN (p = 0.567), CVA (p = 0.153)
and major bleeding (p = 0.322) then culprit only revascularization group.
 CONCLUSION(S): In patients with STEMI and MVD, complete
revascularization was found more favourable in terms of primary and
secondary outcomes compared to culprit only
revascularization. Copyright © 2023. Published by Elsevier, a
division of RELX India, Pvt. Ltd.

<62>
Accession Number
641747567
Title
The safety of thoracic paravertebral block and erector spinae plane block
in patients treated with anticoagulant or antiplatelet therapy. A
narrative review of the evidence.
Source
Minerva anestesiologica. (no pagination), 2023. Date of Publication: 05
Jul 2023.
Author
Nisi F.; Sella N.; DI Gregorio G.; Lubian M.; Giustiniano E.; Rosboch
G.L.; Balzani E.; Toscano A.; Strano G.; Rispoli M.; Massullo D.; Fiorelli
S.; Santonastaso D.; Agnoletti V.; Piccioni F.
Institution
(Nisi) Department of Anesthesia and Intensive Care, IRCCS Humanitas
Research Hospital, Rozzano, Milan, Italy -
(Sella) Institute of Anesthesia and Intensive Care, University Hospital of
Padua, Padua, Italy
(DI Gregorio) Department of Anesthesia and Intensive Care, ULSS6 Euganea,
Cittadella, Padua, Italy
(Lubian, Giustiniano, Strano, Piccioni) Department of Anesthesia and
Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
(Rosboch, Toscano) Department of Anesthesia, Intensive Care and Emergency,
Molinette Hospital, Citta della Salute e della Scienza, Turin, Italy
(Balzani) Department of Surgical Science, University of Turin, Turin,
Italy
(Rispoli) Department of Anesthesia and Intensive Care, AO dei Colli -
Monaldi Hospital, Naples, Italy
(Massullo, Fiorelli) Unit of Anesthesia and Intensive Care Medicine,
Department of Clinical and Surgical Translational Medicine, Sant'Andrea
Hospital, Sapienza University, Rome, Italy
(Santonastaso, Agnoletti) Unit of Anesthesia and Intensive Care,
Department of Surgery and Trauma, Maurizio Bufalini Hospital, Cesena,
Italy
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The management of thoracic paravertebral block (TPVB) and
erector spine plane block (ESPB) in patients treated with anticoagulant or
antiplatelet therapy is based on limited clinical data, mostly from single
case reports. Scientific societies and organizations do not provide strong
detailed indications about the limitations of these regional anesthesia
techniques in patients receiving antithrombotic therapy. This review
summarizes evidence regarding TPVB and ESPB in patients under
antithrombotic therapy. EVIDENCE ACQUSITION: A literature review from
PubMed/MEDLINE, EMBASE, Cochrane, Google Scholar and Web of Science
databases was conducted from 1999 to 2022 to identify articles concerning
TPVB and ESPB for cardio-thoracic surgery or thoracic procedures in
patients under anticoagulant or antiplatelet therapy. EVIDENCE SYNTHESIS:
A total of 1704 articles were identified from the initial search. After
removing duplicates and not-pertinent articles, 15 articles were analyzed.
The results demonstrated a low risk of bleeding for TPVB and minimal or
absent risk for ESPB. Ultrasound guidance was extensively used to perform
ESPB, but not for TPVB. CONCLUSION(S): Although the low level of
evidence available, TPVB and ESPB are reasonably safe options in patients
ineligible for epidural anesthesia due to antithrombotic therapy. The few
published studies suggest that ESPB offers a risk profile safer than TPVB
and the use of ultrasound guidance minimizes any complication. Since the
literature available does not allow us to draw definitive conclusions,
future adequately-powered trials are warranted to determine the
indications and the safety of TPVB and ESPB in patients receiving
anticoagulant or antiplatelet therapy.

<63>
Accession Number
641747525
Title
Acute Glycemic Variability and Early Outcomes After Cardiac Surgery: A
Meta-Analysis.
Source
Hormone and metabolic research = Hormon- und Stoffwechselforschung =
Hormones et metabolisme. (no pagination), 2023. Date of Publication: 04
Jul 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
NLM (Medline)
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. Copyright
Thieme. All rights reserved.

<64>
Accession Number
641747021
Title
Relative efficacy and safety of several regional analgesic techniques
following thoracic surgery: a network meta-analysis of randomized
controlled trials.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 03 Jul 2023.
Author
Li J.; Sun Q.; Zong L.; Lssi D.; Jin X.; Zhang L.
Institution
(Li) Department of Thoracic Surgery, Xinjiang Medical University, First
Affiliated Hospital, Urumqi, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: This network meta-analysis (NMA) was performed to assess the
relative efficacy and safety of various regional analgesic techniques used
in thoracic surgery. MATERIALSAND METHODS: Randomized controlled trials
(RCTs) evaluating different regional analgesic methods were retrieved from
databases, including PubMed, Embase, Web of Science, and the Cochrane
Library, from inception to March 2021. The surface under the cumulative
ranking curve (SUCRA) was estimated to rank the therapies based on the
Bayesian theorem. Moreover, sensitivity and subgroup analyses were
performed on the primary outcomes to obtain more reliable conclusions.
 RESULT(S): Fifty-four trials (3,360 patients) containing six
different methods were included. Thoracic paravertebral block (TPVB) and
erector spinae plane block (ESPB) were ranked the highest in reducing
postoperative pain. As for total adverse reactions and postoperative
nausea and vomiting (PONV), postoperative complications, and duration of
hospitalization, ESPB was found to be superior to other methods. It should
be noted that there were few differences between various methods for all
outcomes. CONCLUSION(S): Available evidence suggests that ESPB might
be the most effective and safest method for relieving pain after thoracic
surgery, shortening the length of hospital stay and reducing the incidence
of postoperative complications. Copyright © 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<65>
Accession Number
2025335293
Title
Calcification of Synthetic Vascular Grafts: A Systematic Review.
Source
EJVES Vascular Forum. 60 (pp 1-7), 2023. Date of Publication: January
2023.
Author
Lejay A.; Bratu B.; Kuntz S.; Neumann N.; Heim F.; Chakfe N.
Institution
(Lejay, Bratu, Kuntz, Chakfe) Department of Vascular Surgery and Kidney
Transplantation, University Hospital of Strasbourg, France
(Lejay, Kuntz, Neumann, Heim, Chakfe) Gepromed, Medical Device Hub for
Patient Safety, Strasbourg, France
(Heim) Laboratoire de Physique et Mecanique Textiles (LPMT), ENSISA,
Mulhouse, France
Publisher
Elsevier Ltd
Abstract
Objective: Calcification of vascular grafts, including polyethylene
terephthalate (PET) and expanded polytetrafluoroethylene (ePTFE) grafts
may contribute to graft failure, but is under reported. The aim of this
study was to review the literature to assess whether vascular graft
calcification is deleterious to vascular graft outcomes. Data sources: The
Medline and Embase databases were searched. Review methods: A systematic
literature search according to PRISMA Guidelines was performed using a
combined search strategy of MeSH terms. The MeSH terms used were
"calcification, physiologic", "calcinosis", "vascular grafting", "blood
vessel prosthesis", "polyethylene terephthalates", and
"polytetrafluoroethylene". Result(s): The systematic search
identified 17 cases of PET graft calcification and 73 cases of ePTFE graft
calcification over a 35 year period. All cases of PET graft calcification
were reported in grafts explanted for graft failure. The majority of cases
of ePTFE graft calcification were unexpectedly noted in grafts used during
cardiovascular procedures and subsequently removed. Conclusion(s):
Calcification of synthetic vascular grafts is under reported but can
compromise the long term performance of the grafts. More data, including
specific analysis of radiological findings as well as explant analysis are
needed to obtain a more sensitive and specific analysis of the prevalence
and incidence of vascular graft calcification and the impact of
calcification on synthetic graft outcomes. Copyright © 2023 The
Authors

<66>
Accession Number
2024044870
Title
Effect of Coronary Sinus Reducer Implantation on Aerobic Exercise Capacity
in Refractory Angina Patients-A CROSSROAD Study.
Source
Journal of Cardiovascular Development and Disease. 10(6) (no pagination),
2023. Article Number: 235. Date of Publication: June 2023.
Author
Mrak M.; Pavsic N.; Zizek D.; Lezaic L.; Bunc M.
Institution
(Mrak, Pavsic, Zizek, Bunc) Department of Cardiology, University Medical
Centre Ljubljana, Ljubljana 1000, Slovenia
(Mrak, Pavsic, Zizek, Lezaic, Bunc) Faculty of Medicine, University of
Ljubljana, Ljubljana 1000, Slovenia
(Lezaic) Department of Nuclear Medicine, University Medical Centre
Ljubljana, Ljubljana 1000, Slovenia
Publisher
MDPI
Abstract
Coronary sinus reducer (CSR) implantation is a new treatment option for
patients with refractory angina pectoris. However, there is no evidence
from a randomized trial that would show an improvement in exercise
capacity after this treatment. The aim of this study was to evaluate the
influence of CSR treatment on maximal oxygen consumption and compare it to
a sham procedure. Twenty-five patients with refractory angina pectoris
(Canadian Cardiovascular Society (CCS) class II-IV) were randomized to a
CSR implantation (n = 13) or a sham procedure (n = 12). At baseline and
after 6 months of follow-up, the patients underwent symptom-limited
cardiopulmonary exercise testing with an adjusted ramp protocol and
assessment of angina pectoris using the CCS scale and Seattle angina
pectoris questionnaire (SAQ). In the CSR group, maximal oxygen consumption
increased from 15.56 +/- 4.05 to 18.4 +/- 5.2 mL/kg/min (p = 0.03) but did
not change in the sham group (p = 0.53); p for intergroup comparison was
0.03. In contrast, there was no difference in the improvement of the CCS
class or SAQ domains. To conclude, in patients with refractory angina and
optimized medical therapy, CSR implantation may improve oxygen consumption
beyond that of optimal medical therapy. Copyright © 2023 by the
authors.

<67>
Accession Number
2023890995
Title
Cerebral embolic protection during transcatheter aortic valve replacement:
a systematic review and meta-analysis of propensity score matched and
randomized controlled trials using the Sentinel cerebral embolic
protection device.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
306. Date of Publication: December 2023.
Author
Wolfrum M.; Handerer I.J.; Moccetti F.; Schmeisser A.; Braun-Dullaeus
R.C.; Toggweiler S.
Institution
(Wolfrum, Moccetti, Toggweiler) Heart Center Lucerne, Luzerner
Kantonsspital, Lucerne, Switzerland
(Wolfrum, Handerer, Schmeisser, Braun-Dullaeus) Department of Internal
Medicine, Division of Cardiology and Angiology, Magdeburg University,
Magdeburg, Germany
Publisher
BioMed Central Ltd
Abstract
Background: The Sentinel cerebral embolic protection device (CEP) aims to
reduce the risk of stroke during transcatheter aortic valve replacement
(TAVR). We performed a systematic review and meta-analysis of propensity
score matched (PSM) and randomized controlled trials (RCT) investigating
the effect of the Sentinel CEP to prevent strokes during TAVR.
 Method(s): Eligible trials were searched through PubMed, ISI Web of
science databases, Cochrane database, and proceedings of major congresses.
Primary outcome was stroke. Secondary outcomes included all-cause
mortality, major or life-threatening bleeding, major vascular
complications and acute kidney injury at discharge. Fixed and random
effect models were used to calculate the pooled risk ratio (RR) with 95%
confidence intervals (CI) and absolute risk difference (ARD).
 Result(s): A total of 4066 patients from 4 RCTs (3'506 patients) and
1 PSM study (560 patients) were included. Use of Sentinel CEP was
successful in 92% of patients and was associated with a significantly
lower risk of stroke (RR: 0.67, 95% CI: 0.48-0.95, p = 0.02. ARD: -1.3%,
95% CI: -2.3 - -0.2, p = 0.02, number needed to treat (NNT) = 77), and a
reduced risk of disabling stroke (RR: 0.33, 95% CI: 0.17-0.65. ARD: -0.9%,
95% CI: -1.5 - -0.3, p = 0.004, NNT = 111). Use of Sentinel CEP was
associated with a lower risk of major or life-threatening bleeding (RR:
0.37, 95% CI: 0.16-0.87, p = 0.02). Risk for nondisabling stroke (RR:
0.93, 95% CI: 0.62-1.40, p = 0.73), all-cause mortality (RR: 0.70, 95% CI:
0.35-1.40, p = 0.31), major vascular complications (RR: 0.74, 95% CI:
0.33-1.67, p = 0.47) and acute kidney injury (RR: 0.74, 95% CI: 0.37-1.50,
p = 0.40) were similar. Conclusion(s): The use of CEP during TAVR was
associated with lower risks of any stroke and disabling stroke with an NNT
of 77 and 111, respectively. Copyright © 2023, The Author(s).

