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<1>
Accession Number
2026391290
Title
Comparison of Ultrasonography Guidance Versus Direct Palpation Technique
for Central Venous Catheterization in Children Undergoing Cardiac Surgery.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 29(2) (pp
88-94), 2023. Date of Publication: 2023.
Author
Bicak E.A.; Elmastas D.; Salik F.; Kilic Y.; Kacar C.K.; Bicak M.
Institution
(Bicak, Elmastas, Kacar, Bicak) Department of Anesthesiology and
Reanimation, Diyarbakir University of Health Sciences, Gazi Yasargil
Training and Research Hospital, Diyarbakir, Turkey
(Salik) Department of Anesthesiology and Reanimation, Dicle University
Faculty of Medicine, Diyarbakir, Turkey
(Kilic) Department of Pediatric Cardiovascular Surgery, Diyarbakir
University of Health Sciences, Gazi Yasargil Training and Research
Hospital, Diyarbakir, Turkey
Publisher
Turkish Anaesthesiology and Intensive Care Society
Abstract
Objectives: We aimed to compare the success rates, procedure times, and
complication rates of the Landmark technique with ultrasonography-guided
(USG) central venous catheterization (CVC) in children undergoing cardiac
surgery. Method(s): This study included 52 patients divided into two
equal groups: the CVC with Landmark technique group (Group-1) and the USG
CVC group (Group-2). Demographic and clinical characteristics of the
patients, internal jugular vein (IJV) diameters, and central venous
pressures were measured. Each needle penetration of the skin,, defined as
one"attempt,"was recorded. The success rate, number of first-attempt
successful cannulations, number of cannulas used, successful cannulation
time, and all observed complications were recorded. Result(s): The
groups had similar age, weight, height, sex, and diagnosis. There were no
differences in IJV diameter, IJV intervention history, and basal central
venous pressure between the groups. The successful cannulation time was
short, and the number of attempts was low in Group-2. The number of
successful cannulations and first-attempt success rate were high in
Group-2. The number of cannulas was lower in Group-2 than in Group-1.
Failed cannulations occurred in no patients in Group-2 and in seven
patients in Group-1. The failed cannulations in five of the patients in
Group-1 were subsequently successfully achieved with USG. The complication
rates were high in Group-1. Conclusion(s): USG CVC catheterization
increased the number of successful cannulations and chance of
first-attempt success on the, shortened the procedure time, and reduced
the incidence rate of complications. ©Copyright 2023.

<2>
Accession Number
2026347215
Title
Efficacy and safety of selenium or vitamin E administration alone or in
combination in ICU patients: A systematic review and meta-analysis.
Source
Clinical Nutrition ESPEN. 57 (pp 550-560), 2023. Date of Publication:
October 2023.
Author
Lu X.; Wang Z.; Chen L.; Wei X.; Ma Y.; Tu Y.
Institution
(Lu, Wang, Ma, Tu) Department of Pharmacy, Shanghai East Hospital, School
of Medicine, Tongji University, Shanghai 200092, China
(Lu, Wang, Chen) Department of Critical Care Medicine, School of
Anesthesiology, Naval Medical University, Shanghai 200433, China
(Wei) Department of Clinical Pharmacy, Xinhua Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China
Publisher
Elsevier Ltd
Abstract
Background: Micronutrient administration that contributes to antioxidant
defense has been extensively studied in critically ill patients, but
consensus remains elusive. Selenium and vitamin E are two important
micronutrients that have synergistic antioxidant effects. This
meta-analysis aimed to assess the effect of selenium or vitamin E
administration alone and the combination of both on clinical outcomes in
patients hospitalized in the ICU. Method(s): After electronic
searches on PubMed, Embase, Cochrane Library, Web of Science, China
National Knowledge Infrastructure (CNKI), SinoMed, VIP database and
Wanfang data, initially 1767 papers were found, and 30 interventional
studies were included in this analysis. We assessed the risk-difference
between treatment and control (standard treatment) groups by pooling
available data on length of stay (ICU length of stay and hospital length
of stay), mortality (ICU mortality, hospital mortality, 28-day mortality,
6-month mortality and all-cause mortality), duration of mechanical
ventilation, adverse events and new infections. Result(s): By
analyzing the included studies, we found no significant effect of selenium
administration alone on mortality, mechanical ventilation duration, or
adverse events in ICU patients. However, after excluding studies with high
heterogeneity, the meta-analysis showed that selenium alone reduced the
length of hospital stay (MD: -1.38; 95% CI: -2.52, -0.23; I-square: 0%).
Vitamin E administration alone had no significant effect on mortality,
duration of mechanical ventilation, or adverse events in ICU patients.
However, after excluding studies with high heterogeneity, the
meta-analysis showed that vitamin E alone could reduce the length of ICU
stay (MD: -1.27; 95% CI: -1.86, -0.67; I-square: 16%). Combined
administration of selenium and vitamin E had no significant effect on
primary outcomes in ICU patients. Conclusion(s): Selenium
administration alone may shorten the length of hospital stay, while
vitamin E alone may reduce the length of ICU stay. The putative
synergistic beneficial effect of combined administration of selenium and
vitamin E in ICU patients has not been observed, but more clinical studies
are pending to confirm it further. Copyright © 2023 European
Society for Clinical Nutrition and Metabolism

<3>
Accession Number
2026336541
Title
Speckle-tracking echocardiography: state of art and its applications.
Source
Minerva Medica. 114(4) (pp 500-515), 2023. Date of Publication: August
2023.
Author
Lotti R.; de Marzo V.; della Bona R.; Porto I.; Rosa G.M.
Institution
(Lotti, de Marzo, della Bona, Porto, Rosa) Unit of Cardiovascular
Diseases, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
(Lotti, de Marzo, della Bona, Porto, Rosa) IRCCS Italian Cardiovascular
Network, Genoa, Italy
(Lotti, de Marzo, Porto, Rosa) Department of Internal Medicine, University
of Genoa, Genoa, Italy
Publisher
Edizioni Minerva Medica
Abstract
Echocardiographic evaluation of left ventricular ejection fraction (LVEF)
provides important information regarding both myocardial function and
prognosis. This parameter presents various limitations and does not allow
early detection of myocardial dysfunction. LVEF may be related to
hemodynamic load, geometric assumptions, to image quality, and it does not
reflect myocardial contractility. It has been hypothesized that speckle
tracking echocardiography (STE) may allow overcoming such limits. STE
through the measurement of strain and strain rate, which detect myocardial
deformation, allows earlier identification of myocardial dysfunction in
different settings both in presence of systolic and diastolic dysfunction,
helps to predict left ventricular remodeling after acute myocardial
infarction (AMI), and helps to decide the timing of surgery in
asymptomatic severe valvular heart disease which is still a problematic
issue. Increasingly interest regards the role of STE for the assessment of
cardiomyopathies, myocarditis, and pulmonary hypertension. STE may be
applied to the evaluation of systolic and diastolic dysfunction. STE is
useful in all conditions in which cardiac dysfunction is not still overt,
but a subclinical involvement is undoubtedly present such as in presence
of cardiovascular risk factors and in cardio-oncology at earlier stages.
It has been confirmed its role in predicting left ventricular remodeling
after AMI which represents an important prognostic datum and in deciding
the timing of surgery in asymptomatic valvular diseases. STE is an
important tool to detect myocardial impairment even at earlier stages.
3DSTE and layer-specific strain represent promising fields of clinical
application of STE. Copyright © 2021 EDIZIONI MINERVA MEDICA.

<4>
Accession Number
2026322344
Title
Early Safety and Performance of the Premounted Dry-Pericardium Vienna
Self-Expandable Transcatheter Aortic Valve System: 30-Day Outcomes of the
First-in-Human VIVA Feasibility Study.
Source
American Journal of Cardiology. 204 (pp 302-311), 2023. Date of
Publication: 01 Oct 2023.
Author
Briedis K.; Aldujeli A.; Zaliunas R.; Benetis R.
Institution
(Briedis, Aldujeli, Zaliunas) Departments of Cardiology
(Benetis) Cardiac, Thoracic and Vascular Surgery, Lithuanian University of
Health Sciences, Kaunas, Lithuania
Publisher
Elsevier Inc.
Abstract
The purpose of this first-in-human (FIH) study was to determine the safety
and feasibility of the transfemoral premounted dry-pericardium Vienna
Self-Expandable Supra-Annular Aortic Valve System. This novel system is
repositionable and retrievable and comes already premounted on the
delivery system, eliminating the need for assembly and crimping of the
device before valve implantation. This is a prospective, nonrandomized,
single-arm, single-center, first-stage FIH feasibility study, which will
be followed by a second-stage pivotal, multicenter, multinational study in
symptomatic patients with severe aortic stenosis. The first-stage FIH
study evaluated the safety and feasibility of the device in 10 patients
with severe aortic stenosis based on recommendations by the Valve Academic
Research Consortium-2 for transcatheter aortic valve implantations. The
mean patient age was 79 +/- 5 years, 60% were male, and all patients were
in New York Heart Association functional class II to III. The primary
safety end point was successful when all patients were alive at 30-day
follow-up. Device and technical success were observed in all patients. Two
patients had a stroke, 1 of which occurred 5 days after the procedure. New
permanent pacemakers were implanted in 2 patients (22.2%), of which only 1
was because of complete heart block. Only 1 patient (10%) had moderate
paravalvular leak at 30 days. After the procedure, the mean aortic valve
gradient decreased from 48.7 +/- 10.8 mm Hg to 8.8 +/- 4.3 mm Hg. In
conclusion, this FIH feasibility study demonstrates successful procedural
feasibility, with no 30-day mortality and favorable valve hemodynamic
performance, leading to an improvement in quality of life.
ClinicalTrials.gov identifier NCT04861805. Copyright © 2023 The
Author(s)

<5>
Accession Number
2026265171
Title
COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE FOR ATTENUATION OF
HAEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION IN
VALVULAR HEART SURGERY.
Source
Journal of Cardiovascular Disease Research. 14(1) (pp 245-250), 2023. Date
of Publication: 2023.
Author
Meena J.K.; Yadav J.; Rathee A.
Institution
(Meena, Yadav) Department Of Anaesthesia, National Institute Of Medical
Sciences And Research Hospital, Jaipur, India
(Rathee) Girls Hostel G Block, Ahilaya Hostel, Nims University, Room
No.415, Delhi Jaipur Highway(11c), Jaipur 303121, India
Publisher
EManuscript Technologies
Abstract
OBJECTIVE-Endotracheal intubation & Laryngoscopy is an integral part of
anesthesiologist's contribution to patient care, but the procedure results
in changes of various hemodynamic parameters. The aim of study was to
access the efficacy of Clonidine and Dexmedetomidine in blocking the
cardiovascular response to laryngoscopy and intubation and ensuring stable
hemodynamics. METHOD-A randomized, double blind, comparative study was
conducted with patients divided randomly into two groups, Group Clonidine
and Group Dexmedetomidine. Baseline parameters of the patients were
recorded before drug administration .Injection Etomidate 0.4 mg\kg i.v
slowly followed by Injection Rocuronium 1.5mg\kg i.v given . Hemodynamic
parameters NIBP,HR, SPO2 measured after intubation 1,3,5,7,10 min. RESULT-
Hemodynamic parameters were increased just after laryngoscopy and
intubation compared to baseline. After few minutes hemodynamic parameter
were stabilized. CONCLUSION- Clonidine and Dexmedetomidine blunts the
hemodynamic response to endotracheal intubation in patients undergoing
valvular heart surgery under general anesthesia and can be safely used at
induction of general anesthesia. Dexmedetomidine shows more attenuated
pressure response to laryngoscopy and intubation compared to
Clonidine. Copyright © 2023 EManuscript Technologies. All rights
reserved.

<6>
Accession Number
2025269928
Title
Can Posterior Pericardial Incision Truly Improve Postoperative
Complications After Cardiac Surgery? A Systematic Review and
Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 38(5) (no pagination), 2023.
Article Number: e20220350. Date of Publication: 2023.
Author
Shen Z.-A.; Hou Y.; Yu L.; Wang X.; Dong A.; Kong M.; Shi H.
Institution
(Shen, Wang, Dong, Kong, Shi) Department of Cardiovascular Surgery, The
Second Affiliated Hospital, Zhejiang University School of Medicine,
Hangzhou, China
(Shen) Department of Biomedical Research, Research and Innovation Center,
Xinjiang Institute of Technology, Xinjiang, China
(Hou) Sanquan College of Xinxiang Medical University, Xinxiang, China
(Yu) Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang
Chinese Medical University, Hangzhou, China
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Postoperative atrial fibrillation (POAF) and pericardial
effusion are important factors affecting prognosis after cardiac surgery.
Recently, it has been reported that posterior pericardiotomy (PP) can
effectively prevent the occurrence of POAF and pericardial effusion. To
validate these conclusions and guide clinical practice, we conducted a
systematic review with meta-analysis. Method(s): We searched multiple
databases for manuscripts published before July 2022 on the use of PP to
prevent POAF and pericardial effusion and included only randomized
controlled trials. The main outcome was atrial fibrillation after coronary
artery bypass grafting, and secondary outcomes were included.
 Result(s): This meta-analysis included 14 randomized controlled
trials with a total of 2275 patients. Meta-analysis showed that the
incidence of POAF after cardiac surgery in the PP group was significantly
lower than that in the control group (risk ratio=0.48; 95% confidence
interval=0.33~0.69; P<0.00001). PP effectively reduced postoperative
pericardial effusion (risk ratio=0.34, 95% confidence interval=0.21-0.55;
P<0.00001). Conclusion(s): PP has shown good results in preventing
POAF, pericardial effusion, and other complications, which indicates that
PP is a safe and effective surgical method, but attention still needs to
be paid to the potential risk of coagulation dysfunction caused by
PP. Copyright © 2023, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

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

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

<9>
Accession Number
2022611216
Title
The efficacy and safety of intravenous thrombolysis with tenecteplase
versus alteplase for acute ischemic stroke: a systematic review and
meta-analysis.
Source
Neurological Sciences. 44(9) (pp 3005-3015), 2023. Date of Publication:
September 2023.
Author
Wei H.; Fu B.; Yang C.; Huang M.
Institution
(Wei, Fu, Huang) Department of Neurology, Hubei Provincial Hospital of
Integrated Chinese and Western Medicine, Hubei University of Chinese
Medicine, Wuhan 430000, China
(Yang) Department of Neurology, People's Hospital of Dongxihu District of
Wuhan Union Hospital, Wuhan 430040, China
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Objectives: We aimed to evaluate the available evidence on the efficacy
and safety outcomes of intravenous tenecteplase (TNK) compared with
intravenous alteplase(ALT) for patients with acute ischemic stroke (AIS)
in randomized controlled trials (RCTs). Method(s): The
MEDLINE/PubMed, Embase, Springer, Web of Science, Cochrane Collaboration
database, China National Knowledge Infrastructure (CNKI) database, and
Wanfang database were comprehensively searched for RCTs regarding the
effects of TNK versus ALT among AIS patients in these English and Chinese
electronic databases from inception dates to August 1, 2022. This
meta-analysis followed PRISMA guidelines. Two reviewers independently
retrieved RCTs and extracted relevant information. The methodological
quality of the included trials was estimated using the Cochrane risk of
bias tool. The pooled analyses were performed using RevMan 5.3 software.
The primary outcome was functional outcome on the modified Rankin Scale
(mRS) (range 0 to 5) and mortality at 90 days. The secondary outcomes
included successful recanalization, early neurologic improvement < 48 h,
any intracranial hemorrhage (ICH), and symptomatic ICH. The follow-up time
of all studies was at least 3 months. Result(s): A total of nine RCTs
involving 1958 patients in TNK group and 1731 patients in ALT group were
finally included. For the efficacy outcomes, there were no significant
differences between the two groups in terms of mRS score 0 ~ 2 (RR 1.00;
95% CI 0.88-1.13; P = 0.96), mRS score 0 ~ 1 (RR 1.03; 95% CI 0.96-1.10; P
= 0.36), successful recanalization (RR 1.25; 95% CI 0.88-1.76; P = 0.21),
and early neurologic improvement < 48 h (RR 1.08; 95% CI 0.92-1.26; P =
0.37). Similar results were seen for the safety outcomes, which have no
statistical differences in terms of any ICH (RR 1.01; 95% CI 0.72-1.41; P
= 0.96), symptomatic ICH (RR 1.19; 95% CI 0.81-1.76; P = 0.37), and
mortality at 90 days (RR 0.99; 95% CI 0.83-1.19; P = 0.94).
 Conclusion(s): Overall, the efficacy and safety outcomes of
intravenous thrombolysis with TNK versus ALT for AIS were not
statistically different. However, TNK at a dose of 0.25 mg/kg may be a
reasonable alternative to ALT for thrombolysis. Copyright © 2023,
Fondazione Societa Italiana di Neurologia.

<10>
Accession Number
2024958257
Title
Sternal wound infections following internal mammary artery grafts for a
coronary bypass: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Li M.; Yu Z.; Chen Q.; Zhao Q.; Chen X.; Lei C.; Wang X.; Yang R.
Institution
(Li) Department of Nephrology, Erqiao Street Community Health Service
Cente affiliated of the Fifth Hospital of Wuhan, Wuhan, China
(Yu) Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan
Hospital, Wuhan, China
(Chen) Department of Infectious Immunolog, Wuhan Jinyintan Hospital,
Wuhan, China
(Zhao, Yang) Department of Thoracic and Cardiovascular Surgery, The Fifth
Hospital of Wuhan, Wuhan, China
(Chen) Department of Health Management Center, Affiliated Hospital of
Guangdong Medical University, Zhanjiang, China
(Lei) Department of Oncology, The Fifth Hospital of Wuhan, Wuhan, China
(Wang) Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
The meta-analysis aims to evaluate and compare the sternal wound
infections following internal mammary artery grafts for a coronary bypass.
Examinations comparing bilateral internal mammary artery to single
internal mammary artery for coronary artery bypass grafting were among the
meta-analyses from various languages that met the inclusion criteria.
Using dichotomous random- or fixed-effect models, the results of these
investigations were examined, and the Odd Ratio (OR) with 95% confidence
intervals (CIs) was computed. A total of 31 examinations from 2001 to 2023
were recruited for the current analysis including 181 503 personals with
coronary artery bypass grafting. Bilateral internal mammary artery had
significantly higher sternal wound infection (OR, 1.51; 95% CI, 1.37-1.68,
p < 0.001), superficial sternal wound infection (OR, 1.72; 95% CI,
1.16-2.56, p = 0.007), deep sternal wound infection (OR, 1.62; 95% CI,
1.41-1.86, p < 0.001), sternal wound infection in diabetics (OR, 1.48; 95%
CI, 1.16-1.90, p = 0.002), sternal wound infection in elderly (OR, 1.38;
95% CI, 1.22-1.57, p < 0.001), sternal wound infection in pedicled
preparation (OR, 1.70; 95% CI, 1.30-2.23, p < 0.001) and sternal wound
infection in skeletonized preparation (OR, 1.40; 95% CI, 1.09-1.81, p =
0.009) compared to single internal mammary artery in personals with
coronary artery bypass grafting. Bilateral internal mammary artery
grafting is linked to a higher risk of impaired wound healing,
particularly in diabetic individuals, elderly, pedicled preparation, and
skeletonized preparation. Nevertheless, caution should be exercised while
interacting with its values since examinations were performed by different
surgeons with different skills on different types of
personals. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<11>
Accession Number
2024958253
Title
Effect of thoracoscopic and thoracotomy on postoperative wound
complications in patients with lung cancer: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Qiu B.; Han J.; Zhao J.
Institution
(Qiu, Zhao) Department of Thoracic Surgery, Affiliated Hospital of Weifang
Medical University, Weifang, China
(Han) Department of Interventional Oncology, Affiliated Hospital of
Weifang Medical University, Weifang, China
Publisher
John Wiley and Sons Inc
Abstract
Because of the difficult surgical procedures, patients with lung cancer
who have received thoracic surgery tend to have postoperative
complications. It may lead to postoperative complications like wound
infection, wound haematoma and pneumothorax. A lot of research has
assessed the effect of various surgery methods on postoperative
complications in pulmonary cancer. The purpose of this meta-analysis is to
establish if thoracoscopic is superior to that of thoracotomy in the rate
of post-operative complications. From the beginning to the end of June
2023, we performed an exhaustive search on four main databases for key
words. The Hazard of Bias in Non-Randomized Interventional Studies
(ROBINS-I) was evaluated in the literature. In the end, 13 trials that
fulfilled the eligibility criteria underwent further statistical analyses.
The results showed that thoracoscopic intervention decreased the risk of
post operative wound infection (dominant ratio [OR], 3.00; 95% confidence
margin [CI], 1.98, 4.55; p < 0.00001) and air-leakage after operation (OR,
1.30; 95% CI, 1.04, 1.63; p = 0.02). There was no statistically
significant difference between the two groups in terms of the rate of
haemorrhage after operation (OR, 0.10; 95% CI, 0.73, 1.66; p = 0.63). Our
findings indicate that thoracoscopic is less likely to cause post
operative infection and gas leakage than thoracotomy, and it does not
decrease the risk of postoperative haemorrhage. As some of the chosen
trials are too small to conduct meta-analyses, care must be taken when
handling the data. In the future, a large number of randomized, controlled
trials will be required to provide additional evidence for this
research. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<12>
Accession Number
2024055465
Title
DOAC versus VKA in patients with atrial fibrillation and bioprosthetic
valves: a systematic review and meta-analysis.
Source
Revista Espanola de Cardiologia. 76(9) (pp 690-699), 2023. Date of
Publication: September 2023.
Author
Guardia Martinez P.; Aviles Toscano A.L.; Martinez Mayoral M.A.; Molto
Miralles J.
Institution
(Guardia Martinez) Servicio de Cardiologia, Hospital Costa del Sol,
Marbella, Malaga, Spain
(Aviles Toscano) Servicio de Cardiologia, Hospital de la Serrania de
Ronda, Ronda, Malaga, Spain
(Martinez Mayoral, Molto Miralles) Departamento de Estadistica,
Matematicas e Informatica, Universidad Miguel Hernandez, Elche, Alicante,
Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Direct oral anticoagulant (DOAC) therapy has
been shown to be safe and effective in patients with atrial fibrillation
(AF). However, outcomes in AF patients with bioprosthetic valves are
unclear, as this population has been underrepresented in clinical trials.
The aim of this study was to assess the safety and efficacy of DOACs in
this population based on the existing published literature.
 Method(s): A systematic search and review were conducted to identify
randomized clinical trials and comparative observational studies published
from 2017 to January 2022 that compared DOACs and vitamin K antagonists
(VKAs) in AF patients with bioprosthetic valves. Hazard ratios (HR) were
collected to compare the 2 treatments in terms of cardiovascular and
all-cause mortality, stroke/systemic embolism, and major bleeding. A
meta-analysis combining the results was performed. Result(s): We
included 12 studies (30 283 patients). DOACs and VKAs were compared based
on HRs at the 95% confidence interval. DOAC therapy was associated with a
significant 9% reduction in all-cause mortality (HR, 0.91; 95%CI,
0.85-0.97; P = .0068; I2 = 8%), with no significant differences
in the risk of stroke/systemic embolism (HR, 0.87; 95%CI, 0.67-1.14; P =
.29; I2 = 45%) or major bleeding (HR, 0.82; 95%CI, 0.67-1.00; P
= .054; I2 = 48.7%). Conclusion(s): DOAC therapy in AF
patients with bioprosthetic valves may be associated with a significant
reduction in all-cause mortality, with no reduction in the efficacy of
stroke/systemic embolism prevention or increase in major bleeding
risk. Copyright © 2023

<13>
Accession Number
642066571
Title
Diabetes after Cardiac Transplant with Low-Dose Everolimus and Tacrolimus.
Source
Diabetes. Conference: 83rd Scientific Sessions of the American Diabetes
Association, ADA 2023. San Diego, CA United States. 72(Supplement 1) (no
pagination), 2023. Date of Publication: June 2023.
Author
Raven L.M.; Muir C.A.; Pouliopoulos J.; Macdonald P.S.; Jabbour A.;
Greenfield J.
Publisher
American Diabetes Association Inc.
Abstract
Background: Although modern immunosuppressants improve survival
post-transplant, they are associated with long-term metabolic
complications, such as post-transplant diabetes mellitus (PTDM).
Calcineurin inhibitor-sparing regimens using everolimus attenuate some
complications such as left ventricular hypertrophy. However, the metabolic
effects of everolimus following transplant are less clear. Aim(s): To
compare incidence of diabetes in heart transplant recipients exposed to
low-dose everolimus and tacrolimus versus standard-dose tacrolimus.
 Method(s): Post-hoc analysis in participants of a randomised
open-label clinical trial of low-dose everolimus and tacrolimus versus
standard-dose tacrolimus in heart transplant recipients. Result(s):
There were 39 participants in the trial, mean follow up was 6.4 +/- 1.5
years. There was a high rate of pre-existing diabetes (26%) and
newly-diagnosed PTDM (36%) during follow-up (Figure 1). Half the patients
who developed PTDM in the everolimus-tacrolimus group (n=4/8) ceased
diabetes medications during follow-up, which was not observed in patients
on standard tacrolimus (n=0/6). Conclusion(s): This study suggests
that treatment with everolimus may improve PTDM outcomes relative to
treatment with standard doses of calcineurin inhibitor. These findings
should be further studied in prospective randomised trials.

<14>
Accession Number
642066063
Title
A family-tailored early motor intervention in infants (EMIheart) with
complex congenital heart disease: Preliminary results of a feasibility
RCT.
Source
Cardiology in the Young. Conference: 56th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology, AEPC 2023.
Dublin Ireland. 33(Supplement 1) (pp S267), 2023. Date of Publication: May
2023.
Author
Mitteregger E.; Dirks T.; Theiler M.; Kretschmar O.; Latal B.
Institution
(Mitteregger, Latal) Child Development Center, University Children's
Hospital Zurich, Switzerland
(Dirks) Paediatric Physiotherapy, Groningen, Netherlands
(Theiler) Swiss Parents' Assoc. for the Child with Heart Disease
(Elternvereinigung fur das Herzkranke Kind), Switzerland
(Kretschmar) Department of Pediatric Cardiology, University Children's
Hospital Zurich, Switzerland
Publisher
Cambridge University Press
Abstract
Background and Aim: Children with congenital heart disease (CHD)
undergoing open-heart surgery are at risk for developmental impairments
with motor delay manifesting first and contributing to parental concerns.
Only a few interventional studies aim to improve motor development in CHD
infants with inconclusive results. We thus developed a family-tailored
early motor intervention (EMI-Heart), which aims to promote postural
control enhancing motor development and partnering with parents to
encourage family well-being. The primary aim is to evaluate the
feasibility of EMI-Heart. The secondary aim is to evaluate differences
between the intervention (EMI-Heart) and control group (standard of care)
in motor outcomes and family well-being at baseline, post-treatment, and
follow-up. Method(s): This single-centre feasibility RCT compares two
groups of CHD infants after open-heart surgery. Infants meeting inclusions
criteria are randomly allocated to EMI-Heart or the control group. Infants
assigned to EMI-Heart receive early motor intervention for 3 months.
Feasibility outcomes are a) clinical recruitment rates and percentage of
families completing, b) average duration and number of sessions, and c)
acceptability using parental questionnaires post-treatment. Secondary
outcomes are a) motor performance (e.g., General Movement Assessment,
Alberta Infant Motor Scale) and b) family well-being (e.g., PedsQL, SF36)
at baseline (3-5 months), post-treatment (6-8 months) and follow-up (12
months). We evaluate the feasibility using descriptive statistics and
access differences between the two groups using nonparametric statistical
analysis at baseline, post-treatment, and follow-up. Result(s):
Regarding feasibility we found a) a recruitment rate of 59% (10/17), all
families completed the study (100%, 10/10), b) average intervention
duration was 3-4 months, the number of EMI-Heart sessions was 9 sessions,
c) the average Likert scale of parental acceptability was 3, 7 (range 1
not agree to 4 totally agree). Regarding secondary outcomes we found that
motor performance scores of the intervention and control group were not
different at baseline. Conclusion(s): EMI-Heart is a feasible early
motor intervention with a good recruitment rate and high parental
adherence and acceptability. This feasibility RCT provides information
about a newly developed early motor intervention in infants with complex
CHD and provides a foundation for a future large-scale RCT.

<15>
Accession Number
642065876
Title
Double-arterial cannulation perfusion provides better brain protection
during surgical correction of aortic coarctation with ventricular septal
defect.
Source
Cardiology in the Young. Conference: 56th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology, AEPC 2023.
Dublin Ireland. 33(Supplement 1) (pp S158), 2023. Date of Publication: May
2023.
Author
Bi J.; Su S.; Zou M.; Chen X.; Li J.; Ma L.
Institution
(Bi, Su, Li, Zou, Chen, Li, Ma) Department of Cardiovascular Surgery,
Guangzhou Women and Children's Medical Center, Guangzhou Medical
University, Guangdong, China & Guangdong Provincial Key Laboratory of
Research in Structural Birth Defect Disease, Department of Pediatric
Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical
University, Guangdong, China
Publisher
Cambridge University Press
Abstract
Background andAim:DHCAis the gold standard perfusion strategy for
CoA-VSDcorrection, but associated with risk of braininjury. Double
arterial cannulation (DAC), firstly introduced in aortic arch
reconstruction due to aortic dissection or aneurysm, is now an alternative
perfusion strategy. The purpose of this study was to evaluated the
effectiveness of brain protection ofDACcomparedwithDHCA. Method(s): A
single-center pilot study of RCT was carried out from 2020 to 2021.
Patients with CoA-VSD ready for surgical correction were enrolled in and
randomly assigned into 2 groups, namely DHCA without cerebral perfusion (n
= 5) and DAC (n = 6). Brain MRI and TCD were applied before and after
operation; EEG and cerebral oxygen saturation were continuously monitored
before, during, and after surgery until 48 hours postoperation.
 Result(s): The operation time, CPB time and cross-clamp time were all
numerically shorter in DAC group. The duration of intraoperative
isoelectric state was shorter in DAC group (22+/-31min vs. 64 +/-30min,
p<0.05). Post-operative cerebral oxygen saturation was higher in DAC group
(66+/-10% vs. 49+/-2%, p = 0.04 18h postoperation; 65+/-5% vs. 56+/-7%, p
= 0.04, 27h post-operation, and 72+/-5% vs. 65+/-2%, p = 0.04, 36h
post-operation; separately). The cerebral vascular resistance was lower in
DAC group, with both pulsatility index and resistivity index were lower
15h postoperation (1.15+/-0.17 vs. 1.51+/-0.09, p<0.01; 0.65+/-0.04 vs.
0.72 +/-0.02, p<0.01; separately). Post-operative intracranial hemorrhage
was numerically lower in DAC group. Though without statistically
difference due to limited number, the non-hemorrhage cases were only seen
in DAC group. 1 seizure case was seen in each group, with comparable
seizure time. Mixed linear regression indicated better systematic
hemodynamic characteristics in DAC group: lower intraoperative (P = 0.03)
and post-operative (p = 0.01) systematic vascular resistance index, and
higher post-operative cardiac index (p = 0.01) were found; lower
post-operative pulsatility index and resistivity index still existed
(p<0.01); and lower pulse pressure variation were seen(p<0.01).
 Conclusion(s): DAC is a better perfusion strategy during surgical
CoA-VSD correction, which could improve cerebral perfusion and reduce
brain injury.

