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<1>
Accession Number
2026298261
Title
Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve
Implantation in Patients With Small Aortic Annulus: A Meta-Analysis.
Source
American Journal of Cardiology. 204 (pp 257-267), 2023. Date of
Publication: 01 Oct 2023.
Author
Hosseinpour A.; Gupta R.; Kamalpour J.; Hosseinpour H.; Chaturvedi A.;
Agrawal A.; Patel N.C.; Patel C.
Institution
(Hosseinpour, Kamalpour, Hosseinpour) School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Gupta, Patel, Patel) Lehigh Valley Heart and Vascular Institute, Lehigh
Valley Health Network, Allentown, PA, United States
(Chaturvedi) Pauley Heart Center, Virginia Commonwealth University School
of Medicine, Richmond, Virginia, United States
(Agrawal) Department of Hospital Medicine, Cleveland Clinic, Cleveland,
Ohio, United States
Publisher
Elsevier Inc.
Abstract
Although transcatheter aortic valve implantation (TAVI) is considered a
superior option to surgery in patients with small aortic annulus (SAA), it
is not clear which type of transcatheter heart valve (THV) has better
results in terms of echocardiographic hemodynamics and clinical outcomes.
A random-effects meta-analysis was performed comparing balloon-expandable
valves (BEVs) and self-expanding valves (SEVs) in patients with SAA who
underwent TAVI regarding their impact on hemodynamic and clinical outcomes
at short- and midterm follow-up. Relative risk (RR) and mean difference
(MD) with 95% confidence interval (95% CI) were measured for the outcomes,
as appropriate. Subgroup analyses were performed based on the generation
type of devices and study designs. A total of 16 articles comprising 1
randomized trial, 3 propensity-matched studies, and 12 observational
studies including 4,341 patients (1,967 in BEV and 2,374 in the SEV group)
with SAA were included. The implantation of BEVs correlated with a lower
indexed effective orifice area (MD -0.19 [-0.25 to -0.13]) and higher
transvalvular mean pressure gradient (MD 3.91, 95% CI 2.96 to 4.87).
Compared with SEVs, BEVs had increased risk of prosthesis-patient mismatch
(PPM; RR 2.09, 95% CI 1.79 to 2.45) and severe PPM (RR 2.16, 95% CI 1.48
to 3.15). However, BEV had lower moderate and severe paravalvular leak (RR
0.45, 95% CI 0.29 to 0.69), risk of stroke (RR 0.57, 95% CI 0.42 to 0.76),
and permanent pacemaker implantation (RR 0.63, 95% CI 0.44 to 0.91). The
1-year all-cause mortality (RR 1.13, 95% CI 0.86 to 1.49) and
cardiac-related mortality (RR 1.53, 95% CI 0.24 to 9.81) were not
different between the 2 groups. In conclusion, SEVs were associated with
larger indexed effective orifice area and lower PPM but higher
paravalvular leak. In contrast, patients with SEVs were more likely to
develop stroke and required permanent pacemaker implantation. Both THVs
did not show difference in terms of early and midterm all-cause and
cardiac mortality. Because both types of THVs show similar results
regarding mortality data, hemodynamics should be among the factors
considered in decision making for patients with SAA who underwent
TAVI. Copyright © 2023 Elsevier Inc.

<2>
Accession Number
2026007492
Title
High-intensity interval training in cardiac rehabilitation: a multi-centre
randomized controlled trial.
Source
European Journal of Preventive Cardiology. 30(9) (pp 745-755), 2023. Date
of Publication: 01 Jul 2023.
Author
McGregor G.; Powell R.; Begg B.; Birkett S.T.; Nichols S.; Ennis S.;
McGuire S.; Prosser J.; Fiassam O.; Hee S.W.; Hamborg T.; Banerjee P.;
Hartfiel N.; Charles J.M.; Edwards R.T.; Drane A.; Ali D.; Osman F.; He
H.; Lachlan T.; Haykowsky M.J.; Ingle L.; Shave R.
Institution
(McGregor, Powell, Ennis, McGuire, Prosser, Fiassam) Department of
Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University
Hospitals Coventry & Warwickshire NHS Trust, Clifford Bridge Road,
Coventry CV1 3LN, United Kingdom
(McGregor, Powell, McGuire, Banerjee) Centre for Sport Exercise & Life
Sciences, Coventry University, Coventry, United Kingdom
(McGregor, Ennis, Banerjee) Warwick Clinical Trials Unit, Warwick Medical
School, University of Warwick, Coventry, United Kingdom
(Begg, Drane) Cardiff Centre for Exercise & Health, Cardiff Metropolitan
University, Cardiff, United Kingdom
(Begg) Cardiac Rehabilitation, Aneurin Bevan University Health Board,
Gwent, United Kingdom
(Birkett) Department of Sport and Exercise Sciences, Manchester
Metropolitan University, Manchester, United Kingdom
(Nichols) Advanced Wellbeing Research Centre, Sheffield Hallam University,
Sheffield, United Kingdom
(Nichols) Sport and Physical Activity Research Centre, Sheffield Hallam
University, Sheffield, United Kingdom
(Hee, He, Lachlan) Division of Health Sciences, Warwick Medical School,
University of Warwick, Coventry, United Kingdom
(Hamborg) Pragmatic Clinical Trials Unit, Centre for Evaluation and
Methods, Wolfson Institute of Population Health, Queen Mary University of
London, London, United Kingdom
(Banerjee, Ali, Osman, He, Lachlan) Department of Cardiology, University
Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
(Hartfiel, Charles, Edwards) Centre for Health Economics and Medicines
Evaluation (CHEME), Bangor University, Bangor, United Kingdom
(Haykowsky) College of Health Sciences, Faculty of Nursing, University of
Alberta, Edmonton, Canada
(Ingle) School of Sport, Exercise & Rehabilitation Science, University of
Hull, Hull, United Kingdom
(Shave) Centre for Heart Lung and Vascular Health, University of British
Columbia, Okanagan, Canada
Publisher
Oxford University Press
Abstract
Background There is a lack of international consensus regarding the
prescription of high-intensity interval training (HIIT) for people with
coronary artery disease (CAD) attending cardiac rehabilitation (CR). Aims
To assess the clinical effectiveness and safety of low-volume HIIT
compared with moderate-intensity steady-state (MISS) exercise training for
people with CAD. Methods and results We conducted a multi-centre RCT,
recruiting 382 patients from 6 outpatient CR centres. Participants were
randomized to twice-weekly HIIT (n = 187) or MISS (n = 195) for 8 weeks.
HIIT consisted of 10 x 1 min intervals of vigorous exercise (>85% maximum
capacity) interspersed with 1 min periods of recovery. MISS was 20-40 min
of moderate-intensity continuous exercise (60-80% maximum capacity). The
primary outcome was the change in cardiorespiratory fitness [peak oxygen
uptake (VO<inf>2 peak</inf>)] at 8 week follow-up. Secondary outcomes
included cardiovascular disease risk markers, cardiac structure and
function, adverse events, and health-related quality of life. At 8 weeks,
VO<inf>2 peak</inf> improved more with HIIT (2.37
mL.kg-1.min-1; SD, 3.11) compared with MISS (1.32
mL.kg-1.min-1; SD, 2.66). After adjusting for age,
sex, and study site, the difference between arms was 1.04
mL.kg-1.min-1 (95% CI, 0.38 to 1.69; P = 0.002).
Only one serious adverse event was possibly related to HIIT. . . . . . . .
. . . . . . . . . . . . . . . . . . Conclusions In stable CAD, low-volume
HIIT improved cardiorespiratory fitness more than MISS by a clinically
meaningful margin. Low-volume HIIT is a safe, well-tolerated, and
clinically effective intervention that produces short-term improvement in
cardiorespiratory fitness. It should be considered by all CR programmes as
an adjunct or alternative to MISS. Copyright © The Author(s)
2023. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<3>
Accession Number
2025917674
Title
Posterior pericardiotomy for the prevention of atrial fibrillation after
cardiac surgery: a systematic review and meta-analysis of 25 randomised
controlled trials.
Source
EuroIntervention. 19(4) (pp 305-317), 2023. Date of Publication: July
2023.
Author
Abdelaziz A.; Hafez A.H.; Elaraby A.; Roshdy M.R.; Abdelaziz M.; Eltobgy
M.A.; Elsayed H.; El-Samahy M.; Elbehbeh N.A.; Philip K.G.; Abdelaty A.M.;
Rizk M.A.; Al-Tawil M.; AboElfarh H.E.; Ramadan A.; Ghaith H.S.; Wahsh
E.A.; Abdelazeem B.; Fayed B.
Institution
(Abdelaziz, Hafez, Elaraby, Roshdy, Abdelaziz, Eltobgy, Elsayed,
El-Samahy, Elbehbeh, Philip, Abdelaty, Rizk, Al-Tawil, AboElfarh, Ramadan,
Ghaith, Wahsh, Abdelazeem) Medical Research Group of Egypt (MRGE), Cairo,
Egypt
(Abdelaziz, Hafez, Elaraby, Abdelaziz, Ghaith) Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Roshdy, Philip) Faculty of Medicine, Sohag University, Sohag, Egypt
(Eltobgy) Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
(Elsayed, El-Samahy, Elbehbeh, Abdelaty, Rizk) Faculty of Medicine,
Zagazig University, Zagazig, Egypt
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(AboElfarh) Mansoura Manchester Programme for Medical Education, Faculty
of Medicine, Mansoura University, Mansoura, Egypt
(Ramadan) Faculty of Medicine, South Valley University, Qena Governorate,
Egypt
(Wahsh) Department of Clinical Pharmacy, Faculty of Pharmacy, October 6
University, Giza, Egypt
(Abdelazeem) McLaren Flint Hospital, Flint, MI, United States
(Abdelazeem) Michigan State University, East Lansing, MI, United States
(Fayed) Cardiothoracic Surgery Department, Faculty of Medicine, Port Said
University, Port Said, Egypt
Publisher
Europa Group
Abstract
Background: Atrial fibrillation (AF) associated with postoperative
pericardial effusion is the most commonly reported adverse event after
cardiac surgery. Aim(s): We aimed to determine the role of posterior
pericardiotomy in preventing postoperative AF (POAF). Method(s): We
searched PubMed, Scopus, Web of Science, Ovid, and EBSCO from inception
until 30 June 2022. We included randomised clinical trials (RCTs) that
compared posterior pericardiotomy (PP) versus control (no PP) in patients
undergoing cardiac surgery. The primary endpoint was the incidence of POAF
after cardiac surgery. The secondary endpoints were supraventricular
arrhythmias, early/late pericardial effusion, pericardial tamponade,
pleural effusion, length of hospital/intensive care unit stay,
intra-aortic balloon pump use, revision surgery for bleeding, and
mortality. Result(s): Twenty-five RCTs comprising 4,467 patients were
included in this systematic review and meta-analysis. The overall
incidence rate of POAF was 11.7% in the PP group compared with 23.67% in
the no PP or control group, with a significant decrease in the risk of
POAF following PP (odds ratio [OR] 0.49, 95% confidence interval [CI]:
0.38-0.61). Compared with the control group, the risk of supraventricular
tachycardia (OR 0.66, 95% CI: 0.43-0.89), early pericardial effusion (OR
0.32, 95% CI: 0.22-0.46), late pericardial effusion (OR 0.15, 95% CI:
0.09-0.25), and pericardiac tamponade (OR 0.18, 95% CI: 0.10-0.33) were
lower in the PP group. Conclusion(s): PP is an effective intervention
for reducing the risk of POAF after cardiac surgery. Also, PP is
economically efficient in terms of decreasing the length of hospital
stay. Copyright © Europa Digital & Publishing 2023. All rights
reserved.

<4>
Accession Number
2025626114
Title
Diagnostic accuracy of brain natriuretic peptide and N-terminal-pro brain
natriuretic peptide to detect complications of cardiac transplantation in
adults: A systematic review and meta-analysis.
Source
Transplantation Reviews. 37(3) (no pagination), 2023. Article Number:
100774. Date of Publication: July 2023.
Author
Zhu V.; Perry L.A.; Plummer M.; Segal R.; Smith J.; Liu Z.
Institution
(Zhu, Perry, Segal, Liu) Department of Anaesthesia, Royal Melbourne
Hospital, Parkville, Australia
(Zhu, Perry, Plummer, Segal, Liu) Department of Critical Care, Melbourne
Medical School, Faculty of Medicine, Dentistry and Health Sciences,
University of Melbourne, Parkville, Australia
(Plummer) Department of Intensive Care Medicine, Royal Adelaide Hospital,
Adelaide, Australia
(Smith) Department of Surgery, Monash University, Clayton, Australia
Publisher
Elsevier Inc.
Abstract
Background: We aimed to evaluate the utility of BNP and NT-proBNP in
identifying adverse recipient outcomes following cardiac transplantation.
 Method(s): We searched MEDLINE (Ovid), Embase (Ovid), and the
Cochrane Library from inception to February 2023. We included studies
reporting associations between BNP or NT-proBNP and adverse outcomes
following cardiac transplantation in adults. We calculated standardised
mean differences (SMD) with 95% confidence intervals (CI); or confusion
matrices with sensitivities and specificities. Where meta-analysis was
inappropriate, studies were analysed descriptively. Result(s):
Thirty-two studies involving 2,297 cardiac transplantation recipients were
included. We report no significant association between BNP or NT-proBNP
and significant acute cellular rejection of grade 3A or higher (SMD 0.40,
95% CI -0.06-0.86) as defined by the latest 2004 International Society for
Heart and Lung Transplantation Guidelines. We also report no strong
associations between BNP or NT-proBNP and cardiac allograft vasculopathy
or antibody mediated rejection. Conclusion(s): In isolation, serum
BNP and NT-proBNP lack sufficient sensitivity and specificity to reliably
predict adverse outcomes following cardiac transplantation. Copyright
© 2023 Elsevier Inc.

<5>
Accession Number
2024116762
Title
Monitoring of Levosimendan Administration in Patients with Pulmonary
Hypertension Undergoing Cardiac Surgery and Effect of Two Different Dosing
Schemes on Hemodynamic and Echocardiographic Parameters.
Source
Pharmaceuticals. 16(6) (no pagination), 2023. Article Number: 815. Date of
Publication: June 2023.
Author
Ftikos P.; Falara A.; Rellia P.; Leontiadis E.; Samanidis G.; Kamperi N.;
Piperakis A.; Tamvakopoulos C.; Antoniou T.; Theodoraki K.
Institution
(Ftikos, Falara, Rellia, Antoniou) Department of Anesthesiology, Onassis
Cardiac Surgery Center, Athens 176 74, Greece
(Leontiadis) Department of Cardiology, Onassis Cardiac Surgery Center,
Athens 176 74, Greece
(Samanidis) Department of Cardiac Surgery, Onassis Cardiac Surgery Center,
Athens 176 74, Greece
(Kamperi, Piperakis, Tamvakopoulos) Center of Clinical Research,
Experimental Surgery and Translational Research, Division of
Pharmacology-Pharmacotechnology, Biomedical Research Foundation, Academy
of Athens, Athens 115 27, Greece
(Theodoraki) Department of Anesthesiology, Aretaieion University Hospital,
National and Kapodistrian University of Athens, Athens 115 28, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: The perioperative management of patients with pulmonary
hypertension (PH) undergoing cardiac surgery represents one of the most
challenging clinical scenarios. This fact mainly depends on the
relationship existing between PH and right ventricular failure (RVF).
Levosimendan (LS) is an inodilator that might be an effective agent in the
treatment of PH and RVF. The aim of this study was to examine the impact
of the duration of cardiopulmonary bypass (CPB) on the therapeutic drug
monitoring of LS and to evaluate the effect of preemptive administration
of LS on perioperative hemodynamic and echocardiographic parameters in
cardiac surgical patients with preexisting PH. Material(s) and
Method(s): In this study, LS was administered in adult patients undergoing
cardiac surgery before CPB in order to prevent exacerbation of preexisting
PH and subsequent right ventricular dysfunction. Thirty cardiac surgical
patients with preoperatively confirmed PH were randomized to receive
either 6 mug/kg or 12 mug/kg of LS after the induction of anesthesia. The
plasma concentration of LS was measured after CPB. In this study, a low
sample volume was used combined with a simple sample preparation protocol.
The plasma sample was extracted by protein precipitation and evaporated;
then, the analyte was reconstituted and detected using specific and
sensitive bioanalytical liquid chromatography with mass spectrometry
(LC-MS/MS) methodology. The clinical, hemodynamic, and echocardiographic
parameters were registered and evaluated before and after the
administration of the drug. Result(s): A fast bioanalytical LC-MS/MS
methodology (a run time of 5.5 min) was developed for the simultaneous
determination of LS and OR-1896, its main metabolite in human plasma. The
LC-MS/MS method was linear over a range of 0.1-50 ng/mL for LS and 1-50
ng/mL for its metabolite OR-1896. Measured plasma concentrations of LS
were inversely related to the duration of CPB. LS administration before
CPB during cardiac surgery was effective in reducing pulmonary artery
pressure and improving hemodynamic parameters after CPB, with a more
pronounced and durable effect of the drug at the dose of 12 mug/kg.
Additionally, administration of LS at a dose of 12 mug/kg in cardiac
surgical patients with PH before CPB improved right ventricular function.
 Conclusion(s): LS administration decreases pulmonary artery pressure
and may improve right ventricular function in patients with PH undergoing
cardiac surgery. Copyright © 2023 by the authors.

<6>
Accession Number
2024026547
Title
Axillary vein puncture versus cephalic vein cutdown for cardiac
implantable electronic device implantation: A meta-analysis.
Source
PACE - Pacing and Clinical Electrophysiology. 46(8) (pp 942-947), 2023.
Date of Publication: August 2023.
Author
Vetta G.; Magnocavallo M.; Parlavecchio A.; Caminiti R.; Polselli M.;
Sorgente A.; Cauti F.M.; Crea P.; Pannone L.; Marcon L.; Savio A.L.;
Pistelli L.; Vetta F.; Chierchia G.-B.; Rossi P.; Bianchi S.; Natale A.;
de Asmundis C.; Rocca D.G.D.
Institution
(Vetta, Parlavecchio, Caminiti, Crea, Savio, Pistelli) Cardiology Unit,
Department of Clinical and Experimental Medicine, University of Messina,
Messina, Italy
(Magnocavallo, Polselli, Cauti, Rossi, Bianchi) Cardiology Division,
Arrhythmology Unit, S. Giovanni Calibita Hospital, Isola Tiberina, Rome,
Italy
(Natale, Rocca) Texas Cardiac Arrhythmia Institute, St. David's Medical
Center, Austin, TX, United States
(Sorgente, Pannone, Marcon, Chierchia, de Asmundis, Rocca) Heart Rhythm
Management Centre, Postgraduate Program in Cardiac Electrophysiology and
Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel,
European Reference Networks Guard-Heart, Brussels, Belgium
(Vetta) Saint Camillus International University of Health Sciences, Rome,
Italy
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Cephalic vein cutdown (CVC) and axillary vein puncture (AVP)
are both recommended for transvenous implantation of leads for cardiac
implantable electronic devices (CIEDs). Nonetheless, it is still debated
which of the two techniques has a better safety and efficacy profile.
 Method(s): We systematically searched Medline, Embase, and Cochrane
electronic databases up to September 5, 2022, for studies that evaluated
the efficacy and safety of AVP and CVC reporting at least one clinical
outcome of interest. The primary endpoints were acute procedural success
and overall complications. The effect size was estimated using a
random-effect model as risk ratio (RR) and relative 95% confidence
interval (CI). Result(s): Overall, seven studies were included, which
enrolled 1771 and 3067 transvenous leads (65.6% [n = 1162] males, average
age 73.4 +/- 14.3 years). Compared to CVC, AVP showed a significant
increase in the primary endpoint (95.7 % vs. 76.1 %; RR: 1.24; 95% CI:
1.09-1.40; p =.001) (Figure 1). Total procedural time (mean difference
[MD]: -8.25 min; 95% CI: -10.23 to -6.27; p <.0001; I2 = 0%)
and venous access time (MD: -6.24 min; 95% CI: -7.01 to -5.47; p <.0001;
I2 = 0%) were significantly shorter with AVP compared to CVC.
No differences were found between AVP and CVC for incidence overall
complications (RR: 0.56; 95% CI: 0.28-1.10; p =.09), pneumothorax (RR:
0.72; 95% CI: 0.13-4.0; p =.71), lead failure (RR: 0.58; 95% CI:
0.23-1.48; p =.26), pocket hematoma/bleeding (RR: 0.58; 95% CI: 0.15-2.23;
p =.43), device infection (RR: 0.95; 95% CI: 0.14-6.60; p =.96) and
fluoroscopy time (MD: -0.24 min; 95% CI: -0.75 to 0.28; p =.36).
 Conclusion(s): Our meta-analysis suggests that AVP may improve
procedural success and reduce total procedural time and venous access time
compared to CVC. Copyright © 2023 Wiley Periodicals LLC.

<7>
Accession Number
2022683040
Title
A Pilot Single-Blinded, Randomized, Controlled Trial Comparing BNT162b2
vs. JNJ-78436735 Vaccine as the Third Dose After Two Doses of BNT162b2
Vaccine in Solid Organ Transplant Recipients.
Source
Transplant International. 36 (no pagination), 2023. Article Number: 10938.
Date of Publication: 2023.
Author
Natori Y.; Martin E.; Mattiazzi A.; Arosemena L.; Ortigosa-Goggins M.;
Shobana S.; Roth D.; Kupin W.L.; Burke G.W.; Ciancio G.; Morsi M.; Phancao
A.; Munagala M.R.; Butrous H.; Manickavel S.; Sinha N.; Sota K.;
Pallikkuth S.; Bini J.; Simkins J.; Anjan S.; Vianna R.M.; Guerra G.
Institution
(Natori, Martin, Mattiazzi, Arosemena, Ortigosa-Goggins, Shobana, Roth,
Kupin, Burke, Ciancio, Morsi, Phancao, Munagala, Butrous, Manickavel,
Sinha, Sota, Bini, Simkins, Anjan, Vianna, Guerra) Miami Transplant
Institute, Jackson Health System, Miami, FL, United States
(Natori, Bini, Simkins, Anjan) Division of Infectious Disease, Department
of Medicine, Miller School of Medicine Miami, University of Miami, Miami,
FL, United States
(Martin, Arosemena) Division of Hepatology, Department of Medicine, Miller
School of Medicine Miami, University of Miami, Miami, FL, United States
(Mattiazzi, Ortigosa-Goggins, Shobana, Roth, Kupin, Guerra) Division of
Nephrology, Department of Medicine, Miller School of Medicine Miami,
University of Miami, Miami, FL, United States
(Burke, Ciancio, Morsi, Vianna) Department of Surgery, Miller School of
Medicine Miami, University of Miami, Miami, FL, United States
(Phancao, Munagala, Butrous) Division of Cardiology, Department of
Medicine, Miller School of Medicine Miami, University of Miami, Miami, FL,
United States
(Manickavel, Sinha) Division of Pulmonology, Department of Medicine,
Miller School of Medicine Miami, University of Miami, Miami, FL, United
States
(Pallikkuth) Division of Microbiology, Department of Medicine, Miller
School of Medicine Miami, University of Miami, Miami, FL, United States
Publisher
European Society for Organ Transplantation
Abstract
Solid Organ Transplant (SOT) recipients are at significant higher risk for
COVID-19 and due to immunosuppressive medication, the immunogenicity after
vaccination is suboptimal. In the previous studies, booster method showed
significant benefit in this population. In the current study, we compared
using a mix-and-match method vs. same vaccine as a third dose in SOT
recipients. This was a patient-blinded, single center, randomized
controlled trial comparing BNT162b2 vs. JNJ-78436735 vaccine as the third
dose after two doses of BNT162b2 vaccine. We included adult SOT recipients
with functional graft who had received two doses of BNT162b2 vaccine.
Participants were randomly assigned to receive either BNT162b2 or
JNJ-78436735 in one-to-one ratio. Primary outcome was SARS-CoV-2 IgG
positivity at 1 month after the third dose. Sixty SOT recipients,
including 36 kidney, 12 liver, 2 lung, 3 heart, and 5 combined
transplants, were enrolled, and 57 recipients were analyzed per protocol.
There were no statistically significant differences between the two
vaccine protocols for IgG positivity (83.3% vs. 85.2% for BNT162b2 and
JNJ-78436735, respectively, p = 0.85, Odds Ratio 0.95, 95% Confidence
Interval 0.23-4.00). Comparison of the geometric mean titer demonstrated a
higher trend with BNT162b2 (p = 0.09). In this pilot randomized controlled
trial comparing mix and match method vs. uniform vaccination in SOT
recipients, both vaccines were safely used. Since this was a small sample
sized study, there was no statistically significant difference in
immunogenicity; though, the mix and match method showed relatively lower
geometric mean titer, as compared to uniform vaccine. Further studies need
to be conducted to determine duration of this immunogenicity. Clinical
Trial Registration:
https://clinicaltrials.gov/ct2/show/NCT05047640?term=20210641&draw=2&rank=
1, identifier 20210641. Copyright © 2023 Natori, Martin,
Mattiazzi, Arosemena, Ortigosa-Goggins, Shobana, Roth, Kupin, Burke,
Ciancio, Morsi, Phancao, Munagala, Butrous, Manickavel, Sinha, Sota,
Pallikkuth, Bini, Simkins, Anjan, Vianna and Guerra.

