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<1>
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

<2>
Accession Number
2025858889
Title
Bempedoic Acid for Primary Prevention of Cardiovascular Events in
Statin-Intolerant Patients.
Source
JAMA. 330(2) (pp 131-140), 2023. Date of Publication: 11 Jul 2023.
Author
Nissen S.E.; Menon V.; Nicholls S.J.; Brennan D.; Laffin L.; Ridker P.;
Ray K.K.; Mason D.; Kastelein J.J.P.; Cho L.; Libby P.; Li N.; Foody J.;
Louie M.J.; Lincoff A.M.
Institution
(Nissen, Menon, Brennan, Laffin, Mason, Cho, Lincoff) Cleveland Clinic,
Cleveland, OH, United States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Ridker, Libby) Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Ray) Imperial College London, London, United Kingdom
(Kastelein) University of Amsterdam, Academic Medical Center, Amsterdam,
Netherlands
(Li, Foody, Louie) Esperion Therapeutics Inc, Ann Arbor, MI, United States
Publisher
American Medical Association
Abstract
Importance: The effects of bempedoic acid on cardiovascular outcomes in
statin-intolerant patients without a prior cardiovascular event (primary
prevention) have not been fully described. Objective(s): To determine
the effects of bempedoic acid on cardiovascular outcomes in primary
prevention patients. Design, Setting, and Participant(s): This
masked, randomized clinical trial enrolled 13970 statin-intolerant
patients (enrollment December 2016 to August 2019 at 1250 centers in 32
countries), including 4206 primary prevention patients.
 Intervention(s): Participants were randomized to oral bempedoic acid,
180 mg daily (n = 2100), or matching placebo (n = 2106). Main Outcome
Measure(s): The primary efficacy measure was the time from randomization
to the first occurrence of any component of a composite of cardiovascular
death, nonfatal myocardial infarction (MI), nonfatal stroke, or coronary
revascularization. Result(s): Mean participant age was 68 years, 59%
were female, and 66% had diabetes. From a mean baseline of 142.2 mg/dL,
compared with placebo, bempedoic acid reduced low-density lipoprotein
cholesterol levels by 30.2 mg/dL (21.3%) and high-sensitivity C-reactive
protein levels by 0.56 mg/L (21.5%), from a median baseline of 2.4 mg/L.
Follow-up for a median of 39.9 months was associated with a significant
risk reduction for the primary end point (111 events [5.3%] vs 161 events
[7.6%]; adjusted hazard ratio [HR], 0.70 [95% CI, 0.55-0.89]; P =.002) and
key secondary end points, including the composite of cardiovascular death,
MI, or stroke (83 events [4.0%] vs 134 events [6.4%]; HR, 0.64 [95% CI,
0.48-0.84]; P <.001); MI (29 events [1.4%] vs 47 events [2.2%]; HR, 0.61
[95% CI, 0.39-0.98]); cardiovascular death (37 events [1.8%] vs 65 events
[3.1%]; HR, 0.61 [95% CI, 0.41-0.92]); and all-cause mortality (75 events
[3.6%] vs 109 events [5.2%]; HR, 0.73 [95% CI, 0.54-0.98]). There was no
significant effect on stroke or coronary revascularization. Adverse
effects with bempedoic acid included a higher incidence of gout (2.6% vs
2.0%), cholelithiasis (2.5% vs 1.1%), and increases in serum creatinine,
uric acid, and hepatic enzyme levels. Conclusion(s): In a subgroup of
high-risk primary prevention patients, bempedoic acid treatment was
associated with reduced major cardiovascular events. Trial Registration:
ClinicalTrials.gov Identifier: NCT02993406. Copyright © 2023
American Medical Association. All rights reserved.

<3>
Accession Number
2025445325
Title
The Efficacy of Dexmedetomidine alone or with Melatonin on Delirium after
Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial.
Source
Anesthesiology and Pain Medicine. 13(4) (no pagination), 2023. Article
Number: e138317. Date of Publication: Aug 2023.
Author
Javaherforooshzadeh F.; Dezfoli A.B.; Malehi A.S.; Gholizadeh B.
Institution
(Javaherforooshzadeh) Department of Anesthesia, Pain Research Centre,
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic
Republic of
(Dezfoli) Pain Research Centre, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
(Malehi) Department of Biostatistics and Epidemiology, Pain Research
Centre, School of Health, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
(Gholizadeh) Department of Cardiac Surgery, Pain Research Centre, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic
of
Publisher
Brieflands
Abstract
Background: One of the most common cognitive disorders after major surgery
is delirium which can increase morbidity and mortality. This study
compared the effect of dexmedetomidine with or without melatonin to reduce
delirium following coronary artery bypass graft (CABG) surgery.
 Method(s): This trial was a double-blind, randomized, controlled
clinical trial. Eighty patients in two different groups with the
administration of dexmedetomidine alone or with melatonin undergoing CABG
surgery in Golestan Hospital, Ahvaz, 2022-2023, were randomly allocated.
This study evaluated the occurrence, onset, and length of delirium,
haloperidol, the time required for weaning, and the duration of stays in
the intensive care unit (ICU) and hospital. Result(s): The occurrence
of delirium was lower in the melatonin/dexmedetomidine group (15%) than in
the dexmedetomidine group (30 %) (P = 0.09). Additionally, the
melatonin/dexmedetomidine group had a significantly lower duration of
delirium than the dexmedetomidine group (1.95 (0, 20) and 8.46 (0, 40) P =
0.04). However, no significant difference was observed in the onset of
delirium between the two groups (P = 0.25). The length of hospital stays
in the melatonin/dexmedetomidine group was significantly shorter than in
the dexmedetomidine group (7.53 (7, 10) and 8.60 (7, 15), P = 0.03).
However, the two groups demonstrated no significant difference between
extubation (P = 0.38) and length of ICU stay (P = 0.19).
 Conclusion(s): The administration of melatonin and dexmedetomidine
reduced the incidence of post-cardiac surgery delirium, shortened its
duration, and decreased the impact of many risk factors observed in those
not receiving the added melatonin. Copyright © 2023, Author(s).