<68>
Accession Number
2021778309
Title
Refraining from Packed Red Blood Cells in Cardiopulmonary Bypass Priming
as a Method of Neuroprotection in Pediatric Cardiac Surgery.
Source
Journal of Clinical Medicine. 12(4) (no pagination), 2023. Article Number:
1465. Date of Publication: February 2023.
Author
Ivkin A.A.; Grigoriev E.; Sinitskaya A.V.
Institution
(Ivkin, Grigoriev, Sinitskaya) Research Institute for Complex Issues of
Cardiovascular Diseases, Kemerovo 650002, Russian Federation
Publisher
MDPI
Abstract
Congenital heart defect (CHD) surgeries are performed with cardiopulmonary
bypass (CPB) and are complicated by several factors that affect the
child's brain. However, to date, the number of studies on brain protection
in cardiac surgery remains small. The aim of this study was to assess the
impact of refraining from using packed red blood cells (PRBCs) in priming
solutions in children with congenital defects (CHDs) who require surgical
interventions using CPB to prevent brain injury in the postoperative
period. Material(s) and Method(s): This study included 40 children,
and the mean age was 14 (12-22.5) months and the mean weight was 8.8
(7.25-11) kg. All patients underwent CHD closure using CPB. The patients
were divided into two groups depending on the use of PRBCs in the priming
solution. Brain injury was assessed using three specific blood serum
markers, namely S100 calcium-binding protein beta (S100beta),
neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP)
before surgery, after the completion of CPB and 16 h after surgery (first,
second and third control points). Markers of systemic inflammatory
response were also analyzed, including interleukin-1, -6, -10 and tumor
necrosis factor alpha (TNF-alpha). A clinical assessment of brain injury
was carried out using a valid, rapid, observational tool for screening
delirium in children of this age group, i.e., "Cornell Assessment of
Pediatric Delirium". Result(s): Factors of the intra- and
postoperative period were analyzed, such as hemoglobin levels, oxygen
delivery (cerebral tissue oxygenation, blood lactate level and venous
oxygen saturation) and indicators of organ dysfunction (creatinine, urea,
bilirubin levels, duration of CPB and length of stay in the ICU).
Following the procedure, there were no significant differences between the
groups and all indicators were within the reference values, thus
demonstrating the safety of CHD closure without transfusion. Moreover, the
highest level of specific markers of brain injury were noted immediately
after the completion of CPB in both groups. The concentration of all three
markers was significantly higher in the group with transfusion after the
completion of CPB. Moreover, GFAP levels were higher in the transfusion
group and 16 h after surgery. Conclusion(s): The results of the study
show the safety and effectiveness of brain injury prevention strategies
that consist of not conducting PRBC transfusion. Copyright © 2023
by the authors.

<69>
Accession Number
641739204
Title
Exploring the Impact of Age, Frailty, and Multimorbidity on ICU
interventions: A Systematic Review.
Source
Canadian Journal of Anesthesia. Conference: Critical Care Canada Forum
2022. Toronto, ON Canada. 70(Supplement 1) (pp S84-S86), 2023. Date of
Publication: May 2023.
Author
Perrella A.; Geen O.; Scott S.; Kaushik R.; Ahuja M.; Rochwerg B.
Institution
(Perrella, Geen) Department of Medicine, Division of Geriatric Medicine,
McMaster University, Hamilton, Canada
(Scott, Ahuja) Department of Medicine, McMaster University, Hamilton,
Canada
(Kaushik) Department of Medicine, Yale University, New Haven, United
States
(Rochwerg) Department of Medicine, Division of Critical Care, McMaster
University, Hamilton, Canada
(Rochwerg) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Canada
Publisher
Springer
Abstract
INTRODUCTION Intensive care unit (ICU) demographics are shifting. Recent
data from the United States has demonstrated that patients aged 85 and
older account for 20% of all ICU admissions,1 and Canada has seen a
similar aging of its ICU population compared to 15 years ago.2 These
trends coincide with medical advances that have allowed for a higher
quality of life into older age and reduced mortality from critical
illness. With the emergence of novel critical care therapeutics, the
question arises whether older adults respond similarly to such treatments
given differences in homeostasis and underlying pathophysiology. However,
it is not clear whether patients with increased age, frailty, or
multimorbidity respond differently to ICU interventions, as very few
trials have specifically examined these populations. OBJECTIVES This
systematic review addresses the prevalence of subgroup effect
modification-statistically significant differences in relative effect-in
older patients, those with increased frailty, and/or those with
multimorbidity, as reported by randomized controlled trials (RCTs)
examining any critical care intervention published in high-impact journals
in the last 10 years. This review also seeks to explore whether there are
study characteristics associated with subgroup effect modification by age,
frailty, or multimorbidity. It is hypothesized that baseline risk may
influence the absolute effect of an intervention, but differences in
relative effects based on subgroups will be rare. METHODS We conducted a
systematic search of high-impact general medicine (JAMA, NEJM, Lancet,
JAMA-IM, Annals of Internal Medicine, CMAJ) or critical care journals
(Critical Care Medicine, Intensive Care Medicine, American Journal of
Respiratory and Critical Care Medicine, CHEST, Lancet Respiratory
Medicine) for RCTs published between January 1, 2011 and December 31,
2021. We included studies if they examined any intervention or treatment
strategy in the ICU and reported data for any of the subgroups of age,
frailty, and/or multimorbidity (all as defined by study authors) for any
outcome of interest. Studies were screened independently and in duplicate
first by title and abstract, and then full-text to determine eligibility.
We defined a statistically significant subgroup effect as an interaction
p-value of <0.05. For any statistically significant subgroup effect, we
assessed credibility in the subgroup finding using the ICEMAN tool.3 We
present results descriptively using proportions and tabular outputs.
RESULTS Of 2037 citations, we included 48 RCTs (n=50,779 patients)
comprising 23 different interventions. All studies reported subgroup data
for age (variably defined), two reported subgroup data for multimorbidity,
and one reported subgroup data for frailty. Seven (14.6%) RCTs found
evidence of statistically significant effect modification based on age.
Interventions examined in these RCTs which were more effective in older
adults than younger adults included restrictive blood transfusion in
cardiovascular surgery patients (moderate credibility), immediate
angiography in out-of-hospital cardiac arrest patients without ST
elevation (low credibility), lower blood pressure targets for vasopressor
therapy in shock (low credibility), and C1-esterase inhibitor use in
sepsis (very low credibility). Interventions examined in these RCTs which
were less effective in older adults included hypothermia in status
epilepticus (low credibility) and talactoferrin use in severe sepsis (very
low credibility). The multimorbidity or frailty subgroups did not find
evidence of statistically significant effect modification. CONCLUSION Most
critical care RCTs do not examine subgroup effects by age, frailty or
multimorbidity. Even when age is considered, true effect modification is
rare. As such, if an intervention or care strategy shows benefit in the
generalized critical care population, it is likely that the same benefit
will remain for older patients. Although interventional effects are likely
similar across age groups, shared decision making based on individual
patient preferences must remain a priority. RCTs focused specifically on
critically ill older adults or those living with frailty and/or
multimorbidity would be crucial to further addressing this research
question.

<70>
Accession Number
641739133
Title
Comparing the Intraoperative use of Balanced Crystalloids Vs. 0.9% Saline
on Postoperative Outcomes: A Systematic Review and Meta-Analysis.
Source
Canadian Journal of Anesthesia. Conference: Critical Care Canada Forum
2022. Toronto, ON Canada. 70(Supplement 1) (pp S52-S54), 2023. Date of
Publication: May 2023.
Author
Vignarajah M.; Berg A.; Abdallah Z.; Arora N.; Rochwerg B.
Institution
(Vignarajah, Berg, Abdallah, Rochwerg) Department of Medicine, McMaster
University, Hamilton, Canada
(Arora) Department of Emergency Medicine, University of Ottawa, Ottawa,
Canada
(Rochwerg) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Canada
Publisher
Springer
Abstract
INTRODUCTION Crystalloids are commonly used intraoperative fluids due to
their low cost, ease of use, and effectiveness in fluid resuscitation.
Balanced crystalloids, such as Ringer's lactate or plasmalyte, are
crystalloids which have an electrolyte composition that closely resembles
blood plasma. Whereas 0.9% saline (saline), an unbalanced crystalloid,
contains only sodium and chloride. The evidence regarding optimal
crystalloid use in the intraoperative period remains unclear.1 OBJECTIVES
The objective of this review is to assess whether use of balanced
crystalloids as compared to saline leads to differences in postoperative
blood test results and patient outcomes. METHODS We searched Ovid MEDLINE,
Embase, the Cochrane library, and Clinicaltrials.gov for randomized
control trials (RCTs) that compared intraoperative use of balanced
crystalloids to saline. Two reviewers independently screened citations in
two stages and extracted study data using a predesigned case report form.
We pooled data using a random effect model and present risk ratios (RR) or
mean differences (MD), along with 95% confidence intervals (CIs). We
assessed risk of bias (RoB) using the modified Cochrane RoB tool and
certainty of evidence using GRADE methodology. For postoperative blood
results, if multiple endpoints were available, we used the time point
closest to the end of surgery. RESULTS Of 5232 citations, we included 41
RCTs (n=3290 patients) examining patients undergoing neurosurgery, general
surgery, renal transplantation, obstetric surgery, orthopedic surgery,
cardiac surgery, and endoscopic procedures. Pooled analysis showed that
use of balanced crystalloids as compared to saline had an uncertain effect
on postoperative mortality (RR 1.65, 95% CI: 0.40 to 6.90, very low
certainty), and may have no effect on hospital length of stay (MD 0.07
days fewer (95% CI: 0.98 days fewer to 0.85 days more, low certainty).
Intraoperative use of balanced crystalloids probably leads to a higher
postoperative serum pH (MD 0.05, 95% CI: 0.04 to 0.06) and higher
postoperative serum bicarbonate (MD 2.45 mmol/L, (95% CI: 1.81 to 3.09),
and a lower postoperative serum chloride (MD 6.18 mmol/L lower, 95% CI
3.98 to 8.37 lower) compared to saline (all moderate certainty) and may
lead to higher postoperative serum lactate (MD 0.18 mmol/L, 95% CI: 0.01
to 0.35, low certainty). CONCLUSION Use of balanced crystalloids in the
intraoperative settings has an uncertain effect on mortality and may have
no effect on hospital length of stay as compared to 0.9% saline. Balanced
crystalloid use is probably associated with increased postoperative serum
pH, chloride, and bicarbonate levels and may increase postoperative
lactate levels. This review has the potential to inform future guidelines
regarding intraoperative fluid management.

<71>
Accession Number
641739125
Title
Use of platelet gel in the rapid closure of the sternum after cardiac
surgery.
Source
Blood Transfusion. Conference: 7. Conferenza Nazionale dei Servizi
Trasfusionali. Vicenza Italy. 21(Supplement 2) (pp s192-s193), 2023. Date
of Publication: May 2023.
Author
Ferrara D.; Bannera A.F.
Institution
(Ferrara, Bannera) Department of Immunohematology and Transfusion
Medicine, ARNAS Civic Hospital, Palermo, Italy
Publisher
Edizioni SIMTI
Abstract
Background. Many heart surgeries require sternotomy, including heart
transplantation. The use of platelet gel is crucial for speeding up the
closure of the wound and for minimizing the risk of postoperative
infections, the length of stay in hospital and with it the health costs.
Methods. In this study, we evaluated the impact of using this topical
blood component in sternotomies for cardiac surgery. Ninety cardiac
surgery operations in which sternotomy had to be performed were observed.
Patients aged between 20 and 80 years were recruited. Of these 45 patients
who did not receive platelet gel on the sternotomies wound was considered
the control group. Were measured as control parameters: a) the length of
hospitalization expressed in days; b) the incidence of postoperative
infections; c) the speed of wound closure. The gel was created using
platelets extracted from 56 mL of whole blood (seven 8 mL tubes of whole
blood are collected). Reptilase (Batroxobin) was used as gelling agent,
left to act for 8 minutes before application, to allow the complete
formation of the gel. Results. The group of patients treated with platelet
gel show different results compared to the controls. The graph shows the
results obtained. The control group, as shown in graph A, differs in the
higher presence of patients with diabetes (glucose > 8.33 mmol/L) but
lower number of smokers and overweight. The results obtained in graph B
are favorable for patients treated with platelet gel; in fact, all the
parameters under examination are lower than those found in patients with
spontaneous wound healing. The treatment group reported no wound
infections; however, three patients (6.6%) in the control group
experienced incision wound infections. Furthermore, a greater speed in the
healing of the sternal wound was observed and therefore a shorter period
of hospitalization. Conclusions. The study conducted represents the
description of our experience, however some randomized studies provide
adequate scientific evidence and confirm the usefulness of platelet gel in
facilitating the healing of operating wounds in cardiac surgery.

