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<1>
Accession Number
2025735226
Title
Off-pump versus on-pump coronary artery bypass grafting in patients with
left main coronary artery disease: A randomized controlled trial.
Source
Journal of the Pakistan Medical Association. 73(4) (pp S22-S25), 2023.
Date of Publication: April 2023.
Author
Mady K.M.; Ettish A.A.A.; Elfeky W.M.; Abdelaal M.M.
Institution
(Mady, Ettish, Elfeky, Abdelaal) Department of Cardiothoracic Surgery,
Kafrelsheikh University, Egypt
Publisher
Pakistan Medical Association
Abstract
Objective: To compare the outcome of off-pump and on-pump coronary artery
bypass graft surgery in patients with left main coronary artery disease.
 Method(s): The randomised, controlled, prospective, multicentric
study was conducted in 2020 during the period from January 2020 to
December 2020 at Kafrelsheikh University Hospital, International Cardiac
Centre and Alexandria New Medical Centre, Egypt, and comprised patients
with left main coronary artery disease who underwent coronary artery
bypass graft surgery. The patients were randomised to on-pump surgery
group I (Control Group) and off-pump surgery group II(Interventional
Group). All patients were assessed pre-operatively for the presence of
comorbid conditions and post-operatively for myocardial infarction, acute
kidney injury, pneumonia, sternal dehiscence and 3-month mortality. Data
was analysed using SPSS 20. Result(s): Of the 60 patients, 44(73.3%)
were men and 16(26.6%) were women. The overall mean age was 66.4+/-9.2
years. There were 30(50%) patients in each of the two groups. There were
2(6.7%) cases of myocardial infarction in group I and 1(3.3%) in group II.
There was 1(3.3%) case of acute kidney injury in group I and none in group
II. There were 3(10%) cases of pneumonia in group 1 compared to 1(3.3%) in
group II. There was 1(3.3%) case of sternal dehiscence in group I and none
in group II. Mortality at 3 months was 2(6.7%) in group I and 1(3.3%) in
group II. There was no significant difference with respect to outcome
between the groups (p>0.05). Conclusion(s): Off-pump coronary artery
bypass graft surgery was found to be efficient and non-inferior to on-pump
procedure in patients with left main coronary artery
disease. Copyright © 2023 Pakistan Medical Association. All
rights reserved.

<2>
Accession Number
2025643336
Title
Off-pump versus on-pump coronary artery bypass grafting in patients with
chronic obstructive pulmonary disease.
Source
Journal of the Pakistan Medical Association. 73(4) (pp S34-S38), 2023.
Date of Publication: 2023.
Author
Mady K.M.; Ettish A.A.A.; Elfeky W.M.; Abdelaal M.M.
Institution
(Mady, Ettish, Elfeky, Abdelaal) Department of Cardiothoracic Surgery,
Kafrelsheikh University, Egypt
Publisher
Pakistan Medical Association
Abstract
Objective: To compare the outcome of coronary artery bypass grafting with
and without cardiopulmonary bypass in patients of chronic obstructive
pulmonary disease. Method(s): The prospective randomised multicentre
study was conducted in 2020 at Kafrelsheikh University Hospital,
International Cardiac Centre and Alexandria New Medical Centre, Egypt.
Patients regardless of age and gender who had ischaemic heart disease and
chronic obstructive pulmonary disease were enrolled, and randomised into
on-pump procedure group 1 and off-pump procedure group II. All patients
were assessed preoperatively for pulmonary function tests and
postoperatively for duration of mechanical ventilation, respiratory
failure, pneumonia, atrial fibrillation, acute respiratory distress
syndrome, pleural effusion, lung atelectasis, sternal dehiscence,
intensive care unit stay and overall hospital stay. Data was analysed
using SPSS ver 25 Armonk, NY: IBM Corp.; Released 2017. Result(s): Of
the 60 patients, 30(50%) were in each of the two groups. Overall, there
were 20(33.3%) women and 40(66.6%) men with mean age 56.5+/-6.05 years.
The mean duration of mechanical ventilation in group I was 12.07+/-5.18
minutes compared to 6.97+/-2.25 minutes in group II (p<0.001). The mean
duration of stay in intensive care unit in group I was 4.17+/-1.64 days
compared to 3.03+/-1.03 days in group II (p<0.001). The mean hospital stay
was 7.40+/-1.90 days in group I and 5.93+/-1.17 days in group II
(p<0.001). There was no significant difference between the groups
regarding the frequency of respiratory failure, pneumonia, atrial
fibrillation, acute respiratory distress syndrome, pleural effusion, lung
atelectasis and sternal dehiscence (p=1.000) Conclusion(s): Off-pump
coronary artery bypass grafting was found to be efficient and had a faster
postoperative course than on-pump procedure in patients with chronic
obstructive pulmonary disease. Copyright © 2023 Pakistan Medical
Association. All rights reserved.

<3>
Accession Number
2024276356
Title
Digital interprofessional communication with families in a cardiac surgery
unit: insights from the pandemic.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1165287. Date of Publication: 2023.
Author
Pozzoli A.; Zurfluh C.; Schulz P.; Bianchi M.; Giuffrida S.; Crivelli D.;
Torre T.; Ferrari E.; Demertzis S.
Institution
(Pozzoli, Zurfluh, Giuffrida, Crivelli, Torre, Ferrari, Demertzis)
Division of Cardiac Surgery, Cardiocentro Ticino Institute, EOC, Lugano,
Switzerland
(Schulz) Department of Communication, Culture and Society, Universita
della Svizzera Italiana (USI), Lugano, Switzerland
(Schulz) Department of Communication & Media, Ewha Womans University,
Seoul, South Korea
(Bianchi) Department of Business Economics, Health and Social Care,
University of Applied Sciences and Arts of Southern Switzerland, Manno,
Switzerland
(Ferrari, Demertzis) Biomedical Sciences, Italian Switzerland University
(USI), Lugano, Switzerland
(Ferrari) Faculty of Medicine, University of Zurich, Zurich, Switzerland
(Demertzis) Faculty of Medicine, University of Bern, Bern, Switzerland
Publisher
Frontiers Media SA
Abstract
Background: The COVID-19 pandemic entailed cutting off the usual access to
hospitals, denying patients daily visits from their relatives and friends.
The standard communication between medical staff and relatives also
suffered, with a perceived negative impact on overall care. We developed
an electronic communication solution to re-establish a proactive daily
communication with patients' families. Method(s): The communication
software allowed families to receive daily interprofessional (medical,
nursing, and physiotherapy) updates by text message, on patients'
postoperative clinical state. Appreciation and performance of this
communication was evaluated through a prospective randomised study. Two
groups were compared (group D, 32 patients "Digital" receiving daily SMS,
and group S, 16 patients "Standard" without SMS), assessing satisfaction
through dedicated surveys under COVID-19 restrictions. Moreover, private
outgoing vs. incoming communication flow between patients and their
relatives (phone calls and text messages, for both groups) were analysed
at different timeframes of the postoperative hospital stay.
 Result(s): Mean age of the population was 66 +/- 7 years for both
groups. The digital communication service was successfully adopted in
group D in all cases, sending overall 155 communications (4.84 per
patient). Calls received from relatives were 13 in group D vs. 22 in group
S (0.4 vs. 1.4 calls per patient, p = 0.002). Patients' outgoing vs.
incoming traffic flow was equal in the two groups for every timeframe
(first two postoperative days vs. the rest), independently from digital
communication. Comparing satisfaction of communication (from 1 to 7),
level of information and understandability resulted in 6.7 in group D vs.
5.6 in group S (p = 0.004). Appreciation of digital communication was
highest during the first three postoperative days. Conclusion(s): The
restrictions caused by the COVID-19 pandemic generated simple and
effective ideas on digital solutions for interprofessional communication.
Offering this digital service, which complements rather than replace the
classic communication, eased the need of the families to be informed and
significantly enhanced the overall satisfaction regarding the healthcare
service. Summary: The COVID-19 pandemic has interrupted access to
hospital patients and cut off physical contact, denying patients, their
families, and medical staff the necessary constant communication about the
progress of their stay. It has become necessary, therefore, to compensate
for the lack of "physical" face-to-face interaction by introducing
innovative digital communication solutions. Our interprofessional project
aims to assess the overall satisfaction and acceptance of digital
communication service between the hospital and the families, updating on
postoperative clinical condition of patients. Specifically, the
introduction of a digital communication module attached to the electronic
patient record allows relatives to be informed on a daily basis. The
development of this module/software enabled families to receive daily,
interprofessional and proactive digital updates, on their relative ones'
postoperative stay. Copyright 2023 Pozzoli, Zurfluh, Schulz, Bianchi,
Giuffrida, Crivelli, Torre, Ferrari and Demertzis.

<4>
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

<5>
Accession Number
2024160461
Title
Long-term outcomes of mini-sternotomy versus conventional sternotomy for
aortic valve replacement: a randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 63(1) (no pagination), 2023.
Article Number: ezac540. Date of Publication: 01 Jan 2023.
Author
Telyuk P.; Hancock H.; Maier R.; Batty J.A.; Goodwin A.; Owens W.A.;
Ogundimu E.; Akowuah E.
Institution
(Telyuk, Batty) Department of Cardiology, The James Cook University
Hospital, Middlesbrough, United Kingdom
(Hancock, Maier) Newcastle Clinical Trials Unit, Newcastle upon Tyne,
United Kingdom
(Goodwin, Owens, Akowuah) Department of Cardiovascular Surgery, The James
Cook University Hospital, Middlesbrough, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Aortic valve replacement (AVR) for severe symptomatic aortic
stenosis is one of the most common cardiac surgical procedures with
excellent long-term outcomes. Multiple previous studies have compared
short-term outcomes of AVR with mini-sternotomy versus AVR with
conventional sternotomy. We have previously reported the results of the
randomized MAVRIC trial, which aimed to evaluate early postoperative
morbidity among patients undergoing mini-sternotomy and conventional
sternotomy AVR. We now report the long-term all-cause mortality,
reoperation, MACE outcomes and echocardiographic data from this trial.
 METHOD(S): The prospective, randomized, single-centre, single-blind
MAVRIC (manubrium-limited mini-sternotomy versus conventional sternotomy
for aortic valve replacement) trial compared manubrium-limited
mini-sternotomy and conventional median sternotomy for the treatment of
patients with severe aortic stenosis. The previously reported primary
outcome was the proportion of patients receiving red cell transfusion
postoperatively and within 7 days of the index procedure. Currently
reported exploratory analyses of a combined long-term all-cause mortality
and reoperation were compared between groups via the log-rank test.
Sensitivity analyses reviewed individual components of the combined end
point. The primary analysis and long-term exploratory analyses were based
on an intention-to-treat principle. RESULT(S): Between March 2014 and
June 2016, 270 patients were enrolled and randomized in a 1:1 fashion to
undergo mini-sternotomy AVR (n = 135) or conventional median sternotomy
AVR (n = 135). At the median follow-up of 6.1 years, the composite outcome
of all-cause mortality and reoperation occurred in 18.5% (25/135) of
patients in the conventional sternotomy group and in 17% (23/135) of
patients in the mini-sternotomy group. The incidence of chronic kidney
disease, cerebrovascular accident and myocardial infarction was not
significantly different between 2 groups. Follow-up echocardiographic data
suggested no difference in peak and mean gradients or incidence of aortic
regurgitation between 2 approaches. CONCLUSION(S): This exploratory
long-term analysis demonstrated that, in patients with severe aortic
stenosis undergoing isolated AVR, there was no significant difference
between manubrium-limited mini-sternotomy and conventional sternotomy with
respect to all-cause mortality, rate of reoperation, MACE events and
echocardiographic data at the median of 6.1-year follow-up. Copyright
© The Author(s) 2022. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<6>
Accession Number
2023964458
Title
Randomized, Double-Blind, Active Comparator Pharmacodynamic Study of
Platelet Inhibition with Crushed and Integral Formulations of Clopidogrel
and Ticagrelor in Acute Coronary Syndrome.
Source
American Journal of Cardiovascular Drugs. 23(4) (pp 455-466), 2023. Date
of Publication: July 2023.
Author
Perla H.T.; Thomson V.S.; Attumalil T.V.; Geevar T.; Alex A.G.; Dave R.G.;
Nair S.C.; Gowri S.M.; Mony P.K.; George P.; Joseph G.
Institution
(Perla, Thomson, Attumalil, Alex, George, Joseph) Department of
Cardiology, Christian Medical College and Hospital, Vellore, India
(Geevar, Dave, Nair) Department of Immunohematology and Transfusion
Medicine, Christian Medical College and Hospital, Vellore, India
(Gowri) Department of Biostatistics, Christian Medical College and
Hospital, Vellore, India
(Mony) Department of Epidemiology and Population Health, St John's
National Academy of Health Sciences, Bangalore, India
(Thomson) Salalah Heart Center, Salalah, Oman
Publisher
Adis
Abstract
Background: Crushed formulations of specific antiplatelet agents produce
earlier and stronger platelet inhibition. We studied the platelet
inhibitory effect of crushed clopidogrel in patients with acute coronary
syndrome (ACS) and its relative efficacy compared with integral
clopidogrel, crushed and integral ticagrelor. Objective(s): We aimed
to compare the platelet inhibitory effect of crushed and integral
formulations of clopidogrel and ticagrelor in patients with acute coronary
syndrome (ACS). Method(s): Overall, 142 patients with suspected ACS
were randomly assigned to receive crushed or integral formulations of
clopidogrel or ticagrelor. Platelet inhibition at baseline and 1 and 8 h
was assessed using the VerifyNow assay. High on-treatment platelet
reactivity (HTPR) >= 235 P2Y<inf>12</inf> reaction units (PRUs) 1 h after
the medication loading dose was also determined. Result(s): The PRU
and percentage inhibition median (interquartile range) at 1 h for the
different formulations were as follows: crushed clopidogrel: 196.50
(155.50, 246.50), 9.36 (- 1.79, 25.10); integral clopidogrel: 189.50
(159.00, 214.00), 2.32 (- 2.67, 19.89); crushed ticagrelor: 59.00 (10.00,
96.00), 75.53 (49.12, 95.18); and integral ticagrelor: 126.50 (50.00,
168.00), 40.56 (25.59, 78.69). There was no significant difference in PRU
or percentage platelet inhibition between the crushed and integral
formulations of clopidogrel (p = 0.990, p = 0.479); both formulations of
ticagrelor were superior to the clopidogrel formulations (p < 0.05). On
paired comparison, crushed ticagrelor showed robust early inhibition of
platelets compared with the integral formulation (p = 0.03). Crushed
clopidogrel exhibited the maximal HTPR of 34.3%, but was < 3% for both
formulations of ticagrelor. Conclusion(s): The platelet inhibitory
effect of crushed clopidogrel is not superior to integral preparation in
patients with ACS. Crushed ticagrelor produced maximal platelet inhibition
acutely. HTPR rates in ACS are similar and very low with both formulations
of ticagrelor, and maximal with crushed clopidogrel. Clinical Trials
Registry of India identifier number CTRI/2020/06/025647. Graphical
Abstract: [Figure not available: see fulltext.] Copyright © 2023,
The Author(s), under exclusive licence to Springer Nature Switzerland AG.

<7>
Accession Number
2023292464
Title
Mitoprotective effect of mesenchymal stem cells-derived conditioned medium
in myocardial reperfusion injury of aged rats: role of
SIRT-1/PGC-1alpha/NRF-2 network.
Source
Molecular Biology Reports. 50(7) (pp 5655-5665), 2023. Date of
Publication: July 2023.
Author
Nejati-Koshki K.; Mokhtari B.; Badalzadeh R.; Arabzadeh A.A.;
Mohammadzadeh A.
Institution
(Nejati-Koshki) Pharmaceutical Sciences Research Center, Ardabil
University of Medical Sciences, Ardabil, Iran, Islamic Republic of
(Mokhtari, Badalzadeh) Molecular Medicine Research Center, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Mokhtari, Badalzadeh) Drug Applied Research Center, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Mokhtari, Badalzadeh) Cardiovascular Research Center, Tabriz University
of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Mokhtari, Badalzadeh) Department of Physiology, Faculty of Medicine,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Arabzadeh) Department of Surgery, School of Medicine, Ardabil University
of Medical Sciences, Ardabil, Iran, Islamic Republic of
(Mohammadzadeh) Department of Cardiothoracic Surgery, Imam Khomeini
Hospital, Ardabil University of Medical Sciences, Ardabil, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media B.V.
Abstract
Background: The aged myocardium experiences various forms of stress that
cause reduction of its tolerance to injury induced by ischemia/reperfusion
(I/R). Developing effective cardioprotective modalities to prevent the
amplification of I/R injury during aging is under focus of investigation.
Mesenchymal stem cells (MSCs) have the ability to regenerate infarcted
myocardium mostly by producing multiple secretory factors. This study
aimed to explore the mechanisms of mitoprotection by MSCs-conditioned
medium (CM) in myocardial I/R injury of aged rats. Method(s): Male
Wistar rats (n = 72, 400-450 g, 22-24 months old) were randomized into
groups with/without I/R and/or MSCs-CM treatment. To establish myocardial
I/R injury, the method of LAD occlusion and re-opening was employed.
MSCs-CM was administered intramyocardially (150 mul) at the onset of
reperfusion in recipient group. After 24 h reperfusion, myocardial infarct
size, LDH level, mitochondrial functional endpoints, expression of
mitochondrial biogenesis-associated genes, and the levels of
pro-inflammatory cytokines were evaluated. After 28 days reperfusion,
echocardiographic assessment of cardiac function was performed.
 Result(s): MSCs-CM treatment improved myocardial function and
decreased infarct size and LDH level in aged I/R rats (P <.05 to P <.001).
It also decreased mitochondrial ROS formation, enhanced mitochondrial
membrane potential and ATP content, upregulated mitochondrial
biogenesis-related genes including SIRT-1, PGC-1alpha, and NRF-2, and
lessened TNF-alpha, IL-1beta, and IL-6 levels (P <.05 to P <.01).
 Conclusion(s): MSCs-CM treatment attenuated myocardial I/R injury in
aged rats, in part by improving mitochondrial function and biogenesis and
restraining inflammatory reaction. the upregulation of
SIRT-1/PGC-1alpha/NRF-2 profiles is a possible target for the
mitoprotective effects of MSCs-CM following I/R injury during
aging. Copyright © 2023, The Author(s), under exclusive licence
to Springer Nature B.V.

<8>
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.

<9>
Accession Number
2022803754
Title
Prognostic factors for chronic post-surgical pain after lung and pleural
surgery: a systematic review with meta-analysis, meta-regression and trial
sequential analysis.
Source
Anaesthesia. 78(8) (pp 1005-1019), 2023. Date of Publication: August 2023.
Author
Clephas P.R.D.; Hoeks S.E.; Singh P.M.; Guay C.S.; Trivella M.; Klimek M.;
Heesen M.
Institution
(Clephas) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Hoeks, Klimek) Department of Anaesthesia, Erasmus University Medical
Center, Rotterdam, Netherlands
(Singh) Department of Anaesthesia, Washington University School of
Medicine in St. Louis, St Louis, MO, United States
(Guay) Department of Anaesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Guay) Picower Institute for Learning and Memory, Massachusetts Institute
of Technology, Cambridge, MA, United States
(Trivella) Centre for Statistics in Medicine, University of Oxford,
Oxford, United Kingdom
(Heesen) Department of Anaesthesia, Kantonsspital Baden AG, Baden,
Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Chronic post-surgical pain is known to be a common complication of
thoracic surgery and has been associated with a lower quality of life,
increased healthcare utilisation, substantial direct and indirect costs,
and increased long-term use of opioids. This systematic review with
meta-analysis aimed to identify and summarise the evidence of all
prognostic factors for chronic post-surgical pain after lung and pleural
surgery. Electronic databases were searched for retrospective and
prospective observational studies as well as randomised controlled trials
that included patients undergoing lung or pleural surgery and reported on
prognostic factors for chronic post-surgical pain. We included 56 studies
resulting in 45 identified prognostic factors, of which 16 were pooled
with a meta-analysis. Prognostic factors that increased chronic
post-surgical pain risk were as follows: higher postoperative pain
intensity (day 1, 0-10 score), mean difference (95%CI) 1.29 (0.62-1.95), p
< 0.001; pre-operative pain, odds ratio (95%CI) 2.86 (1.94-4.21), p <
0.001; and longer surgery duration (in minutes), mean difference (95%CI)
12.07 (4.99-19.16), p < 0.001. Prognostic factors that decreased chronic
post-surgical pain risk were as follows: intercostal nerve block, odds
ratio (95%CI) 0.76 (0.61-0.95) p = 0.018 and video-assisted thoracic
surgery, 0.54 (0.43-0.66) p < 0.001. Trial sequential analysis was used to
adjust for type 1 and type 2 errors of statistical analysis and confirmed
adequate power for these prognostic factors. In contrast to other studies,
we found that age had no significant effect on chronic post-surgical pain
and there was not enough evidence to conclude on sex. Meta-regression did
not reveal significant effects of any of the study covariates on the
prognostic factors with a significant effect on chronic post-surgical
pain. Expressed as grading of recommendations, assessment, development and
evaluations criteria, the certainty of evidence was high for pre-operative
pain and video-assisted thoracic surgery, moderate for intercostal nerve
block and surgery duration and low for postoperative pain intensity. We
thus identified actionable factors which can be addressed to attempt to
reduce the risk of chronic post-surgical pain after lung
surgery. Copyright © 2023 The Authors. Anaesthesia published by
John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

<10>
Accession Number
2020044664
Title
Heart transplantation in end-stage heart failure secondary to cardiac
sarcoidosis: an updated systematic review.
Source
Heart Failure Reviews. 28(4) (pp 961-966), 2023. Date of Publication: July
2023.
Author
Buttar C.; Lakhdar S.; Pavankumar T.; Guzman-Perez L.; Mahmood K.; Collura
G.
Institution
(Buttar) Department of Cardiology, Tulane Hospital, New Orleans, LA,
United States
(Lakhdar, Pavankumar) Department of Cardiology, Ochsner Medical Center,
New Orleans, LA, United States
(Guzman-Perez) Department of Medicine, Icahn School of Medicine at Mount
Sinai/NYC H+H/Queens, Queens, NY, United States
(Mahmood) Department of Heart Failure and Transplant, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Collura) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
NYC H+H/Queens, Queens, NY, United States
Publisher
Springer
Abstract
The prevalence of cardiac sarcoidosis is increasing with improved cardiac
imaging and may lead to severe heart failure, cardiomyopathy, and
arrhythmias that warrant heart transplant consideration. This study aimed
to evaluate the outcomes of heart transplantation in sarcoidosis. We
systematically searched PubMed/MEDLINE, EMBASE and Cochrane Library
following the Preferred Reporting Items for Systematic Reviews and
Meta-analysis (PRISMA) guidelines. We identified 15 articles that examined
patients with cardiac sarcoidosis. The study aimed to evaluate the
outcomes of heart transplantation in cardiac sarcoidosis. We
systematically searched EMBASE, PubMed/MEDLINE, and Cochrane Library
following the Preferred Reporting Items for Systematic Reviews and
Meta-analyses (PRISMA) guidelines. We identified 15 studies that examined
1075 patients with cardiac sarcoidosis who underwent heart
transplantation. A total of five studies reported individual patient data.
Forty-two patients have been pooled for further analysis. There were 22
male patients, 14 female patients, and 7 patients whose gender was not
reported. Among these patients, 10 patients had concomitant pulmonary
sarcoidosis at the time of diagnosis. The mean survival was reported for
all 42 patients. The mean survival in months was 71.4 months, with a range
of 2 days to 288 months. Three patients died of graft failure, 2 patients
from septic shock, 2 patients from pneumonia, 1 patient from cervical
cancer, and 1 patient from sudden cardiac death. One patient developed a
malignant arrythmia in the setting of CMV myocarditis post-heart
transplant. Sarcoidosis recurrence after heart transplant was reported in
3 of 30 patients.Patients with cardiac sarcoidosis have shown to have
favorable outcomes after heart transplant. Despite these outcomes, some
centers still hesitate to pursue heart transplant for CS patients.
Carefully selected patients with advanced-stage heart failure due to
cardiac sarcoidosis have encouraging outcomes after transplantation.
Further studies will be needed to evaluate the outcomes of heart
transplantation in sarcoidosis. Copyright © 2022, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<11>
Accession Number
641798939
Title
Effects of penehyclidine hydrochloride combined with dexmedetomidine on
pulmonary function in patients undergoing heart valve surgery: a
double-blind, randomized trial.
Source
BMC anesthesiology. 23(1) (pp 237), 2023. Date of Publication: 13 Jul
2023.
Author
He F.; Lu Y.; Mao Q.; Zhou L.; Chen Y.; Xie Y.
Institution
(He, Lu, Mao, Zhou) Department of Anesthesiology, First Affiliated
Hospital of Guangxi Medical University, Nanning, China
(Chen) Department of Anesthesiology, First Affiliated Hospital of Guangxi
Medical University, Nanning, China
(Xie) Department of Anesthesiology, First Affiliated Hospital of Guangxi
Medical University, Nanning, China
(Xie) First Affiliated Hospital of Guangxi Medical University, Guangxi Key
Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer,
Nanning, China
Publisher
NLM (Medline)
Abstract
AIM: To investigate the effects of penehyclidine hydrochloride combined
with dexmedetomidine on pulmonary function in patients undergoing heart
valve surgery with cardiopulmonary bypass (CPB). METHOD(S): A total
of 180 patients undergoing elective heart valve surgery with CPB were
randomly divided into four groups: 45 in group P (intravenous
penehyclidine hydrochloride 0.02 mg/kg 10 min before anesthesia induction
and at the beginning of CPB, total 0.04 mg/kg); 43 in group D
(dexmedetomidine 0.5 mug/kg/h after induction of anesthesia until the end
of anesthesia); 44 in group PD ( penehyclidine hydrochloride 0.04 mg/kg
combined with dexmedetomidine 0.5 mug/kg/h intravenously during
anesthesia); and 43 in group C (same amount of normal saline 10 min before
and after anesthesia induction, to the end of anesthesia, and at the
beginning of CPB). The main outcomes were the incidence and severity of
postoperative pulmonary complications (PPCs). The secondary outcomes were:
(1) extubation time, length of stay in intensive care, and postoperative
hospital stay, and adverse events; and (2) pulmonary function evaluation
indices (oxygenation index and respiratory index) and plasma inflammatory
factor concentrations (tumor necrosis factor-alpha, interleukin-6,
C-reactive protein and procalcitonin) during the perioperative period.
 RESULT(S): The incidence of PPCs in groups P, D and PD after CPB was
lower than that in group C (P<0.05), and the incidence in group PD was
significantly lower than that in groups P and D (P<0.05). The scores for
PPCs in groups P, D and PD were lower than those in group C (P<0.05).
 CONCLUSION(S): Combined use of penehyclidine hydrochloride and
dexmedetomidine during anesthesia reduced the occurrence of postoperative
pulmonary dysfunction, and improved the prognosis of patients undergoing
heart valve surgery with CPB. TRIAL REGISTRATION: The trial was registered
in the Chinese Clinical Trial Registry on 3/11/2020 (Registration No.:
ChiCTR2000039610). Copyright © 2023. The Author(s).

<12>
Accession Number
641798928
Title
Effects of intraoperative inspired oxygen fraction (FiO<inf>2</inf> 0.3 vs
0.8) on patients undergoing off-pump coronary artery bypass grafting: the
CARROT multicenter, cluster-randomized trial.
Source
Critical care (London, England). 27(1) (pp 286), 2023. Date of
Publication: 13 Jul 2023.
Author
Nam K.; Nam J.-S.; Kim H.-B.; Chung J.; Hwang I.E.; Ju J.-W.; Bae J.; Lee
S.; Cho Y.J.; Shim J.-K.; Kwak Y.-L.; Chin J.-H.; Choi I.-C.; Lee E.-H.;
Jeon Y.
Institution
(Nam, Chung, Hwang, Ju, Bae, Lee, Cho, Jeon) Department of Anesthesiology
and Pain Medicine, Seoul National University Hospital, Seoul National
University College of Medicine, 101 Daehak-ro ,Jongno-gu, Seoul 03080,
South Korea
(Nam, Chin, Choi) Department of Anesthesiology and Pain Medicine, Asan
Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro
43-gil ,Songpa-gu, Seoul 05505, South Korea
(Kim, Shim, Kwak) Department of Anesthesiology and Pain Medicine,
Severance Hospital, Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Chung) Medical Service Corps of the First Logistics Support Command,
Wonju, South Korea
(Bae) Department of Anesthesiology and Pain Medicine, Ajou University
Medical Center, Ajou University School of Medicine, Gyeonggi Province,
Suwon, South Korea
(Lee) Department of Anesthesiology and Pain Medicine, Asan Medical Center,
University of Ulsan College of Medicine, 88 Olympic-ro 43-gil ,Songpa-gu,
Seoul 05505, South Korea
(Lee) SeoulSouth Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: To maintain adequate oxygenation is of utmost importance in
intraoperative care. However, clinical evidence supporting specific oxygen
levels in distinct surgical settings is lacking. This study aimed to
compare the effects of 30% and 80% oxygen in off-pump coronary artery
bypass grafting (OPCAB). METHOD(S): This multicenter trial was
conducted in three tertiary hospitals from August 2019 to August 2021.
Patients undergoing OPCAB were cluster-randomized to receive either 30% or
80% oxygen intraoperatively, based on the month when the surgery was
performed. The primary endpoint was the length of hospital stay.
Intraoperative hemodynamic data were also compared. RESULT(S): A
total of 414 patients were cluster-randomized. Length of hospital stay was
not different in the 30% oxygen group compared to the 80% oxygen group
(median, 7.0 days vs 7.0 days; the sub-distribution hazard ratio, 0.98;
95% confidence interval [CI] 0.83-1.16; P=0.808). The incidence of
postoperative acute kidney injury was significantly higher in the 30%
oxygen group than in the 80% oxygen group (30.7% vs 19.4%; odds ratio,
1.94; 95% CI 1.18-3.17; P=0.036). Intraoperative time-weighted average
mixed venous oxygen saturation was significantly higher in the 80% oxygen
group (74% vs 64%; P<0.001). The 80% oxygen group also had a significantly
greater intraoperative time-weighted average cerebral regional oxygen
saturation than the 30% oxygen group (56% vs 52%; P=0.002).
 CONCLUSION(S): In patients undergoing OPCAB, intraoperative
administration of 80% oxygen did not decrease the length of hospital stay,
compared to 30% oxygen, but may reduce postoperative acute kidney injury.
Moreover, compared to 30% oxygen, intraoperative use of 80% oxygen
improved oxygen delivery in patients undergoing OPCAB. Trial registration
ClinicalTrials.gov (NCT03945565; April 8, 2019). Copyright ©
2023. The Author(s).

<13>
Accession Number
641798720
Title
The impact of semi-upright position on severity of sleep disordered
breathing in patients with obstructive sleep apnea: a two-arm,
prospective, randomized controlled trial.
Source
BMC anesthesiology. 23(1) (pp 236), 2023. Date of Publication: 13 Jul
2023.
Author
Lukachan G.A.; Yadollahi A.; Auckley D.; Gavrilovic B.; Matelski J.; Chung
F.; Singh M.
Institution
(Lukachan) Department of Anesthesia, Believers Church Medical College
Hospital, Kerala, India
(Yadollahi, Gavrilovic) KITE - Toronto Rehabilitation Institute,
University of Toronto, University Health Network, Toronto, ON, Canada
(Auckley) Division of Pulmonary, Critical Care and Sleep Medicine,
MetroHealth Medical Center, Case Western Reserve University, Cleveland,
OH, United States
(Matelski) Biostatistics Research Unit, University Health Network,
Toronto, ON, Canada
(Chung, Singh) Department of Anesthesia, University of Toronto, McL 2-405,
Toronto Western Hospital ,University Health Network399 Bathurst Street,
Toronto, ON M5T 2S8, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: The severity of sleep-disordered breathing is known to worsen
postoperatively and is associated with increased cardio-pulmonary
complications and increased resource implications. In the general
population, the semi-upright position has been used in the management of
OSA. We hypothesized that the use of a semi-upright position versus a
non-elevated position will reduce postoperative worsening of OSA in
patients undergoing non-cardiac surgeries. METHOD(S): This study was
conducted as a prospective randomized controlled trial of perioperative
patients, undergoing elective non-cardiac inpatient surgeries. Patients
underwent a preoperative sleep study using a portable polysomnography
device. Patients with OSA (apnea hypopnea index (AHI)>5 events/hr),
underwent a sleep study on postoperative night 2 (N2) after being
randomized into an intervention group (Group I): semi-upright position (30
to 45 degrees incline), or a control group (Group C) (zero degrees from
horizontal). The primary outcome was postoperative AHI on N2. The
secondary outcomes were obstructive apnea index (OAI), central apnea index
(CAI), hypopnea index (HI), obstructive apnea hypopnea index (OAHI) and
oxygenation parameters. RESULT(S): Thirty-five patients were
included. Twenty-one patients were assigned to the Group 1 (females-14
(67%); mean age 65+/-12) while there were fourteen patients in the Group C
(females-5 (36%); mean age 63+/-10). The semi-upright position resulted in
a significant reduction in OAI in the intervention arm (Group C vs Group I
postop AHI: 16.6+/-19.0 vs 8.6+/-11.2 events/hr; overall p=0.01), but
there were no significant differences in the overall AHI or other
parameters between the two groups. Subgroup analysis of patients with
"supine related OSA" revealed a decreasing trend in postoperative AHI with
semi-upright position, but the sample size was too small to evaluate
statistical significance. CONCLUSION(S): In patients with newly
diagnosed OSA, the semi-upright position resulted in improvement in
obstructive apneas, but not the overall AHI. TRIAL REGISTRATION: This
trial was retrospectively registered in clinicaltrials.gov NCT02152202 on
02/06/2014. Copyright © 2023. The Author(s).