<4>
Accession Number
2025084982
Title
A systematic review of early motor interventions for infants with
congenital heart disease and open-heart surgery.
Source
Systematic Reviews. 12(1) (no pagination), 2023. Article Number: 149. Date
of Publication: December 2023.
Author
Kaeslin R.; Latal B.; Mitteregger E.
Institution
(Kaeslin, Latal, Mitteregger) Child Development Center, University
Children's Hospital Zurich, Zurich 8032, Switzerland
(Kaeslin, Latal, Mitteregger) University of Zurich, Zurich, Switzerland
(Latal, Mitteregger) Children's Research Center, University Children's
Hospital Zurich, Zurich, Switzerland
Publisher
BioMed Central Ltd
Abstract
Background: Motor development delay is the first neurodevelopmental
impairment that becomes apparent in infants with congenital heart disease
(CHD). Early interventions have addressed high-risk groups like infants
born preterm, but little is known about interventions to improve motor
outcome in CHD infants at risk of motor delay. The purpose of this review
was to systematically review the literature on type and effect of motor
intervention applied during the first year of life in infants with CHD
following open-heart surgery. Method(s): Scoping searches were
performed in May 2020 and April 2023 via MEDLINE, Embase, CINAHL,
Cochrane, PsycINFO, PEDro, and Scopus. The review included studies
published in English from 2015 to 2022. Primary outcome was infants' motor
development measured by standardized and non-standardized motor
assessments, and if available, infants' language and cognitive
development, and any parental quality-of-life assessments as secondary
outcomes. The studies' quality was evaluated with a modified
Newcastle-Ottawa scale. Result(s): Four papers with low to high
methodological quality met inclusion criteria. All studies investigated
the influence of early physiotherapy. Four studies involved parents, and
three studies used standardized tools to assess motor outcomes. No
conclusion can be drawn about any positive effect of early motor
interventions. Conclusion(s): Early motor intervention in CHD infants
may improve motor development; however, the few existing studies do not
provide clear evidence. Thus, more prospective early intervention studies
are needed. Trial registration: PROSPERO CRD42020200981. Copyright
© 2023, BioMed Central Ltd., part of Springer Nature.

<5>
Accession Number
2024913611
Title
Comparison between the Impact of Traditional Cold Crystalloid Cardioplegia
and Histidine-Tryptophan-Ketoglutarate Solution Cardioplegia on Myocardial
Protection during on Pump Coronary Artery Bypass Surgery Assessed by
Transesophageal Echocardiography.
Source
NeuroQuantology. 21(6) (pp 1305-1314), 2023. Date of Publication: 2023.
Author
Ibrahim F.I.A.; El-Taher E.M.; Abdel-Ghaffar M.E.E.-D.; Nasr N.A.; Hassan
H.S.
Institution
(Ibrahim) Department of Anesthesia and Intensive Care, Faculty of
Medicine, Suez Canal University, Egypt
(El-Taher, Abdel-Ghaffar) Professor of Anesthesiology and Intensive Care,
Faculty of Medicine, Suez Canal University, Egypt
(Nasr) Lecturer of Anesthesiology and Intensive Care, Faculty of Medicine,
Suez Canal University, Egypt
(Hassan) Lecturer of Cardiothoracic Surgery, Faculty of Medicine, Suez
Canal University, Egypt
Publisher
Anka Publishers
Abstract
Introduction: Cardioplegia is responsible for myocardial protection during
open heart operation and provides static and bloodless field to facilitate
surgical procedures. The perfect cardioplegic solution for myocardial
protection during cardiac operation is still controversial. Aim(s):
To compare the ejection fraction using trans-esophageal echocardiography,
need for cardiac support, and postoperative complications of custodiol
cardioplegic solution versus traditional crystalloid solution in cases
having a coronary artery bypass graft (CABG) operation while on the pump
using aid of trans-esophageal echocardiography. Method(s): This
prospective randomized clinical trial study involved 48 cases who
underwent on-pump coronary artery bypass graft operation, they were
randomly selected for one of the two groups, group (A) who received
intermittent ante grade traditional cold crystalloid cardioplegia (ICCC),
and Group (B) who received ante grade histidine-tryptophan-ketoglutarate
(HTK). It was conducted in the routine cardiothoracic surgeries, Suez
Canal University Hospital from 2020 to 2023. Result(s): Regarding the
intraoperative SWMA assessment, 5, 30 minutes after CC release, at sternal
closure, and skin closure were shown to be substantially greater in ICCC
group than in HTK group. The intraoperative mean ejection fraction,
fractional shortening, and fractional area change were shown to be
substantially higher in ICCC group than in HTK group 30, 60 min after
weaning, at sternal closure, and skin closure. No substantial variance was
shown among both groups regarding any of the relevant postoperative
complications, mortality, MI, CHF, LOS, stroke, or AF. Conclusion(s):
A single dose of custodiol HTK is superior to intermittent ante grade cold
crystalloid cardioplegia in protecting the myocardium in coronary artery
bypass operation as exhibited by the biomarkers of myocardial damage.
There were no substantial variances in after surgery mortality and
morbidity using custodiol cardioplegia when compared with intermittent
ante grade cold crystalloid cardioplegia for CABG. Copyright ©
2023, Anka Publishers. All rights reserved.

<6>
Accession Number
2024817312
Title
Outcomes in organ transplants from donors with melanoma: a systematic
review.
Source
International Journal of Dermatology. 62(9) (pp 1121-1130), 2023. Date of
Publication: September 2023.
Author
Ng W.H.S.; Curchin D.J.; McGinn S.; Smith S.D.
Institution
(Ng) Faculty of Medicine, University of Newcastle, Newcastle, NSW,
Australia
(Curchin) The Westmead Clinical School, Sydney Medical School, The
University of Sydney, Westmead, NSW, Australia
(McGinn) Department of Renal Medicine, Royal North Shore Hospital, Sydney,
NSW, Australia
(Smith) ANU Medical School, ANU College of Health and Medicine, Australian
National University, Canberra, ACT, Australia
Publisher
John Wiley and Sons Inc
Abstract
Melanoma transmitted through organ transplantation is an increasingly
reported event. Immunosuppression increases the risk of melanoma; however,
transmission of malignancy from transplanted organs is a distinct etiology
of melanoma occurrence. The risk of transmission of melanoma from an organ
donor with melanoma has yet to be determined. The authors aimed to
investigate this phenomenon by reviewing the outcomes of patients that
received organs from donors with melanoma. A systematic literature review
was conducted with emphasis on identifying organ donors with known
histories of melanoma and reported information regarding recipients of
their organs. The databases PubMed, MEDLINE, Embase, and JBI EBP were
searched in January 2023. Search terms included "melanoma," terms for
solid organs, "donor," "transplant," "transmission," and their variations
as well as terms related to temporal relations. Inclusion criteria were
articles that stated outcomes in organ recipients from donors that had a
diagnosis of melanoma either pretransplant or postmortem. Reference lists
of selected articles were hand searched for further studies. A total of
232 articles were identified from the search parameters. After applying
inclusion and exclusion criteria, 13 articles were selected. Hand
searching the references of these articles yielded four additional
articles. Of the 75 organ recipients that received organs from donors with
known melanoma, 43 developed melanoma. While a definitive quantitative
risk cannot be ascertained based on our review, the numerous reported
cases of melanoma in organ recipients from donors that have melanoma
should still be considered by clinicians. Copyright © 2023 the
International Society of Dermatology.