<72>
Accession Number
641737044
Title
Novel Biomarkers in Childhood Acute Kidney Injury: A Meta-analysis of
Diagnostic Test Accuracy.
Source
Pediatric Nephrology. Conference: 19th Congress of the International
Pediatric Nephrology Association, IPNA 2022. Calgary, AB Canada. 38(7) (pp
2433), 2023. Date of Publication: July 2023.
Author
Meena J.; Thomas C.C.; Kumar J.
Institution
(Meena, Kumar) Post-Graduate Institute of Medical Education and Research,
Advanced Pediatrics Centre, Chandigarh, India
(Thomas) Government Medical College- Alappuzha, Pediatrics, Alappuzha,
India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Early accurate recognition of acute kidney injury in children
may improve morbidity and mortality. Traditional diagnosis of AKI by serum
creatinine and urine output has inherent limitations and may delay
diagnosis. Novel non-invasive biomarkers ushered a new era that may allow
early recognition of AKI. Method(s): This meta-analysis aimed to
quantitatively synthesize the diagnostic performance of the novel
biomarkers in predicting AKI. We searched PubMed, EMBASE, and Web of
Sciences for studies published till January 2022. Search terms included
acute kidney injury, pediatrics, adolescent, and biomarker. Two reviewers
independently assessed the studies for eligibility. Cohort and
cross-sectional studies evaluating the diagnostic performance of various
biomarkers in predicting AKI. The QUADAS-2 tool for quality assessment.
The hierarchical summary receiver operating characteristic (HSROC) model
was used to synthesize the summary estimates of diagnostic parameters.
Diagnostic accuracy was reported using summary sensitivity, specificity,
and area under the curve (AUC) with 95% CI. Result(s): Overall,
thirty-five studies were included in this metaanalysis. Urinary NGAL
showed summary sensitivity, specificity, and AUC of 0.75 (95% CI,
0.61-0.86), 0.84 (0.73-0.91), and 0.87 (0.84-0.89) respectively for the
prediction of AKI in children who underwent cardiac surgery. In the
setting of the intensive care unit (ICU) AUC was 0.81 (0.77-0.84) for the
prediction of AKI. Similarly, the AUC of serum NGAL for ICU and cardiac
surgery patients was 0.83 (0.80-0.86) and 0.92 (0.90-0.94), respectively.
We observed a pooled AUC of 0.83 (0.79-0.86) for serum cystatin C in an
ICU setting in the prediction of AKI. The AUC of IL-18 for predicting AKI
was 0.73 (0.69-0.77). Conclusion(s): Pooled evidence suggests that
NGAL and serum cystatin C have good predicting ability and may have
potential role in early recognition of patients at higher risk of AKI in
routine clinical practice.

<73>
Accession Number
641736052
Title
SMOKING CESSATION AND DEATH OR RECURRENCE OF CARDIOVASCULAR EVENTS IN A
LONG-TERM, RANDOMIZED CONTROLLED TRIAL.
Source
European Stroke Journal. Conference: 9th European Stroke Organisation
Conference, ESOC 2023. Munich Germany. 8(2 Supplement) (pp 64), 2023. Date
of Publication: May 2023.
Author
Aslund L.; Irewall A.-L.; Ogren J.; Mooe T.
Institution
(Aslund, Irewall, Ogren, Mooe) Umea University, Department of Public
Health and Clinical Medicine, Ostersund, Umea, Sweden
Publisher
SAGE Publications Ltd
Abstract
Background and aims: About 50% of patients continue to smoke after stroke
and other cardiovascular events. We aimed to assess 1) the effect of
telephone-based advice by a nurse on long-term smoking cessation and 2)
association between early smoking cessation and long-term prognosis.
 Method(s): The NAILED trial included patients with stroke/TIA/acute
coronary syndrome at Ostersund Hospital during 2010-2014. Participants
were randomized to nurse-based, telephone follow-up (intervention) or
usual care (control) and followed until 31-dec-2017. The intervention
consisted of yearly assessment of modifiable risk factors and lifestyle
consultation including advice to quit smoking. Participants that reported
current smoking during hospitalization and were alive at 1 month when the
intervention began were included in this sub study (n=313). We used
chi2-test to compared self-reported smoking cessation at the last
followup. Association between smoking cessation and 1) recurrence of major
cardiovascular events, MACE (stroke, myocardial infarction, cardiac
revascularization, cardiovascular death), and 2) all-cause mortality was
analyzed using Kaplan-Meier survival analysis with log rank test.
 Result(s): After a mean follow-up of 4.2 years, 165 participants
reported non-smoking, 50.3 % and 55.2 % in the intervention and control
group (p=0.387), respectively. Of these, 79.4 % had stopped smoking within
1 month after discharge. A MACE occurred in 72 participants and 59
participants died. Smoking cessation within 1 month was associated with
lower incidence of MACE (p=0.039) and lower all-cause mortality (p=0.004).
 Conclusion(s): Yearly consultation with a nurse did not improve
longterm smoking cessation after stroke/TIA/ACS. Continued smoking past 1
month was associated with worse prognosis.

<74>
[Use Link to view the full text]
Accession Number
2025184420
Title
Transplantation Outcomes with Donor Hearts after Circulatory Death.
Source
New England Journal of Medicine. 388(23) (pp 2121-2131), 2023. Date of
Publication: 2023.
Author
Schroder J.N.; Patel C.B.; Devore A.D.; Bryner B.S.; Casalinova S.; Shah
A.; Smith J.W.; Fiedler A.G.; Daneshmand M.; Silvestry S.; Geirsson A.;
Pretorius V.; Joyce D.L.; Um J.Y.; Esmailian F.; Takeda K.; Mudy K.; Shudo
Y.; Salerno C.T.; Pham S.M.; Goldstein D.J.; Philpott J.; Dunning J.;
Lozonschi L.; Couper G.S.; Mallidi H.R.; Givertz M.M.; Pham D.T.; Shaffer
A.W.; Kai M.; Quader M.A.; Absi T.; Attia T.S.; Shukrallah B.; Sun B.C.;
Farr M.; Mehra M.R.; Madsen J.C.; Milano C.A.; D'alessandro D.A.
Institution
(Schroder, Patel, Devore, Casalinova, Milano) Duke University Medical
Center, Durham, NC, United States
(Bryner, Pham) Northwestern University, Chicago, United States
(Salerno) University of Chicago, Chicago, United States
(Shah, Absi) Vanderbilt University Medical Center, Nashville, United
States
(Smith) University of Wisconsin Hospital and Clinics, Madison, United
States
(Joyce) Medical College of Wisconsin, Milwaukee, United States
(Fiedler) University of California, San Francisco, United States
(Pretorius) University of California, La Jolla, San Diego, United States
(Esmailian) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Shudo) Stanford University Medical Center, Stanford, CA, United States
(Daneshmand, Attia) Emory University Hospital, Atlanta, United States
(Silvestry) Advent Health, Orlando, United States
(Pham) Mayo Clinic, Jacksonville, FL, United States
(Goldstein, Lozonschi) Tampa General Hospital, Tampa, FL, United States
(Geirsson) Yale School of Medicine, New Haven, CT, United States
(Um) Nebraska Medical Center, Omaha, United States
(Takeda) Columbia University Medical Center, New York, United States
(Goldstein) Montefiore Medical Center, Bronx, United States
(Kai) Westchester Medical Center, Valhalla, NY, United States
(Mudy, Shukrallah, Sun) Minneapolis Heart Institute Foundation,
Minneapolis, United States
(Dunning, Shaffer) University of Minnesota Medical Center, Minneapolis,
United States
(Philpott) Sentara Norfolk General Hospital, Norfolk, United States
(Quader) Virginia Commonwealth University, Richmond, VA, United States
(Couper) Tufts Medical Center, Boston, United States
(Mallidi, Givertz, Mehra) Brigham and Women's Hospital, Boston, United
States
(Madsen, D'alessandro) Massachusetts General Hospital, Boston, United
States
(Farr) University of Texas Southwestern Medical Center, Dallas, United
States
Publisher
Massachussetts Medical Society
Abstract
Background Data showing the efficacy and safety of the transplantation of
hearts obtained from donors after circulatory death as compared with
hearts obtained from donors after brain death are limited. Methods We
conducted a randomized, noninferiority trial in which adult candidates for
heart transplantation were assigned in a 3:1 ratio to receive a heart
after the circulatory death of the donor or a heart from a donor after
brain death if that heart was available first (circulatory-death group) or
to receive only a heart that had been preserved with the use of
traditional cold storage after the brain death of the donor (brain-death
group). The primary end point was the risk-adjusted survival at 6 months
in the as-treated circulatory-death group as compared with the brain-death
group. The primary safety end point was serious adverse events associated
with the heart graft at 30 days after transplantation. Results A total of
180 patients underwent transplantation; 90 (assigned to the
circulatory-death group) received a heart donated after circulatory death
and 90 (regardless of group assignment) received a heart donated after
brain death. A total of 166 transplant recipients were included in the
as-treated primary analysis (80 who received a heart from a
circulatory-death donor and 86 who received a heart from a brain-death
donor). The risk-adjusted 6-month survival in the as-treated population
was 94% (95% confidence interval [CI], 88 to 99) among recipients of a
heart from a circulatory-death donor, as compared with 90% (95% CI, 84 to
97) among recipients of a heart from a brain-death donor (least-squares
mean difference, -3 percentage points; 90% CI, -10 to 3; P<0.001 for
noninferiority [margin, 20 percentage points]). There were no substantial
between-group differences in the mean per-patient number of serious
adverse events associated with the heart graft at 30 days after
transplantation. Conclusions In this trial, risk-adjusted survival at 6
months after transplantation with a donor heart that had been reanimated
and assessed with the use of extracorporeal nonischemic perfusion after
circulatory death was not inferior to that after standard-care
transplantation with a donor heart that had been preserved with the use of
cold storage after brain death. Copyright © 2023 Massachusetts
Medical Society.

<75>
Accession Number
2025332615
Title
Efficacy of autologous plateletpheresis in adult aortic surgery: Study
protocol for a randomised controlled trial.
Source
BMJ Open. 13(6) (no pagination), 2023. Article Number: e073341. Date of
Publication: 07 Jun 2023.
Author
Gao J.; Jia J.; Gao X.; Ji H.
Institution
(Gao, Ji) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Science, Peking Union Medical College, Beijing, China
(Jia, Gao, Ji) Department of Transfusion Medicine, Fuwai Hospital, Chinese
Academy of Medical Science, Peking Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Perioperative coagulopathy is common in patients undergoing
aortic surgery, increasing the risk of excessive blood loss and subsequent
allogeneic transfusion. Blood conservation has become a vital part of
cardiovascular surgery, but measures to protect platelets from destruction
by cardiopulmonary bypass (CPB) are still lacking. Autologous platelet
concentrate (APC) may have potential benefits for intraoperative blood
preservation, but its efficacy has not been studied extensively. This
study aims to evaluate the efficacy of APC as a blood conservation
technique to reduce blood transfusion in adult aortic surgery. Methods and
analysis This is a prospective, single-centre, single-blind randomised
controlled trial. A total of 344 adult patients undergoing aortic surgery
with CPB will be enrolled and randomised to either the APC group or the
control group with a 1:1 randomisation ratio. Patients in the APC group
will receive autologous plateletpheresis before heparinisation, while
those in the control group will not. The primary outcome is the
perioperative packed red blood cell (pRBC) transfusion rate. Secondary
endpoints include the volume of perioperative pRBC transfusion; drainage
volume within 72 hours post-surgery; postoperative coagulation and
platelet function; and the incidence of adverse events. Data will be
analysed according to the intention-to-treat principle. Ethics and
dissemination This study was approved by the institutional review board of
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College (no. 2022-1806). All procedures included in this study
will be performed in adherence to the Helsinki Declaration. The results of
the trial will be published in an international peer-reviewed journal.
Trial registration number Chinese Clinical Trial Register
(ChiCTR2200065834). Copyright © 2023 Authors. All rights
reserved.