<16>
Accession Number
642065407
Title
The prognostic role of systolic longitudinal strain in congenital heart
disease with systemic right ventricle: A systematic review and
meta-analysis.
Source
Cardiology in the Young. Conference: 56th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology, AEPC 2023.
Dublin Ireland. 33(Supplement 1) (pp S111-S112), 2023. Date of
Publication: May 2023.
Author
Dorobantu D.M.; Amir N.H.; Wadey C.A.; Sharma C.; Stuart A.G.; Pieles
G.E.; Williams C.A.
Institution
(Dorobantu, Wadey, Williams) Children's Health and Exercise Research
Center (CHERC), University of Exeter, Exeter, United Kingdom
(Amir) Department of Translational Health Sciences, Bristol Medical
School, University of Bristol, Bristol, United Kingdom
(Dorobantu, Sharma) Congenital Heart Unit, Bristol Royal Hospital for
Children and Heart Institute, Bristol, United Kingdom
(Stuart, Pieles) National Institute for Health Research Cardiovascular
Biomedical Research Centre, University of Bristol, United Kingdom
(Pieles) Sports Medicine Department and the Athlete Health and Performance
Research Centre, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital,
Doha, Qatar
(Amir) Faculty of Sports Science and Recreation, Universiti Teknologi MARA
Cawangan Perlis, Kampus Arau, Arau, Perlis, Malaysia
(Pieles) Institute of Sport Exercise and Health, University College
London, London, United Kingdom
Publisher
Cambridge University Press
Abstract
Background and Aim: Congenital heart disease (CHD) with systemic right
ventricle (RV) are associated with high mortality and morbidity. There is
need for better tools for risk stratification in this population, such as
evaluating the RV using speckle tracking echocardiography (STE). This
study aims to evaluate the current literature on the prognostic role of
STE derived RV longitudinal strain (RV-Sl) in CHD with systemic RV.
 Method(s): EMBASE, Medline, Web of Science, Scopus and CENTRAL
databases were searched from inception to February 2022, for terms related
to CHD, STE and prognosis. Patients with transposition of the great
arteries treated by atrial switch techniques (asTGA), congenitally
corrected TGA (ccTGA) and hypoplastic left heart syndrome (HLHS) were
selected. Outcomes of interest were classified as major adverse cardiac
events (MACE) and included death, heart failure, heart transplant and/or
ventricular arrhythmia. For asTGA and ccTGA a meta-analysis was possible,
while for HLHS a synthesis approach was used. Result(s): A total of n
= 1254 abstracts were screened, n = 114 full-text papers assessed for
eligibility and n = 11 cohorts met the inclusion and exclusion criteria: n
=4 on asTGA (n= 255 patients), n = 4 on ccTGA (n = 317 patients), n =4 on
pre-Norwood/Stage 1 HLSH (n = 113 patients), n = 4 on interstage HLHS (n =
155 patients) and n = 3 post-Glenn/Stage 2 HLHS (n = 69 patients). In
pooled analysis of asTGA and ccTGA, RV-Sl was found to be predictive of
MACE both in univariable analyses (HR = 1.12/%, [1.03; 1.22]) and
multivariable analyses (HR = 1.17/%, [1.05; 1.31]). This association was
positive in single disease cohorts (asTGA or ccTGA) and mixed cohorts
alike. In HLHS, RV-Sl was not found to be predictive of MACE when measured
before Norwood/Stage 1 (3/4 found no associations). Interstage RV-Sl was
associated with MACE in 4/4 cohorts, after Norwood/Stage and before
Glenn/Stage 2. All 3 studies reporting RV-Sl after Glenn/Stage 2 reported
associations with MACE. (Table) Conclusion(s): RV-Sl should be used
in risk stratification for patients withTGAand systemicRV(asTGA and
ccTGA), being predictive of MACE. In HLHS, there is limited prognostic
value of RV-Sl measured before Norwood/Stage 1, but there is evidence to
support its role in risk stratification during the interstage period, and
after the Glenn/Stage 2 procedure.

<17>
Accession Number
642065343
Title
Dapagliflozin for Inpatient Hyperglycemia in Cardiac Surgery Patients with
Type 2 Diabetes-Randomized Controlled Trial.
Source
Diabetes. Conference: 83rd Scientific Sessions of the American Diabetes
Association, ADA 2023. San Diego, CA United States. 72(Supplement 1) (no
pagination), 2023. Date of Publication: June 2023.
Author
Kuchay M.S.; Khatana P.; Mishra M.; Parvathi S.; Kaur P.; Wasir J.S.; Kaur
H.; Singh A.; Jain R.; Kohli C.; Bakshi G.; Radhika V.; Saheer S.; Singh
M.K.; Mishra S.
Publisher
American Diabetes Association Inc.
Abstract
Sodium/glucose cotransporter-2 (SGLT2) inhibitors have not been assessed
extensively for the treatment of hyperglycemia in noncritically ill,
hospitalized patients with type 2 diabetes (T2D). In this
investigator-initiated, treat-to-target, randomized trial, 250 cardiac
surgery patients with T2D were randomly assigned (1:1) to receive
dapagliflozin 10 mg daily plus basal-bolus insulin (DAPA group) or
basal-bolus insulin alone (INSULIN group) in the early postoperative
period. The primary outcome was mean differences between groups in their
daily blood glucose (BG) concentrations. The major safety outcomes were
the occurrence of severe ketonemia/diabetic ketoacidosis (DKA) and
hypoglycemia. All analyses were performed according to the
intention-to-treat principle. There were no differences in mean daily BG
concentrations (149 vs. 150 mg/dL), mean percentage of readings within the
target BG of 70-180 mg/dL (82.7% vs. 82.5%), daily total insulin dose
(mean, 39 vs. 40 units/day), number of daily insulin injections (median,
3.9 vs. 4), length of stay (median, 10 vs. 10 days), or hospital
complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. Mean
plasma ketone levels were significantly higher in the DAPA group than in
the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs. 0.19
mmol/L) of randomization. Six patients in the DAPA group developed severe
ketonemia, but none developed DKA. There were no differences in the
proportion of patients with BG <70 mg/dL (9.6% vs. 7.2%) between the
treatment groups. Numerically fewer patients in the DAPA group developed
acute kidney injury (7.2%) than in the insulin group (12.8%). These
findings indicate that dapagliflozin complementary to basal-bolus insulin
does not improve glycemia further over and above the basal-bolus in
hospitalized cardiac surgery patients with T2D. However, dapagliflozin is
safe and does not increase the incidence of DKA or other complications
during the hospital stay.

<18>
Accession Number
642072000
Title
Association of pulmonary artery catheter with in-hospital outcomes after
cardiac surgery in the United States: National Inpatient Sample 1999-2019.
Source
Scientific reports. 13(1) (pp 13541), 2023. Date of Publication: 19 Aug
2023.
Author
Beydoun H.A.; Beydoun M.A.; Eid S.M.; Zonderman A.B.
Institution
(Beydoun) Department of Research Programs, Fort Belvoir Community
Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060, United States
(Beydoun, Zonderman) Laboratory of Epidemiology and Population Sciences,
National Institute on Aging Intramural Research Program, Baltimore, MD
21224, United States
(Eid) Department of Medicine, Johns Hopkins University School of Medicine,
Baltimore, MD 21224, United States
Publisher
NLM (Medline)
Abstract
To examine associations of pulmonary artery catheter (PAC) use with
in-hospital death and hospital length of stay (days) overall and within
subgroups of hospitalized cardiac surgery patients. Secondary analyses of
1999-2019 National Inpatient Sample data were performed using 969,034
records (68% male, mean age: 65 years) representing adult cardiac surgery
patients in the United States. A subgroup of 323,929 records corresponded
to patients with congestive heart failure, pulmonary hypertension,
mitral/tricuspid valve disease and/or combined surgeries. We evaluated PAC
in relation to clinical outcomes using regression and targeted maximum
likelihood estimation (TMLE). Hospitalized cardiac surgery patients
experienced more in-hospital deaths and longer stays if they had>=1
subgroup characteristics. For risk-adjusted models, in-hospital deaths
were similar among recipients and non-recipients of PAC (odds ratio [OR]
1.04, 95% confidence interval [CI] 0.96, 1.12), although PAC was
associated with more in-hospital deaths among the subgroup with congestive
heart failure (OR 1.14, 95% CI 1.03, 1.26). PAC recipients experienced
shorter stays than non-recipients (beta=-0.40, 95% CI-0.64,-0.15), with
variations by subgroup. We obtained comparable results using TMLE. In this
retrospective cohort study, PAC was associated with shorter stays and
similar in-hospital death rates among cardiac surgery patients. Worse
clinical outcomes associated with PAC were observed only among patients
with congestive heart failure. Prospective cohort studies and randomized
controlled trials are needed to confirm and extend these preliminary
findings. Copyright © 2023. Springer Nature Limited.

<19>
Accession Number
2024908060
Title
Safety and efficacy of total thoracoscopic surgery for patients with
tricuspid regurgitation and reduced right ventricular function after left
heart valves replacement: a retrospective comparative study.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
400. Date of Publication: December 2023.
Author
Lin Z.; Xu Z.; Chen X.; Lin F.; Chen L.; Dai X.
Institution
(Lin, Xu, Chen, Lin, Chen, Dai) Department of Cardiovascular Surgery,
Union Hospital, Fujian Medical University, Xinquan Road 29#, Fuzhou
350001, China
(Lin, Xu, Chen, Lin, Chen, Dai) Key Laboratory of Cardio-Thoracic Surgery,
Fujian Medical University, Fujian Province University, Fuzhou 350001,
China
Publisher
BioMed Central Ltd
Abstract
Background: Tricuspid valve surgery is the standard treatment for
tricuspid valve disease refractory to pharmacologic therapy. However,
patients with tricuspid regurgitation after previous left heart valves
replacement with reduced right ventricular (RV) function are at greater
risk of surgery. We compared the clinical outcomes of tricuspid valve
replacement in this subgroup of patients through mini-thoracotomy and
conventional full-sternotomy approach. Method(s): We identified 44
patients at our institution with tricuspid regurgitation and reduced right
ventricular function after left heart valves replacement who underwent
either total thoracoscopic tricuspid valve replacement (T-TVR) or
conventional tricuspid valve replacement (C-TVR) from December 2014 and
May 2021. Patient clinical characteristics, hospital course, and
postoperative changes in RV function were retrospectively reviewed and
analyzed. Result(s): Baseline characteristics between T-TVR (n = 25)
and C-TVR (n = 19) were comparable including a high incidence of liver
dysfunction and renal insufficiency. There were no statistically
differences between the two groups in terms of hospital mortality (8.0%
vs. 21.1%, P =.211). Patients in the T-TVR group had less total drainage
volume (201.60 +/- 77.05 ml vs. 614.74 +/- 182.31 ml, p <.001), required
fewer postoperative blood product transfusions, and had a lower total
length of hospital stay (15(15-16) vs. 16(14-17) days, P =.019) compared
to the C-TVR group. T-TVR was associated with better and faster recovery
of tricuspid annular plane systolic excursion (TAPSE) and right ventricle
fractional area change (RVFAC) (adjusted beta = 0.154, 95% CI: 0.037 to
0.271, p =.010 and adjusted beta = 0.003, 95% CI: 0.000 to 0.005, p =.024;
respectively) within the first 3 months postoperatively compared with
C-TVR. Conclusion(s): T-TVR represents a viable alternative to
current surgical strategies as a potentially sicker cohort demonstrated
similar hospital mortality compared to conventional surgery, with reduced
length of hospital stay, fewer blood transfusions, and more favorable in
promoting RV functional recovery in the early period. Future prospective,
randomized-controlled trials with longer follow-up durations are needed to
validate these findings. Copyright © 2023, BioMed Central Ltd.,
part of Springer Nature.

<20>
Accession Number
2024858500
Title
Comparison of the effects of one-level and bi-level pre-incisional erector
spinae plane block on postoperative acute pain in video-assisted
thoracoscopic surgery; a prospective, randomized, double-blind trial.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 270. Date
of Publication: December 2023.
Author
Zengin E.N.; Zengin M.; Yigit H.; Sazak H.; Sekerci S.; Alagoz A.
Institution
(Zengin, Yigit, Sekerci) Ankara Bilkent City Hospital, Anesthesiology and
Reanimation Clinic, Ministry of Health, Ankara, Turkey
(Zengin) Ankara Etlik City Hospital, Anesthesiology and Reanimation
Clinic, Ministry of Health, Ankara, Turkey
(Sazak, Alagoz) University of Health Sciences, Ankara Ataturk Sanatorium
Training and Research Hospital, Ankara, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: This prospective, randomized, double-blind trial aimed to
compare the postoperative analgesic efficacy of One-Level pre-incisional
erector spinae plane block (ESPB) and Bi-Level pre-incisional ESPB in
patients undergoing video-assisted thoracic surgery (VATS).
 Method(s): This pilot trial was conducted between April 2022 and
February 2023 with sixty patients. The patients were randomly divided into
two groups. In One-Level ESPB Group (n = 30) block was performed at the
thoracal(T)5 level with the 30 ml 0.25% bupivacaine. In the Bi-Level ESPB
Group (n = 30) block was performed at T4 and T6 levels by using 15 ml of
0.25% bupivacaine for each level. In the postoperative period, 50 mg
dexketoprofen every 12 h and 1 g paracetamol every 8 h were given
intravenously (IV). Patient-controlled analgesia (PCA) prepared with
morphine was applied to the patients. 0.5 mg/kg of tramadol was
administered via IV for rescue analgesia. Visual analog scale (VAS) scores
were recorded in the postoperative 1st, 2nd,
4th, 12th, 24th, and 48th
-hours. The need for additional analgesics and side effects were recorded.
In two groups, patients' demographics and postoperative hemodynamic data
were recorded. Result(s): VAS scores at resting were statistically
significantly higher at the 1st (p: 0.002) and 4th
-hour (p: 0.001) in the One-Level ESPB. When the groups were evaluated in
terms of VAS coughing scores, the 4th -hour (p: 0.001) VAS
coughing scores results were found to be statistically significantly
higher in the One-Level ESPB group. In terms of VAS values evaluated
during follow-up, the rates of VAS coughing score > 3 values were found to
be statistically significantly lower in the Bi-Level ESPB group (p:
0.011). There was no statistically significant difference between the
groups in terms of side effects, morphine consumption, and additional
analgesic use (p > 0.05). Conclusion(s): Adequate analgesia was
achieved in the early postoperative period in the group treated with
Bi-Level ESPB with similar morphine consumption and side effects. This may
be an advantage, especially in the early postoperative period when the
pain is quite intense. Copyright © 2023, BioMed Central Ltd.,
part of Springer Nature.

<21>
Accession Number
2024857845
Title
Optimal dose of neostigmine antagonizing cisatracurium-induced shallow
neuromuscular block in elderly patients: a randomized control study.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 269. Date
of Publication: December 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, Hunan, Changsha 410013, China
(Huang) Department of Anesthesiology, The First Affiliated Hospital of
Xiamen University, Xiamen University, Xiamen, China
(Tong) Hunan Province Key Laboratory of Brain Homeostasis, Third Xiangya
Hospital, Central South University, Hunan, Changsha 410013, China
Publisher
BioMed Central Ltd
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.

<22>
Accession Number
2024857397
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) (no pagination), 2023. Article Number:
392. Date of Publication: December 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, Tanta, Egypt
(Mamdouh) Faculty of Medicine, Beni-Suef University, Beni-Suef, 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
BioMed Central Ltd
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.

<23>
Accession Number
2026573510
Title
On-table Extubation After Minimally Invasive Cardiac Surgery: A
Retrospective Observational Pilot Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Jaquet O.; Gos L.; Amabili P.; Donneau A.-F.; Mendes M.A.; Bonhomme V.;
Tchana-Sato V.; Hans G.A.
Institution
(Jaquet, Gos, Amabili, Mendes, Bonhomme, Hans) Department of Anesthesia
and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
(Donneau) Department of Public Health, University of Liege, Liege, Belgium
(Bonhomme) Anesthesia and Perioperative Neuroscience Laboratory,
GIGA-Consciousness Thematic Unit, GIGA-Research, Liege University, Liege,
Belgium
(Tchana-Sato) Department of Cardiovascular Surgery, Liege University
Hospital, Liege, Belgium
Publisher
W.B. Saunders
Abstract
Objective: To assess the safety of "on-table" extubation after
minimally-invasive heart valve surgery. Design(s): A single-center
retrospective observational study. Setting(s): At a tertiary referral
academic hospital. Participant(s): Patients who underwent nonemergent
isolated heart valve surgery through a minithoracotomy approach between
January 2016 and August 2021. Intervention(s): All patients were
treated by 1 of the 6 cardiac anesthesiologists of the hospital. Only some
of them practiced "on-table" extubation, and the outcome of patients
extubated "on-table" was compared to those extubated in the intensive care
unit (ICU). Measurement and Main Results: The primary outcome was the
occurrence of any postoperative respiratory complication during the entire
hospital stay. Secondary outcomes included the use of inotropes and
vasopressors, de novo atrial fibrillation, and lengths of stay in the ICU
and the hospital. A total of 294 patients met inclusion criteria, of whom
186 (63%) were extubated "on-table." Cardiopulmonary bypass duration was
significantly longer, and moderate intraoperative hypothermia was
significantly more frequent in patients extubated in the ICU. After
adjustment for these confounders and for the European System for Cardiac
Operative Risk Evaluation (EuroSCORE) II using a multivariate logistic
model, no association was found between the extubation strategy and
postoperative pulmonary complications (adjusted odds ratio = 0.84; 95% CI
= 0.40-1.77; p = 0.64). "On-table" extubation was associated with a lower
risk of postoperative pneumonia and fewer vasopressors requirements.
 Conclusion(s): "On-table" extubation was not associated with an
increased incidence of respiratory complications. A randomized controlled
trial is warranted to confirm these results and determine whether
"on-table" extubation offers additional benefits. Copyright ©
2023 Elsevier Inc.

<24>
Accession Number
2026533738
Title
Wearable Cardiac Rhythm Monitoring Device for Detection of Postoperative
Atrial Fibrillation.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Hibino M.; Pandey A.K.; Verma S.; Puar P.; Teoh H.; Quan A.; Verma R.; Yau
T.M.; Bisleri G.; Yanagawa B.; Mazer C.D.; Verma A.; Ha A.C.T.
Institution
(Hibino) Division of Cardiothoracic Surgery, Emory University School of
Medicine, Atlanta, Georgia, United States
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Verma, Puar, Teoh, Quan, Bisleri, Yanagawa) Division of Cardiac Surgery,
St. Michael's Hospital of Unity Health Toronto, University of Toronto,
Toronto, ON, Canada
(Verma, Yau, Bisleri, Yanagawa) Division of Cardiovascular Surgery,
Department of Surgery, University of Toronto, Toronto, ON, Canada
(Teoh) Division of Endocrinology and Metabolism, St. Michael's Hospital of
Unity Health Toronto, Toronto, ON, Canada
(Verma) Royal College of Surgeons in Ireland, Dublin, Ireland
(Yau, Ha) Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital of Unity Health
Toronto, University of Toronto, Toronto, ON, Canada
(Verma) Division of Cardiology, McGill University, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: This study evaluated the use of a wearable, patch-based cardiac
rhythm monitoring device in detecting postoperative atrial fibrillation
(POAF) among cardiac surgical patients within 30 days after hospital
discharge. Description: From the SEARCH-AF (The Post-Surgical Enhanced
Monitoring for Cardiac Arrhythmias and Atrial Fibrillation) CardioLink-1
trial, this study examined rates of POAF according to surgery type and the
incremental value of continuous cardiac rhythm monitoring among patients
who underwent valve surgery. The primary outcome was cumulative atrial
fibrillation or atrial flutter lasting for >=6 minutes detected by
continuous monitoring or atrial fibrillation or atrial flutter documented
by a 12-lead electrocardiogram within 30 days of randomization.
Evaluation: The primary outcome occurred in 8.2%, 13.5%, and 21.2% of
patients who underwent isolated coronary artery bypass grafting (CABG),
isolated valve surgery, and combined CABG and valve surgery. Relative to
patients who underwent isolated CABG, those patients who had valve surgery
were more likely to experience POAF. A higher diagnostic yield was
obtained when the patch-based cardiac rhythm monitor was applied in
patients who underwent valve surgery. Conclusion(s): Use of a
wearable, patch-based cardiac monitoring device was an effective detection
strategy among patients undergoing valve surgery, given their higher risk
of developing POAF. Copyright © 2023 The Society of Thoracic
Surgeons

<25>
Accession Number
2026533399
Title
Comparison of radial, dorsalis pedis, and posterior tibial arteries for
ultrasound-guided arterial catheterisation with dynamic needle tip
positioning in paediatric patients: a randomised controlled trial.
Source
British Journal of Anaesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Takeshita J.; Nakayama Y.; Tachibana K.; Nakajima Y.; Hamaba H.; Shime N.
Institution
(Takeshita, Tachibana, Hamaba) Department of Anesthesiology, Osaka
Prefectural Hospital Organization, Osaka Women's and Children's Hospital,
Murodo-cho, Izumi, Osaka, Japan
(Nakayama) Department of Molecular, Cellular and Biomedical Sciences CUNY
School of Medicine, City College of New York, Convent Avenue, New York,
NY, United States
(Nakajima) Department of Anesthesiology and Intensive Care, Kinki
University Faculty of Medicine, Ohnohigashi, Sayama, Osaka, Japan
(Nakajima) Outcomes Research Consortium, Euclid Avenue, Cleveland, OH,
United States
(Shime) Department of Emergency and Critical Care Medicine, Graduate
School of Biomedical & Health Sciences, Hiroshima University, Kagamiyama,
Higashihiroshima, Hiroshima, Japan
Publisher
Elsevier Ltd
Abstract
Background: Arterial catheterisation in children can be challenging and
time-consuming. We aimed to compare the success rates of ultrasound-guided
arterial catheterisation utilising the short-axis out-of-plane approach
with dynamic needle tip positioning in the radial, dorsalis pedis, and
posterior tibial arteries in paediatric patients. We also examined the
factors influencing the catheterisation success using dynamic needle tip
positioning. Method(s): Paediatric patients (aged <3 yr) undergoing
cardiac surgery were randomly assigned to three groups based on puncture
sites: radial artery (Group R), dorsalis pedis artery (Group D), and
posterior tibial artery (Group P). The first-attempt and overall success
rates of arterial catheterisation were compared, followed by multiple
logistic regression analysis (dependent variable: first-attempt success;
independent variables: body weight, diameter and depth of the artery,
targeted artery, and trisomy 21). Result(s): The study included 270
subjects (n=90 per group). There was no significant difference in the
first-attempt (Group R: 82%, Group D: 76%, and Group P: 81%) and overall
success rates (Group R: 94%, Group D: 93%, and Group P: 91%) among the
three groups. The diameter of the artery (per 0.1 mm) (odds ratio: 1.32,
95% confidence interval: 1.09-1.60) and trisomy 21 (odds ratio: 0.43, 95%
confidence interval: 0.20-0.92) were independent predictors of
first-attempt success or failure. Conclusion(s): The first-attempt
and overall success rates of arterial catheterisation of the dorsalis
pedis and posterior tibial arteries were not inferior to those in the
radial artery when using dynamic needle tip positioning. These two lower
extremity peripheral arteries present viable alternative catheterisation
sites in paediatric patients. Clinical trial registration:
UMIN000042847. Copyright © 2023 British Journal of Anaesthesia

<26>
Accession Number
2026433344
Title
Midterm Outcomes of Endovascular vs. Medical Therapy for Uncomplicated
Type B Aortic Dissection: Meta-Analysis of Reconstructed Time to Event
Data.
Source
European Journal of Vascular and Endovascular Surgery. (no pagination),
2023. Date of Publication: 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Chu D.; Serna-Gallegos D.; Singh
M.J.; Chaer R.A.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Singh, Chaer, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Centre, Pittsburgh, PA, United
States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Singh, Chaer) Division of Vascular Surgery, University of Pittsburgh
Medical Centre, Pittsburgh, PA, United States
Publisher
W.B. Saunders Ltd
Abstract
Objective: To evaluate outcomes of thoracic endovascular aortic repair
(TEVAR) vs. medical therapy in uncomplicated type B aortic dissections
(TBAD). Data sources: PubMed/MEDLINE, EMBASE, SciELO, LILACS,
CENTRAL/CCTR, Google Scholar, and reference lists of relevant articles.
Review methods: This was a pooled meta-analysis of time to event data
extracted from studies published by December 2022 for the following
outcomes: all cause mortality, aortic related mortality, and late aortic
interventions. Certainty of evidence was evaluated through the Grading of
Recommendations, Assessment, Development and Evaluations (GRADE) tool.
 Result(s): Ten studies met the eligibility criteria (eight
observational; two randomised trials), comprising 17 906 patients (2 332
patients in the TEVAR groups and 15 574 patients in the medical therapy
group). Compared with patients who received medical therapy, patients who
underwent TEVAR had a statistically significantly lower risk of all cause
death (HR 0.79, 95% CI 0.72 - 0.87, p < .001; GRADE certainty: low) and
lower risk of aortic related death (HR 0.43, 95% CI 0.30 - 0.62, p < .001;
GRADE certainty: low) without statistically significant difference in the
risk of late aortic interventions (HR 1.05, 95% CI 0.88 - 1.26, p = .56;
GRADE certainty: low). In the subgroup analyses, TEVAR was associated with
lower risk of all cause death when randomised controlled trials only were
pooled (HR 0.44, 95% CI 0.23 - 0.83, p = .012; GRADE certainty: moderate),
younger patients only (HR 0.56, 95% CI 0.47 - 0.67, p < .001; GRADE
certainty: low), Western populations only (HR 0.85, 95% CI 0.77 - 0.93, p
= .001; GRADE certainty: low) and non-Western populations only (HR 0.47,
95% CI 0.35 - 0.62, p < .001; GRADE certainty: low). For all cause
mortality and aortic related mortality, restricted mean survival time was
overall 396 days and 398 days longer with TEVAR (p < .001), respectively,
which means that TEVAR was associated with lifetime gain.
 Conclusion(s): TEVAR may be associated with better midterm survival
and lower risk of aortic related death in the follow up of patients
treated for uncomplicated TBAD compared with medical therapy; however,
randomised controlled trials with larger sample sizes and longer follow up
are still warranted. Copyright © 2023 European Society for
Vascular Surgery

<27>
Accession Number
2026432966
Title
Pleural effusion secondary to endometriosis: A systematic review.
Source
American Journal of the Medical Sciences. (no pagination), 2023. Date of
Publication: 2023.
Author
Porcel J.M.; Sancho-Marquina P.; Monteagudo P.; Bielsa S.
Institution
(Porcel, Sancho-Marquina, Monteagudo, Bielsa) Pleural Medicine Unit,
Department of Internal Medicine, Arnau de Vilanova University Hospital
Hospital, IRBLleida, Universitat de Lleida, Lleida, Spain
Publisher
Elsevier B.V.
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
Southern Society for Clinical Investigation

<28>
Accession Number
642072037
Title
Serratus plane block versus standard of care for pain control after
totally endoscopic aortic valve replacement: a double-blind, randomized
controlled, superiority trial.
Source
Regional anesthesia and pain medicine. (no pagination), 2023. Date of
Publication: 18 Aug 2023.
Author
Vandenbrande J.; Jamaer B.; Stessel B.; van Hilst E.; Callebaut I.; Yilmaz
A.; Packle L.; Sermeus L.; Blanco R.; Jalil H.
Institution
(Vandenbrande, Jamaer, Stessel, van Hilst, Callebaut, Jalil) Department of
Anaesthesiology and Pain Medicine, Jessa Hospital Campus Virga Jesse,
Hasselt, Belgium
(Vandenbrande, Stessel, van Hilst, Callebaut) Faculty of Medicine and Life
Sciences, UHasselt, Hasselt, Belgium
(Jamaer) Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Yilmaz, Packle) Department of Cardiothoracic Surgery, Jessa Hospital
Campus Virga Jesse, Hasselt, Belgium
(Sermeus) Anesthesiology, University Hospital Saint-Luc, Brussels, Belgium
(Blanco) Anaesthesia and Intensive Care, King's College Hospital Dubai,
Abu Dhabi, United Arab Emirates
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Serratus anterior plane block has been proposed to reduce
opioid requirements after minimally invasive cardiac surgery, but
high-quality evidence is lacking. METHOD(S): This prospective,
double-blinded, randomized controlled trial recruited patients undergoing
totally endoscopic aortic valve replacement. Patients in the intervention
arm received a single-injection serratus anterior plane block on arrival
to the intensive care unit added to standard of care. Patients in the
control group received routine standard of care, including
patient-controlled intravenous analgesia. Primary outcome was piritramide
consumption within the first 24 hours after serratus anterior plane block
placement. We hypothesized that compared with no block, patients in the
intervention arm would consume 25% less opioids. RESULT(S):
Seventy-five patients were analyzed (n=38 in intervention arm, n=37 in
control arm). When comparing the serratus anterior plane group with the
control group, median 24-hour cumulative opioid use was 9 (IQR 6-19.5) vs
15 (IQR 11.3-23.3) morphine milligram equivalents, respectively (p<0.01).
Also, pain scores at 4, 8 and 24 hours were lower in the intervention arm
at 4, 8 and 24 hours, respectively. CONCLUSION(S): Combined deep and
superficial single-injection serratus anterior plane block is superior to
standard of care in reducing opioid requirements and postoperative pain
intensity up to 24 hours after totally endoscopic aortic valve
replacement. TRIAL REGISTRATION NUMBER: NCT04699422. Copyright ©
American Society of Regional Anesthesia & Pain Medicine 2023. Re-use
permitted under CC BY-NC. No commercial re-use. Published by BMJ.

<29>
Accession Number
642071985
Title
Can language enhance physical therapists' willingness to follow Choosing
Wisely recommendations? A best-worst scaling study.
Source
Brazilian journal of physical therapy. 27(4) (pp 100534), 2023. Date of
Publication: 14 Aug 2023.
Author
Kharel P.; Zadro J.R.; Ferreira G.; Howell M.; Howard K.; Wortley S.;
McLennan C.; Maher C.G.
Institution
(Kharel, Zadro, Ferreira, Maher) Institute for Musculoskeletal Health,
Sydney Local Health District, Sydney, Australia; School of Public Health,
Faculty of Medicine and Health, The University of Sydney, Sydney,
Australia
(Howell, Howard, Wortley) School of Public Health, Faculty of Medicine and
Health, University of Sydney, Sydney, Australia
(McLennan) Institute for Musculoskeletal Health, Sydney Local Health
District, Sydney, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Choosing Wisely recommendations could reduce physical
therapists' use of low-value care. OBJECTIVE(S): To investigate
whether language influences physical therapists' willingness to follow the
Australian Physiotherapy Association's (APA) Choosing Wisely
recommendations. DESIGN: Best-worst Scaling survey METHODS: The six
original APA Choosing Wisely recommendations were modified based on four
language characteristics (level of detail, strength-
qualified/unqualified, framing, and alternatives to low-value care) to
create 60 recommendations. Physical therapists were randomised to a block
of seven choice tasks, which included four recommendations. Participants
indicated which recommendation they were most and least willing to follow.
A multinomial logistic regression model was used to create normalised
(0=least preferred; 10=most preferred) and marginal preference scores.
 RESULT(S): 215 physical therapists (48.5% of 443 who started the
survey) completed the survey. Participants' mean age (SD) was 38.7 (10.6)
and 47.9% were female. Physical therapists were more willing to follow
recommendations with more detail (marginal preference score of 1.1) or
that provided alternatives to low-value care (1.3) and less willing to
follow recommendations with negative framing (-1.3). The use of qualified
('don't routinely') language (vs. unqualified - 'don't') did not affect
willingness. Physical therapists were more willing to follow
recommendations to avoid imaging for non-specific low back pain (3.9) and
electrotherapy for low back pain (3.8) vs. recommendation to avoid
incentive spirometry after upper abdominal and cardiac surgery.
 CONCLUSION(S): Physical therapists were more willing to follow
recommendations that provided more detail, alternatives to low-value care,
and were positively framed. These findings can inform the development of
future Choosing Wisely recommendations and could help reduce low-value
physical therapy. Copyright © 2023 The Author(s). Publicado por
Elsevier Espana, S.L.U. All rights reserved.

