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<1>
Accession Number
2026083089
Title
Infective endocarditis risk in patients with bicuspid aortic valve:
Systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 47 (no pagination), 2023. Article Number:
101249. Date of Publication: August 2023.
Author
Pereira S.C.; Abrantes A.L.; Antonio P.S.; Morais P.; Sousa C.; David C.;
Pinto F.J.; Almeida A.G.; Caldeira D.
Institution
(Pereira, Abrantes, Antonio, Morais, Sousa, David, Pinto, Almeida,
Caldeira) Cardiology Department, Hospital Universitario de Santa Maria -
CHULN, Portugal
(Sousa, Pinto, Almeida, Caldeira) Centro Cardiovascular da Universidade de
Lisboa - CCUL (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de
Lisboa, Portugal
(Caldeira) Laboratory of Clinical Pharmacology and Therapeutics, Faculdade
de Medicina, Universidade de Lisboa, Portugal
Publisher
Elsevier Ireland Ltd
Abstract
Background: Antibiotic prophylaxis in bicuspid aortic valve patients is
currently a matter of debate. Although it is no longer recommended by
international guidelines, some studies indicate a high risk of infective
endocarditis. We aim to evaluate the risk of native valve infective
endocarditis in bicuspid aortic valve patients and compare to individuals
with tricuspid aortic valve. Method(s): Study search of longitudinal
studies regarding infective endocarditis incidence in bicuspid aortic
valve patients (compared with tricuspid aortic valve/overall population)
was conducted through OVID in the following electronic databases: MEDLINE,
CENTRAL, EMBASE; from inception until October 2020. The outcomes of
interest were the incidence rate and relative risk of infective
endocarditis. The relative risk and incidence rate (number of cases for
each 10 000 persons-year) with their 95 % confidence intervals (95 %CI)
were estimated using a random effects model meta-analysis. The study
protocol was registered at PROSPERO CRD42020218639. Result(s): Eight
cohort studies were selected, with a total of 5351 bicuspid aortic valve
patients. During follow up, 184 bicuspid aortic valve patients presented
infective endocarditis, with an incidence rate of 48.13 per 10,000
patients-year (95 %CI 22.24-74.02), and a 12-fold (RR: 12.03, 95 %CI
5.45-26.54) increased risk compared with general population, after
adjusted estimates. Conclusion(s): This systematic review and
meta-analysis suggests that bicuspid aortic valve patients have a
significant high risk of native valve infective endocarditis. Large
prospective high-quality studies are required to estimate more accurately
the incidence of infective endocarditis, the relative risk and the
potential benefit of antibiotic prophylaxis. Copyright © 2023 The
Author(s)

<2>
Accession Number
2025288974
Title
Practice Changing Updates in Perioperative Medicine Literature 2022. A
Systematic Review.
Source
American Journal of Medicine. 136(8) (pp 753-762.e1), 2023. Date of
Publication: August 2023.
Author
Khambaty M.; Devalapalli A.P.; Silbert R.E.; Kashiwagi D.T.; Regan D.W.;
Sundsted K.K.; Mauck K.F.
Institution
(Khambaty, Devalapalli, Kashiwagi, Regan, Sundsted) Division of Hospital
Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN,
United States
(Silbert, Mauck) Division of General Internal Medicine, Department of
Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN,
United States
(Kashiwagi) Department of Internal Medicine, Sheikh Shakhbout Medical City
in partnership with Mayo Clinic, Abu Dhabi, United Arab Emirates
Publisher
Elsevier Inc.
Abstract
Perioperative medicine is a rapidly growing multidisciplinary field with
significant advances published each year. In this review, we highlight
important perioperative publications in 2022. A multi-database literature
search from January to December of 2022 was undertaken. Original research
articles, systematic reviews, meta-analyses, and guidelines were included.
Abstracts, case reports, letters, protocols, pediatric and obstetric
articles, and cardiac surgery literature were excluded. Two authors
reviewed each reference using the Distiller SR systematic review software
(Evidence Partners Inc., Ottawa, Ont, Canada). A modified Delphi technique
was used to identify 8 practice-changing articles. We identified another
10 articles for tabular summaries. We highlight why these articles have
the potential to change clinical perioperative practice and areas where
more information is needed. Copyright © 2023 Elsevier Inc.

<3>
Accession Number
2025096759
Title
Adaptation And Use of the Papworth Haemostasis Checklist - Clinical
Outcomes Analysis at Hospital Estadual Mario Covas.
Source
Brazilian Journal of Cardiovascular Surgery. 38(4) (no pagination), 2023.
Article Number: e20220305. Date of Publication: 2023.
Author
Poltronieri P.B.; Freitas A.C.O.; Batista C.H.R.; da Luz J.L.R.; Barbosa
M.B.; Goncalves R.S.; Smanio M.C.M.; Pires A.C.
Institution
(Poltronieri, Batista, Smanio) Faculdade de Medicina, Centro Universitario
FMABC, Sao Paulo, Santo Andre, Brazil
(Freitas, da Luz, Barbosa, Goncalves) Centro de Cirurgia Cardiovascular,
Hospital Estadual Mario Covas, Sao Paulo, Santo Andre, Brazil
(Barbosa, Goncalves) Cardiovascular Surgery Department, Faculdade de
Medicina, Centro Universitario FMABC, Sao Paulo, Santo Andre, Brazil
(Pires) Cardiothoracic Surgery Department, Faculdade de Medicina, Centro
Universitario FMABC, Sao Paulo, Santo Andre, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Postoperative bleeding is one of the main causes of
complications in cardiovascular surgery, which highlights the importance
of ensuring adequate intraoperative hemostasis, providing a better patient
outcome. This study aimed to improve the prevention of postoperative
bleeding in the Cardiovascular Surgery Department of the Hospital Estadual
Mario Covas (Santo Andre, Brazil) using an adapted version of the Papworth
Haemostasis Checklist to assess the impact of this standardization on
bleeding rate, postoperative complications, reoperation, and mortality.
 Method(s): This is a non-randomized controlled clinical trial, whose
non-probabilistic sample consisted of patients undergoing cardiac surgery
in the abovementioned service within a two-year interval. The Papworth
Haemostasis Checklist was adapted to the Brazilian laboratory parameters
and the questions were translated into Portuguese. This checklist was used
before the surgeon started the chest wall closure. Patients were followed
up until 30 days after surgery. A P-value < 0.05 was considered
statistically relevant. Result(s): This study included 200 patients.
After the checklist, a reduction in 24-hour drain output, postoperative
complications, and reoperation was observed, although statistical
significance was not reached. Finally, there was a significant reduction
in the number of deaths (8 vs. 2; P=0.05). Conclusion(s): The use of
the adapted checklist in our hospital proved to be an effective
intervention to improve the prevention of postoperative bleeding, with a
direct impact in the number of deaths in the study period. The reduction
in deaths was possible thanks to the reduction in the bleeding rate,
postoperative complications, and reoperations for bleeding. Copyright
© 2023, Sociedade Brasileira de Cirurgia Cardiovascular. All rights
reserved.

<4>
Accession Number
2025076169
Title
Outcomes of concomitant surgical ablation in patients undergoing surgical
myectomy for hypertrophic obstructive cardiomyopathy: A systematic review
and meta-analysis.
Source
International Journal of Cardiology. 387 (no pagination), 2023. Article
Number: 131099. Date of Publication: 15 Sep 2023.
Author
Kharbanda R.K.; Ramdat Misier N.L.; Van den Eynde J.; El Mathari S.;
Tomsic A.; Palmen M.; Klautz R.J.M.
Institution
(Kharbanda, Ramdat Misier, Tomsic, Palmen, Klautz) Department of
Cardiothoracic Surgery, Leiden University Medical Center, Leiden,
Netherlands
(Van den Eynde) Helen B. Taussig Heart Center, The Johns Hopkins Hospital
and School of Medicine, Baltimore, MD, United States
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(El Mathari) Department of Cardiothoracic Surgery, Amsterdam University
Medical Center, Amsterdam, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Objective: Studies investigating the efficacy of concomitant surgical
atrial fibrillation (AF) ablation in hypertrophic obstructive
cardiomyopathy (HOCM) patients undergoing myectomy are scarce and limited
in terms of sample size. We aim to summarize current outcomes of
concomitant surgical AF ablation in HOCM patients undergoing surgical
myectomy. Method(s): This systematic review and meta-analysis was
performed according to Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines. We included all studies reporting any of the
following outcomes of concomitant surgical AF ablation in HOCM patients:
freedom from recurrence of AF, overall survival and complications.
Outcomes were evaluated using traditional meta-analysis at given
time-points and using pooled Kaplan-Meier curves. Result(s): A total
of 13 studies were included, resulting in a total of 616 individual
patients available for analysis. AF was paroxysmal in 68.1% of the
patients (95% CI 56.0-78.2%; I2 = 87.1%; 8 studies, 583
participants). The majority of patients (86.2%) underwent either
conventional Cox Maze III or IV (95% CI 39.7-98.3%; I2 = 92.4%;
8 studies, 616 patients) procedure. The incidence of early post-operative
pacemaker implantation was 6.1% (95% CI 3.1-11.8%). Overall survival at 3,
5 and 7 years was 95.6% (95% CI 93.4-97.9%), 93.6% (95% CI 90.8-96.5%) and
90.5% (95% CI 86.5-94.6%), respectively. Freedom from recurrent AF at 3, 5
and 7 years was 77.6% (95% CI 73.7-81.7%), 70.6% (95% CI 65.8-75.7) and
63.2% (95% CI 56.2-73.8%), respectively. Conclusion(s): This
meta-analysis supports concomitant surgical AF ablation at the time of
surgical myectomy in HOCM patients, as it seems to be safe and effective
in terminating AF. Copyright © 2023 The Authors

<5>
Accession Number
2023644601
Title
Outcomes of truncal valve replacement in neonates and infants: A
meta-analysis.
Source
Cardiology in the Young. 29 (no pagination), 2023. Date of Publication: 27
Mar 2023.
Author
Hardy W.A.; Kang L.; Turek J.W.; Rajab T.K.
Institution
(Hardy, Rajab) Section of Pediatric Cardiothoracic Surgery, Medical
University of South Carolina, Charleston, SC, United States
(Kang) Department of Surgery, Duke University Medical Center, Durham, NC,
United States
(Turek) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
Publisher
Cambridge University Press
Abstract
Background: Infants with truncus arteriosus typically undergo repair by
repurposing the truncal valve as the neo-aortic valve and using a valved
conduit homograft for the neo-pulmonary valve. In cases where the native
truncal valve is too insufficient for repair, it is replaced, but this is
a rare occurrence with a paucity of data, especially in the infant
population. Here, we conduct a meta-analysis to better understand the
outcomes of infant truncal valve replacement during the primary repair of
truncus arteriosus. Method(s): We systematically reviewed PubMed,
Scopus, and CINAHL for all studies reporting infant (<12 months) truncus
arteriosus outcomes between 1974 and 2021. Exclusion criteria were studies
which did not report truncal valve replacement outcomes separately. Data
extracted included valve replacement type, mortality, and reintervention.
Our primary outcome was early mortality, and our secondary outcomes were
late mortality and reintervention rates. Result(s): Sixteen studies
with 41 infants who underwent truncal valve replacement were included. The
truncal valve replacement types were homografts (68.8%), mechanical valves
(28.1%), and bioprosthetic valves (3.1%). Overall early mortality was
49.4% (95% CI: 28.4-70.5). The pooled late mortality rate was 15.3%/year
(95% CI: 5.8-40.7). The overall rate of truncal valve reintervention was
21.7%/year (95% CI: 8.4-55.7). Conclusion(s): Infant truncal valve
replacement has poor early and late mortality as well as high rates of
reintervention. Truncal valve replacement therefore remains an unsolved
problem in congenital cardiac surgery. Innovations in congenital cardiac
surgery, such as partial heart transplantation, are required to address
this. Copyright © The Author(s), 2023. Published by Cambridge
University Press.

<6>
Accession Number
2023259904
Title
Myocardial Revascularization in Patients With Ischemic Cardiomyopathy: For
Whom and How.
Source
Journal of the American Heart Association. 12(6) (no pagination), 2023.
Article Number: e026943. Date of Publication: 21 Mar 2023.
Author
Liga R.; Colli A.; Taggart D.P.; Boden W.E.; De Caterina R.
Institution
(Liga, Colli, De Caterina) Cardiology Division, Pisa University Hospital,
University of Pisa, Italy
(Taggart) Nuffield Department of Surgical Sciences, Oxford University John
Radcliffe Hospital, Oxford, United Kingdom
(Boden) VA Boston Healthcare System, Boston University School of Medicine,
Boston, MA, United States
(De Caterina) Fondazione VillaSerena per la Ricerca, Citta Sant'Angelo,
Italy
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Myocardial revascularization has been advocated to improve
myocardial function and prognosis in ischemic cardiomyopathy (ICM). We
discuss the evidence for revascularization in patients with ICM and the
role of ischemia and viability detection in guiding treatment. METHODS AND
RESULTS: We searched for randomized controlled trials evaluating the
prognostic impact of revascularization in ICM and the value of viability
imaging for patient management. Out of 1397 publications, 4 randomized
controlled trials were included, enrolling 2480 patients. Three trials
(HEART [Heart Failure Revascularisation Trial], STICH [Surgical Treatment
for Ischemic Heart Failure], and REVIVED [REVascularization for Ischemic
VEntricular Dysfunction]-BCIS2) randomized patients to revascularization
or optimal medical therapy. HEART was stopped prematurely without showing
any significant difference between treatment strategies. STICH showed a
16% lower mortality with bypass surgery compared with optimal medical
therapy at a median follow-up of 9.8 years. However, neither the
presence/extent of left ventricle viability nor ischemia interacted with
treatment outcomes. REVIVED-BCIS2 showed no difference in the primary end
point between percutaneous revasculari-zation or optimal medical therapy.
PARR-2 (Positron Emission Tomography and Recovery Following
Revascularization) randomized patients to imaging-guided revascularization
versus standard care, with neutral results overall. Information regarding
the consistency of patient management with viability testing results was
available in =65% of patients (n=1623). No difference in survival was
revealed according to adherence or no adherence to viability imaging.
 CONCLUSION(S): In ICM, the largest randomized controlled trial,
STICH, suggests that surgical revascularization improves pa-tients'
prognosis at long-term follow-up, whereas evidence supports no benefit of
percutaneous coronary intervention. Data from randomized controlled trials
do not support myocardial ischemia or viability testing for treatment
guidance. We propose an algorithm for the workup of patients with ICM
considering clinical presentation, imaging results, and surgical
risk. Copyright © 2023 The Authors.

<7>
Accession Number
2022076804
Title
Minimally invasive treatment of mitral valve disease with severe mitral
annular calcification: Meeting paper for Mitral Conclave 2022.
Source
JTCVS Techniques. 18 (pp 44-50), 2023. Date of Publication: April 2023.
Author
Wisneski A.D.; Hamilton B.; Nguyen T.C.
Institution
(Wisneski, Hamilton, Nguyen) Division of Cardiothoracic Surgery,
Department of Surgery, University of California San Francisco, San
Francisco, Calif, United States
Publisher
Elsevier Inc.
Abstract
Objective: Mitral valve disease in presence of severe mitral annular
calcification (MAC) remains a challenge for surgeons to address.
Conventional surgical techniques have potential for heightened morbidity
and mortality. The advent of transcatheter heart valve technology and
transcatheter mitral valve replacement (TMVR) holds promise to treat
mitral valve disease with MAC with excellent clinical outcomes.
 Method(s): We review current treatment strategies for MAC and studies
in which TMVR techniques were used. Result(s): Several studies and a
global registry describe outcomes of TMVR for mitral valve disease with
MAC. We describe our specific technique on how to perform a minimally
invasive transatrial approach for TMVR. Conclusion(s): TMVR
demonstrates strong promise as a safe and effective way to treat mitral
valve disease with MAC. We advocate for a minimally invasive transatrial
approach when performing TMVR for mitral valve disease with
MAC. Copyright © 2022 The Author(s)

<8>
Accession Number
2026225923
Title
Subclinical Leaflet Thrombosis Following Surgical and Transcatheter Aortic
Valve Replacement: A Meta-Analysis.
Source
American Journal of Cardiology. 204 (pp 171-177), 2023. Date of
Publication: 01 Oct 2023.
Author
Moscarelli M.; Prestera R.; Pernice V.; Milo S.; Violante F.; Cuffari F.;
Di Pasquale C.; Ferlisi A.; Speziale G.; Angelini G.D.; Fattouch K.
Institution
(Moscarelli, Prestera, Pernice, Milo, Violante, Cuffari, Di Pasquale,
Ferlisi, Fattouch) Department of Cardiovascular Surgery, Maria Eleonora
Hospital, GVM Care & Research, Palermo, Italy
(Speziale) Department of Cardiovascular Surgery, Anthea Hospital, GVM Care
& Research, Bari, Italy
(Angelini) Department of Cardiac Surgery, Bristol Heart Institute,
University of Bristol, United Kingdom
(Fattouch) DICHIRONS, Discipline Chirurgiche, Oncologiche e
Stomatologiche, University of Palermo, Palermo, Italy
Publisher
Elsevier Inc.
Abstract
Subclinical leaflets valve thrombosis (SLT) is a recently identified
phenomenon with multidetector computer tomography after tissue aortic
valve replacement. Whether SLT is more frequent after transcatheter aortic
valve replacement (TAVR) or surgical aortic valve replacement (SAVR) is
currently not known. Thus, the aim of this pairwise meta-analysis was to
investigate the incidence of SLT after both TAVR and SAVR, the association
with anticoagulation therapy, and the risk for neurological events. We
searched PubMed, Google Scholar, and Ovid MEDLINE/Embase (January 02,
2023, last update) (PROSPERO registration: CRD42022383295). Statistical
analysis was performed according to a prespecified statistical analysis
plan. Time-to-event outcomes were summarized as incidence rate ratios
(IRR). Pooled estimates were calculated using inverse variance method and
random effect model. Overall, 2 registries, 2 randomized trials, and 1
observational study (1,593 patients) were included in this meta-analysis.
There was a statistically significant difference in the incidence rate at
follow-up of SLT between patients who underwent TAVR and SAVR (IRR 2.07,
95% confidence interval [CI]: [1.06; 4.03], I2 79%, 95% CI:
[44; 92], p = 0.03). Oral anticoagulation therapy was associated with a
reduced incidence of SLT (IRR 7.51, 95% CI: [3.24; 17.37], I2
62%, 95% CI: [0; 87], p <0.001). However, the incidence of later
neurological events did not differ between patients with or without SLT
(IRR 1.05, 95% CI: [0.32; 3.47], p = 0.93). In conclusion, SLT was more
frequently detected after TAVR than SAVR. However, it was not associated
with an increased risk for neurological events. Oral anticoagulation
therapy seemed to reduce the incidence of SLT. Copyright © 2023
Elsevier Inc.

<9>
Accession Number
641947359
Title
Can Posterior Pericardial Incision Truly Improve Postoperative
Complications After Cardiac Surgery? A Systematic Review and
Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. 38(5) (pp e20220350), 2023.
Date of Publication: 04 Aug 2023.
Author
Shen Z.-A.; Hou Y.; Yu L.; Wang X.; Dong A.; Kong M.; Shi H.
Institution
(Shen, Wang, Dong, Kong, Shi) Department of Cardiovascular Surgery, Second
Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou,
China
(Shen) Department of Biomedical Research, Research and Innovation Center,
Xinjiang Institute of Technology, Xinjiang, China
(Hou) Sanquan College of Xinxiang Medical University, Xinxiang, China
(Yu) Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang
Chinese Medical University, Hangzhou, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Postoperative atrial fibrillation (POAF) and pericardial
effusion are important factors affecting prognosis after cardiac surgery.
Recently, it has been reported that posterior pericardiotomy (PP) can
effectively prevent the occurrence of POAF and pericardial effusion. To
validate these conclusions and guide clinical practice, we conducted a
systematic review with meta-analysis. METHOD(S): We searched multiple
databases for manuscripts published before July 2022 on the use of PP to
prevent POAF and pericardial effusion and included only randomized
controlled trials. The main outcome was atrial fibrillation after coronary
artery bypass grafting, and secondary outcomes were included.
 RESULT(S): This meta-analysis included 14 randomized controlled
trials with a total of 2275 patients. Meta-analysis showed that the
incidence of POAF after cardiac surgery in the PP group was significantly
lower than that in the control group (risk ratio=0.48; 95% confidence
interval=0.33~0.69; P<0.00001). PP effectively reduced postoperative
pericardial effusion (risk ratio=0.34, 95% confidence interval=0.21-0.55;
P<0.00001). CONCLUSION(S): PP has shown good results in preventing
POAF, pericardial effusion, and other complications, which indicates that
PP is a safe and effective surgical method, but attention still needs to
be paid to the potential risk of coagulation dysfunction caused by PP.

<10>
Accession Number
640834138
Title
The Effects of Preoperative Pain Education on Pain Severity in Cardiac
Surgery Patients: A Pilot Randomized Control Trial.
Source
Pain management nursing : official journal of the American Society of Pain
Management Nurses. 24(4) (pp e18-e25), 2023. Date of Publication: 01 Aug
2023.
Author
Sinderovsky A.; Grosman-Rimon L.; Atrash M.; Nakhoul A.; Saadi H.; Rimon
J.; Birati E.Y.; Carasso S.; Kachel E.
Institution
(Sinderovsky) Ruth and Bruce Rappaport Faculty of Medicine,
Technion-Israel Institute of Technology, Haifa, Israel
(Grosman-Rimon) Division of Cardiovascular Medicine and Surgery, Tzafon
Medical Center, Tiberias, Israel; School of Graduate Studies, The Academic
Center Levinsky-Wingate, Wingate Institute, Netanya, Israel
(Atrash, Nakhoul, Saadi) Division of Cardiovascular Medicine and Surgery,
Tzafon Medical Center, Tiberias, Israel
(Rimon) Faculty of Health, York University, Toronto, Canada
(Birati) Division of Cardiovascular Medicine and Surgery, Tzafon Medical
Center, Tiberias, Israel; The Azrieli Faculty of Medicine, Bar-Ilan
University, Zefat, Israel
(Carasso) The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat,
Israel; The Jesselson Integrated Heart Center, Shaare Zedek Medical
Center, Jerusalem
(Kachel) Division of Cardiovascular Medicine and Surgery, Tzafon Medical
Center, Tiberias, Israel; The Azrieli Faculty of Medicine, Bar-Ilan
University, Zefat, Israel; Department of Cardiac Surgery, Sheba Medical
Centre, Tel Hashomer, Israel
Publisher
NLM (Medline)
Abstract
BACKGROUND: There is minimal research on the effect of individualized
preoperative education on postoperative pain and postoperative pain
medication intake. AIM: The study objective was to assess the effect of
individually tailored preoperative education on postoperative pain
severity, number of pain breakthroughs, and use of pain medication in
participants receiving the intervention compared to controls.
 METHOD(S): A pilot study with 200 participants was conducted. The
experimental group received an informational booklet and discussed their
ideas surrounding pain and pain medication with the researcher. Controls
received no intervention. Postoperative pain severity was measured by a
Numerical Rating System (NRS), which was divided into mild (NRS 1-3),
moderate (NRS 4-6), and severe (NRS 7-10). RESULT(S): In the
participant cohort, 68.8% of participants were male, and the average age
was 60.48+/-10.7. Average postoperative 48-hour cumulative pain scores
were lower in those who received the intervention compared to controls;
50.0 (IQR 35.8-60.0) vs. 65 (IQR 51.0-73.0; p < .01) participants who
received the intervention had less frequent pain breakthroughs when
compared to controls (3.0 [IQR 2.0-5.0] vs. 6.0 [IQR 4.0-8.0; p < .01]).
There was no significant difference in the amount of pain medication taken
by either group. CONCLUSION(S): Participants who receive
individualized preoperative pain education are more likely to have
decreased postoperative pain. Copyright © 2023. Published by
Elsevier Inc.

<11>
Accession Number
639204823
Title
Data standards for transcatheter aortic valve implantation: the European
Unified Registries for Heart Care Evaluation and Randomised Trials
(EuroHeart).
Source
European heart journal. Quality of care & clinical outcomes. 9(5) (pp
529-536), 2023. Date of Publication: 07 Aug 2023.
Author
Aktaa S.; Batra G.; James S.K.; Blackman D.J.; Ludman P.F.; Mamas M.A.;
Abdel-Wahab M.; Angelini G.D.; Czerny M.; Delgado V.; De Luca G.; Agricola
E.; Foldager D.; Hamm C.W.; Iung B.; Mangner N.; Mehilli J.; Murphy G.J.;
Mylotte D.; Parma R.; Petronio A.S.; Popescu B.A.; Sondergaard L.; Teles
R.C.; Sabate M.; Terkelsen C.J.; Testa L.; Wu J.; Maggioni A.P.; Wallentin
L.; Casadei B.; Gale C.P.
Institution
(Aktaa, Blackman, Gale) Leeds Institute of Cardiovascular and Metabolic
Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom
(Aktaa, Wu, Gale) Leeds Institute for Data Analytics, University of Leeds,
Leeds LS2 9JT, United Kingdom
(Aktaa, Blackman, Gale) Department of Cardiology, Leeds Teaching Hospitals
NHS Trust, Leeds LS1 3EX, United Kingdom
(Batra, James, Wallentin) Department of Medical Sciences, Cardiology and
Uppsala Clinical Research Center, Uppsala University, 38 751 85 Uppsala,
Sweden
(Ludman) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham B15 2SQ, United Kingdom
(Mamas) Keele Cardiovascular Research Group, Keele University, United
Kingdom
(Abdel-Wahab) Heart Center Leipzig, University of Leipzig, Leipzig 04109,
Germany
(Angelini) Bristol Heart Institute, Bristol University, Bristol BS8 1TH,
United Kingdom
(Czerny) Department of Cardiovascular Surgery, Faculty of Medicine,
Albert-Ludwigs-University of Freiburg, University Heart Center Freiburg,
Freiburg 79189, Germany
(Delgado) Heart Institute; Department of Cardiology; Cardiovascular
Imaging Section; Hospital University Germans Trias i Pujol, 08916
Badalona, Spain
(De Luca) Clinical and Experimental Cardiology Unit, AOU Sassari, Sassari
07100, Italy
(Agricola) Cardiovascular Imaging Unit, San Raffaele Hospital, Vita-Salute
University, 20132 San Raffaele Milan, Milan, Italy
(Foldager) ESC Patient Forum, Denmark
(Hamm) Medical Clinic I, University of Giessen, Giessen 35390, Germany
(Hamm) Kerckhoff Heart Center, Bad Nauheim 61231, Germany
(Iung) Cardiology Department, Bichat Hospital, Paris 75006, France
(Mangner) Heart Centre Dresden, Department of Internal Medicine and
Cardiology, Technische Universitaet, Dresden 01069, Germany
(Mehilli) Landshut-Achdorf Hospital, Landshut 84036, Germany
(Mehilli) Klinikum der Universitat Munchen,
Ludwig-Maximilians-Universitat, Munich 80539, Germany
(Mehilli) German Centre for Cardiovascular Research (DZHK), Munich Heart
Alliance, Munich 80539, Germany
(Murphy) NIHR Biomedical Research Unit, University of Leicester, Leicester
LE1 7RH, United Kingdom
(Mylotte) Department of Cardiology, University Hospital and National
University of Ireland Galway, H91 YR71 Galway, Ireland
(Parma) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice 40-055, Poland
(Petronio) Cardiothoracic and Vascular Dpt. University of Pisa, Pisa
56126, Italy
(Popescu) Department of Cardiology, University of Medicine and Pharmacy
"Carol Davila" -Euroecolab, Emergency Institute for Cardiovascular
Diseases 050474 Bucharest, Romania
(Sondergaard) Department of cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen 2100, Denmark
(Teles) Centro de Documentacao, Centro Hospitalar de Lisboa Ocidental,
Nova Medical School, Hospital de Santa Cruz, Lisbon 1169056, Portugal
(Sabate) Department of Interventional Cardiology, Cardiovascular
Institute, Hospital Clinic, Institut d'Investigacions Biomediques August
Pi I Sunyer (IDIBAPS), Barcelona 08036, Spain
(Terkelsen) Aarhus University Hospital & The Danish Heart Foundation 8200,
Denmark
(Testa) IRCCS San Donato Hospital, Milan 20097, Italy
(Wu) School of Dentistry, University of Leeds, Leeds LS2 9JT, United
Kingdom
(Maggioni) ANMCO Research Center-Heart Care Foundation, Florence 50121,
Italy
(Casadei) Division of Cardiovascular Medicine, NIHR Oxford Biomedical
Research Centre, University of Oxford, Oxford OX1 2JD, United Kingdom
Publisher
NLM (Medline)
Abstract
AIMS: Standardized data definitions are necessary for the quantification
of quality of care and patient outcomes in observational studies and
randomised controlled trials (RCTs). The European Unified Registries for
Heart Care Evaluation and Randomised Trials (EuroHeart) project of the
European Society of Cardiology (ESC) aims to create pan-European data
standards for cardiovascular diseases and interventions, including
transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We
followed the EuroHeart methodology for cardiovascular data standard
development. A Working Group of 29 members representing 12 countries was
established and included a patient representative, as well as experts in
the management of valvular heart disease from the European Association of
Percutaneous Cardiovascular Interventions (EAPCI), the European
Association of Cardiovascular Imaging (EACVI) and the Working Group on
Cardiovascular Surgery. We conducted a systematic review of the literature
and used a modified Delphi method to reach consensus on a final set of
variables. For each variable, the Working Group provided a definition,
permissible values, and categorized the variable as mandatory (Level 1) or
additional (Level 2) based on its clinical importance and feasibility. In
total, 93 Level 1 and 113 Level 2 variables were selected, with the level
1 variables providing the dataset for registration of patients undergoing
TAVI on the EuroHeart IT platform. CONCLUSION(S): This document
provides details of the EuroHeart data standards for TAVI processes of
care and in-hospital outcomes. In the context of EuroHeart, this will
facilitate quality improvement, observational research, registry-based
RCTs and post-marketing surveillance of devices, and pharmacotherapies.
ONE-SENTENCE SUMMARY: The EuroHeart data standards for transcatheter
aortic valve implantation (TAVI) are a set of internationally agreed data
variables and definitions that once implemented will facilitate
improvement of quality of care and outcomes for patients receiving
TAVI. Copyright © The Author(s) 2022. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<12>
Accession Number
638860094
Title
De-frailing intervention for hospitalized cardiovascular patients in the
TARGET-EFT randomized clinical trial.
Source
European heart journal. Quality of care & clinical outcomes. 9(5) (pp
482-489), 2023. Date of Publication: 07 Aug 2023.
Author
Ahmad F.; Fountotos R.; Goldfarb M.; Bharaj N.; Munir H.; Marsala J.;
Rudski L.G.; Afilalo J.
Institution
(Ahmad, Fountotos, Goldfarb, Munir, Afilalo) Division of Experimental
Medicine, McGill University, Montreal, Canada
(Ahmad, Fountotos, Bharaj, Munir, Afilalo) Centre for Clinical
Epidemiology, Jewish General Hospital, Montreal QC H3T 1E2, Canada
(Goldfarb, Marsala, Rudski, Afilalo) Division of Cardiology, Jewish
General Hospital, McGill University, Montreal QC H3T 1E2, Canada
(Bharaj) Department of Kinesiology & Physical Education, McGill
University, Canada. Institution of research trial: Jewish General
Hospital, Montreal QC H3T 1E2, Canada
Publisher
NLM (Medline)
Abstract
AIMS: Frailty is disproportionately prevalent in cardiovascular disease
patients and exacerbated during hospital admissions, heightening the risk
for adverse events and functional decline. Using the Essential Frailty
Toolset (EFT) to target physical weakness, cognitive impairment,
malnourishment, and anaemia, we tested a multicomponent targeted
intervention to de-frail older adults with acute cardiovascular conditions
during their hospital admission. METHODS AND RESULTS: The TARGET-EFT trial
was a single-center randomized clinical trial at the Jewish General
Hospital, Montreal, Canada. We compared a multicomponent de-frailing
intervention with usual clinical care. Intervention group patients
received exercise, cognitive stimulation, protein supplementation, and
iron replacement, as required. In this study, the primary outcome was
frailty, as assessed by the SPPB score (Short Physical Performance
Battery) at discharge, and the secondary outcome was the SARC-F score
(Strength, Assistance walking, Rising from chair, Climbing, Falls)
assessed 30 days later. The analysis consisted of 135 patients (mean age
of 79.3 years; 54% female) who survived and completed the frailty
assessments.Compared with control patients, intervention group patients
had a 1.52-point superior SPPB score and a 0.74-point superior SARC-F
score. Subgroup analysis suggested that patients with low left ventricular
ejection fraction may have attenuated benefits, and that patients who
underwent invasive cardiac procedures had the greatest benefits from the
intervention. CONCLUSION(S): We achieved our objective of de-frailing
older cardiac inpatients on a short-term basis by improving their physical
performance and functioning using a pragmatic multicomponent intervention.
This could have positive impacts on their clinical outcomes and ability to
maintain independent living in the future. ONE SENTENCE SUMMARY: The
multicomponent intervention targeted to the deficits of vulnerable older
adults hospitalized with acute cardiovascular diseases successfully
de-frailed them on a short-term basis, which can have positive
implications on their post-discharge health outcomes. Copyright ©
The Author(s) 2022. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<13>
Accession Number
638840819
Title
Impact of residual angina on long-term clinical outcomes after
percutaneous coronary intervention or coronary artery bypass graft for
complex coronary artery disease.
Source
European heart journal. Quality of care & clinical outcomes. 9(5) (pp
490-501), 2023. Date of Publication: 07 Aug 2023.
Author
Ono M.; Serruys P.W.; Kawashima H.; Lunardi M.; Wang R.; Hara H.; Gao C.;
Garg S.; O'Leary N.; Wykrzykowska J.J.; Piek J.J.; Holmes D.R.; Morice
M.-C.; Kappetein A.P.; Noack T.; Davierwala P.M.; Spertus J.A.; Cohen
D.J.; Onuma Y.
Institution
(Ono, Kawashima, Hara, Wykrzykowska, Piek) Department of Cardiology,
Academic Medical Centre, University of Amsterdam, Meibergdreef 9,
Amsterdam, Netherlands
(Ono, Serruys, Kawashima, Lunardi, Wang, Hara, Gao, O'Leary, Onuma)
Department of Cardiology, National University of Ireland, Galway (NUIG ),
Galway, Ireland
(Serruys, Onuma) CURAM-SFI Centre for Research in Medical Devices, Galway,
Ireland
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Wang, Gao) Department of Cardiology, Radboud University, Nijmegen,
Netherlands
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Wykrzykowska) Department of Cardiology, University Medical Center
Groningen, Groningen, Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Hopital prive Jacques Cartier, Ramsay Generale de Sante Massy,
France
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Noack, Davierwala) University Department of Cardiac Surgery, Heart Centre
Leipzig, Leipzig, Germany
(Davierwala) Department of Surgery, University of Toronto
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, 15 University Health Network, Toronto,
ON, Canada
(Spertus) Department of Cardiology, Saint Luke's Mid America Heart
Institute/UMKC, Kansas City, MO 22, United States
(Cohen) Clinical and Outcomes Research, Cardiovascular Research
Foundation, New York NY and St. Francis Hospital, United States
Publisher
NLM (Medline)
Abstract
AIMS: The aim of this study was to investigate the impact on 10-year
survival of patient-reported anginal status at 1 year following
percutaneous coronary intervention (PCI) or coronary artery bypass graft
(CABG) in patients with left main coronary artery disease (LMCAD) and/or
three-vessel CAD (3VD). METHODS AND RESULTS: In this post hoc analysis of
the randomized SYNTAX Extended Survival study, patients were classified as
having residual angina (RA) if their self-reported Seattle Angina
Questionnaire angina frequency (SAQ-AF) scale was <=90 at the 1-year
follow-up post-revascularization with PCI or CABG. The primary endpoint of
all-cause death at 10 years was compared between the RA and no-RA groups.
A sensitivity analysis was performed using a 6-month SAQ-AF.At 1 year, 373
(26.1%) out of 1428 patients reported RA. Whilst RA at 1 year was an
independent correlate of repeat revascularization at 5 years [18.3 vs.
11.5%; adjusted hazard ratio (HR): 1.54; 95% confidence interval (CI):
1.10-2.15], it was not associated with all-cause death at 10 years (22.1
vs. 21.6%; adjusted HR: 1.11; 95% CI: 0.83-1.47). These results were
consistent when stratified by the modality of revascularization (PCI or
CABG) or by anginal frequency. The sensitivity analysis replicating the
analyses based on 6-month angina status resulted in similar findings.
 CONCLUSION(S): Among patients with LMCAD and/or 3VD, patient-reported
RA at 1 year post-revascularization was independently associated with
repeat revascularization at 5 years; however, it did not significantly
increase 10-year mortality, irrespective of the primary modality of
revascularization or severity of RA. Copyright © The Author(s)
2022. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<14>
Accession Number
2026251086
Title
Therapeutic Outcomes Following Isolated Transcatheter Tricuspid Valve
Repair: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(12) (no pagination), 2023. Article
Number: 101985. Date of Publication: December 2023.
Author
Siddiqui H.F.; Khan A.B.; Nasir M.M.; Latif F.; Siddiqui A.F.; Akhtar P.;
Hamza M.; Barmanwalla A.
Institution
(Siddiqui, Khan, Nasir, Latif) Department of Internal Medicine, Dow
University of Health Sciences, Sindh, Karachi, Pakistan
(Siddiqui) Department of Internal Medicine, Aga Khan University Hospital,
Sindh, Karachi, Pakistan
(Akhtar) Department of Cardiology, National Institute of Cardiovascular
Diseases, Sindh, Karachi, Pakistan
(Hamza) Department of Internal Medicine, Albany Medical Center, Albany,
NY, United States
(Barmanwalla) MD Brigham and Women's Hospital and Cape Cod Hospital,
Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid regurgitation (TR) is traditionally treated surgically, but
isolated transcatheter tricuspid valve repair (ITTVR) offers a less
invasive option. This study conducts a meta-analysis and systematic review
to evaluate ITTVR outcomes in patients with TR. Database searches until
March 2023 identified studies assessing ITTVR safety and efficacy in
moderate/severe TR patients. Primary outcomes analyzed were severe TR,
NYHA functional class improvement, and 6-minute walking distance.
Meta-analyses used Risk ratio (RR) or mean difference with a random
effects model. The review included 25 studies with 2421 patients. ITTVR
improved NYHA functional class (RR: 3.262), reduced TR severity (RR:
0.303), and enhanced 6-minute walking distance (MD: +47.077 m).
Echocardiographic parameters improved, including reductions in TR vena
contracta, TR EROA, septolateral tricuspid annular diameter, RVEDD, RV
FAC, and TAPSE. LVEF and PASP showed no significant changes. ITTVR
improves functional outcomes and echocardiographic parameters in TR
patients. Copyright © 2023 Elsevier Inc.