<8>
Accession Number
2024855348
Title
Hybrid delivery of behavioral health screening and prevention intervention
for pediatric heart transplant recipients and families: A randomized pilot
study.
Source
Pediatric Transplantation. (no pagination), 2023. Date of Publication:
2023.
Author
Wijesekera K.; Kiff C.; Aralis H.; Sinclair M.; Bursch B.; Alejos J.C.;
Lester P.
Institution
(Wijesekera, Kiff, Aralis, Sinclair, Bursch, Lester) Department of
Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at
UCLA, Los Angeles, CA, United States
(Bursch, Alejos) Department of Pediatrics, David Geffen School of Medicine
at UCLA, Los Angeles, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: A significant number of pediatric heart transplant recipients
and their families experience post-traumatic stress symptoms following
transplantation, which can impact recipient behavioral and medical health
outcomes. Preventive behavioral health interventions may improve outcomes,
especially if interventions can be delivered at a distance to decrease
barriers to mental health care. This pilot study examined the
acceptability and accessibility of an evidence-informed resilience
training program delivered using a video telehealth platform. A secondary
aim was to assess the preliminary efficacy of the intervention on
recipient behavioral health outcomes, perceived barriers to recipient
medication adherence, parent behavioral health outcomes, and family
functioning. Method(s): Seventeen heart transplant recipients (8-18
years old) and their families were recruited and randomly assigned to a
treatment as usual (n = 8) or an intervention group (n = 9). Baseline
assessment data collected included demographic information and validated
behavioral health measures. Follow-up assessments included the validated
measures and acceptability and satisfaction ratings. Result(s): The
study demonstrated that the program has high acceptability by recipients
and parents, and a positive impact on recipients and parents, including
significant reductions in youth behavioral difficulties as well as parent
depression and post-traumatic stress symptoms. Conclusion(s): Results
of this study are promising and call for further evaluation of hybrid
delivery models for behavioral health screening and prevention
interventions for pediatric heart transplant recipients and their
families. Copyright © 2023 The Authors. Pediatric Transplantation
published by Wiley Periodicals LLC.

<9>
Accession Number
641992246
Title
Comparative effects of minimally invasive approaches vs. conventional for
obese patients undergoing aortic valve replacement: a systematic review
and network meta-analysis.
Source
BMC cardiovascular disorders. 23(1) (pp 392), 2023. Date of Publication:
09 Aug 2023.
Author
Abdelaal S.A.; Abdelrahim N.A.; Mamdouh M.; Ahmed N.; Ahmed T.R.; Hefnawy
M.T.; Alaqori L.K.; Abozaid M.
Institution
(Abdelaal) Kharkiv National Medical University, Kharkiv, Ukraine
(Abdelrahim) Faculty of Medicine, Tanta University, Egypt
(Mamdouh) Faculty of Medicine, Beni-Suef University, Egypt
(Ahmed, Ahmed, Hefnawy) Faculty of Medicine, Zagazig University, Zagazig,
Egypt
(Alaqori) Faculty of Medicine, University of Aden, Aden, Yemen
(Abozaid) Mayo Clinic, Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Minimally invasive approaches like mini-thoracotomy and
mini-sternotomy for Aortic Valve Replacement (AVR) showed impressive
outcomes. However, their advantages for obese patients are questionable.
We aimed in this network meta-analysis to compare three surgical
approaches: Full sternotomy (FS), Mini-sternotomy (MS), and
Mini-thoracotomy (MT) for obese patients undergoing AVR. METHOD(S):
We followed the PRISMA extension for this network meta-analysis.
PubMed/Medline, Scopus, Web of Science, and Cochrane searched through
March 2023 for relevant articles. The analysis was performed using R
version 4.2.3. RESULT(S): Out of 344, 8 articles met the criteria
with 1392 patients. The main outcomes assessed were perioperative
mortality, re-exploration, atrial fibrillation, renal failure, ICU stay,
hospital stay, cross-clamp time, and bypass time. In favor of MS, the
length of ICU stay and hospital stay was significantly lower than for FS
[MD -0.84, 95%CI (-1.26; -0.43)], and [MD -2.56, 95%CI (-3.90; -1.22)],
respectively. Regarding peri-operative mortality, FS showed a
significantly higher risk compared to MS [RR 2.28, 95%CI (1.01;5.16)].
Also, patients who underwent minimally invasive approaches; MT and MS,
required less need of re-exploration compared to FS [RR 0.10, 95%CI
(0.02;0.45)], and [RR 0.33, 95%CI (0.14;0.79)], respectively. However,
Intraoperative timings; including aortic cross-clamp, and cardiopulmonary
bypass time, were significantly lower with FS than for MS [MD -9.16, 95%CI
(-1.88; -16.45)], [MD -9.61, 95%CI (-18.64; -0.59)], respectively.
 CONCLUSION(S): Our network meta-analysis shows that minimally
invasive approaches offer some advantages for obese patients undergoing
AVR over full sternotomy. Suggesting that these approaches might be
considered more beneficial alternatives for obese patients undergoing
AVR. Copyright © 2023. BioMed Central Ltd., part of Springer
Nature.

<10>
Accession Number
642006486
Title
Optimal dose of neostigmine antagonizing cisatracurium-induced shallow
neuromuscular block in elderly patients: a randomized control study.
Source
BMC anesthesiology. 23(1) (pp 269), 2023. Date of Publication: 10 Aug
2023.
Author
Cao M.; Huang H.; Tong J.; Ou Y.; Liao Y.
Institution
(Cao, Tong, Ou, Liao) Department of Anesthesiology, Third Xiangya
Hospital, Central South University, Changsha, Hunan 410013, China
(Huang) Department of Anesthesiology, First Affiliated Hospital of Xiamen
University, Xiamen University, Xiamen, China
(Tong) Hunan Province Key Laboratory of Brain Homeostasis, Third Xiangya
Hospital, Central South University, Changsha, Hunan 410013, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Residual neuromuscular block after using neuromuscular
blocking agents is a common and potentially harmful complication of
general anesthesia. Neostigmine is a widely used antagonist, but its
optimal dose for elderly patients is unclear. OBJECTIVE(S): To
compare the optimal dosage and safety of neostigmine for reversing shallow
residual block in elderly patients after cisatracurium-induced
neuromuscular block. METHOD(S): A randomized controlled trial was
conducted in 196 elderly patients undergoing non-cardiac surgery under
general anesthesia with cisatracurium. Patients were assigned to receive
either no neostigmine (control group) or neostigmine at 20 microg/kg, 40
microg/kg or 50 microg/kg when train-of-four (TOF) ratio reached 0.2 at
the end of surgery. The primary outcome was the time to reach TOF ratio of
0.9 after administration. Secondary outcomes included TOF ratio at 10 min
after administration, postoperative nausea and vomiting, postoperative
cognitive impairment and post-anesthesia care unit (PACU) stay time.
 RESULT(S): The time to reach TOF ratio of 0.9 in the 20 microg/kg, 40
microg/kg and 50 microg/kg groups was significantly shorter than the
control group (H=104.257, P<0.01), and the time of 40 microg/kg group and
50 microg/kg group was significantly shorter than the 20 microg/kg group
(P<0.001). There was no significant difference between 40 microg/kg and 50
microg/kg groups (P=0.249). The TOF ratio at 10 min after administration
showed similar results. There were no significant differences among groups
in postoperative nausea and vomiting, postoperative cognitive impairment
or post-operation hospital stay. CONCLUSION(S): Timely use of
neostigmine after general anesthesia in elderly patients can significantly
shorten time of TOF value reaching 0.9, among which 40 microg/kg dosage
may be a more optimized choice. TRIAL REGISTRATION: this study was
registered on chictr.org.cn (ChiCTR2100054685, 24/12/2021). Copyright
© 2023. BioMed Central Ltd., part of Springer Nature.

<11>
Accession Number
642004013
Title
Outcome and management of decompressive hemicraniectomy in malignant
hemispheric stroke following cardiothoracic surgery.
Source
Scientific reports. 13(1) (pp 12994), 2023. Date of Publication: 10 Aug
2023.
Author
Truckenmueller P.; Fritzsching J.; Schulze D.; Fruh A.; Jacobs S.; Ahlborn
R.; Vajkoczy P.; Prinz V.; Hecht N.
Institution
(Truckenmueller, Fruh, Vajkoczy, Hecht) Department of Neurosurgery and
Center for Stroke Research Berlin (CSB), Charite - Universitatsmedizin
Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin 12203, Germany
(Fritzsching, Jacobs) Department of Cardiothoracic and Vascular Surgery,
Deutsches Herzzentrum Berlin, Berlin, Germany
(Schulze) Institute of Medical Biometrics and Clinical Epidemiology,
Charite - Universitatsmedizin Berlin, Berlin, Germany
(Ahlborn) Institute of Medical Informatics, Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Prinz) Department of Neurosurgery, Goethe Universitat Frankfurt,
Frankfurt am Main, Germany
Publisher
NLM (Medline)
Abstract
Management of malignant hemispheric stroke (MHS) after cardiothoracic
surgery (CTS) remains difficult as decision-making needs to consider
severe cardiovascular comorbidities and complex coagulation management.
The results of previous randomized controlled trials on decompressive
surgery for MHS cannot be generally translated to this patient population
and the expected outcome might be substantially worse. Here, we analyzed
mortality and functional outcome in patients undergoing decompressive
hemicraniectomy (DC) for MHS following CTS and assessed the impact of
perioperative coagulation management on postoperative hemorrhagic and
cardiovascular complications. All patients that underwent DC for MHS
resulting as a complication of CTS between June 2012 and November 2021
were included in this observational cohort study. Outcome was determined
according to the modified Rankin Scale (mRS) score at 1 and 3-6 months.
Clinical and demographic data, anticoagulation management and
postoperative hemorrhagic and thromboembolic complications were assessed.
In order to evaluate a predictive association between clinical and
radiological parameters and the outcome, we used a multivariate logistic
regression analysis. Twenty-nine patients undergoing DC for MHS after CTS
with a female-to-male ratio of 1:1.9 and a median age of 60 (IQR 49-64)
years were identified out of 123 patients undergoing DC for MHS.
Twenty-four patients (83%) received pre- or intraoperative substitution.
At 30 days, the in-hospital mortality rate and neurological outcome
corresponded to 31% and a median mRS of 5 (5-6), which remained stable at
3-6 months [Mortality: 42%, median mRS: 5 (4-6)]. Postoperatively, 15/29
patients (52%) experienced new hemorrhagic lesions and Bayesian logistic
regression predicting mortality (mRS=6) after imputing missing data
demonstrated a significantly increased risk for mortality with longer aPPT
(OR=13.94, p=.038) and new or progressive hemorrhagic lesions after DC
(OR=3.03, p=.19). Notably, all but one hemorrhagic lesion occurred before
discontinued anticoagulation and/or platelet inhibition was re-initiated.
Despite perioperative discontinuation of anticoagulation and/or platelet
inhibition, no coagulation-associated cardiovascular complications were
noted. In conclusion, Cardiothoracic surgery patients suffering MHS will
likely experience severe neurological disability after DC, which should
remain a central aspect during counselling and decision-making. The
complex coagulation situation after CTS, however, should not per se rule
out the option of performing life-saving surgical
decompression. Copyright © 2023. Springer Nature Limited.

<12>
Accession Number
2025167478
Title
Association between Serum Oxysterols and Coronary Plaque Regression during
Lipid-Lowering Therapy with Statin and Ezetimibe: Insights from the CuVIC
Trial.
Source
Journal of Atherosclerosis and Thrombosis. 30(8) (pp 907-918), 2023. Date
of Publication: 2023.
Author
Nakano Y.; Yamamoto M.; Matoba T.; Katsuki S.; Nakashiro S.; Takase S.;
Akiyama Y.; Nagata T.; Mukai Y.; Inoue S.; Oi K.; Higo T.; Takemoto M.;
Suematsu N.; Eshima K.; Miyata K.; Usui M.; Sadamatsu K.; Kadokami T.;
Hironaga K.; Ichi I.; Todaka K.; Kishimoto J.; Tsutsui H.
Institution
(Nakano, Matoba, Katsuki, Takase, Akiyama, Nagata, Tsutsui) Department of
Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
(Yamamoto) Department of Cardiovascular Medicine, Harasanshin Hospital,
Fukuoka, Japan
(Nakashiro) Department of Cardiovascular Medicine, Matsuyama Red Cross
Hospital, Ehime, Japan
(Mukai) Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka
Hospital, Fukuoka, Japan
(Inoue) Department of Cardiovascular Medicine, Aso Iizuka Hospital,
Fukuoka, Japan
(Oi, Suematsu) Department of Cardiovascular Medicine, Saiseikai Fukuoka
General Hospital, Fukuoka, Japan
(Higo) Department of Cardiovascular Medicine, National Hospital
Organization Kyushu Medical Centre, Fukuoka, Japan
(Takemoto) Cardiovascular Center, Steel Memorial Yawata Hospital, Fukuoka,
Japan
(Eshima) Department of Cardiovascular Medicine, Saga-ken Medical Centre
Koseikan, Saga, Japan
(Miyata) Department of Cardiovascular Medicine, Japan Community Health
Care Organization, Kyushu Hospital, Fukuoka, Japan
(Usui) Department of Cardiovascular Medicine, Hamanomachi Hospital,
Fukuoka, Japan
(Sadamatsu) Department of Cardiovascular Medicine, Omuta City Hospital,
Fukuoka, Japan
(Kadokami) Department of Cardiovascular Medicine, Saiseikai Futsukaichi
Hospital, Fukuoka, Japan
(Hironaga) Department of Cardiovascular Medicine, Fukuoka City Hospital,
Fukuoka, Japan
(Ichi) Graduate School of Humanities and Science, Ochanomizu University,
Tokyo, Japan
(Todaka, Kishimoto) Center for Clinical and Translational Research of
Kyushu University Hospital, Fukuoka, Japan
(Tsutsui) Department of Cardiovascular Medicine, Kyushu University
Graduate School of Medical Sciences, Fukuoka, Japan
Publisher
Japan Atherosclerosis Society
Abstract
Aim: Several clinical trials using intravascular ultrasound (IVUS)
evaluation have demonstrated that intensive lipid-lowering therapy by
statin or a combination therapy with statin and ezetimibe results in
significant regression of coronary plaque volume. However, it remains
unclear whether adding ezetimibe to statin therapy affects coronary plaque
composition and the molecular mechanisms of plaque regression. We
conducted this prospective IVUS analysis in a subgroup from the CuVIC
trial. Method(s): The CuVIC trial was a prospective randomized, open,
blinded-endpoint trial conducted among 11 cardiovascular centers, where
260 patients with coronary artery disease who received coronary stenting
were randomly allocated into either the statin group (S) or the combined
statin and ezetimibe group (S+E). We enrolled 79 patients (S group, 39
patients; S+E group, 40 patients) in this substudy, for whom serial IVUS
images of nonculprit lesion were available at both baseline and after 6-8
months of follow-up. Result(s): After the treatment period, the S+E
group had significantly lower level of low-density lipoprotein cholesterol
(LDL-C; 80.9+/-3.7 vs. 67.7+/-3.8 mg/dL, p=0.0143). Campesterol, a marker
of cholesterol absorption, and oxysterols (beta-epoxycholesterol,
4beta-hydroxycholesterol, and 27-hydroxycholesterol) were also lower in
the S +E group. IVUS analyses revealed greater plaque regression in the
S+E group than in the S group (-6.14% vs. -1.18% for each group, p
=0.042). It was noteworthy that the lowering of campesterol and
27-hydroxycholesterol, but not LDL-C, had a significant positive
correlation with plaque regression. Conclusion(s): Compared with
statin monotherapy, ezetimibe in combination with statin achieved
significantly lower LDL-C, campesterol, and 27-hydroxycholesterol, which
resulted in greater coronary plaque regression. Copyright © 2023
Japan Atherosclerosis Society.

<13>
Accession Number
2024862208
Title
Efficacy and Safety of Ticagrelor versus Clopidogrel in Dialysis Patients
with Coronary Syndromes: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(15) (no pagination), 2023. Article
Number: 5011. Date of Publication: August 2023.
Author
Burlacu A.; Floria M.; Brinza C.; Covic A.
Institution
(Burlacu, Brinza) Institute of Cardiovascular Diseases "Prof. Dr. George
I.M. Georgescu", Iasi 700503, Romania
(Burlacu, Floria, Brinza, Covic) Faculty of Medicine, University of
Medicine and Pharmacy "Grigore T Popa", Iasi 700115, Romania
(Floria) Medical Clinic, "Sf. Spiridon" Emergency Hospital, Iasi 700111,
Romania
(Covic) Nephrology Clinic, Dialysis and Renal Transplant Center, "C.I.
Parhon" University Hospital, Iasi 700503, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
(1) Background: The optimal antiplatelet therapy for end-stage kidney
disease (ESKD) patients on chronic dialysis presenting with acute or
chronic coronary syndromes (ACS or CCS) remains uncertain. This
meta-analysis aimed to compare the efficacy and safety endpoints of
ticagrelor and clopidogrel in ESKD patients requiring dialysis and
presenting with ACS or CCS. (2) Methods: Studies were included comparing
ticagrelor and clopidogrel in ESKD patients on chronic dialysis with ACS
or CCS. The primary composite efficacy outcome was a combination of
all-cause and cardiovascular mortality, recurrent myocardial infarction or
coronary revascularization, and ischemic or hemorrhagic stroke. The
primary safety outcome was major and non-major bleeding events. (3)
Results: Five observational studies met the eligibility criteria. The
pooled analysis showed no significant difference in the primary composite
efficacy outcome between ticagrelor and clopidogrel (p = 0.40). Similarly,
the 2 groups had no significant differences in all-cause mortality (p =
0.82) or cardiovascular mortality (p = 0.79). Ticagrelor did not show a
significantly different risk of coronary revascularization (p = 0.35) or
recurrent myocardial infarction (p = 0.41) compared to clopidogrel. Also,
the risk of stroke was similar (p = 0.21). The 2 groups had no significant
difference in the primary composite safety outcome (p = 0.22) or major
bleeding events (p = 0.27). (4) Conclusion(s): In ESKD patients on
chronic dialysis with ACS or CCS, there was no significant difference in
efficacy or safety outcomes between ticagrelor and clopidogrel. Further
randomized controlled trials are needed to establish the optimal
antiplatelet therapy in this population. Copyright © 2023 by the
authors.

<14>
Accession Number
2024861337
Title
DOACs in the Anticoagulation of Mechanical Valves: A Systematic Review and
Future Perspectives.
Source
Journal of Clinical Medicine. 12(15) (no pagination), 2023. Article
Number: 4984. Date of Publication: August 2023.
Author
Langenaeken T.; Vanoppen A.; Janssens F.; Tanghe L.; Verbrugghe P.; Rega
F.; Meuris B.
Institution
(Langenaeken, Vanoppen, Janssens, Tanghe, Verbrugghe, Rega, Meuris)
Department of Cardiac Surgery, University Hospitals Leuven, Herestraat 49,
Leuven 3000, Belgium
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Valvular heart disease is a common disease often necessitating valve
replacement. Mechanical heart valves (MHVs) are often used in younger
patients because of their longer durability. Their main disadvantage is
the need for lifelong anticoagulation. Warfarin is considered a standard
treatment, but it is far from perfect. Direct oral anticoagulants (DOACs)
are a new and more patient-friendly alternative to warfarin when
anticoagulation is required, but have not yet been approved for the
indication of mechanical valves. Evidence Acquisition: A literature
search of Pubmed, Embase, Web of Science (Core Collection), and Cochrane
Library (from inception to May 2023) was performed using a search string
that was well defined and not modified during the study. An extensive
overview of the search terms used in each database can be found in the
Appendix. Only prospective clinical trials were included in this review. A
total of 10 publications were included in this review. Relevance to
clinical practice: This systematic review summarizes the different types
of DOACs and their possible use in the anticoagulation of mechanical
valves. We aim to propose future directions in anticoagulation research
for mechanical valves. Conclusion(s): DOAC use in MHVs has been
halted due to the failure of both dabigatran and apixaban in two major
clinical trials. However, rivaroxaban was successful in two small clinical
trials. Ample research is still needed to explore new valve designs as
well as new anticoagulation targets. Copyright © 2023 by the
authors.