<7>
Accession Number
642116595
Title
Extrathoracic Against Intrathoracic Vascular Accesses for Transcatheter
Aortic Valve Replacement: A Systematic Review With Meta-Analysis.
Source
The American journal of cardiology. 203 (pp 473-483), 2023. Date of
Publication: 15 Sep 2023.
Author
Abellan C.; Antiochos P.; Fournier S.; Skali H.; Shah P.; Maurizi N.;
Eeckhout E.; Roguelov C.; Monney P.; Tzimas G.; Kirsch M.; Muller O.; Lu
H.
Institution
(Abellan) Service of Internal Medicine, Lausanne University Hospital and
University of Lausanne, Lausanne, Switzerland
(Antiochos, Fournier, Maurizi, Eeckhout, Roguelov, Monney, Tzimas, Muller)
Service of Cardiology, Lausanne University Hospital and University of
Lausanne, Lausanne, Switzerland
(Skali, Shah) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Kirsch) Service of Cardiovascular Surgery, Lausanne University Hospital
and University of Lausanne, Lausanne, Switzerland
(Lu) Service of Cardiology, Lausanne University Hospital and University of
Lausanne, Lausanne, Switzerland; Division of Cardiovascular Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston,
Massachusetts
Publisher
NLM (Medline)
Abstract
Alternative vascular accesses to transfemoral access for transcatheter
aortic valve replacement (TAVR) can be divided into intrathoracic
(IT)-transapical and transaortic- and extrathoracic (ET)-transcarotid,
transsubclavian, and transaxillary. This study aimed to compare the
outcomes and safety of IT and ET accesses for TAVR as alternatives to
transfemoral access. A systematic review with meta-analysis was performed
by searching PubMed/MEDLINE and EMBASE databases for all studies comparing
IT-TAVR with ET-TAVR published until April 2023. Outcomes included
in-hospital or 30-day all-cause mortality (ACM), 1-year ACM, postoperative
and 30-day complications. A total of 18 studies with 6,800 IT-TAVR
patients and 5,032 ET-TAVR patients were included. IT accesses were
associated with a significantly higher risk of in-hospital or 30-day ACM
(relative risk 1.99, 95% confidence interval 1.67 to 2.36, p <0.001), and
1-year ACM (relative risk 1.31, 95% confidence interval 1.21 to 1.42, p
<0.001). IT-TAVR patients presented more often with postoperative
life-threatening bleeding, 30-day new-onset atrial fibrillation or
flutter, and 30-day acute kidney injury needing renal replacement therapy.
The risks of postoperative permanent pacemaker implantation and
significant paravalvular leak were lower with IT-TAVR. ET-TAVR patients
were more likely to be directly discharged home. There was no
statistically significant difference regarding the 30-day risk of stroke.
Compared with ET-TAVR, IT-TAVR was associated with higher risks of
in-hospital or 30-day ACM, 1-year ACM and higher risks for some critical
postprocedural and 30-day complications. Our results suggest that ET-TAVR
could be considered as the first-choice alternative approach when
transfemoral access is contraindicated. Copyright © 2023 The
Author(s). Published by Elsevier Inc. All rights reserved.

<8>
Accession Number
642128944
Title
Evaluation of the Effect of New Multimodal Analgesia Regimen for Cardiac
Surgery: A Prospective, Randomized Controlled, Single-Center Clinical
Study [Response to Letter.
Source
Drug design, development and therapy. 17 (pp 2457-2460), 2023. Date of
Publication: 2023.
Author
Jin L.; Guo K.
Institution
(Jin, Guo) Department of Anesthesia, Zhongshan Hospital, Fudan University,
Shanghai, China
Publisher
NLM (Medline)

<9>
Accession Number
2026624161
Title
Clinical Frailty Scale as a predictor of adverse outcomes following aortic
valve replacement: A systematic review and meta-analysis.
Source
Open Heart. 10(2) (no pagination), 2023. Article Number: e002354. Date of
Publication: 10 Aug 2023.
Author
Prendiville T.; Leahy A.; Gabr A.; Ahmad F.; Afilalo J.; Martin G.P.;
Mamas M.; Casserly I.P.; Mohamed A.; Saleh A.; Shanahan E.; O'Connor M.;
Galvin R.
Institution
(Prendiville) Department of Cardiology, Cork University Hospital, Cork,
Ireland
(Leahy, Gabr, Mohamed, Saleh, Shanahan, O'Connor) Department of Ageing and
Therapeutics, University Hospital Limerick, Limerick, Ireland
(Ahmad, Afilalo) Division of Cardiology, Centre of Clinical Epidemiology,
Jewish General Hospital, McGill University, Montreal, QC, Canada
(Martin) Division of Informatics Imaging and Data Science, Faculty of
Biology, Medicine and Health, University of Manchester, Manchester, United
Kingdom
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Keele, United Kingdom
(Casserly) Department of Cardiology, Mater Misericordiae University
Hospital, Dublin, Ireland
(Galvin) School of Allied Health, Faculty of Education and Health
Sciences, Ageing Research Centre, Health Research Institute, University of
Limerick, Limerick, Ireland
Publisher
BMJ Publishing Group
Abstract
Objectives Assessment of frailty prior to aortic valve intervention is
recommended in European and North American valvular heart disease
guidelines. However, there is a lack of consensus on how it is best
measured. The Clinical Frailty Scale (CFS) is a well-validated measure of
frailty that is relatively quick to calculate. This meta-analysis sought
to examine whether the CFS predicts mortality and morbidity following
either transcatheter aortic valve implantation (TAVI) or surgical aortic
valve replacement (SAVR). Methods Nine electronic databases were searched
systematically for data on clinical outcomes post-TAVI/SAVR, where
patients had undergone preoperative frailty assessment using the CFS. The
primary endpoint was 12-month mortality. TAVI and SAVR data were assessed
and reported separately. For each individual study, the incidence of
adverse outcomes was extracted according to a CFS score of 5-9 (ie, frail)
versus 1-4 (ie, non-frail), with meta-analysis performed using a random
effects model. Results Of 2612 records screened, nine were included in the
review (five TAVI, three SAVR and one which included both interventions).
Among 4923 TAVI patients, meta-analysis showed 12-month mortality rates of
19.1% for the frail cohort versus 9.8% for the non-frail cohort (RR 2.53
(1.63 to 3.95), p<0.001, I 2 =83%). For the smaller cohort of SAVR
patients (n=454), mortality rates were 20.3% versus 3.9% for the frail and
non-frail cohorts, respectively (RR 5.08 (2.31 to 11.15), p<0.001, I 2
=5%). Conclusions Frailty, as determined by the CFS, was associated with
an increased mortality risk in the 12 months following either TAVI or
SAVR. These data would support its use in the preoperative assessment of
elderly patients undergoing aortic valve interventions. Copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