<30>
Accession Number
642069172
Title
Clinical Outcomes After Caval Valve Implantation for Severe Symptomatic
Tricuspid Regurgitation: A Meta-Analysis.
Source
The American journal of cardiology. 205 (pp 84-86), 2023. Date of
Publication: 16 Aug 2023.
Author
Badwan O.Z.; Skoza W.; Mirzai S.; Bansal A.; Braghieri L.; Karmali R.H.;
Nero N.; Harb S.C.; Puri R.; Kapadia S.
Institution
(Badwan, Skoza, Mirzai, Braghieri, Karmali) Departments of Internal
Medicine, Heart, Vascular, Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Bansal, Harb, Puri) Departments of Cardiovascular Medicine, Heart,
Vascular, Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
(Nero) Medical Library, Cleveland Clinic Floyd D. Loop Alumni Library,
Cleveland, OH, United States
(Kapadia) Departments of Cardiovascular Medicine, Heart, Vascular,
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
NLM (Medline)

<31>
Accession Number
2026389041
Title
A PROSPECTIVE STUDY OF COMPARISON OF DISTAL RADIOCEPHALIC FISTULA VS
PROXIMAL RADIOCEPHALIC FISTULA.
Source
Journal of Cardiovascular Disease Research. 14(6) (pp 2331-2336), 2023.
Date of Publication: 2023.
Author
Kumar K.R.; Swamy K.V.; Sarala M.; Motilal M.
Institution
(Kumar, Swamy, Motilal) Department of Cardiothoracic and Vascular Surgery,
Siddhartha Medical College, Vijayawada, India
(Sarala) Department of Biochemistry, Siddhartha Medical College,
Vijayawada, India
Publisher
EManuscript Technologies
Abstract
Introduction: The preferred type of vascular access (VA) for hemodialysis
is arteriovenous fistulas. When cannulated effectively for dialysis, they
have a longer lifespan and require fewer procedures than grafts.
Autogenous fistulas outperform prosthetic grafts in terms of patency,
infection rate, and postoperative morbidity. The aim of the present study
was to evaluate the outcomes of proximal forearm AV fistula placed at
elbow and distal forearm AV fistula placed at wrist. Material(s) and
Method(s): A prospective comparative study was conducted at the Department
of Cardiothoracic and Vascular Surgery, Siddhartha Medical College,
Vijayawada from January 2022 to December 2022. All patients who underwent
hemodialysis in the medical college were included in the study. All the
patients underwent pre-operative Doppler ultrasound to determine size of
radial artery, size of cephalic vein, and flow rate at wrist and elbow to
determine the feasibility of distal fistula or proximal fistula.
 Result(s): In proximal radiocephalic group, Mean age of the patients
was 57 year ranging from 35 to 66 year. Male to female ratio was 3.12: 1.
27 patients (54%) were diabetic, 40 (80%) were hypertensive, 15 patients
(30%) had cardiovascular disease. Early failure was 4 (8%) cases. Both
cases were due to thrombosis. In distal radiocephalic group, Mean age of
the patients was 46 year ranging from 32 year to 60 year. Male to female
ratio was 3:1. 36 patients (72%) were diabetic, 26 patients (52%)
hypertensive 15 (25%) had cardiovascular disease. Early failure was seen
in 5 cases. Two cases were due to thrombosis and one case was due to low
flow in the fistula. Conclusion(s): With a significantly reduced
primary failure rate, higher patency rate, and lower complication rate,
proximal radiocephalic fistulas (PRCF) are an appealing option to
brachiocephalic fistulas in failed DRCF and patients who cannot undergo a
DRCF. Copyright © 2023 EManuscript Technologies. All rights
reserved.

<32>
Accession Number
2026173765
Title
Therapeutic and safety outcomes of intracoronary nicardipine in coronary
artery disease patients: a systematic review.
Source
Future Cardiology. 19(3) (pp 163-174), 2023. Date of Publication: 01 Mar
2023.
Author
Rehan S.T.; Imran L.; Salim A.; Javed S.O.; Sohail A.; Hussain H.U.; Ahmed
J.; Yasmin F.; Islam M.S.; Asghar M.S.
Institution
(Rehan, Imran, Salim, Javed, Sohail, Hussain, Ahmed, Yasmin) Department of
Internal Medicine, Dow University of Health Sciences, Karachi 74200,
Pakistan
(Islam) Department of Public Health and Informatics, Jahangirnagar
University, Savar, Dhaka 1342, Bangladesh
(Islam) Centre for Advanced Research Excellence in Public Health, Savar,
Dhaka 1342, Bangladesh
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester
55905, United States
Publisher
Newlands Press Ltd
Abstract
Aim: This systematic review aimed to shed light on the efficacy of
intracoronary (IC) nicardipine in treating no reflow with CAD undergoing
revascularization. Method(s): Literature search was performed on
databases with following eligibility criteria: adult patients with CAD;
clinical trials or observational studies; IC nicardipine as intervention;
therapeutic and safety outcome reported. Result(s): A total of 1249
papers were yielded during the literature search. Of these, 11 studies
were finalized for this systematic review. Complete restoration of TIMI 3
flow was observed in 98.6% of the patients receiving IC nicardipine. A
significant increase in the CBF after infusion of IC nicardipine (p <
0.05) was also observed. Conclusion(s): IC nicardipine significantly
increases CBF and decreases coronary vascular resistance. Plain language
summary Coronary artery disease (CAD) is a condition that results in the
narrowing or blockage of heart arteries. Arteries are blood vessels that
bring oxygen-rich blood from your heart to the rest of your body's cells.
We aimed to evaluate the effects of intracoronary (IC) nicardipine, a drug
that blocks calcium from entering the muscle cells and blood vessels of
the heart, which causes the vessels to relax and widen, allowing for blood
to flow more easily, on a phenomenon known as coronary slow flow (CSF).
CSF is defined as a delayed widening of the blood vessels of the heart.
CSF or the no reflow phenomenon is a major negative complication
associated with surgical procedures such as percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG), both of
which are used to open up blocked arteries. The systematic search
identified studies that evaluated the effect of IC nicardipine in patient
during CAD treatment, undergoing PCI, CABG, or having confirmed or
suspected narrowing of the aortic valve or one of the four valves of the
heart, which results in restricted blood flow from the heart to the body.
From the results of studies discussed in the review, it can be concluded
that IC nicardipine significantly increases blood flow to the heart and
can help prevent the no reflow phenomenon in patients undergoing PCI.
Nicardipine proved to be a safe and effective option in the management of
complications such as no reflow in patients receiving therapies to restore
blood flow following CAD. Copyright © 2023 Future Medicine Ltd.

<33>
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

<34>
Accession Number
2024041293
Title
The perioperative use of inhaled prostacyclins in cardiac surgery: a
systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. 70(8) (pp 1381-1393), 2023. Date of
Publication: August 2023.
Author
Marcus B.; Marynen F.; Fieuws S.; Van Beersel D.; Rega F.; Rex S.
Institution
(Marcus, Marynen, Van Beersel, Rex) Department of Anesthesiology,
Universitair Ziekenhuis Leuven, Leuven, Belgium
(Fieuws, Van Beersel, Rega, Rex) Department of Cardiovascular Sciences,
Group Biomedical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
(Fieuws) Leuvens Biostatistiek en Statistische Bioinformatica Centrum,
Katholieke Universiteit Leuven, Leuven, Belgium
(Rega) Department of Cardiac Surgery, Universitair Ziekenhuis Leuven,
Leuven, Belgium
Publisher
Springer
Abstract
Purpose: Perioperative pulmonary hypertension (PH) is an independent risk
factor for morbidity and mortality in cardiac surgery. While inhaled
prostacyclins (iPGI<inf>2</inf>s) are an established treatment of chronic
PH, data on the efficacy of iPGI<inf>2</inf>s in perioperative PH are
scarce. Method(s): We searched PubMed, Embase, the Web of Science,
CENTRAL, and the grey literature from inception until April 2021. We
included randomized controlled trials investigating the use of
iPGI<inf>2</inf>s in adult and pediatric patients undergoing cardiac
surgery with an increased risk of perioperative right ventricle failure.
We assessed the efficacy and safety of iPGI<inf>2</inf>s compared with
placebo and other inhaled or intravenous vasodilators with random-effect
meta-analyses. The primary outcome was mean pulmonary artery pressure
(MPAP). Secondary outcomes included other hemodynamic parameters and
mortality. Result(s): Thirteen studies were included, comprising 734
patients. Inhaled prostacyclins significantly decreased MPAP compared with
placebo (standardized effect size, 0.46; 95% confidence interval [CI],
0.11 to 0.87; P = 0.01) and to intravenous vasodilators (1.26; 95% CI,
0.03 to 2.49; P = 0.045). Inhaled prostacyclins significantly improved the
cardiac index compared with intravenous vasodilators (1.53; 95% CI, 0.50
to 2.57; P = 0.004). In contrast, mean arterial pressure was significantly
lower in patients treated with iPGI<inf>2</inf>s vs placebo (-0.39; 95%
CI, -0.62 to 0.16; P = 0.001), but higher than in patients treated with
intravenous vasodilators (0.81; 95% CI, 0.29 to 1.33; P = 0.002). With
respect to hemodynamics, iPGI<inf>2</inf>s had similar effects as other
inhaled vasodilators. Mortality was not affected by iPGI<inf>2</inf>s.
 Conclusion(s): The results of this systematic review and
meta-analysis show that iPGI<inf>2</inf>s improved pulmonary hemodynamics
with similar efficacy as other inhaled vasodilators, but caused a
significant small decrease in arterial pressure when compared with
placebo, indicating spill-over into the systemic circulation. These
effects did not affect clinical outcomes. Study registration date:
PROSPERO (CRD42021237991); registered 26 May 2021. Copyright ©
2023, Canadian Anesthesiologists' Society.

<35>
Accession Number
2023816647
Title
Hemodynamic effects of intraoperative 30% versus 80% oxygen
concentrations: an exploratory analysis.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1200223.
Date of Publication: 2023.
Author
Reiterer C.; Fleischmann E.; Kabon B.; Taschner A.; Kurz A.; Adamowitsch
N.; von Sonnenburg M.F.; Fraunschiel M.; Graf A.
Institution
(Reiterer, Fleischmann, Kabon, Taschner, Adamowitsch, von Sonnenburg)
Department of Anesthesia, Intensive Care Medicine and Pain Medicine,
Medical University of Vienna, Vienna, Austria
(Reiterer, Fleischmann, Kabon, Taschner, Kurz) Outcome Research
Consortium, Cleveland, OH, United States
(Kurz) Department of General Anesthesiology, Cleveland Clinic, Anesthesia
Institute, Cleveland, OH, United States
(Kurz) Department of General Anesthesiology, Emergency Medicine and
Intensive Care Medicine, Medical University of Graz, Graz, Austria
(Fraunschiel) IT Systems and Communications, Medical University of Vienna,
Vienna, Austria
(Graf) Center for Medical Data Science, Medical University of Vienna,
Vienna, Austria
Publisher
Frontiers Media SA
Abstract
Background: Supplemental oxygen leads to an increase in peripheral
vascular resistance which finally increases systemic blood pressure in
healthy subjects and patients with coronary artery disease, heart failure,
undergoing heart surgery, and with sepsis. However, it is unknown whether
this effect can also be observed in anesthetized patients having surgery.
Thus, we evaluated in this exploratory analysis of a randomized controlled
trial the effect of 80% versus 30% oxygen on intraoperative blood pressure
and heart rate. Method(s): We present data from a previous study
including 258 patients, who were randomized to a perioperative inspiratory
FiO<inf>2</inf> of 0.8 (128 patients) versus 0.3 (130 patients) for major
abdominal surgery. Continuous arterial blood pressure values were recorded
every three seconds and were exported from the electronic anesthesia
record system. We calculated time-weighted average (TWA) and Average Real
Variability (ARV) of mean arterial blood pressure and of heart rate.
 Result(s): There was no significant difference in TWA of mean
arterial pressure between the 80% (80 mmHg [76, 85]) and 30% (81 mmHg [77,
86]) oxygen group (effect estimate -0.16 mmHg, CI -1.83 to 1.51; p =
0.85). There was also no significant difference in TWA of heart rate
between the 80 and 30% oxygen group (median TWA of heart rate in the 80%
oxygen group: 65 beats.min-1 [58, 72], and in the 30% oxygen
group: 64 beats.min-1 [58; 70]; effect estimate: 0.12
beats.min-1, CI -2.55 to 2.8, p = 0.94). Also for ARV values,
no significant differences between groups could be detected.
 Conclusion(s): In contrast to previous results, we did not observe a
significant increase in blood pressure or a significant decrease in heart
rate in patients, who received 80% oxygen as compared to patients, who
received 30% oxygen during surgery and for the first two postoperative
hours. Thus, hemodynamic effects of supplemental oxygen might play a
negligible role in anesthetized patients. Clinical Trail Registration:
https://clinicaltrials.gov/ct2/show/NCT03366857?term=vienna&cond=oxygen&dr
aw=2&rank=1 Copyright © 2023 Reiterer, Fleischmann, Kabon,
Taschner, Kurz, Adamowitsch, von Sonnenburg, Fraunschiel and Graf.

<36>
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.

<37>
Accession Number
2024859428
Title
Regional Anesthesia With Paravertebral Blockade Is Associated With
Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2023. Date of Publication: 2023.
Author
Hsieh M.; Kim D.; Peng D.; Schisler T.; Cook R.C.
Institution
(Hsieh, Schisler) Department of Anesthesiology, Pharmacology, and
Therapeutics, University of British Columbia, Vancouver, BC, Canada
(Kim) University of British Columbia, Vancouver, BC, Canada
(Peng) Centre for Cardiovascular Innovation, University of British
Columbia, Vancouver, BC, Canada
(Cook) Division of Cardiovascular Surgery, University of British Columbia,
Vancouver, BC, Canada
Publisher
SAGE Publications Ltd
Abstract
Objective: Severe postoperative pain has been shown to affect many
patients following minimally invasive cardiac surgeries (MICS). Multimodal
pain management with regional anesthesia, particularly by delivery of
local anesthetics using a paravertebral catheter (PVC), has been shown to
reduce pain in operations involving thoracotomy incisions. However, few
studies have reported high-quality safety and efficacy outcomes of PVCs
following MICS. Method(s): Patients who underwent MICS at Vancouver
General Hospital between 2016 and 2019 (N = 123) were reviewed for
perioperative opioid-narcotic use. Primary outcomes were postoperative
opioid use and hospital length of stay (LOS). Statistical analyses were
performed using univariate and multivariable regression models to
determine independent risk factors. Result(s): A total of 54 patients
received routine systemic analgesia (control), 53 patients received a
paravertebral catheter (PVC), and 16 patients received another mode of
regional analgesia (non-PVC). The mean hospital LOS was significantly
different in patients in the PVC group at 5.8 +/- 2.0 days versus 8.3 +/-
7.1 days in the control and 6.6 +/- 2.3 days in the non-PVC group (P =
0.033). The percentage of patients who did not require postoperative
oxycodone was significantly higher in the PVC group (48.1%), compared with
the control (24.5%) and non-PVC (37.5%; P = 0.043) groups.
 Conclusion(s): The administration of regional anesthesia using PVCs
was associated with reduced need for opioids and a shorter LOS. The
reduction in postoperative opioids may reduce the risk of potential opioid
dependency in this population. Future studies should involve randomized
controlled trials with systematic evaluation of pain scores to verify
current study results. Copyright © The Author(s) 2023.

<38>
Accession Number
2023945785
Title
Impact of Right Ventricular Surface Area-to-Volume Ratio on Ventricular
Remodeling After Pulmonary Valve Replacement.
Source
Pediatric Cardiology. 44(7) (pp 1613-1622), 2023. Date of Publication:
October 2023.
Author
Thatte N.; Sleeper L.A.; Lu M.; Tang D.; Geva T.
Institution
(Thatte, Sleeper, Lu, Geva) Department of Cardiology, Boston Children's
Hospital, 300 Longwood Ave, Boston, MA 02115, United States
(Thatte, Sleeper, Geva) Department of Pediatrics, Harvard Medical School,
Boston, MA, United States
(Tang) Mathematical Sciences Department, Worcester Polytechnic Institute,
Worcester, MA, United States
Publisher
Springer
Abstract
Optimal reverse remodeling of the right ventricle (RV), a sentinel goal of
pulmonary valve replacement (PVR) in patients with repaired tetralogy of
Fallot, is not fully predicted by volume-based pre-PVR parameters. Our
objectives were to characterize novel geometric RV parameters in patients
receiving PVR and in controls, and to identify associations between these
parameters and chamber remodeling post-PVR. Secondary analysis was
performed on cardiac magnetic resonance (CMR) data from 60 patients
enrolled in a randomized trial of PVR with and without surgical RV
remodeling. 20 healthy age-matched subjects served as controls. The
primary outcome was optimal post-PVR RV remodeling (end-diastolic volume
index (EDVi) <= 114 ml/m2 and ejection fraction (EF) >= 48%)
vs. suboptimal remodeling (EDVi >= 120 ml/m2 and EF <= 45%). RV
geometry was markedly different at baseline in PVR patients compared with
controls, with lower systolic surface area-to-volume ratio (SAVR) (1.16
+/- 0.26 vs.1.44 +/- 0.21 cm2/mL, p < 0.001) and lower systolic
circumferential curvature (0.87 +/- 0.27 vs. 1.07 +/- 0.30 cm-
1, p = 0.007) but similar longitudinal curvature. In the PVR cohort,
higher systolic SAVR was associated with higher RVEF both pre- and
post-PVR (p < 0.001). Among PVR patients, 15 had optimal and 19 had
suboptimal remodeling post-PVR. Multivariable modeling showed that among
the geometric parameters, higher systolic SAVR (OR 1.68 per 0.1
cm2/mL increase; p = 0.049) and shorter systolic RV long-axis
length (OR 0.92 per 0.1 cm increase; p = 0.035) were independently
associated with optimal remodeling. Compared with controls, PVR patients
have lower SAVR and lower circumferential but not longitudinal curvature.
Higher pre-PVR systolic SAVR is associated with optimal remodeling
post-PVR. Copyright © 2023, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<39>
Accession Number
641397159
Title
Thoracic Epidural Anesthesia in Cardiac Surgery: A Systematic Review,
Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled
Trials.
Source
Anesthesia and analgesia. 137(3) (pp 587-600), 2023. Date of Publication:
01 Sep 2023.
Author
Chiew J.K.; Low C.J.W.; Zeng K.; Goh Z.J.; Ling R.R.; Chen Y.; Ti L.K.;
Ramanathan K.
Institution
(Chiew, Low, Ling, Chen, Ti, Ramanathan) From the Yong Loo Lin School of
Medicine, National University of Singapore, National University Health
System, Singapore
(Zeng) Faculty of Medicine, University of New South Wales, Sydney, NSW,
Australia
(Goh) Lee Kong Chian School of Medicine, Nanyang Technological University,
Singapore
(Chen) Agency of Science, Technology and Research, Singapore
(Ti) Department of Anaesthesia, National University Hospital, National
University Health System, Singapore
(Ramanathan) Department of Cardiac, Thoracic and Vascular Surgery,
Cardiothoracic Intensive Care Unit, National University Heart Centre,
National University Hospital, National University Health System, Singapore
Publisher
NLM (Medline)
Abstract
BACKGROUND: Research on fast-track recovery protocols postulates that
thoracic epidural anesthesia (TEA) in cardiac surgery contributes to
improved postoperative outcomes. However, concerns about TEA's safety
hinder its widespread usage. We conducted a systematic review and
meta-analysis to assess the benefits and risks of TEA in cardiac surgery.
 METHOD(S): We searched 4 databases for randomized controlled trials
(RCTs) assessing the use of TEA against only general anesthesia (GA) in
adults undergoing cardiac surgery, up till June 4, 2022. We conducted
random-effects meta-analyses, evaluated risk of bias using the Cochrane
Risk-of-Bias 2 tool, and rated certainty of evidence via the Grading of
Recommendations, Assessment, Development, and Evaluations (GRADE)
approach. Primary outcomes were intensive care unit (ICU), hospital length
of stay, extubation time (ET), and mortality. Other outcomes included
postoperative complications. Trial sequential analysis (TSA) was conducted
on all outcomes to elicit statistical and clinical benefit.
 RESULT(S): Our meta-analysis included 51 RCTs (2112 TEA patients and
2220 GA patients). TEA significantly reduced ICU length of stay (-6.9
hours; 95% confidence interval [CI], -12.5 to -1.2; P = .018), hospital
length of stay (-0.8 days; 95% CI, -1.1 to -0.4; P < .0001), and ET (-2.9
hours; 95% CI, -3.7 to -2.0; P < .0001). However, we found no significant
change in mortality. TSA found that the cumulative Z-curve passed the
TSA-adjusted boundary for ICU length of stay, hospital length of stay, and
ET, suggesting a clinical benefit. TEA also significantly reduced pain
scores, pooled pulmonary complications, transfusion requirements,
delirium, and arrhythmia, without additional complications such as
epidural hematomas, of which the risk was estimated to be <0.14%.
 CONCLUSION(S): TEA reduces ICU and hospital length of stay, and
postoperative complications in patients undergoing cardiac surgery with
minimal reported complications such as epidural hematomas. These findings
favor the use of TEA in cardiac surgery and warrant consideration for use
in cardiac surgeries worldwide. Copyright © 2023 International
Anesthesia Research Society.

<40>
[Use Link to view the full text]
Accession Number
642061626
Title
Development and validation of a nomogram model for pneumonia after redo
cardiac surgery.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 23(5) (pp 325-334),
2022. Date of Publication: 01 May 2022.
Author
Wang D.; Li Y.; Sheng W.; Wang H.; Le S.; Huang X.; Du X.
Institution
(Wang, Wang, Le, Huang, Du) Department of Cardiovascular Surgery
(Li, Sheng) Department of Emergency General Surgery, Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
Publisher
NLM (Medline)
Abstract
AIMS: Postoperative pneumonia (POP) after redo cardiac surgery is
prevalent, associated with poor outcome. The aim of this study was to
identify independent risk factors for POP after redo cardiac surgery and
to develop and validate a prediction model. METHOD(S): Adults
undergoing redo cardiac surgery from 2016 to 2019 were identified in a
single-institution database. Using a 2: 1 ratio, the patients were
randomly divided into training and validation sets. Univariate and
multivariate analyses were applied to identify independent predictors for
POP in the training set. A nomogram model was constructed for clinical
utility and was validated in the validation set. RESULT(S): POP
developed in 72 of the 376 patients (19.1%). Four independent risk factors
were identified, including age, chronic obstructive pulmonary disease,
serum creatinine level and intraoperative blood transfusion volume. A
nomogram based on the four predictors was constructed, with good
discrimination in both the training (c-index: 0.86) and validation sets
(c-index: 0.78). The model was well calibrated, with a Hosmer-Lemeshow chi
2 -value of 7.31 ( P = 0.50) in the training set and 7.41 ( P =
0.49) in the validation set. The calibration was also good by visual
inspection. The decision and clinical impact curves of the nomogram
indicated good clinical utility. Three risk intervals were identified
based on the nomogram for better risk stratification. CONCLUSION(S):
We developed and validated a nomogram model for POP after redo cardiac
surgery. The model may have good clinical utility in risk evaluation and
individualized treatment to reduce adverse events. Graphical abstract
Incidence, risk factor, and outcomes of postoperative pneumonia after redo
cardiac surgery: http://links.lww.com/JCM/A445 . Copyright © 2022
The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the
Italian Federation of Cardiology.

<41>
Accession Number
2024958128
Title
Correlation between shock index and postoperative outcomes for patients
undergoing on-pump coronary artery bypass graft surgery (an observational
study).
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 722-730), 2023. Date of
Publication: 2023.
Author
Said A.; Salah M.; Samir M.; Magdy R.
Institution
(Said, Salah, Samir, Magdy) ICU and Pain Management, Faculty of Medicine,
Cairo University, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Shock index (SI) is defined as a ratio of heart rate and
systolic blood pressure. It was originally employed to evaluate hemorrhage
and acute circulatory failure. Recently, SI has been used as a morbidity
and mortality predictor in various fields. An elevated SI was associated
with higher morbidity. Objective(s): To detect the sensitivity and
specificity of SI in predicting major cardiac events. Method(s): We
randomly enrolled 100 patients who were set to undergo on-pump coronary
artery bypass graft (CABG) surgery in the study. The primary outcome was
to detect the sensitivity and specificity of SI to predict the occurrence
of major adverse cardiac events, occurrence of acute kidney injury (AKI)
and the need for ventilator support for >48 h. The secondary outcome was
to correlate between SI and need of inotropic support, length of hospital
stay and in-hospital mortality. Result(s): The main findings of our
study were the presence of a good correlation between SI and occurrence of
postoperative cardiovascular (CV) collapse, AKI and prolonged
postoperative mechanical ventilation after on-pump CABG as primary
outcomes as well as the presence of a significant correlation between the
occurrence of in-hospital mortality and morbidities and high values of SI
as secondary outcomes. Conclusion(s): We believe that SI has a good
prediction of postoperative CV collapse, AKI and prolonged postoperative
mechanical ventilation >48 h. Copyright © 2023 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<42>
Accession Number
642061563
Title
Handgrip exercise in patients scheduled for cardiac surgery to attenuate
troponin release: A feasibility study.
Source
American journal of physiology. Heart and circulatory physiology. (no
pagination), 2023. Date of Publication: 18 Aug 2023.
Author
Hartman Y.A.W.; Konijnenberg L.S.F.; Dinnissen D.J.M.; Rodwell L.; Li
W.W.L.; Nijveldt R.; Van Royen N.; Thijssen D.H.J.
Institution
(Hartman, Dinnissen, Li) Radboud University Nijmegen Medical Centre,
Netherlands
(Konijnenberg) Radboud University Nijmegen Medical Centre, Nijmegen,
Netherlands
(Rodwell) Radboud university medical center, Radboud Institute of Health
Sciences, Department of Cardiology, Nijmegen, Netherlands
(Nijveldt) Radboud UMC, Nijmegen, Netherlands
(Van Royen) Radboud university medical center, Radboud Institute of Health
Sciences, Department of Cardiology, Netherlands
(Thijssen) Radboud University Nijmegen Medical Centre, Nijmegen,
Gelderland, Netherlands
Publisher
NLM (Medline)
Abstract
Background. Cardiac surgery, including surgical aortic valve repair (SAVR)
and coronary artery bypass grafting (CABG), are associated with
ischaemia-reperfusion (IR)-injury. Single bouts of exercise, including
handgrip exercise, may protect against IR-injury. This study explored (I)
the feasibility of daily handgrip exercise in the week prior to SAVR
and/or CABG, and (II) its impact on cardiac IR-injury, measured as
postoperative cardiac troponin-T (cTnT) release. Methods and Results.
Sixty-five patients undergoing elective SAVR and/or CABG were randomised
to handgrip exercise + usual care (intervention, n=33) or usual care alone
(control, n=32). Handgrip exercise consisted of daily 4x5-min handgrip
exercise (30% maximal voluntary contraction) for 2-7 days prior to cardiac
surgery. Feasibility was assessed using validated questionnaires.
Postoperative cTnT release was assessed at 0-6-12-18-24h (primary outcome
area-under-the-curve (cTnTAUC)). Most patients (93%) adhered to handgrip
exercise and 77% was satisfied with this intervention. Handgrip exercise
was associated with lower cTnTAUC (402,943+/-225,206 versus
473,300+/-232,682 ng*min/L), which is suggestive for a medium effect size
(Cohen's D 0.31), and lower cTnTpeak (313 [190 - 623] versus 379 [254 -
699] ng/L) compared to controls. Conclusions. We found that preoperative
handgrip exercise is safe and feasible for patients scheduled for SAVR
and/or CABG, and is associated with a medium effect size to reduce
postoperative cardiac IR-injury. This warrants future studies to assess
the potential clinical impact of exercise protocols prior to cardiac
surgery.

<43>
Accession Number
642056240
Title
Impact of leaflet thrombosis on valve haemodynamic status after
transcatheter aortic valve replacement.
Source
Heart (British Cardiac Society). (no pagination), 2023. Date of
Publication: 16 Aug 2023.
Author
Jang M.H.; Ahn J.-M.; Kang D.-Y.; Kim K.W.; Koo H.J.; Yang D.H.; Jung
S.C.; Kim B.; Wong Y.T.A.; Lam C.C.S.; Yin W.-H.; Wei J.; Lee Y.-T.; Kao
H.-L.; Lin M.-S.; Ko T.-Y.; Kim W.-J.; Kang S.H.; Ko E.; Lee S.-A.; Kim
D.-H.; Kim H.; Choi Y.; Lee J.; Park S.-J.; Park D.-W.
Institution
(Jang) Ulsan University Hospital, Ulsan, South Korea
(Ahn, Kang, Lee, Kim, Kim, Choi, Lee, Park, Park) Cardiology, Asan Medical
Center, Seoul, South Korea
(Kim) Clinical Trial Center, Asan Institue for Life Sciences, Asan Medical
Center, Seoul, South Korea
(Koo, Yang, Jung) Radiology, Asan Medical Center, Seoul, South Korea
(Kim) Radiology, Korea University Anam Hospital, Seoul, South Korea
(Wong, Lam) Cardiology, Queen Mary Hospital, University of Hong Kong, Hong
Kong, China
(Yin, Wei, Lee) Cardiology, Heart Center, Cheng Hsin General Hospital,
Taipei, Taiwan (Republic of China)
(Kao, Lin) Cardiology, National Taiwan University Hospital, Taipei, Taiwan
(Republic of China)
(Ko) Cardiology, National Taiwan University Hospital, Hsin-Chu Branch,
Hsin-Chu, Taiwan (Republic of China)
(Kim) Cardiology, CHA Ilsan Medical Center, Goyang-si ,Gyeonggi-do, South
Korea
(Kang) Cardiology, CHA Bundang Medical Center, Seongnam, Gyeonggi-do,
South Korea
(Ko) Cardiology, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The effect of subclinical leaflet thrombosis, characterised by
hypoattenuated leaflet thickening (HALT), on the valve haemodynamic
function and durability of the bioprosthetic valve, is not yet determined.
We determined the impact of HALT on valve haemodynamics after
transcatheter aortic valve replacement (TAVR) and the predictors of
haemodynamic structural valve deterioration (SVD). METHOD(S): The
Anticoagulation vs Dual Antiplatelet Therapy for Prevention of Leaflet
Thrombosis and Cerebral Embolization after Transcatheter Aortic Valve
Replacement(ADAPT-TAVR) trial is a multicenter, randomised trial that
compared edoxaban and dual antiplatelet therapy in patients who had
undergone successful TAVR. The presence of HALT was evaluated by
four-dimensional CT at 6 months and serial echocardiography performed at
baseline, immediately post-TAVR and after 6 months. SVD was defined as at
least one of the following: (1) mean transprosthetic gradient >=20 mm Hg,
(2) change in the mean gradient >=10 mm Hg from baseline, or (3) new or
increase in intraprosthetic aortic regurgitation of at least >=1 grade,
resulting in moderate or greater regurgitation. RESULT(S): At 6
months, HALT was found in 30 of 211 (14.2%) patients. The presence of HALT
did not significantly affect aortic valve mean gradients (with vs without
HALT; 14.0+/-4.8 mm Hg vs 13.7+/-5.5 mm Hg; p=0.74) at 6 months. SVD was
reported in 30 of 206 patients (14.6%) at 6-month follow-up
echocardiography. Older age (OR: 1.138; 95% CI: 1.019 to 1.293; p=0.033),
use of aortic valve size <=23 mm (OR: 6.254; 95% CI: 2.230 to 20.569;
p=0.001) and mean post-TAVR pressure gradient (OR: 1.233; 95% CI: 1.123 to
1.371; p<0.001) were independent predictors of haemodynamic SVD; however,
the presence of HALT was not identified as a predictor of SVD.
 CONCLUSION(S): In patients who had undergone successful TAVR, aortic
valve haemodynamic status was not influenced by the presence of HALT.
Although HALT was not a predictor of haemodynamic SVD at 6 months, it
warrants further longer-term follow-up to evaluate the effect on long-term
valve durability. TRIAL REGISTRATION NUMBER: NCT03284827
(https://www.gov). Copyright © Author(s) (or their employer(s))
2023. No commercial re-use. See rights and permissions. Published by BMJ.