<15>
Accession Number
2024861071
Title
Features of Myocarditis: Morphological Differential Diagnosis in
Post-COVID-19 Children.
Source
Diagnostics. 13(15) (no pagination), 2023. Article Number: 2499. Date of
Publication: August 2023.
Author
Karev V.; Starshinova A.Y.; Glushkova A.; Kudlay D.; Starshinova A.
Institution
(Karev) Children's Clinical Research Center for Infectious Diseases, St.
Petersburg 194100, Russian Federation
(Karev, Starshinova) Almazov National Medical Research Centre, St.
Petersburg 197341, Russian Federation
(Starshinova) Pediatric Faculty, State Pediatric Medical University, St.
Petersburg 194100, Russian Federation
(Glushkova) Medical Faculty, Pavlov First Saint Petersburg State Medical
University, St. Petersburg 197022, Russian Federation
(Kudlay) Department of Pharmacology, Institute of Pharmacy, I.M. Sechenov
First Moscow State Medical University, Moscow 119991, Russian Federation
(Kudlay) Institute of Immunology, FMBA of Russia, Moscow 115478, Russian
Federation
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Myocarditis is characterized by dysfunction and destruction of
cardiomyocytes, infiltrative inflammation, and development of fibrosis.
Late diagnosis of myocarditis has been a serious global health problem,
especially due to the spread of a new coronavirus infection. The aim of
this review is to identify differences between myocarditis of viral
etiology, including SARS-CoV-2 lesions, based on instrumental and
pathomorphological findings. Material(s) and Method(s): We analyzed
publications covering the period from December 2019 to May 2023, published
in publicly accessible international databases ("Medline", "PubMed",
"Scopus"), with queries for the keywords "myocarditis", "children",
"cardiovascular inflammation", "COVID-19", "SARS-CoV-2", "severe acute
respiratory syndrome coronavirus 2", "differential diagnosis".
 Result(s): It was found that no unambiguous morphological criteria
for the diagnosis of myocarditis coupled to SARS-CoV-2 lesions were
identified. However, the detected histopathological changes such as
virus-associated degeneration, apoptosis, cardiomyocyte necrosis, moderate
interstitial hyperemia, myocardial tissue oedema, and capillary
endothelial cell dysfunction were the major markers of SARS-CoV-2
infection. Conclusion(s): It is necessary further reconsider
morphological criteria to diagnose SARS-CoV-2-caused myocarditis, rather
than solely relying on detecting viral RNA by PCR as the sole
evidence-based criterion. Similar issues accompany diagnostics of
myocardial lesions associated with other viral infections. Evidence for an
etiological diagnosis of myocarditis can be provided by a comprehensive
analysis of the diagnostic criteria obtained, confirming virus exposure,
followed by development of distinct clinical symptoms, MRI and CT changes,
and morphological criteria. Copyright © 2023 by the authors.

<16>
Accession Number
2017704059
Title
Prehabilitation of elderly frail or pre-frail patients prior to elective
surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome
assessor-blinded trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 468. Date of
Publication: December 2022.
Author
Schaller S.J.; Kiselev J.; Loidl V.; Quentin W.; Schmidt K.; Morgeli R.;
Rombey T.; Busse R.; Mansmann U.; Spies C.; Marschall U.; Eckardt-Felmberg
R.; Landgraf I.; Schwantes U.
Institution
(Schaller, Kiselev, Schmidt, Morgeli, Spies) Department of Anesthesiology
and Operative Intensive Care Medicine (CVK/CCM), Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin
and Humboldt-Universitat zu Berlin, Chariteplatz 1, Berlin 10117, Germany
(Loidl, Mansmann) Institute for Medical Information Processing, Biometry,
and Epidemiology - IBE, Ludwig-Maximilians-Universitat Munchen, Munich,
Germany
(Quentin, Rombey, Busse) Department of Health Care Management, Technische
Universitat Berlin, Berlin, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Frailty is expressed by a reduction in physical capacity,
mobility, muscle strength, and endurance. (Pre-)frailty is present in up
to 42% of the older surgical population, with an increased risk for peri-
and postoperative complications. Consequently, these patients often suffer
from a delayed or limited recovery, loss of autonomy and quality of life,
and a decrease in functional and cognitive capacities. Since frailty is
modifiable, prehabilitation may improve the physiological reserves of
patients and reduce the care dependency 12 months after surgery.
 Method(s): Patients >= 70 years old scheduled for elective surgery or
intervention will be recruited in this multicenter, randomized controlled
study, with a target of 1400 participants with an allocation ratio of 1:1.
The intervention consists of (1) a shared decision-making process with the
patient, relatives, and an interdisciplinary and interprofessional team
and (2) a 3-week multimodal, individualized prehabilitation program
including exercise therapy, nutritional intervention, mobility or balance
training, and psychosocial interventions and medical assessment. The
frequency of the supervised prehabilitation is 5 times/week for 3 weeks.
The primary endpoint is defined as the level of care dependency 12 months
after surgery or intervention. Discussion(s): Prehabilitation has
been proven to be effective for different populations, including
colorectal, transplant, and cardiac surgery patients. In contrast,
evidence for prehabilitation in older, frail patients has not been clearly
established. To the best of our knowledge, this is currently the largest
prehabilitation study on older people with frailty undergoing general
elective surgery. Trial registration: ClinicalTrials.gov NCT04418271.
Registered on 5 June 2020. Universal Trial Number (UTN):
U1111-1253-4820 Copyright © 2022, The Author(s).

<17>
Accession Number
2026169273
Title
Comparative study between sugammedex and neostigmine as a reversal agent
of rocuronium for pediatric patients 2-12 years old going for surgery
under general anaesthesia.
Source
Cardiometry. (27) (pp 181-193), 2023. Date of Publication: May 2023.
Author
Abed H.E.A.; Abdelaziz A.M.R.
Institution
(Abed) Mediclinic Al Jowhara Hospital, United Arab Emirates
(Abed) Razi St - Shakhboot Bin Sultan St - Al Jimi, Abu Dhabi, United Arab
Emirates
(Abdelaziz) Al Jalila Children's Speciality Hospital, Dubai, United Arab
Emirates
(Abdelaziz) Al Jaddaf, Dubai, United Arab Emirates
Publisher
Novyi Russkii Universitet
Abstract
Aim. The neuromuscular blocker has long been used during surgical
procedures. The neuromuscular blockade produced by rocuronium can be
reversed with sugammadex and neostigmine as reversal agents. This
systematic review aims to determine the impact of sugammadex and
neostigmine comparison as a reversal agent of rocuronium for pediatric
patients 2-12 years old going for surgery under general anesthesia.
Materials and Methods. This review examined recent studies assessing the
impact of sugammadex and neostigmine comparison as a reversal agent of
rocuronium for pediatric patients 2-12 years old going for surgery under
general anesthesia. Data were searched from Google Scholar, PubMed,
Hindawi, Anesthesiology, MEDLINE, and CENTRAL using keywords' General
Anesthesia,' 'Reversal Agent,' 'Rocuronium for Pediatric Patients,'
'Neuromuscular Blockers,' 'Sugammadex and Neostigmine,' 'Role of
Analgesics.' The review followed PRISMA guidelines. Results. The initial
search for publications comparing sugammadex and neostigmine as a reversal
agent of rocuronium for pediatric patients yielded 9000 papers, from which
600 were selected. The reviews' articles were further analyzed to ensure
they were pertinent to the Comparative Impact of Reversal Agents
(Sugammadex And Neostigmine) of Rocuronium for Pediatric Patients. Around
319 references were examined for their potential applicability to the
medical field of anesthesia. A total of 15 articles were included, with
preference given to those published from 2014 to 2023 during the last ten
years. Conclusion. The particular relaxant-binding medication promptly and
successfully alleviates rocuronium-induced neuromuscular blockade in
pediatric surgery patients. Considering the study's outcomes, it can be
concluded that sugammadex may restore any level of steroidal muscle
relaxant-induced neuromuscular block faster than
neostigmine. Copyright © 2023 Novyi Russkii Universitet. All
rights reserved.

<18>
Accession Number
2024700324
Title
Endovascular Repair of Popliteal Artery Injury Post-total Knee
Arthroplasty is Safe and Effective: A Case Report and Systematic Review of
the Literature.
Source
Annals of Vascular Surgery. 94 (pp 263-271), 2023. Date of Publication:
August 2023.
Author
Melian C.M.; Giannopoulos S.; Tsouknidas I.; Volteas P.; Virvilis D.;
Nicholson J.; Koullias G.J.
Institution
(Melian) Renaissance School of Medicine at Stony Brook University, Stony
Brook, NY, United States
(Giannopoulos, Volteas, Virvilis, Koullias) Division of Vascular and
Endovascular Surgery, Department of Surgery, Stony Brook University
Hospital, Stony Brook, NY, United States
(Giannopoulos, Volteas, Virvilis, Koullias) Limb Preservation Center,
Division of Vascular and Endovascular Surgery, Stony Brook University
Hospital, Stony Brook, NY, United States
(Tsouknidas) Department of Surgery, Stony Brook University Hospital, Stony
Brook, NY, United States
(Nicholson) Department of Orthopaedic Surgery, Stony Brook University
Hospital, Stony Brook, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Popliteal artery pseudoaneurysms are a rare but serious
complication following total knee arthroplasty that have been
traditionally managed with open surgical repair. Endovascular stenting,
while relatively new, offers a promising alternative that is less invasive
and may reduce the risk of perioperative complications. Method(s): A
systematic literature review was conducted, and all clinical reports in
the English language from inception to July 2022 were identified.
References were manually reviewed to identify additional studies.
Demographics, procedural techniques, postprocedural complications, and
followup data were extracted and analyzed using STATA 14.1. Additionally,
we present a case of a patient with a popliteal pseudoaneurysm treated
with a covered endovascular stent. Result(s): A total of 14 studies
(12 case reports, 2 case series; n = 17) were included for review. In all
cases, a stent-graft was placed across the popliteal artery lesion. In 5
out of 11 cases, popliteal artery thrombus was present and treated with
adjacent modalities (i.e., mechanical thrombectomy, balloon angioplasty,
etc.). Procedure success was reported in all cases without perioperative
adverse events. Stents remained patent over a median followup of 32 weeks
(interquartile range: 36). In all but one case, the patients experienced
immediate symptom relief and had an uneventful recovery. For our case, at
the 12-month followup the patient was asymptomatic, and ultrasound
demonstrated vessel patency. Conclusion(s): Endovascular stenting is
a safe and effective treatment for popliteal pseudoaneurysms. Future
studies should be aimed at evaluating the long-term outcomes of such
minimally invasive techniques. Copyright © 2023

<19>
Accession Number
2023479655
Title
The anatomy of the atrioventricular nodal artery: A meta-analysis with
implications for cardiothoracic surgery and ablation procedures.
Source
Clinical Anatomy. 36(6) (pp 951-957), 2023. Date of Publication: September
2023.
Author
Kuniewicz M.; Ostrowski P.; Bonczar M.; Kwiecinska M.; Mozdzen K.;
Murawska A.; Dziedzic M.; Zytkowski A.; Goncerz G.; Walocha J.; Koziej M.
Institution
(Kuniewicz, Ostrowski, Bonczar, Kwiecinska, Mozdzen, Murawska, Dziedzic,
Goncerz, Walocha, Koziej) Department of Anatomy, Jagiellonian University
Medical College, Krakow, Poland
(Ostrowski, Bonczar, Dziedzic, Walocha, Koziej) Youthoria, Youth Research
Organization, Krakow, Poland
(Zytkowski) Faculty of Philology, Department of Polish Dialectology and
Logopaedics, University of Lodz, Lodz, Poland
(Zytkowski) Norbert Barlicki Memorial Teaching Hospital No. 1 of the
Medical University of Lodz, Lodz, Poland
Publisher
John Wiley and Sons Inc
Abstract
The objective of the present meta-analysis was to evaluate recent and
applicable data regarding the location and variation of the
atrioventricular nodal artery (AVNA) in relation to adjacent structures.
In order to minimize postoperative risks and maintain physiological
anastomosis for proper cardiac function, understanding such possible
variations of vascularization of the AV node is of immense importance
prior to cardiothoracic surgery as well as ablations. In order to perform
this meta-analysis, a systematic search was conducted in which all
articles regarding, or at least mentioning, the anatomy of the AVNA was
searched. In general, the results were based on 3919 patients. AVNA was
found to originate only from the RCA in 82.41% (95% CI: 79.46%-85.18%).
The pooled prevalence of AVNA originating only from LCA was found to be
15.25% (95% CI: 12.71%-17.97%). The mean length of AVNA was found to be
22.64 mm (SE = 1.60). The mean maximal diameter of AVNA at its origin was
found to be 1.40 mm (SE = 0.14). In conclusion, we believe that this is
the most accurate and up-to-date study regarding the highly variable
anatomy of the AVNA. The AVNA was found to originate most commonly from
the RCA (82.41%). Furthermore, the AVNA was found to most commonly have no
(52.46%) or only one branch (33.74%). It is hoped that the results of the
present meta-analysis will be helpful for physicians performing
cardiothoracic or ablation procedures. Copyright © 2023 American
Association of Clinical Anatomists and British Association of Clinical
Anatomists.

<20>
Accession Number
2013746467
Title
Treatment and Prophylaxis of Post-pericardiotomy Syndrome in Cardiac
Surgery Patients: a Systematic Review.
Source
Cardiovascular Drugs and Therapy. 37(4) (pp 771-779), 2023. Date of
Publication: August 2023.
Author
Giacinto O.; Minati A.; Lusini M.; Cardetta F.; Saltarocchi S.; D'Abramo
M.; Miraldi F.; Chello M.
Institution
(Giacinto, Lusini, Cardetta, Chello) Department of Cardiovascular Surgery,
University Campus Bio-Medico, Rome, Italy
(Minati, Saltarocchi, D'Abramo, Miraldi) Department of Clinical, Internal
Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University
of Rome, Rome, Italy
Publisher
Springer
Abstract
Purpose: Post-pericardiotomy syndrome (PPS) is a common complication of
cardiac surgery. This systematic review aimed to investigate the efficacy
of colchicine, indomethacin, and dexamethasone in the treatment and
prophylaxis of PPS. Method(s): Literature research was carried out
using PubMed. Studies investigating >= 10 patients with clinically PPS
treated with colchicine, dexamethasone, and indomethacin and compared with
placebo were included. Animal or in vitro experiments, studies on < 10
patients, case reports, congress reports, and review articles were
excluded. Cochrane risk-of-bias tool for randomized trials (RoB2) was used
for the quality assessment of studies. Result(s): Seven studies were
included. Among studies with postoperative colchicine treatment, two of
them demonstrated a significant reduction of PPS. In the single
pre-surgery colchicine administration study, a decrease of PPS cases was
registered. Indomethacin pre-surgery administration was linked to a
reduction of PPS. No significant result emerged with preoperative
dexamethasone intake. Conclusion(s): Better outcomes have been
registered when colchicine and indomethacin were administered as primary
prophylactic agents in preventing PPS and PE. Further RCT studies are
needed to confirm these results. Copyright © 2021, The Author(s).

<21>
Accession Number
2026325983
Title
Efficacy of Incisional Ropivacaine Infiltration by Presternal
Multi-Orifice Catheter for Post-sternotomy Pain Relief in Pediatric
Patients Undergoing Cardiac Surgery: A Prospective, Randomized, Controlled
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Das D.; Chauhan S.; Gayatri S.; Chaudhury M.; Makhija N.; Bisoi A.K.
Institution
(Das, Chauhan, Chaudhury, Makhija) Department of Cardiac Anesthesia and
Critical Care, Cardiothoracic Centre, AIIMS, New Delhi, India
(Gayatri, Bisoi) Department of Cardiothoracic and Vascular Surgery,
Cardiothoracic Centre, AIIMS, New Delhi, India
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the efficacy of incisional ropivacaine infiltration
by presternal multi-orifice catheter to manage poststernotomy pain in
pediatric cardiac surgery. Design(s): A prospective, randomized, and
double-blind comparative study. Setting(s): At a single-institution
tertiary referral cardiac center. Participant(s): The study comprised
200 children undergoing cardiac surgeries through a midline sternotomy.
 Intervention(s): Children were allocated randomly to 1 of 3 groups.
Group A (n = 65) and group B (n = 64) received 0.375% ropivacaine infusion
and intermittent bolus, respectively, by presternal multi-orifice
catheter, whereas Group C (n = 64) did not receive any local anesthetic
(LA) drug. Postoperatively, intravenous paracetamol was used for
multimodal analgesia, and fentanyl was given as rescue analgesia,
respectively. Measurements and Main Results: Pain was assessed by a
Modified Objective Pain Score (MOPS) for 48 hours postextubation. Group B
had significantly lower early MOPS at the first hour, but in the later
period, the mean MOPS was lower in group A. The requirement of the first
rescue analgesia was 3 +/- 1.51, 6.1 +/- 2.26, and 2.6 +/- 0.87 hours for
groups A (n = 60), B (n = 60), and C (n = 60), respectively. The 48-hour
fentanyl consumption was significantly lower (p < 0.001) in group A (0.5
+/- 0.68 microg/kg) and group B (0.7 +/- 0.86 microg/kg) than the control
group (3.4 +/- 0.68 microg/kg). The length of intensive care unit stay was
lower (p < 0.001) in groups A and B than in group C; however, the length
of hospital stay was comparable (p = 0.07). Conclusion(s): LA bolus
and infusion through presternal multi-orifice catheter provided effective
analgesia postoperatively. However, the bolus was more efficacious in the
early phase but equivalent in later periods. Therefore, bolus and LA
infusion can be used for steady poststernotomy pain relief in children
undergoing cardiac surgeries. Copyright © 2023 Elsevier Inc.

<22>
Accession Number
2024855915
Title
Targeted ablation of epicardial ganglionated plexi during cardiac surgery
with pulsed field electroporation (NEURAL AF).
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2023. Date of Publication: 2023.
Author
Musikantow D.R.; Reddy V.Y.; Skalsky I.; Shaburishvili T.; van Zyl M.;
O'Brien B.; Coffey K.; Reilly J.; Neuzil P.; Asirvatham S.; de Groot J.R.
Institution
(Musikantow, Reddy) Helmsley Electrophysiology Center, Icahn School of
Medicine at Mount Sinai, Box 1030, One Gustave L. Levy Place, New York, NY
10029, United States
(Reddy, Skalsky, Neuzil) Homolka Hospital, Prague, Czechia
(Shaburishvili) Tbilisi Heart and Vascular Clinic, Tbilisi, Georgia
(van Zyl) Royal Jubilee Hospital, Victoria, BC, Canada
(O'Brien, Coffey, Reilly) AtriAN Medical, Galway, Ireland
(Asirvatham) Mayo Clinic, Rochester, MN, United States
(de Groot) University Medical Center, Amsterdam, Netherlands
Publisher
Springer
Abstract
Background: Modulation of the cardiac autonomic nervous system (ANS) is a
promising adjuvant therapy in the treatment of atrial fibrillation (AF).
In pre-clinical models, pulsed field (PF) energy has the advantage of
selectively ablating the epicardial ganglionated plexi (GP) that govern
the ANS. This study aims to demonstrate the feasibility and safety of
epicardial ablation of the GPs with PF during cardiac surgery with a
primary efficacy outcome of prolongation of the atrial effective
refractory period (AERP). Method(s): In a single-arm, prospective
analysis, patients with or without a history of AF underwent epicardial GP
ablation with PF during coronary artery bypass grafting (CABG). AERP was
determined immediately pre- and post- GP ablation to assess cardiac ANS
function. Holter monitors were performed to determine rhythm status and
heart rate variability (HRV) at baseline and at 1-month post-procedure.
 Result(s): Of 24 patients, 23 (96%) received the full ablation
protocol. No device-related adverse effects were noted. GP ablation
resulted in a 20.7 +/- 19.9% extension in AERP (P < 0.001). Post-operative
AF was observed in 7 (29%) patients. Holter monitoring demonstrated an
increase in mean heart rate (74.0 +/- 8.7 vs. 80.6 +/- 12.3, P = 0.01).
There were no significant changes in HRV. There were no study-related
complications. Conclusion(s): This study demonstrates the safety and
feasibility of epicardial ablation of the GP using PF to modulate the ANS
during cardiac surgery. Large, randomized analyses are necessary to
determine whether epicardial PF ablation can offer a meaningful impact on
the cardiac ANS and reduce AF. Trial registration: Clinical trial
registration: NCT04775264. Copyright © 2023, The Author(s).

<23>
Accession Number
2024852877
Title
Viscoelastic testing: Critical appraisal of new methodologies and current
literature.
Source
International Journal of Laboratory Hematology. (no pagination), 2023.
Date of Publication: 2023.
Author
Wool G.D.; Carll T.
Institution
(Wool, Carll) Department of Pathology, University of Chicago, Chicago, IL,
United States
Publisher
John Wiley and Sons Inc
Abstract
United States Food and Drug Administration (FDA)-approved viscoelastic
testing (VET) methodologies have significantly changed in the last 10
years, with the availability of cartridge-based VET. Some of these
cartridge-based methodologies use harmonic resonance-based clot detection.
While VET has always allowed for the evaluation of real-time clot
formation, cartridge-based VET provides increased ease of use as well as
greater portability and robustness of results in out-of-laboratory
environments. Here we review the use of VET in a variety of clinical
contexts, including cardiac surgery, trauma, liver transplant, obstetrics,
and hypercoagulable states such as COVID-19. As of now, high quality
randomized trial evidence for new generation VET (TEG 6s, HemoSonics
Quantra, ROTEM sigma) is limited. Nevertheless, the use of VET-guided
transfusion algorithms appears to result in reduced blood usage without
worsening of patient outcomes. Future work comparing the new generation
VET instruments and continuing to validate clinically important cut-offs
will help move the field of point-of-care coagulation monitoring forward
and increase the quality of transfusion management in bleeding
patients. Copyright © 2023 The Authors. International Journal of
Laboratory Hematology published by John Wiley & Sons Ltd.