<10>
Accession Number
2026614862
Title
Tafamidis treatment in patients with transthyretin amyloid cardiomyopathy:
a systematic review and meta-analysis.
Source
eClinicalMedicine. 63 (no pagination), 2023. Article Number: 102172. Date
of Publication: September 2023.
Author
Wang J.; Chen H.; Tang Z.; Zhang J.; Xu Y.; Wan K.; Hussain K.; Gkoutos
G.V.; Han Y.; Chen Y.
Institution
(Wang, Xu, Chen) Department of Cardiology, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
(Wang, Gkoutos) College of Medical and Dental Sciences, Institute of
Cancer and Genomic Sciences, University of Birmingham, Birmingham, United
Kingdom
(Chen, Tang) West China School of Public Health, Sichuan University,
Sichuan, Chengdu, China
(Zhang) Division of Informatics, Imaging, and Data Sciences, Faculty of
Biology, Medicine and Health, University of Manchester, Manchester, United
Kingdom
(Wan) Department of Geriatrics, West China Hospital, Sichuan University,
Sichuan, Chengdu, China
(Hussain) Department of Cardiology, NorthShore University Health Systems,
Evanston, IL, United States
(Gkoutos) Institute of Translational Medicine, University Hospitals
Birmingham NHS Foundation Trust, Birmingham, United Kingdom
(Gkoutos) Health Data Research UK (HDR), Midlands Site, United Kingdom
(Gkoutos) Centre for Health Data Science, University of Birmingham,
Birmingham, United Kingdom
(Han) Cardiovascular Division, Wexner Medical Centre, The Ohio State
University, United States
(Chen) Centre of Rare Diseases, West China Hospital, Sichuan University,
Sichuan, Chengdu, China
Publisher
Elsevier Ltd
Abstract
Background: Previous studies have reported that tafamidis treatment was
associated with better outcomes in patients with transthyretin amyloid
cardiomyopathy (ATTR-CM) compared with those without tafamidis treatment.
Therefore, we aimed to systematically assess the association of tafamidis
treatment with outcomes in patients with ATTR-CM. Method(s): The
protocol for this systematic review and meta-analysis was registered in
the PROSPERO (CRD42022381985). Pubmed, Ovid Embase, Scopus, Cochrane
Library, and Web of Science were interrogated to identify studies that
evaluated the impact of tafamidis on prognosis in ATTR-CM, from January 1,
2000 to June 1, 2023. A random-effects model was used to determine the
pooled risk ratio (RR) for the adverse endpoints. In addition, the main
outcomes included all-cause death or heart transplantation, the composite
endpoints included all-cause death, heart transplantation, cardiac-assist
device implantation, heart failure exacerbations, and hospitalization.
 Finding(s): Fifteen studies comprising 2765 patients (mean age 75.9
+/- 9.3 years; 83.7% male) with a mean follow-up duration of 18.7 +/- 17.1
months were included in the meta-analysis. There was a decrease in left
ventricular ejection fraction (LVEF) (standard mean differences (SMD:
-0.17; 95% confidence interval (CI), -0.31 to -0.03; P = 0.02) but were no
significant differences in intraventricular septum (IVS) thickness or
global longitudinal strain (GLS) after tafamidis treatment. However,
subgroup analysis showed no significant deterioration in LVEF in the
patients with wild-type ATTR after tafamidis treatment (SMD: -0.11; 95%
CI, -0.34 to 0.12, P = 0.34). In addition, the group with tafamidis
treatment had a decreased risk for all-cause death or heart
transplantation compared to patients without treatment (the pooled RR,
0.44; 95% CI, 0.31-0.65; P < 0.01). Subgroup analysis showed that there
was no significant difference of tafamidis on the outcomes in patients
with wild-type or hereditary ATTR (RR, 0.44; 95% CI, 0.27-0.73 versus
0.21, 95% CI, 0.11-0.40, P = 0.08). Furthermore, tafamidis treatment was
associated with a lower risk of the composite endpoint (RR, 0.57; 95% CI,
0.42-0.77; P < 0.01). Interpretation(s): Our findings suggested that
there was no significant deterioration in LVEF in the patients with
wild-type ATTR after tafamidis treatment. In addition, tafamidis treatment
was associated with a low risk of all-cause death and adverse
cardiovascular events. Funding(s): This work was supported by grants
from theNatural Science Foundation of Sichuan Province [Grant
Number:23NSFSC4589] and theNational Natural Science Foundation of China
[Grant Number:82202248]. Copyright © 2023 The Author(s)