<15>
Accession Number
2026211591
Title
Efficacy of Perioperative Infusion of N(2)-L-alanyl-L-glutamine in
Glycemic Control for Patients With Uncontrolled Diabetes Mellitus
Presented for Urgent Coronary Artery Bypass Surgery: A Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Ahmad A.H.M.; Kamal Eldin F.; Rashed M.M.
Institution
(Ahmad, Kamal Eldin, Rashed) Faculty of Medicine, Ain Shams University,
Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the efficacy of preoperative glutamine infusion in
reducing insulin requirements in patients with uncontrolled type 2
diabetes, defined as glycated hemoglobin (HbA1c) >7%, undergoing urgent
coronary artery bypass graft (CABG) surgery. Design(s): A randomized
controlled trial. Setting(s): At Ain Shams University Hospital,
Cardiothoracic Academy. Participant(s): Ninety-three patients (of
both sexes) with uncontrolled diabetes presenting for urgent CABG were
categorized into 2 groups. Intervention(s): The dipeptiven group (n =
46) was given an infusion of dipeptiven 1.5 mL/kg body weight dissolved in
normal saline (200 mL) over 3 hours before surgery. The control group (n =
47) received a normal saline infusion (200 mL). Measurements and Main
Results: The dipeptiven group demonstrated statistically significant lower
intraoperative (173.74 +/- 19.97 mg/dL v 198.22 +/-14.64 mg/dL) and
postoperative (162.36 +/-13.11 mg/dL v 176.13 +/-14.86 mg/dL) mean blood
glucose levels. In addition, dipeptiven infusion was found to reduce mean
total insulin requirements intraoperatively by 3.64 +/- 0.56 units/h and
postoperatively by 37.109 +/- 4.30 units/24 h in comparison to placebo
(50.98 +/- 16.55 units/24 h and 5.10 +/- 2.28 units/h, respectively).
 Conclusion(s): A preoperative infusion of dipeptiven can contribute
to ameliorating stress hyperglycemia in uncontrolled diabetic patients
undergoing urgent CABG. Copyright © 2023 Elsevier Inc.

<16>
Accession Number
2024828372
Title
Utilization and outcomes of V-AV ECMO: A systematic review and
meta-analysis.
Source
Artificial Organs. (no pagination), 2023. Date of Publication: 2023.
Author
Saxena A.; Curran J.; Ahmad D.; Nasher N.; Miyamoto T.; Brailovsky E.;
Shah M.K.; Rajapreyar I.N.; Rame J.E.; Loforte A.; Entwistle J.W.; Massey
H.T.; Tchantchaleishvili V.
Institution
(Saxena, Curran, Ahmad, Nasher, Miyamoto, Entwistle, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Brailovsky, Shah, Rajapreyar, Rame) Division of Cardiology, Thomas
Jefferson University, Philadelphia, PA, United States
(Loforte) Dipartimento Cardio-Toraco-Vascolare, UOC di Cardiochirurgia,
Policlinico di S. Orsola, Universita di Bologna, Bologna, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Veno-arterial-venous extracorporeal membrane oxygenation (V-AV
ECMO) is a less commonly used configuration of ECMO. We sought to
understand the indications, utilization patterns, and outcomes of V-AV
ECMO by quantitatively pooling the existing evidence from the literature.
 Method(s): Electronic search was performed to identify all relevant
studies reporting V-AV ECMO usage. Five studies comprising 77 patients
were selected and cohort-level data were extracted for further analysis.
 Result(s): Mean patient age was 61 (95% CI: 55.2, 66.5) years and 30%
(23/77) were female. The majority of cases [91% (70/77)] were transitioned
to V-AV ECMO from another pre-existing ECMO configuration: V-A ECMO in 55%
(42/77) vs. V-V ECMO in 36% (28/77), p = 0.04. Only 9% (7/77) of cases
were directly placed on V-AV ECMO. The mean duration of hospital stay was
42.3 (95% CI: 10.5, 74.2) days, while ICU mortality was 46% (29, 64).
Transition to durable left ventricular assist device was performed in 3%
(2/64) of patients, while 3% (2/64) underwent heart transplantation. V-AV
ECMO was successfully weaned to explantation in 33% (21/64) of patients.
 Conclusion(s): V-AV ECMO is a viable option for optimizing
cardiopulmonary support in selected patients. Survival to weaning or
bridging therapy appears comparable to more common ECMO
configurations. Copyright © 2023 International Center for
Artificial Organs and Transplantation and Wiley Periodicals LLC.

<17>
Accession Number
2024796175
Title
Nonprocedural bleeding after left atrial appendage closure versus direct
oral anticoagulants: A subanalysis of the randomized PRAGUE-17 trial.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2023. Date
of Publication: 2023.
Author
Branny M.; Osmancik P.; Kala P.; Poloczek M.; Herman D.; Neuzil P.; Hala
P.; Taborsky M.; Stasek J.; Haman L.; Chovancik J.; Cervinka P.; Holy J.;
Kovarnik T.; Zemanek D.; Havranek S.; Vancura V.; Peichl P.; Tousek P.;
Hozman M.; Lekesova V.; Jarkovsky J.; Novackova M.; Benesova K.; Widimsky
P.; Reddy V.Y.
Institution
(Branny, Chovancik) Department of Cardiology, Cardiocenter, Hospital
Podlesi a.s., Trinec, Czechia
(Branny) Department of Internal Medicine and Cardiology, Faculty of
Medicin, University Hospital Ostrava, Ostrava, Czechia
(Osmancik, Herman, Tousek, Hozman, Widimsky) Department of Cardiology,
Third Faculty of Medicine, University Hospital Kralovske Vinohrady,
Charles University, Prague, Czechia
(Kala, Poloczek) Department of Internal Medicine and Cardiology,
University Hospital Brno and Medical Faculty of Masaryk University, Brno,
Czechia
(Neuzil, Hala, Lekesova, Reddy) Department of Cardiology, Cardiocenter, Na
Homolce Hospital, Prague, Czechia
(Taborsky) Department of Cardiology, Cardiocenter, University Hospital
Olomouc, Olomouc, Czechia
(Stasek, Haman) 1st Department of Internal Medicine, Faculty of Medicine,
University Hospital Hradec Kralove, Charles University Prague, Prague,
Czechia
(Cervinka, Holy) Department of Cardiology, Krajska zdravotni a.s., Masaryk
Hospital and UJEP, Usti nad Labem, Czechia
(Kovarnik, Zemanek, Havranek) Cardiocenter, 2nd Internal Clinic-Cardiology
and Angiology, General Faculty Hospital, Charles University, Prague,
Czechia
(Vancura) Department of Cardiology, University Hospital and Faculty of
Medicine Pilsen, Pilsen, Czechia
(Peichl) Cardiocenter, Institute of Clinical and Experimental Medicine,
Prague, Czechia
(Jarkovsky, Novackova, Benesova) Institute of Biostatistics and Analyses,
Masaryk University, Brno, Czechia
(Reddy) Icahn School of Medicine at Mount Sinai, Helmsley
Electrophysiology Center, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Observational studies have shown low bleeding rates in
patients with atrial fibrillation (AF) treated by left atrial appendage
closure (LAAC); however, data from randomized studies are lacking. This
study compared bleeding events among patients with AF treated by LAAC and
nonvitamin K anticoagulants (NOAC). Method(s): The Prague-17 trial
was a prospective, multicenter, randomized trial that compared LAAC to
NOAC in high-risk AF patients. The primary endpoint was a composite of a
cardioembolic event, cardiovascular death, and major and clinically
relevant nonmajor bleeding (CRNMB) defined according to the International
Society on Thrombosis and Hemostasis (ISTH). Result(s): The trial
enrolled 402 patients (201 per arm), and the median follow-up was 3.5 (IQR
2.6-4.2) years. Bleeding occurred in 24 patients (29 events) and 32
patients (40 events) in the LAAC and NOAC groups, respectively. Six of the
LAAC bleeding events were procedure/device-related. In the primary
intention-to-treat analysis, LAAC was associated with similar rates of
ISTH major or CRNMB (sHR 0.75, 95% CI 0.44-1.27, p = 0.28), but with a
reduction in nonprocedural major or CRNMB (sHR 0.55, 95% CI 0.31-0.97, p =
0.039). This reduction for nonprocedural bleeding with LAAC was mainly
driven by a reduced rate of CRNMB (sHR for major bleeding 0.69, 95% CI
0.34-1.39, p =.30; sHR for CRNMB 0.43, 95% CI 0.18-1.03, p = 0.059).
History of bleeding was a predictor of bleeding during follow-up.
Gastrointestinal bleeding was the most common bleeding site in both
groups. Conclusion(s): During the 4-year follow-up, LAAC was
associated with less nonprocedural bleeding. The reduction is mainly
driven by a decrease in CRNMB. Copyright © 2023 The Authors.
Journal of Cardiovascular Electrophysiology published by Wiley Periodicals
LLC.

<18>
Accession Number
641969041
Title
The Effect of Hand Reflexology Massage on Pain and Anxiety After Coronary
Artery Bypass Graft Surgery: A Double-Blind, Randomized,
Placebo-Controlled Trial.
Source
The Journal of cardiovascular nursing. (no pagination), 2023. Date of
Publication: 07 Aug 2023.
Author
Goktuna G.; Dagcan N.; Arslan G.G.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Pain and anxiety are common postoperative problems that impair
recovery and quality of life in patients undergoing coronary artery bypass
graft (CABG) surgery. Reflexology is a nonpharmacologic method used to
control pain and anxiety. OBJECTIVE(S): The aim of this study was to
examine the effects of reflexology hand massage and stroking massage on
pain and anxiety in patients in the immediate postoperative period after
CABG. METHOD(S): In this double-blind, randomized, placebo-controlled
study, we compared the effects of a 20-minute hand-reflexology massage to
placebo stroking massage on pain and anxiety in newly extubated patients
in the intensive care unit who had undergone CABG surgery. Pain was
measured by visual analog scale and anxiety by the State-Trait Anxiety
Inventory before and at 5, 30, and 60 minutes post intervention.
 RESULT(S): A total of 48 patients were enrolled: 24 in the
intervention group and 24 in the placebo. Mean pain scores were
significantly reduced in the group who received reflexology compared with
the placebo group (F = 36.569, P = .000). Mean anxiety scores were
significantly reduced at 60 minutes for the reflexology group compared
with the control group (P = .000). CONCLUSION(S): We found that hand
reflexology massage was effective in reducing pain and anxiety in patients
during the immediate postoperative period after CABG. Copyright ©
2023 Wolters Kluwer Health, Inc. All rights reserved.

<19>
Accession Number
641968651
Title
Influence of regional nerve block in addition to general anesthesia on
postoperative delirium, pain, and in-hospital stay in patients undergoing
cardio-thoracic surgery: a meta-analysis.
Source
Journal of cardiovascular pharmacology. (no pagination), 2023. Date of
Publication: 07 Aug 2023.
Author
Li L.; Liu M.; Li S.; Xu J.; Zheng J.; Lv C.; Wu L.; Heng L.
Institution
(Li, Lv) Department of Critical Care Medicine, First People's Hospital of
Xuzhou, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,
Affiliated Hospital of mining and technology of China University, Xuzhou,
Jiangsu, China
(Liu) Department of Thoracic Surgery, Xuzhou Central Hospital, Xuzhou,
Jiangsu, China
(Li, Zheng) Department of Orthopedics, First People's Hospital of Xuzhou,
Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,
Affiliated Hospital of mining and technology of China University, Xuzhou,
Jiangsu, China
(Xu) Department of Ophthalmology, First People's Hospital of Xuzhou,
Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,
Affiliated Hospital of mining and technology of China University, Xuzhou,
Jiangsu, China
(Wu) Department of Hemodialysis, First People's Hospital of Xuzhou, Xuzhou
Municipal Hospital Affiliated to Xuzhou Medical University, Affiliated
Hospital of mining and technology of China University, Xuzhou, Jiangsu,
China
(Heng) Department of Anesthesiology, Xuzhou Cancer Hospital, Jiangsu
Province 221005, China
(Heng) Department of Anesthesiology, Xuzhou New Healthy Geriatric
Hospital, Jiangsu Province 221005, China
(Heng) Department of Anesthesiology, Affiliated Xuzhou Hospital of JiangSu
University, Jiangsu Province 221005, China
Publisher
NLM (Medline)
Abstract
ABSTRACT: This study aims to investigate whether venous injection of
sedative agent or regional nerve block in alliance with major anesthesia
could decrease the risk of postoperative delirium occurrence in patients
receiving cardio-thoracic surgery. Electronic academic databases were
retrieved for related publications, and statistical software was used for
data pooling and analysis. Forrest plot was used to show the pooled
sensitivity, specificity and diagnostic odds ratio. Combined ROC curve was
used to show the area of under curve of complex data. seven studies were
included for analysis. The risk of occurrence of delirium still showed no
difference (RR = 0.93, 95% CI: 0.85 - 1.03) between intervention group and
placebo group. Postoperative pain feeling was more alleviated in patients
with prophylactic application of regional nerve block. Additionally,
prophylactic application of regional nerve block could decrease the risk
of post-operative in-hospital stay (RR = 0.28, 95% CI: 0.02 - 0.54). Our
study demonstrated that, in elderly patients or pediatric patients
undergoing cardiac surgery, prophylactic application of regional nerve
block failed to decrease the incidence of postoperative delirium. However,
the option of regional nerve block could decrease the duration of
in-hospitalization stay and alleviate the acute pain during postoperative
period after open-heart surgery. Copyright © 2023 Wolters Kluwer
Health, Inc. All rights reserved.

<20>
Accession Number
641967109
Title
Psychological outcomes of the systematic interventions based on the
stress-induced situation, affective, bodily, and cognitive reactions
framework for patients with lung cancer: A randomized clinical trial.
Source
International journal of nursing studies. 146 (pp 104566), 2023. Date of
Publication: 22 Jul 2023.
Author
Zhang Q.; Tang L.; Chen H.; Chen S.; Luo M.; He Y.; Liu M.
Institution
(Zhang, Chen) Department of Medical Psychology, Second Affiliated Hospital
of Army Medical University, Chongqing 400037, China
(Tang, Luo, He) Department of Thoracic Surgery, Second Affiliated Hospital
of Army Medical University, Chongqing 400037, China
(Chen) Digestive Department, Second Affiliated Hospital of Army Medical
University, Chongqing 400037, China
(Liu) Emergency Department, First Affiliated Hospital of Army Medical
University, Chongqing 400038, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Psychological distress is a multi-factorial unpleasant
experience of a psychological, social, spiritual, and/or physical nature
that may interfere with one's ability to cope effectively with cancer,
physical symptoms and treatment. Psychological distress is common and
affects the prognosis of cancer patients. Lung cancer accounted for 11.4%
of all new cancer cases and 18% of all cancer mortality for 36 cancers in
185 countries. The prevalence of distress among Chinese lung cancer
patients ranged from 10.1% to 61.29%. However, the existing intervention
studies on the psychological distress in lung cancer patients are limited
and intervention results may be different. OBJECTIVE(S): To explore
the psychological outcomes of a nurse-led systematic intervention program
based on the stress-induced situation, affective, bodily, and cognitive
reactions framework for patients with lung cancer undergoing operation at
anxiety and depression. DESIGN: A randomized clinical trial. SETTING:
Thoracic surgery ward in a tertiary hospital in China. PARTICIPANTS: Lung
cancer patients undergoing surgery. METHOD(S): This is a 12-month
longitudinal randomized controlled study in a tertiary hospital in China.
A total of 240 lung cancer patients were randomly divided into either the
control group or the intervention group. The nurse-led systematic
intervention contents include psychological education, intervention
measures based on the stress-induced situation, affective, bodily, and
cognitive reactions framework, issuance of daily lifestyle cards, and
regular follow-ups. The Hospital Anxiety and Depression Scale, Functional
Assessment of Chronic Illness Therapy-Fatigue Scale, and Satisfaction with
Life Scale were used for the baseline assessment within 48h upon
admission. The same assessment was performed respectively at 1, 3, 6 and
12months after the intervention started. The effects of the systematic
interventions on depression, anxiety, fatigue, and life satisfaction were
tested by a linear mixed effects model. RESULT(S): Overall
time-by-group interaction effects were significantly different with regard
to anxiety, depression, and fatigue after controlling for the covariates,
while a significant time-by-group interaction effect was not found for
life satisfaction. Changes for anxiety and depression scores at 6 and
12months after initiation of the intervention were significantly greater
in the intervention group compared with those in the control group
(t=3.046, p=0.002, t=3.190, p=0.001; t=3.735, p=0.000, t=2.979, p=0.002),
whereas scores for fatigue were significantly higher in the intervention
group at 6 and 12months (t=-3.096, p=0.002, t=-2.784, p=0.005).
 CONCLUSION(S): The systematic intervention program based on the
stress-induced situation, affective, bodily, and cognitive reactions
framework may effectively relieve anxiety, depression, and fatigue in lung
cancer patients undergoing surgery. REGISTRATION: This study was
registered on December 22, 2019 with the registration number
ChiCTR1900028487, and the date of first recruitment was Jan 5,
2020. Copyright © 2023 Elsevier Ltd. All rights reserved.

<21>
Accession Number
2025993237
Title
Does the weekend effect exist for acute type A aortic dissection?-a
retrospective case-control study.
Source
Journal of Thoracic Disease. 15(6) (pp 3069-3078), 2023. Date of
Publication: June 2023.
Author
Wu J.; Tong G.; Chen J.F.; Yu C.; Yang J.; Chen Z.; Li X.; Yan X.; Zhuang
D.; Yang Y.; Liu Y.; Liang Z.; Liu J.; Zhang Z.; Fan R.; Sun T.
Institution
(Wu, Tong, Yu, Yang, Chen, Li, Yan, Zhuang, Yang, Liu, Liang, Liu, Zhang,
Fan, Sun) Department of Cardiac Surgery, Guangdong Cardiovascular
Institute, Guangdong Provincial People's Hospital, Guangdong Academy of
Medical Sciences, Guangzhou, China
(Chen) Division of Vascular and Endovascular Surgery, Department of
Surgery, University of Toronto, Toronto, Canada
Publisher
AME Publishing Company
Abstract
Background: The weekend effect refers to the mortality difference for
patients admitted/operated on weekends compared to those on weekdays. The
study aimed to provide new evidence on the impact of the weekend effect on
acute type A aortic dissection (ATAAD). Method(s): Primary endpoints
were operative mortality, stroke, paraplegia, and continuous renal
replacement therapy (CRRT). A meta-analysis of current evidence on the
weekend effect was first conducted. Analyses based on single-center data
(retrospective, case-control study) were further performed.
 Result(s): A total of 18,462 individuals were included in the
meta-analysis. The pooled results showed that mortality was not
significantly higher for ATAAD on weekends compared to that on weekdays
[odds ratio (OR): 1.16, 95% CI: 0.94-1.43]. The single-center cohort
included 479 patients, which also showed no significant differences in
primary and secondary outcomes between the two groups. The unadjusted OR
for weekend group over weekday group was 0.90 (95% CI: 0.40-1.86,
P=0.777). The adjusted OR for weekend group was 0.94 (95% CI: 0.41-2.02,
P=0.880) controlling for significant preoperative factors, and 0.75 (95%
CI: 0.30-1.74, P=0.24) controlling for significant preoperative and
operative factors altogether. In PSM matched cohort, the operative
mortality was still comparable between the weekend group [10 (7.2%)] and
weekday group [9 (6.5%)] (P=1.000). No significant survival difference was
observed between the two groups (P=0.970). Conclusion(s): The weekend
effect was not found to be applicable to ATAAD. However, clinicians should
be cautious of the weekend effect as it is disease-specific and may vary
across healthcare systems. Copyright © 2023 AME Publishing
Company. All rights reserved.

<22>
Accession Number
2025495579
Title
Total Arterial Revascularization in Diabetic Patients Undergoing Coronary
Artery Bypass Graft Surgery: A Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(6) (no pagination), 2023. Article
Number: rcm2406183. Date of Publication: June 2023.
Author
Liao G.-Z.; Liu T.; Li Y.-M.; Bai L.; Ye Y.-Y.; Chen X.-F.; Peng Y.
Institution
(Liao, Liu, Li, Bai, Ye, Chen, Peng) Department of Cardiology, West China
Hospital, Sichuan University, Sichuan, Chengdu 610041, China
Publisher
IMR Press Limited
Abstract
Background: Total arterial revascularization (TAR) has gradually become
accepted and recognized, but its effect and safety in diabetic patients
are not clear. We performed a systematic review and meta-analysis to
summarize the safety and efficacy of TAR and additionally evaluated the
clinical outcomes of arterial revascularization using different arterial
deployments in patients with diabetes. Method(s): PubMed, Embase, and
the Cochrane Library databases from inception to July 2022 for studies
that studied the effect of arterial revascularization in diabetic patients
undergoing isolated coronary artery bypass graft (CABG) were searched. The
primary outcome was long-term (>=12 months of follow-up) death by any
cause. The secondary efficacy endpoints were long-term (>=12 months)
cardiovascular death, early sternal wound infection (SWI) and death (<=30
days or in hospital). Risk ratios (RRs), hazard ratios (HRs), and their
corresponding 95% confidence intervals (CIs) were calculated to describe
short-term results and long-term survival outcomes. Two different ways
were used to analyze the effect of TAR and the impact of diabetes on the
clinical outcomes of TAR. Result(s): Thirty-five studies were
included in the study, covering 178,274 diabetic patients. Compared to
conventional surgery with saphenous veins, TAR was not associated with
increased early mortality (RR 0.77, 95% CI 0.48-1.23) and risk of SWI (RR
0.77, 95% CI 0.46-1.28). The overall Kaplan-Meier survival curves based on
reconstructed patient data indicated a significant association between TAR
and reduced late mortality (HR 0.52, 95% CI 0.48-0.67) and the curves
based on the propensity-score matched (PSM) analyses suggested a similar
result (HR 0.74, 95% CI 0.66-0.85). TAR could also effectively decrease
the risk of cardiovascular death (HR 0.42, 95% CI 0.24-0.75). Through
comparing the effect of TAR in patients with and without diabetes, we
found that the presence of diabetes did not elevate the risk of early
adverse events (death: RR 1.50, 95% CI 0.64-3.49 SWI: RR 2.52, 95% CI
0.91-7.00). Although diabetes increased long-term mortality (HR 1.06 95%
CI 1.35-2.03), the cardiovascular death rate was similar in patients with
diabetes and patients without diabetes (HR 1.09 95% CI 0.49-2.45).
Regarding the selection of arterial conduits, grafting via the bilateral
internal mammary artery (BIMA) decreased the risk of overall death (HR
0.67, 95% CI 0.52-0.85) and cardiovascular death (HR 0.55, 95% CI
0.35-0.87) without resulting in a significantly elevated rate of early
death (RR 0.95, 95% CI 0.82-1.11). However, the evidence from PSM studies
indicated no difference between the long-term mortality of the BIMA group
and that of the single internal mammary arteries (SIMA) groups (HR 0.76,
95% CI 0.52-1.11), and the risk of SWI was significantly increased by BIMA
in diabetes (RR 1.65, 95% CI 1.42-1.91). The sub-analysis indicated the
consistent benefit of the radial artery (RA) application in diabetic
patients (HR 0.71, 95% CI 0.63-0.79) compared to saphenous vein graft. In
two propensity-score-matched studies, the evidence showed that the
survival outcomes of the BIMA group were similar to that of the SIMA plus
RA group but that grafting via the RA reduced the risk of sternal wound
infection. Conclusion(s): Compared with conventional surgery using
SVG, TAR was associated with an enhanced survival benefit in diabetes and
this long-term gain did not increase the risk of early mortality or SWI.
Given the increased infection risk and controversial long-term survival
gains of grafting via the BIMA in diabetes, its wide use for grafting in
this cohort should be seriously considered. Compared to using the right
internal mammary artery (RIMA), RA might be a similarly effective but
safer option for patients with diabetes. Copyright: © 2023 The
Author(s).

<23>
Accession Number
2025495578
Title
Different Techniques of Surgical Left Atrial Appendage Closure and Their
Efficacy: A Systematic Review.
Source
Reviews in Cardiovascular Medicine. 24(6) (no pagination), 2023. Article
Number: rcm2406184. Date of Publication: June 2023.
Author
D'Abramo M.; Romiti S.; Saltarocchi S.; Saade W.; Spunticchia F.; Bruno
N.; Peruzzi M.; Miraldi F.; Frati G.; Greco E.; Macrina F.; De Orchi P.;
Marullo A.G.M.
Institution
(D'Abramo, Romiti, Saltarocchi, Saade, Spunticchia, Bruno, Peruzzi,
Miraldi, Greco, Macrina, De Orchi) Department of Clinical, Internal
Anesthesiological and Cardiovascular Sciences, Sapienza University of
Rome, Rome 00161, Italy
(Peruzzi) Department of Cardiology, Mediterranea Cardiocentro, Naples
80122, Italy
(Frati, Marullo) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina 04100, Italy
(Frati) Department of Angiocardioneurology, IRCCS NeuroMed, IS, Pozzilli
86077, Italy
Publisher
IMR Press Limited
Abstract
Background: Atrial fibrillation has been identified as an independent risk
factor for thromboembolic events. Since 1948 different surgical techniques
have described the feasibility and the rationale of left atrial surgical
appendage closure. The aim of this systematic review is to evaluate the
reported patency rates of different surgical techniques. Method(s):
This systematic review was conducted according to preferred reporting
items for systematic reviews and meta-analyses (PRISMA) guidelines. Two
independent investigators searched the PubMed, Scopus, Web of Science,
Cochrane Central Register of Controlled Trials, and OVID (Wolters Kluwer,
Alphen aan den Rijn, Netherlands) to identify relevant studies.
Consecutively, a PICO (Population, Intervention, Comparison and Outcomes)
strategy assessment of literature was performed to search eventual other
relevant studies that may have been ignored. Result(s): A total of 42
studies were included in our analysis. The total number of patients who
underwent surgical left atrial appendage closure was 5671, and in 61.2% an
imaging follow up was performed, mostly with transesophageal
echocardiographic evaluation. Success rate for the different techniques
was: Clip deployment 98% Lariat procedure 88% Surgical amputation 91%
Endocardial suture 74.3%, Epicardial suture 65% Left atrial appendage
closure (LAAC) ligation 60.9% Stapler technique with excision of left
atrial appendage (LAA) 100% Stapler without excision 70%.
 Conclusion(s): To date, data on surgical left atrial appendage
closure are poor and not standardized, even if reported rates are
acceptable and comparable to transcatheter procedures. If validated on
large-scale non-retrospective and multicentric studies, these promising
developments may offer a valuable alternative for patients with atrial
fibrillation (AF) and ineligible for oral anticoagulation
therapy. Copyright: © 2023 The Author(s).

<24>
[Use Link to view the full text]
Accession Number
2025146886
Title
Prehabilitation before elective coronary artery bypass grafting surgery: a
scoping review.
Source
JBI Evidence Synthesis. 21(6) (pp 1190-1242), 2023. Date of Publication:
20 Jun 2023.
Author
Olsen D.B.; Pedersen P.U.; Noergaard M.W.
Institution
(Olsen) Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Pedersen, Noergaard) Danish Centre of Systematic Reviews: A Jbi Centre of
Exellence, Centre of Clinical Guidelines, Danish National Clearinghouse,
Aalborg University, Denmark
(Noergaard) Department of Cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The objective of this scoping review was to identify and map
existing preoperative interventions, referred to as prehabilitation, in
adult patients at home awaiting elective coronary artery bypass grafting
surgery. This review also sought to report feasibility and patient
experiences to shape clinical practice and underpin a future systematic
review. Introduction: As patients age, comorbidities become more common.
Strategies to improve postoperative outcomes and to accelerate recovery
are required in patients undergoing coronary artery bypass grafting.
Prehabilitation refers to a proactive process of increasing functional
capacity before surgery to improve the patient's ability to withstand
upcoming physiologic stress and, thus, avoid postoperative complications.
Inclusion criteria: Studies that included adult patients waiting for
coronary artery bypass grafting surgery at home and that described
interventions optimizing preoperative physical and psychological health in
any setting were included. Method(s): The JBI methodology for
conducting scoping reviews was used to identify relevant studies in
MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Library, Embase (Ovid),
Scopus, SweMed+, PsycINFO (EBSCOhost), and PEDro. Gray literature was
identified searching Google Scholar, ProQuest Dissertations and Theses,
MedNar, OpenGrey, NICE Evidence search, and SIGN. Studies in Danish,
English, German, Norwegian, and Swedish were considered for inclusion,
with no geographical or cultural limitations, or date restrictions. Two
independent reviewers screened titles and abstracts, and studies meeting
the inclusion criteria were imported into Covidence. Sixty-seven studies
from November 1987 to September 2022 were included. The data extraction
tool used for the included papers was developed in accordance with the
review questions and tested for adequacy and comprehensiveness with the
first 5 studies by the same 2 independent reviewers. The tool was then
edited to best reflect the review questions. Extracted findings are
described and supported by figures and tables. Result(s): Sixty-seven
studies were eligible for inclusion, representing 28,553 participants.
Analyses of extracted data identified various preoperative interventions
for optimizing postoperative and psychological outcomes for adult patients
awaiting elective coronary artery bypass grafting surgery. Based on
similarities, interventions were grouped into 5 categories. Eighteen
studies reported on multimodal interventions, 17 reported on psychological
interventions, 14 on physical training interventions, 13 on education
interventions, and 5 on oral health interventions. Conclusion(s):
This scoping review provides a comprehensive summary of strategies that
can be applied when developing a prehabilitation program for patients
awaiting elective coronary artery bypass surgery. Although prehabilitation
has been tested extensively and appears to be feasible, available evidence
is mostly based on small studies. For patients undergoing elective
coronary artery bypass grafting to derive benefit from prehabilitation,
methodologically robust clinical trials and knowledge synthesis are
required to identify optimal strategies for patient selection,
intervention design, adherence, and intervention duration. Future research
should also consider the cost-effectiveness of prehabilitation
interventions before surgery. Finally, there is a need for more
qualitative studies examining whether individual interventions are
meaningful and appropriate to patients, which is an important factor if
interventions are to be effective. Copyright © JBI Evidence
Synthesis. All Rights Reserved.