<24>
Accession Number
2026377808
Title
3-Year Outcome in Patients With Combined Precapillary and Postcapillary
Pulmonary Hypertension: Results From PADN-5 Trial.
Source
JACC: Heart Failure. Part 2. 11(8) (pp 1135-1146), 2023. Date of
Publication: August 2023.
Author
Zhang H.; Kan J.; Zhang J.; Xie D.; Li X.; Zhou W.; Dong J.; Gu H.; Han
Y.; Chen S.-L.
Institution
(Zhang, Kan, Zhang, Zhou, Chen) Division of Cardiology, Nanjing First
Hospital, Nanjing Medical University, Nanjing, China
(Xie, Li) Division of Cardiology, Nanjing Cardiovascular Hospital,
Nanjing, China
(Dong, Gu) Division of Pulmonology, Anzhen Hospital, Capital Medical
University, Beijing, China
(Han) Division of Cardiology, Shenyang Northern Hospital, Shenyang, China
Publisher
Elsevier Inc.
Abstract
Background: Long-term benefits of pulmonary artery denervation (PADN) for
patients with combined precapillary and postcapillary pulmonary
hypertension (CpcPH) secondary to left heart failure are unknown.
 Objective(s): The authors sought to report the 3-year clinical
results of PADN for patients with CpcPH. Method(s): A total of 98
patients with CpcPH, defined as having mean pulmonary arterial pressure of
>=25 mm Hg, pulmonary capillary wedge pressure of >15 mm Hg, and pulmonary
vascular resistance of >3.0 WU, were randomly assigned to receive the sham
+ sildenafil or PADN. The primary endpoint was the occurrence of clinical
worsening defined as cardiopulmonary death, rehospitalization or
heart/lung transplantation at 3-year follow-up. Changes in the 6-minute
walk distance and N-terminal pro-B-type natriuretic peptide served as
secondary points. Result(s): At the 3-year follow-up, clinical
worsening was reported in 49 (50.0%) patients, with 31 (62.0%) in the sham
+ sildenafil group and 18 (37.5%) in the PADN group (HR: 2.13 [95% CI:
1.19-3.81]; P = 0.011), largely driven by a higher rate of
rehospitalization in the sham + sildenafil group (56.2% vs 35.4%; HR: 1.96
[95% CI: 1.07-3.58]; P = 0.029) by Cox proportional hazards regression. At
the end of the study, cardiopulmonary-related deaths occurred in 16
(32.0%) patients in the sham and 9 (18.8%) (P = 0.167) patients in the
PADN group. PADN also resulted in a more profound increase in the 6-minute
walk distance and reduction in N-terminal pro-B-type natriuretic peptide.
 Conclusion(s): PADN is associated with significant improvements in
exercise capacity, cardiac function, and clinical outcomes. Further study
without approved drugs for pulmonary arterial hypertension is required to
confirm the benefits of PADN for patients with CpcPH. (Pulmonary Arterial
Denervation in Patients With Pulmonary Hypertension Associated With the
Left Heart Failure [PADN-5]; NCT02220335) Copyright © 2023
American College of Cardiology Foundation

<25>
Accession Number
2026358908
Title
Percutaneous Left Atrial Appendage Occlusion Therapy: Evolution and
Growing Evidence.
Source
Reviews in Cardiovascular Medicine. 24(7) (no pagination), 2023. Article
Number: 211. Date of Publication: July 2023.
Author
Han X.; Benditt D.G.
Institution
(Han) Cardiology Division of Reid Health, Indiana University School of
Medicine, Richmond, IN 47374, United States
(Benditt) Cardiac Arrhythmia Center, Cardiovascular Division, Department
of Medicine, University of Minnesota Medical School, Minneapolis, MN
55455, United States
Publisher
IMR Press Limited
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia and if
untreated, significantly increases both the risk of intracardiac thrombus
formation and ischemic stroke. In patients with nonvalvular AF (NVAF), the
left atrial appendage (LAA) has been estimated to be the source of
thrombus development in 91% to 99% of cases. Consequently, oral
anticoagulation (OAC) to provide stroke prevention has become the standard
of care for most AF patients; however, OACs are associated with a risk of
bleeding and their efficacy depends on optimal patient compliance. In
terms of alternative approaches to preventing embolic events, surgical LAA
excision was attempted as early as in the late 1940s in patients with
valvular AF; LAA excision remains a recommendation in surgical guidelines
for NVAF patients who need open-heart coronary bypass or valvular
replacement/repair surgeries. However, due to its invasive nature surgical
LAA intervention has limited clinical application in present cardiology
practice. Percutaneous LAA occlusion (LAAO) is increasingly being
performed as an alternative to OAC for stroke prevention; this is
particularly the case in patients at increased bleeding risk. Substantial
progress has been made in percutaneous LAAO therapy since its inception
some twenty years ago. Herein we systematically review both the critical
literature that led to the development of LAAO, and the increasing
clinical evidence supporting the application of this treatment strategy in
NVAF. To this end we focus on recently published critical evaluations of
United States Food and Drug Administration (US FDA) and Conformite
Europeenne (Commercial Sale of Licensed Product in the EU) (CE-Mark)
approved LAAO devices, summarize the current status of LAAO therapy, and
discuss the future perspectives regarding the knowledge and technology
gaps in this area by recognizing the potential contributions of many
ongoing but likely transformative clinical trials. Copyright ©
2023 The Author(s). Published by IMR Press.

<26>
Accession Number
2026245728
Title
More Than 50 Percent Reduction in LDL Cholesterol in Patients With Target
LDL <70 mg/dL After a Stroke.
Source
Stroke. 54(8) (pp 1993-2001), 2023. Date of Publication: 01 Aug 2023.
Author
Amarenco P.; Lavallee P.C.; Kim J.S.; Labreuche J.; Charles H.; Giroud M.;
Lee B.-C.; Mahagne M.-H.; Meseguer E.; Nighoghossian N.; Steg P.G.; Vicaut
E.; Bruckert E.
Institution
(Amarenco, Lavallee, Charles, Meseguer) APHP, Department of Neurology and
Stroke Center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of
Paris, France
(Amarenco, Lavallee, Kim, Labreuche, Charles, Giroud, Lee, Mahagne,
Meseguer, Nighoghossian, Steg, Vicaut, Bruckert) Population Health
Research Institute, MacMaster University, Hamilton, ON, Canada
(Kim) Kangneung Asan Hospital, Kangneung, South Korea
(Labreuche) CHU Lille, Department of Biostatistics, Lille F59000, France
(Giroud) Department of Neurology, University Hospital of Dijon, Dijon
Stroke Registry, EA 7460, University of Burgundy, UBFC, France
(Lee) Department of Neurology, Hallym University Sacred Heart Hospital,
Anyang, South Korea
(Mahagne) Stroke Unit, Pasteur Hospital, Nice, France
(Nighoghossian) Hospices Civils de Lyon, Department of Neurology and
Stroke Center, Lyon University, France
(Steg) Universite de Paris, INSERM LVTS-U1148, Paris F-75018, France
(Steg) AP-HP, Hopital Bichat, Paris F-765018, France
(Vicaut) APHP, Department of Biostatistics, Universite Paris-Diderot,
Sorbonne-Paris Cite, Fernand Widal Hospital, France
(Bruckert) APHP, Department of Endocrinology, Pitie-Salpetriere Hospital,
Sorbonne University, Paris, France
Publisher
Wolters Kluwer Health
Abstract
Background: Whether a strategy to target an LDL (low-density lipoprotein)
cholesterol <70 mg/dL is more effective when LDL is reduced >50% from
baseline rather than <50% from baseline has not been investigated.
 Method(s): The Treat Stroke to Target trial was conducted in France
and South Korea in 61 sites between March 2010 and December 2018. Patients
with ischemic stroke in the previous 3 months or transient ischemic attack
within the previous 15 days and evidence of cerebrovascular or coronary
artery atherosclerosis were randomly assigned to a target LDL cholesterol
of <70 mg/dL or 100+/-10 mg/dL, using statin and/or ezetimibe as needed.
We used the results of repeated LDL measurements (median, 5 [2-6] per
patient) during 3.9 years (interquartile range, 2.1-6.8) of follow-up. The
primary outcome was the composite of ischemic stroke, myocardial
infarction, new symptoms requiring urgent coronary or carotid
revascularization, and vascular death. Cox regression model including
lipid-lowering therapy as a time-varying variable, after adjustment for
randomization strategy, age, sex, index event (stroke or transient
ischemic attack), and time since the index event. Result(s): Among
2860 patients enrolled, patients in the lower target group who had >50%
LDL cholesterol reduction from baseline during the trial had a higher
baseline LDL cholesterol and a lower LDL cholesterol achieved as compared
to patients who had <50% LDL cholesterol reduction (155+/-32 and 62 mg/dL
versus 121+/-34 and 74 mg/dL, respectively, P<0.001 for both). In the <70
mg/dL target group, patients with >50% LDL reduction had a significant
reduction in the primary outcome as compared to the higher target group
(hazard ratio, 0.61 [95% CI, 0.43-0.88]; P=0.007) and patients with <50%
LDL reduction from baseline had little reduction (hazard ratio, 0.96 [95%
CI, 0.73-1.26]; P=0.75). Conclusion(s): In this post hoc analysis of
the TST trial, targeting an LDL cholesterol of <70 mg/dL reduced the risk
of primary outcome compared with 100+/-10 mg/dL provided LDL cholesterol
reduction from baseline was superior to 50%, thereby suggesting that the
magnitude of LDL cholesterol reduction was as important to consider as the
target level to achieve. Copyright © 2023 American Heart
Association, Inc.

<27>
Accession Number
2025255544
Title
Tricuspid Regurgitation and Mortality in Patients Undergoing Transcatheter
Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Arquivos Brasileiros de Cardiologia. 120(7) (no pagination), 2023. Article
Number: e20220319. Date of Publication: 2023.
Author
Erbano B.O.; Schio N.A.; Lopes R.D.; Bignoto T.C.; Olandoski M.; da Luz
R.S.B.; de Carvalho G.D.; Erbano L.H.O.; Ramos A.I.O.; Feres F.; Faria
Neto J.R.; Baena C.P.; Siqueira D.A.A.
Institution
(Erbano, Feres) Programa de Pos-Graduacao, Instituto Dante Pazzanese de
Cardiologia associado a Universidade de Sao Paulo, SP, Sao Paulo, Brazil
(Schio, Olandoski, Erbano, Faria Neto, Baena) Pontificia Universidade
Catolica do Parana, PR, Curitiba, Brazil
(Lopes) Duke University Hospital, Durham, NC, United States
(Bignoto, da Luz, de Carvalho, Ramos, Siqueira) Instituto Dante Pazzanese
de Cardiologia, SP, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: The extent of cardiac damage associated with aortic stenosis
has important prognostic implications after transcatheter aortic valve
replacement (TAVR). However, the role of tricuspid regurgitation (TR) in
this clinical setting is still unclear. Objective(s): To explore the
association between TR and mortality in patients undergoing TAVR and
assess changes in TR severity post TAVR and its relationship with short
and mid-term mortality. Method(s): Relevant databases were searched
for articles published from inception until August 2020. Out of 414
screened studies, we selected 24 that reported the degree of TR pre or
post TAVR. The primary outcome was all-cause mortality, and random effects
meta-analysis models were conducted (at a significance level of 5%).
 Result(s): Seventeen studies reported associations between pre-TAVR
TR and all-cause mortality (> 45,000 participants) and thirteen accessed
TR severity post TAVR (709 participants). Moderate/severe baseline TR was
associated to higher all-cause mortality both at 30 days (HR 1.65; 95% CI,
1.20-2.29) and 1.2 years (HR 1.56; 95% CI, 1.31-1.84). After TAVR, 43% of
patients presented a decrease of at least one grade in TR (30 days, 95%
CI, 30-56%), sustained at 12.5 months in 44% of participants (95% CI,
35-52%). Persistence of significant TR was associated with a two-fold
increase in all-cause mortality (HR 2.12; 95% CI, 1.53-2.92).
 Conclusion(s): Significant TR pre TAVR is associated with higher
mortality. Although TR severity may improve, the persistence of
significant TR post TAVR is strongly associated with increased mortality.
Our findings highlight the importance of a detailed assessment of TR pre
and post TAVR and might help identify patients who may benefit from more
careful surveillance in this scenario. Copyright © 2023,
Sociedade Brasileira de Cardiologia. All rights reserved.

<28>
Accession Number
2024860243
Title
Non-Invasive Assessment of the Intraventricular Pressure Using Novel Color
M-Mode Echocardiography in Animal Studies: Current Status and Future
Perspectives in Veterinary Medicine.
Source
Animals. 13(15) (no pagination), 2023. Article Number: 2452. Date of
Publication: August 2023.
Author
Mandour A.S.; Farag A.; Helal M.A.Y.; El-Masry G.; Al-Rejaie S.; Takahashi
K.; Yoshida T.; Hamabe L.; Tanaka R.
Institution
(Mandour) Department of Animal Medicine (Internal Medicine), Faculty of
Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
(Mandour, Farag, Helal, Hamabe, Tanaka) Veterinary Surgery, Tokyo
University of Agriculture and Technology, Tokyo 183-0054, Japan
(Farag) Department of Surgery, Anesthesiology, and Radiology, Faculty of
Veterinary Medicine, Zagazig University, Zagazig 44519, Egypt
(Helal) Animal Medicine Department, Faculty of Veterinary Medicine, Benha
University, Benha, Moshtohor 13736, Egypt
(El-Masry) Agricultural Engineering Department, Faculty of Agriculture,
Suez Canal University, Ismailia 41522, Egypt
(Al-Rejaie) Department of Pharmacology & Toxicology, College of Pharmacy,
King Saud University, Riyadh 11564, Saudi Arabia
(Takahashi) Department of Pediatrics and Adolescent Medicine, Juntendo
University Graduate School of Medicine, Bunkyo, Tokyo 113-8421, Japan
(Yoshida) Department of Veterinary Surgery, Division of Veterinary
Research, Obihiro University of Agriculture and Veterinary Medicine,
Hokkaido 080-8555, Japan
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The assessment of diastolic function has received great interest in order
to comprehend its crucial role in the pathophysiology of heart failure and
for the early identification of cardiac events. Silent changes in the
intraventricular flow (IVF) dynamics occur before the deterioration of the
cardiac wall, although they cannot be detected using conventional
echocardiography. Collective information on left ventricular (LV)
pressures throughout the cardiac cycle has great value when dealing with
patients with altered hemodynamics. Accurate pressure measurement inside
the ventricle can be obtained by invasive methods to determine the LV
diastolic pressures, which reflect the myocardial relaxation and
compliance. However, catheterization is only feasible in the laboratory
setting and is not suitable for clinical use due to its disadvantages. In
contrast, echocardiography is simple, safe, and accessible. Color M-mode
echocardiography (CMME) is an advanced cardiac evaluation technique that
can measure the intraventricular pressure differences (IVPDs) and
intraventricular pressure gradients (IVPGs) based on the Doppler shift of
the IVF. Recently, the assessment of IVPD and IVPG has gained growing
interest in the cardiovascular literature in both animal and human studies
as a non-invasive method for the early diagnosis of cardiac dysfunctions,
especially diastolic ones. The usability of IVPD and IVPG has been
reported in various surgically induced heart failure or pharmacologically
altered cardiac functions in rats, dogs, cats, and goats. This report aims
to give an overview of the current studies of CMME-derived IVPD and IVPG
in animal studies and its feasibility for clinical application in
veterinary practice and to provide the prospects of the technique's
ability to improve our understanding. Copyright © 2023 by the
authors.

<29>
Accession Number
2023957416
Title
3-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement
in Low-Risk Patients With Aortic Stenosis.
Source
Journal of the American College of Cardiology. 81(17) (pp 1663-1674),
2023. Date of Publication: 02 May 2023.
Author
Forrest J.K.; Deeb G.M.; Yakubov S.J.; Gada H.; Mumtaz M.A.; Ramlawi B.;
Bajwa T.; Teirstein P.S.; DeFrain M.; Muppala M.; Rutkin B.J.; Chawla A.;
Jenson B.; Chetcuti S.J.; Stoler R.C.; Poulin M.-F.; Khabbaz K.; Levack
M.; Goel K.; Tchetche D.; Lam K.Y.; Tonino P.A.L.; Ito S.; Oh J.K.; Huang
J.; Popma J.J.; Kleiman N.; Reardon M.J.; Sorajja P.; Byrne T.; Kirshner
M.; Crouch J.; Coselli J.; Silva G.; Hebeler R.; Stoler R.; Islam A.;
Rousou A.; Bladergroen M.; Fail P.; Netherland D.; Tonino W.A.L.; Sudre
A.; Berthoumieu P.; Khalili H.; Hughes G.C.; Harrison J.K.; De A.; Tsau
P.; van Mieghem N.M.; Larbalestier R.; Yong G.; Agarwal S.; Martin W.;
Park S.; Reardon M.; Mohammadi S.; Rodes-Cabau J.; Sparling J.; Elkins
C.C.; Ganzel B.; Matthews R.V.; Starnes V.A.; Ando K.; Chevalier B.; Farge
A.; Combs W.; Bagur R.; Chu M.; Fontana G.; Dev V.; Leya F.; Tuchek J.M.;
Inglessis I.; Jassar A.; Piazza N.; Lacappelle K.; Steinberg D.; Katz M.;
Wang J.; Kozina J.; Slachman F.; Merritt R.; Jensen B.; Alvarez J.; Gooley
R.; Smith J.; Ibrahim R.; Cartier R.; Rovin J.; Fujita T.; Rutkin B.;
Yakubov S.; Song H.; Zahr F.; Miyagawa S.; Rajagopal V.; Kauten J.; Mumtaz
M.; Bhindi R.; Brady P.; Batra S.; Davis T.; Iskander A.; Heimansohn D.;
Hermiller J.; Takamisawa I.; Haldis T.; Yamazaki S.; Teirstein P.; Tada
N.; Saito S.; Merhi W.; Leung S.; Muller D.; Heijmen R.; Petrossian G.;
Robinson N.; Knight P.; Ling F.; Radhakrishnan S.; Fremes S.; Lehr E.;
Gafoor S.; Noel T.; Walton A.; Resar J.; Adams D.; Sharma S.; Lilly S.;
Tadros P.; Zorn G.; Dauerman H.; Ittleman F.; Horlick E.; Feindel C.; Welt
F.; Sharma V.; Markowitz A.; Carroll J.; Fullerton D.; Griffith B.; Gupta
A.; de Marchena E.; Salerno T.; Chetcuti S.; Sultan I.; Pasupati S.; Kon
N.; Zhao D.; Forrest J.
Institution
(Forrest) Yale University School of Medicine, New Haven, CT, United States
(Deeb, Chetcuti) University of Michigan Health Systems University
Hospital, Ann Arbor, MI, United States
(Yakubov) OhioHealth Riverside Methodist Hospital, Columbus, OH, United
States
(Gada, Mumtaz) University of Pittsburgh Medical Center, Harrisburg, PA,
United States
(Ramlawi) Lankenau Heart Institute, Philadelphia, PA, United States
(Bajwa) Aurora St Luke's Medical Center, Milwaukee, WI, United States
(Teirstein) Scripps Clinic, La Jolla, CA, United States
(DeFrain, Muppala) HealthPark Medical Center, Fort Myers, FL, United
States
(Rutkin) North Shore University Hospital, Manhasset, NY, United States
(Chawla, Jenson) Mercy Medical Center, Iowa Heart, Des Moines, IA, United
States
(Stoler) Baylor Heart and Vascular Hospital, Dallas, TX, United States
(Poulin, Khabbaz) Beth Israel Deaconess Medical Center, Boston, MA, United
States
(Levack, Goel) Vanderbilt University Medical Center, Nashville, TN, United
States
(Tchetche) Clinique Pasteur, Toulouse, France
(Lam, Tonino) Catharina Ziekenhuis, Eindhoven, Netherlands
(Ito, Oh) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN,
United States
(Huang, Popma) Medtronic, Mounds View, MN, United States
(Kleiman, Reardon) Methodist DeBakey Heart and Vascular Center, Houston,
TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Randomized data comparing outcomes of transcatheter aortic
valve replacement (TAVR) with surgery in low-surgical risk patients at
time points beyond 2 years is limited. This presents an unknown for
physicians striving to educate patients as part of a shared
decision-making process. Objective(s): The authors evaluated 3-year
clinical and echocardiographic outcomes from the Evolut Low Risk trial.
 Method(s): Low-risk patients were randomized to TAVR with a
self-expanding, supra-annular valve or surgery. The primary endpoint of
all-cause mortality or disabling stroke and several secondary endpoints
were assessed at 3 years. Result(s): There were 1,414 attempted
implantations (730 TAVR; 684 surgery). Patients had a mean age of 74 years
and 35% were women. At 3 years, the primary endpoint occurred in 7.4% of
TAVR patients and 10.4% of surgery patients (HR: 0.70; 95% CI: 0.49-1.00;
P = 0.051). The difference between treatment arms for all-cause mortality
or disabling stroke remained broadly consistent over time: -1.8% at year
1; -2.0% at year 2; and -2.9% at year 3. The incidence of mild
paravalvular regurgitation (20.3% TAVR vs 2.5% surgery) and pacemaker
placement (23.2% TAVR vs 9.1% surgery; P < 0.001) were lower in the
surgery group. Rates of moderate or greater paravalvular regurgitation for
both groups were <1% and not significantly different. Patients who
underwent TAVR had significantly improved valve hemodynamics (mean
gradient 9.1 mm Hg TAVR vs 12.1 mm Hg surgery; P < 0.001) at 3 years.
 Conclusion(s): Within the Evolut Low Risk study, TAVR at 3 years
showed durable benefits compared with surgery with respect to all-cause
mortality or disabling stroke. (Medtronic Evolut Transcatheter Aortic
Valve Replacement in Low Risk Patients; NCT02701283) Copyright ©
2023 The Authors

<30>
Accession Number
2024854276
Title
Influence of timing of Levosimendan administration on outcomes in cardiac
surgery.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1213696. Date of Publication: 2023.
Author
Schiefenhovel F.; Berger C.; Penkova L.; Grubitzsch H.; Haller B.; Meyer
A.; Heringlake M.; Sander M.; Erb J.M.; Balzer F.; Treskatsch S.
Institution
(Schiefenhovel) Department of Anaesthesiology and Intensive Care (AINS),
Medical Center Rechts der Isar, School of Medicine, Technical University
of Munich, Munich, Germany
(Schiefenhovel, Haller) Institute for Artificial Intelligence and
Informatics in Medicine (AIIM), Chair of Medical Informatics, Medical
Center Rechts der Isar, School of Medicine, Technical University of
Munich, Munich, Germany
(Schiefenhovel, Balzer) Charite-Universitatsmedizin Berlin, Corporate
Member of Freie Universitat Berlin and Humboldt Universitat zu Berlin,
Institute of Medical Informatics, Berlin, Germany
(Berger, Treskatsch) Department of Anaesthesiology and Intensive Care
Medicine, Charite-Universitatsmedizin Berlin, Corporate Member of Freie
Universitat and Humboldt Universitat zu Berlin, Charite Campus Benjamin
Franklin, Berlin, Germany
(Penkova) Department of Anaesthesiology and Intensive Care Medicine,
Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat
and Humboldt Universitat zu Berlin, Charite Campus Mitte and Charite
Campus Virchow, Berlin, Germany
(Grubitzsch, Meyer) Klinik fur Kardiovaskulare Chirurgie,
Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat
and Humboldt Universitat zu Berlin, Campus Virchow Klinikum, Berlin,
Germany
(Meyer) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Heringlake) Department of Anaesthesia, Heart and Diabetes Center,
Klinikum Karlsburg, Karlsburg, Germany
(Sander) Department of Anaesthesiology, Intensive Care Medicine and Pain
Therapy, University Hospital Giesen UKGM, Justus-Liebig University Giesen,
Giesen, Germany
(Erb) Clinic for Anaesthesiology, Intermediate Care, Prehospital Emergency
Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland
Publisher
Frontiers Media SA
Abstract
Purpose: Though a subgroup analysis has shown improved survival for
patients suffering severely reduced ventricular function undergoing
coronary artery bypass grafting, RCTs were not able to demonstrate overall
beneficial effects of perioperative Levosimendan in cardiac surgery. This
might be due to Levosimendan's pharmacokinetics reaching a steady-state
concentration only 4-8 h after administration. Thus, this study now
analysed the influence of timing of Levosimendan administration on
perioperative outcome in cardiac surgery patients preoperatively
presenting with severely reduced ventricular function and therefore
considered at high-risk for intra- or postoperative low cardiac output
syndrome. We hypothesized that prolonged preoperative Levosimendan
administration ("preconditioning") would reduce mortality. Method(s):
All adult patients undergoing cardiac surgery between 2006 and 2018
perioperatively receiving Levosimendan were included in this
retrospective, observational cohort study (n = 498). Patients were
stratified into 3 groups: Levosimendan started on the day prior to surgery
("preop"), Levosimendan started on the day of surgery ("intraop") or post
ICU admission ("postop"). After propensity score matching (PSM) was
performed, outcomes defined according to proposed standard definitions for
perioperative outcome research were compared between groups.
 Result(s): After PSM, there were no significant differences in
patients' characteristics, comorbidities and type/priority of surgery
between groups. Compared to intraop or postop Levosimendan treatment,
preop treated patients had significantly lower in-hospital-mortality
(preop vs. intraop. vs. postop = 16,7% vs. 33,3% vs. 42,3%), duration of
mechanical ventilation and rate of continuous renal replacement therapy.
 Conclusion(s): Prolonged preoperative treatment with Levosimendan of
cardiac surgery patients preoperatively presenting with severely reduced
left ventricular function might be beneficial in terms of postoperative
outcome. Our results are in line with recent experts' recommendations
concerning the prolonged perioperative use of Levosimendan. We strongly
recommend that future randomized trials include this "preconditioning"
treatment as an experimental arm. Copyright 2023 Schiefenhovel,
Berger, Penkova, Grubitzsch, Haller, Meyer, Heringlake, Sander, Erb,
Balzer and Treskatsch.