<11>
Accession Number
2026658220
Title
Trends in the Extracorporeal Membrane Oxygenation Literature: A
Bibliometric Analysis in the COVID-19 Era.
Source
Journal of Extra-Corporeal Technology. 54(1) (pp 19-28), 2022. Date of
Publication: 01 Mar 2022.
Author
Gupta A.K.; Kerr L.D.; Stretton B.; Kovoor J.G.; Ovenden C.D.; Hewitt
J.N.; Chan J.C.Y.
Institution
(Gupta, Kerr) Discipline of Surgery, University of Adelaide, Royal
Adelaide Hospital, Adelaide, SA, Australia
(Stretton, Chan) University of Adelaide, Adelaide, SA, Australia
(Kovoor, Hewitt) Discipline of Surgery, University of Adelaide, The Queen
Elizabeth Hospital, Adelaide, SA, Australia
(Ovenden) Discipline of Surgery, University of Adelaide, Women S and
Children S Hospital, Adelaide, SA, Australia
Publisher
EDP Sciences
Abstract
Extracorporeal Membrane Oxygenation (ECMO) was first used in the 1970s.
Its use is increasingly common in critical care and perioperative settings
and has gained newfound prominence during COVID-19. To guide future
research, we conducted a bibliometric analysis of ECMO literature. Thomson
Reuters Web of Science was searched to March 7, 2021. Articles were ranked
by total number of citations. Data was extracted from the 100 most cited
papers relevant to ECMO for study design, topic, author, year, and
institution. Journal impact factor for 2019 and Eigenfactor scores were
also recorded. Our search retrieved a total of 18,802 articles. Median
number of citations for the top 100 articles was 220 (range 157 1,819).
These were published in 34 journals, with first authors originating from
15 countries. The Annals of Thoracic Surgery had the highest number of
articles (n=9) while Lancet publications had the most citations (n=3,191).
Use of ECMO was most commonly observed in cardiogenic shock or acute
respiratory distress syndrome. United States had the greatest article
output (n=49). With 10 publications, 2013 was the most prolific year.
Using linear regression, when controlled for time since publication, there
was no statistically significant relationship between 2019 journal impact
factor and number of article citations (p=.09). Top articles in the ECMO
literature are of considerable impact and quality. As the United States
produced the bulk of the prominent evidence base, and most data were
regarding respiratory issues, outsized advances in ECMO may be possible
within the United States during the COVID-19 era. Copyright ©
021 AMSECT.

<12>
Accession Number
2026619680
Title
Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative
Delirium (B-Free): A Protocol for a Multi-centre Randomized Cluster
Crossover Trial.
Source
CJC Open. (no pagination), 2023. Date of Publication: 2023.
Author
Spence J.; Belley-Cote E.; Jacobsohn E.; Lee S.F.; D'Aragon F.; Avidan M.;
Mazer C.D.; Rousseau-Saine N.; Rajamohan R.; Pryor K.; Klein R.; Tan
E.C.-H.; Cameron M.; Di Sante E.; DeBorba E.; Mustard M.; Couture E.;
Zamper R.; Law M.; Djaiani G.; Saha T.; Choi S.; Hedlin P.; Pikaluk R.;
Lam W.Y.; Deschamps A.; Whitlock R.; Dulong B.; Devereaux P.J.; Beaver C.;
Kloppenburg S.; Oczkowski S.; McIntyre W.F.; McFarling M.; Lamy A.;
Vincent J.; Connolly S.
Institution
(Spence) Departments of Anesthesia and Critical Care and Health Research
Methods, Evaluation, and Impact, McMaster University; and Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Belley-Cote, Devereaux) Departments of Medicine (Cardiology and Critical
Care), and Health Research Methods, Evaluation, and Impact, McMaster
University, and Perioperative Research Division, Population Health
Research Institute, Hamilton, ON, Canada
(Jacobsohn) Departments of Anesthesia and Perioperative Medicine and
Medicine (Critical Care), University of Manitoba, Winnipeg, MB, Canada
(Lee) Department of Health Research Methods, Evaluation, and Impact,
McMaster University, and Population Health Research Institute, Hamilton,
ON, Canada
(D'Aragon) Departement d'anesthesiologie, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Avidan) Department of Anesthesia, Washington University at St. Louis, St.
Louis, MO, United States
(Mazer) Department of Anesthesia and Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Rousseau-Saine, Deschamps) Departement d'anesthesiologie, Universite de
Montreal, Montreal, QC, Canada
(Rajamohan, Klein, Law) Department of Anesthesia, University of British
Columbia, Vancouver, BC, Canada
(Pryor) Department of Anesthesiology, Weill Cornell Medical College, New
York, NY, United States
(Tan, Dulong) Department of Anesthesia, Dalhousie University, Halifax, NS,
Canada
(Cameron) Department of Anesthesia, McGill University, Montreal, QC,
Canada
(Di Sante, DeBorba, Vincent) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Mustard) St. Michael's Hospital, Toronto, ON, Canada
(Couture) Departement d'anesthesiologie, Universite Laval, Quebec City,
QC, Canada
(Zamper) Department of Anesthesia, University of Western Ontario, London,
ON, Canada
(Djaiani, Choi) Department of Anesthesiology and Pain Medicine, University
of Toronto, Toronto, ON, Canada
(Saha) Department of Anesthesia, Queen's University, Kingston, ON, Canada
(Hedlin, Pikaluk) Department of Anesthesia, University of Saskatchewan,
Saskatoon, SK, Canada
(Lam) Department of Anesthesia, University of Alberta, Edmonton, AB,
Canada
(Whitlock) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University, and Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Beaver) Sheridan College, Brampton, ON, Canada
(Kloppenburg) Population Health Research Institute, Hamilton, ON, Canada
(Oczkowski) Department of Medicine (Critical Care), McMaster University,
Hamilton, ON, Canada
(McIntyre) Department of Medicine (Cardiology), McMaster University, and
Perioperative Research Division, Population Health Research Institute,
Hamilton, ON, Canada
(McFarling) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(Lamy) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University, Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Connolly) Department of Medicine (Cardiology), McMaster University, and
Population Health Research Institute, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Delirium is common after cardiac surgery and is associated with adverse
outcomes. Administration of benzodiazepines before and after cardiac
surgery is associated with delirium; guidelines recommend minimizing their
use. Benzodiazepine administration during cardiac surgery remains common
because of its recognized benefits. The Benzodiazepine-Free Cardiac
Anesthesia for Reduction of Postoperative Delirium (B-Free) trial is a
randomized cluster crossover trial evaluating whether an institutional
policy of restricting intraoperative benzodiazepine administration (ie, >=
90% of patients do not receive benzodiazepines during cardiac surgery), as
compared with a policy of liberal intraoperative benzodiazepine
administration (ie, >= 90% of patients receive >= 0.03 mg/kg midazolam
equivalent), reduces delirium. Hospitals performing >= 250 cardiac
surgeries a year are included if their cardiac anesthesia group agrees to
apply both benzodiazepine policies per their randomization, and patients
are assessed for postoperative delirium every 12 hours in routine clinical
care. Hospitals apply the restricted or liberal benzodiazepine policy
during 12 to 18 crossover periods of 4 weeks each. Randomization for all
periods takes place in advance of site startup; sites are notified of
their allocated policy during the last week of each crossover period.
Policies are applied to all patients undergoing cardiac surgery during the
trial period. The primary outcome is the incidence of delirium at up to 72
hours after surgery. The B-Free trial will enroll >= 18,000 patients
undergoing cardiac surgery at 20 hospitals across North America. Delirium
is common after cardiac surgery, and benzodiazepines are associated with
the occurrence of delirium. The B-Free trial will determine whether an
institutional policy restricting the administration of benzodiazepines
during cardiac surgery reduces the incidence of delirium after cardiac
surgery. Clinicaltrials.gov registration number: NCT03928236 (First
registered April 26, 2019). Copyright © 2023 The Authors