<25>
Accession Number
2024353861
Title
Calcification in Pulmonary Heart Valve Tissue Engineering: A Systematic
Review and Meta-Analysis of Large-Animal Studies.
Source
JACC: Basic to Translational Science. 8(5) (pp 572-591), 2023. Date of
Publication: May 2023.
Author
van der Valk D.C.; Fomina A.; Uiterwijk M.; Hooijmans C.R.; Akiva A.;
Kluin J.; Bouten C.V.C.; Smits A.I.P.M.
Institution
(van der Valk, Fomina, Bouten, Smits) Department of Biomedical
Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
(van der Valk, Bouten, Smits) Institute for Complex Molecular Systems,
Eindhoven University of Technology, Eindhoven, Netherlands
(Uiterwijk, Kluin) Heart Center, Amsterdam University Medical Center,
Amsterdam, Netherlands
(Fomina) Graduate School of Life Sciences, Utrecht University, Utrecht,
Netherlands
(Hooijmans) Department for Health Evidence (Unit SYstematic Review Centre
for Laboratory animal Experimentation [SYRCLE]), Radboud University
Medical Center, Nijmegen, Netherlands
(Hooijmans) Department of Anesthesiology, Pain and Palliative Care,
Radboud University Medical Center, Nijmegen, Netherlands
(Akiva) Department of Biochemistry, Radboud University Medical Center,
Institute for Molecular Life Sciences, Nijmegen, Netherlands
Publisher
Elsevier Inc.
Abstract
Tissue-engineered heart valves (TEHVs) are emerging alternatives to
current valve prostheses and prospectively a lifelong replacement.
Calcification, a pathological complication for biological protheses, has
been reported in preclinical TEHV studies. Systematic analysis of its
occurrence is missing. This review aims to: 1) systematically review
reported calcification of pulmonary TEHVs in large-animal studies; and 2)
analyze the influence of engineering methodology (choice of scaffold
material, cell preseeding) and animal model (animal species and age) on
calcification. Baseline analysis included 80 studies, of which 41 studies
containing 108 experimental groups were included in meta-analysis.
Inclusion was low because only 55% of studies reported on calcification.
Meta-analysis showed an overall average calcification event rate of 35%
(95% CI: 28%-43%). Calcification was more prominent (P = 0.023) in the
arterial conduit region (34%; 95% CI: 26%-43%) than in the valve leaflets
(21%; 95% CI: 17%-27%), and was mostly (42% in leaflets, 60% in conduits)
present in a mild form. Time-analysis showed an initial surge within 1
month after implantation, decreased calcification between 1 and 3 months,
and then progression over time. There were no significant differences in
degree of calcification between TEHV strategy nor animal models. Much
variability between individual studies was observed in degree of
calcification as well as quality of analysis and reporting thereof,
hampering adequate comparisons between studies. These findings underline
the need for improved analysis and better reporting standards of
calcification in TEHVs. It also necessitates control-based research to
further enlighten the risk of calcification for tissue-engineered
transplants compared to current options. This can bring the field of heart
valve tissue engineering forward toward safe clinical use. Copyright
© 2023 The Authors

<26>
Accession Number
2023693619
Title
Efficacy and safety of moderate-intensity statin with ezetimibe
combination therapy in patients after percutaneous coronary intervention:
a post-hoc analysis of the RACING trial.
Source
eClinicalMedicine. 58 (no pagination), 2023. Article Number: 101933. Date
of Publication: April 2023.
Author
Park J.-I.; Lee S.-J.; Hong B.-K.; Cho Y.-H.; Shin W.-Y.; Lim S.-W.; Kang
W.-C.; Park Y.; Lee S.-Y.; Lee Y.-J.; Ahn C.-M.; Kim B.-K.; Ko Y.-G.; Choi
D.; Hong M.-K.; Jang Y.; Kim J.-S.; Lee J.-H.; Kim U.; Lim Jang S.-W.Y.;
Park Jung Y.Y.H.; Kim K.J.; Hong S.-J.; Yun K.H.; Heo J.H.; Rha S.-W.;
Choi W.G.; Lee W.S.L.; Jung J.; Choi S.; Cho Y.H.; Park W.J.; Youn C.; Hur
S.H.; Choi H.H.; Kim J.H.; Kim H.K.; Choi Y.-J.
Institution
(Park, Lee, Lee, Hong, Ahn, Kim, Ko, Choi, Hong, Kim) Severance Hospital,
Yonsei University College of Medicine, Seoul, South Korea
(Park) Yeungnam University College of Medicine, Daegu, South Korea
(Hong) Gangnam Severance Hospital, Seoul, South Korea
(Cho) Myongji Hospital, Hanyang University College of Medicine, Goyang,
South Korea
(Shin, Jang) Soonchunhyang University Cheonan Hospital, Cheonan, South
Korea
(Lim) CHA University College of Medicine, Seongnam, South Korea
(Kang) Gachon University College of Medicine, Incheon, South Korea
(Park) Gyeongsang National University Changwon Hospital, Changwon, South
Korea
(Lee) Inje University Ilsan Paik Hospital, Ilsan, South Korea
Publisher
Elsevier Ltd
Abstract
Background: Moderate-intensity statin role with ezetimibe combination
therapy following percutaneous coronary intervention (PCI) has not been
thoroughly investigated, particularly compared to high-intensity statin
monotherapy. We aimed to investigate the effect of ezetimibe combination
with moderate-intensity statin in patients with atherosclerotic
cardiovascular disease following PCI. Method(s): This was a post-hoc
analysis of a subset of patients who underwent PCI in the RACING trial. At
26 centres in South Korea, patients with atherosclerotic cardiovascular
disease (ASCVD) were randomly assigned to receive either
moderate-intensity statin with ezetimibe combination therapy (rosuvastatin
10 mg with ezetimibe 10 mg) or high-intensity statin monotherapy
(rosuvastatin 20 mg). The prespecified endpoints of the RACING trial were
used. The primary endpoint was the 3-year composite of cardiovascular
death, major cardiovascular events, and nonfatal stroke. Event rates
between the two groups were compared using log-rank tests, and hazard
ratios (HR) with 95% confidence intervals (CI) were estimated using Cox
regression analysis. Consistent with the RACING trial, the primary and
secondary efficacy endpoints were evaluated using an
intention-to-treatment approach, and the safety endpoints were assessed in
the safety population. The RACING trial was registered at
ClinicalTrials.gov (NCT03044665). Finding(s): Between Feb 14, 2017,
and Dec 18, 2018, 3780 participants were enrolled in the RACING trial.
Prior history of PCI was found in 2497 patients (67%, median 64 years, 79%
male), and was associated with higher rates of the primary endpoint
(hazard ratio [HR], 1.34; 95% confidence interval [CI], 1.06-1.69; p =
0.014). Among patients with prior PCI, moderate-intensity statin therapy
with ezetimibe combination versus high-intensity statin therapy did not
increase the risk of the primary endpoint (HR, 0.95; 95% CI, 0.74-1.24; p
= 0.781). The proportion of patients with low-density lipoprotein
cholesterol (LDL-C) <70 mg/dL at 1, 2, and 3 years was 74%, 76%, and 73%,
respectively, in the combination therapy group, and was significantly
higher than that in the high-intensity statin monotherapy group (57%, 62%,
and 59%, respectively, all p < 0.001). Discontinuation of lipid-lowering
drugs occurred less frequently in the combination group (4.2% vs. 7.6%, p
= 0.001). Interpretation(s): The effects of ezetimibe combination
therapy observed in the RACING trial were consistently preserved among
patients with ASCVD following PCI. Ezetimibe combination could be
considered as a suitable therapeutic strategy to achieve strict control of
LDL-C and reduce drug intolerance in patients who underwent PCI.
 Funding(s): Hanmi Pharmaceutical, Seoul, South Korea Copyright
© 2023 The Author(s)

<27>
Accession Number
2018448898
Title
Preoperative hypoalbuminemia in patients undergoing cardiac surgery: a
meta-analysis.
Source
Surgery Today. 53(8) (pp 861-872), 2023. Date of Publication: August 2023.
Author
Xu R.; Hao M.; Zhou W.; Liu M.; Wei Y.; Xu J.; Zhang W.
Institution
(Xu, Hao, Zhou, Liu, Wei, Xu, Zhang) Department of Cardio-Thoracic
Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde
Road, Nanchang 330006, China
(Xu, Hao, Zhou, Liu) Jiangxi Medical College, Nanchang University,
Nanchang 330006, China
Publisher
Springer
Abstract
The preoperative serum albumin level has been shown to be associated with
adverse postoperative complications, meaning that hypoalbuminemia may also
be a risk factor. We performed a meta-analysis to evaluate the association
of serum albumin levels with survival and complication rates after cardiac
surgery. Relevant articles were identified through seven databases. Twenty
studies with 22553 patients (hypoalbuminemia group, n = 9903; normal
group, n = 12650) who underwent cardiac surgery met the inclusion criteria
after screening. The primary outcomes were that hypoalbuminemia was
significantly correlated with serious long-term all-cause mortality
(hazard ratio [HR]: 1.95 [1.54-2.48]; P < 0.00001) and increased mortality
(risk ratio [RR] = 1.91 [1.61-2.27], P < 0.00001). Hypoalbuminemic
patients with cardiopathy were more likely to suffer postoperative
complications (bleeding, infections, renal injury, and others) than those
whose serum albumin levels were normal. Furthermore, hypoalbuminemia
increased the time in the intensive-care unit (ICU) (mean difference [MD]
= 1.18 [0.49-1.87], P = 0.0008), length of hospital stay (LOS) (MD = 3.34,
95% CI: 1.88-4.80, P < 0.00001), and cardiopulmonary bypass time (CPB) (MD
= 12.40 [1.13-23.66], P = 0.03). Hypoalbuminemia in patients undergoing
cardiac surgery appears to have a poor all-cause mortality or increased
risk of complications. Adjusted perioperative serum albumin levels and
treatment strategies for this high-risk population have the potential to
improve the survival. Copyright © 2022, The Author(s) under
exclusive licence to Springer Nature Singapore Pte Ltd.

<28>
Accession Number
2024695274
Title
Analysis of Repair Type and Hypogastric Artery Antegrade Perfusion and
Erectile Function following Repair of Abdominal Aortic Aneurysms.
Source
Annals of Vascular Surgery. 94 (pp 186-194), 2023. Date of Publication:
August 2023.
Author
Bennett K.M.; Hurley L.; Kyriakides T.C.; Matsumura J.S.
Institution
(Bennett, Matsumura) Department of Surgery, University of Wisconsin School
of Medicine and Public Health, Madison, WI, United States
(Bennett, Matsumura) Middleton Veterans Affairs Medical Center, Surgery
Service, Madison, WI, United States
(Hurley, Kyriakides) Department of Veterans Affairs, Cooperative Studies
Program Coordinating Center, West Haven, CT, United States
(Hurley) Department of Biostatistics, School of Public Health, Yale
University, New Haven, CT
Publisher
Elsevier Inc.
Abstract
Background: Published reports suggest that exclusion of antegrade
hypogastric artery flow may have deleterious effects on erectile function
after abdominal aortic aneurysm (AAA) repair. Off-label and open surgical
hybrid procedures and, more recently, purpose-built branched devices have
been developed to maintain antegrade pelvic perfusion in patients
undergoing endovascular repair. Maintaining antegrade perfusion may reduce
a spectrum of risks, including buttock claudication, colorectal ischemia,
and spinal cord ischemia when patients undergo subsequent thoracic aortic
procedures, as well as erectile dysfunction (ED). This project
specifically focuses on erectile function, and analyzes baseline
associations and relationships of hypogastric artery exclusion on changes
in erectile function following aneurysm repair. Method(s): Male
patients in the Veterans Affairs Open Versus Endovascular Repair (CSP#498;
OVER) Trial had erectile function assessed preoperatively and
postoperatively by administration of the International Index of Erectile
Function-5 questionnaire. Bayesian mixed-effects regression models were
created with the outcome variable (erectile function) treated as a latent
variable. Primary effects of differences in erectile function between
groups with and without preservation of bilateral antegrade hypogastric
flow were compared. Result(s): 876 men (442 randomized to
endovascular repair) were enrolled in the trial and included in the
analysis comparing treatment assignment. There is significant ED in
elderly men with aortic aneurysm at baseline. Over 5 years of follow-up,
there is modest decrease in erectile function and the endovascular group
has improved function compared to open repair (0.082; 95% credible
interval (CI) 0.008 and 0.155). A fifth of patients did not have bilateral
preservation of antegrade hypogastric artery perfusion, with no difference
in erectile function by univariate analysis. A more detailed regression
analysis was applied-and after adjustment for baseline score, age, beta
blocker use, diabetes, activity level, ejection fraction, preoperative
ankle-brachial indices and time-preservation of both antegrade hypogastric
arteries' perfusion showed transient improvement in survey scores compared
to occlusion of at least 1 hypogastric artery at 6 months and 12 months
after treatment, although this was not sustained at 60 months (score
change: 0.046; 95% CI: -0.123, 0.215). Retesting this model in the cohort
with complete data as a sensitivity analysis did not meaningfully change
the conclusions. Conclusion(s): In this large prospective aneurysm
treatment trial with systematic measurement of erectile function with a
validated instrument, endovascular repair is associated with improved
erectile function. Preservation of antegrade hypogastric flow with any
repair is associated with early improved erectile function; however, it is
not a sustained benefit. There is limited benefit of maintaining bilateral
hypogastric artery perfusion for this specific indication in unselected
men undergoing AAA repair. Copyright © 2023 Elsevier Inc.

<29>
Accession Number
2023816336
Title
Prophylactic intravenous tranexamic acid and thromboembolism in
non-cardiac surgery: a systematic review, meta-analysis and trial
sequential analysis.
Source
Anaesthesia. 78(9) (pp 1153-1161), 2023. Date of Publication: September
2023.
Author
Tsan S.E.H.; Viknaswaran N.L.; Cheong C.C.; Cheah S.; Ng K.T.; Mong
S.X.Y.; Wang C.Y.
Institution
(Tsan) Department of Anaesthesiology and Intensive Care, Faculty of
Medicine and Health Sciences, University of Malaysia Sarawak, Malaysia
(Viknaswaran) Department of Medicine, Victoria Hospital, Kirkcaldy, United
Kingdom
(Cheong, Ng, Wang) Department of Anaesthesia, Faculty of Medicine,
University of Malaya, Malaysia
(Cheah) Department of Anaesthesiology and Intensive Care, Hospital
Sultanah Nora Ismail, Batu Pahat, Malaysia
(Mong) Department of Anaesthesiology and Intensive Care, Hospital Raja
Permaisuri Bainun, Ipoh, Malaysia
Publisher
John Wiley and Sons Inc
Abstract
Tranexamic acid is an antifibrinolytic drug that is widely used during
surgery, but there are concerns about its thromboembolic effects. We aimed
to investigate the effect of prophylactic intravenous tranexamic acid on
thromboembolic outcomes in patients undergoing non-cardiac surgery. The
MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were
searched. Randomised controlled trials comparing intravenous tranexamic
acid with placebo or no treatment in patients undergoing non-cardiac
surgery were included. The primary outcome was a composite of
peri-operative cardiovascular thromboembolic events, defined as any deep
vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or
cerebral ischaemia/infarction. A total of 191 randomised controlled trials
(40,621 patients) were included in the review. The primary outcome
occurred in 4.5% of patients receiving intravenous tranexamic acid
compared with 4.9% of patients in the control group. Our analysis showed
that there was no difference between groups for composite cardiovascular
thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65,
I2 0%, n = 37,512). This finding remained robust when
sensitivity analysis was performed with continuity correction and in
studies with a low risk of bias. However, in trial sequential analysis,
our meta-analysis only achieved 64.6% of the required information size.
There was no association between intravenous tranexamic acid and seizure
rate or mortality rate within 30 days. Intravenous tranexamic acid was
associated with a reduced blood transfusion rate compared with control
(9.9% vs. 19.4%, risk ratio 0.46, 95%CI 0.41-0.51, p < 0.0001). It was
encouraging to see the evidence that the administration of intravenous
tranexamic in patients undergoing non-cardiac surgery was not associated
with an increased risk of thromboembolic outcomes. However, our trial
sequential analysis demonstrated that currently available evidence is not
yet sufficient to reach a firm conclusion. Copyright © 2023 The
Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists.

<30>
Accession Number
2025096772
Title
The Predictive Ability of MAGGIC Score After Coronary Artery Bypass
Grafting: A Comparative Study.
Source
Brazilian Journal of Cardiovascular Surgery. 38(4) (no pagination), 2023.
Article Number: e20220355. Date of Publication: 2023.
Author
Ozcan S.; Donmez E.; Ziyrek M.; Mert B.; Sahin I.; Okuyan E.; Ozkaynak B.
Institution
(Ozcan, Donmez, Ziyrek, Sahin, Okuyan) Department of Cardiology, Bagcilar
Training and Research Hospital, Istanbul, Bagcilar, Turkey
(Mert, Ozkaynak) Department of Cardiovascular Surgery, Bagcilar Training
and Research Hospital, Istanbul, Bagcilar, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The European System for Cardiac Operative Risk Evaluation
(EuroSCORE) II and the Society of Thoracic Surgeons (STS) are validated
scoring systems for short-term risk estimation after coronary artery
bypass grafting (CABG). The Meta-Analysis Global Group in Chronic Heart
Failure (MAGGIC) risk score is originally aimed to estimate mortality in
heart failure patients; however, it has showed a similar power to predict
mortality after heart valve surgery. In this study, we sought to evaluate
whether MAGGIC score may predict short and long-term mortality after CABG
and to compare its power with EuroSCORE II and STS scoring systems.
 Method(s): Patients who underwent CABG due to chronic coronary
syndrome at our institution were included in this retrospective study.
Follow-up data were used to define the predictive ability of MAGGIC and to
compare it with STS and EuroSCORE-II for early, one-year, and up to
10-year mortality. Result(s): MAGGIC, STS, and EuroSCORE-II scores
had good prognostic power, moreover MAGGIC was better for predicting
30-day (area under the curve [AUC]: 0.903; 95% confidence interval [CI]:
0.871-0.935), one-year (AUC: 0.931; 95% CI: 0.907-0.955), and 10-year
(AUC: 0.923; 95% CI: 0.893-0.954) mortality. MAGGIC was found to be an
independent predictor to sustain statistically significant association
with mortality in follow-up. Conclusion(s): MAGGIC scoring system had
a good predictive accuracy for early and long-term mortality in patients
undergoing CABG when compared to EuroSCORE-II and STS scores. It requires
limited variables for calculation and still yields better prognostic power
in determining 30-day, one-year, and up to 10-year
mortality. Copyright © 2023, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<31>
Accession Number
2026231649
Title
Methods for assessing guideline adherence for invasive procedures in the
care of chronic coronary artery disease: a scoping review.
Source
BMJ Open. 13(3) (no pagination), 2023. Article Number: e069832. Date of
Publication: 15 Mar 2023.
Author
Kentenich H.; Muller D.; Wein B.; Stock S.; Seleznova Y.
Institution
(Kentenich, Muller, Stock, Seleznova) Institute for Health Economics and
Clinical Epidemiology, Faculty of Medicine and University Hospital
Cologne, University of Cologne, Cologne, Germany
(Wein) Department of Cardiology and Angiology, Contilia Heart and Vascular
Center, Elisabeth-Hospital Essen, Essen, Germany
(Wein) Department of Cardiology, Faculty of Medicine, University of
Augsburg, Augsburg, Germany
Publisher
BMJ Publishing Group
Abstract
Objectives In the care of coronary artery disease (CAD), evidence
questions the adequate application of guidelines for cardiovascular
procedures, particularly coronary angiographies (CA) and myocardial
revascularisation. This review aims to examine how care providers'
guideline adherence for CA and myocardial revascularisation in the care of
chronic CAD was assessed in the literature. Design Scoping review. Data
sources PubMed and EMBASE were searched through in June 2021 (rerun in
September 2022). Eligibility criteria We included studies assessing care
providers' adherence to evidence-based guidelines for CA or myocardial
revascularisation in the care of chronic CAD. Studies had to list the
evaluation of guideline adherence as study objective, describe the
evaluation methods used and report the underlying guidelines and
recommendations. Data extraction and synthesis Two independent reviewers
used standardised forms to extract study characteristics, methodological
aspects such as data sources and variables, definitions of guideline
adherence and quantification methods and the extent of guideline
adherence. To elucidate the measurement of guideline adherence, the main
steps were described. Results Twelve studies (311 869 participants) were
included, which evaluated guideline adherence by (1) defining guideline
adherence, (2) specifying the study population, (3) assigning (classes of)
recommendations and (4) quantifying adherence. Thereby, primarily
secondary data were used. Studies differed in their definitions of
guideline adherence, where six studies each considered only recommendation
class I/grade A/strong recommendations as adherent or additionally
recommendation classes IIa/IIb. Furthermore, some of the studies reported
a priori definitions and allocation rules for the assignment of
recommendation classes. Guideline adherence results ranged from 10% for
percutaneous coronary intervention with prior heart team discussion to 98%
for coronary artery bypass grafting. Conclusion Due to remarkable
inconsistencies in the assessment, a cautious interpretation of the
guideline adherence results is required. Future efforts should endeavour
to establish a consistent understanding of the concept of guideline
adherence. 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.

<32>
Accession Number
2026197022
Title
Efficacy of perioperative prophylactic administration of corticosteroids
in pediatric cardiac surgeries using cardiopulmonary bypass: a systematic
review with meta-analysis.
Source
Anaesthesia Critical Care and Pain Medicine. 42(6) (no pagination), 2023.
Article Number: 101281. Date of Publication: December 2023.
Author
Takeshita J.; Nakajima Y.; Tachibana K.; Takeuchi M.; Shime N.
Institution
(Takeshita, Tachibana) Department of Anesthesiology, Osaka Prefectural
Hospital Organization, Osaka Women's and Children's Hospital, 840
Murodo-cho, Osaka, Izumi 594-1101, Japan
(Nakajima) Department of Anesthesiology and Intensive Care, Kinki
University Faculty of Medicine, 377-2 Ohnohigashi, Osaka, Sayama 589-8511,
Japan
(Nakajima) Outcomes Research Consortium, 9500 Euclid Avenue, P77,
Cleveland, OH 44195, United States
(Takeuchi) Department of Critical Care Medicine, National Cerebral and
Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita 564-8565, Japan
(Shime) Department of Emergency and Critical Care Medicine, Graduate
School of Biomedical & Health Sciences, Hiroshima University, 1-3-2
Kagamiyama, Hiroshima, Higashihiroshima 739-8511, Japan
Publisher
Elsevier Masson s.r.l.
Abstract
An updated systematic review with meta-analysis comparing perioperative
prophylactic administration of corticosteroids with placebo in pediatric
cardiac surgeries using cardiopulmonary bypass was conducted. The Cochrane
Central Register of Controlled Trials and MEDLINE (via PubMed) were
searched for relevant randomized controlled trials published between
January 1, 2000, and February 14, 2023. The primary outcome was
postoperative in-hospital mortality. Secondary outcomes were duration of
mechanical ventilation, length of intensive care unit and hospital stay,
postoperative low cardiac output syndrome, and adverse events. A total of
11 studies were included in the meta-analysis. Corticosteroid
administration did not decrease postoperative in-hospital mortality
compared with placebo (relative risk, 0.69; 95% confidence interval,
0.40-1.17). Subgroup analyses according to the type of corticosteroids and
neonates revealed that corticosteroids did not decrease postoperative
in-hospital mortality. In the trial sequential analysis, the last point in
the z-curve was within the futility borders. Although the duration of
mechanical ventilation (mean difference, -5.54 h; 95% confidence interval
(CI), -9.75 - -1.34) and incidence of low cardiac output syndrome
(relative risk, 0.75; 95% CI, 0.59 - 0.96) decreased with corticosteroid
administration, it did not affect the length of intensive care unit (mean
difference, -0.28 days; 95% CI, -0.74 - 0.17) and hospital stay (mean
difference, -0.59 days; 95% CI, -1.31 - 0.14). In conclusion,
perioperative prophylactic corticosteroid administration in pediatric
cardiac surgeries using cardiopulmonary bypass did not decrease
postoperative in-hospital mortality compared with placebo. According to
the trial sequential analysis results, additional randomized controlled
trials assessing mortality are not required. PROSPERO Registry Number: CRD
42023391789. Copyright © 2023 Societe francaise d'anesthesie et
de reanimation (Sfar)

<33>
Accession Number
2026173896
Title
Treatment of long-segment congenital tracheal stenosis with congenital
cardiovascular defects in infancy.
Source
International Journal of Pediatric Otorhinolaryngology. 172 (no
pagination), 2023. Article Number: 111691. Date of Publication: September
2023.
Author
Dai L.; Zhao L.; Shen L.; Pan Z.; Wu C.; Mo L.; Wu Y.
Institution
(Dai, Zhao, Pan, Wu, Wu) Department of Cardiothoracic Surgery, Children's
Hospital of Chongqing Medical University, China
(Dai, Zhao, Shen, Pan, Wu, Mo, Wu) Ministry of Education Key Laboratory of
Child Development and Disorders, China
(Dai, Zhao, Shen, Pan, Wu, Mo, Wu) National Clinical Research Center for
Child Health and Disorders, China
(Dai, Zhao, Shen, Pan, Wu, Mo, Wu) China International Science and
Technology Cooperation Base of Child Development and Critical Disorders,
China
(Dai, Zhao, Shen, Pan, Wu, Mo, Wu) Chongqing Key Laboratory of Pediatrics,
China
(Dai, Zhao, Shen, Pan, Wu, Mo, Wu) Children's Hospital of Chongqing
Medical University, China
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: This study aims to evaluate the outcomes of simultaneous
repair for infants with long-segment congenital tracheal stenosis (LSCTS)
with congenital cardiovascular defects (CCD). Method(s): We
retrospectively reviewed the clinical data of infants aged less than 1
year with LSCTS and CCD who underwent simultaneous repair at Children's
Hospital of Chongqing Medical University from January 2020 to March 2023.
A systematic search of PubMed, Embase, and Cochrane Library for the
relevant published studies that reported the simultaneous repair of CTS
and CCD in infancy was conducted in March 2023. The inverse variance
method of DerSimonian-Laird (D + L) was used for estimate synthesis.
 Result(s): A total of thirteen infants with a mean age of 5.6 +/- 3.1
months and a mean weight of 6.4 +/- 0.9 Kg underwent slide tracheoplasty
with modified procedures and cardiovascular operations. LSCTS was
diagnosed in all thirteen patients. Nine infants were ventilator
dependent, and four patients were operated on due to persistent wheezing
and recurrent respiratory infections. Seven patients underwent pulmonary
artery sling repair, and six underwent atrial septal defect repair. All
infants were repaired utilizing cardiopulmonary bypass (CPB) support.
Significant complications were recorded in three patients. In-hospital
deaths were seen in one case. The median tracheal minimum diameter of
hospital survivors was significantly larger than the preoperative minimum
diameter (p < 0.001). The mean follow-up duration was 17.1 +/- 7.1 months.
There was no late mortality during the follow-up. Twelve studies were
included based on our search strategy. The pooled estimate of mortality in
the literature was 10.9% (95%CI, 5.3%-17.7%, I2 = 0). The
pooled estimate of airway re-interventions was 28.8% (95%CI, 14.5%-43.2%,
I2 = 74%). Conclusion(s): Simultaneous repair of LSCTS and
CCD in infancy is safe and effective. Slide tracheoplasty with appropriate
technical modifications may be valid for LSCTS repair without significant
restenosis and reinterventions. Copyright © 2023 Elsevier B.V.

<34>
Accession Number
2026195988
Title
Coronary endarterectomy combined with coronary artery bypass grafting
might decrease graft patency: A cohort study.
Source
Hellenic Journal of Cardiology. (no pagination), 2023. Date of
Publication: 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
Hellenic Cardiological Society
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 end point 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 an increased risk of graft failure even after
multiple adjustments (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 a
larger sample size is warranted. Copyright © 2023 Hellenic
Society of Cardiology

<35>
Accession Number
2026171202
Title
Comparison of the Outcomes of Oral Versus Nasal Endotracheal Intubation in
Neonates and Infants Undergoing Cardiac Surgery: A Randomized Controlled
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Abdelbaser I.; Abourezk A.R.; Magdy M.; Elnegerey N.; Sabry R.; Tharwat
M.; Sayedalahl M.
Institution
(Abdelbaser, Abourezk, Magdy, Elnegerey, Sayedalahl) Department of
Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura
University, Mansoura, Egypt
(Sabry, Tharwat) Department of Cardiothoracic Surgery, Faculty of
Medicine, Mansoura University, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: The choice of oral or nasal endotracheal intubation in children
undergoing cardiac surgery is affected by several factors. This study
compared the outcomes of oral versus nasal intubation in neonates and
infants who underwent open cardiac surgery. Design(s): A randomized,
controlled, open-labeled study. Setting(s): At a university hospital.
 Participant(s): A total of 220 infants and neonates who underwent
cardiac surgery. Intervention(s): Patients were allocated randomly to
oral or nasal intubation. Measurements and Main Results: The primary
outcome measure was postoperative fentanyl consumption (microg/kg/h) by
intubated patients. Secondary outcome measures were the increase in heart
rate (HR) from baseline during intubation, the time consumed for
intubation, accidental intraoperative extubation, the occurrence of
epistaxis, time to extubation, the onset of full oral feeding, intensive
care unit (ICU) and hospital lengths of stay, and the incidence of
postoperative complications (the need for reintubation, stridor,
pneumonia, wound infection). The mean (SD) postoperative fentanyl
consumption of intubated patients (the primary outcome) was significantly
lower (p < 0.001) in the nasal intubation group (0.53 +/- 0.48)
microg/kg/h compared with the oral intubation group (0.82 +/- 0.20)
microg/kg/h. The median (IQR) time needed for the intubation (31.5, 27-35
v 16, 14.8-18 seconds) was significantly (p < 0.001) longer, and the mean
(SD) increase in HR (beats/min) from baseline during intubation (18 +/- 5
v 26 +/- 7) was significantly (p < 0.001) lower in the nasal intubation
group compared to the oral intubation group. The incidence of inadvertent
intraoperative extubation was significantly (p = 0.029) higher in the oral
(n = 6, 6.1%) than in the nasal (n = 0, 0%) intubation group. The median
(IQR) time to extubation (14, 12.6-17.2 v 20.5, 16.4-25.4 hours) and the
ICU length of stay (27, 26-28 v 30, 28-34 hours) were significantly (p <
0.05) shorter in the nasal group compared to the oral group. The median
(IQR) time to onset of full oral feeding was significantly (p = 0.031)
shorter in the nasal intubation group (3, 1-6 days) compared to the oral
intubation group (4, 2-7 days). There were no significant differences
between the oral and nasal groups in the duration of hospital stay and the
indices for reintubation, postintubation stridor, pneumonia, and surgical
wound infection. Conclusion(s): The nasal route for intubation is
associated with less postoperative fentanyl consumption, earlier
extubation, lower incidence of accidental extubation, and earlier full
oral feeding than oral intubation. The nasal route is not associated with
an increased risk of postoperative pneumonia or surgical wound
infection. Copyright © 2023 Elsevier Inc.

<36>
Accession Number
2026170784
Title
Clinical outcomes following tricuspid transcatheter edge-to-edge repair
with PASCAL: A meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2023. Article
Number: 131194. Date of Publication: 2023.
Author
Badwan O.; Mirzai S.; Skoza W.; Hawk F.; Braghieri L.; Persits I.;
Krishnaswamy A.; Puri R.; Kapadia S.R.
Institution
(Badwan, Mirzai, Skoza, Braghieri, Persits) Department of Internal
Medicine, Cleveland Clinic, Cleveland, OH, United States
(Hawk) Division of Cardiovascular Medicine, University of South Florida
College of Medicine, Tampa, FL, United States
(Krishnaswamy, Puri, Kapadia) Department of Cardiovascular Medicine,
Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Patients with severe tricuspid regurgitation (TR) exhibit high
morbidity and mortality. Tricuspid transcatheter edge-to-edge repair
(T-TEER) is a rapidly evolving strategy to address the unmet clinical need
of severe TR therapies. Objective(s): Organize the current body of
evidence on outcomes following use of the PASCAL (Edwards Lifesciences)
system for T-TEER. Method(s): For this meta-analysis, we searched the
MEDLINE/PubMed, Embase, and Cochrane databases for keywords ["tricuspid"]
and ["transcatheter" or "edge-to-edge"] and ["PASCAL" or "leaflet repair"
or "valve repair"] from the database inception until January 11, 2023.
Primary outcomes of interest were procedural success, mortality, New York
Heart Association (NYHA) functional class, 6-min walking distance (6MWD),
and TR severity. Result(s): A total of 549 patients undergoing PASCAL
or PASCAL Ace T-TEER were included. The mean age ranged from 71.0 to 80.3
years, with 25.0 to 63.6% females. The follow-up duration ranged from 30
days to 1 year. The success rate was 83.5% (409/490). There was
improvement in symptoms based on NYHA classification (at 1- to 6-months;
NYHA >=3 RR 0.27 [95% CI 0.19-0.39]; p < 0.001) and 6MWD (at 1-month;
50.96 [95% CI 32.34-69.59]; p < 0.001) post-procedure. On imaging, there
was improvement in TR severity post-procedure (at 1- to 12-months; >=
severe TR 0.21 [95% CI 0.14-0.31]; p < 0.001), which remained significant
with each study removed. Conclusion(s): PASCAL for T-TEER is
associated with high procedural success rates along with improvements in
NYHA functional class, TR severity, 6MWD, and patient-reported
outcomes. Copyright © 2023

<37>
Accession Number
2024796774
Title
A vanguard randomised feasibility trial comparing three regimens of
peri-operative oxygen therapy on recovery after major surgery.
Source
Anaesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Frei D.R.; Beasley R.; Campbell D.; Forbes A.; Leslie K.; Mackle D.;
Martin C.; Merry A.; Moore M.R.; Myles P.S.; Ruawai-Hamilton L.; Short
T.G.; Young P.J.
Institution
(Frei, Ruawai-Hamilton) Department of Anaesthesia and Pain Management,
Wellington Hospital, Wellington, New Zealand
(Frei, Beasley, Mackle) Medical Research Institute of New Zealand,
Wellington, New Zealand
(Campbell, Merry, Moore, Short, Young) Department of Anaesthesiology,
University of Auckland, Auckland, New Zealand
(Campbell, Short) Department of Anaesthesia and Peri-operative Medicine,
Auckland City Hospital, Auckland, New Zealand
(Forbes, Martin) Biostatistics Unit, Division of Research Methodology,
School of Public Health and Preventive Medicine, Faculty of Medicine,
Nursing, and Health Sciences, Monash University, Melbourne, VIC, Australia
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Leslie) Department of Critical Care, Melbourne Medical School, University
of Melbourne, Melbourne, VIC, Australia
(Myles) Department of Anaesthesiology and Peri-operative Medicine, Alfred
Hospital, Melbourne, VIC, Australia
(Myles) Department of Anaesthesiology and Peri-operative Medicine, Central
Clinical School, Faculty of Medicine, Nursing, and Health Sciences, Monash
University, Melbourne, VIC, Australia
(Young) Department of Intensive Care, Wellington Regional Hospital,
Wellington, New Zealand
Publisher
John Wiley and Sons Inc
Abstract
International recommendations encourage liberal administration of oxygen
to patients having surgery under general anaesthesia, ostensibly to reduce
surgical site infection. However, the optimal oxygen regimen to minimise
postoperative complications and enhance recovery from surgery remains
uncertain. The hospital operating theatre randomised oxygen (HOT-ROX)
trial is a multicentre, patient- and assessor-blinded, parallel-group,
randomised clinical trial designed to assess the effect of a restricted,
standard care, or liberal peri-operative oxygen therapy regimen on days
alive and at home after surgery in adults undergoing prolonged non-cardiac
surgery under general anaesthesia. Here, we report the findings of the
internal vanguard feasibility phase of the trial undertaken in four large
metropolitan hospitals in Australia and New Zealand that included the
first 210 patients of a planned overall 2640 trial sample, with eight
pre-specified endpoints evaluating protocol implementation and safety. We
screened a total of 956 participants between 1 September 2019 and 26
January 2021, with data from 210 participants included in the analysis.
Median (IQR [range]) time-weighted average intra-operative
F<inf>i</inf>O<inf>2</inf> was 0.30 (0.26-0.35 [0.20-0.59]) and 0.47
(0.44-0.51 [0.37-0.68]) for restricted and standard care, respectively
(mean difference (95%CI) 0.17 (0.14-0.20), p < 0.001). Median
time-weighted average intra-operative F<inf>i</inf>O<inf>2</inf> was 0.83
(0.80-0.85 [0.70-0.91]) for liberal oxygen therapy (mean difference
(95%CI) compared with standard care 0.36 (0.33-0.39), p < 0.001). All
feasibility endpoints were met. There were no significant patient adverse
events. These data support the feasibility of proceeding with the HOT-ROX
trial without major protocol modifications. Copyright © 2023
Association of Anaesthetists.

<38>
Accession Number
641954485
Title
Serratus anterior and pectoralis plane blocks for robotically assisted
mitral valve repair: a randomised clinical trial. Comment on Br J Anaesth
2023; 130: 786-94.
Source
British journal of anaesthesia. (no pagination), 2023. Date of
Publication: 03 Aug 2023.
Author
Xue F.S.; Gao X.; Li C.W.
Institution
(Xue, Gao, Li) Department of Anesthesiology, Beijing Friendship Hospital,
Capital Medical University, Beijing, China
Publisher
NLM (Medline)

<39>
Accession Number
641954417
Title
A Systematic Review of Short-Term Outcomes of Leadless Pacemaker
Implantation After Transvenous Lead Removal of Infected Cardiac
Implantable Electronic Device.
Source
The American journal of cardiology. 203 (pp 444-450), 2023. Date of
Publication: 03 Aug 2023.
Author
Tan M.C.; Tan J.L.; Tay S.T.; Sorajja D.; Scott L.; Cha Y.-M.; Russo A.M.;
Hussein A.; Lee J.Z.
Institution
(Tan) Division of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona;
Department of Internal Medicine, New York Medical College at Saint
Michael's Medical Center, Newark, New Jersey
(Tan) Division of Cardiovascular Medicine, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Tay) Department of Medicine, School of Medicine, Chang Gung University,
Taoyuan City, Taiwan (Republic of China)
(Sorajja, Scott) Division of Cardiovascular Medicine, Mayo Clinic,
Phoenix, AZ, United States
(Cha) Division of Cardiovascular Medicine, Mayo Clinic, Rochester, MN,
United States
(Russo) Division of Cardiovascular Medicine, Cooper University Health
Care/Cooper Medical School of Rowan University, Camden, NJ, United States
(Hussein, Lee) Division of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
The outcomes of leadless pacemaker (LP) implantation after transvenous
lead removal (TLR) of infected cardiac implantable electronic devices
(CIEDs) are not well-established. This study sought to describe the
outcomes of LP implantation after TLR of infected CIED. We conducted a
literature search using PubMed and Embase for a combination of terms
including LP implantation, transvenous lead extraction, TLR, transvenous
lead explant, infected CIED, infected pacemaker, and infected implantable
cardioverter defibrillator. The inclusion criterion was LP implantation
after TLR of infected CIED. The exclusion criterion was TLR for
noninfectious reasons. Study end points included procedural complications
and LP infection during follow-up. Of 132 publications reviewed, 13
studies with a total of 253 patients (74 +/- 14 years of age, 174 [69%]
males) were included. The most common indication of the initial device
implantations was a high-degree atrioventricular block (n = 100 of 253,
39.5%). Of the 253 patients included, 105 patients (41.5%) underwent
concomitant LP implantation during the TLR procedure, and 36 patients
(14.2%) had temporary transvenous pacing as a bridge from TLR to LP
implantation. Of the 148 patients with data on the type of CIED infection,
56.8% had systemic CIED infection and 43.2% had isolated pocket infection.
Staphylococcus aureus was the most common causative organism in 33% of the
reported patients. The LP was implanted an average of 5.4 +/- 10.7 days
after TLR of infected CIED. During the LP implantation, 1 patient (0.4%)
had unsuccessful implantation because of an intraprocedural complication
requiring sternotomy. After LP implantation, 2 patients (0.8%) developed
groin hematoma, 2 patients (0.8%) developed femoral arteriovenous fistula,
and 1 patient (0.4%) developed pericardial effusion requiring
pericardiocentesis. During a mean follow-up of 11.3 +/- 10.6 months, 3
patients (1.2%) developed pacemaker syndrome, 1 patient (0.4%) developed
acute on chronic heart failure exacerbation, and only 1 patient (0.4%)
developed LP-related infection requiring LP retrieval. This study suggests
that LP implant is feasible and safe after removal of infected CIED with
cumulative adverse events at 4% and a reinfection rate of 0.4%. Large
prospective studies are needed to better evaluate the best timing of LP
implantation after TLR of an infected CIED. Copyright © 2023
Elsevier Inc. All rights reserved.