<44>
Accession Number
2026367038
Title
Postoperative elevated cardiac troponin levels predict all-cause mortality
and major adverse cardiovascular events following noncardiac surgery: A
dose-response meta-analysis of prospective studies.
Source
Journal of Clinical Anesthesia. 90 (no pagination), 2023. Article Number:
111229. Date of Publication: November 2023.
Author
Yang L.; Shi S.; Li J.; Fang Z.; Guo J.; Kang W.; Shi J.; Yuan S.; Yan F.;
Zhou C.
Institution
(Zhou) Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing 100029, China
(Yang, Shi, Li, Fang, Guo, Kang, Shi, Yuan, Yan, Zhou) Department of
Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences & Peking Union Medical College, Beijing 100037, China
Publisher
Elsevier Inc.
Abstract
Study objective: To perform a dose-response meta-analysis for the
association between postoperative myocardial injury (PMI) in noncardiac
surgery and the risk of all-cause mortality or major adverse
cardiovascular event (MACE). Design(s): Dose-response meta-analysis
of prospective studies with weighted (WL) or generalized (GL) linear and
restricted cubic spline (RCS) regression. Setting(s): Teaching
hospitals. Patient(s): Adult patients undergoing noncardiac surgery.
 Intervention(s): No. Measurements: The primary outcome was all-cause
mortality. The secondary outcome was MACE. Main Result(s): 29 studies
(53,518 patients) were included. The overall incidence of PMI was 26.0%
(95% CI 21.0% to 32.0%). Compared to those without PMI, patients with PMI
had an increased risk of all-cause mortality at short- (<12 months)
(cardiac troponin[cTn]I: unadj OR 1.71,95%CI 1.22 to 2.41, P < 0.001;
cTnT: unadj OR 2.33,95%CI 2.07 to 2.63, P < 0.001), and long-term (>= 12
months) (cTnI: unadj OR 1.80, 95%CI 1.63 to 1.99; cTnT: unadj OR
1.47,95%CI 1.33 to 1.62) (All P < 0.001) follow-up. For MACE, the group
with elevated values was associated with an increased risk (cTnI: unadj OR
1.98, 95% CI 1.13 to 3.47, P = 0.018; cTnT: unadj OR 2.29, 95% CI 1.88 to
2.79, P < 0.001). Dose-response analysis showed positive associations
between PMI (per 1x upper reference limit[URL] increment) and all-cause
mortality both at short- (unadj OR) (WL, OR 1.09, 95% CI 1.09 to 1.10; GL,
OR 1.06, 95% CI 1.06 to 1.07; RCS in the range of 1-2x URL, OR = 2.43,
95%CI 2.25 to 2.62) and long-term follow-up (unadj HR) (WL, OR 1.16, 95%
CI 1.14 to 1.17; GL, OR 1.15, 95% CI 1.13 to 1.16; RCS in the range of
1-2.75x URL, OR = 1.23, 95%CI 1.13 to 1.33), and MACE at longest follow-up
(unadj OR) (WL: OR 1.53, 95% CI 1.49 to 1.57; GL: OR 1.46, 95% CI 1.42 to
1.50; RCS in the range of 1-2 x URL, OR = 3.10, 95%CI 2.51 to 3.81) (All P
< 0.001). For mild cTn increase below URL, the risk of mortality increased
with every increment of 0.25xURL (WL, OR 1.03, 95% CI 1.02 to 1.03; GL, OR
1.05, 95% CI 1.03 to 1.07; RCS in the range of 0-0.5 URL, OR = 9.41, 95%
CI 7.41 to 11.95) (All P < 0.001). Conclusion(s): This study shows
positive WL or GL and RCS dose-response relationships between PMI and
all-cause mortality at short (< 12 mons)- and long-term (>= 12 mons)
follow-up, and MACE at longest follow-up. For mild cTn increase below URL,
the risk of mortality also increases even with every increment of 0.25x
URL. Copyright © 2023

<45>
Accession Number
2000822243
Title
Anticoagulation and Antiplatelet Strategies After On-X Mechanical Aortic
Valve Replacement.
Source
Journal of the American College of Cardiology. 71(24) (pp 2717-2726),
2018. Date of Publication: 19 June 2018.
Author
Puskas J.D.; Kapoor D.; Yanagawa B.; Ely J.; Puskas J.; Gerdisch M.;
Nichols D.; Graeve A.; Fermin L.; Rhenman B.; Copeland J.; Quinn R.;
Hughes G.C.; Azar H.; McGrath M.; Wait M.; Kong B.; Martin T.; Douville
E.C.; Meyer S.; Jamieson W.R.E.; Ye J.; Landvater L.; Trotter T.; Armitage
J.; Askew J.; Accola K.; Levy P.; Duncan D.; Sethi G.; Razi A.; Hagberg
R.; Hamman B.; Swistel D.; Shoukfeh M.F.; Tutuska P.; Sai-Sudhakar C.B.;
Damiano R.; Pettersson G.; Campbell M.; Gregoric I.; Cameron D.; Blackwell
R.; Allen K.
Institution
(Puskas) Icahn School of Medicine at Mount Sinai, New York, New York,
United States
(Gerdisch) Franciscan St. Francis Health, Indianapolis, Indiana, United
States
(Nichols, Graeve) Multicare Tacoma General, Tacoma, Washington, United
States
(Fermin, Rhenman, Kapoor) Southern Arizona Veterans Affairs Hospital,
Tucson, Arizona, United States
(Copeland) University of Arizona, Tucson, Arizona, United States
(Quinn) Maine Medical, Portland, Maine, United States
(Hughes) Duke University, Durham, North Carolina, United States
(Azar, McGrath) Sentara Norfolk General, Norfolk, Virginia, United States
(Wait) University of Texas Southwestern, Dallas, Texas, United States
(Kong) St. Joseph Mercy Hospital, Ann Arbor, Michigan, United States
(Martin) University of Florida, Gainesville, Florida, United States
(Douville) Providence Portland, Portland, Oregon, United States
(Meyer) University of Alberta, Edmonton, Alberta, Canada
(Ye) St. Paul's Hospital, Vancouver, British Columbia, Canada
(Jamieson) Vancouver General Hospital, Vancouver, British Columbia, Canada
(Landvater) Carolina Cardiovascular, Raleigh, North Carolina, United
States
(Hagberg) Hartford Hospital, Hartford, Connecticut, United States
(Trotter) Oklahoma City VA, Oklahoma City, Oklahoma, United States
(Armitage, Askew) Mary Washington, Fredericksburg, Virginia, United States
(Accola) Florida Hospital, Orlando, Florida, United States
(Levy) New Mexico Heart Institute, Albuquerque, New Mexico, United States
(Duncan) Novant Health Forsyth Medical Center, Winston-Salem, North
Carolina, United States
(Yanagawa) St. Michael's Hospital, Toronto, Ontario, Canada
(Ely) On-X Life Technologies, Austin, Texas, United States
Publisher
Elsevier Inc.
Abstract
Background: The burden oral anticoagulation is a limitation of mechanical
valve prostheses. Objective(s): The aim of this study was to test
whether patients could be safely managed with dual-antiplatelet therapy
(DAPT) (aspirin 325 mg and clopidogrel 75 mg) or lower warfarin after On-X
mechanical aortic valve replacement (mAVR). Method(s): PROACT
(Prospective Randomized On-X Anticoagulation Trial) (n = 576) is a
multicenter (41 sites) noninferiority trial. From June 2006 through
February 2014, 201 patients >=18 years of age without thromboembolic risk
factors undergoing mAVR were randomized to receive DAPT (n = 99) or
standard warfarin plus aspirin (n = 102) 3 months after mAVR (low-risk
arm). From June 2006 through October 2009, 375 patients with 1 or more
thromboembolic risk factors were also randomized to lower intensity
warfarin plus aspirin (international normalized ratio 1.5 to 2.0; n = 185)
or standard warfarin plus aspirin (international normalized ratio 2.0 to
3.0; n = 190) 3 months after mAVR (high-risk arm). Result(s): The
low-risk arm was terminated for excess cerebral thromboembolic events
(3.12% per patient-year vs. 0.29% per patient-year, p = 0.02) in the DAPT
group at up to 8.8-year follow-up (631.6 patient-years), with no
differences in bleeding or all-cause mortality. High-risk arm patients
experienced significantly lower major (1.59% per patient-year vs. 3.94%
per patient-year, p = 0.002) and minor (1.27% per patient-year vs. 3.49%
per patient-year, p = 0.002) bleeding up to 8.7-year follow-up (2,035.2
patient-years), with no differences in thromboembolism (0.42% per
patient-year vs. 0.09% per patient-year, p = 0.20) and all-cause
mortality. Conclusion(s): DAPT was associated with higher rates of
thromboembolism and valve thrombosis compared with control in the low-risk
arm. International normalized ratios were safely maintained at 1.5 to 2.0
in high-risk patients, without differences in mortality or thromboembolic
complications. (Randomized On-X Anticoagulation Trial [PROACT];
NCT00291525) Copyright © 2018

<46>
[Use Link to view the full text]
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.

<47>
Accession Number
2025154970
Title
Coronary Artery Aneurysms as a Cause of Acute Coronary Syndrome
Presentation - A Focused Review.
Source
Current Cardiology Reviews. 19(5) (pp 68-72), 2023. Article Number:
e310323215331. Date of Publication: 2023.
Author
Latif A.; Tran A.; Ahsan J.; Lateef N.; Abusina W.; Kapoor V.; Ahsan Z.;
Ahmad S.; Mirza M.
Institution
(Latif) Division of Cardiovascular Medicine, Baylor College of Medicine,
Houston, TX, United States
(Tran, Abusina, Mirza) Department of Medicine, Creighton University
Medical Center, Omaha, NE, United States
(Ahsan) Division of Cardiovascular Medicine, Mercy Medical Center, Iowa
Heart Center, Des Moines, IA, United States
(Lateef) Division of Cardiovascular Medicine, University of Nebraska
Medicine, Omaha, NE, United States
(Kapoor) Department of Medicine, CHI Health Good Samaritan Hospital,
Kearney, NE, United States
(Ahsan) Department of Medicine, Pakistan Medical Center, Islamabad,
Pakistan
(Ahmad) Department of Medicine, East Carolina University/Vidant Medical
Center, Greenville, NC, United States
Publisher
Bentham Science Publishers
Abstract
Coronary artery aneurysms (CAA) are defined as a dilation of a coronary
vessel greater than 1.5 times the diameter of a local reference vessel.
While CAAs tend to be incidental findings on imaging, they result in
complications, such as thrombosis, embolization, ischemia, arrhythmias,
and heart failure. Among symptomatic cases, chest pain has been the most
common manifestation of CAAs. This necessitates an understanding of CAAs
as a cause of acute coronary syndrome (ACS) presentation. However, due to
the unclear pathophysiology of CAAs and their variable presentation
complicated by similar ACS conditions, there is no clear strategy for CAA
manage-ment. In this article, we will discuss the contribution of CAAs to
ACS presentations and review the current management options for
CAAs. Copyright © 2023 Bentham Science Publishers.

<48>
Accession Number
2025096772
Title
The Predictive Ability of MAGGIC Score After Coronary Artery Bypass
Grafting: A Comparative Study.
Source
Brazilian Journal of Cardiovascular Surgery. 38(4) (no pagination), 2023.
Article Number: e20220355. Date of Publication: 2023.
Author
Ozcan S.; Donmez E.; Ziyrek M.; Mert B.; Sahin I.; Okuyan E.; Ozkaynak B.
Institution
(Ozcan, Donmez, Ziyrek, Sahin, Okuyan) Department of Cardiology, Bagcilar
Training and Research Hospital, Istanbul, Bagcilar, Turkey
(Mert, Ozkaynak) Department of Cardiovascular Surgery, Bagcilar Training
and Research Hospital, Istanbul, Bagcilar, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The European System for Cardiac Operative Risk Evaluation
(EuroSCORE) II and the Society of Thoracic Surgeons (STS) are validated
scoring systems for short-term risk estimation after coronary artery
bypass grafting (CABG). The Meta-Analysis Global Group in Chronic Heart
Failure (MAGGIC) risk score is originally aimed to estimate mortality in
heart failure patients; however, it has showed a similar power to predict
mortality after heart valve surgery. In this study, we sought to evaluate
whether MAGGIC score may predict short and long-term mortality after CABG
and to compare its power with EuroSCORE II and STS scoring systems.
 Method(s): Patients who underwent CABG due to chronic coronary
syndrome at our institution were included in this retrospective study.
Follow-up data were used to define the predictive ability of MAGGIC and to
compare it with STS and EuroSCORE-II for early, one-year, and up to
10-year mortality. Result(s): MAGGIC, STS, and EuroSCORE-II scores
had good prognostic power, moreover MAGGIC was better for predicting
30-day (area under the curve [AUC]: 0.903; 95% confidence interval [CI]:
0.871-0.935), one-year (AUC: 0.931; 95% CI: 0.907-0.955), and 10-year
(AUC: 0.923; 95% CI: 0.893-0.954) mortality. MAGGIC was found to be an
independent predictor to sustain statistically significant association
with mortality in follow-up. Conclusion(s): MAGGIC scoring system had
a good predictive accuracy for early and long-term mortality in patients
undergoing CABG when compared to EuroSCORE-II and STS scores. It requires
limited variables for calculation and still yields better prognostic power
in determining 30-day, one-year, and up to 10-year
mortality. Copyright © 2023, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<49>
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.

<50>
Accession Number
2024905598
Title
Myocardial injury after non-cardiac surgery and per operative fibrin
metabolism in patients undergoing hip-fracture surgery: an observational
study.
Source
Scandinavian Journal of Clinical and Laboratory Investigation. (no
pagination), 2023. Date of Publication: 2023.
Author
Wahlstrom K.L.; Ekeloef S.; Gogenur I.; Munster A.-M.B.
Institution
(Wahlstrom, Ekeloef, Gogenur) Center for Surgical Science, Department of
Surgery, Zealand University Hospital, Koge, Denmark
(Gogenur) Institute for Clinical Medicine, Copenhagen University, Denmark
(Munster) Unit for Thrombosis Research, Department of Regional Health
Research, University of Southern Denmark, Odense, Denmark
(Munster) Department of Clinical Biochemistry, Regional Hospital West
Jutland, Holstebro, Denmark
Publisher
Taylor and Francis Ltd.
Abstract
Myocardial injury after non-cardiac surgery (MINS) is associated with a
2-3-fold increased risk of subsequent major cardiovascular events and
postoperative mortality. The pathological mechanism behind MINS is not
fully uncovered. We hypothesized that patients with MINS following hip
fracture surgery would have an altered haemostatic balance pre- and
postoperative compared with patients without MINS. This was investigated
in a prospective single-centre observational study including patients
consecutively. The outcomes were changes in thrombin generation,
fibrinogen/fibrin turnover, tissue plasminogen activator, plasminogen
activator inhibitor-1 and fibrin structure measurements in patients
developing MINS and patients who did not. Outcomes were measured
preoperatively and two hours postoperatively. Seventy-two patients were
included whereof 26 (36%) patients developed MINS. D-dimer delta values
were significantly higher in patients developing MINS than in patients who
did not (p = 0.01). After adjusting for age, sex, smoking, alcohol abuse,
atrial fibrillation, anticoagulant medication preoperative CRP,
preoperative creatinine and duration of surgery, the association remained
significant (p = 0.04). There were no significant changes in thrombin
generation, in markers of fibrinogen/fibrin turnover besides D-dimer, or
in fibrin structure measurements pre- and postoperatively between patients
with and without MINS. As such, a relationship between the coagulative and
fibrinolytic activity and MINS cannot be ruled out in patients with MINS
after hip fracture surgery.Registration: The study was an observational
sub-study to a multicentre randomised clinical trial registered at
ClinicalTrials.gov (NCT02344797). Copyright © 2023 Medisinsk
Fysiologisk Forenings Forlag (MFFF).

<51>
Accession Number
2024892152
Title
Outcomes of transcatheter edge-to-edge repair for atrial functional mitral
regurgitation: A meta-analysis of observational studies.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Hamada S.; Ueyama H.; Aikawa T.; Kampaktsis P.N.; Misumida N.; Takagi H.;
Kuno T.; Latib A.
Institution
(Hamada) Imperial College London, School of Public Health, London, United
Kingdom
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Aikawa) Department of Cardiology, Juntendo University Urayasu Hospital,
Urayasu, Japan
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, NY, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno, Latib) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York City, NY, United States
(Kuno) Department of Cardiology, Jacobi Medical Center, Albert Einstein
College of Medicine, New York, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter edge-to-edge repair (TEER) may have potential
benefits in the treatment of atrial functional mitral regurgitation
(AFMR), but robust evidence is currently lacking. We conducted a
systematic review and meta-analysis to investigate the clinical outcomes
of TEER for AFMR, including comparisons to ventricular functional MR
(VFMR). Method(s): MEDLINE and EMBASE were searched through January
2023 to identify studies eligible for analysis. The primary outcome was
postprocedural MR severity. Postprocedural New York Heart Association
(NYHA) functional class classification and all-cause mortality were also
evaluated. Outcomes were stratified into short term (postprocedure to 6
months) and long term (6 months to 2 years). Result(s): A total of
eight observational studies met the inclusion criteria, enrolling 539 AFMR
and 3486 VFMR patients. Postprocedural MR grade <=2 in the AFMR group was
observed in 93.7% (454/491 patients; 95% confidence interval (CI),
91.1%-96.2%, I2 = 24.3%) and 97.1% (89/93 patients; 95% CI,
92.9%-100%, I2 = 26.4%) in short- and long-term follow-up,
respectively. There was no difference in the rates of postprocedural MR
grade <=2 between AFMR and VFMR either in short-term (risk ratio [RR],
1.00 [95% CI, 0.95-1.06]; p = 0.90; I2 = 53%) or long-term
follow-up (RR, 1.08 [95% CI, 0.89-1.32]; p = 0.44; I2 = 22%).
Similarly, no difference was observed between AFMR and VFMR in the rates
of postprocedural NYHA class <=2 or all-cause mortality.
 Conclusion(s): TEER provides similar clinical outcomes for AFMR and
VFMR. A high rate of MR grade <=2 was observed in patients at both short-
and long-term follow-ups. Further prospective studies with TEER versus
medical therapy and/or rhythm control for AFMR are
warranted. Copyright © 2023 Wiley Periodicals LLC.

<52>
Accession Number
642035666
Title
Pioneering Pre- and Post-Operative Integrative Care to Improve Thoracic
Cancer Quality of Care - The Thoracic Peri-Operative Integrative Surgical
Care Evaluation (POISE) Trial - Stage I.
Source
Journal of Complementary and Integrative Medicine. Conference: 2020 INCAM
Research Symposium. Virtual. 20(2) (pp eA21), 2023. Date of Publication:
June 2023.
Author
Seely D.; Legacy M.; Fazekas A.; Conte E.; Delic E.; Anstee C.; Asmis T.;
Auer R.; Thavorn K.; Fergusson D.; Ramsay T.; Finley C.; Kanji S.; Seely
A.
Institution
(Seely, Legacy, Conte) Ottawa Integrative Cancer Centre, Canada
(Seely, Conte) Canadian College of Naturopathic Medicine, Canada
(Seely, Legacy, Fazekas, Delic, Anstee, Asmis, Auer, Thavorn, Fergusson,
Ramsay, Kanji, Seely) Ottawa Hospital Research Institute, Canada
(Finley) St. Joseph's Healthcare and McMaster University, Canada
(Auer, Seely) University of Ottawa, Department of Surgery, Canada
Publisher
Walter de Gruyter GmbH
Abstract
Background: Despite enormous advances in thoracic surgery and oncology,
patients still experience detrimental effects to health-related quality of
life. This three-stage project has the overarching goal of improving care
for thoracic cancer patients using an integrative approach to care. In
stage I, we evaluated the safety and feasibility of delivering integrative
care interventions in a pragmatic study. Objective(s): (1) Determine
the safety and feasibility of the study protocol, (2) assess compliance
with study interventions, (3) assess communication between practitioners,
(4) evaluate the qualitative experience of care, (5) refine the
interventions. Method(s): In this single-arm study, 22 participants
undergoing complete resection for lung, gastric, or esophageal cancer were
enrolled and followed for one year post-surgery. Participants received
usual hospital care combined with complementary care administered by a
naturopathic doctor (ND). Complementary care included natural health
products (NHPs), nutrition guidance, physical activity recommendations,
and psychological practices. Feasibility was determined by assessment
completion rates and appointment attendance; compliance was assessed
through pill counts and subjective ND ratings; qualitative experiences
were captured through semi-structured interviews; safety was determined by
adverse events (AEs); interventions were refined based on clinical
experience and patient feedback. Result(s): 14 of 22 participants
successfully completed the study; 4 were screen fails, 1 died before
starting the study, and 3 withdrew. ND and hospital visits were well
attended (89% and 96%, respectively). Questionnaire completion rate was
100%. Mean NHP compliance was 76.5%, ranging from 42.4% - 96.2% for
individual NHPs. No serious or severe AEs related to the intervention were
reported. There were no communication barriers, and qualitative interviews
provided rich data regarding patient experiences. Conclusions The study
protocol was feasible and safe. The project will progress to stage II, a
pilot randomized control trial, with an amended protocol based on data
collected from stage.

<53>
Accession Number
642047066
Title
British Cardiovascular Society Annual Conference, 'Future-proofing
Cardiology for the next 10 years'.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2023. Manchester United Kingdom. 109(Supplement 3) (no pagination), 2023.
Date of Publication: June 2023.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 299 papers. The topics discussed include:
myocardial stress perfusion and energetics improves in patients with type
2 diabetes after treatment with a glucagon like peptide-1 receptor agonist
(liraglutide) - a randomized, single center, open label, cross-over drug
trial; understanding the role of cardiac fibrosis in the development and
treatment of heart failure using molecular imaging probes and novel
therapeutics; genetically-proxied low density lipoprotein cholesterol
lowering via pcsk9-inhibitor drug targets and risk of congenital
malformations; exploring the prognostic significance and important
phenotypic and genotypic associations of neural network-derived
electrocardiographic features; investigation of the effects of dietary
nitrate on vascular function, platelet reactivity and restenosis in
patients with stable angina (nitrate-OCT study); genotype-specific
clinical and imaging characteristics of novel rare truncating variants
associated with dilated and arrhythmogenic cardiomyopathy; differential
effects of bariatric surgery type on cardiac reverse remodeling; cardiac
power and power reserve are impaired in asymptomatic patients with aortic
stenosis and associated with exercise capacity; cardiac care study: the
effect of esc 2022 cardio-oncology guidelines on this cohort; and cardiac
care of children with Duchenne muscular dystrophy (DMD) and females
carrying DMD-gene variations: a collaborative approach to care-guidelines
for maintaining heart health for as long as possible in dystrophinopathy.

<54>
Accession Number
642047005
Title
MECHANISMS AND PREDICTORS OF ACUTE KIDNEY INJURY WITH PERIOPERATIVE
ROSUVASTATIN IN PATIENTS UNDERGOING CARDIAC SURGERY.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2023. Manchester United Kingdom. 109(Supplement 3) (pp A221-A223), 2023.
Date of Publication: June 2023.
Author
Wijesurendra R.; Chen Z.; Jayaram R.; Haynes R.; Emberson J.; Staplin N.;
Collins R.; Casadei B.; Hill M.; Zheng Z.; Samuel N.; Sardell R.
Institution
(Wijesurendra, Chen, Jayaram, Haynes, Emberson, Staplin, Collins, Casadei,
Hill, Samuel, Sardell) University of Oxford, United Kingdom
(Zheng) Fuwai Hospital, China
Publisher
BMJ Publishing Group
Abstract
Introduction In patients undergoing cardiac surgery perioperative statin
therapy has been associated with an unexpected increase in postoperative
plasma creatinine. Here we investigated mechanisms and predictors of acute
kidney injury (AKI) in 1922 patients enrolled in the Statin Therapy in
Cardiac Surgery (STICS) randomized placebo-controlled trial of
perioperative rosuvastatin (20 mg once daily for <=8 days before surgery
and for 5 days thereafter). Methods AKI was defined according to
international guidelines (KDIGO) using plasma creatinine, and also by
cystatin C. Potentially mechanistically relevant plasma/serum biomarkers
of muscle injury, inflammation, and kidney injury were investigated,
including total creatine kinase (CK), growth differentiation factor 15
(GDF-15), interleukin-6 (IL-6), procalcitonin (PCT), placental growth
factor (PLGF), kidney injury molecule- 1 (KIM-1), and neutrophil
gelatinase-associated lipocalin (NGAL). Results Baseline characteristics
of patients randomized to rosuvastatin (n=960) and placebo (n=962) are
shown in Table 1. At 48 hours post-surgery, the incidence of AKI was
greater in the rosuvastatin group than in the placebo group when defined
by a rise in creatinine (24.7% vs 19.3%, p=0.005) or cystatin C (9.2% vs
5.1%, p<0.001); the majority of AKI was stage 1 in severity (87% when
defined by creatinine, and 80% when defined by cystatin C; Figure 1).
Compared with placebo, rosuvastatin led to higher postoperative serum
levels of KIM-1 (278+/-5 pg/ml versus 259+/-5 pg/ml, P=0.01; Figure 2),
and to more frequent elevations in CK to >10x and >40x the baseline level
(30.9% versus 26.5%, p=0.032, and 2.1% versus 0.7%, p=0.016,
respectively), whereas postoperative concentrations of GDF-15, IL-6, PCT,
PLGF, and NGAL were similar between groups. In multivariable analyses,
insulin treatment, baseline KIM-1, combined coronary artery bypass
grafting (CABG) and aortic valve replacement (AVR) surgery, and allocation
to rosuvastatin were all independently associated with AKI as defined by
both creatinine and cystatin C (Table 2). Odds ratios for rosuvastatin
compared to placebo for both creatinine- and cystatin C-defined AKI were
not materially altered by further adjustment for post-randomization
increases in CK. Conclusions Perioperative rosuvastatin initiation
increased the absolute risk of AKI after cardiac surgery by 4-5%, whether
defined by creatinine or cystatin C, and led to higher postoperative
KIM-1, suggesting a deleterious effect on renal function, possibly
mediated by proximal tubular injury. Insulin treatment, baseline KIM-1,
combined CABG/AVR surgery, and allocation to rosuvastatin were all
independently associated with AKI by any definition. Temporary statin
cessation in the perioperative period in patients undergoing cardiac
surgery may be a reasonable option to consider on a case-by-case basis.

<55>
Accession Number
642046682
Title
ANTI-COAGULANTS VS ANTI-PLATELETS VS VITAMIN K IN TRANSCATHETER AORTIC
VALVE IMPLANTATION, WHAT TO CHOOSE?: A NETWORK META-ANALYSIS OF RANDOMIZED
CONTROLLED TRIALS.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2023. Manchester United Kingdom. 109(Supplement 3) (pp A76), 2023. Date of
Publication: June 2023.
Author
Varghese K.S.; Gonnah A.R.; Elbadawy M.A.; Awad A.K.; Ahmed A.
Institution
(Awad, Elbadawy) Faculty of Medicine, Ain-Shams University, Cairo, Egypt
(Varghese, Ahmed) CUNY School of Medicine, NY, United States
(Gonnah) School of Medicine, University of Liverpool, Merseyside, United
Kingdom
(Awad) Faculty of Medicine, El-Galala University, Suez, Egypt
Publisher
BMJ Publishing Group
Abstract
Background Transcatheter aortic valve implantation (TAVI) shown its
efficacy to be mainstay treatment for aortic valve diseases over surgical
options, yet postoperative antiplatelet regimen after TAVI is still
debatable. Thus, the aim of our network is to further investigate the
safety and efficacy of direct oral anti-coagulants (DOAC) vs
single-antiplatelet therapies (SAPTs) vs dual-antiplatelet therapies
(DAPT) vs Vitamin K in patients undergoing Transcatheter aortic valve
implantation. Methods PubMed, Web of Science, Scopus, and Embase, were
systematically searched from inception to December 2022. A frequinest
network meta-analysis has been conducted using random-effects method model
calculating the risk ratio (OR) with a 95% confidence interval (CI).
Results 9,087 patients from 11 studies were included. Regarding short-term
outcomes, compared to DOAC, DAPT, SAPT, and vitamin K all were associated
with a significantly lower odds for all-cause mortality with OR [0.66; 95%
CI 0.46-0.86], [0.44; 95% CI 0.29-0.60], [0.64; 95% CI 0.31, 0.94],
respectively (Fig 1A). Although, none of the interventions has
statistically significant difference over DOAC in terms of cardiovascular
death (Fig 1B), DAPT was associated with statistically significant more
than 2 folds high odds for major vascular bleeding with OR [2.66; 95% CI
1.46-3.86]. Furthermore, regarding long term outcomes, both DAPT and SAPT
was associated with a significantly higher bleeding rates with OR [1.78;
95% CI, 1.15-2.41] and [2.32; 95% CI, 1.29-3.35], respectively yet vitamin
K was associated lower bleeding rates with OR [0.61; 95% CI, 0.24-0.98].
No intervention showed significance difference over DOAC in terms of
allcause mortality, cardiovascular mortality, and stroke (Fig 1C) except
for DAPT which showed higher odds of long-term allcause mortality OR
[1.83; 95% CI, 1.29-2.37]. Conclusions Although having long term high
rates of major vascular bleeding, SAPT proven its efficacy in having lower
both short term and long-term all-cause mortality compared to DAPT which
have both short and long term major vascular bleeding and higher long-term
all-cause mortality. Vitamin K has lower rates of both short-term
all-cause death and long term major vascular bleeding yet without
significance in other outcomes.

<56>
Accession Number
642046609
Title
EARLY AND LATE CLINICAL OUTCOMES AFTER ISOLATED TRICUSPID VALVE SURGERY: A
METAANALYSIS.
Source
Heart. Conference: British Cardiovascular Society Annual Conference, BCS
2023. Manchester United Kingdom. 109(Supplement 3) (pp A10-A11), 2023.
Date of Publication: June 2023.
Author
Chick W.; Khawaja S.; Zaman A.; Farag M.; Khokhar A.; Alkhalil M.;
Lucarelli C.; Malik I.; Gorog D.; Egred M.; Mikhail G.
Institution
(Chick, Gorog) Cardiology Department, East and North Hertfordshire NHS
Trust, Hertfordshire, United Kingdom
(Khawaja, Farag, Khokhar, Lucarelli, Malik, Mikhail) Cardiology
Department, Hammersmith hospital, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Zaman, Alkhalil, Egred) Cardiothoracic Centre, Freeman Hospital,
Newcastleupon-Tyne, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Patients with isolated tricuspid valve (ITV) disease have a
poor prognosis with no consensus on their management. Transcatheter ITV
intervention is emerging as a valid option in patients with prohibitive
surgical risk. We aimed to analyse the characteristics and clinical
outcomes of patients who underwent ITV surgery to inform the clinical
decision making in patients undergoing transcatheter ITV intervention and
to advance the development of future technologies. Methods Digital
databases were searched from inception through to 2022 for studies
reporting clinical outcomes on ITV surgeries, namely ITV repair, ITV
replacement with a bioprosthetic valve (ITVR-B), or ITV replacement with a
mechanical valve (ITVR-M). Overall estimates of treatment effect were
calculated with a random-effects model. Results Twenty-seven studies
involving 10,478 patients (4,931 ITV repair, 3,821 ITVR-B, 1,713 ITVR-M)
were included. Overall, early mortality occurred in 9.0% of patients and
did not differ between different ITV surgical approaches. Late mortality
was 27.1% at a median follow-up of 3.9 (3.0-6.0) years and was
significantly higher for all ITV replacement surgeries (30.2% vs. 24.7%,
RR 1.18, 95% CI 1.05-1.31, P=0.004) compared to ITV repair. Late mortality
did not differ between ITVR-B and ITVR-M. Early and late clinical outcomes
after ITV surgery differed according to the surgery performed. Compared to
all ITV replacement surgeries and despite its favourable late mortality
outcomes, ITV repair was observed to have a relatively higher risk of
cerebrovascular accidents or need for permanent pacemaker implantation in
the post-operative period, as well as TV regurgitation recurrence after 1
year. Conclusions Amongst ITV surgeries, ITV repair has favourable
long-term mortality compared to ITV replacements. This supports the
development and refinement of transcatheter ITV repair approaches in
suitable patients..