<13>
Accession Number
642130166
Title
An investigator-sponsored pragmatic randomised controlled trial of
AntiCoagulation versus AcetylSalicylic Acid after Transcatheter Aortic
Valve Implantation - Rationale and design of ACASA-TAVI: Blinded outcome
adjudication.
Source
American heart journal. (no pagination), 2023. Date of Publication: 25
Aug 2023.
Author
Dodgson C.A.S.; Beitnes J.O.; Klove S.F.; Herstad J.; Opdahl A.; Undseth
R.; Eek C.H.; Broch K.; Gullestad L.; Aaberge L.; Lunde K.; Bendz B.; Lie
OH.
Institution
(Dodgson, Bendz) Department of Cardiology, Oslo University Hospital
Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of
Medicine, University of Oslo, Oslo, Norway
(Beitnes, Klove, Eek, Aaberge, Lunde, Lie) Department of Cardiology, Oslo
University Hospital Rikshospitalet, Oslo, Norway
(Herstad) Department of Cardiology, Haukeland University Hospital, Bergen,
Norway
(Opdahl) Department of Cardiology, Oslo University Hospital Ulleval, Oslo,
Norway
(Undseth) Intervention Centre, Oslo University Hospital, Oslo, Norway
(Broch, Gullestad) Department of Cardiology, Oslo University Hospital
Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of
Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Cardiac Research
Centre, University of Oslo, Oslo, Norway
Publisher
NLM (Medline)
Abstract
The optimal antithrombotic therapy after transcatheter aortic valve
implantation (TAVI) is unknown. Bioprosthetic valve dysfunction (BVD) is
associated with adverse outcomes and may be prevented by anticoagulation
therapy. A dedicated randomized trial comparing monotherapy NOAC to single
antiplatelet therapy has not been performed previously. We hypothesize
that therapy with any anti-factor Xa NOAC will reduce BVD compared to
antiplatelet therapy, without compromising safety. ACASA-TAVI is a
multicentre, prospective, randomised, open-label, blinded endpoint,
all-comers trial comparing a monotherapy anti-factor Xa NOAC strategy
(intervention arm) with a single antiplatelet therapy strategy (control
arm) after successful TAVI. Three-hundred and sixty patients without
indication for oral anticoagulation will be randomised in a 1:1 ratio to
either apixaban 5 mg twice per day, edoxaban 60 mg daily, or rivaroxaban
20 mg daily for 12 months followed by acetylsalicylic acid 75 mg daily
indefinitely, or to acetylsalicylic acid 75 mg daily indefinitely. The two
co-primary outcomes are 1) incidence of Hypo-Attenuated Leaflet Thickening
(HALT) on four-dimensional cardiac CT at 12 months, and 2) a Safety
Composite of VARC-3 bleeding events, thromboembolic events (myocardial
infarction and stroke), and death from any cause, at 12 months. The first
100 patients had a mean age of 74 +/- 3.6 years, 33% were female, the
average body-mass index was 27.9 +/- 4.4 kg/m2, and 15% were smokers. A
balloon-expanded valve was used in 82% and a self-expandable valve in 18%.
The trial is planned, initiated, funded, and conducted without industry
involvement. Copyright © 2023. Published by Elsevier Inc.