<40>
Accession Number
641954242
Title
Transient ischemic attack and minor stroke as "surgeons affairs": a
narrative review.
Source
Neurological sciences : official journal of the Italian Neurological
Society and of the Italian Society of Clinical Neurophysiology. (no
pagination), 2023. Date of Publication: 05 Aug 2023.
Author
Caproni S.; Ottavi P.; Borghetti V.; Taddei G.; Conti C.; Riva A.; Di
Schino C.; Costantini F.; Colosimo C.
Institution
(Caproni, Di Schino, Costantini, Colosimo) Neurology and Stroke Unit,
Neuroscience Department, "S. Maria" University Hospital, via Tristano di
Joannuccio 1, Terni 05100, Italy
(Ottavi) Vascular Surgery, Cardio-Thoraco-Vascular Department, "S. Maria"
University Hospital, via Tristano di Joannuccio 1, Terni 05100, Italy
(Borghetti) Heart Surgery, Cardio-Thoraco-Vascular Department, "S. Maria"
University Hospital, via Tristano di Joannuccio 1, Terni 05100, Italy
(Taddei) Neurosurgery, Surgery Department, "S. Maria Goretti" Hospital,
Via Lucia Scaravelli, Latina 04100, Italy
(Conti) Neurosurgery, Neuroscience Department, "S. Maria" University
Hospital, via Tristano di Joannuccio 1, Terni 05100, Italy
(Riva) Neurology, Medicine Department, Via Conca 71, Ancona 60126, Italy
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The scope of this paper is to review the subtypes of transient
ischemic attack (TIA) and minor stroke (mS) in which a surgical treatment
is needed, discussing the importance and the timing of a multidisciplinary
approach, in order to achieve an optimized management and prevent major
strokes or other critical complications. MATERIALS AND METHODS: The
keywords "transient ischemic attack," "minor stroke," "surgical
treatment," "vascular surgery," "heart surgery," "neurosurgery," and
"multidisciplinary" were searched using MEDLINE, EMBASE, and Scopus.
Relevant search results were discussed by the authors for references
inclusion. RESULT(S): Notwithstanding that best medical therapy is
usually the first choice for the most part of cases, there are specific
but recurrent etiologies that must be properly recognized because of a
potential surgical approach, even in urgency. In fact, symptomatic carotid
stenosis, or particular cases of hemodynamic cerebrovascular events,
should be promptly referred to vascular surgeon, since increasing
evidences highlighted a benefit from an early artery revascularization. In
addition, beyond arrhythmic causes, cardioembolic events due to bacterial
endocarditis and atrial myxoma should be quickly diagnosed, possibly in
emergency department, because they are a presumptive urgency for heart
surgery. In addition to the above-mentioned conditions, in patients
suffering from vertebrobasilar TIA or mS, clinicians should keep in mind
the Bow Hunter disease, because surgical artery decompression can
represent the only suitable treatment in selected cases.
 CONCLUSION(S): TIA and mS require a multidisciplinary in order to
discuss therapeutic options, comparing risks and benefits and determining
the best timing for an optimized management. Copyright © 2023.
Fondazione Societa Italiana di Neurologia.

<41>
Accession Number
641954198
Title
Expert Systematic Review on the Choice of Conduits for Coronary Artery
Bypass Grafting: Endorsed by the European Association for Cardio-Thoracic
Surgery (EACTS) and The Society of Thoracic Surgeons (STS).
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 26 Jul 2023.
Author
Gaudino M.; Bakaeen F.G.; Sandner S.; Aldea G.S.; Arai H.; Chikwe J.;
Firestone S.; Fremes S.E.; Gomes W.J.; Bong-Kim K.; Kisson K.; Kurlansky
P.; Lawton J.; Navia D.; Puskas J.D.; Ruel M.; Sabik J.F.; Schwann T.A.;
Taggart D.P.; Tatoulis J.; Wyler von Ballmoos M.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York-Presbyterian Hospital, NY, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Aldea) Division of Cardiothoracic Surgery, University of Washington
School of Medicine, Seattle, WA, United States
(Arai) Department of Cardiovascular Surgery, Graduate School of Medical
and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo,
Japan
(Chikwe) Department of Cardiac Surgery, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Firestone, Kisson) Society of Thoracic Surgeons, Chicago, IL, United
States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre, the
Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Gomes) Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo
Hospital, Escola Paulista de Medicina, Universidade Federal de Sao Paulo
(Unifesp), Sao Paulo, Brazil
(Bong-Kim) Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, South
Korea
(Kurlansky) Division of Cardiac Surgery, Department of Surgery, Columbia
University, NY, United States
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University, Baltimore, MD, Liberia
(Navia) Department of Cardiac Surgery, ICBA Instituto Cardiovascular,
Buenos Aires, Argentina
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
(Schwann) Division of Cardiac Surgery, Baystate Health, Springfield, MA,
United States
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital,
University of Oxford, Oxford, United Kingdom
(Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
University of Melbourne, Melbourne, Australia
(Wyler von Ballmoos) Division of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Houston, TX, United States
Publisher
NLM (Medline)

<42>
Accession Number
641954066
Title
Expert systematic review on the choice of conduits for coronary artery
bypass grafting: endorsed by the European Association for Cardio-Thoracic
Surgery (EACTS) and The Society of Thoracic Surgeons (STS).
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2023. Date of Publication: 25 Jul 2023.
Author
Gaudino M.; Bakaeen F.G.; Sandner S.; Aldea G.S.; Arai H.; Chikwe J.;
Firestone S.; Fremes S.E.; Gomes W.J.; Bong-Kim K.; Kisson K.; Kurlansky
P.; Lawton J.; Navia D.; Puskas J.D.; Ruel M.; Sabik J.F.; Schwann T.A.;
Taggart D.P.; Tatoulis J.; Wyler von Ballmoos M.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York-Presbyterian Hospital, New York, NY. Electronic address:
mfg9004@med.cornell.edu
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Aldea) Division of Cardiothoracic Surgery, University of Washington
School of Medicine, Seattle, United States
(Arai) Department of Cardiovascular Surgery, Graduate School of Medical
and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo,
Japan
(Chikwe) Department of Cardiac Surgery, Cedars-Sinai Medical Center, Los
Angeles, Mexico
(Firestone, Kisson) Society of Thoracic Surgeons, Ill, Chicago, Mexico
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre, the
Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Gomes) Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo
Hospital, Escola Paulista de Medicina, Universidade Federal de Sao Paulo
(Unifesp), Sao Paulo, Brazil
(Bong-Kim) Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, South
Korea
(Kurlansky) Division of Cardiac Surgery, Department of Surgery, Columbia
University, New York, NY
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University, Baltimore, Md, Liberia
(Navia) Department of Cardiac Surgery, ICBA Instituto Cardiovascular,
Buenos Aires, Argentina
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
New York, NY
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
(Schwann) Division of Cardiac Surgery, Baystate Health, Mass, Springfield,
United Kingdom
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital,
University of Oxford, Oxford, United Kingdom
(Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
University of Melbourne, Melbourne, Australia
(Wyler von Ballmoos) Division of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Houston, United States
Publisher
NLM (Medline)

<43>
Accession Number
641953584
Title
Long-term Outcomes of Low-Risk Patients Treated With Transcatheter Aortic
Valve Replacement Versus Surgical Aortic Valve Replacement: Results from A
Meta-Analysis.
Source
Internal and emergency medicine. (no pagination), 2023. Date of
Publication: 04 Aug 2023.
Author
Tariq M.A.; Amin H.; Malik M.K.
Institution
(Tariq, Malik) Department of Cardiology, Dow University Hospital, Dow
University of Health Sciences, Karachi, Pakistan
(Amin) Dr. Ruth K. M. Pfau, Civil Hospital, Karachi, Pakistan
Publisher
NLM (Medline)

<44>
Accession Number
641952445
Title
Evaluation of stable angina by coronary computed tomographic angiography
versus standard of care: A systematic review and meta-analysis.
Source
Cardiovascular revascularization medicine : including molecular
interventions. (no pagination), 2023. Date of Publication: 27 Jul 2023.
Author
Palicherla A.; Ismayl M.; Thandra A.; Budoff M.; Shaikh K.
Institution
(Palicherla, Ismayl) Internal Medicine, Creighton University School of
Medicine, Omaha, NE, United States
(Thandra) Interventional Cardiology, Creighton University School of
Medicine, Omaha, NE, United States
(Budoff) David Geffen School of Medicine at UCLA, Los Angeles, United
States
(Shaikh) University of Tennessee, Knoxville, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: There is limited data comparing Coronary Computed Tomography
Angiography (CCTA) versus the usual Standard of care (SOC) in patients
with suspected stable coronary artery disease (CAD). We aimed to perform a
systematic review and meta-analysis to compare CCTA versus SOC in patients
with stable CAD. METHOD(S): We searched multiple databases for
randomized controlled trials (RCTs) comparing CCTA with SOC, which
included various functional testing approaches for evaluating stable CAD.
We used a random-effects model to calculate risk ratios (RRs) with 95 %
confidence intervals (CIs). Outcomes included all-cause mortality,
myocardial infarction (MI), hospitalization for unstable angina (UA),
invasive angiography, revascularization, percutaneous coronary
intervention (PCI), and coronary artery bypass grafting (CABG).
 RESULT(S): We identified 6 RCTs with 19,881 patients with stable CAD,
of which 9995 underwent CCTA, and 9886 underwent SOC. There were no
significant differences between CCTA and SOC in terms of all-cause
mortality (RR: 0.91; 95 % CI: 0.70-1.19; p = 0.50), MI (RR: 0.78; 95 % CI:
0.58-1.05; p = 0.11), hospitalizations for UA (RR: 1.20; 95 % CI:
0.95-1.51;p = 0.12), invasive angiography (RR: 0.71; 95 % CI: 0.32-1.61; p
= 0.42), revascularization (RR:1.25; 95 % CI: 0.83-1.89; p = 0.29), PCI
(RR: 1.20; 95 % CI: 0.78-1.85; p = 0.40), and CABG rates (RR: 0.89; 95 %
CI: 0.530-1.49; p = 0.65). CONCLUSION(S): In patients with stable
CAD, CCTA is associated with similar outcomes compared to the usual
Standard of care. Given its potential to quickly rule out severe
obstructive disease, its ability to provide non-invasive physiology and
identify non-obstructive CAD with plaque information makes it an
attractive addition to the available armamentarium to evaluate chest
pain. Copyright © 2023 Elsevier Inc. All rights reserved.

<45>
Accession Number
641951763
Title
Hormonal changes in the first 24 postoperative hours after cardiac
surgical procedures.
Source
Physiology international. (no pagination), 2023. Date of Publication: 04
Aug 2023.
Author
Szecsi B.; Toth K.; Szabo A.; Eke C.; Szentgroti R.; Dohan O.; Benke K.;
Radovits T.; Polos M.; Merkely B.; Gal J.; Szekely A.
Institution
(Szecsi, Toth, Eke, Szentgroti) 1Doctoral School of Theoretical and
Translational Medicine, Semmelweis University, Budapest, Hungary
(Szabo, Gal, Szekely) Department of Anesthesiology and Intensive Therapy,
Semmelweis University, Budapest, Hungary
(Dohan) Department of Internal Medicine and Oncology, Semmelweis
University, Budapest, Hungary
(Benke, Radovits, Polos, Merkely) 4Heart and Vascular Centre, Semmelweis
University, Budapest, Hungary
(Szekely) Department of Oxiology and Emergency Care, Semmelweis
University, Budapest, Hungary
Publisher
NLM (Medline)
Abstract
Background: Hormone level changes after heart surgeries are a widely
observed phenomenon due to neurohormonal feedback mechanisms that may
affect postoperative morbidity and mortality. The current study aimed to
analyze the changes in thyroid and sex hormones in the first 24
postoperative hours after heart surgery. Method(s): This prospective,
observational study (registered on ClinicalTrials.gov: NCT03736499;
09/11/2018) included 49 patients who underwent elective cardiac surgical
procedures at a tertiary heart center between March 2019 and December
2019. Thyroid hormones, including thyroid-stimulating hormone (TSH),
triiodothyronine (T3), and thyroxine (T4), and sex hormones, including
prolactin (PRL) and total testosterone, were measured preoperatively and
at 24 h postoperatively. Result(s): Significant decreases in serum
TSH (P < 0.001), T3 (P < 0.001) and total testosterone (P < 0.001) levels
were noted, whereas T4 (P = 0.554) and PRL (P = 0.616) did not
significantly change. Intensive care unit (ICU) hours (P < 0.001),
mechanical ventilation (P < 0.001) and Vasoactive-Inotropic Score (VIS) (P
= 0.006) were associated with postoperative T3 level. ICU hours were
associated with postoperative T4 level (P = 0.028). Postoperative and
delta testosterone levels were in connection with lengths of stay in ICU
(P = 0.032, P = 0.010 respectively). Model for End-Stage Liver Disease
(MELD) scores were associated with thyroid hormone levels and serum
testosterone. Conclusion(s): T3 may represent a marker of
nonthyroidal illness syndrome and testosterone may reflect hepatic
dysfunction. In addition, PRL may act as a stress hormone in female
patients.

<46>
Accession Number
2025991116
Title
In severe tricuspid regurgitation, tricuspid TEER improved QoL more than
medical therapy at 1 y.
Source
Annals of Internal Medicine. 176(6) (pp JC67), 2023. Date of Publication:
01 Jun 2023.
Author
Zajarias A.; Bach R.G.
Institution
(Zajarias, Bach) Washington University, School of Medicine, St. Louis, MO,
United States
Publisher
American College of Physicians

<47>
Accession Number
2025461208
Title
Safety and feasibility of ultrasound-guided serratus anterior plane block
and intercostal nerve block for management of post-sternotomy pain in
pediatric cardiac patients: A prospective, randomized trial.
Source
Anaesthesia Critical Care and Pain Medicine. 42(6) (no pagination), 2023.
Article Number: 101268. Date of Publication: December 2023.
Author
He Y.; Xu M.; Li Z.; Deng L.; Kang Y.; Zuo Y.
Institution
(He, Xu, Zuo) Department of Anesthesiology, West China Hospital, Sichuan
University & The Research Units of West China (2018RU012), Chinese Academy
of Medical Sciences, China
(Li) Department of Critical Care Medicine, Cheng Du Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Sichuan, Chengdu,
China
(Deng) Department of Critical Care Medicine, West China Hospital/West
China School of Medicine, Sichuan University, Sichuan, Chengdu, China
(Kang) Department of Anesthesiology and Translational Neuroscience Center,
Laboratory of Anesthesia and Critical Care Medicine, West China Hospital,
Sichuan University, Chengdu, China
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Postoperative analgesia in the cardiothoracic ICU has
traditionally relied on intravenous opioids. Thoracic nerve blocks are
attractive alternatives for analgesia that reduce the requirement for
opioids, but their safety and feasibility remain unclear. Method(s):
Sixty children were allocated randomly to three groups: group C received
intravenous opioids alone, while group SAPB (deep serratus anterior plane
block) and group ICNB (intercostal nerve block) received opioids combined
with ultrasound-guided regional nerve blocks (0.2% ropivacaine 2.5
mg.kg-1) after patients were transferred to the ICU. The
primary outcome was opioid requirement in the first 24 h after surgery.
Other outcomes included the postoperative FLACC scale value, tracheal
extubation time, and plasma ropivacaine concentrations after the block.
 Result(s): The mean [sd] cumulative dose of opioids administered
postoperatively within 24 h in the SAPB (168.6 [76.9] mug.kg-1)
and ICNB groups (170.0 [86.8] mug.kg-1) were significantly
lower by nearly 53% than those in group C (359.3 [125.3]
mug.kg-1, p = 0.000). The tracheal extubation time was shorter
in the regional block groups than that in the control group, but the
difference was not statistically significant (p = 0.177). The FLACC scale
values at 0, 1, 3, 6, 12, and 24 h post-extubation were similar in the
three groups. The mean peak plasma ropivacaine concentrations in the SAP
and ICNB groups were 2.1 [0.8] and 1.8 [0.7] mg.L-1,
respectively, 10 min post-block and then slowly decreased. No noticeable
complications associated with regional anesthesia were observed.
 Conclusion(s): Ultrasound-guided SAPB and ICNB provided safe and
satisfactory early postoperative analgesia while reducing opioid
consumption following sternotomy in pediatric patients. Clinical trial
registration: Chinese Clinical Trial Registry
ChiChiCTR2100046754. Copyright © 2023 Societe francaise
d'anesthesie et de reanimation (Sfar)

<48>
Accession Number
2025028681
Title
Bilateral Ultrasound-Guided Mid-Point Transverse Process to Pleura Block
for Perioperative Analgesia in Pediatric Cardiac Surgery: A Randomized
Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(9) (pp 1726-1733),
2023. Date of Publication: September 2023.
Author
Abdelbaser I.; Abourezk A.R.; Badran A.; Abdelfattah M.
Institution
(Abdelbaser, Abourezk, Badran, Abdelfattah) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: Mid-point transverse process to pleura (MTP) block is a new
regional analgesia technique. This study aimed to assess the perioperative
analgesic effects of MTP block in children undergoing open-heart surgery.
 Design(s): A single-center, randomized, double-blinded, controlled,
superiority study. Setting(s): At a University Children's Hospital.
 Participant(s): Fifty-two patients aged 2 to 10 years who underwent
open-heart surgery. Intervention(s): Patients were randomized to
receive either bilateral MTP block or no block (control).
 Measurements and Main Results: The primary outcome was fentanyl
consumption in the first postoperative 24 hours. The secondary outcomes
were intraoperative fentanyl consumption, modified objective pain score
(MOPS) measured at 1, 4, 8, 16, and 24 hours after extubation, and the
duration of stay in the intensive care unit (ICU). The mean (SD)
postoperative fentanyl consumption (microg/kg) in the first 24 hours was
significantly reduced in the MTP block group (4.4 +/- 1.2) compared to the
control group (6.0 +/- 1.4, p < 0.001). The mean (SD) intraoperative
fentanyl requirement (microg/ kg) was significantly reduced in the MTP
block group (9.1 +/- 1.9) compared to the control group (13.0 +/- 2.1, p <
0.001). The MOPS was significantly reduced in the MTP block group compared
to the control group at 1, 4, 8, and 16 hours after extubation but was
comparable in both groups at 24 hours. The mean (SD) duration of ICU stay
(hours) was significantly reduced in the MTP block group (25.0 +/- 2.9)
compared to the control group (30.7 +/- 4.2, p < 0.001).
 Conclusion(s): Single-shot bilateral ultrasound-guided MTP block in
children undergoing cardiac surgery reduced the mean fentanyl consumption
in the first postoperative 24 hours, intraoperative fentanyl requirements,
pain score at rest, time to extubation, and duration of ICU
stay. Copyright © 2023 Elsevier Inc.

<49>
Accession Number
2024775186
Title
Comparison of outcomes of self-expanding versus balloon-expandable valves
for transcatheter aortic valve replacement: a meta-analysis of randomized
and propensity-matched studies.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
382. Date of Publication: December 2023.
Author
Wang B.; Mei Z.; Ge X.; Li Y.; Zhou Q.; Meng X.; An G.
Institution
(Wang, Mei, Ge, Li, Zhou, Meng, An) National Key Laboratory for Innovation
and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular
Remodeling and Function Research, Chinese Ministry of Education, Chinese
National Health Commission and Chinese Academy of Medical Sciences, Qilu
Hospital of Shandong University, Jinan, China
Publisher
BioMed Central Ltd
Abstract
Background: The postoperative outcomes of transcatheter aortic valve
replacement (TAVR) with the new generation of self-expanding valves (SEV)
and balloon-expandable valves (BEV) remain uncertain. Method(s): We
conducted a meta-analysis based on randomized controlled trials (RCTs) and
propensity score-matched (PSM) studies to evaluate the performance of the
new generation TAVR devices, with a focus on Edwards SAPIEN 3/Ultra BEV,
Medtronic Evolut R/PRO SEV, and Boston ACURATE neo SEV. Our primary
endpoints were mortality and complications at both 30 days and one year
post-operation. Result(s): A total of 4 RCTs and 14 PSM studies were
included. Our findings showed no significant difference between SEV and
BEV regarding 30-day and 1-year mortality rates. ACURATE SEV required less
permanent pacemaker implantation (PPI) at 30-day as compared to SAPIEN
BEV, while Evolut SEV required a higher rate of PPI than SAPIEN BEV. The
incidence of stroke, major or life-threatening bleeding (MLTB), major
vascular complications (MVC), coronary artery obstruction (CAO) and acute
kidney injury (AKI) did not differ significantly between the two groups.
SEV had a larger effective orifice area (EOA) and lower mean transvalvular
gradients (MPG) compared to BEV. However, there was an increased risk of
paravalvular leakage (PVL) associated with SEV. Conclusion(s): In
terms of 30-day mortality, stroke, bleeding, MVC, AKI, CAO, and one-year
mortality, there was comparability between the two valve types following
TAVR. SEV was associated with better hemodynamic outcomes, except for a
higher incidence of PVL. Compared to SAPIEN BEV, ACURATE SEV had a lower
risk of PPI at 30 days, while Evolut SEV was associated with a higher risk
of PPI. These findings underscore the importance of personalized valve
selection. Copyright © 2023, The Author(s).

<50>
Accession Number
2023632221
Title
Head cooling wrap could suppress the elevation of core temperature after
cardiac surgery during forced-air warming in a pediatric intensive care
unit: a randomized clinical trial.
Source
Journal of Anesthesia. 37(4) (pp 596-603), 2023. Date of Publication:
August 2023.
Author
Sakai W.; Chaki T.; Nawa Y.; Oyasu T.; Ichisaka Y.; Nawa T.; Asai H.;
Ebuoka N.; Oba J.; Yamakage M.
Institution
(Sakai, Chaki, Nawa, Oyasu, Ichisaka, Nawa, Asai, Ebuoka, Oba) Pediatric
Intensive Care Unit, Hokkaido Medical Center for Child Health and
Rehabilitation, Hokkaido, Sapporo 006-0041, Japan
(Sakai, Chaki, Nawa, Yamakage) Department of Anesthesiology, Sapporo
Medical University School of Medicine, East 17, South 1, Chuo-Ku,
Hokkaido, Sapporo 060-8556, Japan
(Ichisaka, Asai, Ebuoka, Oba) Department of Cardiovascular Surgery,
Hokkaido Medical Center for Child Health and Rehabilitation, Hokkaido,
Sapporo 006-0041, Japan
Publisher
Springer
Abstract
Purpose: The main aim of the current trial was to explore our hypothesis
that cooling head wraps lower the core temperature more effectively than
ice packs on the head during forced-air warming after pediatric cardiac
surgeries. Method(s): This study was a single-center Randomized
Controlled Trial. Participants were children with a weight <= 10 kg and
hyperthermia during forced-air warming after cardiac surgeries. When the
core temperature reached 37.5 degreeC, ice packs on the head (group C) or
a cooling head wrap (group H) were used as cooling devices to decrease the
core temperature. The primary outcome was the core temperature. The
secondary outcomes were the foot surface temperature and heart rate. We
measured all outcomes every 30 min for 240 min after the patient developed
hyperthermia. We conducted two-way ANOVA as a pre-planned analysis and
also the Bonferroni test as a post hoc analysis. Result(s): Twenty
patients were randomly assigned to groups C and H. The series of core
temperatures in group H were significantly lower than those in group C (p
< 0.0001), and post hoc analysis showed that there was no significant
difference in core temperatures at T0 between the two groups and
statistically significant differences in all core temperatures at T30-240
between the two groups. There was no difference between the two groups'
surface temperatures and heart rates. Conclusion(s): Compared to ice
packs on the head, head cooling wraps more effectively suppress core
temperature elevation during forced-air warming after pediatric cardiac
surgery. Copyright © 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<51>
Accession Number
2023226503
Title
Postoperative short-term mortality between insulin-treated and
non-insulin-treated patients with diabetes after non-cardiac surgery: a
systematic review and meta-analysis.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1142490.
Date of Publication: 2023.
Author
Jiang J.; Wang S.; Sun R.; Zhao Y.; Zhou Z.; Bi J.; Luo A.; Li S.
Institution
(Jiang, Wang, Sun, Zhao, Zhou, Bi, Luo, Li) Department of Anesthesiology,
Hubei Key Laboratory of Geriatric Anesthesia, Perioperative Brain Health,
Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
Publisher
Frontiers Media SA
Abstract
Background: Diabetes mellitus is an independent risk factor for
postoperative complications. It has been reported that insulin-treated
diabetes is associated with increased postoperative mortality compared to
non-insulin-treated diabetes after cardiac surgery; however, it is unclear
whether this finding is applicable to non-cardiac surgery.
 Objective(s): We aimed to assess the effects of insulin-treated and
non-insulin-treated diabetes on short-term mortality after non-cardiac
surgery. Method(s): Our study was a systematic review and
meta-analysis of observational studies. PubMed, CENTRAL, EMBASE, and ISI
Web of Science databases were searched from inception to February 22,
2021. Cohort or case-control studies that provided information on
postoperative short-term mortality in insulin-treated diabetic and
non-insulin-treated diabetic patients were included. We pooled the data
with a random-effects model. The Grading of Recommendations, Assessment,
Development, and Evaluation system was used to rate the quality of
evidence. Result(s): Twenty-two cohort studies involving 208,214
participants were included. Our study suggested that insulin-treated
diabetic patients was associated with a higher risk of 30-day mortality
than non-insulin-treated diabetic patients [19 studies with 197,704
patients, risk ratio (RR) 1.305; 95% confidence interval (CI), 1.127 to
1.511; p < 0.001]. The studies were rated as very low quality. The new
pooled result only slightly changed after seven simulated missing studies
were added using the trim-and-fill method (RR, 1.260; 95% CI, 1.076-1.476;
p = 0.004). Our results also showed no significant difference between
insulin-treated diabetes and non-insulin-treated diabetes regarding
in-hospital mortality (two studies with 9,032 patients, RR, 0.970; 95% CI,
0.584-1.611; p = 0.905). Conclusion(s): Very-low-quality evidence
suggests that insulin-treated diabetes was associated with increased
30-day mortality after non-cardiac surgery. However, this finding is
non-definitive because of the influence of confounding factors. Systematic
review registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021246752,
identifier: CRD42021246752. Copyright © 2023 Jiang, Wang, Sun,
Zhao, Zhou, Bi, Luo and Li.

<52>
Accession Number
2022485235
Title
Day surgery unit robotics thoracic surgery: feasibility and management.
Source
Journal of Cancer Research and Clinical Oncology. 149(10) (pp 7831-7836),
2023. Date of Publication: August 2023.
Author
Li X.; Liu Y.; Zhou Y.; Gao Y.; Duan C.; Zhang C.
Institution
(Li, Liu, Zhou, Gao, Duan, Zhang) Department of Thoracic Surgery,
XiangyaHospital, Central South University, Hunan, Changsha 410008, China
(Li, Liu, Zhou, Gao, Duan, Zhang) Hunan Engineering Research Center for
Pulmonary Nodules Precise Diagnosis & Treatment, Hunan, Changsha 410008,
China
(Li, Liu, Zhou, Gao, Duan, Zhang) National Clinical Research Center for
Geriatric Disorders, Hunan, Changsha 410008, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Day surgery has been widely carried out in medical developed
countries such as Europe and the United States with high efficiency,
safety and economy. The development of thoracic day surgery started late,
and currently only a few top three hospitals carry thoracic day surgery.
In recent years, with the continuous in-depth application of the concept
of accelerated rehabilitation surgery (ERAS) in the field of surgery,
thoracic surgery ERAS has also entered clinical practice with remarkable
results. At present, the application of day surgery in the field of
thoracic surgery is still in its infancy, and the application of
robot-assisted thoracic surgery in thoracic surgery has brought new
opportunities for the popularization of day surgery in thoracic surgery.
 Method(s): We retrospectively reviewed 86 patients underwent thoracic
day surgery under the application of robot-assisted surgery system and
through systematic randomization method choose 86 patients underwent
conventional thoracic surgery under the application of robot-assisted
surgery system at our Institute between 2020 and 2022. We analyzed the
clinical and pathological features between the two groups. Result(s):
The clinical feature of location of the nodules, the size of nodules, pN,
histology and postoperative complications were homogenous between the two
groups. The average age was significantly higher in the conventional mode
group, the ratio of male patients and the patients with history of smoking
were significantly lower in day-surgery mode group. The major surgical
method in conventional mode group was lobectomy resection (48.8%). While
the segmental resection was the major surgical in day surgery mode group.
The hospital stay and the time of drain was significant longer in
conventional mode group. And the total medical cost in conventional was
more than day-surgery mode group. While the histology and postoperative
complications were homogenous between the two groups. Conclusion(s):
Before this, day surgery and robotics assistant surgery in thoracic
surgery had been proved feasibility and safety. However, there was no
report of day surgery unit robotics assistant thoracic surgery. Our
clinical practice demonstrated that the method of day surgery unit
robotics thoracic surgery is feasibility and safety enough. Copyright
© 2023, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<53>
Accession Number
2022352751
Title
Hypotension prediction index guided versus conventional goal directed
therapy to reduce intraoperative hypotension during thoracic surgery: a
randomized trial.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 101. Date
of Publication: December 2023.
Author
Sribar A.; Jurinjak I.S.; Almahariq H.; Bandic I.; Matosevic J.; Pejic J.;
Persec J.
Institution
(Sribar, Jurinjak, Almahariq, Bandic, Matosevic, Persec) Clinical
Department of Anesthesiology, Reanimatology and Intensive Care Medicine,
University Hospital Dubrava, Avenija Gojka Suska 6, Zagreb 10000, Croatia
(Sribar, Persec) Zagreb University School of Dental Medicine, Gunduliceva
5, Zagreb, Croatia
(Pejic) Department of Thoracic Surgery, University Hospital Dubrava, Av.
Gojka Suska 6, Zagreb, Croatia
Publisher
BioMed Central Ltd
Abstract
Purpose: Intraoperative hypotension is linked to increased incidence of
perioperative adverse events such as myocardial and cerebrovascular
infarction and acute kidney injury. Hypotension prediction index (HPI) is
a novel machine learning guided algorithm which can predict hypotensive
events using high fidelity analysis of pulse-wave contour. Goal of this
trial is to determine whether use of HPI can reduce the number and
duration of hypotensive events in patients undergoing major thoracic
procedures. Method(s): Thirty four patients undergoing esophageal or
lung resection were randomized into 2 groups -"machine learning algorithm"
(AcumenIQ) and "conventional pulse contour analysis" (Flotrac). Analyzed
variables were occurrence, severity and duration of hypotensive events
(defined as a period of at least one minute of MAP below 65 mmHg),
hemodynamic parameters at 9 different timepoints interesting from a
hemodynamics viewpoint and laboratory (serum lactate levels, arterial
blood gas) and clinical outcomes (duration of mechanical ventilation, ICU
and hospital stay, occurrence of adverse events and in-hospital and 28-day
mortality). Result(s): Patients in the AcumenIQ group had
significantly lower area below the hypotensive threshold (AUT, 2 vs 16.7
mmHg x minutes) and time-weighted AUT (TWA, 0.01 vs 0.08 mmHg). Also,
there were less patients with hypotensive events and cumulative duration
of hypotension in the AcumenIQ group. No significant difference between
groups was found in terms of laboratory and clinical outcomes.
 Conclusion(s): Hemodynamic optimization guided by machine learning
algorithm leads to a significant decrease in number and duration of
hypotensive events compared to traditional goal directed therapy using
pulse-contour analysis hemodynamic monitoring in patients undergoing major
thoracic procedures. Further, larger studies are needed to determine true
clinical utility of HPI guided hemodynamic monitoring. Trial registration:
Date of first registration: 14/11/2022 Registration number:
04729481-3a96-4763-a9d5-23fc45fb722d Copyright © 2023, The
Author(s).

<54>
Accession Number
2021692935
Title
Letter from the Editor-in-Chief.
Source
Journal of Interventional Cardiac Electrophysiology. 66(3) (pp 519-520),
2023. Date of Publication: April 2023.
Author
Huang H.D.
Institution
(Huang) Department of Cardiology, Section of Electrophysiology, Rush
University Medical Center, Chicago, IL, United States
Publisher
Springer

<55>
Accession Number
2020155279
Title
Risk Factors for Tube Feeding at Discharge in Infants Undergoing Neonatal
Surgery for Congenital Heart Disease: A Systematic Review.
Source
Pediatric Cardiology. 44(4) (pp 769-794), 2023. Date of Publication: April
2023.
Author
Elgersma K.M.; Trebilcock A.L.; Whipple M.O.; Tanner L.R.; Pilditch S.J.;
Shah K.M.; McKechnie A.C.
Institution
(Elgersma, Trebilcock, Whipple, Tanner, Pilditch, McKechnie) University of
Minnesota School of Nursing, Minneapolis, MN, United States
(Tanner) Children's Minnesota, Minneapolis, MN, United States
(Shah) Department of Pediatrics, M Health Fairview University of Minnesota
Masonic Children's Hospital, Minneapolis, MN, United States
Publisher
Springer
Abstract
Approximately 30-50% of infants undergoing neonatal surgery for congenital
heart disease (CHD) cannot meet oral feeding goals by discharge and
require feeding tube support at home. Feeding tubes are associated with
increased readmission rates and consequent hospital, payer, and family
costs, and are a burden for family caregivers. Identification of
modifiable risk factors for oral feeding problems could support targeted
care for at-risk infants. Therefore, the aim of this systematic review is
to determine risk factors for tube feeding at discharge in infants
undergoing neonatal surgery for CHD. Following Preferred Reporting Items
for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a search was
conducted using MEDLINE, CINAHL, and Cochrane Database of Systematic
Reviews. Studies published before 2010 were excluded. The search resulted
in 607 records, of which 18 were included. Studies were primarily
retrospective cohort designs and results were often inconsistent. Study
quality was assessed using the Joanna Briggs Critical Appraisal Tools. As
a group, the studies exhibited substantial risk for bias. Based on the
findings, infants who struggle with feeding preoperatively, experience
increased nil per os duration and/or low oral feeding volume
postoperatively, experience increased duration of mechanical ventilation,
or have vocal cord dysfunction may be at risk for tube feeding at hospital
discharge. Factors warranting further examination include cardiac
physiology (e.g., aortic arch obstruction) and the relationship between
neurodevelopment and oral feeding. Clinicians should use caution in
assuming risk for an individual and prioritize early implementation of
interventions that facilitate oral feeding development. Copyright
© 2022, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<56>
Accession Number
2017428106
Title
Large animal model of vein grafts intimal hyperplasia: A systematic
review.
Source
Perfusion (United Kingdom). 38(5) (pp 894-930), 2023. Date of Publication:
July 2023.
Author
Fashina O.; Abbasciano R.G.; McQueen L.W.; Ladak S.; George S.J.; Suleiman
S.; Punjabi P.P.; Angelini G.D.; Zakkar M.
Institution
(Fashina, Abbasciano, McQueen, Ladak, Zakkar) Department of Cardiovascular
Sciences, University of Leicester, Glenfield Hospital, Leicester, United
Kingdom
(George, Suleiman, Angelini) Bristol Heart Institute and Translational
Biomedical Research Centre, Bristol Medical School, University of Bristol,
Bristol Royal Infirmary, Bristol, United Kingdom
(Punjabi) Department of Cardiovascular Sciences, Imperial College,
Hammersmith Hospital, London, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Coronary artery bypass grafting remains the treatment of choice for a
large cohort of patients with significant coronary disease. Despite the
increased use of arterial grafts, the long saphenous vein remains the most
commonly used conduit. Long-term graft patency continues to be the
Achilles heel of saphenous vein grafts. This is due to the development of
intimal hyperplasia, a chronic inflammatory disease that results in the
narrowing and occlusion of a significant number of vein grafts. Research
models for intimal hyperplasia are essential for a better understanding of
pathophysiological processes of this condition. Large animal models
resemble human anatomical structures and have been used as a surrogate to
study disease development and prevention over the years. In this paper, we
systematically review all published studies that utilized large animal
models of vein graft disease with a focus on the type of model and any
therapeutic intervention, specifically the use of external
stents/mesh. Copyright © The Author(s) 2022.

<57>
Accession Number
2026164061
Title
A Systematic Review and Meta-Analysis of Transcatheter Versus Surgical
Aortic Valve Replacement in Kidney Transplant Patients.
Source
American Journal of Cardiology. 204 (pp 22-25), 2023. Date of Publication:
01 Oct 2023.
Author
Fong K.Y.; Ong J.H.W.; Chan Y.H.; Yap J.; Ho K.W.; Aslim E.J.; Ng L.G.;
Gan V.H.L.; Lim E.J.
Institution
(Fong) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Ong, Aslim, Ng, Gan, Lim) Department of Urology, Singapore General
Hospital, Singapore
(Chan) Biostatistics Unit, Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
(Yap, Ho) Department of Cardiology, National Heart Centre Singapore,
Singapore
(Gan) SingHealth Duke-NUS Transplant Centre, Singapore
Publisher
Elsevier Inc.