<76>
Accession Number
2024638649
Title
Sequential hybrid ablation versus surgical CryoMaze alone for treatment of
atrial fibrillation (SurHyb Trial): a protocol of the multicentre
randomized controlled trial.
Source
Journal of Applied Biomedicine. 21(2) (pp 67-72), 2023. Date of
Publication: 2023.
Author
Bulava A.; Mokracek A.; Wichterle D.; Budera P.; Osmancik P.; Kacer P.;
Veteskova L.; Nemec P.; Skala T.; Santavy P.; Chovancik J.; Branny P.;
Rizov V.; Kolesar M.; Rybar M.
Institution
(Bulava, Mokracek) University of South Bohemia in Ceske Budejovice,
Faculty of Health and Social Sciences, Cardiac Centre, Ceske Budejovice
Hospital, Ceske Budejovice, Czechia
(Wichterle, Budera) Institute for Clinical and Experimental Medicine,
Praha, Czechia
(Osmancik, Kacer) Charles University and University Hospital Kralovske
Vinohrady, 3rd Faculty of Medicine, Praha, Czechia
(Veteskova, Nemec) Centre of Cardiovascular Surgery and Transplantation,
Brno, Czechia
(Skala, Santavy) Palacky University, Faculty of Medicine and Dentistry,
University Hospital Olomouc, Olomouc, Czechia
(Chovancik, Branny) Hospital Agel Trinec-Podlesi, Trinec, Czechia
(Rizov, Kolesar) Masaryk Hospital, Usti nad Labem, Czechia
(Rybar) Czech Technical University in Prague, Faculty of Biomedical
Engineering, Department of Biomedical Technology, Kladno, Czechia
Publisher
University of South Bohemia in Ceske Budejovice Faculty of Health and
Social Sciences
Abstract
Background: Atrial fibrillation is common in patients with structural
heart disease who are undergoing cardiac surgery. Surgical CryoMaze has
been shown to be an effective treatment in several trials, but success
rates have varied considerably, between 47-95%. The sequential hybrid
approach, combining surgical CryoMaze followed by radiofrequency catheter
ablation, can achieve high freedom from atrial arrhythmias. However, in
patients with concomitant surgical atrial fibrillation treatment, data
comparing the hybrid approach to CryoMaze alone are lacking.
 Method(s): The SurHyb study was designed as a prospective,
open-label, multicentre randomized trial. Patients with non-paroxysmal
atrial fibrillation who were scheduled for coronary artery bypass grafting
or valve repair/replacement were randomized to either surgical CryoMaze
alone or surgical CryoMaze followed by radiofrequency catheter ablation 3
months post-surgery. The primary outcome measure was arrhythmia-free
survival without class I or III antiarrhythmic drugs, which has been
evaluated using implantable cardiac monitors. Conclusion(s): This is
the first randomized study that compares concomitant surgical CryoMaze
alone with the staged hybrid surgical CryoMaze followed by catheter
ablation, in patients with non-paroxysmal atrial fibrillation using
rigorous rhythm monitoring. The results may contribute to the optimization
of the treatment in patients undergoing concomitant CryoMaze for atrial
fibrillation. Copyright © 2023 The Authors. Published by
University of South Bohemia in Ceske Budejovice, Faculty of Health and
Social Sciences.

<77>
Accession Number
2025491765
Title
3D-Printed silicone anatomic patient simulator to enhance training on
cardiopulmonary bypass.
Source
Journal of Extra-Corporeal Technology. 55(2) (pp 53-59), 2023. Date of
Publication: 01 Jun 2023.
Author
Messarra B.T.; Wang Y.; Smith P.A.; Peak P.; Adams D.L.; Crane T.N.
Institution
(Messarra, Adams, Crane) School of Perfusion Technology, Texas Heart
Institute, Houston, TX 77030, United States
(Wang, Smith, Peak) Innovative Device and Engineering Applications (IDEA)
Laboratory, Texas Heart Institute, Houston, TX 77030, United States
Publisher
EDP Sciences
Abstract
Background: Simulator training is important for teaching perfusion
students fundamental skills associated with CBP before they start working
in the clinic. Currently available high-fidelity simulators lack anatomic
features that would help students visually understand the connection
between hemodynamic parameters and anatomic structure. Therefore, a
3D-printed silicone cardiovascular system was developed at our
institution. This study aimed to determine whether using this anatomic
perfusion simulator instead of a traditional a bucketa simulator would
better improve perfusion students'understanding of cannulation sites,
blood flow, and anatomy. Method(s): Sixteen students were tested to
establish their baseline knowledge. They were randomly divided into two
groups to witness a simulated bypass pump run on one of two simulators
-anatomic or bucket -then retested. To better analyze the data, we defined
a true learninga as characterized by an incorrect answer on the
pre-simulation assessment being corrected on the post-simulation
assessment. Result(s): The group that witnessed the simulated pump
run on the anatomic simulator showed a larger increase in mean test score,
more instances of true learning, and a larger gain in the acuity
confidence interval. Conclusion(s): Despite the small sample size,
the results suggest that the anatomic simulator is a valuable instrument
for teaching new perfusion students. Copyright © The Author(s),
published by EDP Sciences, 2023.

<78>
Accession Number
2024103264
Title
Coronary revascularization for heart failure with coronary artery disease:
A systematic review and meta-analysis of randomized trials.
Source
European Journal of Heart Failure. (no pagination), 2023. Date of
Publication: 2023.
Author
Iaconelli A.; Pellicori P.; Dolce P.; Busti M.; Ruggio A.; Aspromonte N.;
D'Amario D.; Galli M.; Princi G.; Caiazzo E.; Rezig A.O.M.; Maffia P.;
Pecorini G.; Crea F.; Cleland J.G.F.
Institution
(Iaconelli, Pellicori, Cleland) School of Cardiovascular and Metabolic
Health, University of Glasgow, Glasgow, United Kingdom
(Iaconelli, Ruggio, Aspromonte) Department of Cardiovascular Medicine,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
(Dolce) Department of Public Health, University of Naples Federico II,
Naples, Italy
(Busti, Princi, Crea) Department of Cardiovascular Sciences, Catholic
University of the Sacred Heart, Rome, Italy
(D'Amario) Department of Translational Medicine, University of Eastern
Piedmont, Novara, Italy
(D'Amario) Division of Cardiology, Azienda Ospedaliero Universitaria
'Maggiore della Carita', Novara, Italy
(Galli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Caiazzo, Maffia) Department of Pharmacy, School of Medicine and Surgery,
University of Naples Federico II, Naples, Italy
(Caiazzo, Rezig, Maffia) School of Infection and Immunity, College of
Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow,
United Kingdom
(Pecorini) Cardiovascular Internal Medicine Unit, Department of
Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Rome, Italy
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Coronary artery disease (CAD) is a common cause of heart failure
(HF). Whether coronary revascularization improves outcomes in patients
with HF receiving guideline-recommended pharmacological therapy (GRPT)
remains uncertain; therefore, we conducted a systematic review and
meta-analysis of relevant randomized controlled trials (RCTs).
 Methods and Results: We searched in public databases for RCTs
published between 1 January 2001 and 22 November 2022, investigating the
effects of coronary revascularization on morbidity and mortality in
patients with chronic HF due to CAD. All-cause mortality was the primary
outcome. We included five RCTs that enrolled, altogether, 2842 patients
(most aged <65 years; 85% men; 67% with left ventricular ejection fraction
<=35%). Overall, compared to medical therapy alone, coronary
revascularization was associated with a lower risk of all-cause mortality
(hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.79-0.99; p =
0.0278) and cardiovascular mortality (HR 0.80, 95% CI 0.70-0.93; p =
0.0024) but not the composite of hospitalization for HF or all-cause
mortality (HR 0.87, 95% CI 0.74-1.01; p = 0.0728). There were insufficient
data to show whether the effects of coronary artery bypass graft surgery
or percutaneous coronary intervention were similar or differed.
 Conclusion(s): For patients with chronic HF and CAD enrolled in RCTs,
the effect of coronary revascularization on all-cause mortality was
statistically significant but neither substantial (HR 0.88) nor robust
(upper 95% CI close to 1.0). RCTs were not blinded, which may bias
reporting of the cause-specific reasons for hospitalization and mortality.
Further trials are required to determine which patients with HF and CAD
obtain a substantial benefit from coronary revascularization by either
coronary artery bypass graft surgery or percutaneous coronary
intervention. Copyright © 2023 The Authors. European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<79>
Accession Number
641743287
Title
Amiodarone accumulates two cholesterol precursors in myocardium: A
controlled clinical study.
Source
Journal of internal medicine. (no pagination), 2023. Date of Publication:
03 Jul 2023.
Author
Simonen P.; Lommi J.; Lemstrom K.; Tolva J.; Sinisalo J.; Gylling H.
Institution
(Simonen, Lommi, Sinisalo) Heart and Lung Center, Cardiology, University
of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Lemstrom, Gylling) Heart and Lung Center, University of Helsinki and
Helsinki University Hospital, Helsinki, Finland
(Tolva) Transplantation Laboratory, Department of Pathology, University of
Helsinki, Helsinki, Finland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Amiodarone is an effective antiarrhythmic drug, which
interferes with cholesterol synthesis. In the human body it inhibits two
enzymes in the cholesterol-synthesis pathway, followed by increases
especially in serum desmosterol and zymostenol concentrations and a
decrease in that of serum lathosterol. OBJECTIVE(S): We explored
whether desmosterol and zymostenol accumulate also in myocardial tissue
during amiodarone treatment. METHOD(S): Thirty-three patients
admitted for cardiac transplantation volunteered for the study. Ten
patients were on amiodarone treatment (AD group) and 23 were not (control
group). The groups were matched as regards demographic and clinical
variables. Myocardial samples were obtained from the removed hearts from
31 patients. Cholesterol, non-cholesterol sterols, and squalene were
quantified by means of gas-liquid chromatography. RESULT(S): In serum
and myocardium, desmosterol was 19- and 18-fold higher and zymostenol
four- and twofold higher in the AD group vs. the control group (P<0.001
for all). In contrast, myocardial cholesterol, squalene, and lathosterol
levels were lower in the AD group than in the control group (P<0.05 for
all). Levels of phytosterols and cholestanol were similar in the serum and
myocardium in the two groups. Levels of myocardial and serum desmosterol,
zymostenol, lathosterol, and phytosterols correlated with each other in
both groups (P<0.05 for all). CONCLUSION(S): Amiodarone treatment
caused the accumulation of desmosterol and zymostenol in myocardium In
particular, myocardial desmosterol concentrations were substantially
elevated, which may play a part in some of the therapeutic and adverse
effects of amiodarone treatment. This article is protected by copyright.
All rights reserved.

<80>
Accession Number
641743051
Title
Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular
Support After Major Cardiac Surgery.
Source
Circulation. (no pagination), 2023. Date of Publication: 04 Jul 2023.
Author
Ghadimi K.; Cappiello J.L.; Wright M.C.; Levy J.H.; Bryner B.S.; DeVore
A.D.; Schroder J.N.; Patel C.B.; Rajagopal S.; Shah S.H.; Milano C.A.
Institution
(Ghadimi, Wright, Levy) Department of Anesthesiology, Divisions of
Cardiothoracic Anesthesiology and Critical Care Medicine, the Clinical
Research Unit, Duke University School of Medicine, M.C.W., Durham, United
Kingdom
(Cappiello) Department of Respiratory Therapy, Boise State University
(Levy, Bryner, Schroder, Milano) Department of Surgery, Adult Cardiac
Surgery Section, Duke University School of Medicine, B.S.B., Durham,
United Kingdom
(DeVore, Patel, Rajagopal, Shah) Department of Medicine, Division of
Cardiology, Duke University School of Medicine, S.R., Durham, United
Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Right ventricular failure (RVF) is a leading driver of
morbidity and mortality after major cardiac surgery for advanced heart
failure, including orthotopic heart transplantation and left ventricular
assist device implantation. Inhaled pulmonary-selective vasodilators, such
as inhaled epoprostenol (iEPO) and nitric oxide (iNO), are essential
therapeutics for the prevention and medical management of postoperative
RVF. However, there is limited evidence from clinical trials to guide
agent selection despite the significant cost considerations of iNO
therapy. METHOD(S): In this double-blind trial, participants were
stratified by assigned surgery and key preoperative prognostic features,
then randomized to continuously receive either iEPO or iNO beginning at
the time of separation from cardiopulmonary bypass with the continuation
of treatment into the intensive care unit stay. The primary outcome was
the composite RVF rate after both operations, defined after
transplantation by the initiation of mechanical circulatory support for
isolated RVF, and defined after left ventricular assist device
implantation by moderate or severe right heart failure according to
criteria from the Interagency Registry for Mechanically Assisted
Circulatory Support. An equivalence margin of 15 percentage points was
prespecified for between-group RVF risk difference. Secondary
postoperative outcomes were assessed for treatment differences and
included: mechanical ventilation duration; hospital and intensive care
unit length of stay during the index hospitalization; acute kidney injury
development including renal replacement therapy initiation; and mortality
at 30 days, 90 days, and 1 year after surgery. RESULT(S): Of 231
randomized participants who met eligibility at the time of surgery, 120
received iEPO, and 111 received iNO. Primary outcome occurred in 30
participants (25.0%) in the iEPO group and 25 participants (22.5%) in the
iNO group, for a risk difference of 2.5 percentage points (two one-sided
test 90% CI, -6.6% to 11.6%) in support of equivalence. There were no
significant between-group differences for any of the measured
postoperative secondary outcomes. CONCLUSION(S): Among patients
undergoing major cardiac surgery for advanced heart failure, inhaled
pulmonary-selective vasodilator treatment using iEPO was associated with
similar risks for RVF development and development of other postoperative
secondary outcomes compared with treatment using iNO. REGISTRATION: URL:
https://www. CLINICALTRIALS: gov; Unique identifier: NCT03081052.