<14>
Accession Number
641798342
Title
Analgesic effectiveness of serratus anterior plane block in patients
undergoing video-assisted thoracoscopic surgery: a systematic review and
updated meta-analysis of randomized controlled trials.
Source
BMC anesthesiology. 23(1) (pp 235), 2023. Date of Publication: 13 Jul
2023.
Author
Li J.; Wang X.; Wang Y.; Zhang W.
Institution
(Li, Wang, Wang) Department of Anesthesiology, Yuncheng Central Hospital,
Shanxi Medical University, Shanxi Province, Yuncheng 044000, China
(Zhang) Department of Anesthesiology, Yuncheng Central Hospital, Shanxi
Medical University, Shanxi Province, Yuncheng 044000, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Serratus anterior plane block (SAPB) is a promising regional
technique for analgesia in thoracic surgery. Till now, several randomized
controlled trials (RCTs) have explored the effectiveness of SAPB for
postoperative pain control in patients undergoing video-assisted
thoracoscopic surgery (VATS), but the sample sizes were small and
conclusions remained in controversy. Therefore, we conducted the present
systematic review and meta-analysis. METHOD(S): RCTs evaluating the
analgesic performance of SAPB, comparing to control methods (no block,
placebo or local infiltration anesthesia), in patients undergoing VATS
were searched in PubMed, EMBASE, Web of Science and Cochrane Library from
inception to December 31, 2022. Mean difference (MD) and corresponding 95%
confidence interval (95%CI) were calculated for postoperative pain scores
at various time points, postoperative opioid consumption and length of
hospital stay. Pooled relative risk (RR) with 95%CI were calculated for
the risk of postoperative nausea and vomiting (PONV) and dizziness. A
random-effect model was applied. RESULT(S): A total of 12 RCTs (837
participants) were finally included. Compared to control group, SAPB had
significant reductions of postoperative pain scores at 2 h (MD=-1.58,
95%CI: -1.86 to -1.31, P<0.001), 6 h (MD=-2.06, 95%CI: -2.74 to -1.38,
P<0.001), 12 h (MD=-1.72, 95%CI: -2.30 to -1.14, P<0.001) and 24 h
(MD=-1.03, 95%CI: -1.55 to -0.52, P<0.001), respectively. Moreover, SAPB
conferred a fewer postoperative opioid consumption (MD=-7.3 mg of
intravenous morphine equivalent, 95%CI: -10.16 to -4.44, P<0.001) and
lower incidence of PONV (RR=0.56, 95%CI: 0.41 to 0.77, P<0.001). There was
no difference between both groups regarding length of hospital stay and
risk of dizziness. CONCLUSION(S): SAPB shows an excellent performance
in postoperative pain management in patients undergoing VATS by reducing
pains scores, postoperative opioid consumption and incidence of PONV.
However, due to huge heterogeneity, more well-designed, large-scale RCTs
are needed to verify these findings in the future. Copyright ©
2023. The Author(s).

<15>
Accession Number
641618867
Title
Early safety and feasibility of a first-in-class biomimetic transcatheter
aortic valve - DurAVR.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
19(4) (pp e352-e362), 2023. Date of Publication: 17 Jul 2023.
Author
Kodali S.K.; Sorajja P.; Meduri C.U.; Feldt K.; Cavalcante J.L.; Garg P.;
Hamid N.; Poon K.K.; Settergren M.R.M.; Burns M.R.; Ruck A.; Sathananthan
J.; Zajarias A.; Shaburishvili T.; Zirakashvili T.; Zhividze M.;
Katchakhidze G.; Bapat V.N.
Institution
(Kodali) Columbia University Irving Medical Center, New York, NY, USA
(Sorajja, Cavalcante, Hamid, Burns, Bapat) Minneapolis Heart Institute,
Abbott Northwestern Hospital, Minneapolis, MN, United States
(Meduri, Feldt, Settergren, Ruck) Department of Cardiology, Karolinska
University Hospital, Stockholm, Sweden
(Feldt, Settergren, Ruck) Department of Medicine, Karolinska Institutet,
Solna, Stockholm, Sweden
(Garg) Norwich Medical School, University of East Anglia, Norwich, United
Kingdom
(Garg) Norfolk and Norwich University Hospitals NHS Foundation Trust,
Norwich, United Kingdom
(Poon) St. Andrew's War Memorial Hospital, Brisbane, Australia
(Sathananthan) St. Paul's Hospital, Vancouver, BC, Canada
(Zajarias) Washington University School of Medicine, St. Louis, MO, United
States
(Shaburishvili, Zirakashvili, Zhividze) Cardiovascular Clinic, Tbilisi
Heart and Vascular Clinic, Tbilisi, Georgia
(Katchakhidze) Aversi Clinic, Tbilisi, Georgia
Publisher
NLM (Medline)
Abstract
BACKGROUND: TAVI is a widely accepted treatment for patients with severe
aortic stenosis (AS). Despite the adoption of diverse therapies,
opportunities remain to develop technologies tailored to provide optimal
acute and potential long-term benefits, particularly around haemodynamics,
flow and durability. AIMS: We aimed to evaluate the safety and feasibility
of the DurAVR transcatheter heart valve (THV), a first-in-class biomimetic
valve, in the treatment of patients with symptomatic severe AS.
 METHOD(S): This was a first-in-human (FIH), prospective,
non-randomised, single-arm, single-centre study. Patients with severe,
symptomatic AS of any surgical risk and who were eligible for the DurAVR
THV prosthesis were recruited; they were assessed at baseline, 30 days, 6
months, and 1 year post-procedure for implant success, haemodynamic
performance, and safety. RESULT(S): Thirteen patients (73.9+/-6.4
years old, 77% female) were enrolled. The DurAVR THV was successfully
implanted in 100% of cases with no device-related complications. One
access site complication, one permanent pacemaker implantation, and one
case of moderate aortic regurgitation occurred. Otherwise, no deaths,
stroke, bleeding, reinterventions, or myocardial infarction were reported
during any of the follow-up visits. Despite a mean annulus size of
22.95+/-1.09 mm, favourable haemodynamic results were observed at 30 days
(effective orifice area [EOA] 2.00+/-0.17 cm2, and mean pressure gradient
[MPG] 9.02+/-2.68 mmHg) and were sustained at 1 year (EOA 1.96+/-0.11 cm2,
MPG 8.82+/-1.38 mmHg), resulting in zero patients with any degree of
prosthesis-patient mismatch. Additionally, new valve performance measures
derived from cardiovascular magnetic resonance displayed restoration of
laminar flow, consistent with a predisease state, in conjunction with a
mean coaptation length of 8.3+/-1.7 mm. CONCLUSION(S): Preliminary
results from the FIH study with DurAVR THV demonstrate a good safety
profile with promising haemodynamic performance sustained at 1 year and
restoration of near-normal flow dynamics. Further clinical investigation
is warranted to evaluate how DurAVR THV may play a role in addressing the
challenge of lifetime management in AS patients.

<16>
Accession Number
641547453
Title
P2Y12 inhibitor monotherapy versus dual antiplatelet therapy in patients
with acute coronary syndromes undergoing coronary stenting: rationale and
design of the NEOMINDSET Trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
19(4) (pp e323-e329), 2023. Date of Publication: 17 Jul 2023.
Author
Guimaraes P.O.; Franken M.; Tavares C.A.M.; Silveira F.S.; Antunes M.O.;
Bergo R.R.; Joaquim R.M.; Hirai J.C.S.; Andrade P.B.; Pitta F.G.; Mariani
J.; Nascimento B.R.; de Paula J.E.T.; Silveira M.S.; Costa T.A.O.;
Dall'Orto F.T.C.; Serpa R.G.; Sampaio F.B.A.; Ohe L.N.; Mangione F.M.;
Furtado R.H.M.; Sarmento-Leite R.; Monfardini F.; Assis S.R.L.; Nicolau
J.C.; Sposito A.C.; Lopes R.D.; Onuma Y.; Valgimigli M.; Angiolillo D.J.;
Serruys P.W.; Berwanger O.; Bacal F.; Lemos P.A.
Institution
(Guimaraes, Franken, Tavares, Hirai, Pitta, Mariani, Monfardini, Assis,
Berwanger, Bacal, Lemos) Hospital Israelita Albert Einstein, Sao Paulo,
Brazil
(Tavares, Pitta, Furtado, Nicolau, Bacal, Lemos) Instituto do Coracao
(InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Brazil and
Universidade de Sao Paulo, Sao Paulo, Brazil
(Silveira, Silveira) Research Center, Clinica do Coracao, Aracaju, Brazil
(Antunes, Costa) Hospital Universitario Sao Francisco de Assis na
Providencia de Deus, Braganca Paulista, Brazil
(Bergo, Dall'Orto) Hospital Santa Lucia, Pocos de Caldas, Brazil
(Joaquim) Instituto de Cardiologia de Santa Catarina, Sao Jose, Brazil
(Andrade) Irmandade da Santa Casa de Misericordia de Marilia, Marilia,
Brazil
(Nascimento) Hospital Universitario Ciencias Medicas, Belo Horizonte,
Brazil
(de Paula) Instituto Cardiovascular de Linhares, Linhares, Brazil
(Serpa) Hospital Santa Casa de Misericordia de Vitoria, Vitoria, Brazil
(Sampaio) Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
(Ohe) Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Mangione) Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil
(Sarmento-Leite) Instituto de Cardiologia do Rio Grande do Sul/Fundacao
Universitaria de Cardiologia, Porto Alegre, Brazil
(Sposito) Department of Internal Medicine, School of Medical Sciences,
State University of Campinas, Campinas, Brazil
(Lopes) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Onuma, Serruys) Department of Cardiology, University of Galway, Galway,
Ireland
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Valgimigli) Universita della Svizzera Italiana, Lugano, Switzerland
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
Publisher
NLM (Medline)
Abstract
Dual antiplatelet therapy (DAPT) is currently the standard of care after
percutaneous coronary intervention (PCI). Recent studies suggest that
reducing DAPT to 1-3 months followed by an aspirin-free single
antiplatelet therapy (SAPT) strategy with a potent P2Y12 inhibitor is safe
and associated with less bleeding. However, to date, no randomised trial
has tested the impact of initiating SAPT immediately after PCI,
particularly in patients with acute coronary syndromes (ACS). NEOMINDSET
is a multicentre, randomised, open-label trial with a blinded outcome
assessment designed to compare SAPT versus DAPT in 3,400 ACS patients
undergoing PCI with the latest-generation drug-eluting stents (DES). After
successful PCI and up to 4 days following hospital admission, patients are
randomised to receive SAPT with a potent P2Y12 inhibitor (ticagrelor or
prasugrel) or DAPT (aspirin plus a potent P2Y12 inhibitor) for 12 months.
Aspirin is discontinued immediately after randomisation in the SAPT group.
The choice between ticagrelor and prasugrel is at the investigator's
discretion. The primary hypothesis is that SAPT will be non-inferior to
DAPT with respect to the composite endpoint of all-cause mortality,
stroke, myocardial infarction or urgent target vessel revascularisation,
but superior to DAPT on rates of bleeding defined by Bleeding Academic
Research Consortium 2, 3 or 5 criteria. NEOMINDSET is the first study that
is specifically designed to test SAPT versus DAPT immediately following
PCI with DES in ACS patients. This trial will provide important insights
on the efficacy and safety of withdrawing aspirin in the early phase of
ACS. (ClinicalTrials.gov: NCT04360720).

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

<18>
Accession Number
640428203
Title
Application of topical pharyngeal anesthesia to reduce adverse reactions
during painless gastroscopy: A prospective randomized study.
Source
Technology and health care : official journal of the European Society for
Engineering and Medicine. 31(4) (pp 1245-1251), 2023. Date of Publication:
2023.
Author
Sun H.; Lin X.; Liu Y.; Hu S.; Yu Y.; Song C.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Studies have reported that certain adverse reactions can occur
during painless gastroscopy examination. Knowing how to decrease the risks
and incidence of adverse reactions is of great importance.
 OBJECTIVE(S): To investigate whether topical pharyngeal anesthesia
combined with intravenous anesthesia is superior to intravenous anesthesia
alone in patients undergoing painless gastroscopy and to determine whether
this combined approach had any additional benefits. METHOD(S): Three
hundred patients undergoing painless gastroscopy were randomly assigned to
either the control group or the experimental group. In the control group,
patients were anesthetized with propofol, while patients in the
experimental group received propofol combined with 2% lidocaine spray for
topical pharyngeal anesthesia. Hemodynamic parameters before and after the
procedure, including the heart rate (HR), mean arterial pressure (MAP),
and pulse oxygen saturation (SPO2) were recorded. Any adverse reactions
experienced by the patient, including choking and respiratory depression,
and the total dosage of propofol required during each procedure were also
documented. RESULT(S): Compared with pre-anesthetic data, the HR,
MAP, and SPO2 were reduced after the completion of the painless
gastroscopy procedure in both groups. However, the HR, MAP, and SPO2
measurements taken after the gastroscopy were significantly lower in the
control group than those of the experimental group (P< 0.05); thus, the
hemodynamic parameters of the experimental group were more stable.
Compared with the control group, there was significant reduction in the
total amount of propofol administered in the experimental group (P< 0.05).
The incidence of adverse reactions, including choking and respiratory
depression, was significantly lower in the experimental group (P< 0.05).
 CONCLUSION(S): The results demonstrated that the application of
topical pharyngeal anesthesia in painless gastroscopy can significantly
reduce the incidence of adverse reactions. Thus, the combination of
topical pharyngeal and intravenous anesthesia is worthy of clinical
application and promotion.

<19>
Accession Number
2024383473
Title
Incidence of delirium after non-cardiac surgery in the Chinese elderly
population: a systematic review and meta-analysis.
Source
Frontiers in Aging Neuroscience. 15 (no pagination), 2023. Article Number:
1188967. Date of Publication: 2023.
Author
Gong X.-Y.; Hou D.-J.; Yang J.; He J.-L.; Cai M.-J.; Wang W.; Lu X.-Y.;
Gao J.
Institution
(Gong, Yang, He, Cai, Wang, Lu, Gao) School of Nursing, Chengdu University
of Traditional Chinese Medicine, Sichuan, Chengdu, China
(Hou) School of Medicine and Life Sciences, Chengdu University of
Traditional Chinese Medicine, Sichuan, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: POD places a heavy burden on the healthcare system as the
number of elderly people undergoing surgery is increasing annually because
of the aging population. As a large country with a severely aging
population, China's elderly population has reached 267 million. There has
been no summary analysis of the pooled incidence of POD in the elderly
Chinese population. Method(s): Systematic search databases included
PubMed, Web of Science, EMBASE, Cochrane Library Databases, China
Knowledge Resource Integrated Database (CNKI), Chinese Biomedical Database
(CBM), WanFang Database, and Chinese Science and Technology Periodicals
(VIP). The retrieval time ranged from the database's establishment to
February 8, 2023. The pooled incidence of delirium after non-cardiac
surgery was calculated using a random effects model. Meta-regression,
subgroup, and sensitivity analyses were used to explore the source of
heterogeneity. Result(s): A total of 52 studies met the inclusion
criteria, involving 18,410 participants. The pooled incidence of delirium
after non-cardiac surgery in the elderly Chinese population was 18.6% (95%
CI: 16.4-20.8%). The meta-regression results revealed anesthesia method
and year of publication as a source of heterogeneity. In the subgroup
analysis, the gender subgroup revealed a POD incidence of 19.6% (95% CI:
16.9-22.3%) in males and 18.3% (95% CI: 15.7-20.9%) in females. The year
of publication subgroup analysis revealed a POD incidence of 20.3% (95%
CI: 17.4-23.3%) after 2018 and 14.6 (95% CI: 11.6-17.6%) in 2018 and
before. In the subgroup of surgical types, the incidence of hip fracture
surgery POD was 20.7% (95% CI: 17.6-24.3%), the incidence of non-cardiac
surgery POD was 18.4% (95% CI: 11.8-25.1%), the incidence of orthopedic
surgery POD was 16.6% (95% CI: 11.8-21.5%), the incidence of abdominal
neoplasms surgery POD was 14.3% (95% CI: 7.6-21.1%); the incidence of
abdominal surgery POD was 13.9% (95% CI: 6.4-21.4%). The anesthesia
methods subgroup revealed a POD incidence of 21.5% (95% CI: 17.9-25.1%)
for general anesthesia, 15.0% (95% CI: 10.6-19.3%) for intraspinal
anesthesia, and 8.3% (95% CI: 10.6-19.3%) for regional anesthesia. The
measurement tool subgroup revealed a POD incidence of 19.3% (95% CI:
16.7-21.9%) with CAM and 16.8% (95% CI: 12.6-21.0%) with DSM. The sample
size subgroup revealed a POD incidence of 19.4% (95% CI: 16.8-22.1%) for
patients <= 500 and 15.3% (95% CI: 11.0-19.7%) for patients > 500. The
sensitivity analysis suggested that the pooled incidence of postoperative
delirium in this study was stable. Conclusion(s): Our systematic
review of the incidence of delirium after non-cardiac surgery in elderly
Chinese patients revealed a high incidence of postoperative delirium.
Except for cardiac surgery, the incidence of postoperative delirium was
higher for hip fracture surgery than for other types of surgery. However,
this finding must be further explored in future large-sample studies.
Systematic review registration: https://www.crd.york.ac.uk/prospero/,
identifier: PROSPERO CRD42023397883. Copyright © 2023 Gong, Hou,
Yang, He, Cai, Wang, Lu and Gao.

<20>
Accession Number
2024349343
Title
Effect of Colchicine on the Risk of Perioperative Acute Kidney Injury:
Clinical Protocol of a Substudy of the Colchicine for the Prevention of
Perioperative Atrial Fibrillation Randomized Clinical Trial.
Source
Canadian Journal of Kidney Health and Disease. 10 (no pagination), 2023.
Date of Publication: January-December 2023.
Author
Garg A.X.; Cuerden M.; Cata J.; Chan M.T.V.; Devereaux P.J.; Fleischmann
E.; Grande A.M.; Kabon B.; Landoni G.; Maziak D.E.; McLean S.; Parikh C.;
Popova E.; Reimer C.; Trujillo Reyes J.C.; Roshanov P.; Sessler D.I.;
Srinathan S.; Sontrop J.M.; Gonzalez Tallada A.; Wang M.K.; Wells J.R.;
Conen D.
Institution
(Garg, Cuerden, Roshanov, Sontrop) London Health Sciences Centre, ON,
Canada
(Cata) MD Anderson Cancer Center, Houston, TX, United States
(Chan) The Chinese University of Hong Kong, Shatin, China
(Devereaux) McMaster University, Hamilton, ON, Canada
(Fleischmann, Kabon) Medical University of Vienna, Austria
(Grande) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Landoni) IRCCS San Raffaele Scientific Institute, Milan, Italy
(Maziak) University of Ottawa, ON, Canada
(McLean) Vancouver Acute Department of Anesthesiology, Vancouver General
Hospital, BC, Canada
(Parikh) Johns Hopkins School of Medicine, Baltimore, MD, United States
(Popova) Institut d'Investigacio Biomedica Sant Pau, Barcelona, Spain
(Reimer) Kingston Health Sciences Centre, ON, Canada
(Trujillo Reyes) Department of Thoracic Surgery, Hospital de la Santa Creu
i Sant Pau, Barcelona, Spain
(Roshanov) Division of Nephrology, Department of Medicine, Western
University, London, ON, Canada
(Roshanov) Department of Epidemiology and Biostatistics, Western
University, London, ON, Canada
(Roshanov, Wang, Wells, Conen) Population Health Research Institute,
Hamilton, ON, Canada
(Sessler) Department of Outcomes Research, Cleveland Clinic, OH, United
States
(Srinathan) Department of Surgery, University of Manitoba, Winnipeg,
Canada
(Gonzalez Tallada) Hospital Universitari Vall d'Hebron, Barcelona, Spain
Publisher
SAGE Publications Ltd
Abstract
Background: Inflammation during and after surgery can lead to organ damage
including acute kidney injury. Colchicine, an established inexpensive
anti-inflammatory medication, may help to protect the organs from
pro-inflammatory damage. This protocol describes a kidney substudy of the
colchicine for the prevention of perioperative atrial fibrillation
(COP-AF) study, which is testing the effect of colchicine versus placebo
on the risk of atrial fibrillation and myocardial injury among patients
undergoing thoracic surgery. Objective(s): Our kidney substudy of
COP-AF will determine whether colchicine reduces the risk of perioperative
acute kidney injury compared with a placebo. We will also examine whether
colchicine has a larger absolute benefit in patients with pre-existing
chronic kidney disease, the most prominent risk factor for acute kidney
injury. Design and Setting: Randomized, superiority clinical trial
conducted in 40 centers in 11 countries from 2018 to 2023.
 Patient(s): Patients (~3200) aged 55 years and older having major
thoracic surgery. Intervention(s): Patients are randomized 1:1 to
receive oral colchicine (0.5 mg tablet) or a matching placebo, given twice
daily starting 2 to 4 hours before surgery for a total of 10 days.
Patients, health care providers, data collectors, and outcome adjudicators
will be blinded to the randomized treatment allocation. Method(s):
Serum creatinine concentrations will be measured before surgery and on
postoperative days 1, 2, and 3 (or until hospital discharge). The primary
outcome of the substudy is perioperative acute kidney injury, defined as
an increase (from the prerandomization value) in serum creatinine
concentration of either >=26.5 mumol/L (>=0.3 mg/dL) within 48 hours of
surgery or >=50% within 7 days of surgery. The primary analysis
(intention-to-treat) will examine the relative risk of acute kidney injury
in patients allocated to receive colchicine versus placebo. We will repeat
the primary analysis using alternative definitions of acute kidney injury
and examine effect modification by pre-existing chronic kidney disease,
defined as a prerandomization estimated glomerular filtration rate (eGFR)
<60 mL/min per 1.73 m2. Limitation(s): The substudy will
be underpowered to detect small effects on more severe forms of acute
kidney injury treated with dialysis. Result(s): Substudy results will
be reported in 2024. Conclusion(s): This substudy will estimate the
effect of colchicine on the risk of perioperative acute kidney injury in
older adults undergoing major thoracic surgery. Clinical trial
registration number: NCT03310125 Copyright © The Author(s) 2023.

<21>
Accession Number
2025698451
Title
Epidemiological Study to Assess the Prevalence of Lung Cancer in patients
with smoking-associated atherosclerotic cardiovascular diseases: PREVALUNG
study protocol.
Source
BMJ Open. 12(12) (no pagination), 2022. Article Number: e067191. Date of
Publication: 26 Dec 2022.
Author
Boulate D.; Fidelle M.; Caramella C.; Issard J.; Planche O.; Pradere P.;
Garelik D.; Hache O.; Lamrani L.; Zins M.; Beaussier H.; Chatellier G.;
Fadel E.; Zitvogel L.; Besse B.; Mercier O.
Institution
(Boulate) Research and Innovation Unit, Centre Chirugical Marie
Lannelongue, Le Plessis-Robinson, France
(Fidelle) INSERM U1015, Gustave Roussy Cancer Campus, Villejuif, France
(Caramella, Planche, Zins) Radiology, Hopital Marie Lannelongue Groupe,
Hospitalier Paris Sain-Joseph, Le Plessis-Robinson, France
(Issard, Lamrani, Beaussier) Research and Innovation Unit, Hopital Marie
Lannelongue Groupe, Hospitalier Paris Sain-Joseph, Le Plessis-Robinson,
France
(Pradere, Fadel) Thoracic Surgery, Hopital Marie Lannelongue Groupe,
Hospitalier Paris Sain-Joseph, Le Plessis-Robinson, France
(Garelik) Addictology, Hopital Marie Lannelongue Groupe, Hospitalier Paris
Sain-Joseph, Le Plessis-Robinson, France
(Hache, Chatellier, Mercier) Hopital Marie Lannelongue Groupe, Hospitalier
Paris Sain-Joseph, Le Plessis-Robinson, France
(Fadel, Mercier) Faculte de Medecine, Universite Paris-Saclay, Le
Plessis-Robinson, France
(Zitvogel) Institut National de la Sante et de la Recherche Medicale
(INSERM) U1015, Gustave Roussy Cancer Campus, Villejuif, France
(Besse) Cancer Medicine Department, Gustave Roussy Cancer Campus,
Villejuif, France
Publisher
BMJ Publishing Group
Abstract
Introduction Eligibility criteria definition for a lung cancer screening
(LCS) is an unmet need. We hypothesised that patients with a history of
atheromatous cardiovascular disease (ACVD) associated with tobacco
consumption are at risk of lung cancer (LC). The main objective is to
assess LC prevalence among patients with ACVD and history of tobacco
consumption by using low-dose chest CT scan. Secondary objectives include
the evaluation LCS in this population and the constitution of a biological
biobank to stratify risk of LC. Methods and analysis We are performing a
monocentric ? ? single-centre' prospective study among patients followed
up in adult cardiovascular programmes of vascular surgery, cardiology and
cardiac surgery recruited from 18 November 2019 to 18 May 2021. The
inclusion criteria are (1) age 45-75 years old, (2) history of ACVD and
(3) history of daily tobacco consumption for 10 years prior to onset of
ACVD. Exclusion criteria are symptoms of LC, existing follow-up for
pulmonary nodule, fibrosis, pulmonary hypertension, resting dyspnoea and
active pulmonary infectious disease. We targeted the inclusion of 500
patients. After inclusion (V0), patients are scheduled for a low-dose
chest CT and blood and faeces harvesting within 7 months (V1). Each
patient is scheduled for a follow-up by telephonic visits at month 3 (V2),
month 6 (V3) and month 12 (V4) after V1. Each patient is followed up until
1 year after V1 (14 February 2023). We measure LC prevalence and quantify
the National Lung Screening Trial and Dutch-Belgian Randomized Lung Cancer
Screening Trial (NELSON) trial eligibility criteria, radiation, positive
screening, false positivity, rate of localised LC diagnosis, quality of
life with the Short Form 12 (SF-12) and anxiety with the Spielberger
State-Trait Anxiety Inventory A and B (STAI-YA and STAI-YB, respectively),
smoking cessation and onset of cardiovascular and oncological events
within 1 year of follow-up. A case-control study nested in the cohort is
performed to identify clinical or biological candidate biomarkers of LC.
Ethics and dissemination The study was approved according the French Jarde
law; the study is referenced at the French ? ? Agence Nationale de
Securite du Medicament et des Produits de Sante' (reference ID RCB:
2019-A00262-55) and registered on clinicaltrial.gov. The results of the
study will be presented after the closure of the follow-up scheduled on 14
February 2023 and disseminated through peer-reviewed journals and national
and international conferences. Trial registration number NCT03976804.
 Copyright © 2022 BMJ Publishing Group. All rights reserved.

<22>
Accession Number
641821645
Title
Effect of permissive hypercarbia on lung oxygenation during one-lung
ventilation and postoperative pulmonary complications in patients
undergoing thoracic surgery: A prospective randomised controlled trial.
Source
European journal of anaesthesiology. (no pagination), 2023. Date of
Publication: 15 Jul 2023.
Author
Joe Y.-E.; Lee C.Y.; Kim N.; Lee K.; Kang S.J.; Oh Y.J.
Institution
(Joe) From the Department of Anaesthesiology and Pain Medicine,
Anaesthesia and Pain Research Institute (Y-EJ, KL, YJO) and Department of
Thoracic and Cardiovascular Surgery, Yonsei University College of
Medicine, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: The effect of hypercarbia on lung oxygenation during thoracic
surgery remains unclear. OBJECTIVE(S): To investigate the effect of
hypercarbia on lung oxygenation during one-lung ventilation in patients
undergoing thoracic surgery and evaluate the incidence of postoperative
pulmonary complications. DESIGN: Prospective randomised controlled trial.
SETTING: A tertiary university hospital in the Republic of Korea from
November 2019 to December 2020. PATIENTS: Two hundred and ninety-seven
patients with American Society of Anaesthesiologists physical status II to
III, scheduled to undergo elective lung resection surgery. INTERVENTION:
Patients were randomly assigned to Group 40, 50, or 60. An autoflow
ventilation mode with a lung protective ventilation strategy was applied
to all patients. Respiratory rate was adjusted to maintain a partial
pressure of arterial carbon dioxide of 40 +/- 5 mmHg in Group 40, 50 +/- 5
mmHg in Group 50 and 60 +/- 5 mmHg in Group 60 during one-lung ventilation
and at the end of surgery. MAIN OUTCOME MEASURES: The primary outcome was
the arterial oxygen partial pressure/fractional inspired oxygen ratio
after 60 min of one-lung ventilation. RESULT(S): Data from 262
patients were analysed. The partial pressure/fractional inspired oxygen
ratio was significantly higher in Group 50 and Group 60 than in Group 40
(269.4 vs. 262.9 vs. 214.4; P < 0.001) but was not significantly different
between Group 50 and Group 60. The incidence of postoperative pulmonary
complications was comparable among the three groups. CONCLUSION(S):
Permissive hypercarbia improved lung oxygenation during one-lung
ventilation without increasing the risk of postoperative pulmonary
complications or the length of hospital stay. TRIAL REGISTRATION:
NCT04175379. Copyright © 2023 European Society of Anaesthesiology
and Intensive Care. Unauthorized reproduction of this article is
prohibited.

<23>
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.

<24>
Accession Number
2024441526
Title
A Systematic Review and Statistical Analysis of Factors Influencing the
Cost-Effectiveness of Transcatheter Aortic Valve Implantation for
Symptomatic Severe Aortic Stenosis.
Source
ClinicoEconomics and Outcomes Research. 15 (pp 459-475), 2023. Date of
Publication: 2023.
Author
Heathcote L.; Candolfi P.; Srivastava T.; Sarmah A.; Kearns B.; Sutton A.
Institution
(Heathcote, Srivastava, Kearns, Sutton) School for Health and Related
Research, University of Sheffield, Sheffield, United Kingdom
(Candolfi, Sarmah) Edwards Lifesciences SA, Nyon, Switzerland
Publisher
Dove Medical Press Ltd
Abstract
Objective: Transcatheter aortic valve implantation (TAVI) is a disruptive
technology recommended for patients with symptomatic severe aortic
stenosis (sSAS). Despite being available for over 15 years in Europe, with
an extensive volume of clinical and economic evaluations across all
surgical risk groups, there is little evidence on the identification of
the key drivers of TAVI's cost-effectiveness. This study sought to
identify these factors and quantify their role. Method(s): A
systematic literature review was conducted to identify published economic
evaluations of TAVI. This was supplemented by health technology assessment
reports. The primary outcome was the likelihood of TAVI being found
cost-effective. Secondary outcomes of TAVI being dominant, and the
incremental health benefits of TAVI were also explored. Result(s):
Forty-two studies, reporting 65 unique analyses, were identified. TAVI was
found to be cost-effective and dominant in 74% and 20% of analyses,
respectively. The latest generation balloon-expandable TAVI device (SAPIEN
3) was more likely to be found cost-effective, as was TAVI use in low-risk
populations and when performed via transfemoral access route. There was
heterogeneity in the approach taken to economic modelling, which may also
influence estimates of cost-effectiveness. Analyses that found TAVI to be
dominant always compared it to surgery and usually considered the latest
generation balloon-expandable TAVI device. Largest health benefits were
observed for the inoperable risk group. Conclusion(s): For patients
with sSAS, TAVI is typically a cost-effective treatment option. There are
important differences by device generation, risk group and access route.
It is crucial to consider these differences when appraising the health
economic evidence-base for TAVI. Copyright © 2023 Heathcote et
al.