<58>
Accession Number
2025124325
Title
Do Intrathecal Opioids Improve Surgical Outcomes After Coronary Artery
Bypass Grafting? A Systematic Review and Analysis.
Source
Pain Physician. 26(4) (pp 319-326), 2023. Date of Publication: July/August
2023.
Author
Young E.; Sedghi S.; Farzin H.; Graffeo N.; Sakha H.; Nader N.D.
Institution
(Young, Sedghi, Graffeo, Nader) University at Buffalo, Jacobs School of
Medicine and Biomedical Sciences, Buffalo, NY, United States
(Farzin, Sakha) Tabriz University of Medical Sciences, Tabriz, Iran,
Islamic Republic of
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Intrathecal opioids have long been used as analgesia for
intractable cancer pain or as part of spinal anesthesia during obstetric
operations. More recently, they have been used preoperatively as a pain
management adjuvant for open cardiac and thoracic procedures.
 Objective(s): This study aims to analyze the impact of administering
intrathecal opioids before cardiac and thoracic surgeries on postoperative
pain and mechanical ventilation. Study design: Systematic review and
meta-analysis. Setting(s): University, School of Medicine, and
several university-affiliated hospitals. Method(s): Five outcomes
were studied, including the primary outcome of time to extubation,
secondary outcomes of analgesia requirements at 24 and 48 hours, resting
pain scores at 1 and 24 hours post-extubation, ICU length of stay in
hours, and hospital length of stay in days. A search of multiple databases
provided 28 studies reporting 4,000 total patients. Outcomes were measured
using continuous mean difference with a 95% confidence interval, and the
studies were examined for heterogeneity and sensitivity analysis.
 Result(s): The primary outcome analysis suggested that time to
extubation was 42 minutes shorter in the intrathecal opioid group (ranging
from 82 to 1 minute, P = 0.04). There was also a decrease in postoperative
analgesia requirements at both 24 hours (mean difference (MD) =-8.95 mg
morphine equivalent doses (MED) [-9.4,-8.5], P < 0.001) and 48 hours (MD
=-17.7 mg MED [-23.1,-12.4], P < 0.001) with I2 of 94% and 85%
respectively, an improvement of pain scores at both 1 hour (MD =-2.24
[-3.16,-1.32], P < 0.001) and 24-hours (MD =-1.64 [-2.48,-0.80], P =<
0.001) I2 of 94% and 85%, no change in both ICU length of stay
(MD =-0.27 hours [-0.55, 0.01], P = 0.06) I2 = 77% and hospital
length of stay (MD =-0.30 days [-0.66, 0.06], P = 0.11) I2 = 32%.
 Limitation(s): The major limitation of this meta-analysis was the
inconsistent dosages of intrathecal opioids utilized. Some used the same
dose for each patient, while other studies used weight-based doses. The
differences in the outcomes observed may then be a result of the different
amounts of opioids administered rather than the technique itself. Another
limitation was the inconsistent timing of reports for pain scores and
postoperative analgesic requirements. Further studies were analyzed at the
2 time periods for both secondary outcomes, making it difficult to
attribute the 2 effects solely to the intervention. Conclusion(s): We
conclude that preoperative injection of intrathecal opioids is
significantly associated with decreased time to extubation, decreased
postoperative analgesia requirement, and improved pain scores. In
controlled conditions with adequate staff education, this method of
analgesia may make it possible to extubate the patients after the surgery
in the operating room and fast-track their discharge from the
hospital. Copyright © 2023, American Society of Interventional
Pain Physicians. All rights reserved.

<59>
Accession Number
641931705
Title
Effects of low versus high inspired oxygen fraction on myocardial injury
after transcatheter aortic valve implantation: A randomized clinical
trial.
Source
PloS one. 18(8) (pp e0281232), 2023. Date of Publication: 2023.
Author
Cho Y.J.; Hyeon C.; Nam K.; Lee S.; Ju J.-W.; Kang J.; Han J.-K.; Kim
H.-S.; Jeon Y.
Institution
(Cho, Hyeon, Nam, Lee, Ju, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Kang, Han, Kim) Department of Internal Medicine, Seoul National
University Hospital, Seoul National University College of Medicine, Seoul,
South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Oxygen therapy is used in various clinical situation, but its
clinical outcomes are inconsistent. The relationship between the fraction
of inspired oxygen (FIO2) during transcatheter aortic valve implantation
(TAVI) and clinical outcomes has not been well studied. We investigated
the association of FIO2 (low vs. high) and myocardial injury in patients
undergoing TAVI. METHOD(S): Adults undergoing transfemoral TAVI under
general anesthesia were randomly assigned to receive FIO2 0.3 or 0.8
during procedure. The primary outcome was the area under the curve (AUC)
for high-sensitivity cardiac troponin I (hs-cTnI) during the first 72 h
following TAVI. Secondary outcomes included the AUC for postprocedural
creatine kinase-myocardial band (CK-MB), acute kidney injury and recovery,
conduction abnormalities, pacemaker implantation, stroke, myocardial
infarction, and in-hospital mortality. RESULT(S): Between October
2017 and April 2022, 72 patients were randomized and 62 were included in
the final analysis (n = 31 per group). The median (IQR) AUC for hs-cTnI in
the first 72 h was 42.66 (24.82-65.44) and 71.96 (35.38-116.34) h.ng/mL in
the FIO2 0.3 and 0.8 groups, respectively (p = 0.066). The AUC for CK-MB
in the first 72 h was 257.6 (155.6-322.0) and 342.2 (195.4-485.2) h.ng/mL
in the FIO2 0.3 and 0.8 groups, respectively (p = 0.132). Acute kidney
recovery, defined as an increase in the estimated glomerular filtration
rate >= 25% of baseline in 48 h, was more common in the FIO2 0.3 group
(65% vs. 39%, p = 0.042). Other clinical outcomes were comparable between
the groups. CONCLUSION(S): The FIO2 level did not have a significant
effect on periprocedural myocardial injury following TAVI. However,
considering the marginal results, a benefit of low FIO2 during TAVI could
not be ruled out. Copyright: © 2023 Cho et al. This is an open
access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<60>
Accession Number
641943568
Title
Full-root aortic valve replacement by Medtronic freestyle xenografts for
infective endocarditis: review of the literature, clinical outcomes and
valvular hemodynamics.
Source
Swiss Medical Weekly. Conference: 2023 Annual Meeting of the Swiss Society
of Cardiology, SSC, Swiss Society for Heart and Thoracic Vascular Surgery,
SSHTVS, Swiss Society of Pneumology, SSP and Swiss Society for Thoracic
Surgery, SSTS. Basel Switzerland. 153(Supplement 268) (pp 106S), 2023.
Date of Publication: June 2023.
Author
Ruchonnet E.; Verdugo-Marchese M.; Papadimitriou-Olivgeris M.; Niclauss
L.; Tozzi P.; Pretre R.; Kirsch M.
Institution
(Ruchonnet, Verdugo-Marchese, Niclauss, Tozzi, Pretre, Kirsch) Lausanne
University Hospital, Cardiac Surgery, Lausanne, Switzerland
(Papadimitriou-Olivgeris) Lausanne University Hospital, Infectious
Diseases, Lausanne, Switzerland
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Introduction: Choice of biological graft for surgical management of
infective endocarditis is debated. Method(s): Between March 1, 2015,
and June 30, 2022, 28 adult patients underwent aortic root replacement
with coronary arteries reimplantation using the modified Bentall technique
with a Medtronic Freestyle Root in our centre for infective endocarditis.
Clinical and echocardiographic data were collected retrospectively.
 Result(s): Mean age was 62.8 +/- 12.5 years. Prosthetic valve
endocarditis represented 71.4% of cases, and 27/28 patients were still
under antibiotic treatment at the time of surgery. Mean EuroSCORE II was
17.3 +/- 11.3%. Three patients were in critical preoperative states (two
on inotropic support and one on mechanical ventilation). Mean durations of
CPB and aortic cross-clamp were 192.7 +/- 88.9 and 147.2 +/- 56.9 minutes,
respectively. Principal identified pathogens were Methicillin-sensitive
Staphylococcus aureus (25.0%), Streptococcus spp. (17.9%), Staphylococcus
epidermidis (10.7%) and lugdunensis (7.1%), and Enterococcus faecalis
(7.1%). Fourteen additional procedures were performed in 12 patients
(42.8%). Annular abscess was present in 71.4% of cases and required
annulus patch repair in 12/20 (60%). Early reoperation rate was 17.9%,
mostly for surgical bleeding. Early mortality was 7.1%. Postoperative mean
and maximal transvalvular gradients were 7.8 +/- 3.9 and 13.9 +/- 6.5
mmHg, respectively. Our review of literature found 102 results. Of these,
31 were considered relevant to the topic by manual sorting. We further
excluded 9 case reports, 3 case series of fewer than five patients, and 7
retrospective controlled studies and one randomized controlled trial that
failed to present outcomes pertinent to our study. Results from the 11
remaining studies aligned with ours. Conclusion(s): Our results and
those from current literature confirm that the Medtronic Freestyle
prosthesis is a valid alternative to homografts for the treatment of
infective endocarditis, particularly in cases necessitating LVOT
reconstruction after extensive debridement of annular abscesses.

<61>
Accession Number
641943398
Title
Prognostic significance of carotid artery stenosis in patients undergoing
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
Swiss Medical Weekly. Conference: 2023 Annual Meeting of the Swiss Society
of Cardiology, SSC, Swiss Society for Heart and Thoracic Vascular Surgery,
SSHTVS, Swiss Society of Pneumology, SSP and Swiss Society for Thoracic
Surgery, SSTS. Basel Switzerland. 153(Supplement 268) (pp 72S-73S), 2023.
Date of Publication: June 2023.
Author
Vella A.; Roux O.; Antiochos P.; Monney P.; Maurizi N.; Skalidis I.;
Fournier S.; Eeckhout E.; Roguelov C.; Oestreicher S.; Kirsch M.; Muller
O.; Lu H.
Institution
(Vella) HUG, Geneva, Switzerland
(Roux) Hirslanden, Zurich, Switzerland
(Antiochos, Monney, Maurizi, Skalidis, Fournier, Eeckhout, Roguelov,
Oestreicher, Kirsch, Muller, Lu) CHUV, Lausanne, Switzerland
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Introduction: Stroke is a known complication of both transcatheter aortic
valve implantation (TAVI) and carotid artery stenosis (CAS). Whether CAS
is a predictor of worse prognosis after TAVI is unclear. We performed a
meta-analysis to assess the impact of CAS on the incidence of
neurovascular complications and mortality after TAVI. Method(s): We
searched PubMed/MEDLINE and EMBASE databases from inception to January
2023. CAS was defined by >=50% stenosis of at least one carotid artery.
All studies comparing CAS versus non-CAS TAVI populations were included.
Patients' baseline characteristics and 30-day clinical outcomes were
extracted. Endpoints included the 30-day incidence of neurovascular
complications (stroke or transient ischemic attack) and 30-day all-cause
mortality. Result(s): We identified six studies, totaling 6'763
patients in the CAS group and 23'861 patients in the non-CAS group. CAS
patients were more often men and polymorbid, with significantly higher
prevalence of hypertension, diabetes, dyslipidemia, coronary artery
disease, previous myocardial infarction and coronary artery bypass graft,
atrial fibrillation, peripheral artery disease, previous stroke or
transient ischemic attack and chronic kidney disease. The gold-standard
transfemoral vascular access for TAVI was more often used in patients
without CAS (Table). Regarding outcomes, there was no significant
difference in the rates of 30-day neurovascular complications between CAS
and non-CAS groups (relative risk [RR]: 1.23, 95%confidence interval [CI]:
0.63, 2.40, p = 0.54) (Figure, panel A). However, CAS was associated with
a higher risk of 30-day all-cause mortality (RR: 1.28, 95%CI: 1.12, 1.47,
p <.0001) (Figure, panel B). Conclusion(s): Patients with CAS
presented with a significantly higher comorbidity burden. CAS was not
associated with an increased risk of 30-day neurovascular complications.
30-day mortality was higher in the CAS group but that may be a surrogate
of the heavy comorbidity burden of CAS patients.

<62>
Accession Number
641943081
Title
EXTRACORPOREAL BLOOD PURIFICATION DURING OPEN HEART SURGERY WITH PROLONGED
CPB: CYTOSORB 300 VS JAFRON HA330.
Source
Nephrology Dialysis Transplantation. Conference: 60th ERA Congress.
Virtual. 38(Supplement 1) (pp i1121-i1122), 2023. Date of Publication:
June 2023.
Author
Jabayeva N.; Bekishev B.; Lesbekov T.; Kaliyev R.; Nurmykhametova Z.; Li
T.; Kuanyshbek A.
Institution
(Jabayeva, Bekishev, Lesbekov, Kaliyev, Nurmykhametova, Li, Kuanyshbek)
National Research Cardiac Surgery Center, Astana, Kazakhstan
Publisher
Oxford University Press
Abstract
Background and Aims: Cardiac surgery is maintained by various
complications. Major contribution associated with cardiopulmonary bypass
(CBP). Cardiac surgery with CPB provokes activation of the cascade
mechanism of inflammation with releasing of cytokines and a systemic
inflammatory response syndrome (SIRS). Activation of the contact system
due to exposure of artificial surface of the bypass circuit to blood
cells, endotoxemia, ischemia and reperfusion injury and surgical trauma
are all potential triggers of inflammation following CPB. This
inflammatory reaction may leads to the development of postoperative
complications, including vasoplegia, cytokine storm, myocardial
dysfunction, respiratory failure, acute kidney injury, coagulopathy
bleeding, and multiple organ dysfunction syndrome (MODS). A number of
different strategies, including new pharmacologic agents, CPB circuits and
components, and surgical techniques, have been employed during the last
few years in attempts to minimize the impact of SIRS on the outcome of
cardiac surgical patients. However, the complex pathophysiology of this
problem has not allowed, until now, the use of a single strategy. The aim
of our study is assessment of early application of extracorporeal cytokine
adsorbers to the inflammation system during open-heart surgery with
prolonged cardiopulmonary bypass. Method(s): This prospective
randomized single-center controlled trial observed patients, who were
assigned a planned open cardiac surgery with a duration of cardiopulmonary
bypass (CPB) more than 120 minutes between January 2021 to January 2023.
Patients were randomized into three groups: CytoSorb -300 group, HA 330
group and the control group. A simple 1:1:1 randomization method was
applied. Cytokine hemadsorption was conducted intraoperatively. Two types
of cytokine cartridges were applied CytoSorb 300 (Cytosorbents Europe
GmbH). HA330 (Jafron Biomedical Co., Ltd. China). The inclusion criteria:
age >=18 years, informed consent to participate in the study, CPB more
than 120 min. The exclusion criteria: Age less than 18 years; refusal to
participate in the study. Result(s): The data of the HA 330 (n = 22)
and CytoSorb300 (n = 22) groups were compared with the data of the control
group (n = 22). The primary results and details of the work are given in
Tables 1-3. Conclusion(s): Intraoperative hemadsorption may be
beneficial for patients who underwent open-heart surgery with prolonged
CPB. The early hemadsorption has positive impact to postoperative period
after cardiac surgery and may reduce requirement of renal replacement
therapy.

<63>
Accession Number
641943028
Title
ARTEMIS: A PHASE 3 STUDY OF RAVULIZUMAB TO PROTECT PATIENTS WITH CKD
UNDERGOING CARDIAC SURGERY FROM AKI AND SUBSEQUENT MAJOR ADVERSE KIDNEY
EVENTS.
Source
Nephrology Dialysis Transplantation. Conference: 60th ERA Congress.
Virtual. 38(Supplement 1) (pp i1110), 2023. Date of Publication: June
2023.
Author
Winterberg P.; Solinsky C.; Li G.; Smith W.
Institution
(Winterberg, Solinsky, Li, Smith) Alexion, Astra Zeneca Rare Disease,
Boston, United States
Publisher
Oxford University Press
Abstract
Background and Aims: In patients undergoing cardiac surgery with
cardiopulmonary bypass (CPB), pre-existing chronic kidney disease (CKD)
confers a substantial risk for poor outcomes, including the development of
cardiac surgery-associated acute kidney injury (CSA-AKI). CSA-AKI occurs
in >=50% of patients with CKD undergoing cardiac surgery with CPB vs ~20-
25% of patients without CKD1,2. The risk of subsequent Major Adverse
Kidney Events (MAKE; a composite of sustained kidney dysfunction,
initiation of dialysis, and death) is also elevated in patients with CKD.
Causes of CSAAKI are multifactorial and complex, and may include
inflammation, oxidative stress, renal congestion, and ischaemic injury
(such as ischaemic-reperfusion injury [IRI]). IRI is a common cause of AKI
and typically results from early hypoperfusion while on bypass, followed
by kidney injury upon reperfusion. There are currently no approved
therapies that reduce the risk of AKI and associated poor outcomes after
cardiac surgery with CPB3. Preclinical and clinical studies suggest that
damage and inflammation caused by IRI and CPB is amplified by complement
activation3; early treatment with C5 inhibitors, especially before onset
of ischaemia, may lower the risk of damage. Method(s): ARTEMIS is a
Phase 3, randomised, double-blind, placebocontrolled, multicentre study of
ravulizumab in adults with CKD and stable cardiac disease undergoing
non-emergent sternotomy with CPB, to reduce the risk of post-operative AKI
and subsequent MAKE 90 days post-surgery. Key inclusion and exclusion
criteria can be found in Figure 1 and a study schematic in Figure 2.
Briefly, the study consists of an up to 28-day screening period,
randomisation and dosing 1-7 days prior to surgery with CPB (Day 1), a
90-day primary evaluation period post-CPB, and a survival follow-up at day
365 post-CPB. Approximately 736 participants will be randomised 1:1 to
receive a single weight-based dose of ravulizumab or placebo;
randomisation will be based on baseline CKD stage (3A, 3B, 4) and surgery
type (mitral valve replacement or combined procedures vs other single
procedures). The primary objective of this study is to assess the efficacy
of ravulizumab in reducing the risk of MAKE90, defined as meeting >=1 of
the following by day 90 post-CPB: >=25% sustained decrease from baseline
in estimated glomerular filtration rate (calculated using the Chronic
Kidney Disease Epidemiology Collaboration equation, based on serum
Cystatin C); initiation of renal replacement therapy; death from any
cause. The safety of ravulizumab in participants with CKD undergoing
non-emergent CPB will also be evaluated. Other secondary objectives
include assessment of ravulizumab efficacy for reducing AKI (based on
serum creatinine) and MAKE risk at earlier timepoints following CPB,
alongside any effects it may have on healthcare resource utilisation and
healthrelated quality of life - as well as treatment immunogenicity - in
participants with CKD undergoing non-emergent CPB. Result(s): The
final analysis will be conducted when all participants have completed the
primary evaluation period. Conclusion(s): The aim of this study is to
assess whether terminal complement inhibition with ravulizumab is safe and
effective in reducing kidney injury and improving outcomes in patients
with CKD undergoing cardiac surgery with CPB.

<64>
Accession Number
2026174265
Title
Prognostic impact of precipitated cardiac decompensation in symptomatic
heart failure with reduced ejection fraction and severe secondary mitral
regurgitation.
Source
American Heart Journal. 265 (pp 83-91), 2023. Date of Publication:
November 2023.
Author
Mewton N.; Donal E.; Picard F.; Derimay F.; Grinberg D.; Boulch D.M.;
Bochaton T.; Piriou N.; De Lorgeril A.; Samson G.; Rouleau F.; Riche B.;
Trochu J.N.
Institution
(Mewton, Derimay, Bochaton, De Lorgeril, Samson) Heart Failure Department,
Centre d'Investigation Clinique, Inserm 1407, CarMeN Inserm 1060, Hopital
Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
(Donal) Cardiology Department, Hospital University Rennes, LTSI UMR1099,
INSERM, Rennes, France
(Picard) Heart Failure Department, Aquitaine Expert Center for Primary
Pulmonary Hypertension, University Hospital Bordeaux, Bordeaux, France
(Grinberg) Cardiac Surgery Department, Hopital Cardiologique Louis Pradel,
Hospices Civils de Lyon, Lyon, France
(Boulch, Riche) Biostatistics Department, Universite de Lyon, F-69000,
Lyon, France, Universite Lyon 1, F-69100, Villeurbanne, France, Hospices
Civils de Lyon, Pole Sante Publique, Service de Biostatistique et
Bioinformatique, F-69003, Lyon, France, CNRS, UMR 5558, Laboratoire de
Biometrie et Biologie Evolutive, Equipe Biostatistique-Sante, Lyon
F-69100, France
(Piriou, Trochu) Cardiology Department, Clinique cardiologique et des
maladies vasculaires Pole hospitalo-universitaire institut du thorax et du
systeme nerveux CIC INSERM 1413 - Institut du Thorax- UMR INSERM 1087
Universite de Nantes, Nantes, France
(Rouleau) Cardiology department, University Hospital Angers, Angers,
France
Publisher
Elsevier Inc.
Abstract
Background: Our aim was to assess the distribution of primary (with no
trigger) and secondary (with a decompensation trigger) heart failure
events in a severe heart failure population and their association with
2-year all-cause mortality in the Mitra.Fr study. Method(s): We
included 304 patients with symptomatic heart failure, and severe mitral
regurgitation and guideline directed medical therapy randomized to medical
therapy alone or medical therapy with percutaneous mitral valve repair.
According to the follow-up, we defined 3 categories of events: follow-up
without any heart failure event, at least 1 decompensation starting with a
primary heart failure decompensation or starting with a precipitated
secondary heart failure event. The primary outcome was 2-years all-cause
mortality. Result(s): A total of 179 patients (59 %) had at least 1
heart failure decompensation within 24-months of follow-up. 129 heart
failure decompensations (72%) were a first primary heart failure and 50
(28%) were a first secondary decompensation. Finally, 30 patients had both
types of decompensations but these were not taken into account for the
comparison of primary and secondary decompensations. Primary
decompensations were 3-times more frequent than secondary decompensations,
but the mean number of heart failure decompensations was similar in the
"Primary heart failure group" compared to the "Secondary heart failure
group": (1.94 +/- 1.39 vs 1.80 +/- 1.07 respectively; P =.480). Compared
to patients without heart failure decompensation, patients with "Only
primary decompensation" or with "Only secondary decompensation" had a
significantly increased risk of death (HR = 4.87, 95% CI [2.86, 8.32] and
2.68 95%CI [1.64, 4.37] respectively). All-cause mortality, was not
significantly different between these 2 type of decompensations (HR =
1.82, 95% CI [0.93, 3.58]; P =.082), but each additional heart failure
recurrence was associated with a significant increase in mortality risk
(HR = 1.27, 95% CI [1.08; 1.50]; P =.005). Conclusion(s): In heart
failure with reduced ejection fraction and severe secondary mitral
regurgitation patients, primary heart failure decompensations were 3-times
more frequent compared to precipitated decompensations with a
nonsignificant trend in increased risk of all-cause mortality. Our results
fail to support the differentiation between primary and secondary
decompensations as they seem to portend the same outcome
impact. Copyright © 2023 Elsevier Inc.

<65>
Accession Number
2026199038
Title
Surgical outcomes of double-orifice mitral valve repair in patients with
atrioventricular canal defects: a systematic review and meta-analysis.
Source
Cardiology in the Young. (no pagination), 2023. Date of Publication:
2023.
Author
Ghosh S.; Halder V.; Mittal A.; Mishra A.; Haranal M.; Aggarwal P.; Singh
H.; Barwad P.; Naganur S.; Thingnam S.K.S.
Institution
(Ghosh, Naganur) Department of Cardiology, Pgimer, Chandigarh, India
(Halder, Haranal, Barwad, Thingnam) Deartment of Ctvs, Unmicrc, Ahmedabad,
India
(Mittal, Mishra, Aggarwal, Singh) Department of Ctvs, Pgimer, Chandigarh,
India
Publisher
Cambridge University Press
Abstract
Introduction: Double-orifice mitral valve or left atrioventricular valve
is a rare congenital cardiac anomaly that may be associated with an
atrioventricular septal defect. The surgical management of double-orifice
mitral valve/double-orifice left atrioventricular valve with
atrioventricular septal defect is highly challenging with acceptable
clinical outcomes. This meta-analysis is aimed to evaluate the surgical
outcomes of double-orifice mitral valve/double-orifice left
atrioventricular valve repair in patients with atrioventricular septal
defect. Methods and Results: A total of eight studies were retrieved
from the literature by searching through PubMed, Google Scholar, Embase,
and Cochrane databases. Using Bayesian hierarchical models, we estimated
the pooled proportion of incidence of double-orifice mitral
valve/double-orifice left atrioventricular valve with atrioventricular
septal defect as 4.88% in patients who underwent surgical repair (7
studies; 3295 patients; 95% credible interval [CI] 4.2-5.7%). As compared
to pre-operative regurgitation, the pooled proportions of post-operative
regurgitation were significantly low in patients with moderate status: 5.1
versus 26.39% and severe status: 5.7 versus 29.38% [8 studies; 171
patients]. Moreover, the heterogeneity test revealed consistency in the
data (p < 0.05). Lastly, the pooled estimated proportions of early and
late mortality following surgical interventions were low, that is, 5 and
7.4%, respectively. Conclusion(s): The surgical management of
moderate to severe regurgitation showed corrective benefits
post-operatively and was associated with low incidence of early mortality
and re-operation. Copyright © The Author(s), 2023. Published by
Cambridge University Press.

<66>
Accession Number
641946582
Title
How robust are recommended waiting times to pacing after cardiac surgery
that are derived from observational data?.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2023. Date of Publication: 04 Aug 2023.
Author
Tindale A.; Cretu I.; Haynes R.; Gomez N.; Bhudia S.; Lane R.; Mason M.J.;
Francis D.P.
Institution
(Tindale, Francis) National Heart and Lung Institute, Imperial College
London, United Kingdom
(Tindale, Haynes, Gomez, Lane, Mason) Department of Cardiology, Harefield
Hospital, Guys & St Thomas' Foundation Trust, London UK
(Cretu, Mason) Brunel University London, United Kingdom
(Bhudia) Department of Cardiothoracic Surgery, Harefield Hospital, Guys &
St Thomas' Foundation Trust, London UK
Publisher
NLM (Medline)
Abstract
BACKGROUND: For bradycardic patients after cardiac surgery, it is unknown
how long to wait before implanting a permanent pacemaker. Current
recommendations vary and are based on observational studies. METHODS AND
RESULTS: We conducted first a study of patients in our institution, and
second a systematic review of studies examining conduction disturbance and
pacing after cardiac surgery.Of 5849 operations over a 6 year period, 103
(1.8%) patients required PPM implantation. Only pacing dependence at
implant and time from surgery to implant were associated with 30-day
pacing dependence. The only predictor of regression of pacing dependence
was time from surgery to implant.We then applied the conventional
procedure of Receiver Operator Curve (ROC) analysis, seeking an optimal
time-point for decision-making. This suggested the optimal waiting time
was 12.5 days for predicting pacing dependence at 30 days for all patients
(AUC 0.620, p=0.031) and for predicting regression of pacing dependence in
patients who were pacing dependent at implant (AUC 0.769,
p<0.001).However, our systematic review showed that recommended optimal
decision-making timepoints were strongly correlated with the average
implant timepoint of those individual studies (R=0.96, p<0.001). We
further conducted modelling which revealed that in any such study, the ROC
method is strongly biased to indicate a value near to the median time to
implant as optimal. CONCLUSION(S): When commonly used automated
statistical methods are applied to observational data with the aim of
defining the optimal time to pacing after cardiac surgery, the suggested
answer is likely to be similar to the average time to pacing in that
cohort. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<67>
Accession Number
641946068
Title
Pain and sleep after open-heart surgery-inhalation peppermint essence:
double-blind randomized clinical trial.
Source
BMJ supportive & palliative care. (no pagination), 2023. Date of
Publication: 03 Aug 2023.
Author
Pour-Abbasi M.-S.; Yadollahi S.; Maghami M.; Azizi-Fini I.; Afazel M.-R.
Institution
(Maghami, Yadollahi, Afazel) Trauma Nursing Research Center, Kashan
University of Medical Sciences, Iran, Islamic Republic of
(Pour-Abbasi) Cardiac Surgery Department, Kashan University of Medical
Sciences, Iran, Islamic Republic of
(Maghami) Biostatics and Epidemiology Department, Isfahan University of
Medical Sciences, Isfahan, Iran, Islamic Republic of
(Azizi-Fini) Trauma Nursing Research Center, Kashan University of Medical
Sciences, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of this study was to determine the effect of inhaling
peppermint essence on pain relief and sleep quality after open-heart
surgery. METHOD(S): In a double-blind randomised clinical trial
carried out in Iran in 2020, 64 cardiac patients were selected by
convenience sampling and randomly allocated to aromatherapy (n=32) and
placebo (n=32) groups. The aromatherapy and control groups received
inhaled aromatherapy using peppermint essence and distilled water,
respectively. Data gathering tools were the Numeric Pain Rating Scale and
St Mary's Hospital Sleep Questionnaire. Data were analysed using an
independent t-test, chi2 test, Mann-Whitney U test and generalised
estimating equation analysis. RESULT(S): The mean severity of pain in
the aromatherapy and placebo groups was 3.22+/-0.88and 4.56+/-0.90,
respectively, which was a statistically significant difference (p=0.0001).
The mean sleep scores after the intervention on day 1 were 20.10+/-4.90and
25.76+/-6.36 in the aromatherapy and placebo groups, respectively, and
18.63+/-5.56and 22.62+/-5.69, respectively, on day 2. The difference
between the two groups was statistically significantly different after the
intervention in terms of sleep quality (p<0.05). CONCLUSION(S):
Aromatherapy attenuated pain and improved sleep quality after open-heart
surgery. Peppermint essence aromatherapy is therefore recommended after
surgery. Copyright © Author(s) (or their employer(s)) 2023. No
commercial re-use. See rights and permissions. Published by BMJ.

<68>
Accession Number
2026035669
Title
Effect of prehabilitation-related DIET ary protein intake on Q uality o f
R ecovery after elective cardiac surgery (DIETQoR) study: Protocol of a
randomised controlled trial.
Source
BMJ Open. 13(7) (no pagination), 2023. Article Number: e069528. Date of
Publication: 20 Jul 2023.
Author
Cheung H.H.T.; Yau D.K.W.; Chiu L.C.S.; Wong M.K.H.; Yeung S.S.Y.;
Underwood M.J.; Wong R.H.L.; Joynt G.M.; Lee A.
Institution
(Cheung, Yau, Chiu, Wong, Joynt, Lee) Anaesthesia and Intensive Care, The
Chinese University of Hong Kong, Hong Kong, Hong Kong
(Yeung) Medicine and Therapeutics, The Chinese University of Hong Kong,
Hong Kong, Hong Kong
(Underwood) Cardiovascular Services, Auckland City Hospital, Auckland, New
Zealand
(Wong) Division of Cardiothoracic Surgery, The Chinese University of Hong
Kong, Hong Kong, Hong Kong
Publisher
BMJ Publishing Group
Abstract
Introduction Protein malnutrition is associated with higher risks of
postoperative complications, mortality, prolonged postoperative stays in
hospital, slower physical and mental recovery after surgery and lower
subsequent health-related quality of life. To reduce the risk of
postoperative morbidity and mortality, nutritional prehabilitation
programmes have been developed recently to build up patient's nutritional
reserve to withstand the stress of surgery. The intervention involves
nutritional screening and counselling, and increasing dietary protein
intake in protein-malnourished patients in the several weeks before
surgery. However, there are few well-conducted preoperative studies to
examine the effect of increasing dietary protein intake on the quality of
recovery of malnourished patients after elective cardiac surgery. Method
and analysis This randomised controlled trial of malnourished patients
undergoing major elective cardiac surgery will compare the quality of
postoperative recovery in patients with or without nutritional
prehabilitation. One hundred and thirty-two patients will be randomised to
receive nutritional prehabilitation (target-adjusted whey protein powder
supplementation and an individualised 1 hour session/week counselling by a
dietician 1 month before operation date) or standard care (no nutritional
prehabilitation). Primary outcomes will be the quality of recovery after
surgery (15-item Quality of Recovery) on the third postoperative day.
Secondary outcomes will include days (alive and) at home within 30 days,
changes in the WHO Disability Assessment Schedule 2.0, changes in
health-related quality of life (EQ-5D) and Cardiac Postoperative Morbidity
Survey. An outcomes assessor will be blinded to the treatment allocation.
Appropriate univariate analyses, generalised estimating equations and
multiple regressions will be performed for intention-to-treat and
per-protocol analyses. Ethics and dissemination The Joint CUHK-NTEC
Clinical Research Ethics Committee approved the study protocol (CREC Ref.
No.: 2021.703 T). The findings will be presented at scientific meetings,
peer-reviewed journals and to study participants. Trial registration
number ChiCTR2200057463. 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
2025917676
Title
Early safety and feasibility of a first-in-class biomimetic transcatheter
aortic valve - DurAVR.
Source
EuroIntervention. 19(4) (pp E352-E361), 2023. Date of Publication: July
2023.
Author
Kodali S.K.; Sorajja P.; Meduri C.U.; Feldt K.; Cavalcante J.L.; Garg P.;
Hamid N.; Poon K.K.; Settergren M.; Burns M.R.; Ruck A.; Sathananthan J.;
Zajarias A.; Shaburishvili T.; Zirakashvili T.; Zhividze M.; Katchakhidze
G.; Bapat V.
Institution
(Kodali) Columbia University Irving Medical Center, New York, NY, United
States
(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, Solna, Karolinska
Institutet, 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, QLD, 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
Europa Group
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. Aim(s): 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. Copyright © Europa Digital &;
Publishing 2023. All rights reserved.

<70>
[Use Link to view the full text]
Accession Number
2025906881
Title
The Effect of Prophylactic Steroids on Shivering in Adults Undergoing
Surgery: A Systematic Review and Meta-analysis of Randomized Controlled
Trials.
Source
Anesthesia and Analgesia. 137(2) (pp 332-344), 2023. Date of Publication:
01 Aug 2023.
Author
Misra S.; Singh S.; Sarkar S.; Behera B.K.; Jena S.S.
Institution
(Misra, Sarkar, Behera, Jena) Departments of Anesthesiology & Critical
Care, India
(Singh) Departments of Obstetrics & Gynaecology, All India Institute of
Medical Sciences (AIIMS), Bhubaneswar, India
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Shivering is common following anesthesia and surgery.
Corticosteroids (steroids) have been tried to reduce the risk of
shivering, but the evidence in favor of their use is uncertain. The
primary objective of this review was to evaluate the effect of steroids on
the risk of perioperative (intra- and postoperative) shivering versus
controls (placebo and active controls). Additional objectives were to
assess the risk of severity of shivering, patient satisfaction with
shivering prophylaxis, quality of recovery (QoR), and the risk of
steroid-related adverse effects. METHOD(S): PubMed, Embase, Cochrane
Central Registry of Trials, Google Scholar, and preprint servers were
searched from inception until November 30, 2022. Randomized controlled
trials (RCTs) published in the English language were retrieved, provided
they reported on shivering either as a primary or secondary outcome
following steroid prophylaxis in adult patients undergoing surgery under
spinal or general anesthesia. RESULT(S): A total of 3148 patients
from 25 RCTs were included in the final analysis. The steroids used in the
studies were either dexamethasone or hydrocortisone. Dexamethasone was
administered intravenously or intrathecally, while hydrocortisone was
administered intravenously. Prophylactic administration of steroids
reduced the risk of overall shivering (risk ratio [RR], 0.65 [95%
confidence interval {CI}, 0.52-0.82]; P =.0002; I2= 77%) as
well as the risk of moderate to severe shivering (RR, 0.49 [95% CI,
0.34-0.71]; P =.0002; I2= 61%) in comparison to controls.
Administration of intravenous dexamethasone (RR, 0.67 [95% CI, 0.52-0.87];
P =.002; I2= 78%) and hydrocortisone (RR, 0.51 [95% CI,
0.32-0.80]; P =.003; I2= 58%) were effective in shivering
prophylaxis. For intrathecal dexamethasone (RR, 0.84 [95% CI, 0.34-2.08];
P =.7; I2= 56%), the null hypothesis of no subgroup difference
was not rejected (P =.47), preventing definitive conclusions about the
efficacy of this route of administration. The prediction intervals for
both overall shivering risk (0.24-1.70) and risk of severity of shivering
(0.23-1.0) precluded generalization of results in future studies.
Meta-regression analysis was used to further explore heterogeneity.
Factors like the dose and timing of administration of steroids or the type
of anesthesia were not found to be significant. Patient satisfaction and
QoR were higher in the dexamethasone groups versus placebo. No increased
risk of adverse events of steroids was noted versus placebo or controls.
 CONCLUSION(S): Prophylactic steroid administration may be beneficial
in reducing the risk of perioperative shivering. However, the quality of
evidence in favor of steroids is very low. Further well-designed studies
are needed for establishing generalization. Copyright © 2023
Lippincott Williams and Wilkins. All rights reserved.