<57>
Accession Number
642034333
Title
Effect of liraglutide on cardiovascular outcomes in elderly patients in
the LEADER trial.
Source
Diabetologia. Conference: 54th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2018. Berlin Germany. 61(Supplement 1) (pp
S368-S369), 2018. Date of Publication: October 2018.
Author
Gilbert M.P.; Bain S.C.; Franek E.; Jodar-Gimeno E.; Nauck M.A.; Pratley
R.E.; Rea R.; Saraiva J.; Rasmussen S.; Tornoe K.; Von Scholten B.; Buse
J.
Institution
(Gilbert) Robert Larner, M.D. College of Medicine, University of Vermont,
South Burlington, United States
(Bain) Institute of Life Science, Swansea University, Swansea, United
Kingdom
(Franek) Mossakowski Medical Research Centre, Polish Academy of Sciences,
Warsaw, Poland
(Jodar-Gimeno) Quironsalud Madrid University Hospital, Madrid, Spain
(Nauck) Diabetes Center BochumHattingen, St. Josef-Hospital
(Ruhr-Universitat Bochum), Bochum, Germany
(Pratley) Florida Hospital Translational Research Institute, Orlando,
United States
(Rea) Clinical Hospital of the Federal University of Parana (SEMPR),
Curitiba, Brazil
(Saraiva) Pontificia Universidade Catolica de Campinas, Campinas, Brazil
(Rasmussen, Tornoe, Von Scholten) Novo Nordisk A/S, Soborg, Denmark
(Buse) University of North Carolina, School of Medicine, Chapel Hill,
United States
Publisher
Springer Verlag
Abstract
Background and aims: The burden of chronic diseases such as type 2
diabetes (T2D) and associated comorbidities increases with ageing, making
the elderly more vulnerable to potential side effects of medical
treatment. Information about the effect of antihyperglycaemic therapy on
cardiovascular (CV) events in the elderly is limited. Liraglutide reduced
the risk of CV events in the LEADER trial compared with placebo, and this
post hoc analysis assesses risk of CV events and all-cause mortality in
elderly patients with T2D. Material(s) and Method(s): In the LEADER
trial, 9340 patients with T2D at high risk for CVevents were randomised
1:1 to liraglutide or placebo, both on top of standard of care, and
followed for up to 5 years. The primary composite outcome was defined as
time to first occurrence of death from CV causes, nonfatal myocardial
infarction (MI) or non-fatal stroke. Secondary outcomes included the
expanded composite outcome and all-cause mortality. In this analysis,
outcomes were assessed in patients aged >=75 years. Result(s): Among
those aged >=75 years, baseline characteristics were well matched between
treatment arms (N = 418 for both treatment arms). Compared with placebo,
liraglutide significantly reduced the risk of the primary composite
outcome, expanded composite outcome, non-fatal MI, coronary
revascularisation, death from any cause and death from non-CV causes
(Table). Conclusion(s): In the LEADER trial, liraglutide treatment
reduced the risk of CV events and all-cause mortality in elderly patients
with T2D.

<58>
Accession Number
642034034
Title
Glycaemic efficacy and safety of linagliptin compared to basal bolus
insulin regimen in non-cardiac surgical patients with type 2 diabetes:
Linagliptin-Surgery trial.
Source
Diabetologia. Conference: 54th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2018. Berlin Germany. 61(Supplement 1) (pp
S377-S378), 2018. Date of Publication: October 2018.
Author
Umpierrez G.; Vellanki P.; Rasouli N.; Baldwin D.; Alexanian S.; Anzola
I.; Urrutia M.; Gomez P.; Cardona S.; Wang H.; Pasquel F.
Institution
(Umpierrez, Vellanki, Anzola, Urrutia, Gomez, Cardona, Wang, Pasquel)
Emory University, School of Medicine, Atlanta, United States
(Rasouli) Medicine, University of Colorado, Denver, United States
(Baldwin) Rush University, Chicago, United States
(Alexanian) Medicine, Boston Universty, Boston, United States
Publisher
Springer Verlag
Abstract
Background and aims: Effective hospital and post-discharge regimens are
needed for the management of general surgery patients with type 2
diabetes. We compared the safety and efficacy of linagliptin with a
basalbolus insulin regimen in the hospital, and determine the efficacy of
an HbA1c-based algorithm to guide post-discharge diabetes therapy.
 Material(s) and Method(s): This prospective, multicenter open-label
study enrolled non-cardiac surgery patients with type 2 diabetes, blood
glucose (BG) between 7.8-22.2 mmol/l and treated with diet, oral agents,
or insulin at a total daily dose (TDD) <=0.5 units/kg. Subjects were
randomized to either linagliptin 5 mg daily (n = 128) or basal-bolus
insulin regimen (n = 122). Insulin treated subjects were started at a TDD
of 0.4 U/kg/day or 0.5 U/kg/ day for randomization BG between 7.8 11.1
mmol/l or >11.1-22.1 mmol/l, respectively. If GFR <45 ml/min/1.73 m2 , TDD
was reduced by 50%. Both groups received correction doses of rapid-acting
insulin for BG >7.8 mmol/l before meals or every 6 hours if NPO. The
discharge algorithm was based on admission HbA1c. If HbA1c <7% (<53
mmol/mol), 221 subjects were discharged on linagliptin or preadmission
oral agents; patients with HbA1c 7% and 9% and those >9% were discharged
on linagliptin with glargine at 50% or 80% of the hospital daily dose,
respectively. The primary outcome was difference in mean hospital daily BG
between groups. Secondary outcomes were inpatient hypoglycaemia and
changes in HbA1c at 3 months after discharge. Result(s): Difference
in mean daily hospital BG between groups was 0.6 mmol/l. Linagliptin
resulted in fewer hypoglycemic events (1.6% vs.11%, p = 0.001, relative
risk reduction of 86%) and in lower number of daily insulin injections
(2.0 +/- 3.3 vs 3.1 +/- 3.3, p < 0.001) compared to basal-bolus. In
patients with a randomization BG <11.1 mmo/l (observed in 63% of overall
cohort), linagliptin resulted in similar mean daily BG (8.9 +/- 2.3 vs.
8.7 +/- 2.3 mmol/l, p = 0.43); however, patients with BG >=11.1 mmol/l
treated with linagliptin had higher BG compared to basalbolus (10.9 +/-
2.6 vs. 9.2 +/- 2.2 mmo/l, p < 0.001). There were no differences in length
of hospital stay or in the rate of perioperative complications between
treatment groups. Three months after discharge, HbA1c decreased from 7.9
+/- 2.0% to 7.1 +/- 1.5%, p < 0.0001 using the discharge algorithm.
 Conclusion(s): Linagliptin is an effective alternative to basal-bolus
insulin regimen in general surgery patients with type 2 diabetes with mild
to moderate hyperglycemia. Our results indicate that in patients with BG
<11.1 mmol/l, treatment with linagliptin resulted in similar improvement
in glycemic control and in significantly lower rates of hypoglycemia
compared to the basal-bolus insulin regimen. However, basal-bolus insulin
regimen was superior to linagliptin in patients with BG >=11.1 mmol/l. The
proposed HbA1c-based hospital discharge algorithm with the use of
linagliptin, with or without basal insulin, showed efficacious glycemic
control after discharge.

<59>
Accession Number
642034008
Title
Effect of empagliflozin on cardiovascular events including recurrent
events in the EMPA-REG OUTCOME trial.
Source
Diabetologia. Conference: 54th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2018. Berlin Germany. 61(Supplement 1) (pp
S324-S325), 2018. Date of Publication: October 2018.
Author
Lund S.S.; McGuire D.K.; Zinman B.; Inzucchi S.E.; Anker S.D.; Wanner C.;
Kaspers S.; George J.T.; Elsasser U.; Woerle H.J.; Fitchett D.
Institution
(Lund, Kaspers, George, Elsasser, Woerle) Boehringer Ingelheim
International GmbH, Ingelheim, Germany
(McGuire) University of Texas, Southwestern Medical Center, Dallas, United
States
(Zinman) Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital,
University of Toronto, Toronto, Canada
(Inzucchi) Section of Endocrinology, Yale University, School of Medicine,
New Haven, United States
(Anker) Division of Cardiology and Metabolism - Heart Failure, Cachexia
and Sarcopenia; Department of Cardiology (Campus CVK), Berlin-Brandenburg
Center for Regenerative Therapies (BCRT); Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Wanner) Wurzburg University Clinic, Wurzburg, Germany
(Fitchett) St Michael's Hospital, Division of Cardiology, University of
Toronto, Toronto, Canada
Publisher
Springer Verlag
Abstract
Background and aims: In the EMPA-REG OUTCOME trial in patients with type 2
diabetes and established CV disease, empagliflozin reduced the risk of
3-point MACE (composite of CV death, MI, or stroke) by 14%, CV death by
38% and hospitalisation for heart failure (HHF) by 35% vs placebo in
analyses of time to first event. We assessed the effect of empagliflozin
on all (first and recurrent) CV events. Material(s) and Method(s):
Patients were randomised to receive empagliflozin 10 mg, empagliflozin 25
mg, or placebo in addition to standard of care. We assessed the effects of
empagliflozin pooled vs placebo based on all adjudicated CV events using a
negative binomial model with confidence intervals based on robust error
variance estimators to account for within-subject correlation.
 Result(s): A total of 7020 patients were treated (mean [SD] age 63
[9] years, 71% male, 47% with history of MI, 23% with history of stroke,
10% with HF). In analyses including all events, the event rate ratio (95%
CI) with empagliflozin vs placebo was 0.78 (0.67, 0.91; p = 0.0020) for
3-point MACE, 0.79 (0.620, 0.998; p = 0.0486) for MI, 1.10 (0.82, 1.49; p
= 0.5248) for stroke, 0.58 (0.42, 0.81; p = 0.0012) for HHF, 0.56 (0.45,
0.69; p < 0.0001) for the composite of CV death or HHF, and 0.80 (0.67,
0.95; p = 0.0119) for the composite of MI or coronary revascularisation.
Results were consistent with analyses of first events (Figure).
 Conclusion(s): Analyses of all (first and recurrent) CVevents in the
EMPAREG OUTCOME trial complement previous analyses and confirm the
consistency of the results.

<60>
Accession Number
642035022
Title
HbA<inf>1c</inf> coefficient of variation is an independent risk factor
for chronic complications in type 2 diabetes in the FIELD study.
Source
Diabetologia. Conference: 54th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2018. Berlin Germany. 61(Supplement 1) (pp
S519), 2018. Date of Publication: October 2018.
Author
Scott E.S.; Januszewski A.S.; O'Connell R.; Colagiuri S.; Fulcher G.R.;
Keech A.; Jenkins A.J.
Institution
(Scott, Januszewski, O'Connell, Keech, Jenkins) NHMRC Clinical Trials
Centre, Sydney, Australia
(Scott, Fulcher) Department of Endocrinology and Diabetes, Royal North
Shore Hospital, Sydney, Australia
(Januszewski, Jenkins) Department of Medicine, St Vincent's University of
Melbourne, Melbourne, Australia
(Colagiuri) Boden Institute, University of Sydney, Sydney, Australia
(Fulcher) Northern Clinical School, University of Sydney, Sydney,
Australia
Publisher
Springer Verlag
Abstract
Background and aims: Glycaemic variability (GV) is implicated in the
pathogenesis of chronic diabetes complications. GV can be measured long-
and short-term by fluctuations in HbA1c or fasting plasma glucose
respectively. Study aims were to assess whether GVis associated with the
development of micro- and macrovascular complications in the Fenofibrate
Intervention and Event Lowering In Diabetes (FIELD) study, and to
determine what baseline factors predict GV. Material(s) and
Method(s): The FIELD study randomised 9795 individuals to fenofibrate 200
mg daily or placebo and followed the development of vascular complications
for a median of 5-years. GV was calculated as coefficient of variation
(CV) and standard deviation (SD) of HbA1c and fasting plasma glucose
(measured at baseline, annually and at study-end). We assessed whether GV
was a predictor of microvascular and/or macrovascular complications from
study year-2 onward using logistic and Cox proportional hazards
regressions with adjustment for significant covariates. The primary
composite endpoint was the development of microvascular disease (defined
as presence of either retinopathy, albuminuria, neuropathy and/or
microvascular amputations), and subsidiary composite endpoints:
macrovascular disease (cardiovascular mortality, myocardial infarction,
stroke, coronary and carotid revascularization), total mortality and
individual vascular complications. Result(s): A logistic regression
model with adjustment for age, gender, glycaemic control, baseline
complications and treatment allocation demonstrated that HbA1c CV was an
independent risk factor for the development of microvascular complications
(OR 1.13 95% CI (1.04-1.22) P = 0.002). All other GV parameters had
similar effects. Although HbA1c CV was significantly associated with the
macrovascular outcome in univariate Cox proportional hazards regression (P
= 0.002), significance was lost in multivariate analysis. Multiple
logistic regression demonstrated that HbA1c CV (quartiles Q1 = reference)
was significantly associated with the development of nephropathy at
2-years (Q2: OR 1.24 (95% CI 0.97-1.59), Q3: OR 1.43 (1.12-1.82), Q4: OR
1.77 (1.38-2.25) P < 0.001). HbA1c CV (quartiles) was significantly
associated in Cox proportional hazards multiple regression with the
development of stroke (Q2: OR 1.48 (95% CI 0.93-2.35), Q3: OR 1.52
(0.96-2.41), Q4: 1.99 (1.27- 3.14) P = 0.02) and totalmortality (Q2: OR
0.97 (95%CI 0.73-1.28), Q3: 1.24 (0.95-1.62), Q4: OR 1.66 (1.29-2.14) (P <
0.001)). In subjects randomised to fenofibrate HbA1c CV increased compared
to placebo across the study (HbA1c CV 8.98 (5.13) vs 8.58 (5.06) (P <
0.001, (Diff 0.39, 95% CI 0.19-0.60). Conclusion(s): In Type 2
diabetes HbA1c CV is an independent risk factor for microvascular
complications, stroke and total mortality. Despite higher HbA1c CV in
individuals randomised to fenofibrate, fenofibrate therapy significantly
reduced total cardiovascular events and all microvascular outcomes in the
FIELD study.

<61>
Accession Number
642034734
Title
Effects of liraglutide on cardiovascular events in patients with type 2
diabetes and polyvascular disease: results of the LEADER trial.
Source
Diabetologia. Conference: 54th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2018. Berlin Germany. 61(Supplement 1) (pp
S555-S556), 2018. Date of Publication: October 2018.
Author
Zinman B.; Verma S.; Bhatt D.L.; Bain S.C.; Mann J.; Nauck M.A.; Pratley
R.E.; Michelsen M.M.; Monk Fries T.; Rasmussen S.; Leiter L.A.
Institution
(Zinman) Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital,
University of Toronto, Toronto, Canada
(Verma, Leiter) Li Ka Shing Knowledge Institute of St. Michael's Hospital,
University of Toronto, Toronto, Canada
(Bhatt) Brigham and Women's Hospital Heart, Vascular Center and Harvard
Medical School, Boston, United States
(Bain) Institute of Life Science, Swansea University, Swansea, United
Kingdom
(Mann) Friedrich Alexander University of Erlangen, Erlangen, Germany
(Nauck) Diabetes Center Bochum-Hattingen, St. Josef-Hospital
(Ruhr-University Bochum), Bochum, Germany
(Pratley) Florida Hospital Translational Research Institute, Orlando,
United States
(Michelsen, Monk Fries, Rasmussen) Novo Nordisk A/S, Soborg, Denmark
Publisher
Springer Verlag
Abstract
Background and aims: Polyvascular disease can predict cardiovascular (CV)
events. In LEADER, liraglutide significantly reduced major adverse
CVevents (MACE) vs placebo. In a post hoc analysis, we assessed CV
outcomes by history of single or polyvascular disease at baseline.
 Material(s) and Method(s): In LEADER, 9340 patients with type 2
diabetes (T2D) and high CV risk were randomised 1:1 to liraglutide vs
placebo, both as add on to standard of care (median follow-up = 3.8
years). The primary outcome (MACE) was a composite of CV death, nonfatal
myocardial infarction, or nonfatal stroke. The secondary outcome (expanded
MACE) also included hospitalisation for unstable angina, coronary
revascularisation, or hospitalisation for heart failure. Cox regression
was used to compare CVoutcomes in patient risk groups stratified by number
of atherosclerotic vascular territories (coronary, cerebrovascular and/or
peripheral artery disease). Polyvascular disease was defined as >=2 and
single vascular disease as 1 atherosclerotic vascular territory.
 Result(s): In LEADER, 6775 patients (72.5%) had documented
atherosclerotic CV disease (ASCVD). Of these, 1536 patients (23%) had
polyvascular and 5239 (77%) had single vascular disease. Patients with
polyvascular disease had a higher risk of CV outcomes than those with
single vascular disease (MACE: HR 1.52, 95% CI 1.33-1.73; expanded MACE:
HR 1.45, 95% CI 1.31-1.62, CV death: HR 1.41, 95% CI 1.13- 1.75).
Liraglutide reduced MACE consistently in patients with polyvascular (HR
0.82, 95% CI 0.66-1.02) and single vascular disease (HR 0.82, 95% CI
0.71-0.95) vs placebo. In patients without ASCVD at baseline, the HR for
liraglutide vs placebo for MACE was 1.08 (95% CI 0.84-1.38). Results were
similar for expanded MACE and CV death (Table). No significant
interactions were found across risk groups for CVoutcomes (Table), with
the exception of expanded MACE (p interaction = 0.03). Conclusion(s):
In patients with T2D, polyvascular disease was associated with greater
risk of CVoutcomes vs single vascular disease. Liraglutide appeared to
reduce consistently CVoutcomes in patients with single and polyvascular
disease vs placebo. A trend towards a neutral response was observed in
patients without ASCVD. (Figure Presented).

<62>
Accession Number
642036353
Title
Liraglutide reduces major cardiovascular events in patients with chronic
kidney disease: results from the LEADER trial.
Source
Diabetologia. Conference: 54th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2018. Berlin Germany. 61(Supplement 1) (pp
S38-S39), 2018. Date of Publication: October 2018.
Author
Poulter N.; Mann J.; Fonseca V.; Mosenzon O.; Raz I.; FrimerLarsen H.; Von
Scholten B.; Idorn T.
Institution
(Poulter) Imperial College London, London, United Kingdom
(Mann) KfH Kidney Center, Munich, Germany
(Fonseca) Tulane University, Health Sciences Center, School of Medicine,
New Orleans, United States
(Mosenzon, Raz) Hadassah Hebrew University Hospital, Jerusalem, Israel
(FrimerLarsen, Von Scholten, Idorn) Novo Nordisk A/S, Soborg, Denmark
Publisher
Springer Verlag
Abstract
Background and aims: People with type 2 diabetes (T2D) and chronic kidney
disease (CKD) are at high risk of cardiovascular (CV) events. We analysed
the effect of liraglutide vs placebo (PBO) on CV outcomes in patients with
T2D and CKD in the LEADER trial. Material(s) and Method(s): LEADER
was a randomised, double-blind, multicentre, CV outcome trial with
liraglutide 1.8 mg/day vs PBO, both in addition to standard of care for
3.5-5 years, in 9340 patients with T2D and high CV risk. The primary
composite outcome was defined as first occurrence of death from CV causes,
non-fatal myocardial infarction, or non-fatal stroke. The expanded
composite CV outcome additionally included coronary revascularisation, and
hospitalisation for unstable angina pectoris or hospitalisation for heart
failure (HF). In this analysis, CV outcomes were assessed in patients with
CKD based on estimated GFR (eGFR) (<60 and >=60 mL/min/1.73 m2 ) and on
albuminuria (>=30 mg/g: micro/macroalbuminuria and <30 mg/g:
normoalbuminuria). Result(s): The mean eGFR in patients with baseline
eGFR <60 (n = 2158) and >=60 mL/min/1.73 m2 (n = 7182) was 45.7 +/- 10.9
and 90.8 +/- 21.6 mL/ min/1.73 m2 , respectively. Versus PBO, liraglutide
was associated with reductions in the risk of the primary composite
outcome: HR 0.69 (CI 0.57; 0.85) for the eGFR <60 subgroup and HR 0.94 (CI
0.83; 1.07) in the eGFR >=60 subgroup. Equivalent reductions in the
expanded composite CV outcome were observed (Figure). In the eGFR <60
mL/min/1.73 m2 subgroup, liraglutide significantly reduced the risk of CV
death, non-fatal stroke and hospitalisation for HF vs PBO (Figure).
Liraglutide also reduced the risk of the primary composite outcome, the
expanded composite CV outcome and CV death in the micro/macroalbuminuria
subgroup vs PBO (Figure). Conclusion(s): In LEADER, there was a
significant reduction of major CV events in patients with CKD.

<63>
Accession Number
642036825
Title
Interleukin-6 blockade ameliorates the effect of exercise on cardiac fat
in abdominally obese individuals.
Source
Diabetologia. Conference: 54th Annual Meeting of the European Association
for the Study of Diabetes, EASD 2018. Berlin Germany. 61(Supplement 1) (pp
S52), 2018. Date of Publication: October 2018.
Author
Christensen R.; Lang Lehrskov L.; Wedell-Neergaard A.-S.; Krogh-Madsen R.;
Karstoft K.; Ellingsgaard H.; Rosenmeier J.; Pedersen B.K.
Institution
(Christensen, Lang Lehrskov, Wedell-Neergaard, Krogh-Madsen, Karstoft,
Ellingsgaard, Pedersen) Capital Hospital of Denmark, Copenhagen, Denmark
(Rosenmeier) Bispebjerg Hospital, Copenhagen, Denmark
Publisher
Springer Verlag
Abstract
Background and aims: Excessive cardiac adipose tissue has been associated
with the incidence and severity of type 2 diabetes and cardiovascular
disease. Exercise training reduces cardiac adipose tissue and may
therefore be a strategy to prevent type 2 diabetes and coronary heart
disease. The underlying mechanisms for exercise-mediated adaptations of
cardiac fat are unclear, but may involve actions of interleukin-6 (IL-6).
IL-6 is a myokine which is released in response to exercise and it has
been shown to increase lipolysis in adipose tissue. Whether this mechanism
is operative in cardiac adipose is unknown. Therefore, the aim of this
study was to investigate whether blocking of IL-6 can ameliorate the
effects of exercise on cardiac fat volume. Material(s) and Method(s):
This was a 12-week, double-blinded, randomised, placebo-controlled
exercise and drug intervention trial. 52 abdominally obese participants
were enrolled to endurance exercise (3 x sessions per week of
interval-based high-intensity training of 70-85% of VO2 max) or no
exercise groups combined with IL-6 blockade (Tocilizumab, 8 mg/kg, toci)
or placebo (saline). Cardiac fat volume was assessed by MRI at baseline
and post intervention. Data is expressed as mean +/- SD. A 2-way ANCOVA
was used to assess whether IL-6 blockade influenced the effect of exercise
on cardiac fat. Result(s): 13 (25%) were men, with an age average of
44 +/- 13 years. Baseline mean cardiac fat was 203 +/- 111 ml. There were
no differences in baseline cardiac fat levels between participants (p =
0.07). Cardiac fat was reduced by 16% (95% CI -31; -1, p = 0.041) after 12
weeks of endurance exercise compared to no exercise (Figure 1). The
reduction in cardiac fat was ameliorated in the group that exercised and
received IL-6 blockade (p = 0.021). IL-6 blockade alone did not lead to
any significant changes on cardiac fat in groups that did not exercise (p
= 0.083) (Figure 1). Conclusion(s): In a randomised
placebo-controlled exercise and drug intervention we found that IL-6
blockade can ameliorate the effects of exercise on cardiac fat in
abdominally obese individuals. These data suggest IL-6 is required to
mediate the adipose reducing effects of exercise specifically on cardiac
adipose tissue.

<64>
Accession Number
2024893051
Title
Incidence of atrioventricular block after isolated coronary artery bypass
grafting: a systematic review and pooled-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1225833. Date of Publication: 2023.
Author
Yaghoobian R.; Hosseini Dolama R.; Soleimani H.; Saeidi S.; Mashayekhi M.;
Mirzayi P.; Alavi Tabatabaei G.; Hosseini K.
Institution
(Yaghoobian, Hosseini Dolama, Soleimani, Saeidi, Mashayekhi, Mirzayi,
Hosseini) Tehran Heart Center, Cardiovascular Diseases Research Institute,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini Dolama) Students' Scientific Research Center (SSRC), Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Alavi Tabatabaei) Isfahan Cardiovascular Research Center, Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Hosseini) Cardiac Primary Prevention Research Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Publisher
Frontiers Media SA
Abstract
Background and objectives: Atrioventricular block (AVB) is a serious
complication following coronary artery bypass grafting (CABG) surgery, and
its high-grade form may necessitate the implantation of a permanent
pacemaker (PPM). AVB is associated with increased morbidity and mortality
rates. This study aims to estimate the incidence of AVB and subsequent PPM
implantation after isolated CABG surgery. Material(s) and Method(s):
We searched electronic databases of PubMed, Embase, and Scopus from
inception to 18 November 2022. Clinical trials and observational studies
reporting the incidence of post-CABG AVB or subsequent PPM implantation in
adult patients were included. The total incidence for all included
outcomes was calculated using the inverse variance method, and the
I2 statistic was reported to evaluate the heterogeneity of
studies. Result(s): A total of 28 studies met the inclusion criteria.
Four studies [3 cohorts, 1 randomized controlled trial (RCT)] reported AVB
without specifying its type; one (cohort) reported different degrees of
AVB, 20 (12 cohorts, 8 RCTs) reported complete heart block (CHB) (or AVB
requiring temporary pacing), and nine (8 cohorts, 1 RCT) reported the
number of PPM inserted due to AVB. The pooled incidence of AVB, CHB (or
AVB requiring temporary pacing), and PPM due to AVB was 1.16%, 1.73%, and
0.58%, respectively. Meta-regression analysis revealed that age, gender,
diabetes, hypertension, hyperlipidemia, or smoking were not significantly
associated with AVB, CHB, or PPM implantation. Conclusion(s): This
study highlights the incidence of AVB and the need for PPM implantation
following CABG surgery. The findings emphasize the importance of
postoperative monitoring and surveillance to improve patient outcomes.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022377181,
identifier PROSPERO CRD42022377181. Copyright 2023 Yaghoobian,
Hosseini Dolama, Soleimani, Saeidi, Mashayekhi, Mirzayi, Alavi Tabatabaei
and Hosseini.

<65>
Accession Number
2026472910
Title
Low-Dose vasopressin and renal perfusion in pediatric cardiac surgery.
Source
Annals of Cardiac Anaesthesia. 26(3) (pp 309-317), 2023. Date of
Publication: July 2023.
Author
Kumar A.; Ghotra G.; Raj S.; Tiwari N.; Ramamurthy H.
Institution
(Kumar, Raj) Department of Anaesthesia and Critical Care, Army Hospital
(Research and Referral), Delhi Cantt, New Delhi, India
(Ghotra) Department of Anaesthesia and Critical Care, Army Institute of
Cardiothoracic Sciences, Maharashtra, Pune, India
(Tiwari) Department of Cardiothoracic Surgery, Army Hospital (Research and
Referral), Delhi Cantt, New Delhi, India
(Ramamurthy) Department of Paediatrics, Army Hospital (Research and
Referral), Delhi Cantt, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Congenital heart surgeries are associated with post-bypass
renal and cardiac dysfunctions. The use of low-dose vasopressin has been
found to be beneficial in adult cardiac surgeries. Objective(s): To
assess the hemodynamic and renal effects of patients undergoing on-pump
pediatric cardiac surgery under general anesthesia (GA) with low-dose
vasopressin infusion. Design(s): Prospective randomized controlled
study. Setting(s): Operation room and ICU, tertiary care teaching
hospital. Patient(s): Fifty-five pediatric cardiac patients
undergoing repair for congenital heart diseases (CHD).
 Intervention(s): Low-dose vasopressin infusion in the study group and
placebo in the control group. Measurements and Main Results: Renal
near-infrared spectroscopy (NIRS), serum NGAL, and inflammatory mediators
- IL6 and IL8 along with other renal and hemodynamic parameters in the
perioperative period were recorded. Diastolic blood pressure (DBP) and
cardiac index were significantly higher in the vasopressin group.
Inflammatory markers were significantly high in the immediate
postoperative period in all patients which later stabilized in the next 48
h but showed similar trends in both groups. Low-dose vasopressin infusion
did not improve either renal perfusion or function. The duration of
mechanical ventilation and length of hospital stay, the incidence of AKI
development, and transfusion requirements were marginally lower in the
vasopressin group, although not significant. Conclusion(s): Low-dose
vasopressin infusion improved hemodynamics and showed a decreased
incidence of complications. However, it failed to show any benefit of
renal function and overall outcome in pediatric cardiac
surgery. Copyright © 2023 Wolters Kluwer Medknow Publications.
All rights reserved.

<66>
Accession Number
2026472905
Title
Impact of ketamine versus propofol for anesthetic induction on cognitive
dysfunction, delirium, and acute kidney injury following cardiac surgery
in elderly, high-risk patients.
Source
Annals of Cardiac Anaesthesia. 26(3) (pp 274-280), 2023. Date of
Publication: July 2023.
Author
Wittwer E.; Cerhan J.; Schroeder D.; Schaff H.; Mauermann W.
Institution
(Wittwer, Mauermann) Department of Anesthesiology and Perioperative
Medicine, Surgery, Mayo Clinic, Rochester, MN, United States
(Cerhan) Department of Psychiatry and Psychology, Surgery, Mayo Clinic,
Rochester, MN, United States
(Schroeder) Department of Health Sciences Research, Surgery, Mayo Clinic,
Rochester, MN, United States
(Schaff) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN,
United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objective: Evaluate the effects of ketamine versus propofol when used for
induction of anesthesia in elderly, high-risk cardiac surgical patients on
postoperative complications including cognitive dysfunction, delirium, and
acute kidney injury. Method(s): Prospective, randomized study
performed at a tertiary medical center. A total of 52 patients aged >=70
and older presenting for complex cardiac surgery were randomized to
receive either ketamine or propofol for induction of anesthesia. Patients
underwent a battery of cognitive testing preoperatively and
postoperatively and the incidence of delirium and acute kidney injury were
measured. Norepinephrine (NEE) equivalents following induction were
assessed for each group. Result(s): A total of 49 patients were
included, 25 in the ketamine group and 24 in the propofol group with 3
patients excluded from the analysis. No difference was found between
groups in either postoperative cognitive dysfunction or delirium
incidence. Acute kidney injury occurred in 6 (24%) patients in the
ketamine group in 12 (50%) patients in the propofol group, but the
difference did not meet statistical significance (P = 0.08; Relative Risk
= 2.1, 95% CI 0.9-4.7). NEE equivalents were lower in the ketamine group,
9.6 +/- 22.2 versus 32.7 +/- 46.0, P < 0.03. Conclusion(s): The use
of ketamine versus propofol for induction of anesthesia did not impact the
incidence of postoperative cognitive dysfunction or delirium. Twice as
many patients in the propofol group developed acute kidney injury,
although not reaching statistical significance and warranting further
investigation. In elderly, high-risk patients, ketamine was associated
with a significantly reduced need for vasopressor support following
induction. Copyright © 2023 Wolters Kluwer Medknow Publications.
All rights reserved.