<25>
Accession Number
2015599783
Title
Ticagrelor for patients undergoing coronary artery bypass grafting: A
meta-analysis of randomized controlled trials.
Source
Perfusion (United Kingdom). 38(4) (pp 698-705), 2023. Date of Publication:
May 2023.
Author
Xiang F.; Lin Y.; Chen B.
Institution
(Xiang, Lin, Chen) Department of Pharmacy, The Second Affiliated Hospital,
Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Ticagrelor may be an alternative to aspirin as it provides
robust and consistent platelet inhibition. However, the effect of
ticagrelor treatment in patients undergoing coronary artery bypass
grafting (CABG) has not been well confirmed. We conducted a meta-analysis
to appraise whether ticagrelor therapy affects outcomes in CABG patients.
 Method(s): We searched PubMed, Embase, EBSCO, and Cochrane databases
from its inception up to 4 December 2020 for randomized controlled trials
that assessed ticagrelor versus non-ticagrelor in patients undergoing
CABG. The primary outcome was the incidence of saphenous vein graft (SVG)
occlusion at 1 year after CABG. Secondary outcomes were SVG occlusion at 7
days, major adverse cardiovascular events (MACE), and bleeding requiring
reoperation. Result(s): Seven trials including 4305 patients (2153
randomized to ticagrelor therapy and 2152 to non-ticagrelor therapy) were
included. One-hundred and thirty of 1140 patients (11.4%) randomized to
the ticagrelor group versus 175 of 1220 patients (14.3%) randomized to the
non-ticagrelor group experienced SVG occlusion at 1 year after CABG.
Compared to the control group, ticagrelor therapy yielded a significantly
lower risk of SVG occlusion [RR 0.79 (0.64-0.97), p = 0.03]. In the
subgroup analysis, ticagrelor plus aspirin compared with aspirin alone did
not decrease the risk of SVG occlusion after 1 year [RR 0.65 (0.40-1.07),
p = 0.09]. There was no difference in the incidence of SVG occlusion at 7
days [RR 0.67 (0.42-1.06), p = 0.09], MACE up to 1 year [RR 0.99
(0.81-1.21), p = 0.90], or bleeding requiring reoperation [RR 1.16
(0.80-1.70), p = 0.44]. Conclusion(s): Compared with non-ticagrelor
therapy, ticagrelor decreased the risk of saphenous vein graft occlusion
after 1 year in patients undergoing elective CABG with saphenous vein
grafting. Copyright © The Author(s) 2022.

<26>
Accession Number
2025644074
Title
Cardiopulmonary Bypass and Continuous Low Tidal Volume.
Source
Medical Forum Monthly. 34(5) (pp 7-10), 2023. Date of Publication: May
2023.
Author
Asad H.; Mehmood H.; Hussain S.; Hussain R.; Arshed M.; Ali I.
Institution
(Asad, Mehmood) Department of Anaesthesiology, Dow University Hospital,
Ojha Campus, Karachi, Pakistan
(Hussain) Department of Anaesthesiology, Murshid Hospital & Health Care
Centre, Karachi, Pakistan
(Hussain) Department of Anaesthesiology, NICVD Hospital, Karachi, Pakistan
(Arshed) Department of Anaesthesiology, Liaquat National Hospital,
Karachi, Pakistan
(Ali) Department of Anaesthesiology, Social Security Hospital, Landhi,
Karachi, Pakistan
Publisher
Medical Forum Monthly
Abstract
Objective: is to compare the effects of low tidal volume ventilation
versus no-ventilation in terms of reducing pulmonary dysfunction during
cardiopulmonary bypass (CPB) in patients undergoing conventional coronary
artery bypass graft (CABG) surgery. Study Design: Randomized
controlled trial study Place and Duration of Study: This study was
conducted at the Dow University of Health Sciences from June 2021 to June
2022. Material(s) and Method(s): A total of 62 patients who were
planned to for cardiac pulmonary bypass graft surgery were enrolled and
randomized in two groups. Group A ventilation group was managed with low
tidal volume ventilation 3 ml/kg, 12 breaths/min respiratory rate and 5
cmHg PEEP. In group B non-ventilation group ventilation was arrested.
 Result(s): The mean PaO2/FiO2 Ratio after intubation of Group A and
Group B was 340.91+/-23.89 and 348.79+/-24.65, respectively. (p=0.207).
The mean PaO2/FiO2 Ratio after 1 hour of CPB and PaO2/FiO2 Ratio after
hours of CPB of Group A was greater than Group B, (p<0.001). Whereas, the
A-a oxygen (O2) gradient after 1 hour of cardiopulmonary bypass CPB (kPa)
and A-a oxygen (O2) gradient after 4 hour of cardiopulmonary bypass CPB
(kPa) of Group A was less than Group B, (p<0.001). The mean ventilation
time of Group A and Group B was 5.61+/-0.86 hours and 7.77+/-0.98 hours,
respectively. (p<0.001). While, ICU stay and hospital stay of both the
groups was almost same, (P>0.050). Conclusion(s): In cardiac surgery
patients especially cardiopulmonary bypass low tidal volume ventilation is
associated with reduce risk of complications and better oxygenation during
cardiopulmonary bypass. Copyright © 2023 Medical Forum Monthly.
All rights reserved.

<27>
Accession Number
641809534
Title
Systematic review and meta-analysis of deep venous reflux correction in
chronic venous insufficiency.
Source
Journal of vascular surgery. Venous and lymphatic disorders. (no
pagination), 2023. Date of Publication: 13 Jul 2023.
Author
Maleti O.; Orso M.; Lugli M.; Perrin M.
Institution
(Maleti, Lugli) National reference Training Center in Phlebology, UEMS,
Vascular Surgery, Cardiovascular Department Hesperia Hospital, Modena,
Italy
(Orso) Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche
'Togo Rosati', Perugia, Italy
(Perrin) Vascular Unit. Chassieu, France
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate the technical feasibility, operative techniques,
safety and efficacy outcomes of procedures aimed at correcting deep venous
reflux, in patients with chronic venous insufficiency (CVI).
 METHOD(S): We performed systematic literature searches in PubMed,
Embase and Web of Science from databases inception to February 2022. We
included systematic reviews, RCTs and observational studies describing
surgical procedures to treat patients with deep reflux due to primary and
secondary incompetence, postthtrombotic syndrome (PTS). Proportion
meta-analyses were performed for all the efficacy and safety outcomes.
 RESULT(S): We included 57 studies in the quantitative synthesis: 3
RCTs including 252 patients and 54 case series including 4,004 patients.
Studies included a median of 38 patients, with a mean age of 51 years; 52%
of them were males. 40% of studies included 2,291 patients with primary
incompetence, 29% of studies included 595 patients with PTS, and 31% of
studies included 1,118 patients with both diseases. As for primary
incompetence, pooled estimates for all procedures showed an 89% (95% CI,
82-94%) of ulcer healing, 10% (4-18%) ulcer recurrence, 98% (93-100%)
valve patency, 84% (78-90%) valve competence, 0.05% (1/1904 patients)
pulmonary embolism, 1% (0-3%) wound infections, 5% (1-9%) hematoma, 2%
(0-6%) lymphocele, 2% (1-4%) thrombosis, 85% (74-94%) pain improvement,
89% (65-100%) edema improvement, 85% (73-93%) lipodermatosclerosis
improvement. PTS patients showed less favourable outcomes: 82% (71-91%) of
ulcer healing, 18% (5-36%) ulcer recurrence, 88% (78-96%) valve patency,
78% (66-88%) valve competence, no pulmonary embolism, 6% (0-22%) wound
infections, 6% (3-10%) hematoma, 5% (1-12%) lymphocele, 7% (1-16%)
thrombosis, 79% (59-94%) pain improvement, 75% (61-88%) edema improvement,
64% (9-100%) lipodermatosclerosis improvement. CONCLUSION(S): 'The
number of studies included in each meta-analysis are limited and knowing
how this element can affect the statistical power, as well as the absence
of comparative control groups, it is not possible to draw definitive
conclusions. Nevertheless, DVRSR may increase the probability of clinical
improvement in patients affected by CVI. Outcomes appear to be
satisfactory even if possible adjunctive procedures may be required over
the course of the patient's lifetime. Consequently, a strict follow-up
protocol is required to maintain outcomes. Further studies are required to
evaluate DVRSR particularly as to how it compares to the more recently
introduced endovenous approaches. Copyright © 2023. Published by
Elsevier Inc.

<28>
Accession Number
2023616107
Title
Postoperative pulmonary complications in older patients undergoing
elective surgery with a supraglottic airway device or tracheal intubation.
Source
Anaesthesia. 78(8) (pp 953-962), 2023. Date of Publication: August 2023.
Author
Yang L.Q.; Zhu L.; Shi X.; Miao C.H.; Yuan H.B.; Liu Z.Q.; Gu W.D.; Liu
F.; Hu X.X.; Shi D.P.; Duan H.W.; Wang C.Y.; Weng H.; Huang Z.L.; Li L.Z.;
He Z.Z.; Li J.; Hu Y.P.; Lin L.; Pan S.T.; Xu S.H.; Tang D.; Sessler D.I.;
Liu J.; Irwin M.G.; Yu W.F.
Institution
(Yang, Zhu, Shi, Pan, Xu, Tang, Yu) Renji Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Yang, Yu) Key Laboratory of Anesthesiology (Shanghai Jiao Tong
University), Ministry of Education, Shanghai, China
(Miao) Fudan University Shanghai Cancer Center, Shanghai, China
(Yuan) Shanghai Changzheng Hospital, Shanghai, China
(Liu) Shanghai First Maternity and Infant Hospital, Tongji University
School of Medicine, Shanghai, China
(Gu) Huadong Hospital, Fudan University, Shanghai, China
(Liu, Liu) West China Hospital, Sichuan University, Chengdu, China
(Hu) Guanghua Hospital Affiliated to Shanghai University of Traditional
Chinese Medicine, Shanghai, China
(Shi) Jiading District Central Hospital Affiliated Shanghai University of
Medicine and Health Sciences, Shanghai, China
(Duan) Shanghai Pudong Hospital Fudan University Pudong Medical Center,
Shanghai, China
(Wang) Huangpu Branch of Ninth People's Hospital Affiliated to Medical
College of Shanghai Jiao Tong University, Shanghai, China
(Weng) Shanghai Fengxian District Central Hospital, Shanghai, China
(Huang) Ren Ji Hospital (West) affiliated to Shanghai Jiao Tong University
School of Medicine, Shanghai, China
(Li) Shanghai Pudong New Area People's Hospital, Shanghai, China
(He) Ren Ji Hospital (South) affiliated to Shanghai Jiao Tong University
School of Medicine, Shanghai, China
(Li) First Affiliated Hospital of Wenzhou Medical University, Wenzhou,
China
(Hu) The Second Hospital of Wuxi affiliated to Nanjing Medical University,
Wuxi, China
(Lin) The First Affiliated Hospital of Xiamen University, Xiamen, China
(Sessler) Cleveland Clinic, Cleveland, OH, United States
(Irwin) Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong
Kong
Publisher
John Wiley and Sons Inc
Abstract
The two most commonly used airway management techniques during general
anaesthesia are supraglottic airway devices and tracheal tubes. In older
patients undergoing elective non-cardiothoracic surgery under general
anaesthesia with positive pressure ventilation, we hypothesised that a
composite measure of in-hospital postoperative pulmonary complications
would be less frequent when a supraglottic airway device was used compared
with a tracheal tube. We studied patients aged >= 70 years in 17 clinical
centres. Patients were allocated randomly to airway management with a
supraglottic airway device or a tracheal tube. Between August 2016 and
April 2020, 2900 patients were studied, of whom 2751 were included in the
primary analysis (1387 with supraglottic airway device and 1364 with a
tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to
have a postoperative pulmonary complication risk index of 1-2.
Postoperative pulmonary complications, mostly coughing, occurred in 270 of
1387 patients (19.5%) allocated to a supraglottic airway device and 342 of
1364 patients (25.1%) assigned to a tracheal tube (absolute difference
-5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001).
Among otherwise healthy older patients undergoing elective surgery under
general anaesthesia with intra-operative positive pressure ventilation of
their lungs, there were fewer postoperative pulmonary complications when
the airway was managed with a supraglottic airway device compared with a
tracheal tube. Copyright © 2023 Association of Anaesthetists.

<29>
Accession Number
2022742055
Title
Proteomic profiling of protein expression changes after 3 months-exercise
in ESRD patients on hemodialysis.
Source
BMC Nephrology. 24(1) (no pagination), 2023. Article Number: 102. Date of
Publication: December 2023.
Author
Jeong H.Y.; An H.-J.; Sung M.J.; Ha M.H.; Lee Y.H.; Yang D.H.; Yang T.Y.;
Han D.; Lee S.-Y.
Institution
(Jeong, An, Sung, Ha, Lee, Yang, Yang, Lee) Division of Nephrology,
Department of Internal Medicine, CHA University School of Medicine, CHA
Bundang Medical Center, 59 Yatap-ro, Bundang-gu, Seongnam-si 13496, South
Korea
(Han) Transdisciplinary Department of Medicine & Advanced Technology,
Seoul National University Hospital, 101 Daehak-ro, Seoul 03080, South
Korea
(Han) Proteomics Core Facility, Biomedical Research Institute, Seoul
National University Hospital, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
The prevalence of chronic kidney disease (CKD) is steadily increasing, and
it is a global health burden. Exercise has been suggested to improve
physical activity and the quality of life in patients with CKD, eventually
reducing mortality. This study investigated the change in physical
performance after exercise in dialysis-dependent patients with CKD and
analyzed differentially expressed proteins before and after the exercise.
Plasma samples were collected at enrollment and after 3 months of
exercise. Liquid chromatography with tandem mass spectrometry analysis and
data-independent acquisition results were analyzed to determine the
significantly regulated proteins. A total of 37 patients on dialysis were
recruited, and 16 were randomized to exercise for 3 months. The hand grip
strength and the walking speed significantly improved in the exercise
group. Proteome analysis revealed 60 significantly expressed proteins
after 3 months of exercise. In the protein functional analysis, the
significantly expressed proteins were involved in the immune response.
Also, some of the key significantly expressed proteins [(M Matrix
metallopeptidase 9 (MMP-9), Activin A Receptor Type 1B (ACVR1B), Fetuin B
(FETUB)] were validated via an enzyme-linked immunosorbent assay. Our
results showed that exercise in dialysis-dependent patients with CKD could
improve their physical performance. These results indicated that this
beneficial effect of exercise in these populations could be associated
with immune response. Copyright © 2023, The Author(s).

<30>
Accession Number
2022707436
Title
Postoperative pulmonary complications after sugammadex reversal of
neuromuscular blockade: a systematic review and meta-analysis with trial
sequential analysis.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 130. Date
of Publication: December 2023.
Author
Liu H.-M.; Yu H.; Zuo Y.-D.; Liang P.
Institution
(Liu, Yu, Zuo, Liang) Department of Anesthesiology, West China Hospital,
Sichuan University, No.37 Guoxue Alley, Sichuan Chengdu 610041, China
(Liang) Day Surgery Center, West China Hospital, Sichuan University,
Chengdu 610041, China
Publisher
BioMed Central Ltd
Abstract
Background: Sugammadex has been reported to lower the incidence of
postoperative residual neuromuscular blockade. Despite the advantages,
until recently the effects of sugammadex on postoperative pulmonary
complications (PPCs) were controversial. We conducted a systematic review
and meta-analysis to determine whether reversal with sugammadex was
associated with a lower risk of PPCs compared with neostigmine.
 Method(s): PubMed, Embase, and Cochrane Central Register of
Controlled Trials were searched from inception to May 2022. Randomized
controlled trials (RCTs) and observational studies comparing PPCs in
patients receiving sugammadex or neostigmine as reversal agent at the end
of surgery were included. The primary outcomes focused on PPCs including
desaturation, pneumonia, atelectasis, noninvasive ventilation (NIV) and
reintubation. Trial sequential analysis was performed on the primary
outcomes to confirm whether firm evidence was reached. Result(s):
Meta-analysis of included studies showed that the rate of desaturation
(43.2% vs 45.0%, RR = 0.82; 95% CI 0.63 to 1.05; p = 0.11) were comparable
between the two groups. When looking at other primary outcomes,
significantly lower risk of pneumonia (1.37% vs 2.45%, RR = 0.65; 95% CI
0.49 to 0.85; p = 0.002), atelectasis (24.6% vs 30.4%, RR = 0.64; 95% CI
0.42 to 0.98; p = 0.04), NIV (1.37% vs 2.33%, RR = 0.65; 95% CI 0.43 to
0.98; p = 0.04) and reintubation (0.99% vs 1.65%, RR = 0.62; 95% CI 0.43
to 0.91; p = 0.01) in the sugammadex group were detected compared with the
neostigmine group. Conclusion(s): We concluded that sugammadex is
more effective at reducing the incidence of PPCs including pneumonia,
atelectasis, NIV and reintubation compared with neostigmine. Further
evidence, preferably from RCTs, is required to confirm these
findings. Copyright © 2023, The Author(s).

<31>
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.

<32>
Accession Number
2024200779
Title
Platelet and Monocyte Activation After Transcatheter Aortic Valve
Replacement (POTENT-TAVR): A Mechanistic Randomized Trial of Ticagrelor
Versus Clopidogrel.
Source
Structural Heart. 7(4) (no pagination), 2023. Article Number: 100182. Date
of Publication: July 2023.
Author
Zidar D.A.; Al-Kindi S.; Longenecker C.T.; Parikh S.A.; Gillombardo C.B.;
Funderburg N.T.; Juchnowski S.; Huntington L.; Jenkins T.; Nmai C.; Osnard
M.; Shishebhor M.; Filby S.; Tatsuoka C.; Lederman M.M.; Blackstone E.;
Attizzani G.; Simon D.I.
Institution
(Zidar, Al-Kindi, Longenecker, Gillombardo, Juchnowski, Huntington,
Jenkins, Osnard, Shishebhor, Filby, Tatsuoka, Lederman, Attizzani, Simon)
Department of Medicine, Case Western Reserve University, Cleveland, OH,
United States
(Zidar, Juchnowski, Huntington) Louis Stokes Cleveland Veterans Affairs
Medical Center, Cleveland, OH, United States
(Zidar, Al-Kindi, Longenecker, Gillombardo, Juchnowski, Huntington,
Jenkins, Shishebhor, Filby, Attizzani, Simon) Harrington Heart & Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Parikh) Division of Cardiology, Center for Interventional Vascular
Therapy, Columbia University Irving Medical Center, New York, NY, United
States
(Funderburg) Division of Medical Laboratory Science, School of Health and
Rehabilitations Sciences, Ohio State University, Columbus, OH, United
States
(Nmai) New York University Grossman School of Medicine, New York, NY,
United States
(Blackstone) Department of Population Health and Quantitative Health
Sciences, Cleveland Clinic Foundation, Cleveland, OH, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Inflammation and thrombosis are often linked mechanistically
and are associated with adverse events after transcatheter aortic valve
replacement (TAVR). High residual platelet reactivity (HRPR) is especially
common when clopidogrel is used in this setting, but its relevance to
immune activation is unknown. We sought to determine whether residual
activity at the purinergic receptor P2Y12 (P2Y12) promotes prothrombotic
immune activation in the setting of TAVR. Method(s): This was a
randomized trial of 60 patients (enrolled July 2015 through December 2018)
assigned to clopidogrel (300mg load, 75mg daily) or ticagrelor (180mg
load, 90 mg twice daily) before and for 30 days following TAVR. Co-primary
endpoints were P2Y12-dependent platelet activity (Platelet Reactivity
Units; VerifyNow) and the proportion of inflammatory (cluster of
differentiation [CD] 14+/CD16+) monocytes 1 day after TAVR.
 Result(s): Compared to clopidogrel, those randomized to ticagrelor
had greater platelet inhibition (median Platelet Reactivity Unit
[interquartile range]: (234 [170.0-282.3] vs. 128.5 [86.5-156.5], p <
0.001), but similar inflammatory monocyte proportions (22.2% [18.0%-30.2%]
vs. 25.1% [22.1%-31.0%], p = 0.201) 1 day after TAVR. Circulating
monocyte-platelet aggregates, soluble CD14 levels, interleukin 6 and 8
levels, and D-dimers were also similar across treatment groups. HRPR was
observed in 63% of the clopidogrel arm and was associated with higher
inflammatory monocyte proportions. Major bleeding events, pacemaker
placement, and mortality did not differ by treatment assignment.
 Conclusion(s): Residual P2Y12 activity after TAVR is common in those
treated with clopidogrel but ticagrelor does not significantly alter
biomarkers of prothrombotic immune activation. HRPR appears to be an
indicator (not a cause) of innate immune activation in this
setting. Copyright © 2023

<33>
Accession Number
2023751246
Title
An Updated Meta-Analysis on Cerebral Embolic Protection in Patients
Undergoing Transcatheter Aortic Valve Intervention Stratified by Baseline
Surgical Risk and Device Type.
Source
Structural Heart. 7(4) (no pagination), 2023. Article Number: 100178. Date
of Publication: July 2023.
Author
Khan S.U.; Zahid S.; Alkhouli M.A.; Akbar U.A.; Zaid S.; Arshad H.B.;
Little S.H.; Reardon M.J.; Kleiman N.S.; Goel S.S.
Institution
(Khan, Zaid, Arshad, Little, Kleiman, Goel) Department of Cardiology,
Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United
States
(Zahid) Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, United States
(Alkhouli) Division of Interventional Cardiology, Mayo Clinic, Rochester,
MN, United States
(Akbar) Department of Medicine, North Shore University Hospital, New York,
NY, United States
(Reardon) Department of Cardiovascular Surgery, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: Transcatheter aortic valve intervention (TAVI) can lead to the
embolization of debris. Capturing the debris by cerebral embolic
protection (CEP) devices may reduce the risk of stroke. New evidence has
allowed us to examine the effects of CEP in patients undergoing TAVI. We
aimed to assess the effects of CEP overall and stratified by the device
used (SENTINEL or TriGuard) and the surgical risk of the patients.
 Method(s): We selected randomized controlled trials using electronic
databases through September 17, 2022. We estimated random-effects risk
ratios (RR) with (95% confidence interval) and calculated absolute risk
differences at 30 days across baseline surgical risks derived from the
TAVI trials for any stroke (disabling and nondisabling) and all-cause
mortality. Result(s): Among 6 trials (n = 3921), CEP vs. control did
not reduce any stroke [RR: 0.95 (0.50-1.81)], disabling [RR: 0.75
(0.18-3.16)] or nondisabling [RR: 0.99 (0.65-1.49)] strokes, or all-cause
mortality [RR: 1.23 (0.55-2.77)]. However, when analyzed by device,
SENTINEL reduced disabling stroke [RR: 0.46 (0.22-0.95)], translating into
6 fewer per 1000 in high-risk, 3 fewer per 1000 in intermediate-risk, and
1 fewer per 1000 in low surgical-risk patients. CEP vs. control did not
reduce the risk of any bleeding [RR: 1.03 (0.44-2.40)], major vascular
complications [RR: 1.41 (0.57-3.48)], or acute kidney injury [RR: 1.36
(0.57-3.28)]. Conclusion(s): This updated meta-analysis showed that
SENTINEL CEP might reduce disabling stroke in patients undergoing TAVI.
Patients with high and intermediate surgical risks were most likely to
derive benefits. Copyright © 2023 The Authors

<34>
Accession Number
2023061741
Title
Rivaroxaban versus nadroparin for thromboprophylaxis following thoracic
surgery for lung cancer: A randomized, noninferiority trial.
Source
American Journal of Hematology. 98(8) (pp 1185-1195), 2023. Date of
Publication: August 2023.
Author
Zhao M.; Bao Y.; Jiang C.; Chen L.; Xu L.; Liu X.; Yang Y.; Jiang G.; Li
J.; She Y.; Chen Q.; Shen L.; Chen C.
Institution
(Zhao, Bao, Jiang, Chen, Liu, Li, Yang, Jiang, She, Chen, Shen, Chen)
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
(Xu) Department of Ultrasound, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
(Li) Clinical Research Center, Ruijin Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China
(Shen) Department of Infectious Diseases, Shanghai Key Laboratory of
Infectious Diseases and Biosafety Emergency Response, National Medical
Center for Infectious Diseases, Huashan Hospital, Fudan University,
Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
The benefit of rivaroxaban in thromboprophylaxis after oncologic lung
surgery remains unknown. To evaluate the efficacy and safety of
rivaroxaban, patients who underwent thoracic surgery for lung cancer were
enrolled, and randomly assigned to rivaroxaban or nadroparin groups in a
1:1 ratio; anticoagulants were initiated 12-24 h after surgery and
continued until discharge. Four hundred participants were required
according to a noninferiority margin of 2%, assuming venous
thromboembolism (VTE) occurrence rates of 6.0% and 12.6% for patients in
the rivaroxaban and nadroparin groups, respectively. The primary efficacy
outcome was any VTE during the treatment and 30-day follow-up periods. The
safety outcome was any on-treatment bleeding event. Finally, 403 patients
were randomized (intention-to-treat [ITT] population), with 381 included
in per-protocol (PP) population. The primary efficacy outcomes occurred in
12.5% (25/200) of the rivaroxaban group and 17.7% (36/203) of the
nadroparin group (absolute risk reduction, -5.2%; 95% confidence interval
[CI], [-12.2-1.7]), indicating the noninferiority of rivaroxaban in ITT
population. Sensitivity analysis was performed in the PP population and
yielded similar results, confirming the noninferiority of rivaroxaban. In
the safety analysis population, the incidence of any on-treatment bleeding
events did not differ significantly between the groups (12.2% for
rivaroxaban vs. 7.0% for nadroparin; relative risk [RR], 1.9; 95% CI,
[0.9-3.7]; p =.08), including major bleeding (9.7% vs. 6.5%; RR, 1.6 [95%
CI, 0.9-3.7]; p =.24), and nonmajor bleeding (2.6% vs. 0.5%; RR, 5.2 [95%
CI, 0.6-45.2]; p =.13). Rivaroxaban for thromboprophylaxis after oncologic
lung surgery was shown to be noninferior to nadroparin. Copyright
© 2023 Wiley Periodicals LLC.

<35>
Accession Number
2021281992
Title
Effect of chest ultrasound compared with pericardial window for the
diagnosis of occult penetrating cardiac wounds in hemodynamically stable
subjects with penetrating thoracic trauma: A meta-analysis.
Source
International Wound Journal. 20(6) (pp 2483-2491), 2023. Date of
Publication: August 2023.
Author
Yan T.; Xie W.; Xu M.
Institution
(Yan, Xu) Department of Liver Surgery, West China Hospital, Sichuan
University, Chengdu, China
(Yan, Xie) Department of Emergency, People's Hospital of Deyang, Deyang,
China
Publisher
John Wiley and Sons Inc
Abstract
We conducted a meta-analysis to assess the diagnostic performance of chest
ultrasound compared with a pericardial window for the detection of occult
penetrating cardiac wounds in patients with penetrating thoracic trauma
who were hemodynamically stable. A systematic literature search up to
December 2022 was performed and 567 related studies were evaluated. The
chosen studies comprised 629 penetrating thoracic trauma subjects who
participated in the selected studies' baseline. Odds ratio (OR) with 95%
confidence intervals (CIs) were calculated to assess the effect of
different chest ultrasounds on wound infection after penetrating thoracic
trauma by the dichotomous methods with a random or fixed effect model. The
chest ultrasound resulted in significantly lower occult penetrating
cardiac wounds detection (OR, 0.02; 95% CI, 0.01-0.08, P < 0.001), higher
false positive (OR, 33.85; 95% CI, 9.21-124.39, P < 0.001), and higher
false negative (OR, 27.31; 95% CI, 7.62-97.86, P < 0.001) compared with
the pericardial window in penetrating thoracic trauma. The chest
ultrasound resulted in significantly lower occult penetrating cardiac
wound detection, higher false positives, and higher false negatives
compared with the pericardial window in penetrating thoracic trauma.
Although care should be taken when dealing with the results because all of
the studies had less than 200 subjects as a sample size. Copyright
© 2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<36>
Accession Number
641454143
Title
Percutaneous Coronary Intervention vs Coronary Artery Bypass Graft Surgery
for Left Main Disease in Patients With and Without Acute Coronary
Syndromes: A Pooled Analysis of 4 Randomized Clinical Trials.
Source
JAMA cardiology. 8(7) (pp 631-639), 2023. Date of Publication: 01 Jul
2023.
Author
Gaba P.; Christiansen E.H.; Nielsen P.H.; Murphy S.A.; O'Gara P.T.; Smith
P.K.; Serruys P.W.; Kappetein A.P.; Park S.-J.; Park D.-W.; Stone G.W.;
Sabik J.F.; Sabatine M.S.; Holm N.R.; Bergmark B.A.
Institution
(Gaba, Murphy, O'Gara, Sabatine, Bergmark) Thrombolysis in Myocardial
Infarction (TIMI) Study Group, Division of Cardiovascular Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Christiansen, Nielsen, Holm) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(O'Gara, Sabatine) JAMA Cardiology
(Smith) Duke University School of Medicine, Duke Clinical Research
Institute, Durham, NC, United States
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Park, Park) Department of Cardiology, Asan Medical Center, Seoul, South
Korea
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
Importance: Patients with left main coronary artery disease presenting
with an acute coronary syndrome (ACS) represent a high-risk and
understudied subgroup of patients with atherosclerosis. Objective(s):
To assess clinical outcomes after PCI vs CABG in patients with left main
disease with vs without ACS. Design, Setting, and Participant(s):
Data were pooled from 4 trials comparing PCI with drug-eluting stents vs
CABG in patients with left main disease who were considered equally
suitable candidates for either strategy (SYNTAX, PRECOMBAT, NOBLE, and
EXCEL). Patients were categorized as presenting with or without ACS.
Kaplan-Meier event rates through 5 years and Cox model hazard ratios were
generated, and interactions were tested. Patients were enrolled in the
individual trials from 2004 through 2015. Individual patient data from the
trials were pooled and reconciled from 2020 to 2021, and the analyses
pertaining to the ACS subgroup were performed from March 2022 through
February 2023. Main Outcomes and Measures: The primary outcome was
death through 5 years. Secondary outcomes included cardiovascular death,
spontaneous myocardial infarction (MI), procedural MI, stroke, and repeat
revascularization. Result(s): Among 4394 patients (median [IQR] age,
66 [59-73] years; 3371 [76.7%] male and 1022 [23.3%] female) randomized to
receive PCI or CABG, 1466 (33%) had ACS. Patients with ACS were more
likely to have diabetes, prior MI, left ventricular ejection fraction less
than 50%, and higher SYNTAX scores. At 30 days, patients with ACS had
higher all-cause death (hazard ratio [HR], 3.40; 95% CI, 1.81-6.37;
P<.001) and cardiovascular death (HR, 3.21; 95% CI, 1.69-6.08; P<.001)
compared with those without ACS. Patients with ACS also had higher rates
of spontaneous MI (HR, 1.70; 95% CI, 1.25-2.31; P<.001) through 5 years.
The rates of all-cause mortality through 5 years with PCI vs CABG were
10.9% vs 11.5% (HR, 0.93; 95% CI, 0.68-1.27) in patients with ACS and
11.3% vs 9.6% (HR, 1.19; 95% CI, 0.95-1.50) in patients without ACS (P=.22
for interaction). The risk of early stroke was lower with PCI vs CABG
(ACS: HR, 0.39; 95% CI, 0.12-1.25; no ACS: HR, 0.35; 95% CI, 0.16-0.75),
whereas the 5-year risks of spontaneous MI and repeat revascularization
were higher with PCI vs CABG (spontaneous MI: ACS: HR, 1.74; 95% CI,
1.09-2.77; no ACS: HR, 3.03; 95% CI, 1.94-4.72; repeat revascularization:
ACS: HR, 1.57; 95% CI, 1.19-2.09; no ACS: HR, 1.90; 95% CI, 1.54-2.33),
regardless of ACS status. Conclusion and Relevance: Among largely stable
patients undergoing left main revascularization and with predominantly low
to intermediate coronary anatomical complexity, those with ACS had higher
rates of early death. Nonetheless, rates of all-cause mortality through 5
years were similar with PCI vs CABG in this high-risk subgroup. The
relative advantages and disadvantages of PCI vs CABG in terms of early
stroke and long-term spontaneous MI and repeat revascularization were
consistent regardless of ACS status. Trial Registration:
ClinicalTrials.gov Identifiers: NCT00114972, NCT00422968, NCT01496651,
NCT01205776.