<71>
Accession Number
2025851145
Title
Comparison of the Effect of Inhalation and Intermittent
Inhalation-Exhalation Incentive Spirometry on Dyspnea Severity and
Atelectasis in Patients undergoing Coronary Artery Bypass Graft.
Source
Iranian Red Crescent Medical Journal. 25(3) (no pagination), 2023. Article
Number: e1918. Date of Publication: 2023.
Author
Sabziani Z.; Khalili Z.; Borzou S.R.; Tapak L.; Shams A.
Institution
(Sabziani) School of Nursing and Midwifery, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Khalili, Borzou) Faculty Member, Chronic Disease (Home Care) Research
Center, Department of Medical Surgical Nursing, School of Nursing and
Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
(Tapak) Department of Biostatistics, School of Public Health and Modeling
of Noncommunicable Diseases Research Center, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Shams) Department of Cardiac Surgery, Medical Faculty, Hamadan University
of Medical Sciences, Hamadan, Iran, Islamic Republic of
Publisher
ZamenPub
Abstract
Background: Dyspnea and atelectasis after Coronary Artery Bypass Graft
(CABG) are common and need nursing attention. Inhalation and exhalation
incentive spirometry is recommended for preventing alveolar collapse and
atelectasis. Objective(s): This study aimed to compare different
methods of incentive spirometry on dyspnea severity and atelectasis of the
patients undergoing CABG. Method(s): This randomized clinical trial
study was conducted on 66 patients undergoing CABG admitted to the
Intensive Care Unit (ICU) of Cardiac Surgery Department in Hamadan, Iran,
in 2020. The patients were selected through convenient sampling and were
divided into two groups through block permutation: inhalation incentive
spirometry and intermittent inhalation-exhalation spirometry. Both groups
performed incentive spirometry according to the instructions they had
received for four days. Then, they were examined for dyspnea and
atelectasis using the Borg scale and chest x-ray, respectively.
 Result(s): During the intervention, dyspnea significantly decreased
in the intermittent inhalation-exhalation group relative to the inhalation
group (P<0.05). Most patients in both inhalation (63.6%) and intermittent
inhalation-exhalation (65.6%) groups had atelectasis; however, no
significant differences were observed between the two groups (P=0.867).
 Conclusion(s): Incentive spirometry via intermittent
inhalation-exhalation method was more effective on dyspnea compared to the
inhalation method. Therefore, this method is recommended to patients and
nurses to reduce pulmonary complications after CABG. Copyright ©
2023, Author(s).

<72>
Accession Number
2025474473
Title
Continuous Ultrafiltration Enhances Recovery After Adult Cardiac Surgery
With Cardiopulmonary Bypass: A Systematic Review and Meta-analysis.
Source
CJC Open. 5(7) (pp 494-507), 2023. Date of Publication: July 2023.
Author
Bierer J.; Horne D.; Stanzel R.; Henderson M.; Boulos L.; Hayden J.A.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Department of Surgery,
Dalhousie University, Halifax, NS, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Halifax, NS, Canada
(Boulos) Maritime SPOR SUPPORT Unit, Halifax, NS, Canada
(Hayden) Department of Community Health & Epidemiology, Dalhousie
University, Halifax, NS, Canada
Publisher
Elsevier Inc.
Abstract
Background: Cardiac surgery with cardiopulmonary bypass is associated with
systemic inflammation. Ultrafiltration used throughout the cardiopulmonary
bypass time, continuously, is hypothesized to be an immunomodulatory
therapy. Method(s): A systematic review and meta-analysis of
randomized trials investigating continuous forms of ultrafiltration during
adult cardiac surgery (CRD42020219309) was conducted and is reported
following PRISMA guidelines. MEDLINE, Embase, CENTRAL, and Scopus were
searched on November 3, 2021. The primary endpoint was operative
mortality, and secondary outcomes included intensive care unit length of
stay (ICU LOS), ventilation time, acute kidney injury or renal failure,
and pneumonia. Each study was assessed for risk of bias using the Cochrane
Risk-of Bias-Tool for Randomized Trials (RoB2) instrument. Outcomes were
analyzed with inverse variance random-effects models and assessed for
GRADE quality of evidence. Result(s): Twelve randomized trials
consisting of 989 adult patients undergoing coronary, valvular, or
concomitant cardiac procedures were included. Compared to controls,
patients receiving continuous ultrafiltration had no statistical
difference in operative mortality; risk ratio of 0.32 (95% confidence
interval [CI]: 0.10-1.03; P = 0.06). Reductions occurred in ICU LOS, by
7.01 hours (95% CI: 1.86-12.15; P = 0.008); ventilation time, by 2.11
hours (95% CI: 0.71-3.51; P = 0.003); and incidence of pneumonia, with a
risk ratio of 0.33 (95% CI: 0.15-0.75; P = 0.008). There wasno difference
in renal injury. The GRADE quality of evidence for these outcomes ranged
from very low to low. Conclusion(s): Continuous forms of
ultrafiltration enhance recovery after adult cardiac surgery by reducing
ICU LOS, ventilation time, and incidence of pneumonia. A multicentre
randomized trial could confirm and generalize these
findings. Copyright © 2023 The Authors

<73>
Accession Number
2025421300
Title
Meta-Analysis Assessing Efficacy and Safety of Vitamin K Antagonists
Versus Direct Oral Anticoagulants for Atrial Fibrillation After
Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 201 (pp 260-267), 2023. Date of
Publication: 15 Aug 2023.
Author
Selvaraj V.; Khan M.S.; Mufarrih S.H.; Kazimuddin M.; Waheed M.A.;
Tripathi A.; Bavishi C.; Hyder O.N.; Aronow H.D.; Saad M.; Abbott J.D.
Institution
(Selvaraj) Department of Medicine, The Miriam Hospital, Warren Alpert
Medical School of Brown University, Providence, Rhode Island, United
States
(Khan, Kazimuddin, Waheed) Division of Cardiology, University of Kentucky
College of Medicine - Bowling Green Campus, Bowling Green, KY, United
States
(Mufarrih) Department of Internal Medicine, University of Kentucky College
of Medicine - Bowling Green Campus, Bowling Green, KY, United States
(Tripathi) Division of Cardiology, CHI St. Vincent Heart Clinic Arkansas,
Searcy, AR, United States
(Bavishi) Division of Cardiology, University of Missouri School of
Medicine, Columbia, Missouri, United States
(Hyder, Saad, Abbott) Division of Cardiology, Lifespan Cardiovascular
Institute, Warren Alpert Medical School of Brown University, Providence,
Rhode Island, United States
(Aronow) Heart & Vascular Services, Henry Ford Health, Detroit, MI, United
States
Publisher
Elsevier Inc.
Abstract
Patients who underwent transcatheter aortic valve implantation (TAVI) with
concomitant atrial fibrillation (AF) are at a higher risk for
thromboembolic and bleeding events. The optimal antithrombotic strategy
for patients with AF after TAVI remains unclear. We sought to determine
the comparative efficacy and safety of direct oral anticoagulants (DOAC)
versus oral vitamin K antagonists (VKAs) in these patients. Electronic
databases such as PubMed, Cochrane, and Embase databases were searched
till January 31, 2023, for relevant studies evaluating clinical outcomes
of VKA versus DOAC in patients with AF after TAVI. Outcomes assessed were
(1) all-cause mortality, (2) stroke, (3) major/life-threatening bleeding,
and (4) any bleeding. Hazard ratios (HRs) were pooled in meta-analysis
using random effect model. Nine studies (2 randomized and 7 observational)
were included in systematic review, and 8 studies with 25,769 patients
were eligible to be included in the meta-analysis. The mean age of the
patients was 82.1 years, and 48.3% were male. Pooled analysis using
random-effects model showed no statistically significant difference in
all-cause mortality (HR 0.91, 95% confidence interval [CI] 0.76 to 1.10, p
= 0.33), stroke (HR 0.96, 95% CI 0.80 to 1.16, p = 0.70), and
major/life-threatening bleeding (HR 1.05, 95% CI 0.82 to 1.35, p = 0.70)
in patients that received DOAC compared with oral VKA. Risk of any
bleeding was lower in the DOAC group compared with oral VKA (HR 0.83, 95%
CI 0.76 to 0.91, p = 0.0001). In patients with AF, DOACs appear to be a
safe alternative oral anticoagulation strategy to oral VKA after TAVI.
Further randomized studies are required to confirm the role of DOACs in
those patients. Copyright © 2023 Elsevier Inc.

<74>
Accession Number
2024647218
Title
The efficacy and safety of patent Foramen Ovale Closure for Refractory
Epilepsy (PFOC-RE): a prospectively randomized control trial of an
innovative surgical therapy for refractory epilepsy patients with PFO of
high-grade right-to-left shunt.
Source
BMC Neurology. 23(1) (no pagination), 2023. Article Number: 282. Date of
Publication: December 2023.
Author
Shuming J.; Hua L.; Yusha T.; Lei C.
Institution
(Shuming) Department of Clinical Research Management, West China Hospital,
Sichuan University, Chengdu 610044, China
(Hua, Yusha, Lei) Department of Neurology, West China Hospital, Joint
Research Institution of Altitude Health, Sichuan University, Chengdu
610044, China
Publisher
BioMed Central Ltd
Abstract
Background: A significant proportion of patients with epilepsy have an
unknown etiology and lack effective targeted therapeutic drugs. Patent
Foramen Ovale (PFO) induces hypoxia and microembolism, leading to cerebral
neurological dysfunction and increased epilepsy risk. This study aims to
assess the efficacy and safety of PFO closure for relieving epileptic
seizures in patients with refractory epilepsy associated with PFO.
Methods/design: Recruitment takes place at the West China Hospital of
Sichuan University, China, for an open-label, randomized controlled
clinical trial. The trial will include 110 patients with refractory
epilepsy and PFO. Disease diagnoses will conform to the diagnostic
criteria of the International League Against Epilepsy (ILAE) for
refractory epilepsy and the American Society of Echocardiography (ASE) for
PFO. Refractory epilepsy and high-grade right-to-left shunt (RLS) of the
PFO will be further diagnosed using 24-hour video electroencephalogram and
transthoracic echocardiography with contrast injection, respectively.
Eligible participants require a secondary or higher volume of RLS. Trial
registration: Chinese Clinical Trial Registry (ChiCTR2200065681).
Registered on November 11, 2022. Copyright © 2023, The Author(s).

<75>
Accession Number
2023625875
Title
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting
in Non-ST-Elevation Coronary Syndromes and Multivessel Disease: A
Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 195 (pp 70-76), 2023. Date of Publication:
15 May 2023.
Author
Kakar H.; Groenland F.T.W.; Elscot J.J.; Rinaldi R.; Scoccia A.; Kardys
I.; Nuis R.J.; Wilschut J.; Dekker W.K.D.; Daemen J.; Zijlstra F.; Van
Mieghem N.M.; Diletti R.
Institution
(Kakar, Groenland, Elscot, Scoccia, Kardys, Nuis, Wilschut, Dekker,
Daemen, Zijlstra, Van Mieghem, Diletti) Department of Cardiology,
Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands
(Rinaldi) Department of Cardiovascular and Pulmonary Sciences, Catholic
University of the Sacred Heart, Rome, Italy
Publisher
Elsevier Inc.
Abstract
There is lack of evidence regarding the optimal revascularization strategy
in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and
multivessel disease (MVD). This systematic review and meta-analysis
compares the clinical impact of percutaneous coronary intervention (PCI)
with that of coronary artery bypass graft surgery (CABG) in this subset of
patients. EMBASE, MEDLINE, and Web of Knowledge were searched for studies
including patients with NSTE-ACS and MVD who underwent PCI or CABG up to
September 1, 2021. The primary end point of the meta-analysis was
all-cause mortality at 1 year. The secondary end points were myocardial
infarction (MI), stroke, or repeat revascularization at 1 year. The
analysis was conducted using the Mantel-Haenszel random-effects model to
calculate the odds ratio (OR) with 95% confidence interval (CI). Four
prospective observational studies met the inclusion criteria, including
1,542 patients who underwent CABG and 1,630 patients who underwent PCI. No
significant differences were found in terms of all-cause mortality (OR
0.91, 95% CI 0.68 to 1.21, p = 0.51), MI (OR 0.78, 95% CI 0.40 to 1.51, p
= 0.46), or stroke (OR 1.54, 95% CI 0.55 to 4.35, p = 0.42) between PCI
and CABG. Repeat revascularization was significantly lower in the CABG
group (OR 0.21, 95% CI 0.13 to 0.34, p <0.00001). In patients presenting
with NSTE-ACS and MVD, 1-year mortality, MI, and stroke were similar
between patients treated with either PCI or CABG, but the repeat
revascularization rate was higher after PCI. Copyright © 2023

<76>
Accession Number
2023609298
Title
Utility of Cerebral Embolic Protection Devices in Transcatheter
Procedures: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101675. Date of Publication: July 2023.
Author
Baloch Z.Q.; Haider S.J.; Siddiqui H.F.; Shaikh F.N.; Shah B.U.D.; Ansari
M.M.; Qintar M.
Institution
(Baloch, Qintar) Michigan State University/Sparrow Hospital Lansing,
Lansing, MI, United States
(Haider) University of Alabama, Birmingham, AL, United States
(Siddiqui, Shaikh) Department of Medicine, Dow University of Health
Sciences
(Shah) Pakistan Institute of Medical Sciences - Islamabad, Islamabad,
Pakistan
(Ansari) Texas Tech University Health Sciences Center
Publisher
Elsevier Inc.
Abstract
With the emergence of the largest randomized control trial to date-the
Stroke Protection With Sentinel During Transcatheter Aortic Valve
Replacement (PROTECTED TAVR) study-we sought to conduct an updated
meta-analyses to evaluate the utility of CEP devices on both clinical
outcomes and neuroimaging parameters. Electronic databases were queried
through November 2022 for clinical trials comparing the utility of
Cerebral Embolic Protection (CEP) devices in Transcatheter Aortic Valve
Replacement (TAVR) with non-CEP TAVR procedures. Meta-analyses were
performed using the generic inverse variance technique, and a
random-effects model, and results are presented as weighted mean
differences (WMD) for continuous outcomes, and hazard ratios (HR) for
dichotomous outcomes. Outcomes of interest included stroke, disabling
stroke, nondisabling stroke, bleeding, mortality, vascular complications,
new ischemic lesions, acute kidney injury (AKI), and total lesion volume.
Thirteen studies (8 RCTs, 5 observational studies) consisting of 128,471
patients were included in the analysis. Results from our meta-analyses
showed a significant reduction in stroke (OR: 0.84 [0.74-0.95]; P < 0.01;
I2 = 0%), disabling stroke (OR: 0.37 [0.21-0.67]; P < 0.01;
I2 = 0%) and bleeding events (OR: 0.91 [0.83-0.99]; P = 0.04;
I2 = 0%) through CEP device use in TAVR. The use of CEP devices
had no significant impact on nondisabling stroke (OR: 0.94 [0.65-1.37]; P
< 0.01; I2 = 0%), mortality (OR: 0.78 [0.53-1.14]; P < 0.01;
I2 = 17%), vascular complications (OR: 0.99 [0.63-1.57]; P <
0.01; I2 = 28%), AKI (OR: 0.78 [0.46-1.32]; P < 0.01;
I2 = 0%), new ischemic lesions (MD: -1.72 [-4.01, 0.57]; P <
0.001; I2 = 95%) and total lesion volume (MD: -46.11 [-97.38,
5.16]; P < 0.001; I2 = 81%). The results suggest that CEP
device use was associated with a lower risk of disabling stroke and
bleeding events in patients undergoing TAVR. Copyright © 2023
Elsevier Inc.

<77>
Accession Number
2023492087
Title
Use of cardiopulmonary bypass is associated with chronic postsurgical pain
among patients undergoing coronary artery bypass graft surgery: follow-up
of a randomized, clinical trial.
Source
Journal of Anesthesia. 37(4) (pp 555-561), 2023. Date of Publication:
August 2023.
Author
Minami K.; Tadokoro N.; Fukushima S.; Fujita T.; Ohnishi Y.
Institution
(Minami) Department of Critical Care Medicine, National Cerebral and
Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita 564-8565, Japan
(Tadokoro, Fukushima, Fujita) Department of Cardiac Surgery, National
Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita
564-8565, Japan
(Ohnishi) Department of Anesthesiology, National Cerebral and
Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita 564-8565, Japan
Publisher
Springer
Abstract
Background: Chronic postsurgical pain (CPSP) worsens patients' mortality,
morbidity, and quality of life. Cardiopulmonary bypass is mandatory for
cardiac surgery, but it induces intense inflammation. The presence of
inflammation is a crucial part of pain sensitization. An extreme
inflammatory response due to cardiopulmonary bypass might cause a high
prevalence of CPSP after cardiac surgery. We hypothesized that the
prevalence and severity of CPSP are higher in patients after on-pump
coronary artery bypass graft (CABG) surgery than in those after off-pump
CABG surgery. Method(s): This prospective, observational study was
performed on a cohort from a randomized trial (on-pump CABG: 81 patients,
off-pump CABG: 86 patients). A questionnaire about the severity of
surgical wound pain that evaluated pain with the numerical rating scale
(NRS) was filled out by the patients. NRS responses for current pain, peak
pain in the last 4 weeks, and average pain in the last 4 weeks were
evaluated. The main outcomes were the severity of CPSP as evaluated using
the NRS and the prevalence of CPSP. CPSP was defined as pain with an NRS
score > 0. Differences in severity between groups were analyzed using
multivariate ordinal logistic regression models adjusted for age and sex,
and differences in prevalence between groups were analyzed using
multivariate logistic regression models adjusted for age and sex.
 Result(s): The questionnaire return rate was 77.0%. During a median
follow-up of 17 years, 26 patients complained of CPSP (on-pump CABG: 20
patients, off-pump CABG: 6 patients). Ordinal logistic regression showed
that the NRS response for current pain (odds ratio [OR] 2.34; 95% CI
1.12-4.92; P = 0.024) and the NRS response for peak pain in the last 4
weeks (OR 2.71; 95% CI 1.35-5.42; P = 0.005) were significantly higher in
patients who underwent on-pump CABG surgery than in those who underwent
off-pump CABG. Logistic regression showed that on-pump CABG surgery was an
independent predictor of CPSP (OR 2.59; 95% CI 1.06-6.31; P = 0.036).
 Conclusion(s): The prevalence and severity of CPSP are higher in
patients with on-pump CABG surgery than in those with off-pump CABG
surgery. Copyright © 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<78>
Accession Number
2022279587
Title
Comparative efficacy of different combinations of acapella, active cycle
of breathing technique, and external diaphragmatic pacing in perioperative
patients with lung cancer: a randomised controlled trial.
Source
BMC Cancer. 23(1) (no pagination), 2023. Article Number: 282. Date of
Publication: December 2023.
Author
Chen X.; Li C.; Zeng L.; Rong T.; Lin P.; Wang Q.; Guo Z.; Long H.; Zhong
J.
Institution
(Chen, Li, Zeng, Rong, Lin, Wang, Guo, Long, Zhong) Department of Thoracic
Surgery, State Key Laboratory of Oncology in South China, Collaborative
Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer
Center, No. 651, Road Dongfengdong, Yuexiu District, Guangdong, Guangzhou,
China
Publisher
BioMed Central Ltd
Abstract
Background: Acapella plus active cycle of breathing technique (ACBT),
external diaphragm pacemaker (EDP) plus ACBT have been shown to facilitate
the recovery of functional capacity and lung function in patients
suffering from airway obstruction but the efficacy in perioperative
patients with lung cancer has not been proven. Method(s): We
conducted a three-arm, prospective, randomized, assessor-blinded,
controlled trial in patients with lung cancer who underwent thoracoscopic
lobectomy or segmentectomy in the department of thoracic surgery, China.
Patients were randomly assigned (1:1:1) to receive Acapella plus ACBT, EDP
plus ACBT, or ACBT group (control group) using SAS software. The primary
outcome was functional capacity, measured by the 6-minute walk test
(6MWT). Result(s): We recruited 363 participants over 17 months: 123
assigned to the Acapella plus ACBT group, 119 to the EDP plus ACBT group,
and 121 to the ACBT group. Statistically significant differences were
noted for functional capacity between the EDP plus ACBT and control groups
at each follow-up time (1-week follow-up: difference = 47.25 m, 95% CI,
31.56-62.93; P < 0.001; and 1-month follow-up: difference = 49.72 m, 95%
CI, 34.04-65.41; P < 0.001), between the Acapella plus ACBT and control
groups at postoperative week 1 (difference = 35.23 m, 95% CI, 19.30-51.16;
P < 0.001) and postoperative month 1 (difference = 34.96 m, 95% CI,
19.03-50.89; P < 0.001), and between the EDP plus ACBT and Acapella plus
ACBT groups at 1-month follow-up (difference = 14.76 m, 95% CI,
1.34-28.19; P = 0.0316). Conclusion(s): EDP plus ACBT and Acapella
plus ACBT significantly improved functional capacity and lung function in
perioperative patients with lung cancer, compared with single-model ACBT,
and the effects of EDP plus ACBT were clearly superior to those of other
programs. Trial registration: The study was registered in the clinical
trial database (clinicaltrials.gov) on June 4, 2021 (No.
NCT04914624). Copyright © 2023, The Author(s).

<79>
Accession Number
2022110883
Title
The protocol for the prehabilitation for thoracic surgery study: a
randomized pragmatic trial comparing a short home-based multimodal program
to aerobic training in patients undergoing video-assisted thoracoscopic
surgery lobectomy.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 194. Date of
Publication: December 2023.
Author
Liu Y.; Liu Z.; Zhang Y.; Cui Y.; Pei L.; Huang Y.
Institution
(Liu, Liu, Pei, Huang) Department of Anesthesiology, Chinese Academy of
Medical Sciences & Peking Union Medical College Hospital, Beijing 100730,
China
(Zhang) Department of Medical Research Center, Chinese Academy of Medical
Sciences & Peking Union Medical College Hospital, Beijing 100730, China
(Cui) Department of Thoracic Surgery, Chinese Academy of Medical Sciences
& Peking Union Medical College Hospital, Beijing 100730, China
Publisher
BioMed Central Ltd
Abstract
Background: Prehabilitation has been shown to have a positive effect on
the postoperative recovery of functional capacity in patients undergoing
video-assisted thoracoscopic surgery (VATS) lobectomy. The optimal way to
implement prehabilitation programs, such as the optimal forms of
prehabilitation, duration, intensity, and methods to improve compliance,
remained to be studied. This Prehabilitation for Thoracic Surgery Study
will compare the effectiveness of multimodal and aerobic training-only
programs in patients undergoing thoracoscopic lobectomy. Method(s):
This randomized pragmatic trial will be conducted in Peking Union Medical
College Hospital (PUMCH) and include 100 patients who are eligible to
undergo VATS lobectomy. Patients will be randomized to a multimodal or
aerobic training group. Prehabilitation training guidance will be provided
by a multidisciplinary care team. The patients in the multimodal group
will perform aerobic exercises, resistance exercises, breathing exercises,
psychological improvement strategies, and nutritional supplementation.
Meanwhile, the patients in the aerobic group will conduct only aerobic
exercises. The interventions will be home-based and supervised by medical
providers. The patients will be followed up until 30 days after surgery to
investigate whether the multimodal prehabilitation program differs from
the aerobic training program in terms of the magnitude of improvement in
functional capability pre- to postoperatively. The primary outcome will be
the perioperative 6-min walk distance (6MWD). The secondary outcomes will
include the postoperative pulmonary functional recovery status,
health-related quality of life score, incidence of postoperative
complications, and clinical outcomes. Discussion(s): Prehabilitation
remains a relatively new approach that is not widely performed by thoracic
surgery patients. The existing studies mainly focus on unimodal
interventions. While multimodal prehabilitation strategies have been shown
to be preferable to unimodal strategies in a few studies, the evidence
remains scarce for thoracic surgery patients. The results of this study
will contribute to the understanding of methods for thoracoscopic
lobectomy patients. Trial registration: ClinicalTrials.gov NCT04049942.
Registered on August 8, 2019. Copyright © 2023, The Author(s).

<80>
Accession Number
2022110824
Title
Individualized flow-controlled versus conventional pressure-controlled
ventilation in on-pump heart surgery (FLOWVENTIN HEARTSURG): study
protocol for a randomized controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 195. Date of
Publication: December 2023.
Author
Becker S.; Schnitzler R.; Rembecki M.; Geppert J.; Kurz C.T.; Wichelhaus
L.-M.; Timmesfeld N.; Zahn P.K.
Institution
(Becker, Schnitzler, Rembecki, Geppert, Kurz, Wichelhaus, Zahn) Department
of Anesthesiology, Intensive Care and Pain Medicine, BG University
Hospital Bergmannsheil, Ruhr-University Bochum, Buerkle de La Camp-Platz
1, Bochum 44789, Germany
(Timmesfeld) Department of Medical Informatics, Biometry & Epidemiology,
Ruhr-University Bochum, Bochum 44780, Germany
Publisher
BioMed Central Ltd
Abstract
Background: In on-pump cardiac surgery, lungs are at high risk of
periprocedural organ impairment because of atelectasis formation,
ventilator-induced lung injury, and hyperinflammation due to the
cardiopulmonary bypass which results in postoperative pulmonary
complications in half of this patient population. The new ventilation mode
flow-controlled ventilation (FCV) uniquely allows full control of ins- and
expiratory airway flows. This approach reduces the mechanical power of
invasive ventilation as a possible cause of ventilator-induced lung
injury. The scope of FLOWVENTIN HEARTSURG is to compare perioperative
individualized FCV with best clinical practice pressure-controlled
ventilation (PVC) modes in patients with elective on-pump cardiac surgery
procedures. We hypothesize that the postoperative inflammatory response
can be reduced by the perioperative application of FCV compared to PCV.
 Method(s): FLOWVENTIN HEARTSURG is a single-center, randomized,
parallel-group trial with two intervention arms: perioperative PCV modes
(n = 70, PCV group) with an individualized positive end-expiratory
pressure (PEEP) and a tidal volume of 6-8 ml/kg predicted bodyweight
compared to perioperative FCV (n = 70, FCV group) with an individualized
PEEP and driving pressure, resulting in a liberal tidal volume. As the
primary study endpoint interleukin 8 plasma level is assessed 6 h after
cardiopulmonary bypass as a surrogate biomarker of systemic and pulmonary
inflammation. As secondary aims clinically relevant patient outcomes are
analyzed, e.g., perioperative lung function regarding oxygenation indices,
postoperative pulmonary and extra-pulmonary complications, SIRS-free days
as well as ICU and total inpatient stays. As additional sub-studies with
an exploratory approach perioperative right ventricular function
parameters are assessed by echocardiography and perioperative lung
aeration by electrical impedance tomography. Discussion(s): Current
paradigms regarding protective low tidal volume ventilation are
consciously left in the FCV intervention group in order to reduce
mechanical power as a determinant of ventilator-induced lung injury in
this high-risk patient population and procedures. This approach will be
compared in a randomized controlled trial with current best clinical
practice PCV in FLOWVENTIN HEARTSURG. Trial registration: German Clinical
Trials Register DRKS00018956. Registered on 12 June 2020 (Version 1), last
update on 22 August 2022 (Version 4). Copyright © 2023, The
Author(s).

<81>
Accession Number
2016427814
Title
A systematic review of the evidence supporting post-operative
antithrombotic use following cardiopulmonary bypass in children with CHD.
Source
Cardiology in the Young. 32(1) (pp 10-20), 2022. Date of Publication: 01
Jan 2022.
Author
Thompson E.J.; Foote H.P.; Li J.S.; Rotta A.T.; Goldenberg N.A.; Hornik
C.P.
Institution
(Thompson, Foote, Li, Rotta, Hornik) Department of Pediatrics, Duke
University School of Medicine, Durham, NC, United States
(Li, Hornik) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
(Goldenberg) Department of Pediatrics and Medicine, Division of
Hematology, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Goldenberg) Institute for Clinical and Translational Research, Cancer and
Blood Disorders Institute, Heart Institute, Johns Hopkins All Children's
Hospital, St. Petersburg, FL, United States
Publisher
Cambridge University Press
Abstract
Objectives: To determine the optimal antithrombotic agent choice, timing
of initiation, dosing and duration of therapy for paediatric patients
undergoing cardiac surgery with cardiopulmonary bypass. Method(s): We
used PubMed and EMBASE to systematically review the existing literature of
clinical trials involving antithrombotics following cardiac surgery from
2000 to 2020 in children 0-18 years. Studies were assessed by two
reviewers to ensure they met eligibility criteria. Result(s): We
identified 10 studies in 1929 children across three medications classes:
vitamin K antagonists, cyclooxygenase inhibitors and indirect thrombin
inhibitors. Four studies were retrospective, five were prospective
observational cohorts (one of which used historical controls) and one was
a prospective, randomised, placebo-controlled, double-blind trial. All
included were single-centre studies. Eight studies used surrogate
biomarkers and two used clinical endpoints as the primary endpoint. There
was substantive variability in response to antithrombotics in the
immediate post-operative period. Studies of warfarin and aspirin showed
that laboratory monitoring levels were frequently out of therapeutic range
(variably defined), and findings were mixed on the association of these
derangements with bleeding or thrombotic events. Heparin was found to be
safe at low doses, but breakthrough thromboembolic events were common.
 Conclusion(s): There are few paediatric prospective randomised
clinical trials evaluating antithrombotic therapeutics post-cardiac
surgery; most studies have been observational and seldom employed clinical
endpoints. Standardised, validated endpoints and pragmatic trial designs
may allow investigators to determine the optimal drug, timing of
initiation, dosing and duration to improve outcomes by limiting
post-operative morbidity and mortality related to bleeding or thrombotic
events. Copyright © The Author(s), 2022. Published by Cambridge
University Press.

<82>
Accession Number
641729900
Title
Social network interventions to support cardiac rehabilitation and
secondary prevention in the management of people with heart disease.
Source
Cochrane Database of Systematic Reviews. 2023(6) (no pagination), 2023.
Article Number: CD013820. Date of Publication: 28 Jun 2023.
Author
Purcell C.; Dibben G.; Hilton Boon M.; Matthews L.; Palmer V.J.; Thomson
M.; Smillie S.; Simpson S.A.; Taylor R.S.
Institution
(Purcell) Faculty of Wellbeing, Education and Language Studies, The Open
University in Scotland, Edinburgh, United Kingdom
(Dibben, Palmer, Thomson, Simpson, Taylor) MRC/CSO Social and Public
Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
(Hilton Boon) School of Health and Life Sciences, Glasgow Caledonian
University, Glasgow, United Kingdom
(Matthews) School of Health and Life Sciences, University of the West of
Scotland, Glasgow, United Kingdom
(Smillie) School of Social and Political Sciences, University of Glasgow,
Glasgow, United Kingdom
(Taylor) Robertson Centre for Biostatistics, University of Glasgow,
Glasgow, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Globally, cardiovascular diseases (CVD, that is, coronary
heart (CHD) and circulatory diseases combined) contribute to 31% of all
deaths, more than any other cause. In line with guidance in the UK and
globally, cardiac rehabilitation programmes are widely offered to people
with heart disease, and include psychosocial, educational, health
behaviour change, and risk management components. Social support and
social network interventions have potential to improve outcomes of these
programmes, but whether and how these interventions work is poorly
understood. Objective(s): To assess the effectiveness of social
network and social support interventions to support cardiac rehabilitation
and secondary prevention in the management of people with heart disease.
The comparator was usual care with no element of social support (i.e.
secondary prevention alone or with cardiac rehabilitation). Search
Method(s): We undertook a systematic search of the following databases on
9 August 2022: CENTRAL, MEDLINE, Embase, and the Web of Science. We also
searched ClinicalTrials.gov and the WHO ICTRP. We reviewed the reference
lists of relevant systematic reviews and included primary studies, and we
contacted experts to identify additional studies. Selection Criteria:
We included randomised controlled trials (RCTs) of social network or
social support interventions for people with heart disease. We included
studies regardless of their duration of follow-up, and included those
reported as full text, published as abstract only, and unpublished data.
 Data Collection and Analysis: Using Covidence, two review authors
independently screened all identified titles. We retrieved full-text study
reports and publications marked 'included', and two review authors
independently screened these, and conducted data extraction. Two authors
independently assessed risk of bias, and assessed the certainty of the
evidence using GRADE. Primary outcomes were all-cause mortality,
cardiovascular-related mortality, all-cause hospital admission,
cardiovascular-related hospital admission, and health-related quality of
life (HRQoL) measured at > 12 months follow-up. Main Result(s): We
included 54 RCTs (126 publications) reporting data for a total of 11,445
people with heart disease. The median follow-up was seven months and
median sample size was 96 participants. Of included study participants,
6414 (56%) were male, and the mean age ranged from 48.6 to 76.3 years.
Studies included heart failure (41%), mixed cardiac disease (31%),
post-myocardial infarction (13%), post-revascularisation (7%), CHD (7%),
and cardiac X syndrome (1%) patients. The median intervention duration was
12 weeks. We identified notable diversity in social network and social
support interventions, across what was delivered, how, and by whom. We
assessed risk of bias (RoB) in primary outcomes at > 12 months follow-up
as either 'low' (2/15 studies), 'some concerns' (11/15), or 'high' (2/15).
'Some concerns' or 'high' RoB resulted from insufficient detail on
blinding of outcome assessors, data missingness, and absence of pre-agreed
statistical analysis plans. In particular, HRQoL outcomes were at high
RoB. Using the GRADE method, we assessed the certainty of evidence as low
or very low across outcomes. Social network or social support
interventions had no clear effect on all-cause mortality (risk ratio (RR)
0.75, 95% confidence interval (CI) 0.49 to 1.13, I2 = 40%) or
cardiovascular-related mortality (RR 0.85, 95% CI 0.66 to 1.10,
I2 = 0%) at > 12 months follow-up. The evidence suggests that
social network or social support interventions for heart disease may
result in little to no difference in all-cause hospital admission (RR
1.03, 95% CI 0.86 to 1.22, I2 = 0%), or cardiovascular-related
hospital admission (RR 0.92, 95% CI 0.77 to 1.10, I2 = 16%),
with a low level of certainty. The evidence was very uncertain regarding
the impact of social network interventions on HRQoL at > 12 months
follow-up (SF-36 physical component score: mean difference (MD) 31.53, 95%
CI -28.65 to 91.71, I2 = 100%, 2 trials/comparisons, 166
participants; mental component score MD 30.62, 95% CI -33.88 to 95.13,
I2 = 100%, 2 trials/comparisons, 166 participants). Regarding
secondary outcomes, there may be a decrease in both systolic and diastolic
blood pressure with social network or social support interventions. There
was no evidence of impact found on psychological well-being, smoking,
cholesterol, myocardial infarction, revascularisation, return to
work/education, social isolation or connectedness, patient satisfaction,
or adverse events. Results of meta-regression did not suggest that the
intervention effect was related to risk of bias, intervention type,
duration, setting, and delivery mode, population type, study location,
participant age, or percentage of male participants. Authors' conclusions:
We found no strong evidence for the effectiveness of such interventions,
although modest effects were identified in relation to blood pressure.
While the data presented in this review are indicative of potential for
positive effects, the review also highlights the lack of sufficient
evidence to conclusively support such interventions for people with heart
disease. Further high-quality, well-reported RCTs are required to fully
explore the potential of social support interventions in this context.
Future reporting of social network and social support interventions for
people with heart disease needs to be significantly clearer, and more
effectively theorised, in order to ascertain causal pathways and effect on
outcomes. Copyright © 2023 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<83>
Accession Number
2026139043
Title
A Systematic Review and Meta-Analysis of the Clinical Outcomes of Isolated
Tricuspid Valve Surgery.
Source
American Journal of Cardiology. 203 (pp 414-426), 2023. Date of
Publication: 15 Sep 2023.
Author
Chick W.; Alkhalil M.; Egred M.; Gorog D.A.; Edwards R.; Das R.;
Abdeldayem T.; Ibrahim O.; Malik I.; Mikhail G.; Zaman A.; Farag M.
Institution
(Chick, Gorog, Abdeldayem, Ibrahim) Cardiology Department, Lister
Hospital, East and North Hertfordshire NHS Trust, Hertfordshire, United
Kingdom
(Alkhalil, Egred, Edwards, Das, Zaman, Farag) Cardiothoracic Department,
Freeman Hospital, Newcastle-upon-Tyne, United Kingdom
(Alkhalil, Zaman) Translational and Clinical Research Institute, Newcastle
University, Newcastle-upon-Tyne, United Kingdom
(Gorog, Malik, Mikhail) Postgraduate Medical School National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Gorog, Farag) Health Services and Clinical Research, Postgraduate Medical
School, University of Hertfordshire, United Kingdom
(Malik, Mikhail) Cardiology Department, Hammersmith Hospital, Imperial
College Healthcare NHS Trust, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Patients with isolated tricuspid valve (TV) disease have poor prognosis
with no consensus on their management. Transcatheter TV intervention is
emerging as a valid option in patients with prohibitive surgical risk. We
analyzed studies of patients who underwent isolated TV surgery to identify
the features associated with successful clinical outcomes. We performed a
systematic review and meta-analysis of studies reporting clinical outcomes
of isolated surgical TV intervention, namely TV repair, TV replacement
with a bioprosthetic valve (TVR-B), or TV replacement with a mechanical
valve (TVR-M). Twenty-seven studies involving 10,478 patients (4,931 TV
repair, 3,821 TVR-B, and 1,713 TVR-M) were included. Early mortality
occurred in 9% and did not differ between TV surgical approaches. Late
mortality was 27% at a median follow-up of 4 (3 to 6) years and was
significantly higher for all-TVR (30% vs 25%, rate ratio 1.18, 95%
confidence interval 1.05 to 1.31, p = 0.004) and TVR-B (28% vs 24%, rate
ratio 1.15, 95% confidence interval 1.02 to 1.30, p = 0.02) compared with
TV repair. Late mortality did not differ between TVR-B and TVR-M. Across
all studies, early complications included bleeding (7.4%), acute kidney
injury (18.7%), permanent pacemaker (13.7%), cerebrovascular accidents
(1.2%), and infection (8.9%). Late clinical outcomes included
reintervention (3.7%), structural valve deterioration (2.4%), valve
thrombosis (2.6%), and TV regurgitation recurrence after 1 year (15.0%).
In conclusion, in isolated TV surgeries, TV repair has favorable long-term
mortality compared with TV replacement. This supports the development and
refinement of transcatheter TV repair approaches. Future research is
recommended to provide comparative data for various transcatheter TV
interventions. Copyright © 2023 Elsevier Inc.