<14>
Accession Number
642129548
Title
Quality and transparency of evidence for implantable cardiovascular
medical devices assessed by the CORE-MD Consortium.
Source
European heart journal. (no pagination), 2023. Date of Publication: 28
Aug 2023.
Author
Siontis G.C.; Coles B.; Haner J.D.; McGovern L.; Bartkowiak J.; Coughlan
J.J.; Spirito A.; Galea R.; Haeberlin A.; Praz F.; Tomii D.; Melvin T.;
Frenk A.; Byrne R.A.; Fraser A.G.; Windecker S.
Institution
(Siontis, Haner, Bartkowiak, Galea, Haeberlin, Praz, Tomii, Frenk,
Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Bern, Switzerland
(Coles) Velindre University NHS Trust Library and Knowledge Service
(McGovern, Coughlan, Byrne) Department of Cardiology and Cardiovascular
Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland;
School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine
and Health Sciences, Dublin, Ireland
(Spirito) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
(Melvin) School of Medicine, Trinity College, Dublin, Ireland
(Fraser) Department of Cardiology, University Hospital of Wales, Cardiff,
United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: The European Union Medical Device Regulation 2017/745
challenges key stakeholders to follow transparent and rigorous approaches
to the clinical evaluation of medical devices. The purpose of this study
is a systematic evaluation of published clinical evidence underlying
selected high-risk cardiovascular medical devices before and after market
access in the European Union (CE marking) between 2000 and 2021.
 METHOD(S): Prespecified strategies were applied to identify published
studies of prospective design evaluating 71 high-risk cardiovascular
devices in 7 different classes (bioresorbable coronary scaffolds, left
atrial appendage occlusion devices, transcatheter aortic valve
implantation systems, transcatheter mitral valve repair/replacement
systems, surgical aortic and mitral heart valves, leadless pacemakers,
subcutaneous implantable cardioverter-defibrillator). The search time-span
covered 20 years (2000-2021). Details of study design, patient population,
intervention(s) and primary outcome(s) were summarized, and assessed with
respect to timing of the corresponding CE-mark approval. RESULT(S):
At least one prospective clinical trial was identified for 70% (50/71) of
the prespecifed devices. Overall, 473 reports of 308 prospectively
designed studies (enrolling 97,886 individuals) were deemed eligible,
including 81% (251/308) prospective non-randomized clinical trials (66,186
individuals) and 19% (57/308) randomized clinical trials (31,700
individuals). Preregistration of the study protocol was available in 49%
(150/308) studies, and 16% (48/308) had a peer-reviewed publicly available
protocol. Device-related adverse events were evaluated in 82% (253/308) of
studies. An outcome adjudication process was reported in 39% (120/308) of
the studies. Sample size was larger for randomized in comparison to
non-randomized trials (median of 304 versus 100 individuals, p<0.001). No
randomized clinical trial published before CE-mark approval for any of the
devices was identified. Non-randomized clinical trials were predominantly
published after the corresponding CE-mark approval of the device under
evaluation (89%, 224/251). Sample sizes were smaller for studies published
before (median of 34 individuals) than after (median of 135 individuals)
CE-mark approval (p<0.001). Clinical trials with larger sample sizes (>50
individuals) and those with longer recruitment periods were more likely to
be published after CE-mark approval, and were more frequent during the
period 2016-2021. CONCLUSION(S): The quantity and quality of publicly
available data from prospective clinical investigations across selected
categories of cardiovascular devices, before and after CE approval during
the period 2000-2021, was deemed insufficient. The majority of studies
were non-randomized, with increased risk of bias, and performed in small
populations without provision of power calculations, and none of the
reviewed devices had randomized trial results published prior to CE mark
certification. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<15>
Accession Number
642128581
Title
Type A aortic dissection: optimal annual case volume for surgery.
Source
European heart journal. (no pagination), 2023. Date of Publication: 28
Aug 2023.
Author
Kawczynski M.J.; van Kuijk S.M.J.; Olsthoorn J.R.; Maessen J.G.; Kats S.;
Bidar E.; Heuts S.
Institution
(Kawczynski, Olsthoorn, Maessen, Kats, Bidar, Heuts) Department of
Cardiothoracic Surgery, Maastricht University Medical Center (MUMC+),
Netherlands
(Kawczynski, Maessen, Bidar, Heuts) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
(van Kuijk) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Center (MUMC+), Netherlands
(Olsthoorn) Department of Cardiothoracic Surgery, Catharina Hospital
Eindhoven, Eindhoven, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: The current study proposes a novel volume-outcome
(V-O) meta-analytical approach to determine the optimal annual hospital
case volume threshold for cardiovascular interventions in need of
centralization. This novel method is applied to surgery for acute type A
aortic dissection (ATAAD) as an illustrative example. METHOD(S): A
systematic search was applied to three electronic databases (January 1st
2012 - March 29th 2023). The primary outcome was early mortality in
relation to annual hospital case volume. Data were presented by volume
quartiles (Qs). Restricted cubic splines were used to demonstrate the V-O
relation, and the elbow method was applied to determine the optimal case
volume. For clinical interpretation, numbers needed to treat (NNT) were
calculated. RESULT(S): 140 studies were included, comprising 38276
patients. A significant non-linear V-O effect was observed (p<0.001), with
a significant between-quartile difference for early mortality (10.3% [Q4]
vs. 16.2% [Q1], p<0.001). The optimal annual case volume was determined at
38 cases/year (95% CI 37-40 cases/year, NNT to save a life in a centre
with the optimal volume vs. 10 cases/year = 21). More pronounced
between-quartile survival differences were observed for long-term survival
(10-year survival [Q4] 69% vs. [Q1] 51%, p<0.001, adjusted HR 0.83, 95% CI
0.75-0.91 per quartile, NNT to save a life in a high-volume [Q4] vs.
low-volume centre [Q1) = 6). CONCLUSION(S): Using this novel
approach, the optimal hospital case volume threshold was statistically
determined. Centralization of ATAAD care to high-volume centres may lead
to improved outcomes. This method can be applied to various other
cardiovascular procedures requiring centralization. Copyright ©
The Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<16>
Accession Number
642128197
Title
A systematic review of contrast-enhanced computed tomography calcium
scoring methodologies and impact of aortic valve calcium burden on TAVI
clinical outcomes.
Source
Journal of cardiovascular computed tomography. (no pagination), 2023.
Date of Publication: 25 Aug 2023.
Author
Flores-Umanzor E.; Keshvara R.; Reza S.; Asghar A.; Rashidul Anwar M.;
Cepas-Guillen P.L.; Osten M.; Halankar J.; Abrahamyan L.; Horlick E.
Institution
(Flores-Umanzor, Keshvara, Osten, Horlick) Toronto Congenital Cardiac
Centre for Adults, Peter Munk Cardiac Centre, University Health Network,
Toronto, ON, Canada
(Reza, Asghar, Rashidul Anwar, Abrahamyan) Toronto General Hospital
Research Institute, University Health Network (UHN), Toronto, ON, Canada;
Institute for Health Policy, Management, and Evaluation, University of
Toronto, ON, Canada
(Cepas-Guillen) Cardiology Department, Cardiovascular Institute, Hospital
Clinic, University of Barcelona, Spain
(Halankar) Joint Department of Medical Imaging, Toronto General Hospital,
Peter Munk Cardiac Centre, University of Toronto, University Health
Network, ON, Canada
Publisher
NLM (Medline)
Abstract
Different methodologies have been used to assess the role of AV
calcification (AVC) on TAVI outcomes. This systematic review aims to
describe the burden of AVC, synthesize the different methods of calcium
score quantification, and evaluate the impact of AVC on outcomes after
TAVI. We included studies of TAVI patients who had reported AV calcium
scoring by contrast-enhanced multidetector CT and the Agatston method. The
impact of calcification on TAVI outcomes without restrictions on follow-up
time or outcome type was evaluated. Results were reported descriptively,
and a meta-analysis was conducted when feasible. Sixty-eight articles were
included, with sample sizes ranging from 23 to 1425 patients.
Contrast-enhanced calcium scoring was reported in 30 studies, calcium
volume score in 28 studies, and unique scoring methods in two. All studies
with calcium volume scores had variable protocols, but most utilized a
modified Agatston method with variable attenuation threshold values of
300-850 HU. Eight studies used the Agatston method, with the overall mean
AV calcium score in studies published from 2010 to 2012 of 3342.9 AU
[95%CI: 3150.4; 3535.4, I2 = 0%]. The overall mean score was lower and
heterogenous in studies published from 2014 to 2020 (2658.9 AU [95% CI:
2517.3; 2800.5, I2 = 79%]. Most studies reported a positive association
between calcium burden and increased risk of adverse outcomes, including
implantation of permanent pacemaker (7/8 studies), paravalvular leak
(13/13 studies), and risk of aortic rupture (2/2 studies). AVC
quantification methodology with contrast-enhanced CT is still variable.
AVC negatively impacts TAVI outcomes independently of the quantification
method. Copyright © 2023. Published by Elsevier Inc.