<31>
Accession Number
2024845105
Title
Randomized controlled trial of liberal vs. standard fasting instructions
in percutaneous cardiac procedures.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 44.
Date of Publication: December 2023.
Author
Atkinson D.J.; Romeiser J.L.; Almasry I.O.; Tannous H.J.; Parikh P.B.;
Bennett-Guerrero E.
Institution
(Atkinson, Romeiser, Almasry, Tannous, Parikh, Bennett-Guerrero)
Departments of Anesthesiology (DA, JLR, EBG), Medicine/Cardiology (IA,
PP), and Surgery/Cardiothoracic (HT), Stony Brook University Medical
Center, 101 Nicolls Road, Stony Brook, NY 11794, United States
(Romeiser) Department of Public Health and Preventive Medicine, SUNY
Upstate Medical University, Syracuse, NY, United States
Publisher
BioMed Central Ltd
Abstract
Background: Pre-procedural fasting to reduce aspiration risk is usual care
prior to surgery requiring anesthesia. Prolonged fasting, however, can
result in dehydration and may adversely affect patient experience and
outcomes. Previous studies suggest that providing a supplemental beverage
to patients undergoing cardiac and a variety of other surgical procedures
improves patients' subjective assessment of thirst and hunger and
potentially decreases the need for inotrope and vasopressor therapy. Less
is known, however, about the effects of ad libitum clear liquids up to 2 h
prior to surgery. Method(s): Adult patients undergoing transcatheter
aortic valve replacement (TAVR) or arrhythmia ablation were randomized
(1:1) to ad libitum clear liquids up to 2 h prior to their procedure vs.
nil per os (NPO) after midnight (control group, usual care). The primary
endpoint was a composite satisfaction score that included patient-reported
thirst, hunger, headache, nausea, lightheadedness, and anxiousness prior
to surgery. The incidence of case-delay was recorded. Intraoperative
vasopressor administration, changes in creatinine, anti-emetic use, and
hospital length of stay (LOS) were recorded. Safety endpoints including
aspiration were assessed. Result(s): A total of 200 patients were
randomized and 181 patients were included in the final analysis. Overall,
92% of patients were ASA class III or IV and 23% of patients had NYHA
class III or IV symptoms. Groups were well balanced with no significant
differences in age, sex or baseline cardiac or renal disease. The
composite satisfaction score (primary endpoint) was not significantly
different between groups (Ad libitum median = 12, IQR = [6, 17], vs
Standard NPO median = 10, IQR = [5, 15], [95% CI = [-1, 4]). No
significant differences between the two groups were observed in any of the
individual survey questions (thirst, hunger, headache, nausea,
lightheadedness, anxiousness). No significant differences between groups
were observed for intra-operative vasopressor use, changes in creatinine,
rescue anti-emetic use or hospital LOS. There were no case delays
attributed to the intervention. There were no cases of suspected
aspiration. Conclusion(s): No adverse events or case delays were
observed in the ad libitum clears group. No significant benefit, however,
was observed in patient satisfaction or any of the pre-specified secondary
endpoints in patients randomized to ad libitum clear liquids up to 2 h
prior to their procedure. Trial registration: NCT04079543. Copyright
© 2023, BioMed Central Ltd., part of Springer Nature.

<32>
Accession Number
2026250333
Title
Exercise-based cardiac rehabilitation programmers for patients after
transcatheter aortic valve implantation: A systematic review and
meta-analysis.
Source
Medicine (United States). 102(30) (pp E34478), 2023. Date of Publication:
28 Jul 2023.
Author
Li Z.; Song W.; Yang N.; Ding Y.
Institution
(Li, Song, Yang) Department of Rehabilitation Medicine, Beijing Daxing
District People's Hospital, Beijing, China
(Ding) Department of Respiratory and Critical Care Medicine, Beijing
Daxing District People's Hospital, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Currently, transcatheter aortic valve implantation (TAVI) is
presently a recognized treatment modality for patients with severe aortic
stenosis who are often old, disabled, frail, and have low exercise
capacity (ExCap). It is further expected from this therapy to improve
quality of life by improving of the cardio function performance. The aim
of this study is to evaluate the effect of exercise-based cardiac
rehabilitation (CR) on patients after TAVI. Method(s): PubMed,
Embase, Cochrane Library, and Web of Science were searched from inception
to December 10, 2022 for relevant studies that evaluated the effect of CR
on patients after TAVI. The primary outcome was the improvement of
6-minute walked distance and Barthel index score after CR. The secondary
outcomes included other parameters such as SF-12 scale, HADS score, Morse
Fall Scale, Frailty-Index, ExCap, and FIM score. All statistical analyses
were performed using the standard statistical procedures provided in
Review Manager 5.2. Result(s): A total of 12 observational studies
were identified, with 2365 participants. Pooled data indicated that CR
programmers significantly improved the 6-minute walked distance (SMD 0.65;
95% confidence intervals [CI] 0.51-0.79) and Barthel index score (SMD
0.83; 95% CI 0.61-1.06). In addition, compared with admission, patients
experienced significant improvement in SF-12 scale at CR discharge, with a
pooled mean differences (MD) of 2.74 (95% CI 0.86-4.61) in physical
component score and 2.76 (95% CI 0.59-4.93) in mental component score.
Similar results were also observed in ExCap (MD 8.10 W; 95% CI 1.57
W-14.63 W) and FIM score (MD 11.0; 95% CI 6.22-15.78). Conclusion(s):
Our analysis indicated that exercise-based CR programmers had significant
effect on patients after TAVI in improving exercise tolerance and
functional independence. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<33>
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.

<34>
Accession Number
2026164585
Title
Endovascular Graft Suprarenal Bare Metal Stent Separation After
Endovascular Aneurysm Repair: Case Reports and Literature Review.
Source
EJVES Vascular Forum. 60 (pp 28-32), 2023. Date of Publication: January
2023.
Author
van der Krogt J.M.A.; van Erp A.C.; Smorenburg S.P.M.; Willems M.C.M.;
Nederhoed J.H.
Institution
(van der Krogt, van Erp, Smorenburg, Willems, Nederhoed) Department of
Surgery, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
(Smorenburg, Nederhoed) Amsterdam Cardiovascular Sciences, Amsterdam,
Netherlands
Publisher
Elsevier Ltd
Abstract
Objective: Suprarenal bare metal stent separation is a rare complication
after endovascular aneurysm repair. In this report, two new cases of this
type of device failure are presented and the literature is reviewed to
identify similar cases and evaluate associated clinical characteristics.
 Method(s): A literature search was conducted in March 2022 using
PubMed, Embase, and The Cochrane Library, with MeSH terms including aortic
aneurysm, stents, and device failure. Two authors independently selected
studies eligible for inclusion. Result(s): Twelve patients with
endovascular graft suprarenal bare metal stent separation were identified.
Endovascular aneurysm repair (EVAR) devices were implanted between May
1996 and November 2017. Suprarenal bare metal stent separation was
detected after a median duration of five years post-operatively.
 Conclusion(s): Endovascular graft suprarenal bare metal stent
separation demands a high level of awareness. A better understanding of
the involved failure mechanisms and associated risk factors is required to
further optimise EVAR follow up protocols. Copyright © 2023 The
Author(s)

<35>
Accession Number
2026109304
Title
Multi-centre, prospective randomized comparison of three different
substrate ablation strategies for persistent atrial fibrillation.
Source
Europace. 25(5) (no pagination), 2023. Date of Publication: 01 May 2023.
Author
Li K.; Xu C.; Zhu X.; Wang X.; Ye P.; Jiang W.; Wu S.; Xu K.; Li X.; Zheng
Q.; Wang Y.; Leng L.; Zhang Z.; Han B.; Zhang Y.; Qin M.; Liu X.
Institution
(Li, Xu, Jiang, Wu, Xu, Zhang, Qin, Liu) Department of Cardiology,
Shanghai Chest Hospital, Shanghai Jiao Tong University, No.241 West
Huaihai Road, Shanghai 200030, China
(Zhu) Department of Clinical Integration of Traditional Chinese and
Western medicine, First Clinical Medical College, Shandong University of
Traditional Chinese Medicine, Jinan, China
(Wang) Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Ye) Department of Cardiology, The Central Hospital of Wuhan, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
(Li) Department of Cardiology, Affiliated Hospital of Jining Medical
University, Jining, China
(Wang) Department of Cardiology, Second Affiliated Hospital, Shandong
University of Traditional Chinese Medicine, Jinan, China
(Zheng) Department of Cardiology, Yuhuan Second People's Hospital, Yuhuan,
China
(Wang) Department of Cardiology, Changshu Hospital of Traditional Chinese
Medicine, Changshu, China
(Leng) Department of Cardiology, The PLA Navy Anqing Hospital, Anqing,
China
(Zhang) Department of Cardiology, Jinan City People's Hospital, Jinan,
China
(Han) Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China
Publisher
Oxford University Press
Abstract
Aims The optimal strategy for persistent atrial fibrillation (PerAF) is
poorly defined. We conducted a multicentre, randomized, prospective trial
to compare the outcomes of different ablation strategies for PerAF.
Methods We enrolled 450 patients and randomly assigned them in a 1:1:1
ratio to undergo pulmonary vein isolation and subsequently and results
undergo the following three different ablation strategies: anatomical
guided ablation (ANAT group, n = 150), electrogram guided ablation (EGM
group, n = 150), and extensive electro-anatomical guided ablation (EXT
group, n = 150). The primary endpoint was freedom from atrial fibrillation
(AF) lasting longer than 30 s at 12 months after a single ablation
procedure. After 12 months of follow-up, 72% (108) of patients in the EXT
group were free from AF recurrence, as compared with the 64% (96) in the
EGM group (P = 0.116), and 54% (81) in the ANAT group (P = 0.002). The EXT
group showed less AF/atrial tachycardia recurrence than the EGM group (60%
vs. 50%, P = 0.064) and the ANAT group (60% vs. 37.3%, P < 0.001). The EXT
group showed the highest rate of AF termination (66.7%), followed by 56.7%
in the EGM group, and 20.7% in the ANAT group. The AF termination
signified less AF recurrence at 12 months compared to patients without AF
termination (30.1% vs. 42.7%, P = 0.008). Safety endpoints did not differ
significantly between the three groups (P = 0.924). Conclusions
Electro-anatomical guided ablation achieved the most favourable outcomes
among the three ablation strategies. The AF termination is a reliable
ablation endpoint. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<36>
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.

<37>
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.

<38>
Accession Number
2025508446
Title
A randomized, double-blind, placebocontrolled pilot trial of low-intensity
pulsed ultrasound therapy for refractory angina pectoris.
Source
PLoS ONE. 18(6 JUNE) (no pagination), 2023. Article Number: e0287714. Date
of Publication: June 2023.
Author
Shindo T.; Ito K.; Ogata T.; Kurosawa R.; Eguchi K.; Kagaya Y.; Hanawa K.;
Hasebe Y.; Nishimiya K.; Shiroto T.; Takahashi J.; Okumura Y.; Noguchi T.;
Ozaki Y.; Daida H.; Hagiwara N.; Masuyama T.; Chikamori T.; Fukumoto Y.;
Tsujita K.; Kanai H.; Yasuda S.; Shimokawa H.
Institution
(Shindo, Ito, Ogata, Kurosawa, Eguchi, Kagaya, Hanawa, Hasebe, Nishimiya,
Shiroto, Takahashi, Yasuda) Department of Cardiovascular Medicine, Tohoku
University Graduate School of Medicine, Sendai, Japan
(Okumura) Department of Medicine, Nihon University Graduate School of
Medicine, Tokyo, Japan
(Noguchi) Department of Cardiovascular Medicine, National Cerebral and
Cardiovascular Center, Suita, Japan
(Ozaki) Department of Cardiology, Fujita Health University School of
Medicine, Toyoake, Japan
(Daida) Department of Cardiology, Juntendo University Graduate School of
Medicine, Tokyo, Japan
(Hagiwara) Department of Cardiology, Tokyo Women's Medical University
Graduate School of Medicine, Tokyo, Japan
(Masuyama) Cardiovascular Division, Department of Internal Medicine, Hyogo
Medical University Graduate School of Medicine, Nishinomiya, Japan
(Chikamori) Department of Cardiology, Tokyo Medical University, Tokyo,
Japan
(Fukumoto) Kurume University School of Medicine, Kurume, Japan
(Tsujita) Division of Cardiovascular Medicine, Department of Internal
Medicine, Kumamoto University Graduate School of Medical Sciences,
Kumamoto, Japan
(Kanai) Division of Biomedical Measurements and Diagnostics, Graduate
School of Biomedical Engineering, Tohoku University, Sendai, Japan
(Shimokawa) Department of Cardiovascular Medicine, International
University of Health and Welfare, Narita, Japan
Publisher
Public Library of Science
Abstract
Background Despite the advances in the treatment of cardiovascular
diseases, effective treatment remains to be established to improve the
quality of life and prognosis of patients with chronic coronary syndromes.
This study was aimed to evaluate the effectiveness and safety of the
low-intensity pulsed ultrasound (LIPUS) therapy, which we have developed
as a novel noninvasive angiogenic therapy through upregulation of
endothelial nitric oxide synthase (eNOS). Methods and findings We
conducted a randomized, double-blind, placebo-controlled (RCT) pilot trial
of the LIPUS therapy for patients with refractory angina pectoris. The
patients who received optimal medical therapy without indication of PCI or
CABG due to the lack of graftability or complexity of coronary lesions
were enrolled. They were randomly divided into the LIPUS treatment group
(N = 31) and the placebo group (N = 25) in a 1:1 fashion. The LIPUS
therapy was performed in a transthoracic manner for 20 min for 3 sections
each (mitral, papillary muscle, and apex levels) under the conditions that
we identified; frequency 1.875 MHz, intensity 0.25 MPa, and 32 cycles. The
primary endpoint was weekly use of nitroglycerin. Secondary endpoints
included stress myocardial perfusion imaging and others. The average
weekly nitroglycerin use (times/week) was decreased from 5.50 to 2.44 in
the LIPUS group and from 5.94 to 2.83 in the placebo group. The changes in
the average weekly nitroglycerin use were comparable; -3.06 (95% CI:
-4.481 to -1.648) in the LIPUS group (P<0.01) and -3.10 (95% CI: -4.848 to
-1.356) in the placebo group (P<0.01). No adverse effects were noted.
Conclusions In the present study, the LIPUS therapy did not further
ameliorate chest pain as compared with optimal medications alone in
patients with refractory angina pectoris. The present findings need to be
confirmed in another trial with a large number of patients. Copyright
© 2023 Shindo et al.

<39>
Accession Number
2025205257
Title
Effect of Active Physiotherapy With Positive Airway Pressure on Pulmonary
Atelectasis After Cardiac Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(9) (pp 1668-1676),
2023. Date of Publication: September 2023.
Author
Baneton S.; Dauvergne J.E.; Gouillet C.; Cartron E.; Volteau C.; Nicolet
J.; Corne F.; Rozec B.
Institution
(Baneton, Gouillet) Service de kinesitherapie, hopital Laennec, CHU
Nantes, Nantes, France
(Dauvergne, Nicolet, Rozec) Nantes Universite, CHU Nantes, CNRS, INSERM,
l'institut du thorax, Nantes, France
(Dauvergne, Rozec) Nantes Universite, CHU Nantes, Service d'Anesthesie
Reanimation, hopital Laennec, INSERM CIC 0004 Immunologie et
Infectiologie, Nantes, France
(Cartron) ECEVE UMR-S 1123, Faculte de sante, Universite Paris Cite,
Paris, France
(Volteau) Nantes Universite, CHU Nantes, Direction de la Recherche et de
l'innovation, Plateforme de methodologie et biostatistique, Nantes, France
(Corne) Service de soins intensifs de pneumologie, hopital Laennec, CHU
Nantes, Nantes, France
Publisher
W.B. Saunders
Abstract
Objectives: The authors investigated the effect of active work with
positive airway pressure (PAP) in addition to chest physiotherapy (CP) on
pulmonary atelectasis (PA) in patients undergoing cardiac surgery with
cardiopulmonary bypass. Design(s): A randomized controlled study.
 Setting(s): At a single-center tertiary hospital.
 Participant(s): Eighty adult patients undergoing cardiac surgery
(coronary artery bypass grafting, valve surgery, or both), and presenting
with PA after tracheal extubation on postoperative days 1 or 2, were
randomized from November 2014 to September 2016. Intervention(s):
Three days of CP, twice daily, associated with active work with PAP effect
(intervention group) versus CP alone (control group). Pulmonary
atelectasis was assessed by using the radiologic atelectasis score (RAS)
measured from daily chest x-rays. All radiographs were reviewed blindly.
 Measurements and Main Results: Among included patients, 79 (99%)
completed the trial. The primary outcome was mean RAS on day 2 after
inclusion. It was significantly lower in the intervention group (mean
difference and 95% CI: -1.1 [-1.6 to -0.6], p < 0.001). The secondary
outcomes were the sniff nasal inspiratory pressure measured before and
after CP and clinical variables. Sniff nasal inspiratory pressure was
significantly higher in the intervention group on day 2 (7.7 [3.0-12.5]
cmH<inf>2</inf>O, p = 0.002). The respiratory rate was lower in the
intervention group (-3.2 [95% CI -4.8 to -1.6] breaths/min, p < 0.001) on
day 2. No differences were found between the 2 groups for percutaneous
oxygen saturation/oxygen requirement ratio, heart rate, pain, and dyspnea
scores. Conclusion(s): Active work with the PAP effect, combined with
CP, significantly decreased the RAS of patients undergoing cardiac surgery
after 2 days of CP, with no differences observed in clinically relevant
parameters. Copyright © 2023 Elsevier Inc.

<40>
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

<41>
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.

<42>
[Use Link to view the full text]
Accession Number
2024555691
Title
Efficacy and safety of aprotinin in paediatric cardiac surgery: A
systematic review and meta-analysis.
Source
European Journal of Anaesthesiology. 39(4) (pp 352-367), 2022. Date of
Publication: 01 Apr 2022.
Author
Atasever A.G.; Eerens M.; Van Den Eynde R.; Faraoni D.; Rex S.
Institution
(Atasever, Eerens, Van Den Eynde, Rex) Department of Anaesthesiology,
University Hospitals of the Ku Leuven, Herestraat, Leuven, Belgium
(Faraoni) Arthur S. Keats Division of Paediatric Cardiovascular
Anesthesia, Department of Anesthesiology, Peri-operative and Pain
Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston,
TX, United States
(Rex) Department of Cardiovascular Sciences, Ku Leuven, Herestraat,
Leuven, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The relicensing of aprotinin in Europe and Canada has
stimulated discussions on its usefulness in paediatric cardiac
surgery.OBJECTIVETo systematically evaluate the available evidence on the
efficacy and safety of aprotinin in paediatric cardiac
surgery.DESIGNSystematic review of all randomised and observational
studies comparing aprotinin with tranexamic acid, epsilon aminocaproic
acid, placebo or no drug in paediatric cardiac surgery. Meta-analyses were
performed on efficacy and safety outcomes.DATA SOURCESPubMed, Cochrane
Central Register of Controlled Trials, Web of Science and Embase were
searched from January 2000 to March 2021.ELIGIBILITY CRITERIAStudies that
enrolled children under 18 years undergoing cardiac surgery with
cardiopulmonary bypass.RESULTSThirty-two studies enrolling a total of 63
894 paediatric cardiac procedures were included. Aprotinin significantly
reduced total blood loss [mean difference -4.70 ml kg-1, 95% confidence
interval (CI), -7.88 to -1.53; P = 0.004], postoperative transfusion
requirements and the incidence of surgical re-exploration for bleeding
[odds ratio (OR) 0.74, 95% CI, 0.56 to 0.97; P = 0.03]. Aprotinin had no
effects on 30-day mortality (OR 1.02, 95% CI, 0.93 to 1.11; P = 0.73) and
on other safety outcomes, except for the incidence of renal replacement
therapy (RRT), which was significantly increased in patients given
aprotinin (OR 1.29, 95% CI, 1.08 to 1.54; P = 0.006). Findings from
observational and randomised controlled trials did not largely differ. A
sub-group analysis in neonates showed that aprotinin significantly reduced
packed red blood cell transfusions and the incidence of postoperative
surgical re-exploration for bleeding and/or tamponade. When compared with
lysine analogues, aprotinin was more effective at reducing bleeding and
transfusion without increasing the risk of side effects.CONCLUSIONThis
meta-analysis suggests that aprotinin is effective and well tolerated in
paediatric cardiac surgery. Given the large heterogeneity of the results
and the risk of selection bias in observational studies, large randomised
controlled trials are warranted. Copyright © European Society of
Anaesthesiology and Intensive Care. Unauthorized reproduction of this
article is prohibited.