<84>
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. 75(4) (pp 274-278), 2023. Date of Publication: 01
Jul 2023.
Author
Jain C.; Dash P.K.; Iyer V.R.; Deshmukh R.
Institution
(Jain, Dash, Iyer, Deshmukh) Department of Cardiology, Sri Satya Sai
General Hospital, 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

<85>
Accession Number
2025404837
Title
Intracranial bleeding and associated outcomes in atrial fibrillation
patients undergoing percutaneous left atrial appendage occlusion: Insights
from National Inpatient Sample 2016-2020.
Source
Heart Rhythm O2. 4(7) (pp 433-439), 2023. Date of Publication: July 2023.
Author
Khan M.Z.; Shatla I.; Darden D.; Neely J.; Mir T.; Abideen Asad Z.U.;
Agarwal S.; Raina S.; Balla S.; Singh G.D.; Srivatsa U.; Munir M.B.
Institution
(Khan, Balla) Division of Cardiology, West Virginia University Heart and
Vascular Institute, Morgantown, WV, United States
(Shatla) Department of Internal Medicine, Kansas University Medical
Center, Kansas City, KS, United States
(Darden) Division of Cardiology, Kansas City Heart Rhythm Institute,
Overland Park, KS, United States
(Neely, Singh, Srivatsa, Munir) Division of Cardiovascular Medicine,
University of California Davis, Sacramento, CA, United States
(Mir) Department of Medicine, Wayne State University, Detroit, MI, United
States
(Abideen Asad, Agarwal) Department of Internal Medicine, University of
Oklahoma, Oklahoma City, OK, United States
(Raina) Division of Cardiovascular Medicine, Stanford University,
Stanford, CA, United States
Publisher
Elsevier B.V.
Abstract
Background: Percutaneous left atrial appendage occlusion (LAAO) has proved
to be a safer alternative for long-term anticoagulation; however, patients
with a history of intracranial bleeding were excluded from large
randomized clinical trials. Objective(s): The purpose of this study
was to determine outcomes in atrial fibrillation (AF) patients with a
history of intracranial bleeding undergoing percutaneous LAAO.
 Method(s): National Inpatient Sample and International Classification
of Diseases, Tenth Revision, codes were used to identify patients with AF
who underwent LAAO during the years 2016-2020. Patients were stratified
based on a history of intracranial bleeding vs not. The outcomes assessed
in our study included complications, in-hospital mortality, and resource
utilization. Result(s): A total of 89,300 LAAO device implantations
were studied. Approximately 565 implantations (0.6%) occurred in patients
with a history of intracranial bleed. History of intracranial bleeding was
associated with a higher prevalence of overall complications and
in-patient mortality in crude analysis. In the multivariate model adjusted
for potential confounders, intracranial bleeding was found to be
independently associated with in-patient mortality (adjusted odds ratio
[aOR] 4.27; 95% confidence interval [CI] 1.68-10.82); overall
complications (aOR 1.74; 95% CI 1.36-2.24); prolonged length of stay (aOR
2.38; 95% CI 1.95-2.92); and increased cost of hospitalization (aOR 1.28;
95% CI 1.08-1.52) after percutaneous LAAO device implantation.
 Conclusion(s): A history of intracranial bleeding was associated with
adverse outcomes after percutaneous LAAO. These data, if proven in a large
randomized study, can have important clinical consequences in terms of
patient selection for LAAO devices. Copyright © 2023 Heart Rhythm
Society

<86>
Accession Number
2025075210
Title
Just TRAC it! Transitioning Responsibly to Adult Care Using Smart Phone
Technology.
Source
Journal of Adolescent Health. 73(3) (pp 561-566), 2023. Date of
Publication: September 2023.
Author
Han A.; Gingrich J.; Yaskina M.; Rankin K.; San Martin-Feeney D.; Mackie
A.S.
Institution
(Han, Gingrich, Mackie) Stollery Children's Hospital, Edmonton, AB, Canada
(Han, Rankin, San Martin-Feeney, Mackie) Department of Pediatrics,
University of Alberta, Edmonton, AB, Canada
(Yaskina, Mackie) Women and Children's Health Research Institute,
Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: There is little evidence on whether smartphone technology
influences transition readiness among adolescents with heart disease. Just
TRAC it! is a method of using existing smartphone features (Notes,
Calendar, Contacts, Camera) to manage personal health. We evaluated the
impact of Just TRAC it! on self-management skills. Method(s):
Randomized clinical trial of 16-18 year-olds with heart disease.
Participants were randomly allocated 1:1 to either usual care (education
session) or intervention (education session including Just TRAC it!). The
primary outcome was change in TRANSITION-Q score between baseline, 3 and 6
months. Secondary outcomes were frequency of use and perceived usefulness
of Just TRAC it! Analysis was intention-to-treat. Result(s): We
enrolled 68 patients (41% female, mean age 17.3 years), 68% having
previous cardiac surgery and 26% had cardiac catheterization. TRANSITION-Q
scores were similar at baseline and increased over time in both groups but
were not significantly different between groups. Each additional point at
the baseline score brought, on average, a 0.7-point increase in
TRANSITION-Q score (95% CI 0.5-0.9) at each of 3 and 6 months. The Camera,
Calendar and Notes apps were reported as most useful. All intervention
participants would recommend Just TRAC it! to others. Discussion(s):
A nurse-led transition teaching with versus without Just TRAC it! improved
transition readiness, with no significant difference between groups.
Higher baseline TRANSITION-Q scores were associated with greater increase
in scores over time. Participants had a positive reception to Just TRAC
it! and would recommend it to others. Smartphone technology may be useful
in transition education. Copyright © 2023 Society for Adolescent
Health and Medicine

<87>
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. 40(9) (pp 691-698), 2023. Date of
Publication: 01 Sep 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.

<88>
Accession Number
641704540
Title
Rhomboid intercostal block or thoracic paravertebral block for
postoperative recovery quality after video-assisted thoracic surgery: A
prospective, non-inferiority, randomised controlled trial.
Source
European journal of anaesthesiology. 40(9) (pp 652-659), 2023. Date of
Publication: 01 Sep 2023.
Author
Wang X.; Jia X.; Li Z.; Zhou Q.
Institution
(Wang) From the Department of Anaesthesiology and Pain Medicine,
Affiliated Hospital of Jiaxing University, China (XW, Zhejiang Province,
Jiaxing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The analgesic characteristics of rhomboid intercostal block
(RIB) remain unclear. Before it can be fully recommended, we compared the
recovery quality and analgesic effects of RIB and thoracic paravertebral
block (TPVB) for video-assisted thoracoscopic surgery (VATS).
 OBJECTIVE(S): The current study aimed to investigate whether there is
a difference in postoperative recovery quality between TPVB and RIB.
DESIGN: A prospective, non-inferiority, randomised controlled trial.
SETTING: Affiliated Hospital of Jiaxing University in China from March
2021 to August 2022. PATIENTS: Eighty patients aged 18 to 80 years, with
ASA physical status I to III, and scheduled for elective VATS were
enrolled in the trial. INTERVENTION: Ultrasound-guided TPVB or RIB was
performed with 20 ml 0.375% ropivacaine. MAIN OUTCOME MEASURES: The
primary outcome of the study was the mean difference of quality of
recovery-40 scores 24 h postoperatively. The non-inferiority margin was
defined as 6.3. Numeric rating scores (NRS) for pain at 0.5, 1, 3, 6, 12,
24 and 48 h postoperatively in all patients were also recorded.
 RESULT(S): A total of 75 participants completed the study. The mean
difference of quality of recovery-40 scores 24 h postoperatively was -1.6
(95% CI, -4.5 to 1.3), demonstrating the non-inferiority of RIB to TPVB.
There was no significant difference between the two groups in the area
under the curve for pain NRS over time, at rest and on movement, at 6, 12,
24 and 48 h postoperatively (all P > 0.05), except for the area under the
curve pain NRS over time on movement at 48 h postoperatively ( P =
0.046). There were no statistical differences between the two groups in
the postoperative sufentanil use at 0 to 24 h or 24 to 48 h (all P >
0.05). CONCLUSION(S): Our study suggests that RIB was non-inferior to
TPVB for the quality of recovery, with almost the same postoperative
analgesic effect as TPVB after VATS. CLINICAL TRIAL REGISTRATION:
chictr.org.cn: ChiCTR2100043841. Copyright © 2023 European
Society of Anaesthesiology and Intensive Care. Unauthorized reproduction
of this article is prohibited.

<89>
Accession Number
2024755476
Title
Preventing and Managing Radial Artery Occlusion following Transradial
Procedures: Strategies and Considerations.
Source
Journal of Cardiovascular Development and Disease. 10(7) (no pagination),
2023. Article Number: 283. Date of Publication: July 2023.
Author
Tsigkas G.; Papanikolaou A.; Apostolos A.; Kramvis A.; Timpilis F.; Latta
A.; Papafaklis M.I.; Aminian A.; Davlouros P.
Institution
(Tsigkas, Papanikolaou, Apostolos, Kramvis, Timpilis, Latta, Papafaklis,
Davlouros) Department of Cardiology, University Hospital of Patras, Patras
265 04, Greece
(Apostolos) First Department of Cardiology, Hippocration General Hospital,
National and Kapodistrian University of Athens, Athens 157 72, Greece
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi 6042, Belgium
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transradial artery access has recently gained widespread acceptance as the
preferred approach for coronary angiography and interventions, due to its
lower incidence of bleeding and vascular complications compared to
transfemoral access. However, thrombotic occlusion of the radial artery
has emerged as the most common complication of this method, impeding its
use in future interventions, and in the creation of arteriovenous fistulae
for hemodialysis patients, or as a graft for coronary artery bypasses
grafting. In this comprehensive review, we delve into the anatomy of the
radial artery, the pathophysiology and diagnosis of radial artery
occlusion, the identification of potential risk factors and, finally,
prevention and treatment strategies. We acknowledge that distal
transradial access provides an effective alternative for coronary
angiography and catheterizations, with a reduced incidence of radial
artery occlusion. Copyright © 2023 by the authors.

<90>
Accession Number
2024754122
Title
Humoral and Cellular Immunity following Five Doses of COVID-19 Vaccines in
Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis.
Source
Vaccines. 11(7) (no pagination), 2023. Article Number: 1166. Date of
Publication: July 2023.
Author
Alotaibi A.S.; Shalabi H.A.; Alhifany A.A.; Alotaibi N.E.; Alnuhait M.A.;
Altheaby A.R.; Alhazmi A.Y.
Institution
(Alotaibi, Shalabi, Alhifany, Alotaibi, Alnuhait, Alhazmi) Clinical
Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah
21955, Saudi Arabia
(Altheaby) Organ Transplant Center, King Saud bin Abdulaziz University for
Health Sciences, Riyadh 11426, Saudi Arabia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Solid organ transplant (SOT) recipients are at increased risk of COVID-19
infection because of their suppressed immunity. The available data show
that COVID-19 vaccines are less effective in SOT recipients. We aimed to
assess the cellular and humoral immunogenicity with an increasing the
number of doses of COVID-19 vaccines in SOT recipients and to identify
factors affecting vaccine response in this population. A systematic review
and meta-analysis were conducted to identify ongoing and completed studies
of humoral and cellular immunity following COVID-19 vaccines in SOT
recipients. The search retrieved 278 results with 45 duplicates, and 43
records did not match the inclusion criteria. After title and abstract
screening, we retained 189 records, and 135 records were excluded. The
reasons for exclusion involved studies with immunocompromised patients
(non-transplant recipients), dialysis patients, and individuals who had
already recovered from SARS-CoV-2 infection. After full-text reading, 55
observational studies and randomized clinical trials (RCTs) were included.
The proportion of responders appeared higher after the third, fourth, and
fifth doses. The risk factors for non-response included older age and the
use of mycophenolate mofetil, corticosteroids, and other
immunosuppressants. This systematic review and meta-analysis demonstrates
the immunogenicity following different doses of COVID-19 vaccines among
SOT patients. Due to the low immunogenicity of vaccines, additional
strategies to improve vaccine response may be necessary. Copyright
© 2023 by the authors.

<91>
Accession Number
2025942421
Title
Buffered Lidocaine as an Endotracheal Tube Cuff Media In Immediate
Postoperative Cardiac Surgery Patients And Its Effect On Sedation
Requirements: A Prospective Feasibility Study.
Source
AANA Journal. 91(1) (pp 7-13), 2023. Date of Publication: February 2023.
Author
Seelhammer T.; Kressin K.; Borhart E.; Schroeder D.; Amsbaugh A.; Steege
J.; DuBois E.; Wittwer E.
Institution
(Seelhammer) Adult Extracorporeal Membrane Oxygenation Service, Mayo
Clinic College of Medicine, Rochester, MN, United States
(Kressin, Borhart) Nurse Anesthesia Practice Program, Mayo Clinic School
of Health Sciences, Rochester, MN, United States
(Schroeder, Steege) Mayo Clinic College of Medicine, Rochester, MN, United
States
(Amsbaugh) Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN,
United States
(DuBois) Associated Anesthesiologists PA, Plymouth, MN, United States
(Wittwer) Post Cardiac Surgical Intensive Care Unit, Mayo Clinic College
of Medicine, Rochester, MN, United States
Publisher
AANA Publishing Inc.
Abstract
Tracheal mucosal inflammation and irritation caused by the endotracheal
tube (ETT) may exacerbate symptoms of pain and discomfort which create
challenges including ETT tolerance and postintubation emergence phenomena.
Various sedative and analgesic agents are used to mitigate these symptoms,
however, there is concern that such medications may contribute to
prolonged duration of intubation, length of intensive care unit (ICU)
stay, as well as increased morbidity. This randomized control pilot study
explored the feasibility and potential efficacy of instillation of a
buffered lidocaine solution as an ETT cuff medium in adult rapid recovery
eligible cardiac surgical patients. Thirty-two patients were randomized to
the intervention (1.8% lidocaine/0.76% sodium bicarbonate) or control
(air) group. Data were analyzed using median, standard deviation (SD),
Wilcoxon rank sum, mean +/- SD, two-sample t-test, and Fisher's exact
test. The intervention arm demonstrated a trend toward a reduction in the
incidence of cough at ICU arrival (0 versus 22%), incidence of pharyngitis
at all time intervals, and propofol requirement (345 +/- 248 mg versus
1,158 +/- 1,426 mg) with no difference in adverse events between groups.
These results support the development of larger studies to confirm the
efficacy and feasibility of buffered lidocaine as an ETT cuff medium in
this population. Copyright © 2023 AANA Publishing Inc.. All
rights reserved.

<92>
Accession Number
2026182347
Title
Cardiovascular Safety of Testosterone-Replacement Therapy.
Source
New England Journal of Medicine. 389(2) (pp 107-117), 2023. Date of
Publication: 2023.
Author
Lincoff A.M.; Bhasin S.; Flevaris P.; Mitchell L.M.; Basaria S.; Boden
W.E.; Cunningham G.R.; Granger C.B.; Khera M.; Thompson I.M.; Wang Q.;
Wolski K.; Davey D.; Kalahasti V.; Khan N.; Miller M.G.; Snabes M.C.; Chan
A.; Dubcenco E.; Li X.; Yi T.; Huang B.; Pencina K.M.; Travison T.G.;
Nissen S.E.
Institution
(Lincoff, Mitchell, Wang, Wolski, Davey, Kalahasti, Nissen) He Cleveland
Clinic Coordinating Center for Clinical Research, Department of
Cardiovascular Medicine, Cleveland Clinic, Boston, United States
(Bhasin, Basaria, Pencina) The Research Program in Men's Health: Aging and
Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Boden) Veterans Affairs Boston Healthcare System and Massachusetts
Veterans Epidemiology, Research, and Information Center, Boston
University, School of Medicine, Boston, MA, United States
(Travison) Marcus Institute for Aging Research, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA, United States
(Flevaris, Khan, Miller, Snabes, Chan, Dubcenco, Li, Yi, Huang) AbbVie,
North Chicago, IL, United States
(Cunningham, Khera) Baylor College of Medicine, Houston, TX, United States
(Thompson) CHRISTUS Santa Rosa Health System, The University of Texas
Health Science Center, San Antonio, TX, United States
(Granger) Duke Clinical Research Institute, Durham, NC, United States
Publisher
Massachussetts Medical Society
Abstract
Background: The cardiovascular safety of testosterone-replacement therapy
in middle-aged and older men with hypogonadism has not been determined.
 Method(s): In a multicenter, randomized, double-blind,
placebo-controlled, noninferiority trial, we enrolled 5246 men 45 to 80
years of age who had preexisting or a high risk of cardiovascular disease
and who reported symptoms of hypogonadism and had two fasting testosterone
levels of less than 300 ng per deciliter. Patients were randomly assigned
to receive daily transdermal 1.62% testosterone gel (dose adjusted to
maintain testosterone levels between 350 and 750 ng per deciliter) or
placebo gel. The primary cardiovascular safety end point was the first
occurrence of any component of a composite of death from cardiovascular
causes, nonfatal myocardial infarction, or nonfatal stroke, assessed in a
time-to-event analysis. A secondary cardiovascular end point was the first
occurrence of any component of the composite of death from cardiovascular
causes, nonfatal myocardial infarction, nonfatal stroke, or coronary
revascularization, assessed in a time-to-event analysis. Noninferiority
required an upper limit of less than 1.5 for the 95% confidence interval
of the hazard ratio among patients receiving at least one dose of
testosterone or placebo. Result(s): The mean (+/-SD) duration of
treatment was 21.7+/-14.1 months, and the mean follow-up was 33.0+/-12.1
months. A primary cardiovascular end-point event occurred in 182 patients
(7.0%) in the testosterone group and in 190 patients (7.3%) in the placebo
group (hazard ratio, 0.96; 95% confidence interval, 0.78 to 1.17; P<0.001
for noninferiority). Similar findings were observed in sensitivity
analyses in which data on events were censored at various times after
discontinuation of testosterone or placebo. The incidence of secondary
end-point events or of each of the events of the composite primary
cardiovascular end point appeared to be similar in the two groups. A
higher incidence of atrial fibrillation, of acute kidney injury, and of
pulmonary embolism was observed in the testosterone group.
 Conclusion(s): In men with hypogonadism and preexisting or a high
risk of cardiovascular disease, testosterone-replacement therapy was
noninferior to placebo with respect to the incidence of major adverse
cardiac events. Copyright © 2023 Massachusetts Medical Society.

<93>
Accession Number
2026173765
Title
Therapeutic and safety outcomes of intracoronary nicardipine in coronary
artery disease patients: a systematic review.
Source
Future Cardiology. 19(3) (pp 163-174), 2023. Date of Publication: 01 Mar
2023.
Author
Rehan S.T.; Imran L.; Salim A.; Javed S.O.; Sohail A.; Hussain H.U.; Ahmed
J.; Yasmin F.; Islam M.S.; Asghar M.S.
Institution
(Rehan, Imran, Salim, Javed, Sohail, Hussain, Ahmed, Yasmin) Department of
Internal Medicine, Dow University of Health Sciences, Karachi 74200,
Pakistan
(Islam) Department of Public Health and Informatics, Jahangirnagar
University, Savar, Dhaka 1342, Bangladesh
(Islam) Centre for Advanced Research Excellence in Public Health, Savar,
Dhaka 1342, Bangladesh
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester
55905, United States
Publisher
Newlands Press Ltd
Abstract
Aim: This systematic review aimed to shed light on the efficacy of
intracoronary (IC) nicardipine in treating no reflow with CAD undergoing
revascularization. Method(s): Literature search was performed on
databases with following eligibility criteria: adult patients with CAD;
clinical trials or observational studies; IC nicardipine as intervention;
therapeutic and safety outcome reported. Result(s): A total of 1249
papers were yielded during the literature search. Of these, 11 studies
were finalized for this systematic review. Complete restoration of TIMI 3
flow was observed in 98.6% of the patients receiving IC nicardipine. A
significant increase in the CBF after infusion of IC nicardipine (p <
0.05) was also observed. Conclusion(s): IC nicardipine significantly
increases CBF and decreases coronary vascular resistance. Plain language
summary Coronary artery disease (CAD) is a condition that results in the
narrowing or blockage of heart arteries. Arteries are blood vessels that
bring oxygen-rich blood from your heart to the rest of your body's cells.
We aimed to evaluate the effects of intracoronary (IC) nicardipine, a drug
that blocks calcium from entering the muscle cells and blood vessels of
the heart, which causes the vessels to relax and widen, allowing for blood
to flow more easily, on a phenomenon known as coronary slow flow (CSF).
CSF is defined as a delayed widening of the blood vessels of the heart.
CSF or the no reflow phenomenon is a major negative complication
associated with surgical procedures such as percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG), both of
which are used to open up blocked arteries. The systematic search
identified studies that evaluated the effect of IC nicardipine in patient
during CAD treatment, undergoing PCI, CABG, or having confirmed or
suspected narrowing of the aortic valve or one of the four valves of the
heart, which results in restricted blood flow from the heart to the body.
From the results of studies discussed in the review, it can be concluded
that IC nicardipine significantly increases blood flow to the heart and
can help prevent the no reflow phenomenon in patients undergoing PCI.
Nicardipine proved to be a safe and effective option in the management of
complications such as no reflow in patients receiving therapies to restore
blood flow following CAD. Copyright © 2023 Future Medicine Ltd.

<94>
Accession Number
2026061844
Title
Association between postoperative delirium and adverse outcomes in older
surgical patients: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 90 (no pagination), 2023. Article Number:
111221. Date of Publication: November 2023.
Author
Yan E.; Veitch M.; Saripella A.; Alhamdah Y.; Butris N.; Tang-Wai D.F.;
Tartaglia M.C.; Nagappa M.; Englesakis M.; He D.; Chung F.
Institution
(Yan, Veitch, Saripella, Alhamdah, Butris, Chung) Department of Anesthesia
and Pain Management, Toronto Western Hospital, University Health Network,
University of Toronto, Toronto, ON, Canada
(Yan, Alhamdah, Butris, Tartaglia, Chung) Institute of Medical Science,
Temerty Faculty of Medicine, University of Toronto, ON, Canada
(Tang-Wai, Tartaglia) Division of Neurology, Department of Medicine,
University of Toronto, Toronto, ON, Canada
(Nagappa) Department of Anesthesia & Perioperative Medicine, Schulich
School of Medicine and Dentistry, Western University, London, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(He) Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: To assess the incidence of postoperative delirium and its
outcomes in older non-cardiac surgical patients. Design(s): A
systematic review and meta-analysis with multiple databases searched from
inception to February 22, 2022. Setting(s): Postoperative
assessments. Patient(s): Non-cardiac and non-neurological surgical
patients aged >=60 years with and without postoperative delirium. Included
studies must report >=1 postoperative outcome. Studies with a small sample
size (N < 100 subjects) were excluded. Measurements: Outcomes comprised
the pooled incidence of postoperative delirium and its postoperative
outcomes, including mortality, complications, unplanned intensive care
unit admissions, length of stay, and non-home discharge. For dichotomous
and continuous outcomes, OR and difference in means were computed,
respectively, with a 95% CI. Main Result(s): Fifty-four studies
(20,988 patients, 31 elective studies, 23 emergency studies) were
included. The pooled incidence of postoperative delirium was 19% (95% CI:
16%, 23%) after elective surgery and 32% (95% CI: 25%, 39%) after
emergency surgery. In elective surgery, postoperative delirium was
associated with increased mortality at 1-month (OR: 6.60; 95% CI: 1.58,
27.66), 6-month (OR: 5.69; 95% CI: 2.33, 13.88), and 1-year (OR: 2.87; 95%
CI: 1.63, 5.06). The odds of postoperative complications, unplanned
intensive care unit admissions, prolonged length of hospital stay, and
non-home discharge were also higher in delirium cases. In emergency
surgery, patients with postoperative delirium had greater odds of
mortality at 1-month (OR: 3.56; 95% CI: 1.77, 7.15), 6-month (OR: 2.60;
95% CI: 1.88, 3.61), and 1-year (OR: 2.30; 95% CI: 1.77, 3.00).
 Conclusion(s): Postoperative delirium was associated with higher odds
of mortality, postoperative complications, unplanned intensive care unit
admissions, length of hospital stay, and non-home discharge. Prevention
and perioperative management of delirium may optimize surgical
outcomes. Copyright © 2023 Elsevier Inc.

<95>
Accession Number
2026005781
Title
Benefits of pre-operative oral Sucrosomial iron supplementation in cardiac
surgery: influence of patient's baseline hemoglobin and gender.
Source
Blood Transfusion. 21(4) (pp 305-313), 2023. Date of Publication: July
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
Edizioni SIMTI
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.
Results - 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. Conclusions - 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. Copyright © 2023 Edizioni SIMTI. All rights
reserved.

<96>
Accession Number
2025588590
Title
Invited commentary on Kowalewski M, Pasierski M, Makhoul M, et al. Topical
vancomycin for sternal wound infection prophylaxis. A systematic review
and updated meta-analysis of over 40,000 cardiac surgery patients.
Source
Surgery (United States). (no pagination), 2023. Date of Publication:
2023.
Author
Sellke F.W.
Institution
(Sellke) Division of Cardiothoracic Surgery, Alpert Medical School of
Brown University and Rhode Island Hospital, Providence, RI
Publisher
Elsevier Inc.

<97>
Accession Number
641935758
Title
Clinical outcomes following different stenting techniques for coronary
bifurcation lesions: a systematic review and network meta-analysis of
randomised controlled trials.
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: 03 Aug 2023.
Author
Bujak K.; Verardi F.M.; Arevalos V.; Gabani R.; Spione F.; Rajwa P.;
Milasinovic D.; Stankovic G.; Gasior M.; Sabate M.; Brugaletta S.
Institution
(Bujak, Verardi, Arevalos, Gabani, Spione, Sabate, Brugaletta) Hospital
Clinic, Cardiovascular Clinic Institute, Institut d'Investigacions
Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona,
Barcelona, Spain
(Bujak, Gasior) 3rd Department of Cardiology, Faculty of Medical Sciences
in Zabrze, Medical University of Silesia, Katowice, Poland
(Verardi) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Cona, Italy
(Spione) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Rajwa) Department of Urology, Medical University of Vienna, Vienna,
Austria
(Milasinovic, Stankovic) Department of Cardiology, University Clinical
Center of Serbia, Belgrade, Serbia
(Milasinovic, Stankovic) Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Controversy still exists regarding the optimal treatment of
coronary bifurcation lesions. AIMS: We aimed to analyse the evidence from
randomised controlled trials (RCTs) to compare outcomes following
different bifurcation stenting techniques. METHOD(S): We
systematically searched for RCTs comparing different techniques published
up to July 2022. We then conducted a pairwise meta-analysis to compare
outcomes between provisional stenting (PS) versus upfront 2-stent
techniques. Moreover, we performed a network meta-analysis (NMA) to
compare all strategies with each other. The primary endpoint was major
adverse cardiac events (MACE). RESULT(S): Twenty-four RCTs (6,890
patients) analysed PS, T-stenting, double-kissing (DK)-crush, crush, or
culotte stenting. The pairwise meta-analysis did not reveal a significant
difference between the PS and 2-stent techniques. However, the
prespecified sensitivity analysis, which included RCTs exclusively
enrolling patients with true bifurcation lesions, showed a lower rate of
MACE following 2-stent techniques, and meta-regression indicated that a
longer side branch lesion was associated with a greater benefit from the
2-stent strategy, which was the most apparent in RCTs with a mean lesion
length >11 mm. NMA revealed that DK-crush was associated with the lowest
MACE rate (odds ratio 0.47, 95% confidence interval: 0.36-0.62; p<0.01; PS
as a reference). CONCLUSION(S): Overall, 2-stent techniques were not
significantly better than PS in terms of clinical outcomes. However, the
results of the sensitivity analysis suggested that there might be a
benefit of a 2-stent approach in selected patients with true bifurcation
lesions, especially in the case of long side branch lesions. An NMA
revealed that DK-crush was associated with the lowest event rates when
compared with other techniques.

<98>
Accession Number
2026035692
Title
Outcomes and complications of nonagenarians undergoing cardiac surgery: A
scoping review protocol.
Source
BMJ Open. 13(7) (no pagination), 2023. Article Number: e072293. Date of
Publication: 18 Jul 2023.
Author
Ludski J.; Carp B.; Makar T.; Yii M.; Lee D.-K.; Weinberg L.
Institution
(Ludski, Carp, Makar, Weinberg) Department of Anesthesia, Austin Health,
Heidelberg, VIC, Australia
(Yii) Department of Cardiac Surgery, Epworth Eastern Hospital, Box Hill,
VIC, Australia
(Lee) Department of Anesthesiology and Pain Medicine, Dongguk University
Ilsan Hospital, Goyang, South Korea
(Weinberg) Department of Critical Care, University of Melbourne,
Parkville, VIC, Australia
Publisher
BMJ Publishing Group
Abstract
Introduction Continually rising life expectancy and a shift towards an
ageing population are resulting in an increasing population of
nonagenarians. By 2030, the global population of nonagenarians is expected
to exceed 30 million. The incidence of symptomatic cardiac disease is
reported to occur in 25% of those aged over 75 years. Therefore, the
number of nonagenarians undergoing cardiac surgery is also expected to
increase. A linear relationship between advanced age and surgical risk has
previously been demonstrated; however, it is not yet known whether this
knowledge extends to the perioperative course and mortality of
nonagenarians undergoing cardiac surgery. This scoping review aims to
review the literature, assess whether a deficiency exists in the published
literature and potentially identify knowledge gaps to guide future efforts
to improve the understanding of nonagenarians undergoing cardiac surgery.
Methods and analysis Following the relevant aspects of the Preferred
Reporting Items for Systematic Review and Meta-Analysis Extension for
Scoping Review guidelines, electronic databases of MEDLINE, EMBASE and the
Cochrane Library will be systematically searched, with additional
reference tracking of eligible studies. Studies reporting the outcomes of
nonagenarians undergoing open cardiac surgery or minimally invasive
cardiac surgery requiring cardiopulmonary bypass will be included.
Screening and data extraction will be performed by two reviewers
independently. The data will be analysed and summarised descriptively with
a narrative approach. Qualitative data that capture quality-of-life
outcomes will be subjected to thematic analysis where feasible.
Additionally, reporting results will highlight similarities and
differences in nonagenarian selection for surgery. Ethics and
dissemination Ethics approval was not required. The findings will be
disseminated through professional networks, conference presentations and
publications in scientific journals. 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.

<99>
Accession Number
2024700620
Title
Use of Preoperative Natriuretic Peptide in Predicting Mortality After
Coronary Artery Bypass Grafting: A Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(9) (pp 1785-1792),
2023. Date of Publication: September 2023.
Author
Comanici M.; Nadarajah D.; Katumalla E.; Cyclewala S.; Raja S.G.
Institution
(Comanici, Nadarajah, Katumalla, Cyclewala, Raja) Department of Cardiac
Surgery, Harefield Hospital, London, United Kingdom
Publisher
W.B. Saunders
Abstract
The objective of this systematic review was to evaluate the current
evidence on the utility of preoperative B-type natriuretic peptide (BNP)
and N-terminal-pro B-type natriuretic peptide (NT-proBNP) in predicting
short-term and long-term mortality after coronary artery bypass grafting
(CABG). OVID MEDLINE, EMBASE, SCOPUS, and PUBMED were searched from 1946
to August 2022 using the following terms: "coronary artery bypass
grafting" and "BNP" and "outcomes." Eligible studies included
observational studies reporting the association between preoperative BNP
and NT-proBNP levels and short- and long-term mortality after CABG.
Articles were selected systematically, assessed for bias, and, when
possible, meta-analyzed using a random effect model. After retrieving 53
articles, 11 were included for qualitative synthesis and 4 for
quantitative meta-analysis. Studies included in this review showed that
elevated preoperative natriuretic peptide levels, despite variable
cut-offs, have been consistently shown to be associated with short- and
long-term mortality after CABG. The median BNP cut-off value was 145.5
pg/mL (25th-75th percentile 95-324.25 pg/mL), and the mean NT-proBNP value
was 765 +/- 372 pg/mL. Compared to patients with normal natriuretic
peptide levels, patients with elevated BNP and NT-proBNP presented higher
mortality rates after CABG (odds ratio 3.96, 95% confidence interval
2.41-6.52; p < 0.00001). Preoperative BNP level is a powerful predictor of
mortality in patients undergoing CABG. The measurement of BNP can add
significant value to these patients' risk stratification and therapeutic
decision-making. Copyright © 2023 Elsevier Inc.