<37>
Accession Number
2025684205
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: 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, Andhra Pradesh, Puttaparthi 515134, India
Publisher
Elsevier B.V.
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 a total of 108
patients presenting at a tertiary care center within 3-24 h
post-thrombolysis and undergoing pharmacoinvasive PCI, 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 for 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 for 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

<38>
Accession Number
2025575159
Title
Vitamin D supplementation and major cardiovascular events: D-Health
randomised controlled trial.
Source
BMJ. (no pagination), 2023. Article Number: e075230. Date of Publication:
2023.
Author
Thompson B.; Waterhouse M.; English D.R.; McLeod D.S.; Armstrong B.K.;
Baxter C.; Duarte Romero B.; Ebeling P.R.; Hartel G.; Kimlin M.G.; Rahman
S.T.; Van Der Pols J.C.; Venn A.J.; Webb P.M.; Whiteman D.C.; Neale R.E.
Institution
(Thompson, Waterhouse, McLeod, Baxter, Duarte Romero, Rahman, Webb,
Whiteman, Neale) Population Health Program, Qimr, Berghofer Medical
Research Institute, Herston, QLD, Australia
(English) Melbourne School of Population Health, University of Melbourne,
Carlton, VIC, Australia
(Armstrong) School of Public Health, The University of Sydney, Sydney,
NSW, Australia
(Ebeling) Department of Medicine, School of Clinical Sciences, Monash
University, Clayton, VIC, Australia
(Hartel) Statistics Unit, Qimr, Berghofer Medical Research Institute,
Herston, QLD, Australia
(Kimlin) School of Biomedical Science, Faculty of Health, Queensland
University of Technology, Kelvin Grove, QLD, Australia
(Van Der Pols) School of Exercise and Nutrition Sciences, Faculty of
Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
(Venn) Menzies Institute for Medical Research, University of Tasmania,
Hobart, TAS, Australia
Publisher
BMJ Publishing Group
Abstract
Objective: To investigate whether supplementing older adults with monthly
doses of vitamin D alters the incidence of major cardiovascular events.
 Design(s): Randomised, double blind, placebo controlled trial of
monthly vitamin D (the D-Health Trial). Computer generated permuted block
randomisation was used to allocate treatments. Setting(s): Australia
from 2014 to 2020. Participant(s): 21 315 participants aged 60-84
years at enrolment. Exclusion criteria were self-reported hypercalcaemia,
hyperparathyroidism, kidney stones, osteomalacia, sarcoidosis, taking >500
IU/day supplemental vitamin D, or unable to give consent because of
language or cognitive impairment. Intervention(s): 60 000 IU/month
vitamin D3 (n=10 662) or placebo (n=10 653) taken orally for up to five
years. 16 882 participants completed the intervention period: placebo 8270
(77.6%); vitamin D 8552 (80.2%). Main Outcome Measure(s): The main
outcome for this analysis was the occurrence of a major cardiovascular
event, including myocardial infarction, stroke, and coronary
revascularisation, determined through linkage with administrative
datasets. Each event was analysed separately as secondary outcomes.
Flexible parametric survival models were used to estimate hazard ratios
and 95% confidence intervals. Result(s): 21 302 people were included
in the analysis. The median intervention period was five years. 1336
participants experienced a major cardiovascular event (placebo 699 (6.6%);
vitamin D 637 (6.0%)). The rate of major cardiovascular events was lower
in the vitamin D group than in the placebo group (hazard ratio 0.91, 95%
confidence interval 0.81 to 1.01), especially among those who were taking
cardiovascular drugs at baseline (0.84, 0.74 to 0.97; P for
interaction=0.12), although the P value for interaction was not
significant (<0.05). Overall, the difference in standardised cause
specific cumulative incidence at five years was -5.8 events per 1000
participants (95% confidence interval -12.2 to 0.5 per 1000 participants),
resulting in a number needed to treat to avoid one major cardiovascular
event of 172. The rate of myocardial infarction (hazard ratio 0.81, 95%
confidence interval 0.67 to 0.98) and coronary revascularisation (0.89,
0.78 to 1.01) was lower in the vitamin D group, but there was no
difference in the rate of stroke (0.99, 0.80 to 1.23). Conclusion(s):
Vitamin D supplementation might reduce the incidence of major
cardiovascular events, although the absolute risk difference was small and
the confidence interval was consistent with a null finding. These findings
could prompt further evaluation of the role of vitamin D supplementation,
particularly in people taking drugs for prevention or treatment of
cardiovascular disease. Trial registration:
ACTRN12613000743763. Copyright © Author(s) (or their employer(s))
2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<39>
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.

<40>
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.

<41>
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.

<42>
Accession Number
2024124582
Title
Incidence of Acute Kidney Injury in Hospitalized Children: A
Meta-analysis.
Source
Pediatrics. 151(2) (no pagination), 2023. Article Number: e2022058823.
Date of Publication: 01 Feb 2023.
Author
Meena J.; Mathew G.; Kumar J.; Chanchlani R.
Institution
(Meena) Department of Pediatrics, All India Institute of Medical Sciences,
Rajasthan, Jodhpur, India
(Mathew) Division of Pediatric Nephrology, Department of Pediatrics,
Christian Medical College, Tamil Nadu, Vellore, India
(Kumar) Advanced Pediatric Center, Postgraduate Institute of Medical
Education and Research, Chandigarh, India
(Chanchlani) Division of Pediatric Nephrology, Department of Pediatrics,
McMaster Children's Hospital, Hamilton, ON, Canada
Publisher
American Academy of Pediatrics
Abstract
BACKGROUND AND OBJECTIVES: There is limited literature on the incidence of
acute kidney injury (AKI) and associated mortality in hospitalized
children. To systematically assess the worldwide incidence of AKI in
hospitalized children to inform policymakers regarding appropriate health
resource allocation. METHOD(S): Three different databases were
searched (PubMed, Embase, Web of Sciences) from March 2012 to January 2022
without language or geographical restrictions. We included cohort and
cross-sectional studies that reported AKI incidence in hospitalized
children. Eligible studies had at least 100 participants and used the
standard Kidney Disease Improving Global Outcomes criteria to define AKI.
Two authors extracted data on the study and patients' characteristics and
outcomes (incidence and AKI-associated mortality) and performed the risk
of bias assessment. We used a random-effects meta-analysis to generate
pooled estimates. RESULT(S): We included 94 studies (202 694
participants) from 26 countries. The incidence of any AKI was 26% (95%
confidence interval: 22-29), and that of moderate-severe AKI was 14%
(11-16). The incidence of AKI was similar in high-income 27% (23-32),
low-middle-income 25% (13-38), and low-income 24% (12-39) countries.
Overall, AKI-associated mortality was observed in 11% (9-13) of the
pediatric population. AKI-associated mortality rate was highest at 18%
(11-25) and 22% (9-38) in low-income and low-middle-income countries,
respectively. CONCLUSION(S): AKI was observed in one-quarter of the
hospitalized children and is associated with increased mortality risk.
Low-income and low-middle-income countries had observed higher mortality
rates compared with high-income countries despite a similar AKI
burden. Copyright © 2023 by the American Academy of Pediatrics.

<43>
Accession Number
2024094312
Title
Anterior leaflet prolapse: does the evidence imply the need for a change
in our repair strategy?.
Source
European Journal of Cardio-thoracic Surgery. 63(4) (no pagination), 2023.
Article Number: ezad109. Date of Publication: 01 Apr 2023.
Author
Tomsic A.; Palmen M.; Klautz R.J.M.
Institution
(Tomsic, Palmen, Klautz) Department of Cardiothoracic Surgery, Leiden
University Medical Centre, K6-S, PO Box 9600, Leiden 2300 RC, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery

<44>
Accession Number
2024088116
Title
Narrative review of single ventricle: where are we after 40 years?.
Source
Translational Pediatrics. 12(2) (pp 221-244), 2023. Date of Publication:
February 2023.
Author
Corno A.F.; Findley T.O.; Salazar J.D.
Institution
(Corno, Salazar) Pediatric and Congenital Cardiac Surgery, Children's
Heart Institute, Department of Pediatrics, Memorial Hermann Children's
Hospital, McGovern Medical School, The University of Texas Health Science
Center in Houston, Houston, TX, United States
(Findley) Division of Neonatal-Perinatal Medicine, Department of
Pediatrics, Memorial Hermann Children's Hospital, McGovern Medical School,
The University of Texas Health Science Center in Houston, Houston, TX,
United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Key medical and surgical advances have been made
in the longitudinal management of patients with "functionally" single
ventricle physiology, with the principles of Fontan circulation applied to
other complex congenital heart defects. The purpose of this article is to
review all of the innovations, starting from fetal life, that led to a
change of strategy for single ventricle. Method(s): Our literature
review included all full articles published in English language on the
Cochrane, MedLine, and Embase with references to "single ventricle" and
"univentricular hearts", including the initial history of the treatments
for this congenital heart defects as well as the innovations reported
within the last decades. Key Content and Findings: All innovations
introduced have been analyzed, including: (I) fetal diagnosis and
interventions, in particular to prevent or reduce brain damages; (II)
neonatal care; (III) post-natal diagnosis; (IV) interventional cardiology
procedures; (V) surgical procedures, including neonatal palliations,
hybrid procedures, bidirectional Glenn and variations, Fontan completion,
biventricular repair; (VI) perioperative management; (VII) Fontan failure,
with Fontan take-down and conversion, and mechanical circulatory support;
(VIII) transplantation, including heart, heart and lung, heart and liver;
(IX) exercise; (X) pregnancy; (XI) adolescents and adults without Fontan
completion; (XII) future studies, including experimental studies on
animals, computational studies, genetics, stem cells and bioengineering.
 Conclusion(s): These last 40 years have certainly changed the course
of natural history for children born with any form of "functionally"
single ventricle, thanks to the improvement in diagnostic and treatment
techniques, and particularly to the increased knowledge of the morphology
and function of these complex hearts, from fetal to adult life. There is
still much left unexplored and room for improvement, and all efforts
should be concentrated in collaborations among different institutions and
specialties, focused on the same matter. Copyright ©
Translational Pediatrics. All rights reserved.

<45>
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.

<46>
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.

<47>
Accession Number
2022039499
Title
Effect of Preoperative Administration of Intravenous Ferric Carboxymaltose
in Patients with Iron Deficiency Anemia after Off-Pump Coronary Artery
Bypass Grafting: A Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 12(5) (no pagination), 2023. Article Number:
1737. Date of Publication: March 2023.
Author
Kim H.-H.; Park E.H.; Lee S.H.; Yoo K.-J.; Youn Y.-N.
Institution
(Kim) Department of Cardiothoracic Surgery, Ilsan Hospital, National
Health Insurance Service, Goyang-si 10444, South Korea
(Park, Lee, Yoo, Youn) Division of Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, Seoul 03722, South Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Patients scheduled for cardiac surgery often have anemia and iron
deficiency. We investigated the effect of the preoperative administration
of intravenous ferric carboxymaltose (IVFC) in patients with iron
deficiency anemia (IDA) who were due to undergo off-pump coronary artery
bypass grafting (OPCAB). Patients who were due to undergo elective OPCAB
between February 2019 and March 2022 who had IDA (n = 86) were included in
this single center, randomized, parallel-group controlled study. The
participants were randomly assigned (1:1) to receive either IVFC or
placebo treatment. Postoperative hematologic parameters [hemoglobin (Hb),
hematocrit, serum iron concentration, total iron-binding capacity,
transferrin saturation, transferrin concentration, and ferritin
concentration] and the changes in these parameters during the follow-up
period were the primary and secondary outcomes, respectively. The tertiary
endpoints were early clinical outcomes, such as the volume of mediastinal
drainage and the need for blood transfusions. IVFC treatment significantly
reduced the need for red blood cell (RBC) and platelet transfusions.
Despite receiving fewer RBC transfusions, patients in the treatment group
had higher levels of Hb, hematocrit, and serum iron and ferritin
concentrations during weeks 1 and 12 after surgery. No serious adverse
events occurred during the study period. Preoperative IVFC treatment in
patients with IDA undergoing OPCAB improved the values of the hematologic
parameters and iron bioavailability. Therefore, is a useful strategy for
stabilizing patients prior to OPCAB. Copyright © 2023 by the
authors.

<48>
Accession Number
2022039316
Title
Systematic Review and Meta-Analysis of Efficiency and Safety of
Double-Lumen Tube and Bronchial Blocker for One-Lung Ventilation.
Source
Journal of Clinical Medicine. 12(5) (no pagination), 2023. Article Number:
1877. Date of Publication: March 2023.
Author
Palaczynski P.; Misiolek H.; Szarpak L.; Smereka J.; Pruc M.; Rydel M.;
Czyzewski D.; Bialka S.
Institution
(Palaczynski, Misiolek, Bialka) Department of Anaesthesiology and
Intensive Care, Faculty of Medical Sciences in Zabrze, Medical University
of Silesia, Zabrze 41-800, Poland
(Szarpak) Henry JN Taub Department of Emergency Medicine, Baylor College
of Medicine, Houston, TX 77030, United States
(Szarpak) Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center,
Bialystok 15-027, Poland
(Smereka) Department of Emergency Medical Service, Wroclaw Medical
University, Wroclaw 51-616, Poland
(Pruc) Research Unit, Polish Society of Disaster Medicine, Warsaw 05-806,
Poland
(Rydel, Czyzewski) Department of Thoracic Surgery, Faculty of Medical
Sciences in Zabrze, Medical University of Silesia, Zabrze 41-800, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
One-lung ventilation is also used in some thoracic or cardiac surgery,
vascular surgery and oesophageal procedures. We conducted a search of the
literature for relevant studies in PubMed, Web of Science, Embase, Scopus
and Cochrane Library. The final literature search was performed on 10
December 2022. Primary outcomes included the quality of lung collapse.
Secondary outcome measures included: the success of the first intubation
attempt, malposition rate, time for device placement, lung collapse and
adverse events occurrence. Twenty-five studies with 1636 patients were
included. Excellent lung collapse among DLT and BB groups was 72.4% vs.
73.4%, respectively (OR = 1.20; 95%CI: 0.84 to 1.72; p = 0.31). The
malposition rate was 25.3% vs. 31.9%, respectively (OR = 0.66; 95%CI: 0.49
to 0.88; p = 0.004). The use of DLT compared to BB was associated with a
higher risk of hypoxemia (13.5% vs. 6.0%, respectively; OR = 2.27; 95%CI:
1.14 to 4.49; p = 0.02), hoarseness (25.2% vs. 13.0%; OR = 2.30; 95%CI:
1.39 to 3.82; p = 0.001), sore throat (40.3% vs. 23.3%; OR = 2.30; 95%CI:
1.68 to 3.14; p < 0.001), and bronchus/carina injuries (23.2% vs. 8.4%; OR
= 3.45; 95%CI: 1.43 to 8.31; p = 0.006). The studies conducted so far on
comparing DLT and BB are ambiguous. In the DLT compared to the BB group,
the malposition rate was statistically significantly lower, and time to
tube placement and lung collapse was shorter. However, the use of DLT
compared to BB can be associated with a higher risk of hypoxemia,
hoarseness, sore throat and bronchus/carina injuries. Multicenter
randomized trials on larger groups of patients are needed to draw
definitive conclusions regarding the superiority of any of these
devices. Copyright © 2023 by the authors.

<49>
Accession Number
2021965707
Title
Short-term risk of periprocedural stroke relative to radial vs. femoral
access: systematic review, meta-analysis, study sequential analysis and
meta-regression of 2,188,047 real-world cardiac catheterizations.
Source
Expert Review of Cardiovascular Therapy. 21(4) (pp 293-304), 2023. Date of
Publication: 2023.
Author
Tuzil J.; Matejka J.; Mamas M.A.; Dolezal T.
Institution
(Tuzil, Dolezal) Value Outcomes s.r.o, Prague, Czechia
(Tuzil) Biomedical informatics, First Medical Faculty, Charles University,
Prague, Czechia
(Matejka) Department of Cardiology, Hospital of Pardubice, Pardubice,
Czechia
(Matejka) Faculty of Health Studies, University of Pardubice, Pardubice,
Czechia
(Matejka) Academic Department of Internal Medicine, Charles University
Faculty of Medicine, Hradec Kralove, Czechia
(Mamas) Keele Cardiovascular Research Group, University of Keele,
StokeonTrent, United Kingdom
(Dolezal) Pharmacology, Faculty of Medicine, Masaryk University, Brno,
Czechia
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: To verify whether transradial (TRA) compared to transfemoral
(TFA) cardiac catheterization reduces the risk of periprocedural stroke
(PS). Method(s): We reviewed (CRD42021277918) published real-world
cohorts reporting the incidence of PS within 3 days following diagnostic
or interventional catheterization. Meta-analyses and meta-regressions of
odds ratios (OR) performed using the DerSimonian and Laird method were
checked for publication bias (Egger test) and adjusted for false-positive
results (study sequential analysis SSA). Result(s): The pooled
incidence of PS from 2,188,047 catheterizations (14 cohorts), was 193 (105
to 355) per 100,000. Meta-analyses of adjusted estimates (OR = 0.66 (0.49
to 0.89); p = 0.007; I2 = 90%), unadjusted estimates (OR = 0.63
(0.51 to 0.77; I2 = 74%; p = 0.000)), and a sub-group of
prospective cohorts (OR = 0.67 (0.48 to 0.94; p = 0.022; I2 =
16%)) had a lower risk of PS in TRA (without indication of publication
bias). SSA confirmed the pooled sample size was sufficient to support
these conclusions. Meta-regression decreased the unexplained heterogeneity
but did not identify any independent predictor of PS nor any effect
modifier. Conclusion(s): Periprocedural stroke remains a rare and
hard-to-predict adverse event associated with cardiac catheterization. TRA
is associated with a 20% to 30% lower risk of PS in real-world/common
practice settings. Future studies are unlikely to change our
conclusion. Copyright © 2023 iHETA o.p.s.

<50>
Accession Number
2021863302
Title
Use of mechanical circulatory support in patients with non-ischaemic
cardiogenic shock.
Source
European Journal of Heart Failure. 25(4) (pp 562-572), 2023. Date of
Publication: April 2023.
Author
Schrage B.; Sundermeyer J.; Beer B.N.; Bertoldi L.; Bernhardt A.;
Blankenberg S.; Dauw J.; Dindane Z.; Eckner D.; Eitel I.; Graf T.; Horn
P.; Kirchhof P.; Kluge S.; Linke A.; Landmesser U.; Luedike P.; Lusebrink
E.; Mangner N.; Maniuc O.; Winkler S.M.; Nordbeck P.; Orban M.; Pappalardo
F.; Pauschinger M.; Pazdernik M.; Proudfoot A.; Kelham M.; Rassaf T.;
Reichenspurner H.; Scherer C.; Schulze P.C.; Schwinger R.H.G.; Skurk C.;
Sramko M.; Tavazzi G.; Thiele H.; Villanova L.; Morici N.; Wechsler A.;
Westenfeld R.; Winzer E.; Westermann D.
Institution
(Schrage, Sundermeyer, Beer, Blankenberg, Kirchhof) Department of
Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
(Schrage, Sundermeyer, Beer, Bernhardt, Blankenberg, Eitel, Graf,
Kirchhof, Reichenspurner) German Center for Cardiovascular Research
(DZHK), Partner site Hamburg/Kiel/Lubeck, Hamburg, Germany
(Bertoldi) Cardio Center, Humanitas Clinical and Research Center - IRCCS,
Milan, Italy
(Bernhardt, Reichenspurner) Department of Cardiothoracic Surgery,
University Heart and Vascular Center Hamburg, Hamburg, Germany
(Dauw) Department of Cardiology, Ziekenhuis Oost-Limburg (ZOL), Genk,
Belgium
(Dauw) Doctoral School for Medicine and Life Sciences, LCRC, Diepenbeek,
Belgium
(Dindane, Linke, Mangner, Winzer) Herzzentrum Dresden, Technische
Universitat Dresden, Dresden, Germany
(Eckner, Pauschinger) Department of Cardiology, Paracelsus Medical
University Nurnberg, Nurnberg, Germany
(Eitel, Graf) University Heart Center Lubeck, University Hospital
Schleswig-Holstein, Lubeck, Germany
(Horn, Westenfeld) Department of Cardiology, Pulmonology and Vascular
Medicine, Heinrich Heine University Dusseldorf, Dusseldorf, Germany
(Kluge) University Medical Center Hamburg-Eppendorf, Department of
Intensive Care Medicine, Hamburg, Germany
(Landmesser, Skurk) Department of Cardiology, Charite Universitatsmedizin
Berlin, Berlin, Germany
(Luedike, Rassaf) Department of Cardiology and Vascular Medicine, West
German Heart and Vascular Center, University Hospital Essen, Essen,
Germany
(Lusebrink, Orban, Scherer) Medizinische Klinik und Poliklinik I, Klinikum
der Universitat Munchen, Munich, Germany
(Maniuc, Nordbeck) Department of Internal Medicine I, University Hospital
Wurzburg, Wurzburg, Germany
(Winkler, Schulze) Department of Internal Medicine I, University Hospital
Jena, Jena, Germany
(Pappalardo) Dept Cardiothoracic and Vascular Anesthesia and Intensive
Care, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
(Pazdernik, Sramko) Department of Cardiology, IKEM, Prague, Czechia
(Proudfoot, Kelham) Department of Perioperative Medicine, St.
Bartholomew's Hospital, London, United Kingdom
(Schwinger, Wechsler) Medizinische Klinik II, Kliniken Nordoberpfalz AG,
Weiden, Germany
(Tavazzi) Department of Clinical-Surgical, Diagnostic and Paediatric
Sciences, University of Pavia, Pavia, Italy
(Tavazzi) Anesthesia and Intensive Care, Fondazione Policlinico San Matteo
Hospital IRCCS, Pavia, Italy
(Thiele) Department of Internal Medicine and Cardiology, Heart Center
Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig,
Germany
(Villanova) Unita di Cure Intensive Cardiologiche and De Gasperis
Cardio-Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
(Morici) IRCCS Santa Maria Nascente Fondazione Don Carlo Gnocchi ONLUS,
Milan, Italy
(Westermann) Department of Cardiology and Angiology, University Heart
Center, Freiburg, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Despite its high incidence and mortality risk, there is no
evidence-based treatment for non-ischaemic cardiogenic shock (CS). The aim
of this study was to evaluate the use of mechanical circulatory support
(MCS) for non-ischaemic CS treatment. Methods and Results: In this
multicentre, international, retrospective study, data from 890 patients
with non-ischaemic CS, defined as CS due to severe de-novo or
acute-on-chronic heart failure with no need for urgent revascularization,
treated with or without active MCS, were collected. The association
between active MCS use and the primary endpoint of 30-day mortality was
assessed in a 1:1 propensity-matched cohort. MCS was used in 386 (43%)
patients. Patients treated with MCS presented with more severe CS (37% vs.
23% deteriorating CS, 30% vs. 25% in extremis CS) and had a lower left
ventricular ejection fraction at baseline (21% vs. 25%). After matching,
267 patients treated with MCS were compared with 267 patients treated
without MCS. In the matched cohort, MCS use was associated with a lower
30-day mortality (hazard ratio 0.76, 95% confidence interval 0.59-0.97).
This finding was consistent through all tested subgroups except when CS
severity was considered, indicating risk reduction especially in patients
with deteriorating CS. However, complications occurred more frequently in
patients with MCS; e.g. severe bleeding (16.5% vs. 6.4%) and access-site
related ischaemia (6.7% vs. 0%). Conclusion(s): In patients with
non-ischaemic CS, MCS use was associated with lower 30-day mortality as
compared to medical therapy only, but also with more complications.
Randomized trials are needed to validate these findings. Copyright
© 2023 The Authors. European Journal of Heart Failure published by
John Wiley & Sons Ltd on behalf of European Society of Cardiology.

<51>
Accession Number
2014191088
Title
Oral preanesthetic medication in children comparison between midazolam
alone and in combination with ketamine: a systematic review and
meta-analysis.
Source
Brazilian Journal of Anesthesiology (English Edition). 73(4) (pp 477-490),
2023. Date of Publication: 01 Jul 2023.
Author
Oliveira Filho G.L.R.D.; Castilhos C.M.; Kriegl J.P.; Bianchi G.N.
Institution
(Oliveira Filho, Castilhos, Kriegl, Bianchi) Universidade Federal de Santa
Catarina, Departamento de Cirurgia, SC, Florian.polis, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Up to 60% of pediatric surgical patients develop high levels
of preoperative anxiety. This study compared the effects of oral
combinations of midazolam and ketamine with oral midazolam alone for
pediatric preanesthetic medication. Method(s): The study protocol was
registered in PROSPERO as CRD42020172920. A systematic literature search
was conducted using Medline, Cochrane, EMBASE, CENTRAL, and Web of Science
for randomized controlled trials comparing oral combinations of midazolam
and ketamine with midazolam alone as preanesthetic medication in elective
surgical pediatric patients. Meta-analyses included the following
outcomes: anxiety and sedation levels, child...s behavior during
separation from parents, face mask acceptance, and venipuncture. The
quality of evidence was assessed using GRADE criteria. Result(s):
Twenty studies were included. The following effects (RR (95% CI)) were
observed for combinations of ketamine and midazolam relative midazolam
alone: anxiolysis (1.2 (0.94...1.52); p.s=.s0.15; I2.s=.s80%;
GRADE.s=.svery low); satisfactory sedation (1.2 ( 1.10...1.31);
p.s<.s0.001; I2.s=.s71%; GRADE.s=.svery low); behavior during parental
separation (1.2 (1.06...1.36); p.s=.s0.003; I2.s=.s88%; GRADE.s=.svery
low); facial mask acceptance (1.13 (1.04...1.24); p.s=.s0.007; I2.s=.s49%;
GRADE.s=.svery low); behavior during venipuncture (1.32 (1.11...1.57);
p.s=.s0.002; I2.s=.s66%; GRADE.s=.svery low). Conclusion(s): While
similar probabilities of obtaining anxiolysis were found, adequate
sedation, calm behavior during child...s separation from parents, low
levels of fear during face mask adaptation, and cooperative behavior
during peripheral venous cannulation were more likely with
midazolam-ketamine combinations. Copyright © 2021 Sociedade
Brasileira de Anestesiologia

<52>
Accession Number
2013587649
Title
Predictive performance of thyromental height for difficult laryngoscopies
in adults: a systematic review and meta-analysis.
Source
Brazilian Journal of Anesthesiology (English Edition). 73(4) (pp 491-499),
2023. Date of Publication: 01 Jul 2023.
Author
Carvalho C.I.C.I.D.; Santos Neto J.M.; Orange F.V.A.D.
Institution
(Carvalho, Orange) Instituto de Medicina Integral Prof. Fernando Figueira
(IMIP), Department of Post-graduation, PE, Recife, Brazil
(Santos Neto) Universidade Federal de Pernambuco (UFPE), Hospital das
Cl.inicas, Department of Anesthesia, PE, Recife, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Thyromental height (TMH) was first reported as a great single
test for prediction of difficult laryngoscopies, although further studies
have shown variable estimates of its accuracy. We thus performed this
meta-analysis to summarize the predictive values of TMH mainly for
prediction of difficult laryngoscopies. Method(s): A search in
PubMed, EMBASE, LILACS, and Scielo was conducted in June 2020. We included
prospective cohorts fully reported with patients. 16 years old, providing
data on predictive values of TMH for prediction of either difficult
laryngoscopies or difficult intubations. Diagnostic properties and
association between TMH and Cormack and Lehanes...s classification by
direct laryngoscopy were evaluated. A random-effects meta-analysis using
hierarchical models was performed. Result(s): Eight studies
evaluating 2844 patients were included. All included studies had high risk
of bias and low concern regarding applicability. There was significant
heterogeneity among the studies. The pooled diagnostic odds ratio (DOR)
and positive (LR+) and negative (LR-) likelihood ratios were as follows:
DOR, 57.94 (95% CI: 18.19...184.55); LR+, 11.32 (95% CI: 4.28...29.92);
and LR-, 0.23 (95% CI: 0.15...0.35). Summary sensitivity and specificity
for studies with common threshold were 82.6 (95% CI: 74...88.8%) and 93.5
(95% CI: 79...98.2%), respectively. The estimated AUC was 81.1%.
 Conclusion(s): TMH arises as a good predictor of difficult
laryngoscopies in adult patients from diverse populations presenting
better predictive values than most previously reported bedside tests.
However, the high risk of bias throughout the studies may have skewed the
results of the individual research as well as the summary points of the
present meta-analysis. Copyright © 2021 Sociedade Brasileira de
Anestesiologia

<53>
Accession Number
2021080771
Title
A meta-analysis examined the effect of topical vancomycin application in
decreasing sternal wound infections post cardiac surgery.
Source
International Wound Journal. 20(6) (pp 2068-2074), 2023. Date of
Publication: August 2023.
Author
Zhang Y.; Zhang P.; Li H.; Chi H.; Zheng N.; Pan X.; Tang C.
Institution
(Zhang, Zhang, Li, Chi, Zheng, Pan, Tang) Department of Cardiovascular
Surgery, Sixth Medical Center, General Hospital of the Chinese People's
Liberation Army, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
To assess the impact of topical vancomycin (TV) application in decreasing
sternal wound infections (SWIs) post cardiac surgery (CS), we lead a
meta-analysis. Twenty-three thousand seven hundred and forty five
participants had CS at the outset of the investigations, according to a
thorough evaluation of the literature done up to November 2022; 8730 of
them used TV, while 15 015 were controls. To assess the effectiveness of
TV application in lowering SWIs following CS, odds ratios (OR) with 95%
confidence intervals (CIs) were computed with dichotomous technique with a
fixed- or random-effect model. The TV had significantly lower SWIs post CS
(OR, 0.34; 95% CI, 0.20-0.57; P <.001), and deep SWIs post CS (OR, 0.26;
95% CI, 0.11-0.65; P =.004) compared with control as shown in Figures 2
and 3. Yet, there was no significant difference found amongst TV and
control in superficial SWIs post CS (OR, 0.30; 95% CI, 0.07-1.30; P
=.011). The TV had significantly lower SWIs, and deep SWIs post CS, and no
significant difference was found in superficial SWIs post CS compared with
control. The low number of included studies in this meta-analysis for
superficial SWIs calls for precaution when analysing the
outcomes. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons
Ltd.

<54>
Accession Number
2020363365
Title
Prevalence and factors associated with pressure injury in patients
undergoing open heart surgery: A systematic review and meta-analysis.
Source
International Wound Journal. 20(6) (pp 2321-2333), 2023. Date of
Publication: August 2023.
Author
Taghiloo H.; Ebadi A.; Saeid Y.; Jalali Farahni A.; Davoudian A.
Institution
(Taghiloo) Department of Operating Room and Anesthesiology, School of
Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan,
Iran, Islamic Republic of
(Ebadi) Behavioral Sciences Research Centre, Life Style Institute, School
of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Saeid) Trauma Research Center and Faculty of Nursing, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Jalali Farahni) Atherosclerosis Research Center, Baqiyatallah University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Davoudian) Deputy of Research and Technology, Zanjan University of
Medical Sciences, Zanjan, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Pressure injuries (PIs) are one of the major and costliest medical
problems with severe implications for patients. Cardiovascular surgery
patients are at the higher risk of developing surgery-related PIs. So this
study was conducted with the aim of investigating the prevalence and
factors associated with PIs in patients undergoing open heart surgery. We
identified articles through electronic databases such as Web of Science,
Scopus, PubMed, ProQuest; and Persian Databases: SID, Magiran and Irandoc
without restriction on language or publication period (from inception
through June 2022). Finally, 17 studies that fulfilled eligibility
criteria were included in final systematic review and meta-analysis. Data
analyses were conducted using STATA version 14. The pooled prevalence of
PI in patients undergoing open heart surgery was 24.06% (95% CI:
17.85-30.27). High heterogeneity was observed across the included studies
(I2 = 96.0, P < 0.000). The prevalence by gender was reported
as 25.19% (95% CI: 13.45-36.93) in men and 33.36% (95 CI%: 19.99-46.74) in
women. The result showed there was statistically significant association
between PI and Female sex (Pooled Est: 1.551, 95% CI: 1.199-2.006, z =
3.345, P = 0.001), diabetes (Pooled Est: 1.985, 95% CI: 1.383-2.849, z =
3.719, P = 0.000), advanced age (SMD: 0.33 years; 95% CI: 0.09-0.57),
Duration of surgery (SMD: 0.47; 95% CI: 0.19-0.75) and preoperative serum
albumin level (SMD: 0.56; 95% CI: 0.14-0.98). The relatively high PIs
incidence among patients undergoing open heart surgery suggests that
typical PI prevention methods are insufficient for this population.
Targeted prevention measures must be developed and
implemented. Copyright © 2022 The Authors. International Wound
Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons
Ltd.