<81>
Accession Number
2024781617
Title
Utility of Intracardiac Echocardiography for Infective Endocarditis and
Cardiovascular Device-Related Endocarditis: A Contemporary Systematic
Review.
Source
Current Problems in Cardiology. 48(9) (no pagination), 2023. Article
Number: 101791. Date of Publication: September 2023.
Author
Sanchez-Nadales A.; Cedeno J.; Sonnino A.; Sarkar A.; Igbinomwanhia E.;
Asher C.R.; Xu B.
Institution
(Sanchez-Nadales, Sarkar, Asher) Department of Cardiovascular Medicine,
Cleveland Clinic Florida, Weston, FL
(Cedeno, Sonnino) Department of Internal Medicine, Cleveland Clinic
Florida, Weston, FL
(Igbinomwanhia) Department of Cardiovascular Disease, MetroHealth System,
Cleveland, OH
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
Publisher
Elsevier Inc.
Abstract
The diagnosis of infective endocarditis (IE) can pose a significant
challenge, particularly in cases of prosthetic valve endocarditis (PVE) or
cardiac device-related endocarditis (CDIE) (1). While echocardiography
remains a crucial diagnostic tool for identifying IE, including PVE and
CDIE, there are certain circumstances where transesophageal
echocardiography (TEE) may not be conclusive or practically feasible (2).
Recently, intracardiac echocardiography (ICE) has emerged as a promising
alternative for diagnosing IE and evaluating intracardiac infections,
especially in cases where transthoracic echocardiography (TTE) has not
been revealing, and TEE has been contraindicated. Furthermore, ICE has
been found to be useful in guiding transvenous lead extractions in
infected implantable cardiac devices (3). This systematic review aims to
comprehensively explore the various applications of ICE in the diagnosis
of IE and assess its efficacy in comparison to traditional diagnostic
methods. Copyright © 2023 Elsevier Inc.

<82>
Accession Number
2024574339
Title
Management of Anxiety in Coronary Artery Bypass Grafting Patients: The
Influence of Chair Aerobics and Nadisodhana Pranayama-A Pilot Randomized
Clinical Trial.
Source
Indian Journal of Pharmaceutical Education and Research. 57(2) (pp
s405-s410), 2023. Date of Publication: Apr-June 2023.
Author
Ashok A.; Ku D.K.; Mundayat G.
Institution
(Ashok, Ku) NITTE Institute of Physiotherapy, NITTE (Deemed to be
University), Deralakatte, Karnataka, Mangalore, India
(Mundayat) Department of Cardiothoracic and Vascular Surgery, K. S. Hegde
Medical Academy, NITTE (Deemed to be University), Deralakatte, Karnataka,
Mangalore, India
Publisher
Association of Pharmaceutical Teachers of India
Abstract
Background: Anxiety is a primary concern affecting the prognosis of CABG
patients. Relieving anxiety is thus a component of management in patients
with CABG. We use two feasible and cost-effective treatment techniques to
know the improvement in symptoms of anxiety. Objective(s): To
evaluate the efficacy of chair aerobics and pranayama on anxiety in
patients who underwent CABG. We hypothesized that there would be an
improvement in anxiety in CABG patients after receiving the interventions.
 Material(s) and Method(s): In a total of 21 screened, 16 met
eligibility requirements. These were randomized into two, group A and
group B. Group A is treated with progressive chair aerobics, and group B
with Nadi-sodhana pranayama. Both groups were given standardised cardiac
rehabilitation techniques. The duration was fifteen minutes of activity
along with phase 1 cardiac rehabilitation. The treatment session was given
once a day in the morning. The intervention starts from the post-operative
day 3 to post-operative day 7. The anxiety is measured by the tool
"hospital anxiety and depression scale". Heart rate is estimated to know
the somatic and physiologic components of anxiety. Took all the outcome
measures before the surgery and on post-operative day 7 by a blinded
outcome assessor. Result(s): The results showed that the improvement
in the p-value of HADS anxiety, depression, and heart rate of both groups
is less than 0.05. Copyright © Author (s) 2023.

<83>
Accession Number
2023197914
Title
Prognostic value of preoperative left ventricular global longitudinal
strain for predicting postoperative myocardial injury and mortality in
patients undergoing major non-cardiac surgery (SOLOMON study).
Source
International Journal of Cardiology. 378 (pp 151-158), 2023. Date of
Publication: 01 May 2023.
Author
Kim M.; Moon I.; Bae S.; Seo H.; Jung I.H.
Institution
(Kim, Bae, Jung) Division of Cardiology, Department of Internal Medicine,
Yonsei University College of Medicine and Cardiovascular Center, Yongin
Severance Hospital, Yongin, South Korea
(Moon, Seo) Division of Cardiology, Department of Internal Medicine,
Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
Publisher
Elsevier Ireland Ltd
Abstract
Background: The usefulness of preoperative measurement of left ventricular
global longitudinal strain (LVGLS) for predicting prognosis in patients
undergoing non-cardiac surgery has not been evaluated. We analyzed the
prognostic value of LVGLS in predicting postoperative 30-day
cardiovascular events and myocardial injury after non-cardiac surgery
(MINS). Method(s): This prospective cohort study was conducted in two
referral hospitals and included 871 patients who underwent non-cardiac
surgery <1 month after preoperative echocardiography. Those with ejection
fraction <40%, valvular heart disease, and regional wall motion
abnormality were excluded. The co-primary endpoints were the (1) composite
incidence of all-cause death, acute coronary syndrome (ACS), and MINS and
(2) composite incidence of all-cause death and ACS. Result(s): Among
the 871 participants enrolled (mean age: 72.9 years; female: 60.8%), there
were 43 cases of the primary endpoint (4.9%): 10 deaths, 3 ACS, and 37
MINS. Participants with impaired LVGLS (<=16.6%) had a higher incidence of
the co-primary endpoints (log-rank P < 0.001 and 0.015) than those
without. The result was similar after adjustment with clinical variables
and preoperative troponin T levels (hazard ratio = 1.30, 95% confidence
interval [CI] = 1.03-1.65; P = 0.027). In sequential Cox analysis and net
reclassification index, LVGLS had an incremental value for predicting the
co-primary endpoints after non-cardiac surgery. Among the 538 (61.8%)
participants who underwent serial troponin assay, LVGLS predicted MINS
independently from the traditional risk factors (odds ratio = 3.54, 95% CI
= 1.70-7.36; P = 0.001). Conclusion(s): Preoperative LVGLS has an
independent and incremental prognostic value in predicting early
postoperative cardiovascular events and MINS. Clinical Trial Registration:
URL: https://trialsearch.who.int/. Unique identifiers:
KCT0005147. Copyright © 2023 The Authors

<84>
Accession Number
2022395333
Title
Dynamic Prediction of Patient Outcomes in the Intensive Care Unit: A
Scoping Review of the State-of-the-Art.
Source
Journal of Intensive Care Medicine. 38(7) (pp 575-591), 2023. Date of
Publication: July 2023.
Author
Lapp L.; Roper M.; Kavanagh K.; Bouamrane M.-M.; Schraag S.
Institution
(Lapp, Roper, Kavanagh) University of Strathclyde, Glasgow, United Kingdom
(Bouamrane) Usher Institute, College of Medicine and Veterinary Medicine,
University of Edinburgh, Glasgow, United Kingdom
(Schraag) Golden Jubilee National Hospital, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Introduction: Intensive care units (ICUs) are high-pressure, complex,
technology-intensive medical environments where patient physiological data
are generated continuously. Due to the complexity of interpreting multiple
signals at speed, there are substantial opportunities and significant
potential benefits in providing ICU staff with additional decision support
and predictive modeling tools that can support and aid decision-making in
real-time. This scoping review aims to synthesize the state-of-the-art
dynamic prediction models of patient outcomes developed for use in the
ICU. We define "dynamic" models as those where predictions are regularly
computed and updated over time in response to updated physiological
signals. Method(s): Studies describing the development of predictive
models for use in the ICU were searched, using PubMed. The studies were
screened as per Preferred Reporting Items for Systematic Reviews and
Meta-Analysis (PRISMA) guidelines, and the data regarding predicted
outcomes, methods used to develop the predictive models, preprocessing the
data and dealing with missing values, and performance measures were
extracted and analyzed. Result(s): A total of n = 36 studies were
included for synthesis in our review. The included studies focused on the
prediction of various outcomes, including mortality (n = 17),
sepsis-related complications (n = 12), cardiovascular complications (n =
5), and other complications (respiratory, renal complications, and
bleeding, n = 5). The most common classification methods include logistic
regression, random forest, support vector machine, and neural networks.
 Conclusion(s): The included studies demonstrated that there is a
strong interest in developing dynamic prediction models for various ICU
patient outcomes. Most models reported focus on mortality. As such, the
development of further models focusing on a range of other serious and
well-defined complications-such as acute kidney injury-would be
beneficial. Furthermore, studies should improve the reporting of key
aspects of model development challenges. Copyright © The
Author(s) 2023.

<85>
Accession Number
2021778092
Title
Peri-Operative Risk Factors Associated with Post-Operative Cognitive
Dysfunction (POCD): An Umbrella Review of Meta-Analyses of Observational
Studies.
Source
Journal of Clinical Medicine. 12(4) (no pagination), 2023. Article Number:
1610. Date of Publication: February 2023.
Author
Travica N.; Lotfaliany M.; Marriott A.; Safavynia S.A.; Lane M.M.; Gray
L.; Veronese N.; Berk M.; Skvarc D.; Aslam H.; Gamage E.; Formica M.;
Bishop K.; Marx W.
Institution
(Travica, Lotfaliany, Lane, Berk, Aslam, Gamage, Marx) IMPACT-The
Institute for Mental and Physical Health and Clinical Translation, Food &
Mood Centre, School of Medicine, Barwon Health, Deakin University,
Geelong, VIC 3220, Australia
(Marriott, Formica, Bishop) Barwon Health, Department of Anaesthesia and
Pain, University Hospital Geelong, Geelong, VIC 3220, Australia
(Safavynia) Department of Anesthesiology, Weill Cornell Medical College,
New York, NY 10065, United States
(Gray) Faculty of Health, School of Medicine, Deakin University, Waurn
Ponds, VIC 3216, Australia
(Veronese) Geriatrics Section, Department of Internal Medicine, University
of Palermo, Palermo 90133, Italy
(Skvarc) Faculty of Health, School of Psychology, Deakin University,
Geelong, VIC 3220, Australia
Publisher
MDPI
Abstract
This umbrella review aimed to systematically identify the peri-operative
risk factors associated with post-operative cognitive dysfunction (POCD)
using meta-analyses of observational studies. To date, no review has
synthesised nor assessed the strength of the available evidence examining
risk factors for POCD. Database searches from journal inception to
December 2022 consisted of systematic reviews with meta-analyses that
included observational studies examining pre-, intra- and post-operative
risk factors for POCD. A total of 330 papers were initially screened.
Eleven meta-analyses were included in this umbrella review, which
consisted of 73 risk factors in a total population of 67,622 participants.
Most pertained to pre-operative risk factors (74%) that were predominantly
examined using prospective designs and in cardiac-related surgeries (71%).
Overall, 31 of the 73 factors (42%) were associated with a higher risk of
POCD. However, there was no convincing (class I) or highly suggestive
(class II) evidence for associations between risk factors and POCD, and
suggestive evidence (class III) was limited to two risk factors
(pre-operative age and pre-operative diabetes). Given that the overall
strength of the evidence is limited, further large-scale studies that
examine risk factors across various surgery types are
recommended. Copyright © 2023 by the authors.