<67>
Accession Number
2026472904
Title
Comparative efficacy of serratus anterior plane block (SAPB) and fentanyl
for postoperative pain management and stress response in patients
undergoing minimally invasive cardiac surgery (MICS).
Source
Annals of Cardiac Anaesthesia. 26(3) (pp 268-273), 2023. Date of
Publication: July 2023.
Author
Saikat S.; Shweta S.; Somalia M.; Dibyendu K.; Sushan M.
Institution
(Saikat) Senior Consultant Anesthesiologist, Apollo Multispeciality
Hospital, West Bengal, Kolkata, India
(Shweta) Resident, Department of Anesthesiology, Apollo Multispeciality
Hospital, West Bengal, Kolkata, India
(Somalia) Senior Registrar, Apollo Multispeciality Hospital, West Bengal,
Kolkata, India
(Dibyendu) Consultant Cardiac Anesthesiologist, Apollo Multispeciality
Hospital, West Bengal, Kolkata, India
(Sushan) Consultant Cardiac Surgeon, Apollo Multispeciality Hospital, West
Bengal, Kolkata, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Fast-tracking plays a significant role in reducing
perioperative morbidity and postoperative hospital stay by facilitating
early extubation and optimal pain control. Attenuating the stress response
to surgery also has a crucial function in enhancing recovery. Serratus
anterior plane block (SAPB) is a recently described technique for chest
wall analgesia. More data is required to find out the effectiveness of
analgesia by SAPB for minimally invasive cardiac surgery (MICS).
 Aim(s): The study aimed to assess the efficacy and safety of
ultrasound-guided SAPB compared to fentanyl for controlling
post-thoracotomy pain and stress response in patients undergoing MICS.
Setting and Design: Time framed comparative, prospective, and
observational study. Material(s) and Method(s): Patients undergoing
MICS for coronary artery bypass grafting under general anesthesia were
randomly assigned into two groups. SAPB group (Group A) patients were
given 0.2% of 20 ml ropivacaine followed by catheter insertion for
continuous infiltration at the end of the procedure. Fentanyl group (Group
B) patients were given fentanyl infusion for postoperative analgesia. The
primary outcome measured changes in visual analog scale (VAS) score (pain)
and cortisol levels (for stress response) in both groups. Result(s):
VAS score was significantly low in Group A when compared to Group B (P <
0.0001). Cortisol levels were also lower in the SAPB group. Hemodynamic
parameters (systolic blood pressure, diastolic blood pressure, pulse rate,
and oxygen saturation) were more stable in Group A with a lesser
requirement of top-up analgesics. Conclusion(s): SAPB was more
effective than fentanyl in managing post-thoracotomy pain after MICS.
Cortisol level was lower in the group that received SAPB. Copyright
© 2023 Wolters Kluwer Medknow Publications. All rights reserved.

<68>
Accession Number
2026472903
Title
Effect of preoperative ivabradine on hemodynamics during elective off-pump
CABG.
Source
Annals of Cardiac Anaesthesia. 26(3) (pp 260-267), 2023. Date of
Publication: July 2023.
Author
Virmani S.; Mallik I.; Mohire V.; Geelani M.; Minhas H.
Institution
(Virmani) Department of Anaesthesiology and Intensive Care, G B Pant
Institute of Postgraduate Medical Education and Research, J L Nehru Marg,
New Delhi, India
(Mallik) Department of Cardiac Anaesthesia, PGIMS Rohtak, Haryana, India
(Mohire) Department of Cardiac Anaesthesia, Superspeciality Hospital, NSCB
Medical College, MP, Jabalpur, India
(Geelani, Minhas) Department of Cardiothoracic Surgery, G B Pant Institute
of Postgraduate Medical Education and Research, J L Nehru Marg, New Delhi,
India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Ivabradine is a specific heart rate (HR)-lowering agent which
blocks the cardiac pacemaker I f channels. It reduces the HR without
causing a negative inotropic or lusitropic effect, thus preserving
ventricular contractility. The authors hypothesized that its usefulness in
lowering HR can be utilized in patients undergoing off-pump coronary
artery bypass (OPCAB) surgery. Objective(s): To study the effects of
preoperative ivabradine on hemodynamics (during surgery) in patients
undergoing elective OPCAB surgery. Method(s): Fifty patients, New
York Heart Association (NYHA) class I and II, were randomized into group I
(control, n = 25) and group II (ivabradine group, n = 25). In group I,
patients received the usual anti-anginal medications in the preoperative
period, as per the institutional protocol. In group II, patients received
ivabradine 5 mg twice daily for 3 days before surgery, in addition to the
usual anti-anginal medications. Anesthesia was induced with fentanyl,
thiopentone sodium, and pancuronium bromide as a muscle relaxant and
maintained with fentanyl, midazolam, pancuronium bromide, and isoflurane.
The hemodynamic parameters [HR and mean arterial pressure (MAP)] and
pulmonary artery (PA) catheter-derived data were recorded at the baseline
(before induction), 3 min after the induction of anesthesia at 1 min and 3
min after intubation and at 5 min and 30 min after protamine
administration. Intraoperatively, hemodynamic data (HR and MAP) were
recorded every 10 min, except during distal anastomosis of the coronary
arteries when it was recorded every 5 min. Post-operatively, at 24 hours,
the levels of troponin T and brain natriuretic peptide (BNP) were
measured. This trial's CTRI registration number is CTRI/005858.
 Result(s): The HR in group II was lower when compared to group I
(range 59.6-72.4 beats/min and 65.8-80.2 beats/min, respectively)
throughout the study period. MAP was comparable [range (78.5-87.8 mm Hg)
vs. (78.9-88.5 mm Hg) in group II vs. group I, respectively] throughout
the study period. Intraoperatively, 5 patients received metoprolol in
group I to control the HR, whereas none of the patients in group II
required metoprolol. The incidence of preoperative bradycardia (HR <60
beats/min) was higher in group II (20%) vs. group I (8%). There was no
difference in both the groups in terms of troponin T and BNP level after
24 hours, time to extubation, requirement of inotropes, incidence of
arrhythmias, in-hospital morbidity, and 30-day mortality.
 Conclusion(s): Ivabradine can be safely used along with other
anti-anginal agents during the preoperative period in patients undergoing
OPCAB surgery. It helps to maintain a lower HR during surgery and reduces
the need for beta-blockers in the intraoperative period, a desirable and
beneficial effect in situations where the use of beta-blockers may be
potentially harmful. Further studies are needed to evaluate the beneficial
effects of perioperative Ivabradine in patients with moderate-to-severe
left ventricular dysfunction. Copyright © 2023 Wolters Kluwer
Medknow Publications. All rights reserved.

<69>
Accession Number
2026472902
Title
Erector spinae plane block for postoperative analgesia in cardiac
surgeries- A systematic review and meta-analysis.
Source
Annals of Cardiac Anaesthesia. 26(3) (pp 247-259), 2023. Date of
Publication: July 2023.
Author
Nair A.; Saxena P.; Borkar N.; Rangaiah M.; Arora N.; Mohanty P.
Institution
(Nair) Department of Anaesthesiology, Ibra Hospital, Ministry of
Health-Oman, Ibra 414, Oman
(Saxena, Mohanty) Department of Cardiac Anesthesia, National Heart Center,
Royal Hospital, Muscat, Oman
(Borkar) Department of Pediatric Surgery, All India Institute of Medical
Sciences, Chhattisgarh, Raipur, India
(Rangaiah) Department of Anaesthetics and Pain Management, Walsall Manor
Hospital, Moat Rd, Walsall WS2 9PS, United Kingdom
(Arora) Department of Anaesthesiology, Kings College Hospital, NHS
Foundation Trust, London, United Kingdom
Publisher
Wolters Kluwer Medknow Publications
Abstract
Ultrasound-guided erector spinae plane block (ESPB) has been used in many
studies for providing opioid-sparing analgesia after various cardiac
surgeries. We performed a systematic review and meta-analysis of
randomized controlled trials to assess the efficacy of ESPB in cardiac
surgeries. We searched PubMed, Embase, Cochrane Central Register of
Controlled Trials (CENTRAL), and Google Scholar to identify the studies in
which ESPB was compared with the control group/sham block in patients
undergoing cardiac surgeries. The primary outcomes were postoperative
opioid consumption and postoperative pain scores. The secondary outcomes
were intraoperative opioid consumption, ventilation time, time to the
first mobilization, length of ICU and hospital stay, and adverse events.
Out of 607 studies identified, 16 studies (n = 1110 patients) fulfilled
inclusion criteria and were used for qualitative and quantitative
analysis. Although, 24-hr opioid consumption were comparable in both
groups group (MD, -18.74; 95% CI, -46.85 to 9.36, P = 0.16), the 48-hr
opioid consumption was significantly less in ESPB group than control ((MD,
-11.01; 95% CI, -19.98 to - 2.04, P = 0.02). The pain scores at various
time intervals and intraoperative opioid consumption were significantly
less in ESPB group. Moreover, duration of ventilation, time to the first
mobilization, and length of ICU and hospital were also less in ESPB group
(P < 0.00001, P < 0.00001, P < 0.00001, and P < 0.0001, respectively).
This systematic review and meta-analysis demonstrated that ESPB provides
opioid-sparing perioperative analgesia, facilitates early extubation and
mobilization, leads to early discharge from ICU and hospital, and has
lesser pruritus when compared to control in patients undergoing cardiac
surgeries. Copyright © 2023 Wolters Kluwer Medknow Publications.
All rights reserved.

<70>
Accession Number
2026456253
Title
Effects of low versus high inspired oxygen fraction on myocardial injury
after transcatheter aortic valve implantation: A randomized clinical
trial.
Source
PLoS ONE. 18(8 August) (no pagination), 2023. Article Number: e0281232.
Date of Publication: August 2023.
Author
Cho Y.J.; Hyeon C.; Nam K.; Lee S.; Ju J.-W.; Kang J.; Han J.-K.; Kim
H.-S.; Jeon Y.
Institution
(Cho, Hyeon, Nam, Lee, Ju, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University,
College of Medicine, Seoul, South Korea
(Kang, Han, Kim) Department of Internal Medicine, Seoul National
University Hospital, Seoul National University, College of Medicine,
Seoul, South Korea
Publisher
Public Library of Science
Abstract
Background Oxygen therapy is used in various clinical situation, but its
clinical outcomes are inconsistent. The relationship between the fraction
of inspired oxygen (FIO2) during transcatheter aortic valve implantation
(TAVI) and clinical outcomes has not been well studied. We investigated
the association of FIO2 (low vs. high) and myocardial injury in patients
undergoing TAVI. Methods Adults undergoing transfemoral TAVI under general
anesthesia were randomly assigned to receive FIO2 0.3 or 0.8 during
procedure. The primary outcome was the area under the curve (AUC) for
high-sensitivity cardiac troponin I (hs-cTnI) during the first 72 h
following TAVI. Secondary outcomes included the AUC for postprocedural
creatine kinase-myocardial band (CK-MB), acute kidney injury and recovery,
conduction abnormalities, pacemaker implantation, stroke, myocardial
infarction, and in-hospital mortality. Results Between October 2017 and
April 2022, 72 patients were randomized and 62 were included in the final
analysis (n = 31 per group). The median (IQR) AUC for hs-cTnI in the first
72 h was 42.66 (24.82-65.44) and 71.96 (35.38-116.34) h ng/mL in the FIO2
0.3 and 0.8 groups, respectively (p = 0.066). The AUC for CK-MB in the
first 72 h was 257.6 (155.6-322.0) and 342.2 (195.4-485.2) h ng/mL in the
FIO2 0.3 and 0.8 groups, respectively (p = 0.132). Acute kidney recovery,
defined as an increase in the estimated glomerular filtration rate >= 25%
of baseline in 48 h, was more common in the FIO2 0.3 group (65% vs. 39%, p
= 0.042). Other clinical outcomes were comparable between the groups.
Conclusions The FIO2 level did not have a significant effect on
periprocedural myocardial injury following TAVI. However, considering the
marginal results, a benefit of low FIO2 during TAVI could not be ruled
out. Copyright © 2023 Cho et al. This is an open access article
distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are credited.

<71>
Accession Number
2026440900
Title
Vascular complications of ProGlide versus Prostar in transcatheter aortic
valve replacement (TAVR) procedures: meta-analysis.
Source
BJS Open. 7(4) (no pagination), 2023. Article Number: zrad061. Date of
Publication: 01 Aug 2023.
Author
Xiang Y.; Chen C.; Zhao J.; Ma Y.; Huang B.; Wu Z.
Institution
(Xiang, Zhao, Ma, Huang, Wu) Division of Vascular Surgery, Department of
General Surgery, West China Hospital, Sichuan University, Chengdu, China
(Chen) Division of Cardiology, West China Hospital, Sichuan University,
Chengdu, China
Publisher
Oxford University Press
Abstract
Background: The aim of this study was to compare the vascular
complications of ProGlide and Prostar in percutaneous transfemoral
transcatheter aortic valve replacement. Method(s): Electronic
databases were searched in July 2022 for studies that compared the
vascular complications of ProGlide and Prostar for percutaneous closure in
transcatheter aortic valve replacement. The primary outcome was major
vascular complications and the secondary outcomes were minor vascular
complications, types of access-site vascular complications, device
failure, and additional intervention. Estimates of relative effects were
pooled to generate ORs and their 95 per cent c.i. using a random-effects
model. The risk of bias in non-randomized comparative studies was assessed
using the Risk Of Bias In Non-randomized Studies - of Interventions
('ROBINS-I') tool. Result(s): Nine studies were identified and a
total of 7529 patients were included. Among them, 4144 patients received
ProGlide and 3385 received Prostar. The pooled data showed that the risk
of major vascular complications was significantly lower with ProGlide
versus Prostar (OR 0.50, 95 per cent c.i. 0.32 to 0.78). Regarding the
types of vascular complications, vascular trauma was the most common
complication and the risk was similar between groups (OR 1.02, 95 per cent
c.i. 0.55 to 1.91). ProGlide had a lower risk of bleeding complications
(OR 0.46, 95 per cent c.i. 0.22 to 0.94), but a higher risk of ischaemia
complications (OR 1.90, 95 per cent c.i. 1.10 to 3.27). The risk of device
failure was lower in the ProGlide group (OR 0.45, 95 per cent c.i. 0.21 to
0.95). Both groups had a similar risk of having additional interventions
for vascular complications (OR 1.02, 95 per cent c.i. 0.75 to 1.39). The
use of ProGlide was associated with a lower risk of additional surgical
treatments (OR 0.52, 95 per cent c.i. 0.34 to 0.80), but a higher risk of
endovascular treatments (OR 2.69, 95 per cent c.i. 1.29 to 5.63).
 Conclusion(s): In percutaneous transfemoral transcatheter aortic
valve replacement procedures, ProGlide has superior safety and efficacy
when compared with Prostar; it is associated with fewer major vascular
complications and device failures. The vascular complications of ProGlide
are more likely to be dealt with using endovascular treatments than
surgical treatments. Copyright © 2023 The Author(s). Published by
Oxford University Press on behalf of BJS Society Ltd.

<72>
Accession Number
2026388963
Title
A COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND FENTANYL ADDED TO
ROPIVACAINE AS ADJUVANT IN PARAVERTEBRAL BLOCK FOR POST OPERATIVE
ANALGESIA IN PATIENTS UNDERGOING THORACOTOMY FOR VARIOUS SURGICAL
PROCEDURES.
Source
Journal of Cardiovascular Disease Research. 14(6) (pp 2218-2228), 2023.
Date of Publication: 2023.
Author
Rashmi R.; Dahiya A.; Chand R.K.; Dutta R.; Tobin R.
Institution
(Dahiya, Dutta) Cardiac Anaesthesia, India
(Chand) The Department Cardiac Anaesthesia, India
(Tobin) The Department of Anaesthesiology and Pain Management, India
Publisher
EManuscript Technologies
Abstract
Pain after thoracotomy is one of the most severe pains after surgery.
Respiratory muscle splinting due to poor control of post-operative pain
may lead to respiratory complications and delayed recovery. In studies
addition of dexmedetomidine or fentanyl to local anaesthetics showed
enhanced quality of anaesthesia, reduced post-operative analgesic
requirement and improved quality and duration of sensory neural blockade.
But there are very few studies comparing dexmedetomidine and fentanyl as
an adjuvant to ropivacaine in paravertebral block for post thoracotomy
analgesia. 80 patients scheduled to undergo elective thoracotomy were
randomly divided into two groups. Group A patients received infusion of
0.2% ropivacaine + 2microg/ml(microgram/millilitre) fentanyl @
0.1ml/kg/h(millilitre/kilogram/hour) and Group B patients received
infusion of 0.2% ropivacaine + 1microg/ml dexmedetomidine @ 0.1ml/kg/h in
continuous paravertebral block. The patients had visual analogue
scale(VAS) at rest between 1-3 in fentanyl group and 1-2 in
dexmedetomidine group.(p value >0.05) The mean VAS score for the severity
of pain at coughing was between 2-3 in fentanyl group and 1-2.5 in
dexmedetomidine group and the difference is statistically significant.(p
value <0.05) 12 patients in fentanyl group received rescue analgesic
compared to 4 patients in dexmedetomidine group.(p value <0.05) Total
fentanyl consumption was more in fentanyl group compared to
dexmedetomidine group.(p value >0.05) There was no difference in incidence
of side effects in both groups.(p value >0.05) Dexmedetomidine as an
adjuvant to ropivacaine provided better post-operative analgesia during
coughing and significantly reduced the requirement of rescue analgesic in
comparison to fentanyl group without any significant adverse
effects. Copyright © 2023 EManuscript Technologies. All rights
reserved.

<73>
Accession Number
642045464
Title
Adenosine Triphosphate Citrate Lyase and Fatty Acid Synthesis Inhibition:
A Narrative Review.
Source
JAMA cardiology. (no pagination), 2023. Date of Publication: 16 Aug 2023.
Author
Duarte Lau F.; Giugliano R.P.
Institution
(Duarte Lau) Houston Methodist DeBakey Heart & Vascular Center, Houston,
TX, United States
(Giugliano) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, MA, United States
Publisher
NLM (Medline)
Abstract
Importance: Adenosine triphosphate citrate lyase (ACLY) is a key
regulatory enzyme of glucose metabolism, cholesterol and fatty acid
synthesis, and the inflammatory cascade. Bempedoic acid, an ACLY
inhibitor, significantly reduces atherogenic lipid markers, including
low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein
cholesterol, and apolipoprotein B. Additional effects of ACLY inhibition
include antitumor growth; reduction of triglycerides and proinflammatory
molecules such as high-sensitivity C-reactive protein; less insulin
resistance; reduction of hepatic lipogenesis; and weight loss.
Observations: While numerous ACLY inhibitors have been identified, most of
the clinical data have focused on bempedoic acid. The Cholesterol Lowering
via Bempedoic Acid, an ACL-Inhibiting Regimen (CLEAR) program was a series
of phase 3 clinical trials that evaluated its effects on lipid parameters
and safety, leading to US Food and Drug Administration approval in 2020.
CLEAR Outcomes was a phase 3, double-blind, randomized, placebo-controlled
trial in individuals with a history of statin intolerance, serum LDL-C
level of 100 mg/dL or higher, and a history of, or at high risk for,
cardiovascular disease. Bempedoic acid modestly reduced the primary 4-way
cardiovascular composite end point as well as the individual components of
myocardial infarction and coronary revascularization but did not reduce
stroke, cardiovascular death, or all-cause mortality. Rates of gout and
cholelithiasis were higher with bempedoic acid, and small increases in
serum creatinine, uric acid, and hepatic-enzyme levels were also observed.
Conclusions and relevance: ACLY inhibition with bempedoic acid has been
established as a safe and effective therapy in high-risk patients who
require further LDL-C lowering, particularly for those with a history of
statin intolerance. The recently published CLEAR Outcomes trial revealed
modest reductions in cardiovascular events with bempedoic acid,
proportional to its LDL-C lowering, in high-risk individuals with statin
intolerance and LDL-C levels of 100 mg/dL or higher. The additional
effects of ACLY inhibition have prompted a more thorough search for novel
ACLY inhibitors for conditions such as cancer, hypertriglyceridemia,
chronic inflammation, type 2 diabetes, fatty liver disease, obesity, and
metabolic syndrome. Similarly, therapies that reduce fatty acid synthesis
are being explored for their use in cardiometabolic conditions.

<74>
Accession Number
642044868
Title
Aortic Valve Repair in Neonates, Infants and Children: A Systematic
Review, Meta-Analysis and Microsimulation Study.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 16 Aug 2023.
Author
Notenboom M.L.; Rhellab R.; Etnel J.R.G.; van den Bogerd N.; Veen K.M.;
Taverne Y.J.H.J.; Helbing W.A.; van de Woestijne P.C.; Bogers A.J.J.C.;
Takkenberg J.J.M.
Institution
(Notenboom, Rhellab, Etnel, van den Bogerd, Veen, Taverne, van de
Woestijne, Bogers, Takkenberg) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Helbing) Department of Paediatrics, Div. of Cardiology, Erasmus
University Medical Centre, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To support clinical decision-making in children with aortic
valve disease, this study aims to compile the available evidence on
outcome after paediatric aortic valve repair. METHOD(S): A systematic
review of literature reporting clinical outcome after paediatric aortic
valve repair (mean age at surgery <18y) published between
01/01/1990-23/12/2021 was conducted. Early event risks, late event rates
and time-to-event data were pooled. A microsimulation model was employed
to simulate lives of children. RESULT(S): Forty-one publications were
included, encompassing 2,623 patients with 17,217 patient-years of
follow-up (median follow-up:7.3y; range:1.0-14.4y). Pooled mean age during
repair for aortic stenosis in children(<18y), infants(<1y) or
neonates(<30d) was 5.2+/-3.9 years, 35+/-137 days, and 11+/-6 days,
respectively. Pooled early mortality after stenosis repair in children,
infants and neonates, respectively, was 2.7%(95%CI:1.7%-4.3%),
7.4%(4.2-13.0%), and 10.7%(6.8-16.9%). Pooled late reintervention rate
after stenosis repair in children, infants and neonates, respectively, was
4.19%/y(2.94-5.96%/y), 6.84%/y(3.95-11.83%/y), and 6.32%/y(3.04-13.15%/y),
endocarditis 0.25%/y(0.09-0.70%/y), 0.23%/y(0.07-0.71%/y), and
0.49%/y(0.18-1.29%/y), and valve thrombosis 0.14%/y(0.05-0.34%/y),
0.15%/y(0.04-0.53%/y), and 0.19%/y(0.05-0.77%/y). Microsimulation-based
mean life-expectancy in the first 20 years for children, infants and
neonates with aortic stenosis, respectively, was 18.8y(95%CrI:18.6-18.9y;
relative survival compared to general population: 94.2%),
16.8y(16.5-17.0y; relative survival: 84.2%) and 15.9y(14.8-17.0y; relative
survival: 80.1%). Microsimulation-based 20-year risk of reintervention in
children, infants and neonates, respectively, was 75.2%(72.9%-77.2%),
53.8%(51.9%-55.7%) and 50.8%(47.0%-57.6%). CONCLUSION(S): Outcome
after paediatric aortic valve repair for stenosis is dependent on age at
surgery. Despite a high hazard of reintervention for valve dysfunction and
slightly impaired survival relative to the general population, aortic
valve repair is associated with low valve-related event occurrences.
PROSPERO: CRD42022292320. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<75>
Accession Number
642043200
Title
Procedural safety of transcatheter aortic valve replacement with Portico
valve: a systematic review.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 15 Aug 2023.
Author
Jaiswal V.; Wajid Z.; Suresh V.; Hanif M.; Rajak K.; Halder A.; Endurance
E.; Aiwuyo H.; Choudhari J.; Naz S.; Ang S.P.; Srestha A.B.
Institution
(Jaiswal, Choudhari) Division of Cardiovascular Research, Larkin Community
Hospital, South Miami, Fl, United States
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Wajid) Department of Internal Medicine, Wayne State University School of
Medicine, MI, United States
(Suresh) Department of Medicine, King George's Medical University,
Lucknow, India
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY, United States
(Rajak, Halder) Department of Internal Medicine, PA, United States
(Endurance) Internal Medicine Department, St. Luke's Hospital, St. Louis,
MO, United States
(Aiwuyo) Department of Internal Medicine, Brookdale Hospital Medical
Center, Brooklyn, United States
(Naz) University of Texas, MD Anderson Cancer Center, TX, United States
(Ang) Department of Medicine, Bangalore Medical College and Research
Institute, India
(Srestha) Department of Internal Medicine, Rutgers Health/Community
Medical Center, NJ, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The Portico transcatheter aortic heart valve is a
self-expandable, fully resheathable bioprosthetic valve with a nitinol
frame and porcine pericardial sealing cuff. It has been used among
symptomatic severe aortic stenosis who are at high or extreme surgical
risk. However, till date very few studies has been reported with
inconclusive evidence for its post-procedure safety outcomes.
 OBJECTIVE(S): We aim to evaluate the safety of the Portico
transcatheter aortic valve replacement system among patients with aortic
stenosis. METHODOLOGY: We conducted a systematic literature search on
PubMed, Embase, and Scopus from inception till 10th April 2023 by using
predefined MESH terms using "AND" and "OR." The following search terms
were used: "Aortic Stenosis" AND "Transcatheter aortic valve replacement"
OR "Portico valve." Finally, descriptive statistics were used to summarize
the data in this paper. The mean and standard deviation were adopted to
describe continuous variables, whereas frequencies and percentages were
used for dichotomous data. RESULT(S): A total of 7 studies with 2782
patients were included in the analysis. The mean age of patients was 82.3
years, and 54.63% were female. The most common comorbidity was
hypertension (65.21%) and diabetes mellitus (26.45%). Among patients of AS
with Portico valve implants, 6.47% reported all-cause mortality at a
follow-up. Post-procedural outcomes including 30-day mortality (2.32%),
cardiovascular mortality (2.37%), stroke (2.23%), myocardial infarction
(0.94%), major bleeding (3.97%), major vascular complications (4.91%),
acute kidney injury (AKI) (1.37%), and permanent pacemaker implantations
(PPI) in 15.73% patients were reported. Overall, device success was
observed in 95.82% of patients. CONCLUSION(S): Transcatheter aortic
valve replacement with the repositionable Portico valve, a new
bioprosthesis, appears to have a low post-procedural mortality rate and
other clinical outcomes in high-risk patients with severe
AS. Copyright © 2023 The Author(s). Published by Wolters Kluwer
Health, Inc.

<76>
Accession Number
642039352
Title
Paravertebral versus epidural anesthesia for video-assisted thoracic
surgery: A randomized trial.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 11 Aug 2023.
Author
Wu Z.; Wang Q.; Wu C.; Yu H.; Chen C.; He H.; Wu M.
Institution
(Wu, Wang, Wu, Yu, He, Wu) Department of Thoracic Surgery, Second
Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou,
China
(Wu) Department of Medical Quality Management, Women's Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Chen) Department of Anesthesiology, Second Affiliated Hospital, Zhejiang
University School of Medicine, Hangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The choice of postoperative pain management for patients who
experience moderate to severe acute pain after thoracoscopic surgery is
debatable. This study aimed to determine whether paravertebral block (PVB)
provides more benefits than thoracic epidural analgesia (TEA) for
thoracoscopic surgery. METHOD(S): From February 2020 to April 2022,
patients without chronic pain who were scheduled to undergo thoracoscopic
surgery were randomly assigned to the PVB group or the TEA group. The
visual analog scale score was used to measure the degree of pain when the
patients were at rest or coughing. RESULT(S): In total, 176 eligible
patients were enrolled in this study. No significant difference in the
visual analog scale score was found between the two groups at rest
(p=0.395) or with coughing (p=0.157). Additionally, there was no
significant difference in the average pain score between these two states
(p=0.221). The median time for catheter placement in the PVB group was 5
mins, which was shorter than that (14 mins) in the TEA group (p<0.001).
Moreover, the catheter placement failure rate in the PVB group was lower
than that in the TEA group (p=0.038). The incidence of hypotension
(p=0.016) and urinary retention (p=0.006) in the PVB group was lower than
that in the TEA group. CONCLUSION(S): A PVB can provide pain relief
that is similar to that of TEA but with no additional puncture pain, a
shorter catheter placement time and fewer side effects in patients
undergoing VATS. Copyright © 2023. Published by Elsevier Inc.

<77>
Accession Number
2026360358
Title
Effect of dexmedetomidine on postoperative nausea and vomiting in patients
under general anaesthesia: an updated meta-analysis of randomised
controlled trials.
Source
BMJ Open. 13(8) (no pagination), 2023. Article Number: e067102. Date of
Publication: 01 Aug 2023.
Author
Zhao W.; Li J.; Wang N.; Wang Z.; Zhang M.; Zhang H.; Liu M.; He J.; Yu D.
Institution
(Zhao, Li, Zhang, Zhang, Liu, He, Yu) Department of Anesthesiology, Hebei
General Hospital, Hebei Province, Shijiazhuang, China
(Wang) Department of Rheumatology, Hebei General Hospital, Hebei Province,
Shijiazhuang, China
(Wang) Department of Anesthesiology, The Fifth People's Hospital of
Hengshui, Hebei Province, Hengshui, China
Publisher
BMJ Publishing Group
Abstract
Objectives To explore the effect of dexmedetomidine (DEX) on postoperative
nausea and vomiting (PONV) in adult patients after general anaesthesia.
Design Systematic review and meta-analysis. Eligibility criteria for
selecting studies Randomised controlled trials (RCTs) comparing the
efficacy of DEX with placebo or a single drug on PONV in adult patients
after general anaesthesia. Data sources We searched the PubMed, the Web of
Science, the Cochrane Library and Embase (1 January 2000 to 30 June 2022)
to select the relevant RCTs. Data analysis All the relevant data were
analysed by using RevMan V.5.4. Heterogeneity was tested for each outcome,
and random-effect or fixed-effect models was selected according to the
level of heterogeneity. The primary outcome was the incidence of PONV. The
secondary outcomes were the incidence of bradycardia, perioperative opioid
consumption, extubation time and the length of hospitalisation. Results A
total of 18 trials involving 2018 patients were included in this
meta-analysis. Notably, 15 updated studies were not involved in the
previous meta-analysis. The incidence of PONV in DEX group was lower than
that in the control group (OR=0.49, 95% CI: 0.36 to 0.67) and the
perioperative opioid consumption in DEX group was also decreased
significantly (standard mean difference (SMD)=-1.04, 95% CI: -1.53 to
-0.54). Moreover, the length of hospitalisation (SMD=-2.29, 95% CI: -4.31
to -0.28) and the extubation time (SMD=-0.75, 95% CI: -1.26 to -0.25) in
DEX group were shorter. Whereas, more number of patients receiving DEX
might increase the occurrence of bradycardia (OR=1.60, 95% CI: 1.13 to
2.27). Conclusions DEX could decrease the occurrence of PONV in adult
patients under general anaesthesia and promote the recovery after surgery.
However, DEX might increase the occurrence of bradycardia. PROSPERO
registration number CRD 42022341548. Copyright © 2023 BMJ
Publishing Group. All rights reserved.