<100>
Accession Number
2023461363
Title
Revascularisation, periprocedural events and survival - and the survival
of the randomised controlled trial.
Source
EuroIntervention. 18(15) (pp 1218-1219), 2023. Date of Publication: March
2023.
Author
Lansky A.J.; Ahmad Y.
Institution
(Lansky, Ahmad) Division of Cardiovascular Medicine, Department of
Internal Medicine, Yale School of Medicine, New Haven, CT, United States
Publisher
Europa Group

<101>
Accession Number
2022126453
Title
Relationships Between Systemic Inflammation, Intestinal Damage and
Postoperative Organ Dysfunction in Adults Undergoing Low-Risk Cardiac
Surgery.
Source
Heart Lung and Circulation. 32(3) (pp 395-404), 2023. Date of Publication:
March 2023.
Author
Habes Q.L.M.; Kant N.; Beunders R.; van Groenendael R.; Gerretsen J.; Kox
M.; Pickkers P.
Institution
(Habes, Kant, Beunders, van Groenendael, Gerretsen, Kox, Pickkers) Radboud
University Medical Center, Department of Intensive Care, Nijmegen,
Netherlands
Publisher
Elsevier Ltd
Abstract
Background: Approximately half of patients who undergo cardiac surgery
develop systemic inflammatory response syndrome. Extracorporeal
circulation and intestinal injury may play a role in this inflammatory
response, although their relative contributions remain elusive. Moreover,
it is largely unknown to what extent these factors contribute to cardiac
surgery-induced postoperative organ dysfunction. Method(s): In this
secondary analysis, we measured circulating levels of the intestinal
damage marker intestinal fatty acid binding protein (I-FABP) and of the
inflammatory cytokines tumour necrosis factor (TNF)-alpha, interleukin
(IL)-6, IL-8, IL-10, IL-1RA, monocyte chemoattractant protein (MCP)-1,
macrophage inflammatory protein (MIP)-1alpha, and MIP-1beta in 180
patients undergoing on-pump cardiac surgery. The average Z-score of levels
of the different cytokines was used as an integral measure of the cytokine
response. Relationships between duration of extracorporeal circulation,
extent of intestinal injury, inflammation, and postoperative organ
dysfunction were explored. Result(s): Plasma I-FABP levels increased
during surgery, with peak levels observed at the end of cardiopulmonary
bypass (CPB). Except for TNF-alpha, the levels of all cytokines increased
during surgery, with peak levels observed either 2 (MCP-1, MIP-1alpha, and
MIP-1beta), 4 (IL-6, IL-8, and IL-1RA) or 6 (IL-10) hours after the end of
CPB. While the duration of CPB significantly correlated with cytokine
Z-score (r=0.544, p<0.05), no relationship with I-FABP levels was found.
Furthermore, no significant correlations between I-FABP and cytokine
levels were observed. The duration of CPB correlated with a deterioration
in postoperative kidney function (estimated glomerular filtration rate
[eGFR]) and troponin levels. Cytokine Z-score was associated with
postoperative troponin levels, fluid administration, inotropic score,
pulmonary alveolar-arterial gradient on the first postoperative morning,
and deterioration of kidney function (eGFR). I-FABP levels did not
correlate with any of the cardiovascular, pulmonary, or renal parameters.
 Conclusion(s): In patients undergoing low-risk cardiac surgery, the
duration of CPB represents an important determinant of the systemic
cytokine response, whereas both the CPB duration and the systemic
inflammatory response contribute to subsequent organ dysfunction.
Intestinal damage does not appear to play a relevant role in the
postoperative inflammatory response and development of postoperative organ
dysfunction in these patients. Copyright © 2022 The Author(s)

<102>
Accession Number
2017402693
Title
The effects of music intervention on anxiety and stress responses in
adults with CHD undergoing cardiac catheterisation.
Source
Cardiology in the Young. 33(2) (pp 213-220), 2023. Date of Publication: 14
Feb 2023.
Author
Moon J.R.; Song J.; Huh J.; Kang I.-S.; Kim J.H.; Park S.W.; Chang S.-A.
Institution
(Moon) Department of Nursing, Adult Congenital Heart Clinic, Heart
Vascular and Stroke Institute, Samsung Medical Center, Seoul, South Korea
(Song, Huh, Kang) Department of Pediatrics, Adult Congenital Heart Clinic,
Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan
University, School of Medicine, Seoul, South Korea
(Kim) Cardiac Catheterization Laboratory, Heart Vascular and Stroke
Institute, Samsung Medical Center, Seoul, South Korea
(Park, Chang) Division of Cardiology, Department of Internal Medicine,
Adult Congenital Heart Clinic, Heart Vascular and Stroke Institute,
Samsung Medical Center, Sungkyunkwan University, School of Medicine,
Seoul, South Korea
Publisher
Cambridge University Press
Abstract
Introduction: This study evaluated the effect of music intervention on the
anxiety and stress responses of patients who underwent an interventional
cardiac catheterisation. Method(s): The study design was a pre- and
post-test randomised controlled trial that included 94 patients who
underwent a transcatheter atrial septal defect closure. Patients were
allocated to receive either music intervention (n = 47) or usual care (n =
47) during the interventional cardiac catheterisation. Music intervention
effectiveness was examined in terms of anxiety, salivary cortisol level,
and heart rate variability. Result(s): The average age of
participants was 45.40 years (+/-16.04) in the experimental group and
47.26 years (+/-13.83) in the control group. Two-thirds (66.0%) of the
participants in each group were women. State anxiety (F = 31.42, p <
0.001), anxiety-numerical rating scale (F = 20.08, p < 0.001), salivary
cortisol levels (F = 4.98, p = 0.021), and low-frequency
component/high-frequency component ratio (F = 17.31, p < 0.001) in the
experimental group were significantly reduced compared with those in the
control group at the end of the music intervention. Conclusion(s):
This study provides practical evidence of a reduction in anxiety and
stress response from music intervention preceding an interventional
cardiac catheterisation, indicating that this intervention should be
considered in clinical management. Copyright © Sungkyunkwan
University School of Medicine, and Heart Vascular and Stroke Institute,
2022. Published by Cambridge University Press.

<103>
Accession Number
2026116367
Title
The TA Trial (Total Arterial) in Australia.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S325), 2023. Date of Publication: July 2023.
Author
Royse A.; Bowyer A.; Ren J.; Bellomo R.; Royse C.
Institution
(Royse, Bowyer, Ren, Bellomo, Royse) The University of Melbourne,
Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Introduction: Exclusive use of arterial conduits, total arterial
revascularisation (TAR), is performed in approximately 5% of coronary
surgery (CABG) internationally. Overall, approximately 75% of all coronary
grafts utilise the saphenous vein (SVG) yet the late development of
conduit atherosclerosis leading to stenosis or occlusion is high, and well
documented. The approach of TAR is therefore to eliminate the use of SVG
which is known to progressively fail. Local angiographic data suggest that
all arterial conduits that survive the early period, appear never to fail.
Use of late survival, as a surrogate for graft failure, favours TAR over
non-TAR in propensity score matched meta-analyses. Equipoise exists as
both TAR and non-TAR are considered as "standard of care". Method(s):
A Medical Research Future Fund (MRFF) AUD$5 million grant for a
prospective randomised trial of TAR versus non-TAR (>=1 SVG) will commence
in 2023, the "TA Trial". Isolated CABG, with >=2 grafts will be included
at 17 sites in Australia. All elements of intraoperative, perioperative,
and postoperative management will be according to the treating team usual
practice-excepting for the randomised treatment allocation. The primary
endpoint is the number of perfectly patent grafts at 24 months, measured
by CT coronary angiography (CTCA). Secondary endpoints include CTCA at
three months (to examine competitive flow impacts), clinical outcomes,
postoperative quality of recovery (postopQRS) and health economics
evaluation. Conclusion(s): A prospective randomised trial of total
arterial revascularisation in coronary surgery will commence in 2023 in
Australia measuring graft patency directly with CT coronary
angiography. Copyright © 2023

<104>
Accession Number
2026116357
Title
The Incidence of Delayed High-Grade Atrioventricular Block After
Transcatheter Aortic Valve Implantation: A Systematic Review of 15,626
patients.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S453), 2023. Date of Publication: July 2023.
Author
Rao K.; Baer A.; Peter H.; Bhindi R.
Institution
(Rao, Peter, Bhindi) Royal North Shore Hospital, Sydney, NSW, Australia
(Rao, Baer, Peter, Bhindi) North Shore Private Hospital, Sydney, NSW,
Australia
Publisher
Elsevier Ltd
Abstract
Background: High-grade atrioventricular (HGAVB) block is common after
TAVI, often necessitating permanent pacemaker (PPM) implantation. Delayed
HGAVB generally refers to an onset at least 24 hours following the
procedure and can lead to syncope and sudden cardiac death. This
systematic review estimates the incidence of delayed HGAVB after TAVI
based on published literature. Method(s): A systematic review was
performed of the following online databases: MEDLINE, Cochrane, Web of
Science, and Scopus. Studies which labelled the outcome of "delayed" or
"late" atrioventricular block after TAVI were included, patients with
prior PPM or aortic valve surgery were excluded. Initial search yielded
775 studies, which, after screening, was narrowed to 21 studies.
 Result(s): A total of 21 studies totalling 15,626 patients were
included. Participants mean age was 82 years, whilst 47% were male. Mean
STS score was 5.6%, and 31.3% of patients had pre-existing atrial
fibrillation. The most common access site was transfemoral (84.8%), whilst
balloon-expandable valves were used in 62.1%, self-expanding valves in
34.0%, and mechanically expanding valves in 3.9% of cases. The incidence
of delayed HGAVB ranged from 1.4%-14.6% (overall incidence 4.1%). A
sub-analysis of five prospective studies with the lowest assessed risk of
bias, yielded an incidence of 5.4% Conclusion(s): Delayed HGAVB is a
common and potentially serious complication of TAVI. Specific conclusions
are difficult to draw due to the significant methodological heterogeneity
amongst studies. With a move towards minimalist TAVI and earlier patient
discharge, further prospective study of delayed HGAVB is warranted to
improve understanding of predisposing factors, incidence, timing, and
implications. Copyright © 2023

<105>
Accession Number
2026116187
Title
Thoracoscopic Left Atrial Appendage Exclusion With the AtriClip PRO2-An
Initial Experience.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S325), 2023. Date of Publication: July 2023.
Author
Wang E.; Sadlier P.; Sourinathan V.; Weerasooriya R.; Playford D.; Joshi
P.
Institution
(Wang, Sadlier, Joshi) Sir Charles Gairdner Hospital, Perth, WA, Australia
(Sadlier, Sourinathan, Weerasooriya, Joshi) Hollywood Private Hospital,
Perth, WA, Australia
(Weerasooriya) The University of Western Australia, Perth, WA, Australia
(Playford) The University of Notre Dame, Perth, WA, Australia
Publisher
Elsevier Ltd
Abstract
Background: Stroke reduction with left atrial appendage (LAA) exclusion or
occlusion in patients with atrial fibrillation is now well established.
Various surgical and percutaneous techniques have been used, with some
yielding less than desired outcomes. An epicardial clip device, AtriClip,
can be placed thoracoscopically and offers linear closure of the LAA at
its ostium. This study sought to evaluate its efficacy and safety.
 Method(s): This is a prospective series of thoracoscopic AtriClip LAA
exclusions as a standalone procedure or as an adjunct to minimally
invasive cardiac and thoracic surgery. Result(s): A total of 144
thoracoscopic AtriClip procedures were conducted by a single surgeon from
2017 to 2021; 56 were standalone and 88 were concomitant to minimally
invasive surgery. There were no mortalities or major morbidities:
procedural stroke, haemorrhage, open conversion, phrenic nerve injury or
circumflex artery injury. LAA exclusion was 100% success with 87%
follow-up. Following cessation of anticoagulation, no strokes were
reported with 180 patient-years of follow-up. Conclusion(s): This
study demonstrates that thoracoscopic AtriClip can safely and effectively
achieve consistent LAA exclusion without any leaks and may be a useful
alternative to percutaneous technology where indicated. Future randomised
trials are needed to compare its outcomes with percutaneous
devices. Copyright © 2023

<106>
Accession Number
2026115949
Title
Predicting Surgical Coronary Disease Prior to Invasive Coronary
Angiography to Inform Selective Avoidance of Radial Artery Access and
Preserve it for Use as a Bypass Graft.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S445), 2023. Date of Publication: July 2023.
Author
Hamilton G.; Jones H.; Ko J.; Wong E.; Yeoh J.; Churilov L.; Farouque O.
Institution
(Hamilton, Ko, Wong, Yeoh, Farouque) Department of Cardiology, Austin
Health, Melbourne, Vic, Australia
(Hamilton, Jones, Churilov, Farouque) Department of Medicine, University
of Melbourne, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Background: Radial artery (RA) conduits are desirable in contemporary
coronary surgery. However, RAs previously instrumented for invasive
coronary angiography (ICA) endure structural and functional impairment
that impacts on graft longevity. Avoiding trans-radial access (TRA) in
select patients who ultimately require CABG may improve long-term
outcomes. Method(s): 1,485 stable patients undergoing ICA were
included. Surgical coronary artery disease (CAD) was defined as either
left main >=50%, three major epicardial vessels with >=70% stenoses, or
two major epicardial vessels with >=70% stenosis including the proximal
left anterior descending (LAD) artery. A predictive model using elastic
net regularised logistic regression was built incorporating clinical
variables available pre-ICA. Testing (80%) and training (20%) data sets
were randomly allocated. Result(s): For predicting surgical CAD, the
model had a sensitivity of 70.3% and specificity of 71.8% (AUC=0.7105).
When defining the variable importance of included parameters, an abnormal
non-invasive test (resting or stress echocardiogram, or nuclear tress
test), typical chest pain, insulin dependent diabetes, prior elevated
troponin, exertional chest pain, prior stroke, and peripheral vascular
disease were most associated with surgical disease. Conversely, prior
haemorrhagic stroke, ICA performed prior to non-cardiac surgery, having
lung disease, taking warfarin, and female sex were most associated with
not having surgical disease. Conclusion(s): Clinical data available
prior to ICA can assist in predicting the likelihood of surgical CAD. The
potential surgical advantage of avoiding TRA to preserve the RA for
conduit use in such patients should be balanced against the
peri-procedural risk of alternative access, and this model can inform such
decision making. Copyright © 2023

<107>
Accession Number
2026115944
Title
A Systematic Review of Evidence-based Practice in Australian Cardiology
Guidelines.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S346), 2023. Date of Publication: July 2023.
Author
Moran T.; Venus C.
Institution
(Moran, Venus) The Royal Melbourne Hospital, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Introduction: Clinical practice guidelines aim to assist medical
practitioners in making evidence-based decisions in daily practice.
Studies have shown that recommendations in American and European
guidelines lack robust evidence. To date, there has been no assessment of
these standards across Australian Cardiology Guidelines. Aim(s): The
aim of this study was to review Australian clinical practice guidelines in
Cardiology and assess the level of evidence. Method(s): Australian
guidelines and positional statements on Cardiology and Cardiothoracic
Surgery were identified from the National Health and Medical Research
Council (NHMRC) clinical practice guideline database and other sources
from February 2013 to February 2023. Graded recommendations were
extracted, and a descriptive analysis was used to assess the levels of
evidence across the publications. Result(s): 31 publications were
identified. 10 used an international grading scheme to assess the level of
evidence for each recommendation. A total of 451 graded recommendations
were analysed, and only 21% (n=95) of these recommendations were based on
Level I (or equivalent) evidence. Recommendations based on Level II
evidence accounted for 25% (n=114), 34% (n=155) were based on Level III,
and 19% (n=87) were based on Level IV. Recommendations published under
General Cardiology had the highest proportion of Level 1 or 2 evidence
(45%), while interventional/surgical guidelines had the lowest proportion
(35%). Conclusion(s): This study highlights the need for continued
evaluation and enhancement of clinical practice guidelines in Australian
Cardiology to guide informed decision-making by medical professionals in
daily practice. Copyright © 2023

<108>
Accession Number
2026115753
Title
Perioperative Aspirin and Coronary Artery Bypass Surgery: A Meta-Analysis
of Randomised Controlled Trials.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S323-S324), 2023. Date of Publication: July 2023.
Author
Zaka A.; Gupta A.; Lombardo A.; Kovoor J.; Bacchi S.; Smith J.; Bennetts
J.; Maddern G.
Institution
(Zaka, Lombardo) Gold Coast University Hospital, Gold Coast, QLD,
Australia
(Zaka) Bond University, Gold Coast, QLD, Australia
(Gupta, Kovoor, Bacchi, Maddern) University of Adelaide, Adelaide, SA,
Australia
(Smith) Department of Surgery, Monash University, Melbourne, Vic,
Australia
(Bennetts) Cardiothoracic Surgical Unit, Flinders Medical Centre,
Adelaide, SA, Australia
Publisher
Elsevier Ltd
Abstract
Background: Although consensus guidelines demonstrate clear benefit for
the continuation of aspirin in patients awaiting coronary artery bypass
grafting (CABG) following an acute coronary syndrome where risk of
re-infarction outweighs bleeding risk, the evidence remains unclear in the
case of elective CABG. We performed the largest to date systematic review
and meta-analysis to compare outcomes between CABG patients who stopped
and continued aspirin perioperatively. Method(s): PubMed, MEDLINE and
CENTRAL databases were searched to 25 July 2022 for randomised control
trials of patients undergoing CABG. Odds ratios were calculated using a
random effects model. Subgroup and sensitivity analyses were conducted in
order to explore sources of heterogeneity. Result(s): 16 eligible
studies were included with a total of 6,188 patients. Patients who
continued aspirin perioperatively demonstrated an increased risk of
all-cause mortality (OR 1.37 [0.81-2.33]) and reduced risk of
perioperative myocardial infarction (OR 0.81 [0.55-1.18]); however,
neither were statistically significant. No significant difference was
observed between low-dose and higher doses of aspirin. There was minimal
heterogeneity amongst included studies (i2=0%, p=0.97 and i2=33%, p=0.13,
respectively). Continuing aspirin produced a modest increase in
postoperative blood loss (mean difference 66.12mL [-1.45 to133.69]), as
was a dose greater than 100mg [216.87(-152.99 to 586.72), p=0.60], however
this was not statistically significant. Conclusion(s): Continuing
aspirin before CABG is not associated with a significantly increased risk
of all-cause mortality, of perioperative myocardial infarction, and of
postoperative bleeding. Future trials with more robust methodology should
be aimed at further evaluating this patient cohort to guide perioperative
Aspirin use. [Formula presented] Copyright © 2023

<109>
Accession Number
2026115651
Title
Trends in the Uptake of Transcatheter Aortic Valve Implantation in
Australia: 2017-2022.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S455), 2023. Date of Publication: July 2023.
Author
Chandrasekhar J.
Institution
(Chandrasekhar) Eastern Health, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is the
definitive alternative to surgical aortic valve replacement. Item numbers
for intermediate- and low-risk TAVI were approved in Australia in 2022.
 Method(s): We conducted a review of the Australian government
Medicare data using the MBS item numbers for high-risk (38495),
intermediate-risk (38514) and low-risk (38522) TAVI. We examined the
uptake of these services by age and gender. Result(s): Between
2017-2022, 8,818 high-risk TAVIs were performed in Australia, with a
significant increase over time (Table 1). State-wide data showed that the
highest numbers were performed in New South Wales. About 39% of the
high-risk patients were females and 89.6% were >=75 years old. In 2022,
198 intermediate-risk and 88 low-risk TAVIs were performed. About 31.3% of
intermediate-risk and 36.3% low-risk patients were women; 79.8% of
intermediate-risk and 58% low-risk patients were >=75 years old.
 Conclusion(s): Medicare data indicate significant growth in TAVI
numbers over the last five years. Females constitute a smaller proportion
of high- and intermediate-risk TAVI but similar proportion of low-risk
TAVI when compared to randomised trials. [Formula presented] Copyright
© 2023

<110>
Accession Number
2026115523
Title
The Impact of Resting Heart Rate on the Progression of Aortic Stenosis.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S117), 2023. Date of Publication: July 2023.
Author
Courtney W.; Budgeon C.; Giudicatti L.; Strange G.; Playford D.; Ihdayhid
A.; Schultz C.; Hillis G.
Institution
(Courtney) Medical School, University of Western Australia, Perth, WA,
Australia
(Budgeon) School of Population and Global Health, University of Western
Australia, Perth, WA, Australia
(Giudicatti, Ihdayhid) Department of Cardiology, Fiona Stanley Hospital,
Perth, WA, Australia
(Strange, Playford) National Echocardiography Database of Australia
(NEDA), Sydney, NSW, Australia
(Schultz, Hillis) Department of Cardiology, Royal Perth Hospital, Perth,
WA, Australia
Publisher
Elsevier Ltd
Abstract
Aims: We hypothesised that elevated resting heart rate (RHR) independently
predicts the development of severe aortic stenosis (AS), and accelerated
haemodynamic progression of AS in patients without severe disease.
 Method(s): A retrospective observational study, using the National
Echocardiography Database of Australia (NEDA), on patients without severe
AS, a bicuspid aortic valve or prior aortic valve replacement. The
association between baseline RHR and time to the primary endpoint of
severe AS was tested using Cox proportional hazards regression.
Subsequently, the relationship between annualised AS progression rate,
defined as change in standard indices of AS severity (maximal jet velocity
[Vmax], mean pressure gradient [MPG], and aortic valve area [AVA]), and
RHR were analysed using general linear models. Result(s): The initial
study cohort comprised 55,585 individuals: 54% male, mean age 63 years and
median baseline RHR 73 bpm. The primary endpoint, reached by 847 patients,
was independently associated with RHR (hazard ratio [per 10bpm increase],
1.06; 95% CI 1.01-1.12; p=0.017). RHR was also independently associated
with rate of change of each individual measurement index of AS severity
including Vmax (beta=0.01 m/s/year [per 10 bpm increase]; p<0.001), MPG
(beta=0.05 mmHg/year [per 10 bpm increase]; p<0.001), and AVA (beta= -0.01
cm2/year [per 10 bpm increase]; p<0.001). Conclusion(s):
RHR is independently associated with the development of de novo severe AS,
and haemodynamic progression of AS in patients without severe disease.
Future randomised controlled trials should investigate the effect of
lowering RHR on clinical endpoints and progression of AS. Copyright
© 2023

<111>
Accession Number
2026115404
Title
Transcatheter Aortic Valve Implantation (TAVI) for Patients at Low Risk
for Surgery is Cost-Saving Compared to Surgical Aortic Valve Replacement
(SAVR) from an Australian Health care System Perspective.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S325-S326), 2023. Date of Publication: July 2023.
Author
Hill M.; Challis G.; Dunster K.; Amr D.
Institution
(Hill, Challis, Dunster, Amr) SydneyNSWAustralia
Publisher
Elsevier Ltd
Abstract
Background: TAVI access has been expanded to patients at low surgical risk
(LR) [1]. TAVI is cost-effective relative to SAVR in LR patients with a
dominant ICER for self-expanding valves (i.e., cost saving with an
improved quality of life (QOL)) [2]. Objective(s): To examine the
hospital costs, length of stay and QOL of TAVI vs SAVR in an Australian
setting with a LR patient cohort. Method(s): This study was conducted
as an addendum to the EVOLUT LR RCT (NCT02701283) comparing the safety and
efficacy of TAVI to SAVR. The addendum was a multi-centre, prospective,
non-randomised trial using Evolut TAVI. Result(s): Total hospital
episode cost was AUD$45,164+/- AUD$12,265 for TAVI and
AUD$54,877+/-AUD$23,770 for SAVR. Hospital length of stay was shorter for
TAVI with a mean of 2.75+/-1.29 days compared with 6.92+/-1.56 days for
SAVR. TAVI patients required less resource-intensive care in a Critical
Care Unit (CCU) (51.07+/-34.54 hours), while SAVR patients required care
in an Intensive Care Unit (ICU) (70.60+/-66.79 hours). The cost per day
was AUD$1,062 for the ward (regardless of procedure type), AUD$2,322 for
the CCU and AUD$7,868 for the ICU. EQ-5D change from baseline was greater
for TAVI compared with SAVR patients at all timepoints up to 36 months (up
to 0.22 vs up to 0.1). Conclusion(s): TAVI for patients at LR for
surgery is cost saving compared to SAVR due to a shorter hospital length
of stay and no ICU stay required. References: [1] [2] Zhou JY, Liew D,
Duffy SJ, Walton A, Htun N, Stub D. Cost-effectiveness of transcatheter
versus surgical aortic valve replacement in low-risk patients with severe
aortic stenosis. Heart Lung Circ. 2021;30(4):547-554. Copyright ©
2023

<112>
Accession Number
2026114347
Title
DurAVR TAVI First-in-Human Study Confirms Excellent Haemodynamics to One
Year.
Source
Heart Lung and Circulation. Conference: 71st Annual Scientific Meeting of
the Cardiac Society of Australia and New Zealand. Adelaide Australia.
32(Supplement 3) (pp S431), 2023. Date of Publication: July 2023.
Author
Poon K.; Meduri C.; Kodali S.; Sorajja P.; Feldt K.; Garg P.; Cavalcante
J.; Hamid N.; Sathananthan J.; Bapat V.; Sinhal A.
Institution
(Poon) St. Andrews Hospital, Brisbane, QLD, Australia
(Meduri, Feldt) Karolinska Institutet, Stockholm, Sweden
(Sorajja, Cavalcante, Hamid, Bapat) Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Kodali) Columbia University, New York, NY, United States
(Garg) University of East Anglia, Norwich, United Kingdom
(Sathananthan) St. Paul's Hospital, Vancouver, BC, Canada
(Sinhal) Flinders Medical Centre, SA, Australia
Publisher
Elsevier Ltd
Abstract
Aim: Optimal haemodynamics and extended durability of bioprosthetic
transcatheter aortic valve systems are key in the lifetime management of
patients with severe aortic stenosis (AS). The Anteris DurAVR
transcatheter heart valve (THV) is the first in class biomimetic TAVR
valve shaped to mimic the performance of a native aortic valve through its
unique design and ADAPT anti-calcification tissue treatment.
 Method(s): Prospective, non-randomised, single-arm, single-centre,
First-in-human (FIH) study, designed to evaluate safety and feasibility of
the DurAVR THV in subjects with severe symptomatic AS. Follow-ups to one
year are ongoing. Result(s): Thirteen (13) subjects were enrolled:
mean age 73.9, 77% female, and mean annulus area-derived diameter 22.95
mm. Procedural success was 100% with no device-related complications, one
access site complication, and one new pacemaker in a patient with
pre-existing conduction disturbances. Mean intra-operative coaptation
length was 8.3 mm. 30-day haemodynamic results were excellent: mean EOA
was 2.0 cm2 (EOAi 1.14 cm2/m2), mean MPG
9.02 mmHg, and mean DVI 0.53. The first five patients completed their TTE
at one-year, which confirmed sustained optimal haemodynamics: mean EOA of
1.96 cm2 (EOAi 1.11 cm2/m2), mean MPG
8.82 mmHg, and mean DVI 0.54. No moderate or severe PVL or central AR were
observed. Cardiac MRI confirmed consistent laminar flow throughout all
valves and showed significant improvement in LVEF and LV GLS at one-year
compared to six-month. Conclusion(s): The DurAVR THV FIH study
results at one-year demonstrate that the biomimetic design restores
near-normal function through the unique single-piece native shaped valve
with evidence of improved safety and hemodynamic performance Copyright
© 2023

<113>
Accession Number
2024731466
Title
Incretins-Based Therapies and Their Cardiovascular Effects: New
Game-Changers for the Management of Patients with Diabetes and
Cardiovascular Disease.
Source
Pharmaceutics. 15(7) (no pagination), 2023. Article Number: 1858. Date of
Publication: July 2023.
Author
Bernardini F.; Nusca A.; Coletti F.; La Porta Y.; Piscione M.; Vespasiano
F.; Mangiacapra F.; Ricottini E.; Melfi R.; Cavallari I.; Ussia G.P.;
Grigioni F.
Institution
(Bernardini, Nusca, Coletti, La Porta, Piscione, Vespasiano, Mangiacapra,
Ricottini, Melfi, Cavallari, Ussia, Grigioni) Unit of Cardiac Sciences,
Department of Medicine, Campus Bio-Medico University of Rome, Rome 00128,
Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Atherosclerosis is the leading cause of death worldwide, especially in
patients with type 2 diabetes mellitus (T2D). GLP-1 receptor agonists and
DPP-4 inhibitors were demonstrated to play a markedly protective role for
the cardiovascular system beyond their glycemic control. Several
cardiovascular outcome trials (CVOT) reported the association between
using these agents and a significant reduction in cardiovascular events in
patients with T2D and a high cardiovascular risk profile. Moreover, recent
evidence highlights a favorable benefit/risk profile in myocardial
infarction and percutaneous coronary revascularization settings. These
clinical effects result from their actions on multiple molecular
mechanisms involving the immune system, platelets, and endothelial and
vascular smooth muscle cells. This comprehensive review specifically
concentrates on these cellular and molecular processes mediating the
cardiovascular effects of incretins-like molecules, aiming to improve
clinicians' knowledge and stimulate a more extensive use of these drugs in
clinical practice as helpful cardiovascular preventive
strategies. Copyright © 2023 by the authors.

<114>
Accession Number
2026080694
Title
Intercostal Nerve Cryoablation for Postoperative Pain Control in Pediatric
Thoracic Surgery: A Scoping Review.
Source
Journal of Laparoendoscopic and Advanced Surgical Techniques. (no
pagination), 2023. Date of Publication: 2023.
Author
Lai K.; Eldredge R.S.; Zobel M.; Hargis-Villanueva A.; Ostlie A.; Padilla
B.E.
Institution
(Lai, Eldredge, Hargis-Villanueva, Padilla) Division of Pediatric Surgery,
Phoenix Children's Hospital, Phoenix, AZ, United States
(Zobel) Division of Pediatric Surgery, University of California San
Francisco, San Francisco, United States
(Ostlie, Padilla) Department of Child Health, University of Arizona School
of Medicine, Tucson, AZ, United States
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Cryoanalgesia uses the application of cold temperatures to
temporarily disrupt peripheral sensory nerve function for pain control.
This review outlines the principles of cryoablation, clinical
applications, and clinical data for its use in pediatric thoracic surgery.
 Method(s): A comprehensive PubMed search was performed using the
principal terms and combinations of cryoablation, cryoanalgesia, Nuss,
Nuss repair, pectus, pectus excavatum, thoracic surgery, thoracotomy, and
chest wall. Pediatric articles were reviewed and included if relevant.
Adult articles were reviewed for supporting information as needed.
Reference lists of included articles were reviewed for possible additional
sources. Discussion(s): The scientific and clinical principles of
cryoablation are outlined, followed by a focused review of current
clinical application and outcome data. Conclusion(s): Postoperative
pain is a major challenge following thoracic surgery. Cryoanalgesia is
emerging as an adjunct in pediatric thoracic surgery, particularly for the
Nuss procedure or minimally invasive repair of pectus excavatum. It
effectively controls pain, decreasing postoperative opioid use and
hospital length of stay with few short-term complications. Although more
long-term studies are needed, early evidence suggests there is reliable
return of sensation to the chest wall and long-term neuropathic pain is
rare. Copyright 2023, Mary Ann Liebert, Inc., publishers.

<115>
Accession Number
641926742
Title
Moderate-Intensity Statin With Ezetimibe Combination Therapy vs
High-Intensity Statin Monotherapy in Patients at Very High Risk of
Atherosclerotic Cardiovascular Disease: A Post Hoc Analysis From the
RACING Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2023. Date of Publication: 02 Aug 2023.
Author
Lee S.-J.; Cha J.-J.; Choi W.G.; Lee W.-S.; Jeong J.-O.; Choi S.; Cho
Y.-H.; Park W.; Yoon C.-H.; Lee Y.-J.; Hong S.-J.; Ahn C.-M.; Kim B.-K.;
Ko Y.-G.; Choi D.; Hong M.-K.; Jang Y.; Hong S.J.; Kim J.-S.
Institution
(Lee, Lee, Hong, Ahn, Kim, Ko, Choi, Hong, Kim) Division of Cardiology,
Severance Hospital, Yonsei University College of Medicine, Seoul, South
Korea
(Cha, Hong) Department of Cardiology, Cardiovascular Center, Korea
University Anam Hospital, Korea University College of Medicine, Seoul,
South Korea
(Choi) Konkuk University Chungju Hospital, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Chung-Ang
University College of Medicine, Seoul, South Korea
(Jeong) Chungnam National University Hospital, Daejeon, South Korea
(Choi) Division of Cardiology, Department of Internal Medicine, Kangnam
Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South
Korea
(Cho) Buchon Soonchunhyang Hospital, Soonchunhyang University, College of
Medicine, Bucheon, South Korea
(Park) Cardiovascular Division, Department of Internal Medicine, Hallym
University Medical Center, Anyang, South Korea
(Yoon) Division of Cardiology, Department of Internal Medicine, Seoul
National University Bundang Hospital, Seongnam, South Korea
(Jang) CHA University College of Medicine, Seongnam, South Korea
Publisher
NLM (Medline)
Abstract
Importance: High-intensity statin is strongly recommended in patients at
very high risk (VHR) of atherosclerotic cardiovascular disease (ASCVD).
However, concerns about statin-associated adverse effects result in
underuse of this strategy in practice. Objective(s): To evaluate the
outcomes of a moderate-intensity statin with ezetimibe combination in VHR
and non-VHR patients with ASCVD. Design, Setting, and Participant(s):
This was a post hoc analysis of the Randomized Comparison of Efficacy and
Safety of Lipid Lowering With Statin Monotherapy vs Statin/Ezetimibe
Combination for High-Risk Cardiovascular Disease (RACING) open-label,
multicenter, randomized clinical trial. The study was conducted from
February 2017 to December 2018 at 26 centers in Korea. Study participants
included patients with documented ASCVD. Data were analyzed from April to
June 2022. Intervention(s): Patients were randomly assigned to
moderate-intensity statin with ezetimibe (rosuvastatin, 10 mg, with
ezetimibe, 10 mg) or high-intensity statin monotherapy (rosuvastatin, 20
mg). Patients at VHR for ASCVD were defined according to the 2018 American
Heart Association/American College of Cardiology guidelines. Main
Outcomes and Measures: The primary end point was the 3-year outcome of
cardiovascular death, coronary or peripheral revascularization,
hospitalization of cardiovascular events, or nonfatal stroke.
 Result(s): A total of 3780 patients (mean [SD] age, 64 [10] years;
2826 male [75%]) in the RACING trial, 1511 (40.0%) were categorized as
VHR, which was associated with a greater occurrence of the primary end
point (hazard ratio [HR], 1.42; 95% CI, 1.15-1.75). There was no
significant difference in the primary end point between those who received
combination therapy and high-intensity statin monotherapy among patients
with VHR disease (11.2% vs 11.7%; HR, 0.96; 95% CI, 0.71-1.30) and non-VHR
disease (7.7% vs 8.7%; HR, 0.88; 95% CI, 0.66-1.18). The median
low-density lipoprotein cholesterol (LDL-C) level was significantly lower
in the combination therapy group than in the high-intensity statin group
(VHR, 1 year: 57 [47-71] mg/dL vs 65 [53-78] mg/dL; non-VHR, 1 year: 58
mg/dL vs 68 mg/dL; P<.001). Furthermore, in both the VHR and non-VHR
groups, combination therapy was associated with a significantly greater
mean change in LDL-C level (VHR, 1 year: -19.1 mg/dL vs -10.1 mg/dL; 2
years: -22.3 mg/dL vs -13.0 mg/dL; 3 years: -18.8 mg/dL vs -9.7 mg/dL;
non-VHR, 1 year: -23.7 mg/dL vs -12.5 mg/dL; 2 years: -25.2 mg/dL vs -15.1
mg/dL; 3 years: -23.5 mg/dL vs -12.6 mg/dL; all P<.001) and proportion of
patients with LDL-C level less than 70 mg/dL (VHR, 1 year: 73% vs 58%;
non-VHR, 1 year: 72% vs 53%; P<.001). Discontinuation or dose reduction of
the lipid-lowering drug due to intolerance occurred less frequently in the
combination therapy group (VHR, 4.6% vs 7.7%; P=.02; non-VHR, 5.0% vs
8.7%; P=.001). Conclusions and Relevance: Results suggest that the
outcomes of ezetimibe combination observed in the RACING trial were
consistent among patients at VHR of ASCVD. Trial Registration:
ClinicalTrials.gov Identifier: NCT03044665.

<116>
Accession Number
641922962
Title
Roles and competencies of nurses and physicians in shared decision-making
in cardiac surgery: A scoping review.
Source
Journal of advanced nursing. (no pagination), 2023. Date of Publication:
31 Jul 2023.
Author
van Dieen M.S.H.; Paans W.; Mariani M.A.; Dieperink W.; Blokzijl F.
Institution
(van Dieen, Paans, Dieperink, Blokzijl) Research Group Nursing
Diagnostics, Hanze University of Applied Sciences, Groningen, Netherlands
(van Dieen, Paans, Dieperink) Department of Critical Care, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Mariani, Blokzijl) Department of Cardiothoracic Surgery, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
Publisher
NLM (Medline)
Abstract
AIM: Identification and synthesis of research data related to the roles
and competencies of physicians and nurses that are prerequisites for
careful shared decision-making with patients potentially undergoing
cardiac surgery. DESIGN: A scoping review was conducted in accordance with
the Joanna Briggs Institute's methodology for scoping reviews and the
PRISMA Extension for Scoping Reviews. METHOD(S): PubMed, EMBASE and
CINAHL were searched from inception dates up to March 2022, to identify
primary studies published in a peer-reviewed journal. Study selection,
assessment of the methodological quality and data extracting of the
included studies were done by at least two independent researchers. To
describe the findings of the studies, an emergent synthesis approach was
used to visualize a descriptive representation of professional roles and
competencies in shared decision-making, in an overview. RESULT(S):
The systematic search revealed 10,055 potential papers, 8873 articles were
screened on title and abstract and 76 full texts were retrieved. Eight
articles were included for final evaluation. For nurses and physicians, 26
different skills were identified in the literature to practice shared
decision-making in cardiac surgery. The skills that emerged were divided
into five professional roles: moderator; health educator; data collector;
psychological supporter and translator. CONCLUSION(S): This review
specifies the professional roles and required competencies related to
shared decision-making in cardiac surgery. Further research is needed to
compare our findings with other clinical areas and from there to arrive at
a professional division of roles between the different clinical
disciplines involved. IMPACT: The visualization of generic shared
decision-making competencies and roles should establish the professional
division of positions between various clinical physician and nurse
disciplines in order to create a treatment plan based on evidence, values,
preferences and the patient's personal situation. PATIENT OR PUBLIC
CONTRIBUTION: No patient or public contribution. Copyright © 2023
The Authors. Journal of Advanced Nursing published by John Wiley & Sons
Ltd.

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