<86>
Accession Number
2025421300
Title
Meta-Analysis Assessing Efficacy and Safety of Vitamin K Antagonists
Versus Direct Oral Anticoagulants for Atrial Fibrillation After
Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 201 (pp 260-267), 2023. Date of
Publication: 15 Aug 2023.
Author
Selvaraj V.; Khan M.S.; Mufarrih S.H.; Kazimuddin M.; Waheed M.A.;
Tripathi A.; Bavishi C.; Hyder O.N.; Aronow H.D.; Saad M.; Abbott J.D.
Institution
(Selvaraj) Department of Medicine, The Miriam Hospital, Warren Alpert
Medical School of Brown University, Providence, Rhode Island, United
States
(Khan, Kazimuddin, Waheed) Division of Cardiology, University of Kentucky
College of Medicine - Bowling Green Campus, Bowling Green, KY, United
States
(Mufarrih) Department of Internal Medicine, University of Kentucky College
of Medicine - Bowling Green Campus, Bowling Green, KY, United States
(Tripathi) Division of Cardiology, CHI St. Vincent Heart Clinic Arkansas,
Searcy, AR, United States
(Bavishi) Division of Cardiology, University of Missouri School of
Medicine, Columbia, Missouri, United States
(Hyder, Saad, Abbott) Division of Cardiology, Lifespan Cardiovascular
Institute, Warren Alpert Medical School of Brown University, Providence,
Rhode Island, United States
(Aronow) Heart & Vascular Services, Henry Ford Health, Detroit, MI, United
States
Publisher
Elsevier Inc.
Abstract
Patients who underwent transcatheter aortic valve implantation (TAVI) with
concomitant atrial fibrillation (AF) are at a higher risk for
thromboembolic and bleeding events. The optimal antithrombotic strategy
for patients with AF after TAVI remains unclear. We sought to determine
the comparative efficacy and safety of direct oral anticoagulants (DOAC)
versus oral vitamin K antagonists (VKAs) in these patients. Electronic
databases such as PubMed, Cochrane, and Embase databases were searched
till January 31, 2023, for relevant studies evaluating clinical outcomes
of VKA versus DOAC in patients with AF after TAVI. Outcomes assessed were
(1) all-cause mortality, (2) stroke, (3) major/life-threatening bleeding,
and (4) any bleeding. Hazard ratios (HRs) were pooled in meta-analysis
using random effect model. Nine studies (2 randomized and 7 observational)
were included in systematic review, and 8 studies with 25,769 patients
were eligible to be included in the meta-analysis. The mean age of the
patients was 82.1 years, and 48.3% were male. Pooled analysis using
random-effects model showed no statistically significant difference in
all-cause mortality (HR 0.91, 95% confidence interval [CI] 0.76 to 1.10, p
= 0.33), stroke (HR 0.96, 95% CI 0.80 to 1.16, p = 0.70), and
major/life-threatening bleeding (HR 1.05, 95% CI 0.82 to 1.35, p = 0.70)
in patients that received DOAC compared with oral VKA. Risk of any
bleeding was lower in the DOAC group compared with oral VKA (HR 0.83, 95%
CI 0.76 to 0.91, p = 0.0001). In patients with AF, DOACs appear to be a
safe alternative oral anticoagulation strategy to oral VKA after TAVI.
Further randomized studies are required to confirm the role of DOACs in
those patients. Copyright © 2023 Elsevier Inc.

<87>
Accession Number
2025395994
Title
Effects of Elective Coronary Revascularization vs Medical Therapy Alone on
Noncardiac Mortality: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 16(10) (pp 1144-1156), 2023. Date of
Publication: 22 May 2023.
Author
Navarese E.P.; Lansky A.J.; Farkouh M.E.; Grzelakowska K.; Bonaca M.P.;
Gorog D.A.; Raggi P.; Kelm M.; Yeo B.; Uminska J.; Curzen N.; Kubica J.;
Wijns W.; Kereiakes D.J.
Institution
(Navarese, Grzelakowska, Yeo, Uminska, Kubica) Interventional Cardiology
and Cardiovascular Medicine Research, Department of Cardiology and
Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
(Navarese, Raggi) Faculty of Medicine, University of Alberta, Edmonton,
AB, Canada
(Navarese, Grzelakowska, Yeo, Uminska, Kubica) SIRIO MEDICINE Research
Network, Bydgoszcz, Poland
(Lansky) Yale School of Medicine, New Haven, CT, United States
(Farkouh) Peter Munk Cardiac Centre, University of Toronto, Toronto, ON,
Canada
(Farkouh) Cedars Sinai Health System, Los Angeles, Canada
(Bonaca) CPC Clinical Research, University of Colorado School of Medicine,
Aurora, CO, United States
(Gorog) Faculty of Medicine, National Heart and Lung Institute, Imperial
College London, London, United Kingdom
(Gorog) Cardiology Department, East and North Hertfordshire NHS Trust,
Stevenage, United Kingdom
(Kelm) Heinrich Heine University Medical Center Dusseldorf, Dusseldorf,
Germany
(Kelm) Division of Cardiology, Pulmonology, and Vascular Medicine,
Cardiovascular Research Institute Dusseldorf, Dusseldorf, Germany
(Curzen) University Hospital Southampton NHS Foundation Trust,
Southampton, United Kingdom
(Curzen) University of Southampton, Southampton, United Kingdom
(Wijns) Lambe Institute for Translational Medicine and CURAM, National
University of Ireland Galway and Saolta University Healthcare Group,
Galway, Ireland
(Kereiakes) Christ Hospital and Lindner Research Center, Cincinnati, OH,
United States
Publisher
Elsevier Inc.
Abstract
Background: Uncertainty exists whether coronary revascularization plus
medical therapy (MT) is associated with an increase in noncardiac
mortality in chronic coronary syndrome (CCS) when compared with MT alone,
particularly following recent data from the ISCHEMIA-EXTEND (International
Study of Comparative Health Effectiveness with Medical and Invasive
Approaches) trial. Objective(s): This study conducted a large-scale
meta-analysis of trials comparing elective coronary revascularization plus
MT vs MT alone in patients with CCS to determine whether revascularization
has a differential impact on noncardiac mortality at the longest
follow-up. Method(s): We searched for randomized trials comparing
revascularization plus MT vs MT alone in patients with CCS. Treatment
effects were measured by rate ratios (RRs) with 95% CIs, using
random-effects models. Noncardiac mortality was the prespecified endpoint.
The study is registered with PROSPERO (CRD42022380664). Result(s):
Eighteen trials were included involving 16,908 patients randomized to
either revascularization plus MT (n = 8,665) or to MT alone (n = 8,243).
No significant differences were detected in noncardiac mortality between
the assigned treatment groups (RR: 1.09; 95% CI: 0.94-1.26; P = 0.26),
with absent heterogeneity (I2 = 0%). Results were consistent
without the ISCHEMIA trial (RR: 1.00; 95% CI: 0.84-1.18; P = 0.97). By
meta-regression, follow-up duration did not affect noncardiac death rates
with revascularization plus MT vs MT alone (P = 0.52). Trial sequential
analysis confirmed the reliability of meta-analysis, with the cumulative
Z-curve of trial evidence within the nonsignificance area and reaching
futility boundaries. Bayesian meta-analysis findings were consistent with
the standard approach (RR: 1.08; 95% credible interval: 0.90-1.31).
 Conclusion(s): In patients with CCS, noncardiac mortality in late
follow-up was similar for revascularization plus MT compared with MT
alone. Copyright © 2023 American College of Cardiology Foundation

<88>
Accession Number
2024135454
Title
Intraoperative suggestions to prevent postoperative delirium in patients
undergoing transaortic valvular replacement: a randomized
placebo-controlled trial.
Source
Aging Clinical and Experimental Research. (no pagination), 2023. Date of
Publication: 2023.
Author
Kaufmann C.; Zech N.; Brandt F.; Hilker M.; Debl K.; Creutzenberg M.;
Zeman F.; Graf B.M.; Sinner B.
Institution
(Kaufmann, Zech, Brandt, Creutzenberg, Graf, Sinner) Department of
Anesthesiology, University Hospital Regensburg, Regensburg, Germany
(Hilker) Department of Cardiothoracic Surgery, University Hospital
Regensburg, Regensburg, Germany
(Debl) Department of Cardiology, University Hospital Regensburg,
Regensburg, Germany
(Zeman) Department of Medical Biostatistics, University Hospital
Regensburg, Regensburg, Germany
(Sinner) Department of Anesthesia and Intensive Care, Medical University
Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Postoperative delirium (POD) is a serious complication
following anaesthesia and surgery and significantly influences
postoperative outcome especially in the elderly population. Intraoperative
music and positive suggestions influence postoperative outcomes by
attenuating analgesic demand and increasing patient satisfaction.
 Aim(s): Here, we examined the effect of intraoperative music and
positive suggestions on the development of POD in aged patients undergoing
transcatheter aortic valve replacement (TAVR) procedure under general
anaesthesia. Method(s): For this randomized placebo-controlled study,
eligible patients without cognitive deficit, indicated by a MMSE < 10
points, were anesthetized using remifentanil and sevoflurane. Anaesthetic
depth was guide with bispectral index. An audiotape with positive
suggestions was applied from a MP3 player via headphones. POD, pain and
PONV was assessed. CAM-ICU and Nu-DESC were done twice daily for the first
5 days. Result(s): Of 140 patients 118 patients could be analysed (57
male, 80.6 +/- 5.1 years). POD was diagnosed in 16 patients (12.7%). POD
was significantly more often observed in male (12, 21.1%) than in female
(4, 6.6%, p = 0.02) and in patients with a low MMSE (23.6 +/- 4.5 vs. 26.8
+/- 2.8, p = 0.001). Anaesthetic depth did not influence the incidence of
POD. Intraoperative music and suggestions did not affect the rate of POD,
pain, analgesic requirement or PONV. Discussion(s): In patients
undergoing TAVR male sex and low MMSE scoring are associated with an
increase in POD. Conclusion(s): Intraoperative music and positive
suggestions do not influence the incidence of POD in this patient group.
Study registration: DRKS: 00024444, start of registration: 4.02.202, final
registration: 17.09.2021 Copyright © 2023, The Author(s).

<89>
Accession Number
641715648
Title
Multicentre, randomised, double-blind, parallel controlled trial to
investigate timing of platelet inhibition after coronary artery bypass
grafting: TOP-CABG trial study.
Source
BMJ open. 13(6) (pp e070823), 2023. Date of Publication: 29 Jun 2023.
Author
Yuan X.; Chu Q.; Chen K.; Wang Y.; Zhang L.; Zheng Y.; Hu S.
Institution
(Yuan, Chu, Chen, Hu) State Key Laboratory of Cardiovascular Disease,
Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
(Yuan, Chu, Chen, Hu) Department of Cardiac Surgery, Fuwai Hospital,
Chinese Academy of Medical Science and Peking Union Medical College,
Beijing, China
(Wang, Zhang) National Clinical Research Centre of Cardiovascular
Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Centre for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Zheng) Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical
Science and Peking Union Medical College, Beijing, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Dual antiplatelet therapy (DAPT), referred to as the
combination of aspirin and P2Y12 receptor antagonist (clopidogrel or
ticagrelor), potentially improves patency of saphenous vein grafts (SVG)
after coronary artery bypass grafting (CABG), while it is further proposed
that DAPT potentially increases bleeding risk. Compared with DAPT,
de-escalated DAPT (De-DAPT) is an effective antiplatelet strategy for
acute coronary syndrome treatment, which significantly reduces the risk of
bleeding without increasing the incidence of major adverse cardiovascular
events. However, insufficient evidence is available to determine the
timing of DAPT after CABG. METHODS AND ANALYSIS: ETHICS AND DISSEMINATION:
The Ethics Committee in Fuwai hospital approved this study (2022-1774).
Fifteen centres agreed to participate the TOP-CABG trial, and the study
has been approved in these 15 centres by whose ethics committee. The
results of the trial will be submitted for publication in a peer-reviewed
journal. TRIAL REGISTRATION NUMBER: NCT05380063. Copyright ©
Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<90>
Accession Number
641443504
Title
Effect of sexual counseling on sexual function and sexual quality of life
for women undergoing open heart surgery: a pilot randomized controlled
trial.
Source
The journal of sexual medicine. 20(7) (pp 1010-1017), 2023. Date of
Publication: 28 Jun 2023.
Author
Tuncer M.; Yesiltepe Oskay U.
Institution
(Tuncer) Department of Women's Health and Diseases Nursing, Istanbul
University, School of Nursing, Istanbul, Turkey
(Yesiltepe Oskay) Department of Women's Health and Diseases Nursing,
Florence Nightingale Faculty of Nursing, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Sexual counseling can improve or may have benefit to patients'
sexual function after open heart surgery. AIM: The study aims to determine
the effect of sexual counseling on sexual function and quality of sexual
life with the PLISSIT model (ie, permission, limited information, specific
suggestions, intensive therapy) for women undergoing open heart surgery.
 METHOD(S): The study was a pilot randomized controlled trial. Seventy
women who planned open heart surgery were randomly divided into the
control group or the sexual counseling group between November 2020 and
November 2021. In addition to routine care, sexual counseling with the
PLISSIT model was given to women in the sexual counseling group for 12
weeks after the operation. During the research, 6 PLISSIT sessions were
conducted. Women in the control group received routine postoperative care,
which included hospital-provided postoperative home care practices
(medication, nutrition, physical activity). OUTCOME(S): Data were
obtained with an information form, the Beck Depression Inventory, the
Female Sexual Function Index, and the Sexual Quality of Life
Questionnaire-Female. RESULT(S): The women in the sexual counseling
and control groups were similar in terms of sociodemographic, obstetric,
gynecologic, general health, current heart disease, and sexual function
data (P>.05). After sexual counseling with the PLISSIT model, scores on
the Female Sexual Function Index and Sexual Quality of Life
Questionnaire-Female significantly increased in the sexual counseling
group while Beck Depression Inventory scores decreased (P<.05).
Comparisons were made within and between groups. CLINICAL IMPLICATIONS:
Sexual counseling with the PLISSIT model is a useful and effective model
for health professionals to improve the sexual function and sexual quality
of life of women's who will undergo open heart surgery. STRENGTHS AND
LIMITATIONS: The limitations of the study were as follows: only 1
assessment after the intervention ended, no short- or long-term follow-up,
and a small sample size. Other limitations include the absence of controls
for therapeutic context or positive expectations in the experimental
group. CONCLUSION(S): Sexual counseling with the PLISSIT model after
open heart surgery increased the sexual function and sexual quality of
life of women while reducing the symptoms of depression. Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf
of The International Society of Sexual Medicine.