<78>
Accession Number
2026225923
Title
Subclinical Leaflet Thrombosis Following Surgical and Transcatheter Aortic
Valve Replacement: A Meta-Analysis.
Source
American Journal of Cardiology. 204 (pp 171-177), 2023. Date of
Publication: 01 Oct 2023.
Author
Moscarelli M.; Prestera R.; Pernice V.; Milo S.; Violante F.; Cuffari F.;
Di Pasquale C.; Ferlisi A.; Speziale G.; Angelini G.D.; Fattouch K.
Institution
(Moscarelli, Prestera, Pernice, Milo, Violante, Cuffari, Di Pasquale,
Ferlisi, Fattouch) Department of Cardiovascular Surgery, Maria Eleonora
Hospital, GVM Care & Research, Palermo, Italy
(Speziale) Department of Cardiovascular Surgery, Anthea Hospital, GVM Care
& Research, Bari, Italy
(Angelini) Department of Cardiac Surgery, Bristol Heart Institute,
University of Bristol, United Kingdom
(Fattouch) DICHIRONS, Discipline Chirurgiche, Oncologiche e
Stomatologiche, University of Palermo, Palermo, Italy
Publisher
Elsevier Inc.
Abstract
Subclinical leaflets valve thrombosis (SLT) is a recently identified
phenomenon with multidetector computer tomography after tissue aortic
valve replacement. Whether SLT is more frequent after transcatheter aortic
valve replacement (TAVR) or surgical aortic valve replacement (SAVR) is
currently not known. Thus, the aim of this pairwise meta-analysis was to
investigate the incidence of SLT after both TAVR and SAVR, the association
with anticoagulation therapy, and the risk for neurological events. We
searched PubMed, Google Scholar, and Ovid MEDLINE/Embase (January 02,
2023, last update) (PROSPERO registration: CRD42022383295). Statistical
analysis was performed according to a prespecified statistical analysis
plan. Time-to-event outcomes were summarized as incidence rate ratios
(IRR). Pooled estimates were calculated using inverse variance method and
random effect model. Overall, 2 registries, 2 randomized trials, and 1
observational study (1,593 patients) were included in this meta-analysis.
There was a statistically significant difference in the incidence rate at
follow-up of SLT between patients who underwent TAVR and SAVR (IRR 2.07,
95% confidence interval [CI]: [1.06; 4.03], I2 79%, 95% CI:
[44; 92], p = 0.03). Oral anticoagulation therapy was associated with a
reduced incidence of SLT (IRR 7.51, 95% CI: [3.24; 17.37], I2
62%, 95% CI: [0; 87], p <0.001). However, the incidence of later
neurological events did not differ between patients with or without SLT
(IRR 1.05, 95% CI: [0.32; 3.47], p = 0.93). In conclusion, SLT was more
frequently detected after TAVR than SAVR. However, it was not associated
with an increased risk for neurological events. Oral anticoagulation
therapy seemed to reduce the incidence of SLT. Copyright © 2023
Elsevier Inc.

<79>
Accession Number
2026007511
Title
Issue 30.09. Focus on cardiac rehabilitation, exercise, and sport
cardiology.
Source
European Journal of Preventive Cardiology. 30(9) (pp 741-744), 2023. Date
of Publication: 01 Jul 2023.
Author
Halasz G.; Bandera F.; De Luca L.; Piepoli M.
Institution
(Halasz, De Luca) Department of Cardiosciences, Azienda Ospedaliera San
Camillo-Forlanini, Circonvallazione Gianicolense, 87, Rome 00152, Italy
(Bandera, Piepoli) Clinical Cardiology, IRCCS Policlinico San Donato, Via
Morandi 30, San Donato Milanese, Milan 20097, Italy
(Bandera, Piepoli) Department of Biomedical Science for Health, University
of Milan, Via Festa del Perdono 7, Milan 20122, Italy
Publisher
Oxford University Press

<80>
[Use Link to view the full text]
Accession Number
2025640242
Title
del Nido versus blood cardioplegia in adult cardiac surgery: a
meta-analysis.
Source
Journal of Cardiovascular Medicine. 24(8) (pp 522-529), 2023. Date of
Publication: 01 Aug 2023.
Author
Malvindi P.G.; Tian D.H.; Bifulco O.; Berretta P.; Alfonsi J.; Cefarelli
M.; Yan T.D.; Di Eusanio M.
Institution
(Malvindi, Bifulco, Berretta, Alfonsi, Cefarelli, Di Eusanio) Cardiac
Surgery Unit, Lancisi Cardiovascular Center, Ospedali Riuniti delle
Marche, Polytechnic University of Marche, Ancona, Italy
(Tian) Department of Anaesthesia and Perioperative Medicine, Westmead
Hospital, Australia
(Tian) Critical Care Division, The George Institute for Global Health,
Sydney, Australia
(Tian) Department of Surgery, University of Melbourne, Melbourne, VIC,
Australia
(Bifulco) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, University of Padua, Padova, Italy
(Yan) Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital,
Sydney, NSW, Australia
(Yan) Sydney Medical School, Sydney University, Sydney, NSW, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
AimsInitially developed for myocardial protection in immature
cardiomyocytes, del Nido cardioplegia has been increasingly used over the
past decade in adult patients. Our aim is to analyse the results from
randomized controlled trials and observational studies comparing early
mortality and postoperative troponin release in patients who underwent
cardiac surgery using del Nido solution and blood cardioplegia.
 Method(s): A literature search was performed through three online
databases between January 2010 and August 2022. Clinical studies providing
early mortality and/or postoperative troponin evaluation were included. A
random-effects meta-analysis with a generalized linear mixed model,
incorporating random study effects, was implemented to compare the two
groups. Result(s): Forty-two articles were included in the final
analysis for a total of 11 832 patients, 5926 of whom received del Nido
solution and 5906 received blood cardioplegia. del Nido and blood
cardioplegia populations had comparable age, gender distribution, history
of hypertension and diabetes mellitus. There was no difference in early
mortality between the two groups. There was a trend towards lower 24 h
[mean difference -0.20; 95% confidence interval (CI) -0.40 to 0.00; I2 =
89%; P = 0.056] and lower peak postoperative troponin levels (mean
difference -0.10; 95% CI -0.21 to 0.01; I2 = 0.87; P = 0.087) in the del
Nido group. Conclusiondel Nido cardioplegia can be safely used in adult
cardiac surgery. The use of del Nido solution was associated with similar
results in terms of early mortality and postoperative troponin release
when compared with blood cardioplegia myocardial protection. Copyright
© 2023 Italian Federation of Cardiology.

<81>
Accession Number
2025220032
Title
Comparison of the Effects of Dexmedetomidine and Lidocaine on Stress
Response and Postoperative Delirium of Older Patients Undergoing
Thoracoscopic Surgery: A Randomized Controlled Trial.
Source
Clinical Interventions in Aging. 18 (pp 1275-1283), 2023. Date of
Publication: 2023.
Author
Lai Y.; Chen Q.; Xiang C.; Li G.; Wei K.
Institution
(Lai, Chen, Wei) Department of Anesthesiology, First Clinical College of
Chongqing Medical University, Chongqing, China
(Lai) Department of Anesthesiology, Affiliated People's Hospital of
Chongqing Three Gorges Medical College, Chongqing, China
(Chen) Department of Anesthesiology, Chongqing University Cancer Hospital,
Chongqing, China
(Xiang) Department of Thoracic Surgery, Chongqing University Three Gorges
Hospital, Chongqing, China
(Li) Department of Anesthesiology, Guangdong Hospital of Traditional
Chinese Medicine, The Second affiliated Hospital of Guangzhou University
of Chinese Medicine, Guangzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: We investigated the effects of intraoperative intravenous
lidocaine or dexmedetomidine infusion on inflammatory factors and
cognitive function in patients undergoing thoracoscopic surgery.
 Patients and Methods: Patients aged >65 years undergoing elective
thoracoscopic lobectomy or segmentectomy were randomly grouped as
dexmedetomidine group (group D), lidocaine group (group L), and control
group (group C). The plasma cortisol, interleukin-6, and tumor necrosis
factor-alpha concentrations were measured before anesthesia (T0) and
immediately (T1), 24 h (T2), and 48 h postoperatively (T3). Postoperative
delirium (POD) was assessed by 3D-CAM on days 2 and 7. Result(s): The
cortisol concentrations decreased for all groups at T1 from T0 although
they were significantly higher at T2. Group L had significantly lower
interleukin-6 concentrations at T1 and T2 than the other groups (P<0.05).
The interleukin-6 concentrations were significantly higher at T1, T2, and
T3 than at T0 for all the groups, significantly lower for groups D and L
than for group C at T1 and T2 (P<0.05), and significantly lower for group
L than for group D at T2 (P<0.05). The tumor necrosis factor-alpha
concentrations were significantly higher at T1, T2, and T3 than at T0 for
all the groups and significantly lower for groups D and L than for group C
at T1 and T2 (P<0.05), although they were not statistically significantly
different for groups D and L. There were no statistically significant
differences in the postoperative incidence of POD between the three groups
on days 2 and day 7. Conclusion(s): Intraoperative continuous
intravenous lidocaine or dexmedetomidine infusion reduced surgical stress
and inflammatory responses. The inhibitory effect of lidocaine on surgical
stress remained significant for up to 24 h postoperatively without
affecting patient awakening. However, the administration of either drug
failed to prevent postoperative POD. Copyright © 2023 Lai et al.

<82>
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.

<83>
Accession Number
2025154967
Title
Leadless Pacemakers: State of the Art and Selection of the Ideal
Candidate.
Source
Current Cardiology Reviews. 19(5) (pp 43-50), 2023. Article Number:
e310323215316. Date of Publication: 2023.
Author
Blank E.A.; El-Chami M.F.; Wenger N.K.
Institution
(Blank, El-Chami) Division of Cardiology, Section of Electrophysiology,
Emory University School of Medicine, Atlanta, GA, United States
(Wenger) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
Publisher
Bentham Science Publishers
Abstract
The field of cardiac pacing has been defined by constant development to
provide effica-cious, safe, and reliable therapy. Traditional pacing
utilizes transvenous leads, which dwell in the venous system and place
patients at risk for complications, including pneumothorax, bleeding,
in-fection, vascular obstruction, and valvular compromise. Leadless
pacemakers have been developed to overcome many of the challenges of
transvenous pacing while providing safe and effective pacing therapy for
an increasing population of patients. The Medtronic Micra transcatheter
pacing system was approved by the FDA in April of 2016 and the Abbott
Aveir pacemaker was approved in April of 2022. Several additional leadless
pacemakers are in various stages of development and testing. There exists
limited guidance on the selection of the ideal candidate for leadless
pacemakers. Advantages of leadless pacemakers include decreased infection
risk, overcoming limited vascular access, and avoidance of interaction
with the tricuspid valve apparatus. Disadvantages of leadless pacemakers
include right ventricular-only pacing, unclear lifecycle management, cost,
perforation risk, and lack of integration with defibrillator systems. This
review aims to provide an overview of the current state of the art of
leadless pacemakers, currently approved systems, clinical trials and
real-world evidence, considerations for patient selection, and future
directions of this promising technology. Copyright © 2023 Bentham
Science Publishers.

<84>
Accession Number
2025154952
Title
Temporary Mechanical Circulatory Support: Left, Right, and Biventricular
Devices.
Source
Current Cardiology Reviews. 19(5) (pp 27-42), 2023. Article Number:
e140323214613. Date of Publication: 2023.
Author
Dangl M.; Albosta M.; Butros H.; Loebe M.
Institution
(Dangl, Albosta) Department of Internal Medicine, University of Miami
Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, United
States
(Butros) Department of Medicine, Cardiovascular Division, University of
Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL,
United States
(Loebe) Department of Surgery, Division of Cardiothoracic Surgery,
University of Miami Miller School of Medicine, Jackson Memorial Hospital,
Miami, FL, United States
Publisher
Bentham Science Publishers
Abstract
Temporary mechanical circulatory support (MCS) encompasses a wide array of
invasive devices, which provide short-term hemodynamic support for
multiple clinical indications. Alt-hough initially developed for the
management of cardiogenic shock, indications for MCS have ex-panded to
include prophylactic insertion prior to high-risk percutaneous coronary
intervention, treatment of acute circulatory failure following cardiac
surgery, and bridging of end-stage heart failure patients to more
definitive therapies, such as left ventricular assist devices and cardiac
transplantation. A wide variety of devices are available to provide left
ventricular, right ventricular, or biventricular support. The choice of a
temporary MCS device requires consideration of the clinical scenario,
patient characteristics, institution protocols, and provider familiarity
and training. In this review, the most common forms of left, right, and
biventricular temporary MCS are discussed, along with their indications,
contraindications, complications, cannulations, hemodynamic effects, and
available clinical data. Copyright © 2023 The Author(s).

<85>
Accession Number
2025096385
Title
Comparison of fiberoptic bronchoscopic intubation using silicone and
polyvinyl chloride double-lumen tubes.
Source
Korean Journal of Anesthesiology. 76(4) (pp 300-306), 2023. Date of
Publication: Aug 2023.
Author
Kang S.; Chae Y.J.; Kim D.H.; Kim T.G.; Yoo J.Y.
Institution
(Kang, Chae, Kim, Yoo) Department of Anesthesiology and Pain Medicine,
Ajou University School of Medicine, Suwon, South Korea
(Kim) Department of Dermatology, Abijou Clinic, Incheon, South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Direct insertion of a double-lumen tube (DLT) using a flexible
fiberoptic bronchoscope (FOB) is an option for DLT intubation. The
difficult process of fiberoptic intubation is that the different
properties of polyvinyl chloride and silicone DLTs may affect railroading
differently. Therefore, we aimed to compare intubation using polyvinyl
chloride and silicone DLTs over an FOB. Method(s): Patients aged
19-75 years who required one-lung ventilation under general anesthesia
were enrolled in this study. After induction of anesthesia, the
anesthesiologist in-tubated the DLT using FOB. The primary outcome was the
difficulty of railroading over the flexible FOB scaled into five grades
(I, II-1, II-2, III, and IV). Additionally, the intubation time and
mucosal damage were recorded. Result(s): A total of 46 patients
participated in this study, 23 each in the silicone and polyvinyl groups.
The difficulty of railroading over the FOB was significantly different
between the two groups (P < 0.001). In the silicone group, the grades of
difficulty in railroading were limited to I and II-1; 20 patients (87%)
presented no difficulty in advancing the tube. In contrast, in the
polyvinyl group, 13 patients (57%) had scores of II-2 and III. Both the
intubation time and mucosal damage were significantly better in the
silicone group than in the polyvinyl group. Conclusion(s): Intubation
using a silicone DLT over an FOB was easier and faster than that with a
polyvinyl chloride DLT with lesser trauma around the
glottis. Copyright © The Korean Society of Anesthesiologists,
2023.

<86>
Accession Number
2025063948
Title
Deep Learning Model to Predict In-hospital Mortality of Newborns during
Congenital Heart Disease Surgery.
Source
Open Bioinformatics Journal. 16 (no pagination), 2023. Article Number:
e187503622306220. Date of Publication: 2023.
Author
Jiwani N.; Gupta K.; Sarveshwaran V.; Ravi V.
Institution
(Jiwani, Gupta) Department of Information Technology, University of The
Cumberlands, Williamsburg, KY, United States
(Sarveshwaran) Department of Computational Intelligence, SRM Institute of
Science and Technology, Kattankulathur Campus, India
(Ravi) Center for Artificial Intelligence, Prince Mohammad Bin Fahd
University, Khobar, Saudi Arabia
Publisher
Bentham Science Publishers
Abstract
Purpose: Many parents are concerned about the cost of saving their child's
life. The operation's cost depends on the pathology's nature and the
chosen clinic's class. The human body functions as a single system where
each organ performs its function. The heart is the main organ of the
circulatory system and is responsible for filling all the blood vessels in
the body. Surgery in 72% of diseases gives a chance for a complete
recovery of the child. Its success depends on timing. Method(s): In
this paper, an AI-induced deep learning model has been proposed to predict
in-hospital mortality of newborns in congenital heart disease surgery. If
the structure of the heart chambers or large vessels is different from
normal, this indicates a defect. Heart disease is a disease caused by
changes in the structure of valves, septa or blood vessels. These defects
can lead to poor blood circulation in the body and depending on the
affected area. Almost all heart defects are curable, often with surgery.
Modern medicine has many successful cases of surgical treatment of heart
defects in adults and children. Result(s): The proposed model reached
68.41% of training accuracy and 84.83% of testing accuracy, 83.44%
training false discovery rate and 85.18% testing false discovery rate,
78.48% training false omission rate and 84.72% testing false omission
rate, 70.26% training Positive likelihood ratio and 82.40% of testing
positive likelihood ratio and 80.15% of training negative likelihood ratio
and 82.97% of testing negative likelihood ratio. Conclusion(s): With
the development of modern surgery, early correction of CHD is possible
even in low birth weight and premature babies. During surgery, the heart
and lungs are cut off from the bloodstream, during which it is enriched
with oxygen, which is distributed throughout the body. If the case is
complicated, additional surgery may be required over a period of several
months to 1 year from the previous surgery. Copyright © 2023 The
Author(s). Published by Bentham Science Publisher.

<87>
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.

<88>
Accession Number
2023908064
Title
Evaluation of the effectiveness and safety of a multi-faceted computerized
antimicrobial stewardship intervention in surgical settings: A
single-centre cluster-randomized controlled trial.
Source
International Journal of Antimicrobial Agents. 61(5) (no pagination),
2023. Article Number: 106787. Date of Publication: May 2023.
Author
Yuan X.; Chen K.; Yuan J.; Chu Q.; Gao Y.; Yu F.; Diao X.; Chen X.; Li Y.;
Sun H.; Shu C.; Wang W.; Pan X.; Zhao W.; Hu S.
Institution
(Yuan, Chen, Chu, Li, Sun, Shu, Wang, Pan, Hu) State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Yuan, Chen, Chu, Li, Sun, Shu, Wang, Pan, Hu) Department of Cardiac
Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Yuan, Yu, Diao, Zhao) Information Centre, Fuwai Hospital, Chinese Academy
of Medical Sciences and Peking Union Medical College, Beijing, China
(Hu, Gao) National Clinical Research Centre of Cardiovascular Diseases,
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National
Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Chen) Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
Publisher
Elsevier B.V.
Abstract
Background: Inappropriate antimicrobial use is common among patients
undergoing surgery. It remains unclear whether a multi-faceted
computerized antimicrobial stewardship programme is effective and safe in
reducing inappropriate antimicrobial use in surgical settings.
 Method(s): A multi-faceted computerized antimicrobial stewardship
intervention system was developed, and an open-label, cluster-randomized,
controlled trial was conducted among 18 surgical teams that enrolled 2470
patients for open chest cardiovascular surgery. The surgical teams were
divided at random into intervention and control groups at a ratio of 1:1.
The primary endpoints were days of therapy (DOT)/1000 patient-days,
defined daily dose (DDD)/1000 patient-days and length of therapy
(LOT)/1000 patient-days. Result(s): Mean DOT, DDD and LOT per 1000
patient-days were significantly lower in the intervention group compared
with the control group (472.2 vs 539.8, 459.5 vs 553.8, and 438.4 vs
488.7; P<0.05), with reductions of 14.2% [95% confidence interval (CI)
11.8-16.7%], 18.7% (95% CI 15.9-21.4%) and 11.9% (95% CI 9.6-14.1%),
respectively. The daily risk of inappropriate antimicrobial use after
discharge from the intensive care unit decreased by 23.9% [95% CI
15.5-31.5% (incidence risk ratio 0.76, 95% CI 0.69-0.85)] in the
intervention group. There was no significant difference in rates of
infection or surgical-related complications between the groups. Median
antimicrobial costs were significantly lower in the intervention group
{873.4 [interquartile range (IQR) 684.5-1255.4] RMB vs 1178.7 (IQR
869.1-1814.5) RMB; P<0.001} (1 RMB approximately equivalent to 0.16 US$ in
2022). Conclusion(s): The multi-faceted computerized antimicrobial
stewardship interventions reduced inappropriate antimicrobial use safely.
Clinical trial registration: Clinicaltrials.gov:
NCT04328090. Copyright © 2023 The Authors

<89>
Accession Number
2021633429
Title
A Randomized Trial of Preoperative Planning of Left Atrial Appendage
Occlusion Using Cardiac Computed Tomography Angiography.
Source
Surgical Innovation. 30(3) (pp 303-313), 2023. Date of Publication: June
2023.
Author
Wang M.; Li W.; Ruan Z.; Zhu L.; Gao R.; Zhao J.
Institution
(Wang, Li, Ruan, Zhu) Department of Cardiology, Taizhou People's Hospital,
Jiangsu, Taizhou, China
(Wang, Li, Gao) Graduate School of Dalian Medical University, Liaoning,
Dalian, China
(Zhao) Medical College of Nantong University, Jiangsu, Nantong, China
Publisher
SAGE Publications Inc.
Abstract
Objective. To evaluate the value of individualized planning of left atrial
appendage occlusion (LAAO) using cardiac computed tomography angiography
(CCTA) reconstruction techniques. Methods. A total of 96 patients treated
for LAAO with the Watchman occluder were included in this study. All
patients were randomized by random number table in a 2:1 ratio into the
CCTA (+) and CCTA (-) groups according to whether CCTA was performed
preoperatively. 3D cardiac reconstruction was performed preoperatively in
the CCTA (+) group to plan the location of the atrial septal puncture
site, left atrial appendage(LAA) landing zone, predict the size of the
occluder and simulate occluder release. In the CCTA(-) group, only
transesophageal echocardiography (TEE) and fluoroscopy were used to guide
LAAO. Results. The number of occluders used in a single procedure (1.06
+/-.24 vs 1.22 +/-.42), the number of intraoperative angiography positions
(1.23 +/-.58 vs 2.28 +/-.85) and the procedure time (45.88 +/- 5.08 vs
62.44 +/- 5.60) in the CCTA(+) group were lower than in the CCTA(-) group
(P <.05), and the first-attempt blocking success rate was higher than that
of the CCTA(-) group (85.9% vs 65.6%, P =.021). Furthermore, the
Bland-Altman plots showed good agreement between the longest diameter of
the CCTA-predicted landing zone and the longest diameter of the actual
landing zone (95% LoA -7.49, 10.24). A strong positive correlation was
observed between the predicted compression ratio and the actual
compression ratio (r =.890, P <.001). In addition, a strong positive
correlation was found between the CCTA-predicted longest diameter of the
landing zone and the actual occluder size (r =.863, P <.001). Conclusion.
Accurate planning for LAAO using preoperative CCTA can reduce
intraoperative angiography positions and occluder changes, shorten the
procedure time, increase the success rate of first-attempt blocking and
reduce the difficulty of the procedure. Copyright © The Author(s)
2023.

<90>
Accession Number
2020196679
Title
The Predictive Value of Myocardial Native T1 Mapping Radiomics in Dilated
Cardiomyopathy: A Study in a Chinese Population.
Source
Journal of Magnetic Resonance Imaging. 58(3) (pp 772-779), 2023. Date of
Publication: September 2023.
Author
Zhang J.; Xu Y.; Li W.; Zhang C.; Liu W.; Li D.; Chen Y.
Institution
(Zhang, Zhang) West China Biomedical Big Data Center, West China Hospital,
Sichuan University, Chengdu, China
(Zhang, Zhang) Med-X Center for Informatics, Sichuan University, Chengdu,
China
(Xu, Li, Chen) Division of Cardiology, West China Hospital, Sichuan
University, Chengdu, China
(Liu) Fundamental Technology Center of CCB Financial Technology Co., Ltd,
Shanghai, China
(Li) Division of Hospital Medicine, Emory School of Medicine, Atlanta, GA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Investigation of the factors influencing dilated
cardiomyopathy (DCM) prognosis is important as it could facilitate risk
stratification and guide clinical decision-making. Purpose(s): To
assess the prognostic value of magnetic resonance imaging (MRI) radiomics
analysis of native T1 mapping in DCM. Study Type: Prospective. Subjects:
Three hundred and thirty consecutive patients with non-ischemic DCM (mean
age 48.42 +/- 14.20 years, 247 males). Field Strength/Sequence: Balanced
steady-state free precession and modified Look-Locker inversion recovery
T1 mapping sequences at 3 T. Assessment: Clinical characteristics,
conventional MRI parameters (ventricular volumes, function, and mass),
native myocardial T1, and radiomics features extracted from native T1
mapping were obtained. The study endpoint was defined as all-cause
mortality or heart transplantation. Models were developed based on 1)
clinical data; 2) radiomics data based on T1 mapping; 3) clinical and
conventional MRI data; 4) clinical, conventional MRI, and native T1 data;
and 5) clinical, conventional MRI, and radiomics T1 mapping data. Each
prediction model was trained according to follow-up results with AdaBoost,
random forest, and logistic regression classifiers. Statistical Tests: The
predictive performance was evaluated using the area under the receiver
operating characteristic curve (AUC) and F1 score by 5-fold
cross-validation. Result(s): During a median follow-up of 53.5 months
(interquartile range, 41.6-69.5 months), 77 patients with DCM experienced
all-cause mortality or heart transplantation. The random forest model
based on radiomics combined with clinical and conventional MRI parameters
achieved the best performance, with AUC and F1 score of 0.95 and 0.89,
respectively. Data Conclusion(s): A machine-learning framework based
on radiomics analysis of T1 mapping prognosis prediction in DCM.
 Level of Evidence: 1. Technical Efficacy: Stage 2. Copyright
© 2022 International Society for Magnetic Resonance in Medicine.

<91>
Accession Number
2025522471
Title
Use of a mixed reality system for navigational mapping during cardiac
electrophysiological testing does not prolong case duration: A subanalysis
from the Cardiac Augmented REality study.
Source
Cardiovascular Digital Health Journal. 4(4) (pp 111-117), 2023. Date of
Publication: August 2023.
Author
Bloom D.; Catherall D.; Miller N.; Southworth M.K.; Glatz A.C.; Silva
J.R.; Avari Silva J.N.
Institution
(Bloom, Glatz, Avari Silva) Department of Pediatrics, Division of
Cardiology, Washington University in St. Louis, School of Medicine, St.
Louis, Missouri, United States
(Catherall) School of Medicine, Washington University School of Medicine,
St. Louis, Missouri, United States
(Miller) Pediatric Cardiology/Electrophysiology, St. Louis Children's
Hospital, St. Louis, Missouri, United States
(Southworth, Silva, Avari Silva) SentiAR, Inc., St. Louis, Missouri,
United States
(Silva, Avari Silva) Department of Biomedical Engineering. Washington
University in St. Louis, McKelvey School of Engineering, St. Louis,
Missouri, United States
Publisher
Elsevier Inc.
Abstract
Background: CommandEPTM is a mixed reality (MXR) system for cardiac
electrophysiological (EP) procedures that provides a real-time
3-dimensional digital image of cardiac geometry and catheter locations. In
a previous study, physicians using the system demonstrated improved
navigational accuracy. This study investigated the impact of the CommandEP
system on EP procedural times compared to the standard-of-care
electroanatomic mapping system (EAMS) display. Objective(s): The
purpose of this retrospective case-controlled analysis was to evaluate the
impact of a novel MXR interface on EP procedural times compared to a
case-matched cohort. Method(s): Cases from the Cardiac Augmented
REality (CARE) study were matched for diagnosis and weight using a
contemporary cohort. Procedural time was compared from the roll-in and
full implementation cohort. During routine EP procedures, operators
performed tasks during the postablation waiting phase, including creation
of cardiac geometry and 5-point navigation under 2 conditions: (1) EAMS
first; and (2) CommandEP. Result(s): From a total of 16 CARE study
patients, the 10 full implementation patients were matched to a cohort of
20 control patients (2 controls:1 CARE, matched according to pathology and
age/weight). No statistical difference in total case times between CARE
study patients vs control group (118 +/- 29 minutes vs 97 +/- 20 minutes;
P = .07) or fluoroscopy times (6 +/- 4 minutes vs 7 +/- 6 minutes; P =
.9). No significant difference in case duration for CARE study patients
comparing roll-in vs full-implementation cohort (121 +/- 26 minutes vs 118
+/- 29 minutes; P = .96). CommandEP wear time during cases was
significantly longer in full implementation cases (53 +/- 24 minutes vs 24
+/- 5 minutes; P = .0009). During creation of a single cardiac geometry,
no significant time difference was noted between CommandEP vs EAMS (284
+/- 45 seconds vs 268 +/- 43 seconds; P = .1) or fluoroscopy use (9 +/- 19
seconds vs 6 +/- 18 seconds; P = .25). During point navigation tasks,
there was no difference in total time (CommandEP 31 +/- 14 seconds vs EAMS
28 +/- 15 seconds; P = .16) or fluoroscopy time (CommandEP 0 second vs
EAMS 0 second). Conclusion(s): MXR did not prolong overall procedural
time compared to a matched cohort. There was no prolongation in study task
completion time. Future studies with experienced CommandEP users directly
assessing procedural time and task completion time in a randomized study
population would be of interest. Copyright © 2023

<92>
Accession Number
2022062308
Title
A sealant with a hemostatic mechanism independent of the blood coagulation
function was effective in both elective and emergency surgery for thoracic
aorta.
Source
General Thoracic and Cardiovascular Surgery. 71(9) (pp 505-514), 2023.
Date of Publication: September 2023.
Author
Morita S.; Yaku H.
Institution
(Morita) Department of Cardiovascular Surgery, National Hospital
Organization Kyushu Medical Center, Fukuoka, Fukuoka 810-8563, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Kyoto, Japan
Publisher
Springer
Abstract
Objectives: Matsudaito is a unique surgical sealant with a powerful
hemostatic effect that works independent of a patient's blood coagulation
function. Because of its mechanism, this sealant is expected to be
particularly useful in patients with a poor blood coagulation function,
such as in cases of acute aortic syndrome requiring emergency surgery. We,
therefore, evaluated the hemostatic static effect of the sealant in both
emergency and elective surgery of the thoracic aorta. Method(s): We
used data obtained from post-marketing surveillance of the sealant.
Patients who underwent replacement of the thoracic aorta were enrolled.
The hemostatic effect was evaluated as effective if a further hemostatic
procedure was not performed after applying the sealant. Result(s):
From 46 hospitals in Japan, a total of 542 patients (327 elective and 215
emergency cases) were enrolled. Hospital mortality was 4.0% and 11.6% in
elective and emergency cases, respectively (p < 0.05). Among the 1039
anastomoses (609 elective and 430 emergency cases), effective hemostasis
was confirmed in 436 (71.6%) elective and 259 (60.2%) emergency cases. The
data from the clinical trial of the sealant showed a hemostatic rate of
44.4% in elective control cases without the sealant. Conclusion(s):
Given that the hemostatic rate in emergency surgery with the sealant
seemed to be better than that in elective surgery without the sealant
(determined from the clinical trial), we concluded that the sealant was
effective in both emergency and elective thoracic surgery of the
aorta. Copyright © 2023, The Author(s).