<55>
Accession Number
2016000501
Title
Patient and caregiver preferences and prioritized outcomes for cardiac
surgery: A scoping review and consultation workshop.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(2) (pp 598-609.e7),
2023. Date of Publication: August 2023.
Author
Oravec N.; Arora R.C.; Bjorklund B.; Gregora A.; Monnin C.; Dave M.G.;
Duhamel T.A.; Kent D.E.; Schultz A.S.H.; Chudyk A.M.
Institution
(Oravec, Arora) Section of Cardiac Surgery, Department of Surgery, Max
Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Arora, Dave, Kent) Department of Cardiac Sciences, St Boniface General
Hospital, Winnipeg, MB, Canada
(Bjorklund, Gregora) Enhanced Recovery Protocols for Cardiac Surgery
Patient Researcher Group, St Boniface General Hospital, Winnipeg, MB,
Canada
(Monnin) Neil John Maclean Health Sciences Library, University of
Manitoba, Winnipeg, MB, Canada
(Dave, Duhamel) Faculty of Kinesiology and Recreation Management,
University of Manitoba, Winnipeg, MB, Canada
(Duhamel) Institute of Cardiovascular Sciences, St Boniface General
Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
(Schultz, Chudyk) Rady Faculty of Health Sciences, College of Nursing,
University of Manitoba, Winnipeg, MB, Canada
(Schultz, Chudyk) Health Services & Structural Determinants of Health
Research Group, St Boniface General Hospital Albrechtsen Research Centre,
Winnipeg, MB, Canada
Publisher
Elsevier Inc.
Abstract
Objective(s): In light of the absence of patient and caregiver input in
Enhanced Recovery After Surgery Cardiac Surgery guideline development, we
conducted a scoping review to identify patient and caregiver preferences
and prioritized outcomes related to perioperative care in cardiac surgery
and its lifelong impact. Method(s): Five electronic databases were
searched to retrieve studies investigating patient or caregiver
preferences and prioritized outcomes. Information was charted in duplicate
and analyzed using descriptive statistics or thematic analysis. A patient
and caregiver consultation workshop validated scoping review findings and
solicited novel preferences and outcomes. Result(s): Of the 5292
articles retrieved, 43 met inclusion criteria. Most were from Europe (n =
19, 44%) or North America (n = 15, 35%) and qualitative and quantitative
designs were represented in equal proportions. Fifty-two methods were used
to obtain stakeholder preferences and prioritized outcomes, the majority
being qualitative in nature (n = 32, 61%). Based on the collective
preferences of 3772 patients and caregivers from the review and 17 from
the consultation workshop, a total of 108 patient preferences, 32
caregiver preferences, and 19 prioritized outcomes were identified. The
most commonly identified theme was "information and education." Improved
quality of life was the most common patient-prioritized outcome, and all
caregiver-prioritized outcomes were derived from the consultation
workshop. Conclusion(s): Patient and caregiver preferences overlap
with Enhanced Recovery After Surgery Cardiac Surgery recommendations
targeting preoperative risk reduction strategies, prehabilitation, patient
engagement technology, and intra- and postoperative strategies to reduce
discomfort. To support clinical practice, future research should
investigate associations with key surgical outcomes. Copyright ©
2021 The American Association for Thoracic Surgery

<56>
Accession Number
639897154
Title
Benefits of pre-operative oral Sucrosomial iron supplementation in cardiac
surgery: influence of patient's baseline hemoglobin and gender.
Source
Blood transfusion = Trasfusione del sangue. 21(4) (pp 305-313), 2023. Date
of Publication: 01 Jul 2023.
Author
Weltert L.P.; De Rosa A.; Rondinelli M.B.; Falco M.; Turani F.; Pierelli
L.
Institution
(Weltert) Heart Surgery, European Hospital, Rome, Italy
(De Rosa, Rondinelli, Pierelli) Transfusion Medicine Department "San
Camillo Forlanini" Hospital, Rome, Italy
(Falco) Anesthesiology Department, European Hospital, Rome, Italy
(Turani) Anesthesiology Department, "Aurelia" Hospital, Rome, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: The prevalence of low pre-operative hemoglobin (Hb) among
cardiac surgery patients is high. As iron homeostasis is often impaired in
these patients, restoration of iron availability might over-ride
iron-restricted erythropoiesis. This post-hoc analysis of a previously
published, large, randomized clinical trial (ClincalTrials.gov
NCT03560687; n=1,000) assesses which sub-cohort of patients benefits the
most from pre-operative Hb optimization with oral Sucrosomial iron.
MATERIALS AND METHODS: Patients without baseline Hb (n=349) or receiving
>5 red blood cell units (n=57) were excluded from the study. Data from the
remaining 594 were reanalyzed according to treatment, baseline anemia (Hb
<13 g/dL) or gender. Patients (pt) received a one-month course of 60
mg/day Sucrosomial iron (Iron group, n=309) or routine care (Control
group, n=285) prior to elective cardiac surgery. Main end-point variables
were increase in Hb from randomization to hospital admission, transfusion
requirements, and cost-effectiveness of Sucrosomial iron administration.
 RESULT(S): At hospital admission, Hb had increased 0.7 g/dL and 0.1
g/dL, for Iron and Control groups, respectively (p<0.001), with no
gender-related differences, leading to a decrease in transfusion rate (30
vs 59%, respectively; p<0.001) and transfusion index (0.5 units/patient vs
1.2 units/pt, respectively; p<0.001). Sucrosomial iron administration was
well-tolerated, and yielded cost-savings of 92/pt (p<0.001), particularly
in those presenting with baseline Hb <13 g/dL. CONCLUSION(S): This
post-hoc analysis confirms pre-operative Sucrosomial iron administration
is a safe and cost-effective strategy to increase preoperative Hb and
decrease transfusion requirements in elective cardiac surgery, especially
in those anemic at baseline.

<57>
[Use Link to view the full text]
Accession Number
633346601
Title
Heart Transplantation From Brain Dead Donors: A Systematic Review of
Animal Models.
Source
Transplantation. 104(11) (pp 2272-2289), 2020. Date of Publication: 01 Nov
2020.
Author
See Hoe L.E.; Wells M.A.; Bartnikowski N.; Obonyo N.G.; Millar J.E.; Khoo
A.; Ki K.K.; Shuker T.; Ferraioli A.; Colombo S.M.; Chan W.; McGiffin
D.C.; Suen J.Y.; Fraser J.F.
Institution
(See Hoe, Wells, Bartnikowski, Obonyo, Millar, Khoo, Ki, Shuker,
Ferraioli, Colombo, Chan, McGiffin, Suen, Fraser) Critical Care Research
Group, The Prince Charles Hospital, Brisbane, QLD, Australia
(See Hoe, Millar, Khoo, Ki, Shuker, Ferraioli, Colombo, Chan, Suen,
Fraser) Faculty of Medicine, University of Queensland, Brisbane, QLD,
Australia
(Wells) School of Medical Science, Griffith University, Gold Coast, QLD,
Australia
(Bartnikowski) Faculty of Science and Engineering, Queensland University
of Technology, Brisbane, QLD, Australia
(Obonyo) Wellcome Trust Centre for Global Health Research, Imperial
College London, London, United Kingdom
(Millar) Wellcome-Wolfson Institute for Experimental Medicine, Queen's
University Belfast, Belfast, United Kingdom
(Colombo) Department of Pathophysiology and Transplantation, Universita
Degli Studi di Milano, Milan, Italy
(McGiffin) Cardiothoracic Surgery and Transplantation, The Alfred
Hospital, Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Despite advances in mechanical circulatory devices and pharmacologic
therapies, heart transplantation (HTx) is the definitive and most
effective therapy for an important proportion of qualifying patients with
end-stage heart failure. However, the demand for donor hearts
significantly outweighs the supply. Hearts are sourced from donors
following brain death, which exposes donor hearts to substantial
pathophysiological perturbations that can influence heart transplant
success and recipient survival. Although significant advances in recipient
selection, donor and HTx recipient management, immunosuppression, and
pretransplant mechanical circulatory support have been achieved, primary
graft dysfunction after cardiac transplantation continues to be an
important cause of morbidity and mortality. Animal models, when
appropriate, can guide/inform medical practice, and fill gaps in knowledge
that are unattainable in clinical settings. Consequently, we performed a
systematic review of existing animal models that incorporate donor brain
death and subsequent HTx and assessed studies for scientific rigor and
clinical relevance. Following literature screening via the U.S National
Library of Medicine bibliographic database (MEDLINE) and Embase, 29
studies were assessed. Analysis of included studies identified marked
heterogeneity in animal models of donor brain death coupled to HTx, with
few research groups worldwide identified as utilizing these models.
General reporting of important determinants of heart transplant success
was mixed, and assessment of posttransplant cardiac function was limited
to an invasive technique (pressure-volume analysis), which is limitedly
applied in clinical settings. This review highlights translational
challenges between available animal models and clinical heart transplant
settings that are potentially hindering advancement of this field of
investigation. Copyright © 2020 Wolters Kluwer Health, Inc. All
rights reserved.

<58>
[Use Link to view the full text]
Accession Number
631577896
Title
Everolimus Initiation with Early Calcineurin Inhibitor Withdrawal in de
Novo Heart Transplant Recipients: Long-term Follow-up from the Randomized
SCHEDULE Study.
Source
Transplantation. 104(1) (pp 154-164), 2020. Date of Publication: 01 Jan
2020.
Author
Gustafsson F.; Andreassen A.K.; Andersson B.; Eiskjaer H.; Radegran G.;
Gude E.; Jansson K.; Solbu D.; Karason K.; Arora S.; Dellgren G.;
Gullestad L.; Larsen L.; Sigurdardottir V.; Selimovic N.; Bollano E.;
Bartfay S.-E.; Roy S.D.; Rexius H.; Janssen A.; Rosenberg M.; Tram E.M.;
Molgard D.; Konrad L.; Mortensen B.; Persson L.; Koch M.; Kornhall B.;
Ekmehag B.; Reitan O.; Stueflotten W.; Bjorkelund E.; Relbo A.; Grov I.;
Erikstad I.; Solberg O.G.; Ragnarsson A.; Aakhus S.; Massey R.
Institution
(Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Gustafsson) Department of Clinical Medicine, University of Copenhagen,
Denmark
(Andreassen, Gude, Arora, Gullestad) Department of Cardiology, Oslo
University Hospital Rikshospitalet, Oslo, Norway
(Andersson, Karason) Department of Cardiology, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Eiskjaer) Department of Cardiology, Aarhus University Hospital, Skejby,
Denmark
(Radegran) Section for Heart Failure and Valvular Disease, Skane
University Hospital, Department of Clinical Sciences, Cardiology, Lund
University, Lund, Sweden
(Jansson) Department of Cardiology, Heart and Medicine, Center County
Council of Ostergotland, Linkoping University, Linkoping, Sweden
(Solbu) Novartis Norge AS, Oslo, Norway
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Gullestad) K.G. Jebsen Cardiac Research Center and Center for Heart
Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway
(Larsen) CopenhagenDenmark
(Sigurdardottir, Selimovic, Bollano, Bartfay, Roy, Rexius, Janssen,
Rosenberg) GoteborgSweden
(Tram, Molgard, Konrad, Mortensen) AarhusDenmark
(Persson, Koch, Kornhall, Ekmehag, Reitan) LundSweden
(Stueflotten, Bjorkelund, Relbo, Grov, Erikstad, Solberg, Ragnarsson,
Aakhus, Massey) OsloNorway
Publisher
Lippincott Williams and Wilkins
Abstract
Background. A calcineurin inhibitor (CNI)-free immunosuppressive regimen
has been demonstrated to improve renal function early after heart
transplantation, but long-term outcome of such a strategy has not been
well described. Methods. In the randomized SCHEDULE trial, de novo heart
transplant recipients received (1) everolimus with reduced-exposure CNI
(cyclosporine) followed by CNI withdrawal at week 7-11 posttransplant or
(2) standard-exposure cyclosporine, both with mycophenolate mofetil and
corticosteroids; 95/115 randomized patients were followed up at 5-7 years
posttransplant. Results. Mean measured glomerular filtration rate was 74.7
mL/min and 62.4 mL/min with everolimus and CNI, respectively. The mean
difference was in favor of everolimus by 11.8 mL/min in the
intent-to-treat population (P = 0.004) and 17.2 mL/min in the per protocol
population (n = 75; P < 0.001). From transplantation to last follow-up,
the incidence of biopsy-proven acute rejection (BPAR) was 77% (37/48) and
66% (31/47) (P = 0.23) with treated BPAR in 50% and 23% (P < 0.01) in the
everolimus and CNI groups, respectively; no episode led to hemodynamic
compromise. Coronary allograft vasculopathy (CAV) assessed by coronary
intravascular ultrasound was present in 53% (19/36) and 74% (26/35) of
everolimus-and CNI-treated patients, respectively (P = 0.037). Graft
dimensions and function were similar between the groups. Late adverse
events were comparable. Conclusions. These results suggest that de novo
heart transplant patients randomized to everolimus and low-dose CNI
followed by CNI-free therapy maintain significantly better long-term renal
function as well as significantly reduced CAV than patients randomized to
standard CNI treatment. Increased BPAR in the everolimus group during year
1 did not impair long-term graft function. Copyright © 2020
Lippincott Williams and Wilkins. All rights reserved.

<59>
Accession Number
641788599
Title
Comparison of two oxygenation SpO<inf>2</inf> targets with two different
oximeters-impact on oxygen flow rates and on oxygenation parameters.
Source
Annals of Intensive Care. Conference: French Intensive Care Society
International Congress 2023. Paris France. 13(Supplement 1) (no
pagination), 2023. Date of Publication: June 2023.
Author
Lellouche F.; Bouchard P.-A.
Institution
(Lellouche, Bouchard) Institut Universitaire de Cardiologie et de
Pneumologie de Quebec, Quebec, Canada
Publisher
Springer
Abstract
Rationale: SpO<inf>2</inf> target influences oxygen utilization (1). It
was recently shown that oximeter brand influenced the SpO<inf>2</inf>
measurements (2). The objective of the study is to evaluate the impact of
the combination of SpO<inf>2</inf> target and oximeter brand on oxygen
utilization, occult hypoxemia and occult hyperoxemia. Patients and
methods/materials and methods: We currently conduct a randomized
cross-over study in stable ICU patients requiring oxygen therapy delivered
through nasal canula after cardiac surgery. Patients without adequate
SpO<inf>2</inf> signal are excluded. Four randomized periods of 10 min are
conducted in all patients with different SpO<inf>2</inf> targets (90 and
94%) and different oximeters (Nonin and Philips). For each period we
collect the oxygen flow and oxygen blood gases at the end of the period.
We compare the oxygen flow, the rate of occult hypoxemia ( SaO<inf>2</inf>
< 90% with SpO<inf>2</inf> >= 90%) and occult hyperoxemia (
SaO<inf>2</inf> > 96% with SpO<inf>2</inf> <= 96%), oxygen partial weaning
(< 0.5 L/min) or complete weaning and the rate of high O<inf>2</inf> flow
requirements (> 5 L/min). Result(s): We present preliminary data
based on first 12 patients (mean age 68 +/- 9 years, 100% were men with
light skin pigmentation, none had shock). At baseline, SpO<inf>2</inf> was
93.3 +/- 1.5% and oxygen flow was 2.5 +/- 1.6 L/min. Main results for the
oxygen flow and oxygenation parameters in the different study periods are
displayed in the Figure. Differences in mean oxygen flow during Nonin 90
(2.0 +/- 2.2 L/min) and Philips 94 (2.5 +/- 2.3 L/min) are not
statistically different (P = 0.11). However, all other comparisons of the
flow are statistically different. The rate of complete weaning was 50% in
the Philips 90 period and 0% in other periods. Oxygenation parameters (
SaO<inf>2</inf>, PaO<inf>2</inf>) were similar during Nonin 90 (94 +/- 1%,
72 +/- 5 mmHg) and Philips 94% (94 +/- 1%, 72 +/- 8 mmHg). Conversely,
there were statistically different oxygenation levels with Nonin 94 (97
+/- 1%, 91 +/- 7 mmHg) and Philips 90 (91 +/- 1%, 62 +/- 5 mmHg). The rate
of occult hypoxemia and hyperoxemia were 4/12 and 0/12 in the Philips 90
period and 0/12, 10/12 in the Nonin 94 period. Conclusion(s): In
patients requiring conventional oxygen therapy, the SpO<inf>2</inf>
target, the oximeter brand and even more the combination of both had major
impact on oxygen utilization, oxygen weaning and both occult hypoxemia and
hyperoxemia. Patients managed with Nonin 90 and Philips 94 had similar
oxygen flow and similar arterial oxygenation parameters. These data
underline the necessity to use corrected SpO<inf>2</inf> targets rather
than universal SpO<inf>2</inf> targets to manage oxygen therapy.

<60>
Accession Number
641788421
Title
ESCP Spring Workshop 2023: Advancing Clinical Pharmacy and Care in
Diabetes and Cardiovascular Comorbidities.
Source
International Journal of Clinical Pharmacy. Conference: ESCP Spring
Workshop 2023. Antwerp Belgium. 45(3) (no pagination), 2023. Date of
Publication: June 2023.
Author
Anonymous
Publisher
Springer
Abstract
The proceedings contain 23 papers. The topics discussed include:
pharmacist-led personalization of antiplatelet therapy and outcomes after
percutaneous coronary intervention; pilot-study: concentration of direct
oral anticoagulants in patients undergoing cardioversion; implementation
of a clinical pharmacy consultation for oral anticancer drugs at the
outpatient clinic of a tertiary care hospital; pharmacist-led prescription
verification in Belgian hospitals: where do we stand?; Evolocumab
real-world data: five-year experience of an Italian hospital; safety and
efficacy of imidazoline receptor agonistsa network meta-analysis; bleeding
risk and gaps in the evidence: the story of a diabetic patient undergoing
cardiac surgery after myocardial infarction; development of preliminary
guidelines to improve pharmaceutical care for cancer patients with type 2
diabetes mellitus ongoing anticancer treatment in one oncology
day-hospital; and optimization of the (pharmacotherapeutic) treatment and
care of the type 2 diabetes patient in Belgium through
medical-pharmaceutical concertation between general practitioners and
community pharmacists.

<61>
Accession Number
641785023
Title
Defibrillation testing during S-ICD implantation: How relevant? Results
from a multicenter study.
Source
Europace. Conference: Annual Congress of the European Heart Rhythm
Association, EHRA 2023. Barcelona Spain. 25(Supplement 1) (pp i703), 2023.
Date of Publication: June 2023.
Author
Ben Kilani M.; Jacon P.; Badenco N.; Marquie C.; Ollitrault P.; Behar N.;
Khattar P.; Carabelli A.; Venier S.; Defaye P.
Institution
(Ben Kilani, Jacon, Badenco, Marquie, Ollitrault, Behar, Khattar,
Carabelli, Venier, Defaye) Grenoble Alpes University Hospital, Grenoble,
France Hospital Pitie-Salpetriere, Paris, France Lille University
Hospital, Lille, France University Hospital of Caen, Caen, France Rennes
University Hospital , Rennes, France Scorff Hospital - Hospital Centre of
Bretagne Sud, Lorient, France
Publisher
Oxford University Press
Abstract
Introduction: Defibrillation testing (DFT) is still recommended in
patients with subcutaneous implantable cardioverter-defibrillator (S-ICD)
to ensure proper detection of ventricular fibrillation and confirm
effective defibrillation. Given the Significant risk of complications,
recent studies, are reconsidering the interest of the DFT in S-ICD. The
purpose of this study was to assess the clinical "real-life" outcomes of
DFT over a mid-term follow-up period after third-generation S-ICD
implantation. Methods and Results: 368 patients (pts) (47.9 +/- 15.5
years old; male 72.8%) implanted with Generation 3 S-ICD system were
included in this retrospective multicenter registry-based study. Mean left
ventricular ejection fraction (LVEF) was 40.8% (primary prevention 56.1%).
For 99.2% pts, S-ICD implantation was performed using the two-incision
technique and intermuscular positioning of the generator was performed for
all pts. 81% pts underwent ICD testing during implantation. Reasons for
not performing DFT were: very low LVEF (3.5%), intracardiac thrombus
(2.4%) and VF induction failure. In 2.2% (8 pts) DFT was unsuccessful,
causes were: induction of ventricular tachycardias with rates falling
below the shock zone for 3 pts while shocks were ineffective for 5 pts.
One patient required revision for contralateral lead implantation, while
sensing vector reprogramming and shock polarity modification were
efficient for the others. The mean impedance was 68.4 (+/-14.7) OMEGA and
time to shock therapy ranged from 10 to 33 s, with a mean of 16.7 (+/-4)
s. A total of 36 appropriate shocks (10.1%) have been observed after a FU
period of 11.02+/-8.8 months (1.8 shocks per patient, several shocks for
12pts, failure of the first shock for 5 patients). 17 patients (4.6%)
underwent S-ICD system extraction. The reasons were pocket site
complication (7 pts), pacing indication for cardiac resynchronization
therapy or bradycardia (3 pts), and S-ICD lead dysfunction (4 pts).
Extraction after heart transplant was needed in 3 pts. Among the 4 pts
explanted for system dysfunction, only one patient had a DFT during
implantation. After a mean follow-up of 19+/-12.1 months, the mortality
rate was 3.8% (no S-ICD-related deaths were reported). There was no
Significant difference between the 2 groups of pts with and without DFT
testing (p=0.629). Conclusion(s): The DFT remains for the moment
highly recommended during S-ICD implantations. Results from randomized
studies are still needed to confirm the relevance of DFT during S-ICD
implantation.

<62>
Accession Number
641784997
Title
Ventricular tachycardia predicts all-cause mortality and non-sudden
cardiac death in non-ischaemic cardiomyopathy.
Source
Europace. Conference: Annual Congress of the European Heart Rhythm
Association, EHRA 2023. Barcelona Spain. 25(Supplement 1) (pp i444-i446),
2023. Date of Publication: June 2023.
Author
Omara S.; Godsk T.S.; Koeber L.; Thune J.J.; Pehrson S.; Tedrow U.B.;
Ebert M.; Carbucicchio C.; Berruezo A.; Vaseghi M.; Deneke T.; Wijnmaalen
A.P.; Stevenson W.G.; Nielsen J.C.; Zeppenfeld K.
Institution
(Omara, Godsk, Koeber, Thune, Pehrson, Tedrow, Ebert, Carbucicchio,
Berruezo, Vaseghi, Deneke, Wijnmaalen, Stevenson, Nielsen, Zeppenfeld)
Willem Einthoven center for cardiac arrhythmia research and management
(WECAM), Leiden, Netherlands (The) Aarhus University Hospital, Department
of Cardiology, Aarhus, Denmark Rigshospitalet - Copenhagen University
Hospital, Cardiology, Copenhagen, Denmark University of Copenhagen,
Bispebjerg Hospital, Department of Cardiology, Aarhus, Denmark Brigham and
Women's Hospital, Cardiology, Boston, United States of America Heart
Centre Dresden - Dresden Technical University Hospital, Dresden, Germany
IRCCS Centro Cardiologico Monzino, Department of Clinical
Electrophysiology and Cardiac Pacing, Milan, Italy Teknon Medical Centre,
Heart Institute, Barcelona, Spain David Geffen School of Medicine at UCLA,
UCLA Cardiac Arrhythmia Center, Los Angeles, United States of America
Heart Center Bad Neustadt, Bad Neustadt a. d. Saale, Germany Vanderbilt
University Medical Center, Department of Cardiology, Nashville, United
States of America
Publisher
Oxford University Press
Abstract
Background: Endstage heart failure, ventricular tachycardia (VT) and
sudden cardiac death (SCD) are sequels of non-ischaemic cardiomyopathies
(NICM). Implantable cardioverter defibrillators (ICDs) can terminate VT
and prevent SCD but mortality benefit has been limited in recent trials
suggesting that VT may also be associated with non-sudden cardiovascular
death (NSCVD). Purpose(s): To assess the effect of VT on all-cause
mortality and NSCVD in NICM patients with ICDs. Method(s): Two
multicenter cohorts of NICM patients were merged for analysis: (1)
patients randomized to ICD in the DANISH trial, which included patients
with NICM, LVEF <=35% and no prior VT and (2) the DCM-VT study cohort,
which included consecutive NICM patients with any LVEF referred for
ablation of sustained VT. Predictors for the primary composite outcome of
all-cause death and heart transplant (death/HTx) and for the secondary
outcome of NSCVD were assessed. In addition, propensity score matching was
performed using the parameters age, gender, LVEF and eGFR. Finally,
survival following VT occurrence was compared between DANISH and DCM-VT
patients. Result(s): A total of 828 patients (556 DANISH, 272 DCM-VT)
were followed for a median of 3.9 years (2.1 - 5.8). DANISH patients had a
median LVEF of 25% (20 - 30) and DCM-VT patients 35% (27 - 43). A total of
148 patients (DANISH 16.4%, DCM-VT 21.0%) experienced death/HTx and NSCVD
occurred in 78 patients (7.7%, 12.9%, respectively). In multivariable
analysis history of VT at inclusion was a Significant predictor of the
primary outcome with an adjusted hazard ratio (HRa) of 3.81 (95% CI 2.33 -
6.24) as were age [HRa 1.02 per year (1.01 - 1.04)], LVEF [HRa 0.96 per 1%
increase (0.94 - 0.98)] and reduced eGFR [HRa 1.71 (1.15 - 2.53 )].
History of VT predicted NSCVD with an HRa of 7.54 (3.97 - 14.33). After
matching, history of VT still predicted death/HTx [HR 4.12 (2.48 - 6.82)]
and NSCVD [HR 6.92 (3.30 - 14.52)]. Risk of death/HTx, as well as NSCVD,
for DANISH patients was similar to DCM-VT patients after they experienced
their first VT event [HRa 0.90 (0.48 - 1.69) and HRa 1.07 (0.56 - 2.06)
resp.]. Conclusion(s): VT occurrence appears to be an important
predictor of non-sudden CV death as well as all-cause death in NICM
patients independent of other markers of heart failure severity. VT may be
a marker of progressive disease and remodelling that could be incorporated
into risk-stratification to help predict deterioration and need for HTx.

<63>
Accession Number
641784984
Title
Single-lead ECGs with wearable technology: Diagnostic accuracy in patients
with cardiovascular disease.
Source
Europace. Conference: Annual Congress of the European Heart Rhythm
Association, EHRA 2023. Barcelona Spain. 25(Supplement 1) (pp
i1002-i1003), 2023. Date of Publication: June 2023.
Author
Briosa E Gala A.; Sharp A.J.; Schramm D.; Ries W.; Pope M.T.B.; Leo M.;
Paisey J.R.; Curzen N.; Betts T.R.
Institution
(Briosa E Gala, Sharp, Schramm, Ries, Pope, Leo, Paisey, Curzen, Betts)
Oxford University Hospitals NHS Trust, Oxford, United Kingdom of Great
Britain & Northern Ireland University Dorset Hospital, Bournemouth, United
Kingdom of Great Britain & Northern Ireland Portsmouth Hospitals NHS
Trust, Portsmouth, United Kingdom of Great Britain & Northern Ireland
University Hospital Southampton NHS Foundation Trust, Southampton, United
Kingdom of Great Britain & Northern Ireland
Publisher
Oxford University Press
Abstract
Introduction: The 2020 ESC AF management guideline states that a 30-second
single-lead electrocardiogram (sl-ECG) can be used to diagnose atrial
fibrillation, but advises caution as most validation studies used small,
carefully selected cohorts and are prone to bias. Patients with frequent
ectopy, other atrial arrhythmias, and cardiac implantable electronic
devices, which are important sources of false-positive detection, are
noticeably absent from many studies. Purpose(s): We sought to compare
the diagnostic accuracy of the Apple Watch and CART-I ring automated AF
detection to physician interpretation of a sl-ECG in a broad cohort of
patients with pre-existing cardiovascular disease. Method(s): This
prospective single-centre randomised study recruited patients with known
cardiovascular disease in a large UK tertiary centre. All patients
underwent simultaneous 12-lead ECG recordings with a 30-second sl-ECG from
an Apple Watch Series 6 and a CART-I Ring. The order of devices was
randomly assigned. Two cardiologists independently adjudicated all ECGs;
any disagreements were resolved by a third cardiologist. The wearable
devices' algorithm labelled ECGs as "AF", "Not AF" or "Unclassified".
Unclassified ECGs were categorised as false-positive (no AF on the 12-lead
ECG) or false-negative (AF on the 12-lead ECG). Diagnostic accuracy was
determined by calculating AF sensitivity and specificity for each device
and comparing it to 12-lead ECGs. Result(s): A total of 1600 ECGs
from 400 consecutive patients were recorded. Seven patients were excluded
due to uninterpretable 12-lead ECGs. The median age was 63 (58-75) years;
24% were female; 75.1% had coronary artery disease; 64% had a history of
AF; and 10 % had undergone previous cardiac surgery. Interobserver
reproducibility for sl-ECGs was high, with levels of agreement for the
Apple Watch and the CART-I ring being 89.8% and 91.1%, respectively
(p=0.54). The CART-I ring's AF sensitivity from automated detection was
Significantly higher than the Apple Watch's (mean difference 18.6%; 95%CI
17.0%-20.6%, p=0.03). Physician interpretation of the Apple Watch sl-ECGs
led to a Significant increase in AF sensitivity and specificity, 95.8%
(95% CI: 91.6 %-97.9%) and 90.8 % (95% CI: 86.2 %-93.9%), respectively
(Figure 1B). In contrast, physician interpretation of the CART-I ring's
sl-ECG resulted in higher AF sensitivity (94.6% [95% CI: 90.0%-97.1%]) but
a marginal decrease in specificity (89.4% [95% CI: 84.8%-92.8%]). There
was no statistically Significant difference in AF detection between
physician-interpreted sl-ECG from the wearable devices: 4.74% difference
in AF sensitivity (p=0.12) and 1.32% difference in AF specificity
(p=0.75). Conclusion(s): In patients with cardiovascular disease,
automatic AF detection algorithms from wearable devices have a higher rate
of false-positive detections than previously reported.
Physician-interpreted sl-ECGs have excellent diagnostic accuracy for AF.

<64>
Accession Number
641784603
Title
Permanent pacemaker implantation following transcatheter aortic valve
implantation: A systematic review and Bayesian network meta-analysis.
Source
Europace. Conference: Annual Congress of the European Heart Rhythm
Association, EHRA 2023. Barcelona Spain. 25(Supplement 1) (pp i591), 2023.
Date of Publication: June 2023.
Author
Bonanno C.; Borio G.L.; Paccanaro M.; Rossillo A.; Vittadello S.; Varotto
L.; Caprioglio F.
Institution
(Bonanno, Borio, Paccanaro, Rossillo, Vittadello, Varotto, Caprioglio) San
Bortolo Hospital, Vicenza, Italy
Publisher
Oxford University Press
Abstract
Introduction: Permanent pacemaker implantation (PPI) remains a common
complication after transcatheter aortic valve implantation (TAVI).
Different transcatheter heart valves (THVs) exist, and newly approved
devices are growing. A comparison according to the mechanisms of TAVI
prosthesis with longer follow-up needs to be made. We address this issue
using a systematic review and a Bayesian network meta-analysis (NMA).
 Method(s): A systematic literature review was carried out up to Oct
31, 2022, to identify studies reporting the use of balloon-expandable
valves (BEVs), self-expandable valves (SEVs), and mechanically expandable
valves (MEVs). We compared the various THVs, or standard medical treatment
(STD), with a common comparator of surgical aortic valve replacement
(SAVR) concerning PPI. Data at the most extended follow-up for each study
were extracted. A random-effects Bayesian NMA was used to calculate odds
ratios (OR) and 95% credible intervals (CrI) using MetInsight V4.0.0. The
surface under the cumulative ranking area (SUCRA) probabilities was
selected to calculate the ranking and hierarchy of the different
treatments. The larger SUCRA indicates the greater likelihood of becoming
the best intervention. Result(s): We included 15 RCTs comprising
12.783 patients, among whom 8.585 underwent TAVI using various
commercially available THVs, including BEVs (Sapien & Sapien XT, Sapien
3), MEVs (Corevalve, Evolut & Pro/R, Acurate Neo, Portico), and MEVs
(Lotus). The median follow-up was 2.5 years (IQR 1-5). No Significant
differences in the risk of PPI were observed between STD: 1.70 [0.556,
5.39], Sapien & Sapien XT: 1.39 [0.834, 2.41], Sapien 3: 1.70 [0.977,
2.88], and Acurate Neo: 1.68 [0.768, 3.789], compared with SARV. All the
other THVs (Corevalve: 3.07 [1.99. 4.959]; Evolut & Pro/ R: 3.19 [1.80,
6.03]; Lotus: 5.22 [2.08, 13.7]; Portico: 7.22 [2.85, 19.4]) showed
Significant differences in the risk of PPI compared with SARV. In Bayesian
ranking results, Sapien & Sapien XT had the highest chance (77%) of
providing a lower PPI rate. Meanwhile, Portico THV was ranked the worst
(5%) regarding the likelihood of PPI rate (Figure 1). According to the
mechanism, all the THVs showed a higher risk for PPI than SARV (BEVs: 1.60
[1.01, 2.54]; SEVs: 3.09 [1.97, 4.96]; and MEV: 5.30 [1.62, 17.7]). STD:
1.92 [0.518, 7.14] had a non-Significant PPI rate compared with SARV.
SUCRA plot showed that SARV was the intervention with the lowest (95%)
probability of PPI, followed by BEVs (65%), STD (55%), SEVs (27%) and MEVs
(7%) (Figure 2). In both analyses, the assessment of inconsistency between
direct and indirect estimates was not Significant (P > 0.05).
 Conclusion(s): This NMA of RCTs includes a more Significant number of
patients with longer follow-up. We demonstrated that BEVs are associated
with lower PPI rates than SEVs and MEVs. Some newer generations of THVs
(Acurate Neo, Evolut R/Pro) performed better than the older ones, reducing
the PPI rate.