<43>
[Use Link to view the full text]
Accession Number
2024555624
Title
Virtual reality and hypnosis for anxiety and pain management in intensive
care units: A prospective randomised trial among cardiac surgery patients.
Source
European Journal of Anaesthesiology. 39(1) (pp 58-66), 2022. Date of
Publication: 01 Jan 2022.
Author
Rousseaux F.; Dardenne N.; Massion P.B.; Ledoux D.; Bicego A.; Donneau
A.-F.; Faymonville M.-E.; Nyssen A.-S.; Vanhaudenhuyse A.
Institution
(Rousseaux, Bicego, Nyssen) Laboratory of Cognitive Ergonomics and Work
Intervention, University of Liege, ULiege (B32) Quartier Agora - Place des
Orateurs, Belgium
(Faymonville, Vanhaudenhuyse) Algology Department, University Hospital of
Liege, Chu Sart Tilman, Domaine Universitaire du Sart Tilman, Belgium
(Rousseaux, Bicego, Faymonville, Nyssen, Vanhaudenhuyse) Sensation &
Perception Research Group, Giga Consciousness, University of Liege, Giga
(B34), Belgium
(Massion, Ledoux) Intensive Care Units, University Hospital of Liege
(B35), Belgium
(Dardenne, Donneau) Public Health Department, Biostatistics, University of
Liege, Chu (B35), Belgium
(Ledoux) Anesthesia & Intensive Care, Giga Consciousness, University of
Liege, Giga (B34), Quartier Hopital - Avenue de l'Hopital, Liege, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Virtual reality and hypnosis are little studied in complex
contexts, such as intensive care, where patients need significant physical
and psychological assistance.OBJECTIVESTo compare and combine hypnosis and
virtual reality benefits on anxiety and pain on patients before and after
cardiac surgery.DESIGNProspective randomised controlled clinical
trial.SETTINGThe study was conducted in the University Hospital of Liege
(Belgium) from October 2018 to January 2020.PATIENTSOne hundred patients
(66 +/- 11.5 years; 24 women, 76 men) were included. Participants were
adults undergoing cardiac surgery. Exclusion criteria: psychiatric
diseases, claustrophobia, acrophobia, hearing loss, visual impairment,
extreme fatigue, confusion surgery cancelled.INTERVENTIONSPatients were
randomly assigned to four arms (control; hypnosis; virtual reality;
virtual reality hypnosis) and had 20 min of one of the techniques the day
before and the day after surgery.MAIN OUTCOMES MEASURESAnxiety, pain,
fatigue, relaxation, physiological parameters, and opioid use were
evaluated before and after each session.RESULTSThe main results did not
show any significant differences between the groups. In all groups,
anxiety decreased and pain increased from baseline to the postoperative
day. Relaxation increased in all groups in the pre-operative (P < 0.0001)
and postoperative period (P = 0.03). There were no significant differences
for fatigue, physiological measures, or opioid use.CONCLUSIONAs there were
no significant differences between groups for the measured variables, we
cannot affirm that one technique is better than another. Additional
studies are required to compare and evaluate the cost-effectiveness of
these techniques for critical care patients and caregivers. Copyright
© 2021 European Society of Anaesthesiology and Intensive Care.
Unauthorized reproduction of this article is prohibited.

<44>
Accession Number
2024277083
Title
P-wave duration and interatrial block as predictors of new-onset atrial
fibrillation: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. 72 (pp 57-64), 2023. Date of Publication:
01 Jul 2023.
Author
Zagoridis K.; Koutalas E.; Intzes S.; Symeonidou M.; Zagoridou N.;
Karagogos K.; Spanoudakis E.; Kanoupakis E.; Kochiadakis G.; Dinov B.;
Dagres N.; Hindricks G.; Bollmann A.; Nedios S.
Institution
(Zagoridis, Intzes, Symeonidou, Zagoridou, Karagogos, Spanoudakis)
Democritus University of Thrace, Medical School, Alexandroupoli, Greece
(Koutalas, Kanoupakis, Kochiadakis) Cardiology Department, Heraklion
University Hospital, Crete, Greece
(Dinov, Dagres, Hindricks, Bollmann, Nedios) Electrophysiology Department,
Heart Center, University of Leipzig, Germany
Publisher
Hellenic Cardiological Society
Abstract
Background: Early detection of atrial fibrillation (AF) could improve
patient outcomes. P-wave duration (PWD) and interatrial block (IAB) are
known predictors of new-onset AF and could improve selection for AF
screening. This meta-analysis reviews the published evidence and offers
practical implications. Method(s): Publication databases were
systematically searched, and studies reporting PWD and/or morphology at
baseline and new-onset AF during follow-up were included. IAB was defined
as partial (pIAB) if PWD>=120 ms or advanced (aIAB) if the P-wave was
biphasic in the inferior leads. After quality assessment and data
extraction, random-effects analysis calculated odds ratio (OR) and
confidence intervals (CI). Subgroup analysis was performed for those with
implantable devices (continuous monitoring). Result(s): Among 16,830
patients (13 studies, mean 66 years old), 2,521 (15%) had new-onset AF
over a median of 44 months. New-onset AF was associated with a longer PWD
(mean pooled difference: 11.5 ms, 13 studies, p < 0.001). The OR for
new-onset AF was 2.05 (95% CI: 1.3-3.2) for pIAB (5 studies, p = 0.002)
and 3.9 (95% CI: 2.6-5.8) for aIAB (7 studies, p < 0.001). Patients with
pIAB and devices had higher AF-detection risk (OR: 2.33, p < 0.001) than
those without devices (OR: 1.36, p = 0.56). Patients with aIAB had
similarly high risk regardless of device presence. There was significant
heterogeneity but no publication bias. Conclusion(s): Interatrial
block is an independent predictor of new-onset AF. The association is
stronger for patients with implantable devices (close monitoring). Thus,
PWD and IAB could be used as selection criteria for intensive screening,
follow-up or interventions. Copyright © 2023 Hellenic Society of
Cardiology

<45>
Accession Number
2024103114
Title
Prophylactic noninvasive respiratory support in the immediate
postoperative period after cardiac surgery - a systematic review and
network meta-analysis.
Source
BMC Pulmonary Medicine. 23(1) (no pagination), 2023. Article Number: 233.
Date of Publication: December 2023.
Author
Zhou X.; Pan J.; Wang H.; Xu Z.; Zhao L.; Chen B.
Institution
(Zhou, Pan, Wang, Xu, Chen) Department of Intensive Care Medicine, Ningbo
No.2 Hospital, Zhejiang, Ningbo 315000, China
(Zhao) Department of Cardiovascular Surgery, Ningbo No.2 Hospital,
Zhejiang, Ningbo, Ningbo 315000, China
Publisher
BioMed Central Ltd
Abstract
Background: Noninvasive respiratory support has been increasingly applied
in the immediate postoperative period to prevent postoperative pulmonary
complications (PPCs). However, the optimal approach remains uncertain. We
sought to evaluate the comparative effectiveness of various noninvasive
respiratory strategies used in the immediate postoperative period after
cardiac surgery. Method(s): We conducted a frequentist random-effect
network meta-analysis (NMA) of randomized controlled trials (RCTs)
comparing the prophylactic use of noninvasive ventilation (NIV),
continuous positive airway pressure (CPAP), high flow nasal cannula
(HFNC), or postoperative usual care (PUC) in the immediate postoperative
period after cardiac surgery. Databases were systematically searched
through September 28, 2022. Study selection, data extraction, and quality
assessment were performed in duplicate. The primary outcome was the
incidence of PPCs. Result(s): Sixteen RCTs enrolling 3011 patients
were included. Compared with PUC, NIV significantly reduced the incidence
of PPCs [relative risk (RR) 0.67, 95% confidence interval (CI): 0.49 to
0.93; absolute risk reduction (ARR) 7.6%, 95% CI: 1.6-11.8%; low
certainty] and the incidence of atelectasis (RR 0.65, 95% CI: 0.45 to
0.93; ARR 19.3%, 95% CI: 3.9-30.4%; moderate certainty); however,
prophylactic NIV was not associated with a decreased reintubation rate (RR
0.82, 95% CI: 0.29 to 2.34; low certainty) or reduced short-term mortality
(RR 0.64, 95% CI: 0.16 to 2.52; very low certainty). As compared to PUC,
the preventive use of CPAP (RR 0.85, 95% CI: 0.60 to 1.20; very low
certainty) or HFNC (RR 0.74, 95% CI: 0.46 to 1.20; low certainty) had no
significant beneficial effect on the incidence of PPCs, despite exhibiting
a downward trend. Based on the surface under the cumulative ranking curve,
the highest-ranked treatment for reducing the incidence of PPCs was NIV
(83.0%), followed by HFNC (62.5%), CPAP (44.3%), and PUC (10.2%).
 Conclusion(s): Current evidence suggest that the prophylactic use of
NIV in the immediate postoperative period is probably the most effective
noninvasive respiratory approach to prevent PPCs in patients undergoing
cardiac surgery. Given the overall low certainty of the evidence, further
high-quality research is warranted to better understand the relative
benefits of each noninvasive ventilatory support. Clinical Trial
Registration: PROSPERO, https://www.crd.york.ac.uk/prospero/ , registry
number: CRD42022303904. Copyright © 2023, The Author(s).

<46>
Accession Number
2023399032
Title
The Impact of Statins on Postdischarge Atrial Fibrillation After Cardiac
Surgery: Secondary Analysis from a Randomized Trial.
Source
CJC Open. 5(4) (pp 285-291), 2023. Date of Publication: April 2023.
Author
Hibino M.; Verma S.; Pandey A.K.; Bisleri G.; Yanagawa B.; Verma R.; Puar
P.; Quan A.; Teoh H.; Yau T.M.; Verma A.; Ha A.C.T.; Mazer C.D.
Institution
(Hibino) Division of Cardiothoracic Surgery, Emory University, School of
Medicine, Atlanta, GA, United States
(Verma, Bisleri, Yanagawa, Puar, Quan, Teoh) Division of Cardiac Surgery,
St. Michael's Hospital of Unity Health Toronto, Toronto, ON, Canada
(Verma, Bisleri, Yanagawa, Yau) Division of Cardiovascular Surgery,
Department of Surgery, University of Toronto, Toronto, ON, Canada
(Verma, Yanagawa) Department of Pharmacology and Toxicology, University of
Toronto, Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Verma) School of Medicine, Royal College of Surgeons in Ireland, Dublin,
Ireland
(Teoh) Division of Endocrinology and Metabolism, St. Michael's Hospital of
Unity Health Toronto, Toronto, ON, Canada
(Yau) Division of Cardiovascular Surgery, Toronto General Hospital
Research Institute, Toronto, ON, Canada
(Yau, Ha) Peter Munk Cardiac Centre, Toronto General Hospital, University
Health Network, Toronto, ON, Canada
(Verma) Division of Cardiology, McGill University, Montreal, QC, Canada
(Ha) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital of Unity Health
Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Mazer) Department of Physiology, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Whether statins reliably reduce the risk of postoperative
atrial fibrillation (POAF) in patients undergoing cardiac surgery remains
controversial. We sought to determine the impact of statin use on
new-onset postdischarge POAF in the Post-Surgical Enhanced Monitoring for
Cardiac Arrhythmias and Atrial Fibrillation (SEARCH-AF) CardioLink-1
randomized controlled trial. Method(s): We randomized 336 patients
with risk factors for stroke (CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=
2) and no history of preoperative atrial fibrillation (AF) to 30-day
continuous cardiac rhythm monitoring after discharge from cardiac surgery
with a wearable, patched-based device or to usual care. The primary
endpoint was the occurrence of cumulative AF and/or atrial flutter lasting
for >= 6 minutes detected by continuous monitoring, or AF and/or atrial
flutter documented by a 12-lead electrocardiogram within 30 days of
randomization. Result(s): The 260 patients (77.4%) discharged on
statins were more likely to be male (P = 0.018) and to have lower
CHA<inf>2</inf>DS<inf>2</inf>-VASc scores (P = 0.011). Patients treated
with statins at discharge had a 2-fold lower rate of POAF than those who
were not treated with statins in the entire cohort (18.4% vs 8.1%,
log-rank P = 0.0076). On multivariable Cox regression including the
CHA<inf>2</inf>DS<inf>2</inf>-VASc score adjustment, statin use was
associated with a lower risk of POAF (hazard ratio 0.43, 95% confidence
interval: 0.25-0.98, P = 0.043). Use of statins at a higher intensity was
associated with lower risk of POAF, suggestive of a dose-response effect
(log-rank P<inf>trend</inf> = 0.0082). Conclusion(s): The use of
statins was associated with a reduction in postdischarge POAF risk among
patients undergoing cardiac surgery. The routine use of high-intensity
statin to prevent subacute POAF after discharge deserves further
study. Copyright © 2022 The Authors

<47>
Accession Number
2022943799
Title
The Influence of Extracerebral Tissue on Continuous Wave Near-Infrared
Spectroscopy in Adults: A Systematic Review of In Vivo Studies.
Source
Journal of Clinical Medicine. 12(8) (no pagination), 2023. Article Number:
2776. Date of Publication: April 2023.
Author
Eleveld N.; Esquivel-Franco D.C.; Drost G.; Absalom A.R.; Zeebregts C.J.;
de Vries J.-P.P.M.; Elting J.W.J.; Maurits N.M.
Institution
(Eleveld, Esquivel-Franco, Drost, Elting, Maurits) Department of
Neurology, University Medical Centre Groningen, University of Groningen,
Postbus 30001, Groningen 9700 RB, Netherlands
(Drost) Department of Neurosurgery, University Medical Centre Groningen,
University of Groningen, Postbus 30001, Groningen 9700 RB, Netherlands
(Absalom) Department of Anaesthesiology, University Medical Centre
Groningen, University of Groningen, Postbus 30001, Groningen 9700 RB,
Netherlands
(Zeebregts, de Vries) Department of Surgery, Division of Vascular Surgery,
University Medical Centre Groningen, University of Groningen, Postbus
30001, Groningen 9700 RB, Netherlands
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Near-infrared spectroscopy (NIRS) is a non-invasive technique for
measuring regional tissue haemoglobin (Hb) concentrations and oxygen
saturation (rSO<inf>2</inf>). It may be used to monitor cerebral perfusion
and oxygenation in patients at risk of cerebral ischemia or hypoxia, for
example, during cardiothoracic or carotid surgery. However, extracerebral
tissue (mainly scalp and skull tissue) influences NIRS measurements, and
the extent of this influence is not clear. Thus, before more widespread
use of NIRS as an intraoperative monitoring modality is warranted, this
issue needs to be better understood. We therefore conducted a systematic
review of published in vivo studies of the influence of extracerebral
tissue on NIRS measurements in the adult population. Studies that used
reference techniques for the perfusion of the intra- and extracerebral
tissues or that selectively altered the intra- or extracerebral perfusion
were included. Thirty-four articles met the inclusion criteria and were of
sufficient quality. In 14 articles, Hb concentrations were compared
directly with measurements from reference techniques, using correlation
coefficients. When the intracerebral perfusion was altered, the
correlations between Hb concentrations and intracerebral reference
technique measurements ranged between r = 0.45-0.88. When the
extracerebral perfusion was altered, correlations between Hb
concentrations and extracerebral reference technique measurements ranged
between r = 0.22-0.93. In studies without selective perfusion
modification, correlations of Hb with intra- and extracerebral reference
technique measurements were generally lower ( r < 0.52). Five
articles studied rSO<inf>2</inf>. There were varying correlations of
rSO<inf>2</inf> with both intra- and extracerebral reference technique
measurements (intracerebral: r = 0.18-0.77, extracerebral:
 r = 0.13-0.81). Regarding study quality, details on the domains,
participant selection and flow and timing were often unclear. We conclude
that extracerebral tissue indeed influences NIRS measurements, although
the evidence (i.e., correlation) for this influence varies considerably
across the assessed studies. These results are strongly affected by the
study protocols and analysis techniques used. Studies employing multiple
protocols and reference techniques for both intra- and extracerebral
tissues are therefore needed. To quantitatively compare NIRS with intra-
and extracerebral reference techniques, we recommend applying a complete
regression analysis. The current uncertainty regarding the influence of
extracerebral tissue remains a hurdle in the clinical implementation of
NIRS for intraoperative monitoring. The protocol was pre-registered in
PROSPERO (CRD42020199053). Copyright © 2023 by the authors.

<48>
Accession Number
2024852830
Title
Tricuspid Valve Repair Can Restore the Prognosis of Patients with
Hypoplastic Left Heart Syndrome and Tricuspid Valve Regurgitation: A
Meta-analysis.
Source
Pediatric Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Ponzoni M.; Azzolina D.; Vedovelli L.; Gregori D.; Vida V.L.; Padalino
M.A.
Institution
(Ponzoni, Vida, Padalino) Pediatric and Congenital Cardiac Surgery Unit,
Department of Cardiac, Thoracic Vascular Sciences and Public Health,
University of Padua Medical School, Via Giustiniani 2, Padua 35128, Italy
(Azzolina, Vedovelli, Gregori) Unit of Biostatistics, Epidemiology and
Public Health, Department of Cardiac Thoracic and Vascular Sciences,
University of Padua Medical School, Padua, Italy
(Azzolina) Department of Environmental and Preventive Sciences, University
of Ferrara, Ferrara, Italy
Publisher
Springer
Abstract
To date, evidence supporting the efficacy of tricuspid valve (TV) repair
in interrupting the progression of systemic right ventricular (RV) adverse
remodeling in hypoplastic left heart syndrome (HLHS) is conflicting. We
conducted a systematic review and meta-analysis of scientific literature
to assess the impact of TV repair in effectively modifying the prognosis
of patients with HLHS. We conducted a systematic review of PubMed, Web of
Science, and Scopus databases. A random-effect meta-analysis was performed
and transplant-free survival, freedom from TV regurgitation, and TV
reoperation data were reconstructed using the published Kaplan-Meier
curves. Nine studies were included, comprising 203 HLHS patients
undergoing TV repair and 323 HLHS controls. The estimated transplant-free
survival at 1, 5, and 10 years of follow-up was 75.5% [95% confidence
interval (CI) = 67.6-84.3%], 63.6% [95% CI = 54.6-73.9%], and 61.9% [95%
CI = 52.7-72.6%], respectively. Transplant-free survival was comparable to
HLHS peers without TV regurgitation (p = 0.59). Five-year freedom from
recurrence of TV regurgitation and freedom from TV reoperation was 57%
[95% CI = 46.7-69.7%] and 63.6% [95% CI = 54.5-74.3%], respectively.
Younger age and TV repair at the time of Norwood operation increased the
risk of TV regurgitation recurrence and the need for TV reoperation. Our
meta-analysis supports the efficacy of TV repair in favorably modifying
the prognosis of patients with HLHS and TV regurgitation, reestablishing a
medium-term transplant-free survival which is comparable to HLHS peers.
However, durability of surgery and long-term fate of TV and RV performance
are still unclear. Graphical Abstract: [Figure not available: see
fulltext.] Copyright © 2023, The Author(s).

<49>
Accession Number
2024275460
Title
Sutureless valves versus aortic root enlargement for aortic valve
replacement in small aortic annulus: A systematic review and pooled
analysis.
Source
Asian Cardiovascular and Thoracic Annals. 31(6) (pp 524-532), 2023. Date
of Publication: July 2023.
Author
Agarwal R.; Arnav A.; Ranjan A.; Mudgal S.; Singh D.
Institution
(Agarwal) Department of Cardiothoracic Surgery, All India Institute of
Medical Sciences (AIIMS), Jharkhand, Deoghar, India
(Arnav) Department of Surgical Oncology, All India Institute of Medical
Sciences (AIIMS), Jharkhand, Deoghar, India
(Ranjan) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jharkhand, Deoghar, India
(Mudgal) College of Nursing, All India Institute of Medical Sciences
(AIIMS), Jharkhand, Deoghar, India
(Singh) Department of Radiotherapy, All India Institute of Medical
Sciences (AIIMS), Jharkhand, Deoghar, India
Publisher
SAGE Publications Inc.
Abstract
Background: Very few studies provide direct comparisons between aortic
root enlargement and sutureless valve implantation in patients with a
small aortic annulus who underwent aortic valve replacement. This study
aims to provide comparative outcomes between the two in such a subset of
patients, through a systematic review and pool analysis. Method(s):
The PubMed, Scopus and Embase databases were searched using the
appropriate terms. The data from original articles mentioning aortic root
enlargement and sutureless valves in a single or comparative study with
another group of patients with a small aortic annulus were pooled and
analyzed using descriptive statistics. Result(s): Both
cardiopulmonary bypass (68.4 vs. 125.03 min, p < 0.001) and aortic
cross-clamp times were significantly shorter in the sutureless valve
group, along with a concomitantly higher number of minimally invasive
surgeries. The incidence of permanent pacemaker implantation (9.76% vs.
3.16%, p < 0.00001), patient prosthesis mis-match and paravalvular leak
was significantly higher in the sutureless valve group. In comparison, the
incidence of re-exploration for bleeding was higher in the aortic root
enlargement group (5.27% vs. 3.16%, p < 0.02). The two groups had no
differences in the duration of hospital stays or mortality.
 Conclusion(s): Sutureless valves demonstrated a comparable
hemodynamic outcome with aortic root enlargement in patients with a small
aortic annulus. In addition to this, it greatly facilitated minimally
invasive surgery. However, the high incidence of pacemaker implantation is
still a concern for the widespread recommendation of sutureless valves,
especially in young patients with a small aortic annulus. Copyright
© The Author(s) 2023.

<50>
Accession Number
2023778207
Title
Regional anesthesia for transplantation surgery - A white paper part 1:
Thoracic transplantation surgery.
Source
Clinical Transplantation. 37(8) (no pagination), 2023. Article Number:
e15043. Date of Publication: August 2023.
Author
Ander M.; Mugve N.; Crouch C.; Kassel C.; Fukazawa K.; Izaak R.; Deshpande
R.; McLendon C.; Huang J.
Institution
(Ander, Mugve, McLendon) Department of Anesthesiology & Perioperative
Medicine, Loyola University Medical Center, Maywood, IL, United States
(Crouch) Department of Anesthesiology, University of Colorado Anschutz
Medical Campus, Aurora, CO, United States
(Kassel) Department of Anesthesiology, Nebraska Medical Center, 984455
Nebraska Medical Center, Omaha, NE, United States
(Fukazawa) Department of Anesthesiology, University of Washington School
of Medicine, Seattle, WA, United States
(Izaak) Department of Anesthesiology, UNC Hospitals, N2198 UNC Hospitals,
NC, United States
(Deshpande) Department of Anesthesiology, Yale University/Yale New Haven
Hospital, New Haven, CT, United States
(Huang) Department of Anesthesiology & Perioperative Medicine, University
of Louisville, Louisville, KY, United States
Publisher
John Wiley and Sons Inc
Abstract
Transplantation surgery continues to evolve and improve through
advancements in transplant technique and technology. With the increased
availability of ultrasound machines as well as the continued development
of enhanced recovery after surgery (ERAS) protocols, regional anesthesia
has become an essential component of providing analgesia and minimizing
opioid use perioperatively. Many centers currently utilize peripheral and
neuraxial blocks during transplantation surgery, but these techniques are
far from standardized practices. The utilization of these procedures is
often dependent on transplantation centers' historical methods and
perioperative cultures. To date, no formal guidelines or recommendations
exist which address the use of regional anesthesia in transplantation
surgery. In response, the Society for the Advancement of Transplant
Anesthesia (SATA) identified experts in both transplantation surgery and
regional anesthesia to review available literature concerning these
topics. The goal of this task force was to provide an overview of these
publications to help guide transplantation anesthesiologists in utilizing
regional anesthesia. The literature search encompassed most
transplantation surgeries currently performed and the multitude of
associated regional anesthetic techniques. Outcomes analyzed included
analgesic effectiveness of the blocks, reduction in other analgesic
modalities-particularly opioid use, improvement in patient hemodynamics,
as well as associated complications. The findings summarized in this
systemic review support the use of regional anesthesia for postoperative
pain control after transplantation surgeries. Part 1 of the manuscript
focuses on regional anesthesia performed in thoracic transplantation
surgeries, and part 2 in abdominal transplantations. Copyright ©
2023 The Authors. Clinical Transplantation published by John Wiley & Sons
Ltd.