<93>
Accession Number
2026430475
Title
Percutaneous mitral annuloplasty with the Carillon device: Outcomes in
proportionate and disproportionate functional mitral regurgitation.
Source
American Heart Journal. 265 (pp 137-142), 2023. Date of Publication:
November 2023.
Author
Kalmucki P.; Lipiecki J.; Witte K.K.; Goldberg S.L.; Baszko A.; Siminiak
T.
Institution
(Kalmucki, Baszko, Siminiak) Poznan University of Medical Sciences, HCP
Medical Center, Poznan, Poland
(Lipiecki) Clinique Pole Sante Republique, Clermont Ferrand, France
(Witte) Universitatsklinikum, RWTH, Aachen, Germany
(Goldberg) Tyler Heart Institute at Community Hospital of the Monterey
Peninsula, Monterey, CA
(Goldberg) Cardiac Dimensions, Kirkland, WA
Publisher
Elsevier Inc.
Abstract
Background: It has been suggested that the disparity of outcomes between
the studies of transcutaneous edge-to-edge repair (TEER) for functional
mitral regurgitation (FMR) in heart failure with reduced ejection fraction
(HFrEF) could be due to systematic differences in the populations studied.
One proposal is that there are 2 broad groups: those with proportional FMR
who respond less favorably, and those in whom the FMR is greater than
expected (disproportionate) FMR where edge-to-edge TEER seems to be more
effective. Whether this grouping is relevant for other percutaneous
interventions for FMR is unknown. Objective(s): We sought to compare
clinical and echocardiographic outcomes of patients with HFrEF and
proportionate and disproportionate FMR treated with indirect annuloplasty
using the Carillon device. Method(s): This is a pooled analysis from
3 trials of patients with FMR. Key patient eligibility in these trials
specified persistent grade 2+ to 4+ FMR with >5.5 cm left ventricular (LV)
end-diastolic diameter (LVEDD) and reduced ejection fraction. Patients
with an effective regurgitant orifice area/LV end-diastolic volume
(EROA/LVEDV) ratio under 0.15 were assigned to the proportionate FMR group
(n = 74;65%) and those with a ratio above 0.15 were classed as having
disproportionate FMR (n = 39;35%). Result(s): At 12 months following
treatment, both groups showed improvements in all MR variables including
regurgitation volume, EROA and vena contracta. Moreover, in patients with
proportionate MR there were clinically relevant and statistically
significant improvements in LV volumes and diameters. There was no
independent relationship between the degree of proportionality as a
continuous variable and the remodeling response to Carillon therapy
(change in LVEDV r = 0.17; change in LVESV r = 0.14). Conclusion(s):
Percutaneous mitral annuloplasty with the Carillon device reduces MR in
patients with both proportionate and disproportionate FMR, and also
results in LV reverse remodeling in those with proportionate FMR. The
effect on remodeling remains to be verified in a large-scale
trial. Copyright © 2023

<94>
Accession Number
2026389008
Title
Effectiveness of Beta Blocker In Preventing Arrhythmia in Post Operative
[CABG] Patients.
Source
Journal of Cardiovascular Disease Research. 14(6) (pp 2395-2400), 2023.
Date of Publication: 2023.
Author
Tarlekar S.R.; Kane G.R.; Jadhav U.; Tarlekar A.S.
Institution
(Tarlekar) Dr. D.Y. Patil Medical College, Maharashtra, New Mumbai, India
(Kane) Department of Cardiology, D.Y. Patil Medical College, Hospital &
Research Centre, Maharashtra, New Mumbai, India
(Jadhav) Department of Cardio Vascular Thorasic Surgery, KEM Hospital,
Maharashtra, Mumbai, India
(Tarlekar) Sushrusha Heart Care Center, Speciality Hospital, Maharashtra,
New Mumbai, India
Publisher
EManuscript Technologies
Abstract
Introduction- Postoperative atrial fibrillation (POAF) is a potentially
lethal and morbid complication after heart surgery. The present study was
conducted to study the use of metoprolol in pre and post isolated CABG
cases to reduce the incidence of atrial fibrillation. Material and
methods- 50 cases and controls who had undergone isolated CABG surgery
with extracorporeal circulation participated in a randomised research. The
administration of metoprolol orally to the patients during the
postoperative phase was randomised. The results included the
identification of persistent arrhythmia that was symptomatic or needed
medical attention. Patients having baseline left ventricular ejection
fractions less than 35%, prior episodes of AF, a history of bronchospasm,
second- and third-degree atrioventricular blocks, inadequate cardiac
output, and heart failure were excluded from the trial. Results- In the
metoprolol group, 10% patients experienced arrhythmias, compared to 23% in
the control group (P=0.03). The arrhythmia that was seen the most commonly
(85%) was AF. Arrhythmias occurred in 52% metoprolol-treated patients and
56% control patients among patients aged 70 or older with the 95%
confidence interval for the risk was 0.10. Conclusion- In the
postoperative period following CABG surgery, metoprolol is useful in
reducing arrhythmia, and this effect was especially noticeable in the
group of senior patients. Copyright © 2023 EManuscript
Technologies. All rights reserved.

<95>
Accession Number
2026280452
Title
Effect of single dose intravenous Amiodarone on post bypass cardiac rhythm
in patients with preexisting atrial fibrillation undergoing mitral valve
replacement - A prospective, randomized, double blind con trolled study.
Source
Journal of Cardiovascular Disease Research. 14(3) (pp 559-569), 2023. Date
of Publication: 2023.
Author
Thomas N.S.; Fernandes S.; Tyagi S.
Institution
(Thomas) Department of Anesthesiology, Lokmanya Tilak Municipal Medical
College and General Hospital, India
(Fernandes, Tyagi) Department of Anesthesiology, Topiwala National Medical
College, BYL Nair Ch Hospital, India
Publisher
EManuscript Technologies
Abstract
Introduction: Atrial Fibrillation (AF) is the most common arrhythmia found
in patients scheduled to undergo mitral valve replacement surgery. Various
ablation therapies or pharmacological agents are used to prevent AF.
Although ablation therapies can be effective in some patients, these
therapies may not be appropriate for all patients, and pharmacological
treatments will continue to have an important place in the prevention of
AF and maintenance of normal sinus rhythm. Aim(s): The aim of our
study was to evaluate the effect of single dose intravenous amiodarone on
post bypass cardiac rhythm in patients with pre-existing atrial
fibrillation undergoing valvular surgery and study if Amiodarone (IV)
given prior to cross-clamp release is helpful in preventing the recurrence
of Atrial fibrillation. Material(s) and Method(s): In this
prospective randomized, double blind controlled study, patients with
pre-existing atrial fibrillation undergoing mitral valve replacement (MVR)
were divided into two groups, Group A receiving prophylactic intravenous
amiodarone 3mg/kg and their post bypass rhythms were compared with group B
(control group). If NSR was established, it's maintenance or recurrence of
AF was watched for. If NSR was not established, the need for
cardioversion, amount of energy needed for defibrillation and the response
to defibrillation was compared in both the groups. Result(s): There
was statistically significant difference in the number of patients who
reverted to normal sinus rhythm after aortic cross clamp removal when
given IV Amiodarone prophylactic ally as compared to the control group.
There was statistically significant difference in the number of patients
who needed cardioversion. In the control group, 39 patients (54.9%)
required cardioversion whereas only 21 patients (29.5%) who received IV
Amiodarone group required cardioversion. The duration of ICU stay and
duration of hospital stay was comparable between the groups. There was no
significant difference in the incidence of complications between Group A
and Group B. Conclusion(s): Amiodarone given as a single intravenous
dose in patients with pre-existing atrial fibrillation undergoing valvular
surgery, prior to cardiopulmonary bypass was found to be effective in
reducing the incidence of atrial fibrillation after aortic cross clamp
release. It decreased the requirement of cardioversion after the release
of aortic cross clamp. Copyright © 2023 EManuscript Technologies.
All rights reserved.

<96>
Accession Number
2026433177
Title
Appraisal of Postoperative Outcomes of Volatile and Intravenous
Anesthetics: A Network Meta-Analysis of Patients Undergoing Cardiac
Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Heybati K.; Zhou F.; Baltazar M.; Poudel K.; Ochal D.; Ellythy L.; Deng
J.; Chelf C.J.; Welker C.; Ramakrishna H.
Institution
(Heybati, Poudel, Ochal, Ellythy) Mayo Clinic Alix School of Medicine,
Mayo Clinic - Rochester, Rochester, MN, United States
(Zhou) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Baltazar) Philadelphia College of Osteopathic Medicine, Philadelphia, PA,
United States
(Deng) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Chelf) Mayo Clinic Libraries, Rochester, MN, United States
(Welker, Ramakrishna) Department of Anesthesiology and Perioperative
Medicine, Mayo Clinic - Rochester, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Objectives: To determine the relative efficacy of specific regimens used
as primary anesthetics, as well as the potential combination of volatile
and intravenous anesthetics among patients undergoing cardiac, thoracic,
and vascular surgery. Design(s): This frequentist, random-effects
network meta-analysis was registered prospectively (CRD42022316328) and
conducted according to the PRISMA-NMA framework. Literature searches were
conducted up to April 1, 2022 across relevant databases. Risk of bias
(RoB) and confidence of evidence were assessed by RoB-2 and CINeMA,
respectively. Pooled treatment effects were compared with propofol
monotherapy. Setting(s): Fifty-three randomized controlled trials (N
= 8,085) were included, of which 46 trials (N = 6,604) enrolled patients
undergoing cardiac surgery. Participant(s): Trials enrolling adults
(>=18) undergoing cardiac, thoracic, and vascular surgery, using the same
induction regimens, and comparing volatile and/or total intravenous
anesthesia for the maintenance of anesthesia. Given that the majority of
trials focused on those undergoing cardiac surgery and the heterogeneity,
analyses were restricted to this population. Measurement and Main Results:
Outcomes of interest included intensive care unit (ICU) length of stay
(LOS), myocardial infarction, in-hospital and 30-day mortality, stroke,
and delirium. Across 19 trials (N = 1,821; 9 arms; I2 = 64.5%),
sevoflurane combined with propofol decreased ICU LOS (mean difference [MD]
-18.26 hours; 95% CI -34.78 to -1.73 hours), whereas midazolam with
propofol (MD 17.51 hours; 95% CI 2.78-32.25 hours) was associated with a
significant increase in ICU LOS, when compared with propofol monotherapy.
Among 27 trials (N = 4,080; 10 arms; I2 = 0%), midazolam was
associated with significantly greater risk of myocardial infarction versus
propofol (risk ratio 1.94; 95% CI 1.01-3.71). There were no significant
differences across other outcomes. Conclusion(s): In patients
undergoing cardiac surgery, sevoflurane with propofol was associated with
decreased ICU LOS compared with propofol monotherapy. Midazolam with
propofol increased ICU LOS compared with propofol alone. The combined use
of intravenous and volatile anesthetics should be explored further. Future
trials in thoracic and vascular surgery are warranted. Copyright
© 2023 Elsevier Inc.

<97>
Accession Number
2026367244
Title
Rationale and Design of the Randomized Bayesian Multicenter COME-TAVI
Trial in Patients With a New Onset Left Bundle Branch Block.
Source
CJC Open. (no pagination), 2023. Date of Publication: 2023.
Author
Rivard L.; Nault I.; Krahn A.D.; Daneault B.; Roux J.-F.; Natarajan M.;
Healey J.S.; Quadros K.; Sandhu R.K.; Kouz R.; Greiss I.; Leong-Sit P.;
Gourraud J.B.; Ben Ali W.; Asgar A.; Aguilar M.; Bonan R.; Cadrin-Tourigny
J.; Cartier R.; Dorval J.-F.; Dubuc M.; Durrleman N.; Dyrda K.; Guerra P.;
Ibrahim M.; Ibrahim R.; Macle L.; Mondesert B.; Moss E.; Raymond-Paquin
A.; Roy D.; Tadros R.; Thibault B.; Talajic M.; Nozza A.; Guertin M.-C.;
Khairy P.
Institution
(Rivard, Asgar, Aguilar, Bonan, Cadrin-Tourigny, Dorval, Dubuc, Dyrda,
Guerra, Ibrahim, Macle, Mondesert, Raymond-Paquin, Roy, Tadros, Thibault,
Talajic, Khairy) Department of Cardiology, Montreal Heart Institute,
Universite de Montreal, Montreal, QC, Canada
(Nault) Department of Cardiology, Quebec Heart and Lung Institute, Quebec
City, QC, Canada
(Krahn) Centre for Cardiovascular Innovation, University of British
Columbia, Vancouver, BC, Canada
(Daneault, Roux) Department of Cardiology, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Natarajan, Healey) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
(Quadros, Sandhu) Division of Cardiology, Department of Medicine,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB,
Canada
(Kouz) Department of Cardiology, Hopital Sacre-Coeur de Montreal,
Montreal, QC, Canada
(Greiss) Department of Cardiology, Centre Hospitalier de Universite de
Montreal, Montreal, QC, Canada
(Leong-Sit) Department of Cardiology, Western University, London, ON,
Canada
(Gourraud) Department of Cardiology, Centre Hospitalier Nantes, Nantes,
France
(Ben Ali, Cartier, Durrleman, Ibrahim, Moss) Department of Cardiac
Surgery, Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Nozza, Guertin) Montreal Health Innovations Coordinating Center, Montreal
Heart Institute, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Patients with new-onset left bundle branch block (LBBB) after
transcatheter aortic valve implantation (TAVI) are at risk of developing
delayed high-degree atrioventricular block. Management of new-onset LBBB
post-TAVI remains controversial. In the Comparison of a Clinical
Monitoring Strategy Versus Electrophysiology-Guided Algorithmic Approach
in Patients With a New LBBB After TAVI (COME-TAVI) trial, consenting
patients with new-onset LBBB that persists on day 2 after TAVI, meeting
exclusion/inclusion criteria, are randomized to an electrophysiological
study (EPS)-guided approach or 30-day electrocardiographic monitoring. In
the EPS-guided approach, patients with a His to ventricle (HV) interval >=
65 ms undergo permanent pacemaker implantation. Patients randomized to
noninvasive monitoring receive a wearable continuous electrocardiographic
recording and transmitting device for 30 days. Follow-up will be performed
at 3, 6, and 12 months. The primary endpoint is a composite outcome
designed to capture net clinical benefit. The endpoint incorporates major
consequences of both strategies in patients with new-onset LBBB after
TAVI, as follows: (i) sudden cardiac death; (ii) syncope; (iii)
atrioventricular conduction disorder requiring a pacemaker (for a class I
or IIa indication); and (iv) complications related to the pacemaker or
EPS. The trial incorporates a Bayesian design with a noninformative prior,
outcome-adaptive randomization (initially 1:1), and 2 prespecified interim
analyses once 25% and 50% of the anticipated number of primary endpoints
are reached. The trial is event-driven, with an anticipated upper limit of
452 patients required to reach 77 primary outcome events over 12 months of
follow-up. In summary, the aim of this Bayesian multicentre randomized
trial is to compare 2 management strategies in patients with new-onset
LBBB post-TAVI-an EPS-guided approach vs noninvasive 30-day
monitoring. Copyright © 2023 The Authors

<98>
Accession Number
2025684205
Title
Culprit vessel only versus complete revascularization following
thrombolysis in patients with ST elevation myocardial infraction and
multivessel coronary artery disease - A prospective study.
Source
Indian Heart Journal. 75(4) (pp 274-278), 2023. Date of Publication: 01
Jul 2023.
Author
Jain C.; Dash P.K.; Iyer V.R.; Deshmukh R.
Institution
(Jain, Dash, Iyer, Deshmukh) Department of Cardiology, Sri Satya Sai
General Hospital, Andhra Pradesh, Puttaparthi 515134, India
Publisher
Elsevier B.V.
Abstract
Objective: The present study compares the treatment outcomes of only
culprit vessel PCI and complete revascularization in patients with STEMI
and multivessel disease (MVD) following thrombolysis. Method(s): This
was a single-center, prospective randomized study including a total of 108
patients presenting at a tertiary care center within 3-24 h
post-thrombolysis and undergoing pharmacoinvasive PCI, and randomized into
two groups: complete revascularization PCI group and culprit only PCI
group. The primary outcomes were evaluated by cardiac mortality, repeat
myocardial infarction (MI)/acute coronary syndrome (ACS) and refractory
angina. The secondary outcomes include repeat revascularization and safety
outcomes namely contrast induced nephropathy (CIN), cerebrovascular
accident (CVA) and major bleeding were compared among both the groups at
one year follow-up. Result(s): Complete revascularization PCI group
and culprit only PCI group had 54 patients in each group. Left ventricular
ejection fraction did not show significant difference at discharge (p = 1)
but was significantly improved in complete revascularization PCI group (p
= 0.001) at one year follow-up. Reduced number of outcomes with a
significant difference in both the groups were seen for primary outcomes
such as cardiac mortality (p = 0.01), repeat MI/ACS (p = 0.01) and
refractory angina (p = 0.038) along with repeat revascularization (p =
0.001) at one year follow-up. Complete revascularization did not show any
statistically significant difference for CIN (p = 0.567), CVA (p = 0.153)
and major bleeding (p = 0.322) then culprit only revascularization group.
 Conclusion(s): In patients with STEMI and MVD, complete
revascularization was found more favourable in terms of primary and
secondary outcomes compared to culprit only
revascularization. Copyright © 2023

<99>
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.

<100>
Accession Number
2023816336
Title
Prophylactic intravenous tranexamic acid and thromboembolism in
non-cardiac surgery: a systematic review, meta-analysis and trial
sequential analysis.
Source
Anaesthesia. 78(9) (pp 1153-1161), 2023. Date of Publication: September
2023.
Author
Tsan S.E.H.; Viknaswaran N.L.; Cheong C.C.; Cheah S.; Ng K.T.; Mong
S.X.Y.; Wang C.Y.
Institution
(Tsan) Department of Anaesthesiology and Intensive Care, Faculty of
Medicine and Health Sciences, University of Malaysia Sarawak, Malaysia
(Viknaswaran) Department of Medicine, Victoria Hospital, Kirkcaldy, United
Kingdom
(Cheong, Ng, Wang) Department of Anaesthesia, Faculty of Medicine,
University of Malaya, Malaysia
(Cheah) Department of Anaesthesiology and Intensive Care, Hospital
Sultanah Nora Ismail, Batu Pahat, Malaysia
(Mong) Department of Anaesthesiology and Intensive Care, Hospital Raja
Permaisuri Bainun, Ipoh, Malaysia
Publisher
John Wiley and Sons Inc
Abstract
Tranexamic acid is an antifibrinolytic drug that is widely used during
surgery, but there are concerns about its thromboembolic effects. We aimed
to investigate the effect of prophylactic intravenous tranexamic acid on
thromboembolic outcomes in patients undergoing non-cardiac surgery. The
MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were
searched. Randomised controlled trials comparing intravenous tranexamic
acid with placebo or no treatment in patients undergoing non-cardiac
surgery were included. The primary outcome was a composite of
peri-operative cardiovascular thromboembolic events, defined as any deep
vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or
cerebral ischaemia/infarction. A total of 191 randomised controlled trials
(40,621 patients) were included in the review. The primary outcome
occurred in 4.5% of patients receiving intravenous tranexamic acid
compared with 4.9% of patients in the control group. Our analysis showed
that there was no difference between groups for composite cardiovascular
thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65,
I2 0%, n = 37,512). This finding remained robust when
sensitivity analysis was performed with continuity correction and in
studies with a low risk of bias. However, in trial sequential analysis,
our meta-analysis only achieved 64.6% of the required information size.
There was no association between intravenous tranexamic acid and seizure
rate or mortality rate within 30 days. Intravenous tranexamic acid was
associated with a reduced blood transfusion rate compared with control
(9.9% vs. 19.4%, risk ratio 0.46, 95%CI 0.41-0.51, p < 0.0001). It was
encouraging to see the evidence that the administration of intravenous
tranexamic in patients undergoing non-cardiac surgery was not associated
with an increased risk of thromboembolic outcomes. However, our trial
sequential analysis demonstrated that currently available evidence is not
yet sufficient to reach a firm conclusion. Copyright © 2023 The
Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists.

<101>
Accession Number
2024862699
Title
A Systematic Review of Short-Term Outcomes of Minimally Invasive
Thoracoscopic Surgery for Lung Cancer after Neoadjuvant Systemic Therapy.
Source
Cancers. 15(15) (no pagination), 2023. Article Number: 3908. Date of
Publication: August 2023.
Author
Sedighim S.; Frank M.I.; Heutlinger O.; Lee C.; Hachey S.J.; Keshava H.B.
Institution
(Sedighim, Lee, Keshava) Department of General Surgery, Irvine School of
Medicine, University of California, 3800 Chapman Ave, Suite, 6200, Orange,
CA 92868, United States
(Frank, Heutlinger) Irvine School of Medicine, University of California,
Orange, CA 92868, United States
(Hachey) Department of Molecular and Cell Biology, Irvine School of
Biological Sciences, University of California, Orange, CA 92868, United
States
(Keshava) Division of Thoracic Surgery, Irvine School of Medicine,
University of California, Orange, CA 92868, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Minimally invasive surgeries for non-small cell lung cancers
(NSCLCs) such as video-assisted thoracoscopic surgeries (VATSs) and
robotic-assisted thoracoscopic surgeries (RATSs) have become standard of
care for patients needing surgical resection in early stages. The role for
neoadjuvant systemic therapy has increased with patients receiving
neoadjuvant systemic chemotherapy and immunotherapy. However, there has
been some equipoise over the intraoperative and overall outcomes for these
patients. Here, we review the current data regarding outcomes of patients
undergoing minimally invasive thoracic surgical resection after systemic
chemotherapy, immunotherapy, or both. Method(s): A systematic
literature review of randomized controlled trials and observational
studies presenting data on patients with NSCLC that underwent neoadjuvant
systemic therapy followed by minimally invasive surgery was performed
assessing complications, conversion rates, and lymph node yield.
 Result(s): Our search strategy and review of references resulted in
239 publications to screen with 88 full texts assessed and 21 studies
included in our final review. VATS had a statistically significant higher
lymph node yield in five studies. The reported conversion rates ranged
from 0 to 54%. Dense adhesions, bleeding, and difficult anatomy were the
most common reported reasons for conversion to open surgeries. The most
common complications between both groups were prolonged air leak,
arrythmia, and pneumonia. VATS was found to have significantly fewer
complications in three papers. Conclusion(s): The current literature
supports VATS as safe and feasible for patients with NSCLC after
neoadjuvant systemic treatment. Surgeons should remain prepared to convert
to open surgeries in those patients with dense adhesions and bleeding
risk. Copyright © 2023 by the authors.

<102>
Accession Number
2024862259
Title
Infective Endocarditis Risk with Melody versus Sapien Valves Following
Transcatheter Pulmonary Valve Implantation: A Systematic Review and
Meta-Analysis of Prospective Cohort Studies.
Source
Journal of Clinical Medicine. 12(15) (no pagination), 2023. Article
Number: 4886. Date of Publication: August 2023.
Author
Machanahalli Balakrishna A.; Dilsaver D.B.; Aboeata A.; Gowda R.M.;
Goldsweig A.M.; Vallabhajosyula S.; Anderson J.H.; Simard T.; Jhand A.
Institution
(Machanahalli Balakrishna) Department of Internal Medicine, Creighton
University School of Medicine, Omaha, NE 68124, United States
(Dilsaver) Department of Medicine, Division of Clinical Research and
Public Health, Creighton University School of Medicine, Omaha, NE 68124,
United States
(Aboeata) Division of Cardiovascular Medicine, Department of Medicine,
Creighton University School of Medicine, Omaha, NE 68124, United States
(Gowda) Department of Interventional Cardiology, Icahn School of Medicine
at Mount Sinai Morningside and Beth Israel, New York, NY 10029, United
States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical
Center, Springfield, MA 01199, United States
(Goldsweig) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE 68105, United States
(Vallabhajosyula) Section of Cardiovascular Medicine, Department of
Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
27101, United States
(Anderson, Simard, Jhand) Department of Cardiovascular Medicine, Mayo
Clinic, Rochester, MN 55905, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Transcatheter pulmonary valve implantation (TPVI) is an
effective non-surgical treatment method for patients with right ventricle
outflow tract dysfunction. The Medtronic Melody and the Edwards Sapien are
the two valves approved for use in TPVI. Since TPVI patients are typically
younger, even a modest annual incidence of infective endocarditis (IE) is
significant. Several previous studies have shown a growing risk of IE
after TPVI. There is uncertainty regarding the overall incidence of IE and
differences in the risk of IE between the valves. Method(s): A
systematic search was conducted in the MEDLINE, EMBASE, PubMed, and
Cochrane databases from inception to 1 January 2023 using the search terms
'pulmonary valve implantation', 'TPVI', or 'PPVI'. The primary outcome was
the pooled incidence of IE following TPVI in Melody and Sapien valves and
the difference in incidence between Sapien and Melody valves. Fixed effect
and random effect models were used depending on the valve. Meta-regression
with random effects was conducted to test the difference in the incidence
of IE between the two valves. Result(s): A total of 22 studies
(including 10 Melody valve studies, 8 Sapien valve studies, and 4 studies
that included both valves (572 patients that used the Sapien valve and
1395 patients that used the Melody valve)) were used for the final
analysis. Zero IE incidence following TPVI was reported by eight studies
(66.7%) that utilized Sapien valves compared to two studies (14.3%) that
utilized Melody valves. The pooled incidence of IE following TPVI with
Sapien valves was 2.1% (95% CI: 0.9% to 5.13%) compared to 8.5% (95% CI:
4.8% to 15.2%) following TPVI with Melody valves. Results of
meta-regression indicated that the Sapien valve had a 79.6% (95% CI: 24.2%
to 94.4%, p = 0.019; R2 = 34.4) lower risk of IE incidence
compared to the Melody valve. Conclusion(s): The risk of IE following
TPVI differs significantly. A prudent valve choice in favor of Sapien
valves to lower the risk of post-TPVI endocarditis may be
beneficial. Copyright © 2023 by the authors.

<103>
Accession Number
2026366812
Title
Clinical Practice Guideline of Spanish Society of Pneumology and Thoracic
Surgery (SEPAR) on Pharmacological Treatment of Tobacco Dependence 2023.
Source
Archivos de Bronconeumologia. (no pagination), 2023. Date of Publication:
2023.
Author
Rabade-Castedo C.; de Granda-Orive J.I.; Riesco-Miranda J.A.; De
Higes-Martinez E.; Ramos-Pinedo A.; Cabrera-Cesar E.; Signes-Costa Minana
J.; Garcia Rueda M.; Pastor-Espla E.; Jimenez-Ruiz C.A.
Institution
(Rabade-Castedo) Servicio de Neumologia, Complejo Hospitalario
Universitario de Santiago de Compostela, Santiago de Compostela, La
Coruna, Spain
(de Granda-Orive) Servicio de Neumologia, Hospital Universitario 12 de
octubre Madrid, Spain
(de Granda-Orive) Universidad Complutense, Madrid, Spain
(Riesco-Miranda) Servicio de Neumologia, Hospital Universitario de
Caceres, Caceres, Spain
(Riesco-Miranda) Centro de Investigacion en Red de enfermedades
respiratorias (CIBERES), Madrid, Spain
(Riesco-Miranda) Instituto Universitario de Investigacion Biosanitaria de
Extremadura (INUBE), Spain
(De Higes-Martinez, Ramos-Pinedo) Unidad de Neumologia, Hospital
Universitario Fundacion Alcorcon, Spain
(De Higes-Martinez, Ramos-Pinedo) Universidad Rey Juan Carlos, Madrid,
Spain
(Cabrera-Cesar) Servicio de Neumologia, Hospital Universitario Virgen de
la Victoria, Malaga, Spain
(Signes-Costa Minana) Servicio de Neumologia, Hospital Clinico
Universitario de Valencia, Spain
(Signes-Costa Minana) Instituto de Investigacion Sanitaria de Valencia
(INCLIVA), Valencia, Spain
(Garcia Rueda) Servicio de Neumologia, Hospital Carlos Haya de Malaga,
Malaga, Spain
(Pastor-Espla) Servicio de Neumologia, Hospital Universitario San Juan de
Alicante, Alicante, Spain
(Jimenez-Ruiz) Unidad Especializada en Tabaquismo de la Comunidad de
Madrid, Hospital Clinico San Carlos, Madrid, Spain
Publisher
Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
Abstract
Introduction: There are multiple systematic reviews and meta-analyses on
the efficacy and safety of pharmacological treatments against nicotine
dependence. However, there are few guidelines to answer frequent questions
asked by a clinician treating a smoker. Therefore, the aim of this paper
is to facilitate the treatment of tobacco addiction. Material(s) and
Method(s): 12 PICO questions are formulated from a GLOBAL PICO question:
"Efficacy and safety of pharmacological treatment of tobacco dependence".
A systematic review was carried out to answer each of the questions and
recommendations were made. The GRADE (Grading of Recommendations,
Assessment, Development and Evaluation) system was used to grade the
certainty of the estimated effects and the strength of the
recommendations. Result(s): Varenicline, nicotine replacement therapy
(NRT), bupropion and cytisine are more effective than placebo. Varenicline
and combined nicotine therapy are superior to the other therapies. In
smokers with high dependence, a combination of drugs is recommended, being
more effective those associations containing varenicline. Other
optimization strategies with lower efficacy consist of increasing the
doses, the duration, or retreat with varenicline. In specific populations
varenicline or NRT is recommended. In hospitalized, the treatment of
choice is NRT. In pregnancy it is indicated to prioritize behavioral
treatment. The financing of smoking cessation treatments increases the
number of smokers who quit smoking. There is no scientific evidence of the
efficacy of pharmacological treatment of smoking cessation in adolescents.
 Conclusion(s): The answers to the 12 questions allow us to extract
recommendations and algorithms for the pharmacological treatment of
tobacco dependence. Copyright © 2023 The Author(s)

<104>
Accession Number
642017463
Title
Physicians' Perspectives on Percutaneous Left Atrial Appendage Occlusion
for Patients with Atrial Fibrillation.
Source
American heart journal. (no pagination), 2023. Date of Publication: 09
Aug 2023.
Author
Kir D.; Van Houten H.K.; Walvatne K.N.; Behnken E.M.; Alkhouli M.A.;
Graff-Radford J.; Melduni R.M.; Gersh B.J.; Friedman P.A.; Shah N.D.;
Noseworthy P.A.; Yao X.
Institution
(Kir, Alkhouli, Melduni, Gersh, Friedman) Department of Cardiovascular
Diseases, Mayo Clinic
(Van Houten, Walvatne) Robert D. and Patricia E. Kern Center for the
Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
(Behnken) Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester,
MN, United States
(Graff-Radford) Department of Neurology, Mayo Clinic, Rochester, MN,
United States
(Shah) Delta Airlines, Atlanta, GA, United States
(Noseworthy, Yao) Department of Cardiovascular Diseases, Mayo Clinic,
Rochester MN; Robert D. and Patricia E. Kern Center for the Science of
Health Care Delivery, Mayo Clinic, Rochester, Minnesota
Publisher
NLM (Medline)
Abstract
BACKGROUND: There has been an increasing uptake of transcatheter left
atrial appendage occlusion (LAAO) for stroke reduction in atrial
fibrillation. OBJECTIVE(S): To investigate the perceptions and
approaches among a nationally representative sample of physicians METHODS:
Using the American Medical Association Physician Masterfile, we selected a
random sample of 500 physicians from each of the specialties: general
cardiologists, interventional cardiologists, electrophysiologists, and
vascular neurologists. The participants received the survey by mail up to
three times from 11/9/2021-1/14/2022. In addition to the questions about
experiences, perceptions, and approaches, physicians were randomly
assigned to one of the four versions of a patient vignette: white man,
white woman, black man, and black woman, to investigate potential bias in
decision-making. RESULT(S): The top three reasons for considering
LAAO were a history of intracranial bleeding (94.3%), a history of major
extracranial bleeding (91.8%), and gastrointestinal lesions (59.0%),
whereas the top three reasons for withholding LAAO were: other indications
for long-term oral anticoagulation (87.7%), a low bleeding risk (77.0%),
and a low stroke risk (65.6%). For the reasons limiting recommendations
for LAAO, 59.8% mentioned procedural risks, 42.6% mentioned "limiting
efficacy data comparing LAAO to NOAC" and 32.8% mentioned "limited safety
data comparing LAAO to NOAC." There was no difference in physicians'
decision-making by patients' race, gender, or the concordance between
patients' and physicians' race or gender. CONCLUSION(S): In the first
U.S. national physician survey of LAAO, individual physicians'
perspectives varied greatly, which provided information that will help
customize future educational activities for different audiences. CONDENSED
ABSTRACT: Although diverse practice patterns of LAAO have been documented,
little is known about the reasoning or perceptions that drive these
variations. Unlike prior surveys that were directed to Centers that
performed LAAO, the current survey obtained insights from individual
physicians, not only those who perform the procedures (interventional
cardiologists and electrophysiologists) but also those who are closely
involved in the decision-making and referral process (general
cardiologists and vascular neurologists). The findings identify key
evidence gaps and help prioritize future studies to establish a consistent
and evidence-based best practice for AF stroke prevention. Copyright
© 2023 Elsevier Ltd. All rights reserved.

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