<65>
Accession Number
641784535
Title
Tick Tock timing of permanent pacemaker implantation after transcatheter
aortic valve replacement. A single center review.
Source
Europace. Conference: Annual Congress of the European Heart Rhythm
Association, EHRA 2023. Barcelona Spain. 25(Supplement 1) (pp i394), 2023.
Date of Publication: June 2023.
Author
Rexha E.; Schlichting A.; Chung D.; Tigges E.P.; Ubben T.; Hassan K.;
Nejahsie Y.; Gessler N.; Willems S.; Kaiser L.; Hakmi S.
Institution
(Rexha, Schlichting, Chung, Tigges, Ubben, Hassan, Nejahsie, Gessler,
Willems, Kaiser, Hakmi) Asklepios Clinic St. Georg, Cardiology, Hamburg,
Germany
Publisher
Oxford University Press
Abstract
Background: Permanent pacemaker implantation (PPI) for high degree
atrio-ventricular block (AVB) is common in patients after transcatheter
aortic valve replacement (TAVR). There is still no clear recommendation
regarding the optimal timing of PPI and programming of the pacemakers (PM)
in these patients. Method(s): Data of all 1363 patients who underwent
TAVR in our center between July 2019 and September 2022 was included in
this retrospective study. In patients with high degree AVB a PPI was
performed either in the same procedure or at least within 24 h after TAVR.
All patients underwent a PM-interrogation before discharge.
 Result(s): A permanent PM was implanted in 122 of 1363 (9%) patients
with a mean age of 82 years. AVB that required PPI occurred in 9.2%
(100/1087) of the patients with a self-expandable (SE) valve and in 8%
(22/276) of the patients with a balloon expandable (BE) valve. In 34
patients PPI was performed in the same TAVR procedure, and 88 patients
were treated in an average of 3.5 days after TAVR. Right-sided PM was
implanted in 27 out of the 34 (79.4%) intra-procedural cases and in 3 of
the 88 (3.4%) post-procedural cases. No major complications were reported.
Two revision procedures were performed due to lead dislodgements in both
groups respectively [(2/34 (5.9%); 2/88 (2.3%)]. Two pneumothoraces (2/88,
2.3%) were reported in the post-procedural PPI patients. The overall
complication rate was 4.9 % (6/122). The AV-conduction showed recovery in
37 Patients (37/122, 30%) during the first interrogation in an average of
2.1 days after TAVR [(9/ 34(26.5%); 28/88 (31.8%)]. The AV-hysteresis was
programmed in 48 out of the 94 implanted dual chamber pacemakers during
the first interrogation. The average length of stay in hospital in
patients with intra-procedural PPI and in those who underwent PPI in a
second procedure was 13.7 and 14 days respectively with no Significant
difference between both groups (p>0.05). Conclusion(s):
Intra-procedural PPI was not associated with Significant reduction of in
hospital stay. The percentage of AV-conduction recovery after TAVR was
high, even in short term follow up. Patients could benefit from a longer
monitoring to avoid PPI and programming of AV-hysteresis during the first
interrogation in these population should be recommended. Randomized and
long-term follow up data are needed.

<66>
Accession Number
2025683570
Title
The clinical and angiographic impact of intravascular ultrasound guided
stenting of unprotected left main and proximal left anterior descending
coronary artery. A prospective randomized controlled study in Egypt.
Source
Cor et Vasa. 65(3) (pp 468-476), 2023. Date of Publication: 2023.
Author
Hanboly N.H.; Kamel Baghdady Y.M.; Mostafa M.M.; Fahmy Hashad A.A.; Sadek
Y.A.
Institution
(Hanboly, Kamel Baghdady, Mostafa, Fahmy Hashad) Cardiovascular
Department, Faculty of Medicine, Cairo University, Cairo, Egypt
(Sadek) Cardiovascular Department, Faculty of Medicine, Helwan University,
Egypt
Publisher
Czech Society of Cardiology Z.S
Abstract
Background: Coronary angiography has some limitations in the proper
assessment of coronary artery lesions. Intravascular ultrasound (IVUS)
before percutaneous coronary intervention (PCI) can identify significant
stenosis, select the appropriate stent and detect complications. The study
aimed to evaluate the impact of intravascular ultrasound on clinical and
angiographic outcomes after revascularization by stenting for patients
with unprotected left main (ULM) or proximal left anterior descending
(LAD) coronary artery disease (CAD). Material(s) and Method(s): A
prospective randomized controlled study that was carried on sixty patients
presented with stable angina or non-ST elevation acute coronary syndrome.
Coronary angiography that was carried out at cardiac catheterization
laboratory at the National Heart Institute in Egypt revealed significant
left main or proximal LAD coronary artery disease. Patients were scheduled
for revascularization by PCI. Percutaneous coronary intervention guided by
coronary IVUS was done in thirty patients (Group A). Whereas, Group B
included 30 patients in which PCI was not guided by IVUS. The patients
were followed for six months to detect any primary or secondary endpoints.
 Result(s): IVUS guidance was associated with a significant higher
post-stent minimal lumen diameter as found by quantitative coronary
angiography (QCA) (p = 0.001), stent diameter (p = 0.001), and adjunct
post-dilatation (p = 0.02). By comparing both study groups it was found
that IVUS guidance was associated with significant lower rates of stent
thrombosis in target lesions, non-fatal myocardial infarction related to
target lesions, target lesion revascularization and all cause major
adverse cardiac events (MACE) within 6 months of follow-up (p-value 0.038,
for all). Conclusion(s): IVUS guided PCI during ULM and proximal LAD
coronary artery stenting improves clinical outcome with significant lower
rates of MACE at 6 months which is due to significant lower risk of target
lesion revascularization and stent thrombosis. We recommended routine use
of IVUS during revascularization by stenting in cases of ULM or proximal
LAD CAD. Copyright © 2023 Czech Society of Cardiology Z.S. All
rights reserved.

<67>
Accession Number
2025698490
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) (no pagination), 2023. Article Number: e070823. 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, Peking Union Medical College, Beijing, China
(Yuan, Chu, Chen, Hu) Department of Cardiac Surgery, Fuwai Hospital,
Chinese Academy of Medical Science, 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, Peking Union Medical College, Beijing, China
(Zheng) Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical
Science, Peking Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Dual antiplatelet therapy (DAPT), referred to as the
combination of aspirin and P2Y 12 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 analysisEthics 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.

<68>
Accession Number
2025468110
Title
Single-injection serratus anterior plane block for cardiothoracic surgery
via thoracotomy in children: A systematic review and meta-analysis of
randomised controlled trials.
Source
BMJ Paediatrics Open. 7(1) (no pagination), 2023. Article Number: e001912.
Date of Publication: 14 Jun 2023.
Author
He Y.; Li Z.; Xu M.; Du B.; Zuo Y.
Institution
(He, Xu, Du, Zuo) Department of Anesthesiology, West China Hospital,
Sichuan University, The Research Units of West China (2018RU012), Chinese
Academy of Medical Sciences, Sichuan University West China Hospital,
Sichuan, Chengdu, China
(Li) Department of Critical Care Medicine, Cheng du Shang Jin Nan Fu
Hospital, Sichuan University West China Hospital, Sichuan, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Background Serratus anterior plane block (SAPB) has gained popularity in
cardiothoracic surgery due to its feasibility and simplicity. However, the
efficacy of ultrasound-guided single-injection SAPB in the paediatric
population has not been well evaluated, as only a few studies with small
sample sizes are available. Methods We searched PubMed, Embase (Ovid),
Cochrane Central Register of Controlled Trials, Wanfang databases and
China National Knowledge Infrastructure from their inception to 31
September 2022 for randomised comparative clinical trials that compared
single-injection SAPB with systemic analgesia or different forms of
regional analgesia in children. The primary outcomes included
postoperative opioid consumption and pain scores within 24 hours. The
secondary outcomes included postoperative adverse events, the need for
rescue analgesia and the time from the end of surgery to endotracheal tube
removal. Results Five randomised controlled trials with 418 children
meeting the inclusion criteria were included. SAPB markedly reduced
postoperative opioid consumption up to 24 hours compared with controls
(mean difference (MD): -0.29 mg/kg, 95% CI -0.38 to -0.20, I 2 =67%]. The
postoperative pain scores were reduced compared with controls: 1 hour (MD
-0.6, 95% CI -1.17 to -0.04, I 2 =92%), 4-6 hours (MD -1.16, 95% CI -1.87
to -0.45, I 2 =90%) and 12 hours (MD -0.71, 95% CI -1.35 to -0.08, I 2
=86%). The incidence of postoperative nausea and vomiting was comparable
between SAPB and controls. One trial suggested that the analgesic effect
of SAPB was comparable to that of ICNB (intercostal nerve block).
Conclusion Single-injection SAPB is associated with a reduction in opioid
consumption and pain intensity after cardiothoracic surgery via
thoracotomy in children. Due to the high heterogeneity, the Grading of
Recommendations Assessment, Development and Evaluation scores were low.
Clinical trials with rigorous methodological approaches as well as safety
endpoints are needed to confirm these preliminary findings. PROSPERO
registration number CRD42021241691. 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.

<69>
Accession Number
2025465321
Title
European Society of Cardiology quality indicators for the cardiovascular
pre-operative assessment and management of patients considered for
non-cardiac surgery. Developed in collaboration with the European Society
of Anaesthesiology and Intensive Care.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 9(4) (pp
331-341), 2023. Date of Publication: 01 Jun 2023.
Author
Gencer B.; Gale C.P.; Aktaa S.; Halvorsen S.; Beska B.; Abdelhamid M.;
Mueller C.; Tutarel O.; McGreavy P.; Schirmer H.; Geissler T.; Sillesen
H.; Niessner A.; Zacharowski K.; Mehilli J.; Potpara T.
Institution
(Gencer) Cardiology Division, Geneva University Hospitals, Geneva,
Switzerland
(Gencer) Institute of Primary Health Care (BIHAM), Bern University, Bern,
Switzerland
(Gale, Halvorsen) Leeds Institute of Cardiovascular and Metabolic
Medicine, University of Leeds, United Kingdom
(Gale, Beska) Leeds Institute for Data Analytics, University of Leeds,
Leeds, United Kingdom
(Gale, Aktaa, Beska) Department of Cardiology, Leeds Teaching Hospitals
Nhs Trust, Leeds, United Kingdom
(Aktaa) Department of Cardiology, Oslo University Hospital Ulleval, Oslo,
Norway
(Beska) Cardiology Department, Faculty of Medicine, Kase Al Ainy, Cairo
University, Cairo, Egypt
(Abdelhamid) Cardiovascular Research Institute Basel, University Heart
Center, University of Basel, University Hospital Basel, Basel, Switzerland
(Mueller) Department of Congenital Heart Disease and Paediatric
Cardiology, German Heart Centre Munich, Tum School of Medicine, Technical
University of Munich, Munich, Germany
(Tutarel) Patient Representatives, European Society of Cardiology (ESC),
France
(McGreavy) Department of Cardiology, Akershus University Hospital,
Lorenskog, Norway
(Schirmer) Institute of Clinical Medicine, Campus Ahus, University of
Oslo, Lorenskog, Norway
(Schirmer) Department of Cardiology and Angiology, University Hospital
Tubingen, Tubingen, Germany
(Geissler) Vascular Surgery, Rigshospitalet, University of Copenhagen,
Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
(Sillesen) Department of Internal Medicine Ii, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Niessner) Department Anaesthesiology, Intensive Care Medicine & Pain
Therapy, University Hospital Frankfurt, Goethe University, Frankfurt,
Germany
(Zacharowski) Department of Cardiology, Lmu University Hospital and German
Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart
Alliance, Munich, Germany
(Mehilli) Department of Cardiology, Medizinische Klinik I,
Landshut-Achdorf Hospital, Landshut, Germany
(Mehilli) Cardiology Clinic, University Clinical Centre of Serbia,
Belgrade, Serbia
(Potpara) School of Medicine, University of Belgrade, Belgrade, Serbia
Publisher
Oxford University Press
Abstract
Aims: To establish a set of quality indicators (QIs) for the
cardiovascular (CV) assessment and management of patients undergoing
non-cardiac surgery (NCS). Methods and Results: The Quality Indicator
Committee of the European Society of Cardiology (ESC) and European Society
of Anaesthesiology and Intensive Care (ESAIC) in collaboration with Task
Force members of the 2022 ESC Guidelines on CV assessment and management
of patients undergoing NCS followed the ESC methodology for QI
development. This included (1) identification, by constructing a
conceptual framework of care, of domains of the CV assessment, and
management of patients with risk factors or established cardiovascular
disease (CVD) who are considered for or undergoing NCS, (2) development of
candidate QIs following a systematic literature review, (3) selection of
the final set of QIs using a modified Delphi method, and (4) evaluation of
the feasibility of the developed QIs. In total, eight main and nine
secondary QIs were selected across six domains: (1) structural framework
(written policy), (2) patient education and quality of life (CV risk
discussion), (3) peri-operative risk assessment (indication for diagnostic
tests), (4) peri-operative risk mitigation (use of hospital therapies),
(5) follow-up (post-discharge assessment), and (6) outcomes (major CV
events). Conclusion(s): We present the 2022 ESC/ESAIC QIs for the CV
assessment and management of patients with risk factors or established CVD
who are considered for or are undergoing NCS y. These indicators are
supported by evidence from the literature, underpinned by expert
consensus, and align with the 2022 ESC Guidelines on CV assessment and
management of patients undergoing NCS. Copyright © 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Society of Cardiology.

<70>
Accession Number
2024258620
Title
Effect of superficial and deep parasternal blocks on recovery after
cardiac surgery: study protocol for a randomized controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 444. Date of
Publication: December 2023.
Author
Jeanneteau A.; Demarquette A.; Blanchard-Daguet A.; Fouquet O.; Lasocki
S.; Riou J.; Rineau E.; Leger M.
Institution
(Jeanneteau, Demarquette, Blanchard-Daguet, Lasocki, Rineau, Leger)
Departement d'Anesthesie Reanimation, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Fouquet) Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire
d'Angers, Angers, France
(Riou) Departement de Biostatistiques Et Methodologie, Centre Hospitalier
Universitaire d'Angers, Angers, France
(Leger) INSERM UMR 1246, SPHERE, Nantes University, Tours University,
France
Publisher
BioMed Central Ltd
Abstract
Background: Pain is frequent after cardiac surgery and source of multiple
complications that can impair postoperative recovery. Regional anesthesia
seems to be an interesting technique to reduce the pain in this context,
but its effectiveness in improving recovery has been poorly studied so
far. The objective of this study is to compare the effectiveness of two of
the most studied chest wall blocks in cardiac surgery, i.e., the
superficial and the deep parasternal intercostal plane blocks (SPIP and
DPIP respectively), in addition to standard care, versus the standard care
without regional anesthesia, on the quality of postoperative recovery
(QoR) after cardiac surgery with sternotomy. Method(s): This is a
single-center, single-blind, controlled, randomized trial with a 1:1:1
ratio. Patients (n = 254) undergoing cardiac surgery with sternotomy will
be randomized into three groups: a control group with standard care and no
regional anesthesia, a SPIP group with standard care and a SPIP, and a
DPIP with standard care and a DPIP. All groups will receive the usual
analgesic protocol. The primary endpoint is the value of the QoR evaluated
by the QoR-15 at 24 h after the surgery. Discussion(s): This study
will be the first powered trial to compare the SPIP and the DPIP on global
postoperative recovery after cardiac surgery with sternotomy. Trial
registration: ClinicalTrials.gov NCT05345639. Registered on April 26,
2022. Copyright © 2023, The Author(s).

<71>
Accession Number
2024311908
Title
Analgesic efficacy of pre-emptive ultrasound-guided mid-point transverse
process to pleura block for patients undergoing posterolateral thoracotomy
incisions: Randomized controlled trial.
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 538-545), 2023. Date of
Publication: 2023.
Author
Mohammed H.A.; Belal A.M.; Elkalla R.S.; Soliman S.M.
Institution
(Mohammed, Belal, Elkalla, Soliman) Anesthesiology, Surgical Intensive
Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta,
Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: For anesthesiologists, managing pain during and after thoracic
surgery remains a significant challenge. This research aims to assess the
safety and efficacy of ultrasound (US)-guided pre-emptive mid-point
transverse process to pleura (MTP) block for posterolateral thoracotomy.
 Method(s): This prospective randomized, double-blind clinical trial
was conducted on 70 patients scheduled for a posterolateral thoracotomy
operation under general anesthesia (GA). Patients were classified randomly
and equally into Group I (MTP group) received MTP blocks, and Group II
(sham block) received 2 ml of saline solution. The blocks were done after
induction of GA but before the skin incision. Result(s): Numerical
rating scale (NRS) at rest and cough, total morphine consumption, the
incidence of chronic pain at 3 months, and undesirable side effects
(nausea, vomiting, respiratory depression) were significantly lower in MTP
block than in sham block. Oxygen saturation and
SpO<inf>2</inf>/FiO<inf>2</inf> raised significantly in the MTP block than
in the sham block (P < 0.001). Conclusion(s): The US-guided MTP block
provided effective analgesia with a lower pain score, lesser rescue
analgesics consumption, and reduced risk of developing chronic pain
posterolateral thoracotomy. Copyright © 2023 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<72>
Accession Number
2025680391
Title
Impact of bariatric surgery on carotid intima-media thickness,
flow-mediated dilation, and nitrite-mediated dilation: a systematic review
and meta-analysis.
Source
Surgery for Obesity and Related Diseases. (no pagination), 2023. Date of
Publication: 2023.
Author
Esparham A.; Roohi S.; Ahmadyar S.; Dalili A.; Nelson P.R.; Khorgami Z.
Institution
(Esparham, Roohi, Ahmadyar) Student Research Committee, College of
Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Dalili) Department of General Surgery, School of Medicine, Surgical
Oncology Research Center, Imam, Reza Hospital, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Nelson) Division of Vascular Surgery, Department of Surgery, University
of Oklahoma, Tulsa, Oklahoma, United States
(Khorgami) Department of Surgery, University of Oklahoma College of
Community Medicine, Tulsa, Oklahoma, United States
(Khorgami) Harold Hamm Diabetes Center, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Obesity is considered one of the independent risk factors for
atherosclerosis and is strongly correlated with cardiovascular morbidity
and mortality. Previous studies showed carotid intima-media thickness
(CIMT), flow-mediated dilation (FMD), and nitrite-mediated dilatation
(NMD) are reliable non-invasive markers of arterial damage and
dysfunction. The aim of this study was to evaluate the effect of bariatric
surgery on CIMT, FMD, and NMD markers in patients with obesity. A
systematic search was performed in the PubMed, Embase, Scopus, and Web of
Science databases until May 2022. All the English-published studies on the
effect of bariatric surgery on CIMT, FMD, and NMD were included. A
quantitative meta-analysis was performed, as well as subgroup analyses for
the type of procedure and duration of follow-up. Meta-analysis of 41
studies with 1639 patients showed CIMT was significantly reduced by .11 mm
after bariatric surgery (95% CI, -.14 to -.08; P < .001; mean follow-up =
10.8 mo). The pooled analysis of 23 studies with 1106 patients showed an
increase of FMD by 4.57% after bariatric surgery (95% CI, 2.69-6.44; P <
.001; mean follow-up = 11.5 mo). The results of a pooled analysis of 12
studies with 346 patients showed a significant increase of NMD by 2.46%
after bariatric surgery (95% CI, .99-3.94; P < .001; mean follow-up = 11.4
mo). The random effect meta-regression demonstrated that baseline CIMT and
FMD significantly affect the changes in CIMT and FMD. This meta-analysis
showed bariatric surgery can improve CIMT, FMD, and NMD markers in
patients with obesity. These improvements show the known effect of
metabolic surgery in decreasing cardiovascular risk. Copyright ©
2023 American Society for Metabolic and Bariatric Surgery

<73>
Accession Number
2024290075
Title
Patients' expectations, experience and acceptability of postoperative
analgesia: a nested qualitative study within a randomised controlled trial
comparing rectus sheath catheter and thoracic epidural analgesia.
Source
Anaesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Brearley S.G.; Varey S.; Krige A.
Institution
(Brearley, Varey) Division of Heath Research, Faculty of Health and
Medicine, Lancaster University, Lancaster, United Kingdom
(Krige) Department of Anaesthesia and Critical Care, Royal Blackburn
Teaching Hospital, Blackburn, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Adequate postoperative analgesia is a key element of enhanced recovery
programmes. Thoracic epidural analgesia is associated with superior
postoperative analgesia but can lead to complications. Rectus sheath
catheter analgesia may provide an alternative. In a nested qualitative
study (within a two-year randomised controlled trial) focussing on the
acceptability, expectations and experiences of receiving the
interventions, participants (n = 20) were interviewed 4 weeks
post-intervention using a grounded theory approach. Constant comparative
analysis, with patient and public involvement, enabled emerging findings
to be pursued through subsequent data collection. We found no notable
differences regarding postoperative acceptability or the experience of
pain management. Pre-operatively, however, thoracic epidural analgesia was
a source of anticipatory fear and anxiety. Both interventions resulted in
some experienced adverse events (proportionately more with thoracic
epidural analgesia). Participants had negative experiences of the
insertion of thoracic epidural analgesia; others receiving the rectus
sheath catheter lacked confidence in staff members' ability to manage the
local anaesthetic infusion pump. The anticipation of the technique of
thoracic epidural analgesia, and concerns about its impact on mobility,
represented an additional, unpleasant experience for patients already
managing an illness experience, anticipating a life-changing operation and
dealing with concerns about the future. The anticipation of rectus sheath
catheter analgesia was not associated with such anxieties. Patients'
experiences start far earlier than the experience of the intervention
itself through anticipatory anxieties and fears about receiving a
technique and its potential implications. Complex pain packages can take
on greater meaning than their actual efficacy in relieving postoperative
pain. Future research into patient acceptability and experience should not
focus solely on efficacy of pain relief but should include anticipatory
fears, anxieties and experiences. Copyright © 2023 The Authors.
Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists.

<74>
Accession Number
2024275460
Title
Sutureless valves versus aortic root enlargement for aortic valve
replacement in small aortic annulus: A systematic review and pooled
analysis.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2023. Date of
Publication: 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, Deoghar, India
(Arnav) Department of Surgical Oncology, All India Institute of Medical
Sciences (AIIMS), Jharkhand, Deoghar, India
(Ranjan) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jharkhand, Deoghar, India
(Mudgal) College of Nursing, All India Institute of Medical Sciences
(AIIMS), Jharkhand, Deoghar, India
(Singh) Department of Radiotherapy, All India Institute of Medical
Sciences (AIIMS), Jharkhand, Deoghar, India
Publisher
SAGE Publications Inc.
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. Copyright
© The Author(s) 2023.

<75>
Accession Number
641790125
Title
Coronary endarterectomy combined with coronary artery bypass grafting
might decrease graft patency: a cohort study.
Source
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.
(no pagination), 2023. Date of Publication: 10 Jul 2023.
Author
Tiemuerniyazi X.; Yang Z.; Song Y.; Xu F.; Zhao W.; Feng W.
Institution
(Tiemuerniyazi, Yang, Song, Xu, Zhao, Feng) Department of Cardiovascular
Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases,
National Clinical Research Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Little is known about the graft patency after coronary
endarterectomy (CE) combined with coronary artery bypass grafting (CABG).
This study aimed to investigate the graft patency after CABG+CE.
 METHOD(S): Eligible patients hospitalized at our center during
September 2008 and July 2022 with complete follow-up coronary angiographic
data available were retrospectively enrolled. The primary endpoint was the
follow-up graft patency of CE targets. Logistic regression was performed
to explore the potential predictors of the CE-targeted graft failure.
 RESULT(S): A total of 160 patients (age: 59.4+/-9.3 years, male:
75.6%) were enrolled, and 560 grafts were anastomosed. CE was performed on
166 sites, including LAD (36.1%), right coronary artery (RCA, 48.2%), left
circumflex artery (9.6%) and diagonal branches (6.0%). Postoperative
myocardial infarction was observed in 7 (4.4%) of the patients. During a
median follow-up of 12.1 months, the CE-targeted graft patency was 69.9%.
The CE-targeted graft patency rate was much higher among the LAD-CE
patients than the non-LAD-CE patients (80.0% vs. 64.2 %, P=0.032), but
lower than non-endarterectomized LAD (80.0% vs. 92.9%, P=0.013). No
difference was observed regarding the graft patency between off-pump and
on-pump surgery (P=0.585). In the logistic regression, RCA-CE was
associated with increased risk of graft failure even after multiple
adjustment (odds ratio: 2.35, 95% confidence interval: 1.05-5.28,
P=0.028). CONCLUSION(S): CABG+CE might be associated with decreased
graft patency, especially in those who received RCA-CE irrespective of
surgical technique or antiplatelet/anticoagulation regimen. A multi-center
prospective, possibly randomized study with larger sample size is
warranty. Copyright © 2023 Hellenic Society of Cardiology.
Published by Elsevier B.V. All rights reserved.

<76>
Accession Number
2025467732
Title
Exercise in patients with repaired tetralogy of Fallot: A systematic
review and meta-analysis.
Source
Heart. 109(13) (pp 984-991), 2023. Date of Publication: 01 Jul 2023.
Author
Schuermans A.; Boerma M.; Sansoni G.A.; Van Den Eynde J.; Takkenberg
J.J.M.; Helbing W.A.; Geva T.; Moons P.; Van De Bruaene A.; Budts W.
Institution
(Schuermans, Van Den Eynde, Van De Bruaene, Budts) Department of
Cardiovascular Sciences, KU Leuven, Flanders, Leuven, Belgium
(Boerma) Faculty of Medical Sciences, Radboud University Medical Center,
Gelderland, Nijmegen, Netherlands
(Sansoni) Faculty of Medicine and Surgery, Universita Degli Studi di
Milano, Milan, Italy
(Takkenberg) Department of Cardiothoracic Surgery, Erasmus University
Medical Center, Zuid-Holland, Rotterdam, Netherlands
(Helbing) Department of Pediatrics, Erasmus University Medical Center,
Zuid-Holland, Rotterdam, Netherlands
(Geva) Department of Cardiology, Boston Children's Hospital, Boston, MA,
United States
(Moons) Department of Public Health and Primary Care, KU Leuven, Flanders,
Leuven, Belgium
(Moons) Institute of Health and Care Sciences, University of Gothenburg,
Vastra Gotaland, Goteborg, Sweden
(Van De Bruaene, Budts) Congenital and Structural Cardiology, KU Leuven
University Hospitals Leuven, Flanders, Leuven, Belgium
Publisher
BMJ Publishing Group
Abstract
Objective Children and adults with repaired tetralogy of Fallot (rTOF)
have an impaired exercise capacity, a less active lifestyle and an
increased long-term risk of adverse outcomes compared with healthy peers.
This study aimed to summarise the current evidence for the effectiveness
and safety of exercise training interventions in patients with rTOF.
Methods PubMed/MEDLINE, EMBASE, the Cochrane Central Register of
Controlled Trials (CENTRAL), Web of Science, Scopus and reference lists of
relevant articles were searched for prospective studies published by
November 2021. Random-effects meta-analysis and descriptive synthesis were
performed to assess the effectiveness and safety of exercise training in
patients with rTOF. Results Of the 9677 citations identified, 12 articles
were included that reported on 10 unique studies and covered 208 patients
with rTOF (range of mean/median age: 7.4-43.3 years). All studies
implemented 2 to 7 aerobic or respiratory training sessions per week with
durations ranging from 6 to 26 weeks. Meta-analysis of the included
randomised controlled trials showed that exercise training was associated
with a significant improvement in peak VO 2 (pooled mean difference: +3.1
mL/min/kg; 95% CI: 0.76 to 5.36 mL/min/kg, p=0.019). Cardiac imaging
studies revealed no subclinical adverse remodelling after the exercise
interventions. No serious adverse events including arrhythmias were
reported in these studies. Conclusion Current evidence suggests that
exercise training can improve exercise capacity in patients with rTOF with
a low risk for adverse events. Exercise prescription may be a safe and
effective tool to help improving outcomes in patients with rTOF. PROSPERO
registration number CRD42021292809. Copyright © Author(s) (or
their employer(s)) 2023. No commercial re-use. See rights and permissions.
Published by BMJ.

<77>
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

<78>
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.

<79>
Accession Number
2024223923
Title
Definitions of massive transfusion in adults with critical bleeding: a
systematic review.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 265. Date of
Publication: December 2023.
Author
Lin V.S.; Sun E.; Yau S.; Abeyakoon C.; Seamer G.; Bhopal S.; Tucker H.;
Doree C.; Brunskill S.J.; McQuilten Z.K.; Stanworth S.J.; Wood E.M.; Green
L.
Institution
(Lin, McQuilten, Wood) Transfusion Research Unit, School of Public Health
and Preventive Medicine, Monash University, Melbourne, Australia
(Sun) Faculty of Medicine, Dentistry and Health Sciences, University of
Melbourne, Parkville, Australia
(Yau, Seamer, Bhopal) Faculty of Medicine, Nursing, and Health Sciences,
Monash University, Clayton, Australia
(Abeyakoon, McQuilten, Wood) Department of Clinical Haematology, Monash
Health, Clayton, Australia
(Tucker, Green) Blizard Institute, Queen Mary University of London,
London, United Kingdom
(Doree, Brunskill, Stanworth) Systematic Review Initiative, NHS Blood and
Transplant, Oxford, United Kingdom
(Stanworth) Radcliffe Department of Medicine, University of Oxford,
Oxford, United Kingdom
(Stanworth) National Institute for Health Research Biomedical Research
Centre Haematology Theme, Oxford, United Kingdom
(Stanworth) Department of Haematology, Oxford University Hospitals NHS
Foundation Trust, Oxford, United Kingdom
(Green) NHS Blood and Transplant, London, United Kingdom
(Green) Barts Health NHS Trust, London, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Definitions for massive transfusion (MT) vary widely between
studies, contributing to challenges in interpretation of research findings
and practice evaluation. In this first systematic review, we aimed to
identify all MT definitions used in randomised controlled trials (RCTs) to
date to inform the development of consensus definitions for MT.
 Method(s): We systematically searched the following databases for
RCTs from inception until 11 August 2022: MEDLINE, Embase, Cochrane
Central Register of Controlled Trials (CENTRAL), PubMed, Cumulative Index
to Nursing and Allied Health Literature, and Transfusion Evidence Library.
Ongoing trials were sought from CENTRAL, ClinicalTrials.gov, and World
Health Organisation International Clinical Trials Registry Platform. To be
eligible for inclusion, studies had to fulfil all the following three
criteria: (1) be an RCT; (2) include an adult patient population with
major bleeding who had received, or were anticipated to receive, an MT in
any clinical setting; and (3) specify a definition for MT as an inclusion
criterion or outcome measure. Result(s): Of the 8,458 distinct
references identified, 30 trials were included for analysis (19 published,
11 ongoing). Trauma was the most common clinical setting in published
trials, while for ongoing trials, it was obstetrics. A total of 15
different definitions of MT were identified across published and ongoing
trials, varying greatly in cut-offs for volume transfused and time period.
Almost all definitions specified the number of red blood cells (RBCs)
within a set time period, with none including plasma, platelets or other
haemostatic agents that are part of contemporary transfusion
resuscitation. For completed trials, the most commonly used definition was
transfusion of >= 10 RBC units in 24 h (9/19, all in trauma), while for
ongoing trials it was 3-5 RBC units (n = 7), with the timing for
transfusion being poorly defined, or in some trials not provided at all (n
= 5). Conclusion(s): Transfusion of >= 10 RBC units within 24 h was
the most commonly used definition in published RCTs, while lower RBC
volumes are being used in ongoing RCTs. Any consensus definitions should
reflect the need to incorporate different blood components/products for MT
and agree on whether a 'one-size-fits-all' approach should be used across
different clinical settings. Copyright © 2023, The Author(s).

<80>
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.