<51>
Accession Number
2024847074
Title
Inspiratory muscle training to reduce risk of pulmonary complications
after coronary artery bypass grafting: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1223619. Date of Publication: 2023.
Author
Xiang Y.; Zhao Q.; Luo T.; Zeng L.
Institution
(Xiang, Zhao, Luo, Zeng) Department of Critical Care Medicine, West China
Hospital, Sichuan University, West China School of Nursing, Sichuan
University, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: Pulmonary complications occur in a substantial proportion of
patients who undergo coronary artery bypass grafting. Inspiratory muscle
training (IMT), a simple, well-tolerated physical therapy, has been
proposed to reduce the risk of complications, but its efficacy remains
controversial. Method(s): Randomized controlled trials (RCTs)
examining the influence of IMT on the risk of pulmonary complications
after coronary artery bypass grafting were identified from PubMed, Embase,
CENTRAL, CINAL, and Web of Science through March 2023. Data were
meta-analyzed for the primary outcomes of pulmonary complications, defined
as pneumonia, pleural effusion, and atelectasis; and in terms of the
secondary outcomes of maximum inspiratory pressure, maximum expiratory
pressure, length of hospitalization, 6 min walk test, and peak expiratory
flow and other outcomes. Risk of bias and quality of evidence assessments
were carried out using the RoB 2.0 and Grading of Recommendations
Assessment, Development and Evaluation (GRADE) applied to primary outcomes
of pulmonary complications. Result(s): Data from eight RCTs involving
755 patients were meta-analyzed. IMT was associated with a significantly
lower risk of postoperative pneumonia [relative risk (RR) 0.39, 95%
confidence interval (CI) 0.25-0.62, P < 0.0001] and atelectasis (RR 0.43,
95% CI 0.27-0.67, P = 0.0002), but not pleural effusion (RR 1.09, 95% CI
0.62-1.93, P = 0.76). IMT was associated with significantly better maximum
inspiratory pressure (preoperative: mean difference (MD) 16.55
cmH<inf>2</inf>O, 95% CI 13.86-19.24, P < 0.00001; postoperative: mean
difference (MD) 8.99 cmH<inf>2</inf>O, 95% CI 2.39-15.60, P = 0.008) and
maximum expiratory pressure (MD 7.15 cmH<inf>2</inf>O, 95% CI: 1.52-12.79,
P = 0.01), and with significantly shorter hospitalization (MD -1.71 days,
95% CI -2.56 to -0.87, P < 0.001). IMT did not significantly affect peak
expiratory flow or distance traveled during the 6 min walk test.
 Conclusion(s): The available evidence from medium and high quality
trials suggests that IMT can significantly decrease the risk of pneumonia
and atelectasis after coronary artery bypass grafting while shortening
hospitalization and improving the strength of respiratory muscles.
Systematic Review Registration: https://www.crd.york.ac.uk/prospero/,
identifier: CRD42023415817. Copyright 2023 Xiang, Zhao, Luo and Zeng.

<52>
[Use Link to view the full text]
Accession Number
2026311351
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, Lee, Kim, Lee, Kang) Department of Anaesthesiology and Pain
Medicine, Anaesthesia and Pain Research Institute, South Korea
(Oh) Department of Thoracic and Cardiovascular Surgery, Yonsei University,
College of Medicine, Seoul, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe effect of hypercarbia on lung oxygenation during thoracic
surgery remains unclear.OBJECTIVETo 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.DESIGNProspective randomised controlled trial.SETTINGA
tertiary university hospital in the Republic of Korea from November 2019
to December 2020.PATIENTSTwo hundred and ninety-seven patients with
American Society of Anaesthesiologists physical status II to III,
scheduled to undergo elective lung resection surgery.INTERVENTIONPatients
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 MEASURESThe primary outcome was the
arterial oxygen partial pressure/fractional inspired oxygen ratio after 60
min of one-lung ventilation.RESULTSData 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.CONCLUSIONPermissive hypercarbia
improved lung oxygenation during one-lung ventilation without increasing
the risk of postoperative pulmonary complications or the length of
hospital stay.TRIAL REGISTRATIONNCT 04175379. Copyright © 2023
Lippincott Williams and Wilkins. All rights reserved.

<53>
[Use Link to view the full text]
Accession Number
2026311348
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, Jia, Li, Zhou) Department of Anaesthesiology and Pain Medicine,
Affiliated Hospital of Jiaxing University, Zhejiang Province, Jiaxing,
China
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe 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).OBJECTIVEThe
current study aimed to investigate whether there is a difference in
postoperative recovery quality between TPVB and RIB.DESIGNA prospective,
non-inferiority, randomised controlled trial.SETTINGAffiliated Hospital of
Jiaxing University in China from March 2021 to August 2022.PATIENTSEighty
patients aged 18 to 80 years, with ASA physical status I to III, and
scheduled for elective VATS were enrolled in the
trial.INTERVENTIONUltrasound-guided TPVB or RIB was performed with 20 ml
0.375% ropivacaine.MAIN OUTCOME MEASURESThe 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.RESULTSA 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).CONCLUSIONOur 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
REGISTRATIONchictr.org.cn: ChiCTR2100043841. Copyright © 2023
Lippincott Williams and Wilkins. All rights reserved.

<54>
Accession Number
641983400
Title
Arrhythmia and Death Following Percutaneous Revascularization in Ischemic
Left Ventricular Dysfunction: Prespecified Analyses From the REVIVED-BCIS2
Trial.
Source
Circulation. (no pagination), 2023. Date of Publication: 09 Aug 2023.
Author
Perera D.; Morgan H.P.; Ryan M.; Dodd M.; Clayton T.; O'Kane P.D.;
Greenwood J.P.; Walsh S.J.; Weerackody R.; McDiarmid A.; Amin-Youssef G.;
Strange J.; Modi B.; Lockie T.; Hogrefe K.; Ahmed F.Z.; Behan M.; Jenkins
N.; Abdelaal E.; Anderson M.; Watkins S.; Evans R.; Rinaldi C.A.; Petrie
M.C.
Institution
(Perera, Morgan, Ryan) National Institute for Health Research Biomedical
Research Center and British Heart Foundation Center of Research Excellence
at the School of Cardiovascular Medicine and Sciences, King's College
London, United Kingdom (D.P., United Kingdom
(Dodd, Rinaldi) Guy's and St Thomas' NHS Foundation Trust, United Kingdom
(D.P., London, United Kingdom
(Dodd, Clayton, Evans) London School of Hygiene & Tropical Medicine,
United Kingdom (M.D., T.C., United Kingdom
(O'Kane) Royal Bournemouth and Christchurch Hospital, United Kingdom
(P.D.O.), Bournemouth, United Kingdom
(Greenwood, Anderson) Leeds Teaching Hospitals NHS Trust and University of
Leeds, United Kingdom (J.P.G., United Kingdom
(Walsh) Belfast Health and Social Care NHS Trust, United Kingdom (S.J.W.),
United Kingdom
(Weerackody) Barts Health NHS Trust, United Kingdom (R.W.), London, United
Kingdom
(McDiarmid) Newcastle Hospitals NHS Foundation Trust, United Kingdom
(A.M.), United Kingdom
(Amin-Youssef) King's College Hospital NHS Foundation Trust, United
Kingdom (G.A.-Y.), London, United Kingdom
(Strange) University Hospitals Bristol NHS Foundation Trust, United
Kingdom (J.S.), United Kingdom
(Modi) University Hospitals of Leicester NHS Trust, United Kingdom (B.M.),
United Kingdom
(Lockie) United Kingdom (T.L.), Royal Free Hospital, London, United
Kingdom
(Hogrefe) Kettering General Hospital, United Kingdom (K.H.), Northampton,
United Kingdom
(Ahmed) Manchester Royal Infirmary, University NHS Foundation Trust,
United Kingdom (F.Z.A.), United Kingdom
(Behan) Edinburgh Royal Infirmary, United Kingdom (M.B.), United Kingdom
(Jenkins) Sunderland Royal Hospital, United Kingdom (N.J.), United Kingdom
(Abdelaal) Wythenshawe Hospital, United Kingdom (E.A.), Manchester,
Jamaica
(Watkins, Petrie) Institute of Cardiovascular and Medical Sciences,
University of Glasgow, United Kingdom (S.W., United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Ventricular arrhythmia is an important cause of mortality in
patients with ischemic left ventricular dysfunction. Revascularization
with coronary artery bypass graft or percutaneous coronary intervention is
often recommended for these patients before implantation of a cardiac
defibrillator because it is assumed that this may reduce the incidence of
fatal and potentially fatal ventricular arrhythmias, although this premise
has not been evaluated in a randomized trial to date. METHOD(S):
Patients with severe left ventricular dysfunction, extensive coronary
disease, and viable myocardium were randomly assigned to receive either
percutaneous coronary intervention (PCI) plus optimal medical and device
therapy (OMT) or OMT alone. The composite primary outcome was all-cause
death or aborted sudden death (defined as an appropriate implantable
cardioverter defibrillator therapy or a resuscitated cardiac arrest) at a
minimum of 24 months, analyzed as time to first event on an
intention-to-treat basis. Secondary outcomes included cardiovascular death
or aborted sudden death, appropriate implantable cardioverter
defibrillator (ICD) therapy or sustained ventricular arrhythmia, and
number of appropriate ICD therapies. RESULT(S): Between August 28,
2013, and March 19, 2020, 700 patients were enrolled across 40 centers in
the United Kingdom. A total of 347 patients were assigned to the PCI+OMT
group and 353 to the OMT alone group. The mean age of participants was 69
years; 88% were male; 56% had hypertension; 41% had diabetes; and 53% had
a clinical history of myocardial infarction. The median left ventricular
ejection fraction was 28%; 53.1% had an implantable defibrillator inserted
before randomization or during follow-up. All-cause death or aborted
sudden death occurred in 144 patients (41.6%) in the PCI group and 142
patients (40.2%) in the OMT group (hazard ratio, 1.03 [95% CI, 0.82-1.30];
P=0.80). There was no between-group difference in the occurrence of any of
the secondary outcomes. CONCLUSION(S): PCI was not associated with a
reduction in all-cause mortality or aborted sudden death. In patients with
ischemic cardiomyopathy, PCI is not beneficial solely for the purpose of
reducing potentially fatal ventricular arrhythmias. REGISTRATION: URL:
https://www. CLINICALTRIALS: gov; Unique identifier: NCT01920048.

<55>
Accession Number
641981596
Title
Pleural effusion secondary to endometriosis: A systematic review.
Source
The American journal of the medical sciences. (no pagination), 2023. Date
of Publication: 06 Aug 2023.
Author
Porcel J.M.; Sancho-Marquina P.; Monteagudo P.; Bielsa S.
Institution
(Porcel) Pleural Medicine Unit, Department of Internal Medicine, Arnau de
Vilanova University Hospital Hospital, IRBLleida, Universitat de Lleida,
Lleida, Spain
(Sancho-Marquina, Monteagudo, Bielsa) Pleural Medicine Unit, Department of
Internal Medicine, Arnau de Vilanova University Hospital Hospital,
IRBLleida, Universitat de Lleida, Lleida, Spain
Publisher
NLM (Medline)
Abstract
BACKGROUND: Endometriosis-associated pleural effusion is a rare occurrence
with poorly defined clinical characteristics. METHOD(S): A systematic
review was performed to examine all articles on endometriosis-associated
pleural effusion extracted from 4 databases (PubMed, Embase, Web of
Science and Scopus) from inception until November 2022. RESULT(S): A
total of 142 articles (isolated cases and small retrospective series)
involving 176 patients (median age 33 years) with endometriosis-associated
pleural effusion were included. The most frequent symptoms were dyspnea
(67%), chest pain (55%) and abdominal pain (40%). Pleural effusion was
predominantly unilateral (89%), right-sided (88.5%) and massive (56%).
Ascites was evident in 42% of the cases. Pleural fluid had a bloody
appearance in 99% of cases and always met the exudate criteria. Pleural
fluid cytology identified only 9% of the patients, with pleural biopsy
being the most common diagnostic procedure (74%). Most patients were
treated with hormones (76%), thoracic surgery (60%) and abdominal surgery
(27%). Effusion recurrence was observed in 26% of cases after a median
follow-up of 1 year. CONCLUSION(S): The presence of right-sided
hemorrhagic pleural effusion in a young woman warrants an assessment for
the possibility of endometriosis. Despite conventional treatment, effusion
recurs in approximately a quarter of patients. Copyright © 2023.
Published by Elsevier Inc.

<56>
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.

<57>
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.

<58>
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.

<59>
Accession Number
2025917557
Title
Feasibility of redo-TAVI in self-expanding Evolut valves: a CT analysis
from the Evolut Low Risk Trial substudy.
Source
EuroIntervention. 19(4) (pp E330-E339), 2023. Date of Publication: July
2023.
Author
Grubb K.J.; Shekiladze N.; Spencer J.; Perdoncin E.; Tang G.H.L.; Xie J.;
Lisko J.; Sanchez J.Z.; Lucas L.M.; Sathananthan J.; Rogers T.; Michael
Deeb G.; Fukuhara S.; Blanke P.; Leipsic J.A.; Forrest J.K.; Reardon M.J.;
Gleason P.
Institution
(Grubb, Shekiladze, Perdoncin, Xie, Lisko) Division of Cardiothoracic
Surgery, Emory University, Atlanta, GA, United States
(Grubb, Shekiladze, Perdoncin, Xie, Lisko, Gleason) Structural Heart and
Valve Center, Emory University, Atlanta, GA, United States
(Spencer, Sanchez) Research and Development, Structural Heart & Aortic,
Medtronic, Mounds View, MN, United States
(Tang) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
(Lucas) NAMSA, Minneapolis, MN, United States
(Sathananthan, Blanke, Leipsic) Centre for Heart Valve Innovation, St.
Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
(Rogers) Section of Interventional Cardiology, MedStar Washington Hospital
Center, Washington, DC, United States
(Michael Deeb, Fukuhara) Department of Cardiac Surgery, University of
Michigan Hospital, Ann Arbor, MI, United States
(Forrest) Section of Cardiology, Yale School of Medicine, New Haven, CT,
United States
(Reardon) Department of Cardiovascular Surgery, Houston Methodist,
Houston, TX, United States
(Gleason) Division of Cardiology, Emory University, Atlanta, GA, United
States
Publisher
Europa Group
Abstract
Background: Transcatheter aortic valve implantation in an existing
transcatheter valve (redo-TAVI) pins the index valve leaflets in the open
position (neoskirt), which can cause coronary flow compromise and limit
access. Whether anatomy may preclude redo-TAVI in self-expanding Evolut
valves is unknown. Aim(s): We aimed to evaluate the anatomical
feasibility of redo-TAVI by simulating implantation of a
balloon-expandable SAPIEN 3 (S3) within an Evolut or an Evolut within an
Evolut. Method(s): A total of 204 post-TAVI computed tomography (CT)
scans from the Evolut Low Risk CT substudy were analysed. Five redo-TAVI
positions were evaluated: S3-in-Evolut inflow-to-inflow, S3 outflow at
Evolut nodes 4, 5, and 6, and Evolut-in-Evolut inflow-to-inflow.
Univariable modelling identified pre-TAVI clinical characteristics, CT
anatomical parameters, and procedural variables associated with coronary
flow compromise using the neoskirt height and post-TAVI aortic root
dimensions. Result(s): The risk of coronary flow compromise was
lowest when the S3 outflow was at Evolut node 4 (20%) and highest when at
Evolut node 6 (75%). The highest likelihood of preserving coronary
accessibility occurred with the S3 outflow at Evolut node 4. Female sex
and higher body mass index were associated with a higher risk of coronary
flow compromise, as were a smaller annulus diameter, lower sinus of
Valsalva height and width, shorter coronary height, smaller sinotubular
junction diameter, and shallower Evolut implant depth. Conclusion(s):
The feasibility of redo-TAVI after Evolut failure is multifactorial and
relates to the native annular anatomy, as well as the implantation depth
of the index and second bioprostheses. Placement of an S3 at a lower
Evolut position may reduce the risk of coronary flow compromise while
preserving coronary access. Copyright © Europa Digital &
Publishing 2023. All rights reserved.

<60>
Accession Number
2023408125
Title
Animal versus plant-based protein and risk of cardiovascular disease and
type 2 diabetes: a systematic review of randomized controlled trials and
prospective cohor t studies.
Source
Food and Nutrition Research. 67 (no pagination), 2023. Article Number:
9003. Date of Publication: 2023.
Author
Lamberg-Allardt C.; Barebring L.; Arnesen E.K.; Nwaru B.I.; Thorisdottir
B.; Ramel A.; Soderlund F.; Dierkes J.; Akesson A.
Institution
(Lamberg-Allardt) Department of Food and Nutrition, University of
Helsinki, Finland
(Barebring) Department of Internal Medicine and Clinical Nutrition,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Sweden
(Arnesen) Department of Nutrition, Institute of Basic Medical Sciences,
University of Oslo, Norway
(Nwaru) Krefting Research Centre, Institute of Medicine, University of
Gothenburg, Sweden
(Thorisdottir) Health Science Institute, University of Iceland, Iceland
(Ramel) Faculty of Food Science and Nutrition, University of Iceland,
Iceland
(Soderlund, Akesson) Unit of Cardiovascular and Nutritional Epidemiology,
Institute of Environmental Medicine, The Karolinska Institute, Sweden
(Dierkes) Centre for Nutrition, Department of Clinical Medicine,
University of Bergen, Norway
(Dierkes) Department of Laborator y Medicine and Pathology, Haukeland
University Hospital, Norway
Publisher
Swedish Nutrition Foundation
Abstract
Objectives: To systematically review the evidence on the effect of
replacing the intake of animal protein with plant protein on
cardiovascular disease (CVD) and type 2 diabetes (T2D) and their
intermediate risk factors. Method(s): We searched MEDLINE, Embase,
Cochrane Central Register of Controlled Trials, and Scopus up to 12th May
2022 for randomized controlled trials (RCTs) or prospective cohort studies
that investigated replacement of animal protein with plant protein from
foods. Outcomes were CVDs, T2D, and in RCTs also the effects on blood
lipids, glycemic markers, and blood pressure. Risk of bias was evaluated
with the Cochrane's RoB2, ROBINS-I, and USDA's RoB-NObS tools.
Random-effects meta-analyses assessed the effects of plant vs. animal
proteins on blood lipids in RCTs. The evidence was appraised according to
the World Cancer Research Fund's criteria. Result(s): After screening
15,090 titles/abstracts, full text of 124 papers was scrutinized in
detail, from which 13 RCTs and seven cohort studies were included. Eight
of the RCTs had either some concern or high risk of bias, while the
corresponding evaluation of cohort studies resulted in moderate risk of
bias for all seven. Meta-analyses of RCTs suggested a protective effect on
total cholesterol (mean difference-0.11 mmol/L; 95% CI-0.22,-0.01) and
low-density lipoprotein cholesterol (-0.14 mmol/L; 95% CI-0.25,-0.02) by
replacing animal protein with plant protein. The substitution of animal
protein with plant protein (percentage of energy intake) in cohort studies
was associated with lower CVD mortality (n = 4) and lower T2D incidence (n
= 2). The evidence was considered limited-suggestive for both outcomes.
 Conclusion(s): Evidence that the substitution of animal protein with
plant protein reduces risk of both CVD mortality and T2D incidence is
limited-suggestive. Replacing animal protein with plant protein for
aspects of sustainability may also be a public health strategy to lower
the risk of CVD mortality and T2D. Copyright © 2023 Christel
Lamberg-Allardt et al.

<61>
Accession Number
2021965167
Title
Attitudes of patients with renal disease on xenotransplantation: A
systematic review.
Source
Xenotransplantation. 30(2) (no pagination), 2023. Article Number: e12794.
Date of Publication: March/April 2023.
Author
DeLaura I.; Anwar I.J.; Ladowski J.; Patino A.; Cantrell S.; Sanoff S.
Institution
(DeLaura, Anwar, Ladowski) Duke Transplant Center, Department of Surgery,
Duke University Medical Center, Durham, NC, United States
(Patino) Duke University School of Medicine, Durham, NC, United States
(Cantrell) Duke University Medical Center Library & Archives, Duke
University School of Medicine, Durham, NC, United States
(Sanoff) Department of Medicine, Division of Nephrology, Duke University,
Durham, NC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Recent years have seen major advancements in
xenotransplantation: the first pig-to-human heart transplant, the
development of a brain-dead recipient model for kidney
xenotransplantation, and the registration of the first xenokidney clinical
trial. The attitudes of patients with kidney disease or transplants on
xenotransplantation and an assessment of their reservations and
considerations regarding the technology are crucial to successful clinical
translation and eventual widespread implementation. Method(s): This
systematic review was registered through PROSPERO (CRD42022344581) prior
to initiation of the study and reported using the Preferred Reporting
Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. We
included studies that evaluated attitudes towards and willingness to
undergo xenotransplantation in patients with end-stage renal disease
(ESRD), including those who had already undergone transplantation. MEDLINE
(via Ovid), Embase (via Elsevier), and Web of Science (via Clarivate) were
searched from database inception to July 15, 2022 by an experienced
medical librarian for studies on xenotransplantation and attitudes.
Abstracts and full text were screened using Covidence software and data
items regarding study methodology, patient demographics, and attitudes
regarding xenotransplantation were extracted using Microsoft Excel. Risk
of bias assessments were performed using the Critical Appraisal Skills
Programmed and National Institute of Health study quality assessment
tools. Result(s): Of 1992 studies identified, 14 studies met the
inclusion criteria. These studies were conducted across eight countries,
four in the United States, for a total of 3114 patients on the kidney
waitlist or with a kidney transplant. All patients were over 17 years old
and 58% were male. Acceptance of a xenotransplant was assessed using
surveys in 12 studies. Sixty-three percent (n = 1354) of kidney patients
reported that they would accept a xenotransplant with function comparable
to that of an allotransplant. Acceptance of xenografts with inferior
function to allografts (15%) or as bridge organs (35%) to
allotransplantation was lower. Specific concerns expressed by patients
included graft function, infection, social stigma, and animal rights.
Subgroup analyses showed higher acceptance in already transplanted
compared to waitlist patients and white compared to Black Americans.
 Conclusion(s): An understanding of patient attitudes and reservations
is key to the successful execution of the first xenotransplantation
clinical trials. This study compiles important factors to consider, such
as patient concerns, attitudes regarding practical clinical scenarios for
the use of xenotransplantation, and the impact of demographic factors on
acceptance of this emerging technology. Copyright © 2023 John
Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