<91>
Accession Number
641093396
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 KerckhoffBenekestr. 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
NLM (Medline)
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.
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. CONCLUSION(S): Additional statin loading
before CABG failed to reduce the rate of MACCE occuring within 30 days of
surgery. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<92>
Accession Number
2024116762
Title
Monitoring of Levosimendan Administration in Patients with Pulmonary
Hypertension Undergoing Cardiac Surgery and Effect of Two Different Dosing
Schemes on Hemodynamic and Echocardiographic Parameters.
Source
Pharmaceuticals. 16(6) (no pagination), 2023. Article Number: 815. Date of
Publication: June 2023.
Author
Ftikos P.; Falara A.; Rellia P.; Leontiadis E.; Samanidis G.; Kamperi N.;
Piperakis A.; Tamvakopoulos C.; Antoniou T.; Theodoraki K.
Institution
(Ftikos, Falara, Rellia, Antoniou) Department of Anesthesiology, Onassis
Cardiac Surgery Center, Athens 176 74, Greece
(Leontiadis) Department of Cardiology, Onassis Cardiac Surgery Center,
Athens 176 74, Greece
(Samanidis) Department of Cardiac Surgery, Onassis Cardiac Surgery Center,
Athens 176 74, Greece
(Kamperi, Piperakis, Tamvakopoulos) Center of Clinical Research,
Experimental Surgery and Translational Research, Division of
Pharmacology-Pharmacotechnology, Biomedical Research Foundation, Academy
of Athens, Athens 115 27, Greece
(Theodoraki) Department of Anesthesiology, Aretaieion University Hospital,
National and Kapodistrian University of Athens, Athens 115 28, Greece
Publisher
MDPI
Abstract
Introduction: The perioperative management of patients with pulmonary
hypertension (PH) undergoing cardiac surgery represents one of the most
challenging clinical scenarios. This fact mainly depends on the
relationship existing between PH and right ventricular failure (RVF).
Levosimendan (LS) is an inodilator that might be an effective agent in the
treatment of PH and RVF. The aim of this study was to examine the impact
of the duration of cardiopulmonary bypass (CPB) on the therapeutic drug
monitoring of LS and to evaluate the effect of preemptive administration
of LS on perioperative hemodynamic and echocardiographic parameters in
cardiac surgical patients with preexisting PH. Material(s) and
Method(s): In this study, LS was administered in adult patients undergoing
cardiac surgery before CPB in order to prevent exacerbation of preexisting
PH and subsequent right ventricular dysfunction. Thirty cardiac surgical
patients with preoperatively confirmed PH were randomized to receive
either 6 mug/kg or 12 mug/kg of LS after the induction of anesthesia. The
plasma concentration of LS was measured after CPB. In this study, a low
sample volume was used combined with a simple sample preparation protocol.
The plasma sample was extracted by protein precipitation and evaporated;
then, the analyte was reconstituted and detected using specific and
sensitive bioanalytical liquid chromatography with mass spectrometry
(LC-MS/MS) methodology. The clinical, hemodynamic, and echocardiographic
parameters were registered and evaluated before and after the
administration of the drug. Result(s): A fast bioanalytical LC-MS/MS
methodology (a run time of 5.5 min) was developed for the simultaneous
determination of LS and OR-1896, its main metabolite in human plasma. The
LC-MS/MS method was linear over a range of 0.1-50 ng/mL for LS and 1-50
ng/mL for its metabolite OR-1896. Measured plasma concentrations of LS
were inversely related to the duration of CPB. LS administration before
CPB during cardiac surgery was effective in reducing pulmonary artery
pressure and improving hemodynamic parameters after CPB, with a more
pronounced and durable effect of the drug at the dose of 12 mug/kg.
Additionally, administration of LS at a dose of 12 mug/kg in cardiac
surgical patients with PH before CPB improved right ventricular function.
 Conclusion(s): LS administration decreases pulmonary artery pressure
and may improve right ventricular function in patients with PH undergoing
cardiac surgery. Copyright © 2023 by the authors.

<93>
Accession Number
2024070947
Title
The effect of combined ultrasound-guided transverse thoracic muscle plane
block and rectus sheath plane block on the peri-operative consumption of
opioids in open heart surgeries with median sternotomy.
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 488-495), 2023. Date of
Publication: 2023.
Author
Nessim F.M.M.; Hassan A.E.M.; Eskander F.S.L.; Nady R.F.G.
Institution
(Nessim, Hassan, Eskander, Nady) Department of Anesthesia, Intensive Care,
and Pain Management, Faculty of Medicine, Ain Shams University, Cairo,
Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Patients undergoing heart surgery with a midline sternotomy
typically get intravenous opioids as their primary form of post-operative
pain management. Due to its possible drawbacks, regional neuraxial
anesthesia is still controversial. There have been reports on the impact
of rectus sheath plane (RSP) block in conjunction with ultrasound-guided
transverse thoracic muscle plane (TTP) block on postoperative pain
following sternotomy. Aim Of The Study: The efficiency of combining TTP
and RSP blocks in lowering the targeted patients' perioperative
requirement for opioids, minimizing opioid adverse effects, and attaining
a potential Fast-Tract Extubation. Patients And Methods: 50 patients
undergoing open cardiac surgery via median sternotomy were randomly
assigned to one of two groups in this randomized, prospective, comparative
trial. Group (B) got combined ultrasound-guided TTP and RSP blocks, while
Group (S) received saline in the same planes before to the incision.
 Result(s): There was no significant difference between the groups for
the demographic information, postoperative opioid consumption, or VAS pain
scores, however there was a very significant difference between the groups
for intraoperative opioid intake and time to extubation.
 Conclusion(s): Combining TTP and RSP blocks has improved fast-track
extubation, decreased hemodynamic changes in response to surgical stress,
and decreased intraoperative opioid usage. The blocks directed by routine
pain score evaluation did not, however, have a significant impact on
postoperative opioid use. Copyright © 2023 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<94>
Accession Number
2025495579
Title
Total Arterial Revascularization in Diabetic Patients Undergoing Coronary
Artery Bypass Graft Surgery: A Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(6) (no pagination), 2023. Article
Number: rcm2406183. Date of Publication: June 2023.
Author
Liao G.-Z.; Liu T.; Li Y.-M.; Bai L.; Ye Y.-Y.; Chen X.-F.; Peng Y.
Institution
(Liao, Liu, Li, Bai, Ye, Chen, Peng) Department of Cardiology, West China
Hospital, Sichuan University, Sichuan, Chengdu 610041, China
Publisher
IMR Press Limited
Abstract
Background: Total arterial revascularization (TAR) has gradually become
accepted and recognized, but its effect and safety in diabetic patients
are not clear. We performed a systematic review and meta-analysis to
summarize the safety and efficacy of TAR and additionally evaluated the
clinical outcomes of arterial revascularization using different arterial
deployments in patients with diabetes. Method(s): PubMed, Embase, and
the Cochrane Library databases from inception to July 2022 for studies
that studied the effect of arterial revascularization in diabetic patients
undergoing isolated coronary artery bypass graft (CABG) were searched. The
primary outcome was long-term (>=12 months of follow-up) death by any
cause. The secondary efficacy endpoints were long-term (>=12 months)
cardiovascular death, early sternal wound infection (SWI) and death (<=30
days or in hospital). Risk ratios (RRs), hazard ratios (HRs), and their
corresponding 95% confidence intervals (CIs) were calculated to describe
short-term results and long-term survival outcomes. Two different ways
were used to analyze the effect of TAR and the impact of diabetes on the
clinical outcomes of TAR. Result(s): Thirty-five studies were
included in the study, covering 178,274 diabetic patients. Compared to
conventional surgery with saphenous veins, TAR was not associated with
increased early mortality (RR 0.77, 95% CI 0.48-1.23) and risk of SWI (RR
0.77, 95% CI 0.46-1.28). The overall Kaplan-Meier survival curves based on
reconstructed patient data indicated a significant association between TAR
and reduced late mortality (HR 0.52, 95% CI 0.48-0.67) and the curves
based on the propensity-score matched (PSM) analyses suggested a similar
result (HR 0.74, 95% CI 0.66-0.85). TAR could also effectively decrease
the risk of cardiovascular death (HR 0.42, 95% CI 0.24-0.75). Through
comparing the effect of TAR in patients with and without diabetes, we
found that the presence of diabetes did not elevate the risk of early
adverse events (death: RR 1.50, 95% CI 0.64-3.49; SWI: RR 2.52, 95% CI
0.91-7.00). Although diabetes increased long-term mortality (HR 1.06; 95%
CI 1.35-2.03), the cardiovascular death rate was similar in patients with
diabetes and patients without diabetes (HR 1.09; 95% CI 0.49-2.45).
Regarding the selection of arterial conduits, grafting via the bilateral
internal mammary artery (BIMA) decreased the risk of overall death (HR
0.67, 95% CI 0.52-0.85) and cardiovascular death (HR 0.55, 95% CI
0.35-0.87) without resulting in a significantly elevated rate of early
death (RR 0.95, 95% CI 0.82-1.11). However, the evidence from PSM studies
indicated no difference between the long-term mortality of the BIMA group
and that of the single internal mammary arteries (SIMA) groups (HR 0.76,
95% CI 0.52-1.11), and the risk of SWI was significantly increased by BIMA
in diabetes (RR 1.65, 95% CI 1.42-1.91). The sub-analysis indicated the
consistent benefit of the radial artery (RA) application in diabetic
patients (HR 0.71, 95% CI 0.63-0.79) compared to saphenous vein graft. In
two propensity-score-matched studies, the evidence showed that the
survival outcomes of the BIMA group were similar to that of the SIMA plus
RA group but that grafting via the RA reduced the risk of sternal wound
infection. Conclusion(s): Compared with conventional surgery using
SVG, TAR was associated with an enhanced survival benefit in diabetes and
this long-term gain did not increase the risk of early mortality or SWI.
Given the increased infection risk and controversial long-term survival
gains of grafting via the BIMA in diabetes, its wide use for grafting in
this cohort should be seriously considered. Compared to using the right
internal mammary artery (RIMA), RA might be a similarly effective but
safer option for patients with diabetes. Copyright: © 2023 The
Author(s).