<81>
Accession Number
640792941
Title
Systemic opioids versus other analgesics and sedatives for postoperative
pain in neonates.
Source
Cochrane Database of Systematic Reviews. 2023(3) (no pagination), 2023.
Article Number: CD014876. Date of Publication: 03 Mar 2023.
Author
Kinoshita M.; Stempel K.S.; Borges do Nascimento I.J.; Bruschettini M.
Institution
(Kinoshita) Department of Pediatrics, Clinical Sciences Lund, Lund
University, Lund, Sweden
(Kinoshita) Fetal Medicine Research Center, University of Barcelona,
Barcelona, Spain
(Stempel) Faculty of Medicine, Lund University, Lund, Sweden
(Borges do Nascimento) School of Medicine and University Hospital,
Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
(Borges do Nascimento) Department of Medicine, Medical College of
Wisconsin, Milwaukee, WI, United States
(Bruschettini) Department of Clinical Sciences Lund, Paediatrics, Lund
University, Skane University Hospital, Lund, Sweden
(Bruschettini) Cochrane Sweden, Lund University, Skane University
Hospital, Lund, Sweden
Publisher
John Wiley and Sons Ltd
Abstract
Background: Neonates may undergo surgery because of malformations such as
diaphragmatic hernia, gastroschisis, congenital heart disease, and
hypertrophic pyloric stenosis, or complications of prematurity, such as
necrotizing enterocolitis, spontaneous intestinal perforation, and
retinopathy of prematurity that require surgical treatment. Options for
treatment of postoperative pain include opioids, non-pharmacological
interventions, and other drugs. Morphine, fentanyl, and remifentanil are
the opioids most often used in neonates. However, negative impact of
opioids on the structure and function of the developing brain has been
reported. The assessment of the effects of opioids is of utmost
importance, especially for neonates in substantial pain during the
postoperative period. Objective(s): To evaluate the benefits and
harms of systemic opioid analgesics in neonates who underwent surgery on
all-cause mortality, pain, and significant neurodevelopmental disability
compared to no intervention, placebo, non-pharmacological interventions,
different types of opioids, or other drugs. Search Method(s): We
searched Cochrane CENTRAL, MEDLINE via PubMed and CINAHL in May 2021. We
searched the WHO ICTRP, clinicaltrials.gov, and ICTRP trial registries. We
searched conference proceedings, and the reference lists of retrieved
articles for RCTs and quasi-RCTs. Selection Criteria: We included
randomized controlled trials (RCTs) conducted in preterm and term infants
of a postmenstrual age up to 46 weeks and 0 days with postoperative pain
where systemic opioids were compared to 1) placebo or no intervention; 2)
non-pharmacological interventions; 3) different types of opioids; or 4)
other drugs. Data Collection and Analysis: We used standard Cochrane
methods. Our primary outcomes were pain assessed with validated methods,
all-cause mortality during initial hospitalization, major
neurodevelopmental disability, and cognitive and educational outcomes in
children more than five years old. We used the fixed-effect model with
risk ratio (RR) and risk difference (RD) for dichotomous data and mean
difference (MD) for continuous data. We used GRADE to assess the certainty
of evidence for each outcome. Main Result(s): We included four RCTs
enrolling 331 infants in four countries across different continents. Most
studies considered patients undergoing large or medium surgical procedures
(including major thoracic or abdominal surgery), who potentially required
pain control through opioid administration after surgery. The randomized
trials did not consider patients undergoing minor surgery (including
inguinal hernia repair) and those individuals exposed to opioids before
the beginning of the trial. Two RCTs compared opioids with placebo; one
fentanyl with tramadol; and one morphine with paracetamol. No
meta-analyses could be performed because the included RCTs reported no
more than three outcomes within the prespecified comparisons. Certainty of
the evidence was very low for all outcomes due to imprecision of the
estimates (downgrade by two levels) and study limitations (downgrade by
one level). Comparison 1: opioids versus no treatment or placebo. Two
trials were included in this comparison, comparing either tramadol or
tapentadol with placebo. No data were reported on the following critical
outcomes: pain; major neurodevelopmental disability; or cognitive and
educational outcomes in children more than five years old. The evidence is
very uncertain about the effect of tramadol compared with placebo on
all-cause mortality during initial hospitalization (RR 0.32, 95%
Confidence Interval (CI) 0.01 to 7.70; RD -0.03, 95% CI -0.10 to 0.05, 71
participants, 1 study; I2 = not applicable). No data were reported on:
retinopathy of prematurity; or intraventricular hemorrhage. Comparison 2:
opioids versus non-pharmacological interventions. No trials were included
in this comparison. Comparison 3: head-to-head comparisons of different
opioids. One trial comparing fentanyl with tramadol was included in this
comparison. No data were reported on the following critical outcomes:
pain; major neurodevelopmental disability; or cognitive and educational
outcomes in children more than five years old. The evidence is very
uncertain about the effect of fentanyl compared with tramadol on all-cause
mortality during initial hospitalization (RR 0.99, 95% CI 0.59 to 1.64; RD
0.00, 95% CI -0.13 to 0.13, 171 participants, 1 study; I2 = not
applicable). No data were reported on: retinopathy of prematurity; or
intraventricular hemorrhage. Comparison 4: opioids versus other analgesics
and sedatives. One trial comparing morphine with paracetamol was included
in this comparison. The evidence is very uncertain about the effect of
morphine compared with paracetamol on COMFORT pain scores (MD 0.10, 95% CI
-0.85 to 1.05; 71 participants, 1 study; I2 = not applicable). No data
were reported on the other critical outcomes, i.e. major
neurodevelopmental disability; cognitive and educational outcomes in
children more than five years old, all-cause mortality during initial
hospitalization; retinopathy of prematurity; or intraventricular
hemorrhage. Authors' conclusions: Limited evidence is available on opioid
administration for postoperative pain in newborn infants compared to
either placebo, other opioids, or paracetamol. We are uncertain whether
tramadol reduces mortality compared to placebo; none of the studies
reported pain scores, major neurodevelopmental disability, cognitive and
educational outcomes in children older than five years old, retinopathy of
prematurity, or intraventricular hemorrhage. We are uncertain whether
fentanyl reduces mortality compared to tramadol; none of the studies
reported pain scores, major neurodevelopmental disability, cognitive and
educational outcomes in children older than five years old, retinopathy of
prematurity, or intraventricular hemorrhage. We are uncertain whether
morphine reduces pain compared to paracetamol; none of the studies
reported major neurodevelopmental disability, cognitive and educational
outcomes in children more than five years old, all-cause mortality during
initial hospitalization, retinopathy of prematurity, or intraventricular
hemorrhage. We identified no studies comparing opioids versus
non-pharmacological interventions. Copyright © 2023 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<82>
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.

<83>
Accession Number
2023891247
Title
Effect of Nicorandil, Diltiazem, or Isosorbide Mononitrate for Oral
Antispastic Therapy After Coronary Artery Bypass Grafting Using Radial
Artery Grafts-A Pilot Randomized Controlled Trial (ASRAB-Pilot): Rationale
and Study Protocol.
Source
Advances in Therapy. 40(8) (pp 3588-3597), 2023. Date of Publication:
August 2023.
Author
Zhu Y.; Qing K.; Liu Y.; Yao H.; Zhang W.; Zhao Q.
Institution
(Zhu, Qing, Liu, Yao, Zhao) Department of Cardiovascular Surgery, Ruijin
Hospital Shanghai Jiao Tong University School of Medicine, No.197 Ruijin
Er Road, Shanghai, China
(Zhang) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai, China
Publisher
Adis
Abstract
Introduction: The current evidence for chronic oral antispastic medication
use after coronary artery bypass grafting using radial artery grafts
(RA-CABG) is controversial. Calcium channel blockers, such as diltiazem,
are the most commonly used antispastic medications after RA-CABG; other
options include nitrates and nicorandil, but to date no sufficiently
powered randomized controlled trials have been conducted to compare their
efficacy. Method(s): This is a single-center, open-label, parallel
three-arm, pilot randomized controlled trial. Patients without
contraindications to any study medications and who successfully underwent
RA-CABG surgery will be consecutively screened. Eligible patients will be
randomized in a ratio of 1:1:1 (a total of 150 patients, 50 per arm) to
receive nicorandil 5 mg orally thrice daily, diltiazem 180 mg orally once
daily, or isosorbide mononitrate 50 mg orally once daily for 24 weeks. The
primary outcomes are RA graft failure at week 1 and week 24. The secondary
outcomes include major adverse cardiovascular event (MACE, a composite of
all-cause death, myocardial infarction, stroke, and unplanned
revascularization) and angina recurrence. The safety outcomes include
hypotension occurrence, withdrawal of renin angiotensin aldosterone system
inhibitors, serious adverse events, and other concerned adverse events
within 24 weeks. Conclusion(s): This pilot trial will compare the
preliminary effects of nicorandil, diltiazem, and isosorbide mononitrate
on angiographic and clinical outcomes in patients who have undergone
RA-CABG. Recruitment began in June 2020, and the estimated primary
completion date is early 2023. Results of this study will provide much
needed information for design of large confirmatory trials on the
effectiveness of oral antispastic medications after RA-CABG. Copyright
© 2023, The Author(s), under exclusive licence to Springer Healthcare
Ltd., part of Springer Nature.

<84>
Accession Number
2022489959
Title
Effect of Perioperative Oral Vitamin C Supplementation on In-Hospital
Postoperative Medication Costs for Cardiac Surgery Patients: A
Prospective, Single-Centre, Randomised Clinical Trial.
Source
PharmacoEconomics - Open. 7(4) (pp 655-663), 2023. Date of Publication:
July 2023.
Author
Heerman J.; Boydens C.; Allaert S.; Cathenis K.; Deryckere K.;
Vanoverschelde H.
Institution
(Heerman, Boydens, Allaert, Vanoverschelde) Department of Anaesthesia and
Intensive Care, AZ Maria Middelares Hospital, Buitenring Sint-Denijs 30,
Ghent 9000, Belgium
(Cathenis) Department of Cardiac Surgery, AZ Maria Middelares Hospital,
Buitenring Sint-Denijs 30, Ghent 9000, Belgium
(Deryckere) Department of Pharmaceutics, AZ Maria Middelares Hospital,
Buitenring Sint-Denijs 30, Ghent 9000, Belgium
Publisher
Adis
Abstract
Background: Due to its antioxidant properties, vitamin C might be a
promising and effective strategy for preventing postoperative atrial
fibrillation (POAF) after cardiac surgery. This study was aimed at
evaluating whether vitamin C supplementation is effective in reducing the
cost of in-hospital postoperative medication used for patients undergoing
coronary artery bypass (CABG) or valve surgery (+/-CABG).
 Objective(s): The primary goal of this study was to evaluate the
impact of perioperative vitamin C supplementation in patients undergoing
cardiac surgery on in-hospital postoperative medication costs, while
secondary endpoints were the effects on length of stay (LOS) in both the
intensive care unit (ICU) and the hospital, and the incidence of POAF.
 Material(s) and Method(s): From November 2018 to January 2021, 253
patients planned for CABG or valve surgery (+/-CABG) in AZ Maria
Middelares, Ghent, Belgium, and who met the inclusion criteria (>=18 years
of age, all having cardiac sinus rhythm, and who provided written informed
consent) were randomised into a placebo group or vitamin C group. The
medication was administered orally (1 g twice daily), starting from 5 days
preoperatively until 10 days postoperatively. The medication used, LOS in
the hospital/ICU, and development of clinically relevant POAF in the ICU
were registered. Result(s): Mean medication costs were 264.6 +/- 98.1
for patients in the vitamin C group and 294.9 +/- 267.3 for patients in
the placebo group. When stratifying according to the type of surgery (CABG
or valve surgery [+/-CABG]), these costs did not significantly differ.
There was no significant difference in LOS or the incidence of clinically
relevant POAF. Conclusion(s): Our data did not identify any
short-term financial impact on postoperative medication costs after oral
perioperative vitamin C supplementation (1 g twice daily) for patients
undergoing a CABG procedure or valve surgery (+/-CABG). No effect was
found on the LOS or the incidence of clinically relevant POAF. Potential
effects in the longer term, after intravenous administration of vitamin C
or in other types of (cardiac) surgery, are still to be investigated.
Clinical Trials registration number: NCT03592680. Copyright ©
2023, The Author(s).

<85>
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.

<86>
Accession Number
2025147193
Title
The Effect of Supervised Early Resistance Training Versus Aerobic-Based
Rehabilitation on Cognitive Recovery Following Cardiac Surgery Via Median
Sternotomy (SECRET): A Pilot Randomised Controlled Trial.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S61), 2023. Date of Publication: June 2023.
Author
Pengelly J.; Royse C.; Williams G.; Bryant A.; Clarke-Errey S.; Royse A.;
El-Ansary D.
Institution
(Pengelly, Royse, Williams, Bryant, Clarke-Errey, Royse, El-Ansary)
Swinburne University, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Cognitive impairment is a significant complication following
cardiac surgery. This study aimed to investigate the effects of an early
resistance training program compared with aerobic-based rehabilitation on
cognitive recovery following cardiac surgery via median sternotomy.
 Method(s): This was a multicentre, prospective, pragmatic,
non-blinded, pilot randomised controlled trial of two parallel groups: a
12-week early moderate-intensity resistance training (RT) group and an
aerobic training (AT) control group. English-speaking adults (aged >=18
years) undergoing their first elective cardiac surgery via median
sternotomy were randomised 1:1 using sealed envelopes following surgery.
The primary outcome was cognitive function, assessed using the Alzheimer's
Disease Assessment Scale-cognitive subscale (ADAS-cog), preoperatively and
postoperatively (14 weeks and 6 months). Result(s): Thirty-eight
participants were randomised to resistance training (n=20) or
aerobic-based (n=18) intervention. Thirty-one participants completed their
allocated intervention (RT n=14, AT n=17). A significant improvement in
cognitive function occurred in the resistance training group (7.2+/-1.4;
95% CI 4.3, 10.2; p=0.010) compared with the aerobic training group
(9.2+/-1.3; 95% CI 6.6, 11.9) at 14-weeks postoperatively, but not at 6
months (p=0.053). At 14-weeks postoperatively, cognitive decline of >=2
points from baseline ADAS-cog score was experienced by 53% of the aerobic
training group (nine of 17) compared with 0% of the resistance training
group (zero of 14; p=0.001). No major adverse cardiovascular or cerebral
events or serious adverse events were experienced during the study.
 Conclusion(s): Early resistance training, inclusive of upper limb
exercise, may improve cognitive recovery more so than aerobic-based
rehabilitation following cardiac surgery via median
sternotomy. Copyright © 2023

<87>
Accession Number
2025127129
Title
Multicentre, Adaptive, Double-Blind, Three-Arm, Placebo-Controlled,
Noninferiority Trial Examining Antimicrobial Prophylaxis Duration in
Cardiac Surgery: CALIPSO Trial.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S62-S63), 2023. Date of Publication: June 2023.
Author
Peel T.; Myles P.; Smith J.; McGiffin D.; Marasco S.; Forbes A.; Pilcher
D.; Petrie D.; Stewardson A.; Peleg A.; Forster S.; Wisniewski J.; Russo
P.; Astbury S.; Druce P.; Goulding K.; Roney J.
Institution
(Peel, Myles, Smith, McGiffin, Marasco, Forbes, Pilcher, Petrie,
Stewardson, Peleg, Forster, Wisniewski, Russo, Astbury, Druce, Goulding,
Roney) Monash University, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Administration of antibiotics before incision ("surgical
antimicrobial prophylaxis") is a critical infection prevention strategy in
cardiac surgery. Extending doses of prophylaxis into the postoperative
period is common practice in cardiac surgery; however, the benefit has not
been clearly established and may drive emergence of antimicrobial
resistance and lead to patient harm. Recent World Health Organization
guidelines have recommended that prophylaxis be limited to the
intraoperative period only for all surgical procedures, but potential
benefits with extending prophylaxis postoperatively in cardiac surgery
were noted. The efficacy, safety, and microbiome impact of differing
durations of surgical antimicrobial prophylaxis in cardiac surgery have
not been established. Method(s): The CALIPSO trial is a large
(n=9,000), 5-year, multicentre, adaptive, pragmatic, double-blind,
three-arm, placebo-controlled, randomised, non-inferiority clinical trial
examining the optimal duration of antibiotic therapy to prevent infections
in patients undergoing cardiac surgery. The trial compares three different
dosing regimens of surgical antimicrobial prophylaxis administered
following completion of the operation (i.e., postoperative doses):
intraoperatively only; intraoperatively plus 24 hours postoperatively; and
intraoperatively plus 48 hours postoperatively of intravenous cefazolin.
The trial is funded through Australian Medical Research Future Fund
Funding initiative 2022 (APP3914635) and coordinated through the
Australian and New Zealand College of Anaesthetists Clinical Trial Network
(ANZCA CTN). The multidisciplinary investigator team includes infectious
diseases clinicians, anaesthetists, cardiac surgeons, and intensive care
physicians. Copyright © 2023

<88>
Accession Number
2025101258
Title
Epidemiology of Prolonged Opioid Use After Cardiac Surgery: A Systematic
Review and Meta-Analysis.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S63), 2023. Date of Publication: June 2023.
Author
Perry L.; Liu Z.; Smith J.; Karamesinis A.; Plummer M.; Segal R.; Bellomo
R.
Institution
(Perry, Liu, Smith, Karamesinis, Plummer, Segal, Bellomo) The University
of Melbourne, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: The epidemiology of prolonged opioid use at least 3 months
after cardiac surgery is poorly characterised despite its potential public
health importance. Method(s): MEDLINE, Embase, and Google Scholar
were searched from inception to December 2021. Studies reporting the rate
and risk factors of prolonged opioid use after cardiac surgery in
opioid-naive and opioid-exposed patients were included. Incidence rates
and odds ratios (ORs) with 95% confidence intervals (CIs) were recorded
for risk factors from individual studies, and random-effects inverse
variance modelling was used to generate pooled estimates. Result(s):
From 10 studies involving 112,298 patients, the pooled rate of prolonged
opioid use in opioid-naive patients was 5.7% (95% CI 4.2-7.2%). Risk
factors included female gender (OR 1.18; 95% CI 1.09-1.29), smoking (OR
1.34; 95% CI 1.06-1.69), alcohol use (OR 1.43; 95% CI 1.17-1.76), anxiety
(OR 1.17; 95% CI 1.02-1.35), congestive cardiac failure (OR 1.17; 95% CI
1.08-1.27), diabetes (OR 1.21; 95% CI 1.07-1.37), chronic lung disease (OR
1.42; 95% CI 1.16-1.75), chronic kidney disease (OR 1.35; 95% CI
1.08-1.68), perioperative opioid usage (per 10 mg morphine equivalent) (OR
1.01; 95% CI 1.01-1.02), and length of hospital stay (per day) (OR 1.03;
95% CI 1.02-1.04). Preoperative opioid use was the strongest risk factor
for prolonged opioid use in opioid-exposed patients (OR 15.11; 95% CI
6.65-34.35). Conclusion(s): Prolonged opioid use after cardiac
surgery affects at least one in 20 patients. The identification of risk
factors may help target interventions aimed at decreasing its
prevalence. Copyright © 2023

<89>
Accession Number
2025101124
Title
Coronary Revascularisation for Multivessel Disease: A Systematic Review
and Network Meta-Analysis.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S36), 2023. Date of Publication: June 2023.
Author
Gupta A.; Kovoor J.; Jacobsen J.; Edwards S.; Chan J.; Bennetts J.;
Maddern G.
Institution
(Gupta, Kovoor, Jacobsen, Edwards, Chan, Bennetts, Maddern) University of
Adelaide, Adelaide, SA, Australia
Publisher
Elsevier Ltd
Abstract
Background: The optimal revascularisation strategy for multivessel
coronary artery disease (CAD) remains controversial. Evidence suggests
potential superiority of multiple and total arterial approaches to
coronary artery bypass graft (CABG) surgery. However, a randomised
controlled trial (RCT) has not yet directly compared these with
percutaneous coronary intervention (PCI) with drug-eluting stents (DES),
or hybrid coronary revascularisation (HCR) for multivessel CAD. This study
performed a pairwise and network meta-analysis of RCTs comparing
revascularisation strategies for multivessel CAD. Method(s): MEDLINE,
Embase, Cochrane Library, and CINAHL were searched for RCTs comparing
revascularisation strategies for multivessel CAD (single, multiple, total
arterial CABG, PCI with DES, and HCR). Outcomes including all-cause
mortality, stroke, myocardial infarction, and repeat revascularisation
were analysed via network meta-analysis for a duration of up to 10 years.
 Result(s): A total of 28,416 studies were retrieved, of which 18 RCTs
of strong design were included involving a total of 11,150 patients. For
all-cause mortality at 12 months, 2 years, 5 years, and 10 years, there
was a trend favouring multiple and total arterial CABG, but this failed to
achieve statistical significance. Results of analysis of the secondary
outcomes were varied, and PCI was associated with significantly greater
rates of repeat revascularisation compared with CABG modalities.
 Conclusion(s): For patients with multivessel CAD, the current RCT
evidence base is insufficient in size and quality to produce results of
statistical significance regarding comparisons of all-cause mortality
between single, multiple, and total arterial CABG, PCI with DES, and
HCR. Copyright © 2023

<90>
Accession Number
2025101119
Title
Robotic Versus Conventional Sternotomy Mitral Valve Surgery: A Systematic
Review and Meta-Analysis.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S3), 2023. Date of Publication: June 2023.
Author
Williams M.; Hwang B.; Huang L.; Wilson-Smith A.; Brookes J.; Eranki A.;
Yan T.
Institution
(Williams, Hwang, Huang, Wilson-Smith, Brookes, Eranki, Yan) Department of
Cardiothoracic Surgery, Dunedin Hospital, Dunedin, New Zealand
Publisher
Elsevier Ltd
Abstract
Background: Robotic mitral valve surgery (RMVS) is becoming an
increasingly performed procedure in cardiac surgery. However, its safety
and efficacy compared with the gold standard conventional sternotomy
approach (CSMVS) remains debated. This meta-analysis aimed to provide a
comprehensive review of the literature comparing RMVS with CSMVS.
 Method(s): Electronic searches of five databases were performed to
identify relevant studies comparing RMVS with CSMVS. Predefined primary
outcomes of interest included all-cause mortality, cerebrovascular
accidents (CVA), and reoperation for bleeding. Other operative and
postoperative outcomes were secondary outcomes of interest.
 Result(s): Fourteen studies qualified for inclusion in this
meta-analysis. Outcomes of 6,341 patients (2,804 RMVS and 3,537 CSMVS)
were included. Robotic MVS had significantly lower mortality when compared
with CSMVS (OR 0.33; 95% CI 0.19-0.57; p<0.0001). There was no significant
between-group difference in rates of CVA or reoperation for bleeding. The
CSMVS had significantly shorter cross-clamp time by 28.3 minutes (95% CI
19.3-37.3; p<0.0001) and cardiopulmonary bypass time by 48.6 minutes (95%
CI 36.2-61.0; p<0.0001). Robotic MVS had shorter ICU (MD 26.4 hours; 95%
CI -34.3 to -18.5; p<0.0001) and hospital LOS (MD 2.0 days; 95% CI -2.7 to
-1.4; p<0.0001). The RMVS group also had fewer red blood cell transfusions
(OR 0.44; 95% CI 0.28-0.70; p=0.0004). Conclusion(s): Current
evidence on comparative outcomes of RMVS and CSMVS is limited, with only
low-quality studies available. This meta-analysis suggests that RMVS may
have lower mortality and shorter ICU and hospital LOS; however, CSMVS may
be associated with significantly shorter cross-clamp and cardiopulmonary
bypass times. Copyright © 2023

<91>
Accession Number
2025101113
Title
Systematic Review and Meta-Analysis of Mid-Term Survival, Reoperation, and
Recurrent Mitral Regurgitation for Robotic-Assisted Mitral Valve Repair.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S20), 2023. Date of Publication: June 2023.
Author
Hwang B.; Williams M.; Eranki A.; Mamo A.; Wilson-Smith A.; Yan T.
Institution
(Hwang, Williams, Eranki, Mamo, Wilson-Smith, Yan) The Collaborative
Research (CORE) Group, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Over the past two decades, surgical approaches for mitral
valve (MV) disease have evolved with the advent of minimally invasive
techniques. The safety and efficacy of robotic MV repair (RMVr) has been
well documented; however, mid- to long-term data are limited. This review
aimed to provide a comprehensive analysis of the available mid- to
long-term data for RMVr. Method(s): An electronic search of five
databases was performed to identify all relevant studies reporting minimum
5-year data on RMVr. Primary outcomes of interest were overall survival at
>=5 years, freedom from MV reoperation and from significant mitral
regurgitation (MR). A random-effects meta-analysis of proportions or means
was performed to aggregate the data. Kaplan-Meier curves were aggregated
using reconstructed individual patient data. Result(s): Nine studies
totalling 3,300 patients undergoing RMVr were identified. Rates of overall
survival at 1, 5, and 10 years were 99.2%, 97.4%, and 92.3%, respectively.
Freedom from MV reoperation at 8 years post-RMVr was 95.0%. Freedom from
moderate or worse MR at 7 years was 86.0%. Rates of early postoperative
complications were low, with 0.2% all-cause mortality and 1.0%
cerebrovascular accident. Reoperation for bleeding was low at 2.2% and
successful RMVr was 99.8%. Mean intensive care unit and hospital stays
were 22.4 hours and 5.2 days, respectively. Conclusion(s): Robotic MV
repair is a safe and effective procedure, with low rates of early
mortality and postoperative complications when performed in high-volume,
experienced centres. Evaluation of available mid- to long-term data
post-RMVr suggests favourable rates of overall survival, freedom from MV
reoperation, and freedom from moderate or worse MR
recurrence. Copyright © 2023

<92>
Accession Number
2025101022
Title
Coronary Artery Bypass Surgery for Acute Coronary Syndrome: A Network
Meta-Analysis of On-Pump Cardioplegic Arrest, Off-Pump and On-Pump Beating
Heart Strategies.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S4-S5), 2023. Date of Publication: June 2023.
Author
Hwang B.; Williams M.; Tian D.; Yan T.; Misfeld M.
Institution
(Hwang, Williams, Tian, Yan, Misfeld) University of New South Wales,
Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Coronary artery bypass grafting (CABG) in the setting of an
acute coronary syndrome is a high-risk procedure, and the best strategy
for myocardial revascularisation remains debated. This study aimed to
compare the 30-day mortality benefit of on-pump CABG (ONCAB), off-pump
CABG (OPCAB), and on-pump beating heart CABG (OnBHCAB) strategies.
 Method(s): A systematic search of PubMed, Embase, and CENTRAL was
conducted for studies comparing ONCAB with OPCAB or OnBHCAB in patients
with acute coronary syndrome (ACS). The 30-day mortality of the three
approaches was compared using a Bayesian hierarchical network
meta-analysis (NMA). A random effects consistency model was applied, and
direct and indirect comparisons were made to determine the relative
effectiveness of each strategy on postoperative outcomes. Result(s):
One randomised controlled trial and 18 observational studies fulfilling
the inclusion criteria were identified. A total of 4,320, 5,559, and 1,962
patients underwent ONCAB, OPCAB, and OnBHCAB, respectively. The NMA showed
that OPCAB (OR 0.50; 95% CrI 0.23-1.00) had the highest probability of
ranking as the most effective treatment in terms of 30-day mortality,
followed by OnBHCAB (OR 0.62; 95% CrI 0.20-1.57); however, the 95%
credible interval crossed or included unity. A subgroup NMA of nine
studies assessing only acute myocardial infarction (AMI) patients
demonstrated a 72% reduction in likelihood of 30-day mortality after OPCAB
(CrI 0.07-0.83). No significant increase in rate of stroke, renal
dysfunction, or length of intensive care unit stay was found for either
strategy. Conclusion(s): Although no single best surgical
revascularisation approach in ACS patients was identified, the significant
mortality benefit with OPCAB seen in AMI suggests that high acuity
patients may benefit most from avoiding further myocardial inflammatory
and ischaemic injury associated with cardiopulmonary bypass and
cardioplegic arrest. Copyright © 2023

<93>
Accession Number
2025100995
Title
Bilateral Versus Single Internal Thoracic Artery Grafting for Elderly
Patients Undergoing Coronary Revascularisation for Multivessel Disease: A
Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S7), 2023. Date of Publication: June 2023.
Author
Gupta A.; Kovoor J.; Nathin K.; Aujayeb N.; Litwin P.; Chong E.; Stretton
B.; Hewitt J.; Ovenden C.; Jacobsen J.; Edwards S.; Chan J.; Maddern G.;
Bennetts J.
Institution
(Gupta, Kovoor, Nathin, Aujayeb, Litwin, Chong, Stretton, Hewitt, Ovenden,
Jacobsen, Edwards, Chan, Maddern, Bennetts) University of Adelaide,
Adelaide, SA, Australia
Publisher
Elsevier Ltd
Abstract
Background: International guidelines suggest that multiple arterial
grafting is preferred for young patients undergoing coronary artery bypass
graft (CABG) surgery for multivessel disease. Limited data exist comparing
outcomes of single internal thoracic artery (SITA) with bilateral internal
thoracic artery (BITA) grafting in elderly patients. Method(s):
MEDLINE, Embase, Cochrane Library, and CINAHL were searched for
comparative studies of patients aged >=65 years undergoing CABG using
either SITA or BITA conduit strategies. The primary endpoint was all-cause
early mortality and secondary endpoints were stroke, myocardial infarction
(MI), and deep sternal wound infection (DSWI). Result(s): A total of
2,982 studies were retrieved, of which 22 retrospective studies of
moderate quality design were included, involving 25,743 patients (14,922
SITA, 10,821 BITA). Odds ratios of all-cause early mortality and adverse
events for SITA and BITA groups were pooled using a random effects
meta-analysis model. Significant heterogeneity was demonstrated using the
I2 statistic (99.8%) and Cochran's Q p-value (<0.0001). Early
mortality associated with BITA was lower (OR 0.79; 95% CI 0.70-0.89),
whilst DSWI was significantly higher (OR 1.62; 95% CI 1.29-2.04). There
was no significant association for stroke or MI. Conclusion(s): This
study reports the largest analysis investigating the use of BITA in
elderly patients. Non-propensity matched analysis showed that early
mortality was reduced in the BITA group, whilst the incidence of DSWI was
considerably higher. Longer-term follow-up and analysis of all-cause
mortality and adverse events should be undertaken through
propensity-matched systematic review and adequately powered randomised
controlled trials. Copyright © 2023

<94>
Accession Number
2025100993
Title
Ultrasound Guidance Versus Palpation Technique for Arterial Line
Insertion: A Prospective Randomised Trial.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S66), 2023. Date of Publication: June 2023.
Author
Van Der Merwe L.; Rapchuk I.
Institution
(Van Der Merwe, Rapchuk) The Prince Charles Hospital, Brisbane, QLD,
Australia
Publisher
Elsevier Ltd
Abstract
Background: Arterial line (IAL) insertion is a core procedure in
cardiothoracic anaesthesia and can prove challenging at times. Anaesthetic
trainees (ATs) in the current era are experienced in the use of ultrasound
(US) guidance for vascular access, which has become common practice and
increasingly available. This study sought to determine the impact of US on
IAL success by ATs in cardiothoracic patients at the current institution.
 Method(s): A single-centre, prospective, randomised trial was
conducted of IAL insertion using the palpation technique (PT) or US by ATs
in patients who presented for cardiothoracic surgery. Outcome measures
were total time taken for successful insertion, number of attempts, need
for US rescue in the PT group, and localised complications (pain, arterial
injury, swelling, bruising, ooze). Result(s): Between October 2020
and June 2021, 15 ATs placed IALs in 106 patients using either PT (52 of
106) or US (54 of 106). Mean total time taken for insertion using PT was
239 seconds (range 68-986) vs US 178 seconds (range 74-887) (p<0.05). The
median number of attempts using PT was one pass (range 1-4) vs one pass
(range 1-3) using US. The failure rate of PT with conversion to US was
35%. Complications were reported in 10 of 52 in the PT group and 13 of 54
in the US group. Conclusion(s): The use of US guidance for the
placement of IALs in cardiothoracic patients by ATs reduced the time taken
for the procedure. The failure rate in the palpation group was
significant, necessitating conversion to US guidance and highlighting the
need for US availability in this patient population. Localised
complications were mostly minor, although remained relevant in both
groups. Copyright © 2023

<95>
Accession Number
2025100980
Title
Perceval Valve Intermediate Outcomes: A Systematic Review and
Meta-Analysis at 5-Year Follow-Up.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S4), 2023. Date of Publication: June 2023.
Author
Jolliffe J.; Moten S.; Tripathy A.; Skillington P.; Tatoulis J.; Muneretto
C.; Di Bacco L.; Figueiredo Galvao H.B.; Goldblatt J.
Institution
(Jolliffe, Moten, Tripathy, Skillington, Tatoulis, Muneretto, Di Bacco,
Figueiredo Galvao, Goldblatt) The Royal Melbourne Hospital, Melbourne,
VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: New technologies for the treatment of aortic stenosis are
evolving to minimise risk and treat an increasingly comorbid population.
The sutureless Perceval Valve is one such alternative. Whilst short-term
data are promising, there have been limited mid-term outcomes until now.
This is the largest systematic review and meta-analysis to evaluate
mid-term outcomes in the Perceval Valve in isolation. Method(s): A
systematic literature review of five databases was performed. Articles
included evaluated echocardiographic and mortality outcomes beyond 5 years
in patients who had undergone Perceval Valve aortic valve replacement. Two
reviewers extracted and reviewed the articles. Weighted estimates were
performed for all postoperative and mid-term data. Aggregated Kaplan Meier
curves were reconstructed from digitised images to evaluate long-term
survival. Result(s): Four multicentre observational studies were
identified, with a total number of 1,649 patients analysed. EuroSCORE
weighted average was 11.3. Aggregated survival at 1, 2, 3, 4, and 5 years
was 94.6%, 91.8%, 88.52%, 84.6%, and 80.8%, respectively. Permanent
pacemaker implantation (7.6%), severe paravalvular leak (1.9%), structural
valve deterioration (1%), stroke (4.4%), endocarditis (2%), and valve
explant (2.9%) were acceptable at up to 5-year follow-up. Haemodynamics
were also acceptable at up to 5 years, with mean valve gradient (range
8.8-13.6 mmHg), peak valve gradient (17.8-22.3 mmHg), and effective
orifice area (1.5-1.8 cm2) across all valve sizes.
Cardiopulmonary bypass (66.2 minutes) and aortic cross-clamp times (41.6
minutes) were also favourable. Conclusion(s): It is believed that
this represents the first meta-analysis to date evaluating mid-term
outcomes of the Perceval Valve in isolation and demonstrates good 5-year
mortality, haemodynamic and morbidity outcomes. Copyright © 2023

<96>
Accession Number
2025100972
Title
Intracranial Atherosclerosis and Postoperative Stroke Following Coronary
Artery Bypass Surgery: A Literature Review.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S5), 2023. Date of Publication: June 2023.
Author
Yang A.
Institution
(Yang) Austin Health, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Stroke is a devastating complication of cardiac surgery.
Extracranial carotid atherosclerosis (ECAS) is a risk factor for
postoperative stroke, but there is limited insight into the effect of
intracranial atherosclerosis (ICAS). It is believed that this is the first
literature review investigating ICAS and postoperative stroke in a cardiac
surgery patient cohort. This review aimed to explore the prevalence and
predictors of intracranial ICAS, association with postoperative stroke,
and treatment options in patients with ICAS undergoing cardiac surgery.
 Method(s): A systematic literature search was performed using the key
words: "stroke", "intracranial atherosclerosis", "intracranial stenosis",
"intracranial atherosclerotic disease", "coronary artery bypass", and
"cardiac surgery". Databases included PubMed, Embase, and Google Scholar.
Prospective and retrospective studies, case reports, and references of all
included articles were screened for completeness. Result(s): Sixteen
studies were reviewed. Prevalence of ICAS in pre-coronary artery bypass
grafting patients was 7.3-36.4%. Older age, female gender, hypertension,
diabetes, cerebrovascular disease, peripheral vascular disease, and left
main disease were significantly associated with ICAS. Six of seven (85%)
studies found a significant association between ICAS and postoperative
stroke or neurological complications. Preoperative single photon emission
computed tomography with acetazolamide challenge or staged intracerebral
revascularisation are described perioperative treatment options for ICAS.
 Conclusion(s): Intracranial atherosclerosis may be the cause of
previously unexplained postoperative stroke or neurological complications.
Several predictors for ICAS have been demonstrated, identifying a subset
of patients who may benefit from preoperative screening for ICAS. Further
research should include larger, more diverse cohorts. Evidence-based
management guidelines should be developed for this important risk factor
for stroke. Copyright © 2023