<62>
Accession Number
2014637874
Title
Percutaneous coronary intervention versus coronary artery surgery for left
main disease according to lesion site: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(1) (pp 120-132.e11),
2023. Date of Publication: July 2023.
Author
De Filippo O.; Di Franco A.; Boretto P.; Bruno F.; Cusenza V.; Desalvo P.;
Demetres M.; Saglietto A.; Franchin L.; Piroli F.; Marengo G.; Elia E.;
Falk V.; Conrotto F.; Doenst T.; Rinaldi M.; De Ferrari G.M.; D'Ascenzo
F.; Gaudino M.
Institution
(De Filippo, Boretto, Bruno, Cusenza, Desalvo, Saglietto, Franchin,
Piroli, Marengo, Elia, Conrotto, De Ferrari, D'Ascenzo) Division of
Cardiology, Cardiovascular and Thoracic Department, AOU Citta della Salute
e della Scienza di Torino and University of Turin, Turin, Italy
(Di Franco, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
(Falk) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Falk) Department of Cardiothoracic Surgery, Charite-Universitatsmedizin
Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat
Berlin, Berlin Institute of Health, Berlin, Germany
(Falk) Department of Health Sciences, Translational Cardiovascular
Technologies, ETH Zurich, Zurich, Switzerland
(Doenst) Jena University Hospital, Friedrich-Schiller-University of Jena,
Jena, Germany
(Rinaldi) Division of Cardiac Surgery, Cardiovascular and Thoracic
Department, AOU Citta della Salute e della Scienza di Torino and
University of Turin, Turin, Italy
Publisher
Elsevier Inc.
Abstract
Background: Comparative data after percutaneous coronary intervention
(PCI) or coronary artery bypass grafting (CABG) for unprotected left main
coronary artery (ULMCA) disease according to lesion site (ostial/shaft vs
distal) are scant. The aim of this meta-analysis was to investigate
outcomes after PCI or CABG for ULMCA disease according to lesion site.
 Method(s): Randomized controlled trials (RCTs) and adjusted
observational studies that compared PCI versus CABG in patients with ULMCA
disease and reported outcomes according to lesion site were systematically
identified. Major adverse cardiovascular events (MACE; a composite of
all-cause death, myocardial infarction, stroke, and repeat
revascularization) and all-cause death were the co-primary end points.
Individual components of MACE were secondary end points. Sensitivity
analysis including RCTs only were performed for each outcome.
 Result(s): Nine studies (3 RCTs, 6 adjusted observational),
encompassing 6296 patients (2274 and 4022 treated for ostial/shaft or
distal ULMCA, respectively) were included. At the 5-year follow-up, there
were no significant differences between CABG and PCI for MACE, death, or
any other secondary outcome for ostial/shaft ULMCA lesions (MACE: hazard
ratio [HR], 1.0 [95% confidence interval (CI), 0.79-1.27]; death: HR, 1.10
[95% CI, 0.84-1.46]). For distal ULMCA, PCI was associated with an
increased risk of MACE (HR, 1.32; 95% CI, 1.10-1.58), death (HR, 1.56; 95%
CI, 1.19-2.04), and revascularization (HR, 2.07; 95% CI, 1.5-2.84). The
benefit of CABG for MACE and revascularization was confirmed in the
analysis limited to RCTs, whereas the benefit for mortality was not.
 Conclusion(s): Among patients with distal ULMCA disease, CABG is
associated with lower incidence of MACE and revascularization compared
with PCI, whereas no differences in outcomes were observed for
ostial/shaft ULMCA disease. Copyright © 2021 The American
Association for Thoracic Surgery

<63>
Accession Number
641883301
Title
Invasive management for patent ductus arteriosus in preterm infants.
Source
Cochrane Database of Systematic Reviews. 2023(7) (no pagination), 2023.
Article Number: CD014862. Date of Publication: 28 Jul 2023.
Author
Lingappan K.; Malviya M.N.; Pammi M.; Mitra S.
Institution
(Lingappan, Pammi) Section of Neonatology, Department of Pediatrics,
Baylor College of Medicine, Houston, TX, United States
(Malviya) Neonatal Intensive Care Unit, Khoula Hospital, Muscat, Oman
(Mitra) Departments of Pediatrics, Community Health & Epidemiology,
Dalhousie University & IWK Health Centre, Halifax, Canada
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. Primary objective: to assess the effectiveness
and safety of invasive PDA closure strategies in preterm infants compared
to medical management (pharmacotherapy or conservative) or no treatment.
Secondary objective: to analyse subgroups based on the following.
Postnatal age at intervention (less than four weeks versus late rescue)
Initial mode of treatment versus after failed medical management (based on
courses and timing of pharmacotherapy) Invasive closure following primary
pharmacotherapy versus repeat pharmacotherapy Within seven days versus
after seven days TCPC coil versus occluder Gestational age (< 32 weeks
versus 32 to 36 weeks) Birth weight (< 1500 g or < 1000 g) Weight at the
time of the procedure (< 1000 g or > 1000 g). Copyright © 2023
The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<64>
Accession Number
2024838689
Title
Intraoperative hemodynamics and risk of cardiac surgery-associated acute
kidney injury: An observation study and a feasibility clinical trial.
Source
Clinical and Experimental Pharmacology and Physiology. (no pagination),
2023. Date of Publication: 2023.
Author
Noe K.M.; Don A.; Cochrane A.D.; Zhu M.Z.L.; Ngo J.P.; Smith J.A.; Thrift
A.G.; Vogiatjis J.; Martin A.; Bellomo R.; McMillan J.; Evans R.G.
Institution
(Noe, Don, Zhu, Ngo, Vogiatjis, Martin, Evans) Cardiovascular Disease
Program, Department of Physiology, Biomedicine Discovery Institute, Monash
University, Melbourne, VIC, Australia
(Noe, Cochrane, Zhu, Smith, Martin, Evans) Department of Surgery, School
of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC,
Australia
(Cochrane, Zhu, Smith, Martin) Department of Cardiothoracic Surgery,
Monash Health, Monash University, Melbourne, VIC, Australia
(Ngo) Department of Cardiac Physiology, National Cerebral and
Cardiovascular Center Research Institute, Osaka, Japan
(Thrift) Department of Medicine, School of Clinical Sciences at Monash
Health, Monash University, Melbourne, VIC, Australia
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
(Bellomo) Department of Intensive Care, Austin Health, Heidelberg, VIC,
Australia
(Bellomo, Evans) Pre-clinical Critical Care Unit, Florey Institute of
Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
(McMillan) Perfusion Services Pty Ltd, Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Targeting greater pump flow and mean arterial pressure (MAP) during
cardiopulmonary bypass (CPB) could potentially alleviate renal hypoxia and
reduce the risk of postoperative acute kidney injury (AKI). Therefore, in
an observational study of 93 patients undergoing on-pump cardiac surgery,
we tested whether intraoperative hemodynamic management differed between
patients who did and did not develop AKI. Then, in 20 patients, we
assessed the feasibility of a larger-scale trial in which patients would
be randomized to greater than normal target pump flow and MAP, or usual
care, during CPB. In the observational cohort, MAP during hypothermic CPB
averaged 68.8 +/- 8.0 mmHg (mean +/- SD) in the 36 patients who developed
AKI and 68.9 +/- 6.3 mmHg in the 57 patients who did not (p = 0.98). Pump
flow averaged 2.4 +/- 0.2 L/min/m2 in both groups. In the
feasibility clinical trial, compared with usual care, those randomized to
increased target pump flow and MAP had greater mean pump flow (2.70 +/-
0.23 vs. 2.42 +/- 0.09 L/min/m2 during the period before
rewarming) and systemic oxygen delivery (363 +/- 60 vs. 281 +/- 45
mL/min/m2). Target MAP >=80 mmHg was achieved in 66.6% of
patients in the intervention group but in only 27.3% of patients in the
usual care group. Nevertheless, MAP during CPB did not differ
significantly between the two groups. We conclude that little insight was
gained from our observational study regarding the impact of variations in
pump flow and MAP on the risk of AKI. However, a clinical trial to assess
the effects of greater target pump flow and MAP on the risk of AKI appears
feasible. Copyright © 2023 The Authors. Clinical and Experimental
Pharmacology and Physiology published by John Wiley & Sons Australia, Ltd.

<65>
Accession Number
2024278697
Title
Hydroxocobalamin for Vasodilatory Hypotension in Shock: A Systematic
Review With Meta-Analysis for Comparison to Methylene Blue.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(9) (pp 1757-1772),
2023. Date of Publication: September 2023.
Author
Brokmeier H.M.; Seelhammer T.G.; Nei S.D.; Gerberi D.J.; Mara K.C.;
Wittwer E.D.; Wieruszewski P.M.
Institution
(Brokmeier, Nei, Wieruszewski) Department of Pharmacy, Mayo Clinic,
Rochester, MN
(Seelhammer, Wittwer, Wieruszewski) Department of Anesthesiology, Mayo
Clinic, Rochester, MN
(Gerberi) Mayo Medical Libraries, Mayo Clinic, Rochester, MN
(Mara) Department of Quantitative Health Sciences, Division of Clinical
Trials and Biostatistics, Mayo Clinic, Rochester, MN
Publisher
W.B. Saunders
Abstract
Hydroxocobalamin inhibits nitric oxide-mediated vasodilation, and has been
used in settings of refractory shock. However, its effectiveness and role
in treating hypotension remain unclear. The authors systematically
searched Ovid Medline, Embase, EBM Reviews, Scopus, and Web of Science
Core Collection for clinical studies reporting on adult persons who
received hydroxocobalamin for vasodilatory shock. A meta-analysis was
performed with random-effects models comparing the hemodynamic effects of
hydroxocobalamin to methylene blue. The Risk of Bias in Nonrandomized
Studies of Interventions tool was used to assess the risk of bias. A total
of 24 studies were identified and comprised mainly of case reports (n =
12), case series (n = 9), and 3 cohort studies. Hydroxocobalamin was
applied mainly for cardiac surgery vasoplegia, but also was reported in
the settings of liver transplantation, septic shock, drug-induced
hypotension, and noncardiac postoperative vasoplegia. In the pooled
analysis, hydroxocobalamin was associated with a higher mean arterial
pressure (MAP) at 1 hour than methylene blue (mean difference 7.80, 95% CI
2.63-12.98). There were no significant differences in change in MAP (mean
difference -4.57, 95% CI -16.05 to 6.91) or vasopressor dosage (mean
difference -0.03, 95% CI -0.12 to 0.06) at 1 hour compared to baseline
between hydroxocobalamin and methylene blue. Mortality was also similar
(odds ratio 0.92, 95% CI 0.42-2.03). The evidence supporting the use of
hydroxocobalamin for shock is limited to anecdotal reports and a few
cohort studies. Hydroxocobalamin appears to positively affect hemodynamics
in shock, albeit similar to methylene blue. Copyright © 2023
Elsevier Inc.

<66>
Accession Number
2024103264
Title
Coronary revascularization for heart failure with coronary artery disease:
A systematic review and meta-analysis of randomized trials.
Source
European Journal of Heart Failure. 25(7) (pp 1094-1104), 2023. Date of
Publication: July 2023.
Author
Iaconelli A.; Pellicori P.; Dolce P.; Busti M.; Ruggio A.; Aspromonte N.;
D'Amario D.; Galli M.; Princi G.; Caiazzo E.; Rezig A.O.M.; Maffia P.;
Pecorini G.; Crea F.; Cleland J.G.F.
Institution
(Iaconelli, Pellicori, Cleland) School of Cardiovascular and Metabolic
Health, University of Glasgow, Glasgow, United Kingdom
(Iaconelli, Ruggio, Aspromonte) Department of Cardiovascular Medicine,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
(Dolce) Department of Public Health, University of Naples Federico II,
Naples, Italy
(Busti, Princi, Crea) Department of Cardiovascular Sciences, Catholic
University of the Sacred Heart, Rome, Italy
(D'Amario) Department of Translational Medicine, University of Eastern
Piedmont, Novara, Italy
(D'Amario) Division of Cardiology, Azienda Ospedaliero Universitaria
'Maggiore della Carita', Novara, Italy
(Galli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Caiazzo, Maffia) Department of Pharmacy, School of Medicine and Surgery,
University of Naples Federico II, Naples, Italy
(Caiazzo, Rezig, Maffia) School of Infection and Immunity, College of
Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow,
United Kingdom
(Pecorini) Cardiovascular Internal Medicine Unit, Department of
Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Rome, Italy
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Coronary artery disease (CAD) is a common cause of heart failure
(HF). Whether coronary revascularization improves outcomes in patients
with HF receiving guideline-recommended pharmacological therapy (GRPT)
remains uncertain; therefore, we conducted a systematic review and
meta-analysis of relevant randomized controlled trials (RCTs).
 Methods and Results: We searched in public databases for RCTs
published between 1 January 2001 and 22 November 2022, investigating the
effects of coronary revascularization on morbidity and mortality in
patients with chronic HF due to CAD. All-cause mortality was the primary
outcome. We included five RCTs that enrolled, altogether, 2842 patients
(most aged <65 years; 85% men; 67% with left ventricular ejection fraction
<=35%). Overall, compared to medical therapy alone, coronary
revascularization was associated with a lower risk of all-cause mortality
(hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.79-0.99; p =
0.0278) and cardiovascular mortality (HR 0.80, 95% CI 0.70-0.93; p =
0.0024) but not the composite of hospitalization for HF or all-cause
mortality (HR 0.87, 95% CI 0.74-1.01; p = 0.0728). There were insufficient
data to show whether the effects of coronary artery bypass graft surgery
or percutaneous coronary intervention were similar or differed.
 Conclusion(s): For patients with chronic HF and CAD enrolled in RCTs,
the effect of coronary revascularization on all-cause mortality was
statistically significant but neither substantial (HR 0.88) nor robust
(upper 95% CI close to 1.0). RCTs were not blinded, which may bias
reporting of the cause-specific reasons for hospitalization and mortality.
Further trials are required to determine which patients with HF and CAD
obtain a substantial benefit from coronary revascularization by either
coronary artery bypass graft surgery or percutaneous coronary
intervention. Copyright © 2023 The Authors. European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<67>
Accession Number
2015944758
Title
Celiac Artery Coverage After Thoracic Endovascular Aortic Procedure: A
Meta-Analysis of Early and Late Results.
Source
Journal of Endovascular Therapy. 30(4) (pp 499-509), 2023. Date of
Publication: August 2023.
Author
Mezzetto L.; Mastrorilli D.; Bravo G.; Scorsone L.; Gennai S.; Leone N.;
D'Oria M.; Veraldi E.; Veraldi G.F.
Institution
(Mezzetto, Mastrorilli, Scorsone, Veraldi, Veraldi) Vascular Surgery,
Integrated University Hospital of Verona, Verona, Italy
(Bravo) Department of Medicine, University of Udine, Udine, Italy
(Gennai, Leone) Vascular Surgery, Ospedale Civile di Baggiovara, Azienda
Ospedaliero-Universitaria di Modena, University of Modena and Reggio
Emilia, Modena, Italy
(D'Oria) Vascular and Endovascular Surgery, Trieste University Hospital,
Trieste, Italy
Publisher
SAGE Publications Inc.
Abstract
Background/aim: Clinical outcomes of celiac artery (CA) coverage during
aortic procedures are often contradicting and the fate of this additional
maneuver is still unclear. This study summarizes the results of available
literature and aims to clarify the impact of CA coverage during thoracic
endovascular aneurysm repair (TEVAR) in patients with inadequate distal
sealing zone. Method(s): Prospective and retrospective, observational
original articles focused on CA coverage during elective/urgent TEVAR for
descending thoracic aortic pathology (DTAP) were included. PubMed/MEDLINE,
Embase, and Cochrane Central Register of Controlled Trials database were
examined to identify articles published from January 2007 to December
2020, according to PRISMA guidelines. Early and late visceral (any sign or
symptom reported) and neurological (both transient and permanent)
complications were considered as primary outcomes. Onset of any endoleak,
type IB endoleak, need of reintervention, and TEVAR-related mortality were
considered as secondary outcomes. Result(s): A total of 5618 articles
were extracted for analysis and 13 studies were finally included in the
synthesis. A total of 178 CAs were covered during 2653 TEVAR (7%). Spinal
cord ischemia was 8% (95% CI, 5-14%, I2 0%) Any endoleak and
type IB endoleak was observed in 12% (95% CI, 6-21%, I2 17%)
and 5% (95% CI, 2-11%, I2 0%), respectively. Thoracic
endovascular aneurysm repair-related reoperation was necessary in 8% (95%
CI, 4-14%, I2 0%), the majority of which (14/18, 78%) performed
for distal sealing failure; mortality rate was 9% (95% CI, 5-14%,
I2 0%). Out of 178 patients, 168 (94%) were available for
follow-up, ranged 12 to 42 months. Visceral complications, any endoleak,
and type IB endoleak were identified in 15% (95% CI, 10-23%, I2
45%), 20% (95% CI, 13-29%, I2 8%), and 8% (95% CI, 4-15%,
I2 0%), respectively. Thoracic endovascular aneurysm
repair-related reintervention was required in 8% (95% CI, 4-14%,
I2 0%). Mortality rate was 17% (95% CI, 12-25%, I2
4%). Conclusion(s): Celiac artery coverage in DTAP should be regarded
as a "bailout" procedure especially in urgent/emergent settings but
requires caution in elective cases. Even if transient visceral ischemia is
frequent, life-threatening complications are rare. Early and late
mortality rates are similar to standard TEVAR although the risk of type IB
endoleak and reintervention may be an issue. Copyright © The
Author(s) 2022.

<68>
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.

<69>
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.

<70>
Accession Number
2025804376
Title
Coronary artery bypass grafting using bilateral internal thoracic arteries
in patients with diabetes and obesity: A systematic review and
meta-analysis.
Source
IJC Heart and Vasculature. 47 (no pagination), 2023. Article Number:
101235. Date of Publication: August 2023.
Author
Stefil M.; Dixon M.; Benedetto U.; Gaudino M.; Lees B.; Gray A.; Gerry S.;
Taggart D.; Flather M.
Institution
(Stefil, Dixon) Norwich Medical School, University of East Anglia,
Norwich, United Kingdom
(Benedetto) Bristol Heart Institute, University of Bristol, School of
Clinical Sciences, United Kingdom
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York City, NY, United States
(Lees, Taggart) Nuffield Department of Surgical Sciences, University of
Oxford, John Radcliffe Hospital, Oxford, United Kingdom
(Gray) Health Economics Research Centre, Nuffield Department of Population
Health, University of Oxford, Oxford, United Kingdom
(Gerry) Centre for Statistics in Medicine, Nuffield Department of
Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of
Oxford, Oxford, United Kingdom
(Flather) Norwich Medical School, University of East Anglia, Norfolk and
Norwich University Hospital, Norwich, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Patients with diabetes and obesity are at higher risk of
adverse long-term outcomes following coronary artery bypass grafting. The
use of bilateral internal thoracic arteries (BITA) can potentially offer
survival benefit in higher risk patients compared to single internal
thoracic artery (SITA), but BITA is not routinely used due to lack of
clear evidence of efficacy and concerns over sternal wound complications.
 Method(s): Medline, Embase and the Cochrane Library were searched for
studies comparing the efficacy and safety of BITA and SITA grafting in
patients with diabetes and obesity. Meta-analysis of mortality and sternal
wound complications was performed. Result(s): We identified eight
observational and ten propensity matched studies, and one RCT, comparing
BITA and SITA which included patients with diabetes (n = 19,589); two
propensity matched studies and one RCT which included patients with
obesity (n = 6,972); mean follow up was 10.5 and 11.3 years respectively.
Meta-analysis demonstrated a mortality reduction for BITA compared to SITA
in patients with diabetes (risk ratio [RR] 0.79; 95% confidence interval
[CI] 0.70-0.90; p = 0.0003). In patients with obesity there was a
non-significant reduction in mortality in the BITA group (RR 0.73, 95% CI
0.47-1.12; p = 0.15). There was a significantly higher rate of sternal
wound complications following BITA observed in patients with diabetes (RR
1.53, 95% CI 1.23-1.90; p = 0.0001) and obesity (RR 2.24, 95% CI
1.63-3.07; p < 0.00001). Conclusion(s): BITA is associated with
better long-term survival in patients with diabetes. The effects of BITA
grafting in patients with obesity are uncertain. BITA is associated with
higher rates of sternal wound complications compared to SITA in both
patients with diabetes and obesity. Copyright © 2023

<71>
Accession Number
2026342242
Title
Impact of early versus class I-triggered surgery on postoperative survival
in severe aortic regurgitation: An observational study from the Aortic
Valve Insufficiency and Ascending Aorta Aneurysm International Registry.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Hanet V.; Schafers H.-J.; Lansac E.; de Kerchove L.; El Hamansy I.;
Vojacek J.; Contino M.; Pouleur A.-C.; Beauloye C.; Pasquet A.;
Vanoverschelde J.-L.; Vancraeynest D.; Gerber B.L.
Institution
(Hanet, de Kerchove, Pouleur, Beauloye, Pasquet, Vanoverschelde,
Vancraeynest, Gerber) Department of Cardiovascular Diseases, Cliniques
Universitaires St Luc, Pole de Recherche Cardiovasculaire (CARD), Institut
de Recherche Experimentale et Clinique IREC UCLouvain, Brussels, Belgium
(Schafers) Surgery Department, Homburg-Saarland University Medical Center,
Homburg, Germany
(Lansac) Surgery Department, Institut Mutualiste Montsouris, Paris, France
(El Hamansy) Surgery Department, Montreal Heart Institute, Montreal,
Canada
(Vojacek) Surgery Department, Charles University Hospital, Hradec Kralove,
Czechia
(Contino) Surgery Department, Socio Sanitaria Territoriale Universita
degli Studi di Milano, Milano, Italy
Publisher
Elsevier Inc.
Abstract
Objectives: Class I triggers for severe and chronic aortic regurgitation
surgery mainly rely on symptoms or systolic dysfunction, resulting in a
negative outcome despite surgical correction. Therefore, US and European
guidelines now advocate for earlier surgery. We sought to determine
whether earlier surgery leads to improved postoperative survival.
 Method(s): We evaluated the postoperative survival of patients who
underwent surgery for severe aortic regurgitation in the international
multicenter registry for aortic valve surgery, Aortic Valve Insufficiency
and Ascending Aorta Aneurysm International Registry, over a median
follow-up of 37 months. Result(s): Among 1899 patients (aged 49 +/-
15 years, 85% were male), 83% and 84% had class I indication according to
the American Heart Association and European Society of Cardiology,
respectively, and most were offered repair surgery (92%). Twelve patients
(0.6%) died after surgery, and 68 patients died within 10 years after the
procedure. Heart failure symptoms (hazard ratio, 2.60 [1.20-5.66], P =
.016) and either left ventricular end-systolic diameter greater than 50 mm
or left ventricular end-systolic diameter index greater than 25
mm/m2 (hazard ratio, 1.64 [1.05-2.55], P = .030) predicted
survival independently over and above age, gender, and bicuspid phenotype.
Therefore, patients who underwent surgery based on any class I trigger had
worse adjusted survival. However, patients who underwent surgery while
meeting early imaging triggers (left ventricular end-systolic diameter
index 20-25 mm/m2 or left ventricular ejection fraction 50% to
55%) had no significant outcome penalty. Conclusion(s): In this
international registry of severe aortic regurgitation, surgery when
meeting class I triggers led to postoperative outcome penalty compared
with earlier triggers (left ventricular end-systolic diameter index 20-25
mm/m2 or ventricular ejection fraction 50%-55%). This
observation, which applies to expert centers where aortic valve repair is
feasible, should encourage the global use of repair techniques and the
conduction of randomized trials. Copyright © 2023 The American
Association for Thoracic Surgery

<72>
Accession Number
2024836675
Title
Transient ischemic attack and minor stroke as "surgeons affairs": a
narrative review.
Source
Neurological Sciences. (no pagination), 2023. Date of Publication: 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, "Universita Politecnica delle
Marche", Via Conca 71, Ancona 60126, Italy
Publisher
Springer-Verlag Italia s.r.l.
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. Material(s) and Method(s):
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.

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