<95>
Accession Number
2025495578
Title
Different Techniques of Surgical Left Atrial Appendage Closure and Their
Efficacy: A Systematic Review.
Source
Reviews in Cardiovascular Medicine. 24(6) (no pagination), 2023. Article
Number: rcm2406184. Date of Publication: June 2023.
Author
D'Abramo M.; Romiti S.; Saltarocchi S.; Saade W.; Spunticchia F.; Bruno
N.; Peruzzi M.; Miraldi F.; Frati G.; Greco E.; Macrina F.; De Orchi P.;
Marullo A.G.M.
Institution
(D'Abramo, Romiti, Saltarocchi, Saade, Spunticchia, Bruno, Peruzzi,
Miraldi, Greco, Macrina, De Orchi) Department of Clinical, Internal
Anesthesiological and Cardiovascular Sciences, Sapienza University of
Rome, Rome 00161, Italy
(Peruzzi) Department of Cardiology, Mediterranea Cardiocentro, Naples
80122, Italy
(Frati, Marullo) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina 04100, Italy
(Frati) Department of Angiocardioneurology, IRCCS NeuroMed, IS, Pozzilli
86077, Italy
Publisher
IMR Press Limited
Abstract
Background: Atrial fibrillation has been identified as an independent risk
factor for thromboembolic events. Since 1948 different surgical techniques
have described the feasibility and the rationale of left atrial surgical
appendage closure. The aim of this systematic review is to evaluate the
reported patency rates of different surgical techniques. Method(s):
This systematic review was conducted according to preferred reporting
items for systematic reviews and meta-analyses (PRISMA) guidelines. Two
independent investigators searched the PubMed, Scopus, Web of Science,
Cochrane Central Register of Controlled Trials, and OVID (Wolters Kluwer,
Alphen aan den Rijn, Netherlands) to identify relevant studies.
Consecutively, a PICO (Population, Intervention, Comparison and Outcomes)
strategy assessment of literature was performed to search eventual other
relevant studies that may have been ignored. Result(s): A total of 42
studies were included in our analysis. The total number of patients who
underwent surgical left atrial appendage closure was 5671, and in 61.2% an
imaging follow up was performed, mostly with transesophageal
echocardiographic evaluation. Success rate for the different techniques
was: Clip deployment 98%; Lariat procedure 88%; Surgical amputation 91%;
Endocardial suture 74.3%, Epicardial suture 65%; Left atrial appendage
closure (LAAC) ligation 60.9%; Stapler technique with excision of left
atrial appendage (LAA) 100%; Stapler without excision 70%.
 Conclusion(s): To date, data on surgical left atrial appendage
closure are poor and not standardized, even if reported rates are
acceptable and comparable to transcatheter procedures. If validated on
large-scale non-retrospective and multicentric studies, these promising
developments may offer a valuable alternative for patients with atrial
fibrillation (AF) and ineligible for oral anticoagulation
therapy. Copyright: © 2023 The Author(s).

<96>
Accession Number
2025461208
Title
Safety and feasibility of ultrasound-guided serratus anterior plane block
and intercostal nerve block for management of post-sternotomy pain in
pediatric cardiac patients: A prospective, randomized trial.
Source
Anaesthesia Critical Care and Pain Medicine. 42(6) (no pagination), 2023.
Article Number: 101268. Date of Publication: December 2023.
Author
He Y.; Xu M.; Li Z.; Deng L.; Kang Y.; Zuo Y.
Institution
(He, Xu, Zuo) Department of Anesthesiology, West China Hospital, Sichuan
University & The Research Units of West China (2018RU012), Chinese Academy
of Medical Sciences, China
(Li) Department of Critical Care Medicine, Cheng Du Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Sichuan, Chengdu,
China
(Deng) Department of Critical Care Medicine, West China Hospital/West
China School of Medicine, Sichuan University, Sichuan, Chengdu, China
(Kang) Department of Anesthesiology and Translational Neuroscience Center,
Laboratory of Anesthesia and Critical Care Medicine, West China Hospital,
Sichuan University, Chengdu, China
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Postoperative analgesia in the cardiothoracic ICU has
traditionally relied on intravenous opioids. Thoracic nerve blocks are
attractive alternatives for analgesia that reduce the requirement for
opioids, but their safety and feasibility remain unclear. Method(s):
Sixty children were allocated randomly to three groups: group C received
intravenous opioids alone, while group SAPB (deep serratus anterior plane
block) and group ICNB (intercostal nerve block) received opioids combined
with ultrasound-guided regional nerve blocks (0.2% ropivacaine 2.5
mg.kg-1) after patients were transferred to the ICU. The
primary outcome was opioid requirement in the first 24 h after surgery.
Other outcomes included the postoperative FLACC scale value, tracheal
extubation time, and plasma ropivacaine concentrations after the block.
 Result(s): The mean [sd] cumulative dose of opioids administered
postoperatively within 24 h in the SAPB (168.6 [76.9] mug.kg-1)
and ICNB groups (170.0 [86.8] mug.kg-1) were significantly
lower by nearly 53% than those in group C (359.3 [125.3]
mug.kg-1, p = 0.000). The tracheal extubation time was shorter
in the regional block groups than that in the control group, but the
difference was not statistically significant (p = 0.177). The FLACC scale
values at 0, 1, 3, 6, 12, and 24 h post-extubation were similar in the
three groups. The mean peak plasma ropivacaine concentrations in the SAP
and ICNB groups were 2.1 [0.8] and 1.8 [0.7] mg.L-1,
respectively, 10 min post-block and then slowly decreased. No noticeable
complications associated with regional anesthesia were observed.
 Conclusion(s): Ultrasound-guided SAPB and ICNB provided safe and
satisfactory early postoperative analgesia while reducing opioid
consumption following sternotomy in pediatric patients. Clinical trial
registration: Chinese Clinical Trial Registry
ChiChiCTR2100046754. Copyright © 2023 Societe francaise
d'anesthesie et de reanimation (Sfar)

<97>
Accession Number
641730841
Title
Effect of bariatric surgery on cardio-psycho-metabolic outcomes in severe
obesity: A randomized controlled trial.
Source
Metabolism: clinical and experimental. (pp 155655), 2023. Date of
Publication: 30 Jun 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, Fassnacht) Dept. Internal Medicine I, Division of Endocrinology
and Diabetology, University Hospital, University of Wurzburg, Wurzburg,
Germany; Dept. Clinical Research & Epidemiology, Comprehensive Heart
Failure Center, University Hospital, University of Wurzburg, Wurzburg,
Germany
(Warrings, Herrmann) Dept. Clinical Research & Epidemiology, Comprehensive
Heart Failure Center, University Hospital, University of Wurzburg,
Wurzburg, Germany; Dept. Psychiatry, Psychosomatics, and Psychotherapy,
Center for Mental Health, University Hospital, University of Wurzburg,
Wurzburg, Germany
(Morbach, Frantz, Stork) Dept. Clinical Research & Epidemiology,
Comprehensive Heart Failure Center, University Hospital, University of
Wurzburg, Wurzburg, Germany; Dept. of Internal Medicine I, Division of
Cardiology, University Hospital, University of Wurzburg, Wurzburg, Germany
(Seyfried) Dept. General, Visceral, Transplant, Vascular, Pediatric
Surgery, University Hospital, University of Wurzburg, Wurzburg, Germany
(Jung) Dept. Internal Medicine I, Division of Pneumology, University
Hospital, University of Wurzburg, Wurzburg, Germany
(Dischinger) Dept. Internal Medicine I, Division of Endocrinology and
Diabetology, University Hospital, University of Wurzburg, Wurzburg,
Germany
(Edelmann) Dept. Internal Medicine and Cardiology, Campus Virchow
Klinikum, Charite University Medicine Berlin, Berlin, Germany; German
Centre for Cardiovascular research (DZHK), Partner Site Berlin, Germany
(Stier) Dept. Internal Medicine I, Division of Endocrinology and
Diabetology, University Hospital, University of Wurzburg, Wurzburg,
Germany; Dept. General, Visceral, Transplant, Vascular, and Pediatric
Surgery, University Hospital, University of Wurzburg, Wurzburg, Germany
(Malzahn) Center for Clinical Trials, University Hospital Wurzburg,
Wurzburg, Germany
Publisher
NLM (Medline)
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 6-12month 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 12months later.
Thereafter, PELI patients could opt for surgery and patients were
reassessed 24months after randomization. Co-primary endpoints were mean
change (95% confidence intervals) in peak VO2 (ml/min/kg body weight) in
CPET and the physical functioning scale (PFS) of the Short Form health
survey (SF-36). RESULT(S): Of 93 patients entering the study, 60 were
randomized. Among these (median age 38years; 88% women; mean BMI
48.2kg/m2), 46 (RYGB: 22 and PELI: 24) were evaluated after 12months.
Total weight loss was 34.3% after RYGB vs. 1.2% with PELI, while peak VO2
increased by +4.3ml/min/kg (2.7, 5.9) vs +1.1ml/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: +44m
(17, 72) vs +6m (-14, 26); p<0.0001. Left ventricular mass decreased after
RYGB, but not with PELI: -32g (-46, -17) vs 0g (-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. 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. Copyright
© 2023. Published by Elsevier Inc.

<98>
Accession Number
641730674
Title
PRDM16 Deletion Is Associated With Sex-dependent Cardiomyopathy and
Cardiac Mortality: A Translational, Multi-Institutional Cohort Study.
Source
Circulation. Genomic and precision medicine. (pp e003912), 2023. Date of
Publication: 03 Jul 2023.
Author
Kramer R.J.; Fatahian A.N.; Chan A.; Mortenson J.; Osher J.; Sun B.;
Parker L.E.; Rosamilia M.B.; Potter K.B.; Moore K.; Atkins S.L.; Rosenfeld
J.A.; Birjiniuk A.; Jones E.; Howard T.S.; Kim J.J.; Scott D.A.; Lalani
S.; Rouzbehani O.M.T.; Kaplan S.; Hathaway M.A.; Cohen J.L.; Asaki S.Y.;
Martinez H.R.; Boudina S.; Landstrom A.P.
Institution
(Kramer, Chan, Sun, Parker, Rosamilia, Potter, Moore, Atkins, Landstrom)
Department of Pediatrics, Division of Pediatric Cardiology, Duke
University School of Medicine, A.C., B.S., L.E.P., S.L.A., K.M., Durham,
United Kingdom
(Fatahian, Rouzbehani, Hathaway, Boudina) Department of Nutrition and
Integrative Physiology, University of Utah
(Mortenson, Osher, Martinez) Department of Pediatrics, Division of
Pediatric Cardiology, University of Tennessee Health Science Center
(Rosenfeld) Baylor Genetic Laboratories, Baylor College of Medicine,
Houston, United States
(Rosenfeld, Scott, Lalani) Department of Molecular and Human Genetics,
Baylor College of Medicine, Houston, TX. (J.A.R., D.A.S., S.L.)
(Birjiniuk) Department of Pediatrics, Division of Pediatric Cardiology,
Northwestern Feinberg School of Medicine, Chicago, Mexico
(Jones, Howard, Kim) Department of Pediatrics, Section of Pediatric
Cardiology, Baylor College of Medicine, T.S.H., Houston, United States
(Kaplan) Medical Center Library & Archives, Duke University School of
Medicine, Durham, United Kingdom
(Cohen) Department of Pediatrics, Division of Medical Genetics, Duke
University School of Medicine, Durham, United Kingdom
(Asaki) Department of Pediatrics, Division of Pediatric Cardiology,
University of Utah
(Landstrom) Department of Cell Biology, Duke University School of
Medicine, Durham, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: 1p36 deletion syndrome can predispose to pediatric-onset
cardiomyopathy. Deletion breakpoints are variable and may delete the
transcription factor PRDM16. Early studies suggest that deletion of PRDM16
may underlie cardiomyopathy in patients with 1p36 deletion; however, the
prognostic impact of PRDM16 loss is unknown. METHOD(S): This
retrospective cohort included subjects with 1p36 deletion syndrome from 4
hospitals. Prevalence of cardiomyopathy and freedom from death, cardiac
transplantation, or ventricular assist device were analyzed. A systematic
review cohort was derived for further analysis. A cardiac-specific Prdm16
knockout mouse (Prdm16 conditional knockout) was generated.
Echocardiography was performed at 4 and 6 to 7 months. Histology staining
and qPCR were performed at 7 months to assess fibrosis. RESULT(S):
The retrospective cohort included 71 patients. Among individuals with
PRDM16 deleted, 34.5% developed cardiomyopathy versus 7.7% of individuals
with PRDM16 not deleted (P=0.1). In the combined retrospective and
systematic review cohort (n=134), PRDM16 deletion-associated
cardiomyopathy risk was recapitulated and significant (29.1% versus 10.8%,
P=0.03). PRDM16 deletion was associated with increased risk of death,
cardiac transplant, or ventricular assist device (P=0.04). Among those
PRDM16 deleted, 34.5% of females developed cardiomyopathy versus 16.7% of
their male counterparts (P=0.2). We find sex-specific differences in the
incidence and the severity of contractile dysfunction and fibrosis in
female Prdm16 conditional knockout mice. Further, female Prdm16
conditional knockout mice demonstrate significantly elevated risk of
mortality (P=0.0003). CONCLUSION(S): PRDM16 deletion is associated
with a significantly increased risk of cardiomyopathy and cardiac
mortality. Prdm16 conditional knockout mice develop cardiomyopathy in a
sex-biased way. Patients with PRDM16 deletion should be assessed for
cardiac disease.

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