<97>
Accession Number
2025100971
Title
Levosimendan Preloading in Low Ejection Fraction Cardiac Surgery Patients.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S48), 2023. Date of Publication: June 2023.
Author
Balachandran V.; Huang L.; Beukes L.; Mejia R.; James A.; Singh T.; Seah
P.
Institution
(Balachandran, Huang, Beukes, Mejia, James, Singh, Seah) John Hunter
Hospital, Newcastle, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: A low cardiac output state (LCOS) after cardiac surgery has
been variously defined in global literature but has a common consensus on
the consequence-increased mortality and morbidity. Levosimendan, with its
interesting inotropic properties, has been used to combat this situation
and has led to many meta-analyses and clinical trials over the years. The
bulk of global literature focuses on prescribing levosimendan as an
infusion at induction of anaesthesia or in the immediate postoperative
period. This study presents data from a 6-year period with the use of
levosimendan as a 24-hour preoperative infusion to prevent LCOS.
 Conclusion(s): Based on this study, levosimendan preloading may
confer an improvement in 30-day mortality rates and cardiac
index. Copyright © 2023

<98>
Accession Number
2025100968
Title
Vein Harvesting Techniques in Coronary Artery Bypass Grafting: A
Prospective Comparative Observational Study.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S6), 2023. Date of Publication: June 2023.
Author
Harris-Nave C.; Henwood M.; Doi A.; Martin C.; McGiffin D.; Gangahanumaiah
S.
Institution
(Harris-Nave, Henwood, Doi, Martin, McGiffin, Gangahanumaiah) Alfred
Hospital, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Despite well-established recommendations for endoscopic vein
harvesting (EVH) internationally, open vein harvesting (OVH) is still the
main harvesting technique for the great saphenous vein in coronary artery
bypass graft (CABG) surgery in Australia. At the Alfred Hospital, EVH is
currently being performed by perioperative nurse surgical assistants
(PNSA) on patients who are high risk for postoperative leg wound
complications. This study aimed to compare and evaluate postoperative leg
wound complications of both EVH and OVH at the Alfred Hospital.
 Method(s): Patients undergoing CABG were recruited for this
prospective non-randomised comparative observational study. The EVH was
performed by two PNSAs and one consultant, OVH was performed by two PNSAs,
residents, registrars and/or consultants. Intraoperative data were
collected, and postoperative wound assessments were performed on the ward
at day 5 and via telephone at 6 weeks. Result(s): Patients in the EVH
group had fewer instances of infective and non-infective wound
complications despite the OVH patients being lower risk for leg wound
complications. The infection rates in the EVH and OVH groups were 1.6% and
11.5%, respectively (p<0.001). The EVH group experienced less pain and
better cosmetic results. Repairs to the vein were more common in the EVH
group; however, this did not have any impact on early surgical outcomes.
 Conclusion(s): In patients undergoing CABG at the Alfred Hospital, it
was found that with the use of experienced PNSA EVH harvesters, EVH was
found to have fewer leg wound complications. Further investigation into
the long-term outcomes such as major adverse cardiovascular events will
need to be evaluated. Copyright © 2023

<99>
Accession Number
2025100956
Title
First Hundred Off-Pump Coronary Artery Bypass Grafting Using Only
Acrobat-SUV Stabilizer: How to Do It.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S4), 2023. Date of Publication: June 2023.
Author
Ziaur R.M.; Choudhury S.R.; Biswas S.K.
Institution
(Ziaur, Choudhury, Biswas) National Heart Foundation Hospital & RI, Dhaka,
Bangladesh
Publisher
Elsevier Ltd
Abstract
Background: Off-pump coronary artery bypass grafting (OPCAB) avoids the
deleterious systemic inflammatory effects of the extracorporeal circuit.
When a patient must pay all treatment expenses, cost cutting becomes very
important to the treating surgeon. Considering both factors, an
Acrobat-SUV heart stabiliser was used in the first 110 OPCAB patients to
keep the expenditure minimal; the results were analysed at the end of 5
years. Method(s): The first 110 patients scheduled for OPCAB
performed by one surgeon in a single centre from November 2015 to June
2017 were randomly assigned to this study. The primary short-term endpoint
was death or complications (atrial fibrillation, stroke, acute kidney
injury) within 30 days after surgery. The primary long-term endpoint was
death or complications (myocardial infarction, renal failure, reappearance
of angina) after 30 days to approximately 5 years of follow-up. Secondary
short-term end points included number of grafts, duration of intensive
care unit (ICU) stay, and duration of hospital stay before discharge.
Secondary long-term end points were repeat revascularisation - either
percutaneous coronary interventions or redo-CABG. Result(s): There
was no mortality. Seven patients had atrial fibrillation (6.4%), one had a
stroke (0.9%), and 14 had acute kidney injury (12.7%) within 30 days. The
mean duration of follow-up was 4.8+/-0.51 years. Three patients had died
after 30 days (2.7%), one had died at 3 years post-surgery and tow had
died at 4 years post-surgery. Four had re-appearance of angina (3.6%),
four had myocardial infarction (3.6%), and there was no renal failure. The
average number of grafts was 3.3+/-0.77, duration of ICU stay was
1.06+/-0.25 days, and duration of hospital stay was 5.17+/-0.43 days. No
repeat revascularisation was required. Conclusion(s): In a country
like Bangladesh, where one of the indications for CABG is financial
inadequacy, performing OPCAB with only an Acrobat-SUV stabiliser (Cost
US$1,150 including taxes) with good results could immensely help the
general population. However, it has a steep learning curve, and a team
approach is of paramount importance to master this. Copyright ©
2023

<100>
Accession Number
2025100955
Title
Contemporary Outcomes of Continuous-Flow Left Ventricular Assist Devices:
A Systematic Review.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S24), 2023. Date of Publication: June 2023.
Author
Mcnamara N.; Narroway H.; Farag J.; Cistulli D.; Bannon P.; Marasco S.;
Potapov E.; Loforte A.
Institution
(Mcnamara, Narroway, Farag, Cistulli, Bannon, Marasco, Potapov, Loforte)
Royal Prince Alfred Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: End-stage heart failure is a major cause of morbidity and
mortality, and its prevalence is expected to rise with the ageing
population. For suitable patients, orthotopic heart transplantation
remains the gold standard therapy; however, a paucity of donor organs has
led to the development of left ventricular assist devices (LVAD). These
devices can be utilised as either a bridge to transplant or as an
alternative to heart transplantation. While these devices can prolong life
and improve quality of life, they are associated with a significant number
of adverse events. This study aimed to systematically review the
literature to quantify survival and the incidence of adverse events
following implantation of continuous flow left ventricular assist devices
(cf-LVAD). Method(s): A systematic review was performed to determine
outcomes following implantation of a CF-LVAD. Primary outcomes were
survival and frequency of adverse events (such as bleeding, infection,
thrombosis, stroke, and right ventricular failure). Secondary outcomes
included quality of life and assessment of functional status.
 Result(s): Sixty-three studies reported clinical outcomes of 9,280
patients. Survival after cf-LVAD varied between studies. Industry-funded
trials generally reported better overall survival than the single-centre
and multicentre case series, which showed significant variation. The
largest registry report documented 12-, 24-, and 48-month survival rates
of 82%, 72%, and 57%, respectively. The most reported adverse events were
gastrointestinal bleeding, device-related infection, neurological events,
and right heart failure. Bleeding, right heart failure, and infection were
the most frequent complications experienced by those supported with
cf-LVAD, occurring in up to 35%, 40%, and 55% of patients, respectively.
Quality of life, as measured using the Kansas City Cardiomyopathy
Questionnaire, and functional status, as measured with the 6-minute walk
test, improved after cf-LVAD implantation with no decline evident 2 years
after implantation. Conclusion(s): The paucity of donor hearts has
led to the development of LVAD as a bridge to transplant or as a
destination therapy. Outcomes after cf-LVAD implantation are excellent,
with short-term survival comparable with heart transplantation, but
long-term survival remains limited due to the incidence of
post-implantation adverse events. Despite these complications, quality of
life and functional status significantly improve post-implantation and
remain improved over the long-term. This study demonstrates the potential
benefits of cf-LVAD therapy whilst also identifying adverse events as an
area of increased morbidity and mortality. Copyright © 2023

<101>
Accession Number
2025100929
Title
Platelet Transfusion in Cardiac Surgery: A Multicentre, Propensity-Matched
Analysis.
Source
Heart Lung and Circulation. Conference: Inaugural Tri-Society Cardiac and
Thoracic Symposium (3SCTS 2022). Cairns Australia. 32(Supplement 1) (pp
S63), 2023. Date of Publication: June 2023.
Author
Fletcher C.; Perry L.; Smith J.; Segal R.; Hinton J.; Xing Z.; Coulson T.;
Williams-Spence J.; Bellomo R.
Institution
(Fletcher, Perry, Smith, Segal, Hinton, Xing, Coulson, Williams-Spence,
Bellomo) The University of Melbourne, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Platelet transfusion is common in cardiac surgery but some
studies have suggested an association with harm. Method(s): A
retrospective analysis of prospectively collected data from the Australian
Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database
was conducted. Consecutive adults from 2005 to 2019 across 40 centres were
included. Propensity score matching was used to investigate the
association of perioperative platelet transfusion with operative mortality
(including both 30-day and in-hospital mortality), long-term mortality,
and other clinical outcomes. Result(s): Among 119,132 eligible
patients, 14,061 who received platelets were evenly matched to 14,061
controls. Platelet transfusion was associated with reduced operative (OR
0.77; 99% CI 0.65, 0.93; p=0.0003) and long-term (HR 0.91; 99% CI 0.84,
0.98; p=0.002) mortality. Moreover, it was associated with reduced odds of
deep sternal wound infection (OR 0.56; 99% CI 0.38, 0.82; p=0.0002), new
renal failure (OR 0.82; 99% CI 0.71, 0.94; p=0.0003), and readmission to
intensive care (OR 0.78; 99% CI 0.66, 0.91; p<0.0001). These positive
associations were observed despite an association with increased odds of
return to theatre for bleeding (OR 1.92; 99% CI 1.61, 2.29; p<0.0001) and
increased drain tube output (adjusted mean difference: 91.21 mL; 99% CI
81.57, 100.84 mL; p<0.0001). Conclusion(s): In cardiac surgery
patients, perioperative platelet transfusion was associated with reduced
mortality. Until randomised controlled trials either confirm or refute
these findings, platelet transfusion according to clinical judgment
appears safe. Copyright © 2023

<102>
Accession Number
641773728
Title
SHARED DECISION-MAKING AND ADVANCE CARE PLANNING IN PATIENTS WITH AORTIC
STENOSIS: STATUS QUO AND INTEGRATION IN A DECISION AID.
Source
BMJ Supportive and Palliative Care. Conference: 8th International
Conference on Advance Care Planning, ACP 2023. Singapore Singapore.
13(Supplement 4) (pp A26), 2023. Date of Publication: May 2023.
Author
Rosca A.; Steiger S.; Bauernschmitt R.; Scherff F.; Karzig I.; Kasper J.;
Krones T.
Institution
(Rosca, Karzig, Krones) Triemli Hospital Zurich, Clinical Ethics Unit,
Switzerland
(Steiger) University Hospital/University of Zurich, Clinical Ethics,
Institute of Biomedical Ethics and History of Medicine, Zurich,
Switzerland
(Bauernschmitt) Cardiac Surgery University Hospital Zurich, Zurich,
Switzerland
(Scherff) Cardiology Unit, University Hospital Zurich, Zurich, Switzerland
(Kasper) Department of Nursing and health Promotion Faculty of health
sciences OsloMet, Metropolitan University Oslo, Oslo, Norway
Publisher
BMJ Publishing Group
Abstract
Background Shared decision making (SDM) and advance care planning (ACP)
are two patient-centered concepts that support patients, their relatives
and clinicians to engage in a decisionmaking process in which patient
autonomy is better respected. Integrating the two complex interventions
into one may support patients with moderate and high treatment
complication risks to make well-informed choices. The purpose of this
study was a) to determine how the two concepts are currently applied in
usual care and b) to build an integrative evidence based decision aid for
patients with aortic stenosis (AS). Methods For evaluating the status quo,
a mixed methods approach was applied. We performed direct observations of
patient-clinician consultations and analyzed patients electronic records
to determine how SDM and ACP is being applied in current decision-making
process. The data were analyzed using thematic analysis with focus on ACP
and SDM elements. We further developed a decision aid according to the
Decision Aid Factory approach. Results 15 consultations were observed and
22 randomly selected patient records (from 299) were analyzed until
saturation of topics occurred. It revealed that clinicians documented
single SDM and ACP elements. Yet no integral process of 'full ACP or SDM
procedure' was observed. The procedure in case of complications was often
prescribed by clinicians due to urgency, instead of engaging in an ACP
process with the patient. We used the results, supported by input from
expert panels and patient representatives to develop a comprehensive
decision aid, separated in three parts: overview, detailed information and
graphical comparison of three most common treatment options: transcatheter
aortic valve implantation (TAVI), surgical aortic valve replacement (SAVR)
or palliative care. Conclusions Meaningful integration of SDM and ACP into
a decision aid may help patients make better medical choices regarding
their immediate and advance care planning.

<103>
Accession Number
641773717
Title
AN INTEGRATIVE MODEL OF SHARED DECISIONMAKING AND ADVANCE CARE PLANNING:
THE EXAMPLE OF PEOPLE WITH AORTIC STENOSIS.
Source
BMJ Supportive and Palliative Care. Conference: 8th International
Conference on Advance Care Planning, ACP 2023. Singapore Singapore.
13(Supplement 4) (pp A25), 2023. Date of Publication: May 2023.
Author
Rosca A.; Kasper J.; Karzig I.; Krones T.
Institution
(Rosca, Kasper, Karzig, Krones) University Hospital, University Zurich,
Zurich, Switzerland
Publisher
BMJ Publishing Group
Abstract
Background Shared decision making (SDM) and advance care planning (ACP)
are two patient-centered concepts that support patients, their relatives
and healthcare professionals engage in a decision-making process in which
patient autonomy is best put into practice. Combining these complex
interventions into one may support patients with moderate and high
treatment complication risks make better evidence-based informed choices.
The aim of the study was to: (1) To assess how SDM and ACP is being
applied in the care of patients with high and moderate treatment
complication risks and (2) propose a model to best combine the two tools
and integrate them into the care process. Methods (1) Systematic
literature review with focus on the decision-making process of patients
with aortic stenosis who need to decide between transcatheter aortic valve
implantation (TAVI), surgical aortic valve replacement (SAVR) or
palliative care. (2) Abductive reasoning for developing new concepts based
on the ones broader used. Results (1) From 1843 identified individual
publications only eight were included. Based on the SDM Model by Makoul
and Clayman, seven studies report the integration of some SDM components
in the decision-making process and one study reported the use of goals of
care (important ACP component). (2) Based on the decision-making process
described in the included studies, the existing SDM and ACP literature as
well as guidelines, we have developed an integrative SDM and ACP model
(please see figure below), which can be integrated in the treatment
decision-making process of patients with moderate or high treatment risks.
Conclusion Integration of SDM and ACP for patients with moderate and high
treatment risks may ensure a continuous patient-centered support for short
and long-term decisions and outcomes.

<104>
Accession Number
641773365
Title
P232: Clinical outcomes of percutaneous endoscopic lumbar annuloplasty and
nucleoplasty for discogenic low back pain: Meta-analysis.
Source
Global Spine Journal. Conference: Global Spine Congress, GSC 2023. Prague
Czechia. 13(2 Supplement) (pp 339S), 2023. Date of Publication: May 2023.
Author
Pairuchvej S.; Kongtharvonskul J.
Institution
(Pairuchvej) Orthopedics Department, Queen Savang Vadhana Memorial
Hospital, Sriracha, Cholburi, Thailand
(Kongtharvonskul) Orthopedics Department, Faculty of Medicine Ramathibodi
Hospital, Mahidol University, Bangkok, Thailand
Publisher
SAGE Publications Ltd
Abstract
Objective: Percutaneous endoscopic lumbar discectomy and annuloplasty
(PELDA) and nucleoplasty (PELAN) is a minimally invasive spinal technique
for relief back pain in lumbar disc herniation and chronic, non-radicular,
and discogenic low back pain (DLBP). The aim of the present article is to
present the outcomes of the systematic review and meta-analysis regarding
the short-term outcomes of this surgical technique. Method(s): We
searched all prospective and retrospective studies that reported
post-operative VAS ODI and modified Mcnab's criteria, complications and
reoperation of percutaneous endoscopic lumbar discectomy and annuloplasty
and nucleoplasty for surgical treatment of lumbar disc herniation and
chronic discogenic back pain from the PubMed and Scopus databases up to 01
September 2022. Data were independently extracted by two reviewers. A
meta-analysis was applied to assess treatment outcomes. Result(s): 13
cohort studies (N = 708 patients) met inclusion criteria. Interventions
were percutaneous endoscopic lumbar discectomy and annuloplasty and
nucleoplasty (PELAN) in lumbar disc herniation (N = 155) and chronic
discogenic back pain (N = 553). A meta-analysis showed that the UMD of
back pain Visual Analog Score (VAS), leg pain VAS and Oswestry disability
index after PELAN in lumbar disc herniation were significantly difference
of -2.67 (95%CI: -5.24 to -0.10), -4.10 (95%CI: -7.64 to -0.56) and -34.71
(95%CI: -55.08 to -14.34) scores when compared to before surgery while the
UMD of back pain Visual Analog Score (VAS) and Oswestry disability index
after PELAN in chronic discogenic back pain were significantly difference
of -4.64 (95%CI: -5.28 to -4.01), and -30.56 (95%CI: -38.66 to -22.47)
scores when compared to before surgery. Results by the modified Macnab's
criteria showed an excellent and good outcome, with a success rate of
34%-90% in chronic discogenic back pain and 81%-99% in lumbar disc
herniation. The prevalence of complication including dura tear and nerve
root injury and reoperation of PELAN in Lumbar disc herniation were 0.116
(95%CI: 0.020 to 0.212) and 0 respectively while in chronic discogenic
back pain were 0.064 (95%CI: 0.022 to 0.106) and 0.045 (95%CI: 0.017
0.106) respectively. Conclusion(s): Percutaneous endoscopic lumbar
discectomy and annuloplasty and nucleoplasty provides favorable outcomes
for carefully selected groups of patients with lumbar disc herniation and
chronic discogenic back pain.

<105>
Accession Number
641771683
Title
A004: Full endoscopic discectomy for thoracic disc herniations: A single
arm meta-analysis of safety and efficacy outcomes.
Source
Global Spine Journal. Conference: Global Spine Congress, GSC 2023. Prague
Czechia. 13(2 Supplement) (pp 5S-6S), 2023. Date of Publication: May 2023.
Author
Daniel J.; Da Silva L.E.C.T.; Araujo R.; Oliveira J.A.
Institution
(Daniel) Neurosurgery, Hospital of Federal University of Piaui, Teresina,
Brazil
(Da Silva) Orthopedics and Spine Surgery, Instituto Nacional de
Traumatologia e Ortopedia Jamil Haddad - into, Rio de Janeiro, Brazil
(Araujo) Neurosurgery, Universidade de Sao Paulo, Sao Paulo, Brazil
(Oliveira) Orthopedics and Spine, Universidade Federal Do Ceara,
Fortaleza, Brazil
Publisher
SAGE Publications Ltd
Abstract
Introduction: Surgical intervention is the treatment of choice in patients
with thoracic disc herniation (TDH) with refractory symptoms and
progressive acute myelopathy. Due to high occurrence of complications from
open surgery, minimally invasive approaches are desirable. Nowadays,
endoscopic techniques have become increasingly popular and full endoscopic
surgery can be performed in the thoracic spine with low complication
rates. Method(s): Cochrane Central, PubMed and EMBASE databases were
systematically searched for studies that evaluated patients who underwent
full endoscopic spine thoracic surgery. The outcomes of interest were
dural tear, myelopathy, epidural hematoma, recurrent disc herniation and
dysthesia. In the absence of comparative studies, a single arm
meta-analysis was performed. Result(s): We included 16 studies with a
total of 292 patients. Follow-up ranged from 6 to 89 months, age from 17
to 82 years, with 56.2% male. The procedure was performed under local
anesthesia with sedation 228 (78.08) surgeries local anesthesia and
sedation was applied. A transforaminal approach was used in 87.3% of the
cases. There were no cases of infection or death reported. The data showed
a pooled incidence of outcomes as follows, with their respective 95%
confidence intervals (CI) - dural tear (1.4%; 95% CI 0 - 2.7%); myelopathy
(2.2%; 95% CI 0.5 - 3.9%), epidural hematoma (1.1%; 95% CI 0.2 - 2.5%),
dysesthesia (4.7%; 95% CI 2.0 - 7.3%), recurrent disc herniation (1.8%;
95% CI 0 - 3.7%) and reoperation (1.7%; 95% CI 0.1 - 3.4%).
 Conclusion(s): Full endoscopic discectomy has a low incidence of
adverse outcomes in patients with thoracic disc herniations. Controlled
studies, ideally randomized, are warranted to establish the comparative
efficacy and safety of the endoscopic approach relative to open surgery.

<106>
[Use Link to view the full text]
Accession Number
2025640242
Title
del Nido versus blood cardioplegia in adult cardiac surgery: a
meta-analysis.
Source
Journal of Cardiovascular Medicine. 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, Australia
(Tian) Critical Care Division, The George Institute for Global Health,
Sydney, Australia
(Tian) Department of Surgery, University of Melbourne, Melbourne, VIC,
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,
Sydney, NSW, Australia
(Yan) Sydney Medical School, Sydney University, Sydney, NSW, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
AimsInitially 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. Conclusiondel 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.

<107>
Accession Number
2024259356
Title
Amiodarone accumulates two cholesterol precursors in myocardium: A
controlled clinical study.
Source
Journal of Internal Medicine. (no pagination), 2023. Date of Publication:
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
John Wiley and Sons Inc
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 4-
and 2-fold higher in the AD group versus 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. Copyright © 2023 The Authors.
Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf
of Association for Publication of The Journal of Internal Medicine.

<108>
Accession Number
2024220676
Title
A randomised controlled trial of prehabilitation in patients undergoing
elective cardiac surgery.
Source
Anaesthesia. (no pagination), 2023. Date of Publication: 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.; Wilkinson C.;
Kasim A.; Witharana P.; Trevis J.; Neave C.; Sarginson L.; Honeyman B.;
Walker Y.; Lewis S.; Holden A.; Ainsworth K.; Wanless F.; Hauxwell T.;
Metson L.
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
John Wiley and Sons Inc
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
12 weeks 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 > 50 years 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) -7.8 m (-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 12 weeks after surgery (10.6
cmH<inf>2</inf>O (4.6-16.6) cmH<inf>2</inf>O, p < 0.001). There were no
differences in handgrip strength or quality of life up to 12 weeks 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.

<109>
Accession Number
641781094
Title
Comparison of different percutaneous revascularisation timing strategies
in patients undergoing transcatheter aortic valve implantation.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 12 Jul 2023.
Author
Rheude T.; Costa G.; Ribichini F.L.; Pilgrim T.; Amat Santos I.J.; De
Backer O.; Kim W.-K.; Ribeiro H.B.; Saia F.; Bunc M.; Tchetche D.; Garot
P.; Mylotte D.; Burzotta F.; Watanabe Y.; Bedogni F.; Tesorio T.; Tocci
M.; Franzone A.; Valvo R.; Savontaus M.; Wienemann H.; Porto I.; Gandolfo
C.; Iadanza A.; Bortone A.S.; Mach M.; Latib A.; Biasco L.; Taramasso M.;
Zimarino M.; Tomii D.; Nuyens P.; Sondergaard L.; Camara S.F.; Palmerini
T.; Orzalkiewicz M.; Steblovnik K.; Degrelle B.; Gautier A.; Del Sole
P.A.; Mainardi A.; Pighi M.; Lunardi M.; Kawashima H.; Criscione E.;
Cesario V.; Biancari F.; Zanin F.; Esposito G.; Adam M.; Grube E.; Baldus
S.; De Marzo V.; Piredda E.; Cannata S.; Iacovelli F.; Andreas M.;
Frittitta V.; Dipietro E.; Reddavid C.; Strazzieri O.; Motta S.;
Angellotti D.; Sgroi C.; Xhepa E.; Kargoli F.; Tamburino C.; Joner M.;
Barbanti M.
Institution
(Rheude, Xhepa, Joner) Department of Cardiovascular Diseases, German Heart
Center Munich, Technical University Munich, Munich, Germany
(Costa, Sgroi, Tamburino, Barbanti) Division of Cardiology, Catania, Italy
(Ribichini, Del Sole, Mainardi, Pighi, Lunardi) Division of Cardiology,
Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
(Pilgrim, Tomii) Inselspital, Bern University Hospital, University of
Bern, Bern, Switzerland
(Amat Santos) Division of Cardiology, Hospital Clinico Universitario de
Valladolid, Valladolid, Spain
(De Backer, Nuyens) Heart Center, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Kim) Kerckhoff Heart Center, Bad Nauheim, Germany
(Ribeiro, Camara) Heart Institute of Sao Paulo (InCor), University of Sao
Paulo, Sao Paulo, Brazil
(Saia, Palmerini, Orzalkiewicz) Cardiology Unit, Cardiac Thoracic and
Vascular Department, Italy and Cardiac Thoracic and Vascular Department,
Universita degli Studi di Bologna, Bologna, Italy
(Bunc, Steblovnik) University Medical Centre Ljubljana, Ljubljana,
Slovenia
(Tchetche, Degrelle) Clinique Pasteur, Toulouse, France
(Garot, Gautier) Institute Cardiovasculaire Paris Sud (ICPS), Hopital
Jacques Cartier, Massy, France
(Mylotte, Lunardi) Galway University Hospital, Galway, Ireland
(Burzotta) Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Watanabe, Kawashima) Department of Cardiology, Teikyo University School
of Medicine, Tokyo, Japan
(Bedogni, Tesorio, Criscione) Division of Cardiology, IRCSS Policlinico
San Donato, San Donato Milanese, Milano, Italy
(Tocci) Division of Cardiology, Policlinico Umberto I, Roma, Italy
(Franzone, Esposito, Angellotti) Division of Cardiology, AOU Federico II,
Universita di Napoli, Napoli, Italy
(Valvo, Frittitta, Dipietro, Reddavid, Strazzieri, Motta) University of
Catania, Catania, Italy
(Savontaus) Heart Center, Turku University Hospital, Turku, Finland
(Wienemann, Adam, Grube, Baldus) Faculty of Medicine and University
Hospital Cologne, Clinic III for Internal Medicine, University of Cologne,
Cologne, Germany
(Porto, De Marzo, Piredda) Cardiothoracic and Vascular Department, San
Martino Policlinico Hospital, Genova, Italy
(Gandolfo, Cannata) Interventional Cardiology Unit, IRCCS Istituto
Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT),
Palermo, Italy
(Iadanza) UOSA Cardiologia Interventistica, Azienda
ospedaliera-universitaria Senese, Policlinico Le Scotte, Siena, Italy
(Bortone, Iacovelli) Division of University Cardiology, Cardiothoracic
Department, Policlinico University Hospital, Bari, Italy
(Mach, Andreas) Wien University Hospital, Vienna, Austria
(Latib, Kargoli) Montefiore Medical Center, New York, NY, USA
(Biasco) Azienda Sanitaria Locale di Cirie, Chivasso e Ivrea, ASL TO4,
Ivrea, Italy
(Taramasso) HerzZentrum Hirslanden Zurich, Zurich, Switzerland
(Zimarino) Department of Cardiology, SS. Annunziata Hospital Chieti, Italy
and Department of Neuroscience, Imaging and Clinical Sciences, "G.
d'Annunzio" University of Chieti-Pescara, ASL 2 Abruzzo, Chieti, Italy
(Sondergaard) Abbott Structural Heart, Santa Clara, CA, United States
(Cesario) Sant'Andrea Hospital, Sapienza University, Rome, Italy
(Biancari, Zanin) Clinica Montevergine, GVM Care & Research, Mercogliano,
Italy
(Barbanti) Universita degli Studi di Enna "Kore", Enna, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal timing to perform percutaneous coronary
interventions (PCI) in transcatheter aortic valve implantation (TAVI)
patients remains unknown. AIMS: We sought to compare different PCI timing
strategies in TAVI patients. METHOD(S): The REVASC-TAVI registry is
an international registry including patients undergoing TAVI with
significant, stable coronary artery disease (CAD) at preprocedural workup.
In this analysis, patients scheduled to undergo PCI before, after or
concomitantly with TAVI were included. The main endpoints were all-cause
death and a composite of all-cause death, stroke, myocardial infarction
(MI) or rehospitalisation for congestive heart failure (CHF) at 2 years.
Outcomes were adjusted using the inverse probability treatment weighting
(IPTW) method. RESULT(S): A total of 1,603 patients were included.
PCI was performed before, after or concomitantly with TAVI in 65.6%
(n=1,052), 9.8% (n=157) or 24.6% (n=394), respectively. At 2 years,
all-cause death was significantly lower in patients undergoing PCI after
TAVI as compared with PCI before or concomitantly with TAVI (6.8% vs 20.1%
vs 20.6%; p<0.001). Likewise, the composite endpoint was significantly
lower in patients undergoing PCI after TAVI as compared with PCI before or
concomitantly with TAVI (17.4% vs 30.4% vs 30.0%; p=0.003). Results were
confirmed at landmark analyses considering events from 0 to 30 days and
from 31 to 720 days. CONCLUSION(S): In patients with severe aortic
stenosis and stable coronary artery disease scheduled for TAVI,
performance of PCI after TAVI seems to be associated with improved 2-year
clinical outcomes compared with other revascularisation timing strategies.
These results need to be confirmed in randomised clinical trials.

<110>
Accession Number
641778199
Title
Predicting Death or Disability after Surgery in the Older Adult.
Source
Anesthesiology. (no pagination), 2023. Date of Publication: 11 Jul 2023.
Author
Shulman M.A.; Wallace S.; Gilbert A.; Reilly J.R.; Kasza J.; Myles P.S.
Institution
(Shulman) Staff Anesthesiologist and Senior Adjunct Lecturer, Department
of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash
University, Melbourne, VIC, Australia
(Wallace) Research Manager, Department of Anaesthesiology and
Perioperative Medicine, Alfred Hospital and Monash University, Melbourne,
VIC, Australia
(Gilbert) Director, Data Governance and Security, Alfred Hospital,
Melbourne, VIC, Australia
(Reilly) Anesthesiologist and Adjunct Research Fellow, Department of
Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash
University, Melbourne, VIC, Australia
(Kasza) School of Public Health and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(Myles) Department of Anaesthesiology and Perioperative Medicine, Alfred
Hospital and Monash University, Melbourne, VIC, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Older patients are vulnerable to developing new or worsening
disability after surgery. Despite this, patient or surgical
characteristics predisposing to postoperative disability are poorly
defined. Our aim was to develop and validate a model, subsequently
transformed to point-score form, to predict 6-month death or disability in
older patients after surgery. METHOD(S): The authors built a
prospective, single-center registry to develop and validate the prediction
model. The registry included patients 70 years of age or older undergoing
elective and non-elective, cardiac and non-cardiac surgery between 25 May
2017 to 11 February 2021, and combined clinical data from the electronic
medical record, hospital administrative data (ICD-10 AM codes) and World
Health Organization Disability Assessment Schedule (WHODAS) data collected
directly from the patients. Death or disability was defined as being dead
or having a WHODAS score >=16%. Included patients were randomly divided
into model development (70%) and internal validation (30%) cohorts. Once
constructed, the logistic regression and point-score models were assessed
using the internal validation cohort and an external validation cohort
comprising data from a separate randomized trial. RESULT(S): Of 2176
patients who completed the WHODAS immediately prior to surgery, 927 (43%)
patients were disabled and 413 (19%) had significant disability. By 6
months after surgery, 1640 patients (75%) had data available for the
primary outcome analysis. Of these patients 195 (12%) patients had died
and 691 (42%) were dead or disabled.The developed point-score model
included the preoperative WHODAS score, patient age, dementia, and chronic
kidney disease. The point score model retained good discrimination in the
internal (area under the curve 0.74, 95% CI 0.69 to 0.79) and external
(area under the curve 0.77, 95% CI 0.74, 0.80) validation data sets.
 CONCLUSION(S): We developed and validated a point score model to
predict death or disability in older patients after surgery. Copyright
© 2023 American Society of Anesthesiologists. All Rights Reserved.

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