<17>
Accession Number
642127931
Title
Cardiac Magnetic Resonance Imaging Versus Computed Tomography to Guide
Transcatheter Aortic Valve Replacement (TAVR-CMR): A Randomized,
Open-Label, Non-Inferiority Trial.
Source
Circulation. (no pagination), 2023. Date of Publication: 27 Aug 2023.
Author
Reindl M.; Lechner I.; Holzknecht M.; Tiller C.; Fink P.; Oberhollenzer
F.; von der Emde S.; Pamminger M.; Troger F.; Kremser C.; Lassnig E.;
Danninger K.; Binder R.K.; Ulmer H.; Brenner C.; Klug G.; Bauer A.;
Metzler B.; Mayr A.; Reinstadler S.J.
Institution
(Reindl, Lechner, Holzknecht, Tiller, Fink, Oberhollenzer, von der Emde,
Brenner, Klug, Bauer, Metzler, Reinstadler) University Clinic of Internal
Medicine III, Cardiology and Angiology, Medical University of Innsbruck,
Anichstrasse 35, Innsbruck A-6020, Austria
(Pamminger, Troger, Kremser, Mayr) University Clinic of Radiology, Medical
University of Innsbruck, Anichstrasse 35, Innsbruck A-6020, Austria
(Lasnig, Danninger, Binder) Department of Cardiology and Intensive Care,
University Teaching Hospital Klinikum Wels-Grieskrichen, Wels, Austria
(Ulmer) Institute of Medical Statistics and Informatics, Medical
University of Innsbruck, Innsbruck, Austria
Publisher
NLM (Medline)
Abstract
Background: Computed tomography (CT) is recommended for guiding
transcatheter aortic valve replacement (TAVR). However, as a sizable
proportion of TAVR candidates have chronic kidney disease (CKD), the use
of iodinated contrast media is a limitation. Cardiac magnetic resonance
(CMR) is a promising alternative, yet randomized data comparing the
effectiveness of CMR- versus CT-guided TAVR are lacking. Method(s):
An investigator-initiated, prospective, randomized, open-label,
non-inferiority trial was conducted at two Austrian heart centers.
Patients evaluated for TAVR according to the inclusion (severe symptomatic
aortic stenosis) and exclusion criteria (contraindication to CMR, CT, or
TAVR, a life expectancy < 1 year, CKD 4 or 5) were randomized (1:1) to
undergo CMR- or CT-guiding. The primary outcome was defined according to
the Valve Academic Research Consortium-2 definition of implantation
success at discharge, including absence of procedural mortality, correct
positioning of a single prosthetic valve, and proper prosthetic valve
performance. Non-inferiority was assessed using a hybrid modified
intention-to-treat (mITT)/per-protocol (PP) approach based on an absolute
risk difference margin of 9%. Result(s): Between September 11, 2017,
and December 16, 2022, 380 candidates for TAVR were randomized to
CMR-guided (191 patients) or CT-guided (189 patients) TAVR planning. Of
these, 138 patients (72.3%) in the CMR-guided group and 129 patients
(68.3%) in the CT-guided group eventually underwent TAVR (mITT cohort). Of
these 267, 19 patients had protocol deviations, resulting in a PP cohort
of 248 patients (n=121 CMR-guided, n=127 CT-guided). In the mITT cohort,
implantation success was achieved in 129 patients (93.5%) in the CMR group
and in 117 patients (90.7%) in the CT group (between-group difference,
2.8%; 90% confidence interval [CI]: -2.7 to 8.2%; p<0.01 for
non-inferiority). In the PP cohort (n=248), the between-group difference
was 2.0% (90% CI: -3.8 to 7.8%; p<0.01 for non-inferiority).
 Conclusion(s): CMR-guided TAVR was non-inferior to CT-guided TAVR in
terms of device implantation success. CMR can therefore be considered as
an alternative for TAVR planning.

<18>
Accession Number
642127742
Title
Scoping review of percutaneous mechanical aspiration for valvular and
cardiac implantable electronic device infective endocarditis.
Source
Clinical microbiology and infection : the official publication of the
European Society of Clinical Microbiology and Infectious Diseases. (no
pagination), 2023. Date of Publication: 25 Aug 2023.
Author
Mourad A.; Hillenbrand M.; Skalla L.A.; Holland T.L.; Zwischenberger B.A.;
Williams A.R.; Turner N.A.
Institution
(Mourad, Hillenbrand, Holland, Turner) Department of Medicine, Division of
Infectious Diseases, Duke University Medical Center, Durham, NC, United
States
(Skalla) Duke University Medical Center Library & Archives, Duke
University School of Medicine, Durham, NC, United States
(Zwischenberger, Williams) Department of Surgery, Division of
Cardiovascular and Thoracic Surgery, Duke University Medical Center,
Durham, NC, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Percutaneous mechanical aspiration (PMA) of intravascular
vegetations is a novel strategy for management of patients with infective
endocarditis (IE) who are at high risk of poor outcomes with conventional
cardiac surgery. However, clear indications for its use as well as patient
outcomes are largely unknown. OBJECTIVE(S): To conduct a scoping
review of the literature to summarize patient characteristics and outcomes
of those undergoing PMA for management of IE. SOURCES: MEDLINE, Embase,
and Web of Science. STUDY ELIGIBILITY: Studies published until February
21, 2023, describing the use of PMA for management of patients with
cardiac implantable electronic device (CIED) or valvular IE.
 METHOD(S): Two independent reviewers screened abstracts and full text
for inclusion and independently extracted data. Descriptive data was
reported. RESULT(S): We identified 2,252 titles, of which 1,442
abstracts were screened, and 125 full text articles were reviewed for
inclusion. Fifty-one studies, describing a total of 294 patients who
underwent PMA for IE were included in our review. Over 50% (152/294) of
patients underwent PMA to debulk cardiac implantable electronic device
lead vegetations prior to extraction (152/294), and 38.8% (114/294) of
patients had a history of drug use. Patient outcomes were inconsistently
reported, but few had procedural complications, and all-cause in-hospital
mortality was 6.5% (19/294). IMPLICATIONS: While PMA is a promising
advance in the care of patients with IE, higher quality data regarding
patient outcomes are needed to better inform the use of this
procedure. Copyright © 2023. Published by Elsevier Ltd.

<19>
Accession Number
642125471
Title
Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation.
Source
The New England journal of medicine. (no pagination), 2023. Date of
Publication: 27 Aug 2023.
Author
Sohns C.; Fox H.; Marrouche N.F.; Crijns H.J.G.M.; Costard-Jaeckle A.;
Bergau L.; Hindricks G.; Dagres N.; Sossalla S.; Schramm R.; Fink T.; El
Hamriti M.; Moersdorf M.; Sciacca V.; Konietschke F.; Rudolph V.; Gummert
J.; Tijssen J.G.P.; Sommer P.
Institution
(Sohns, Fox, Marrouche, Crijns, Costard-Jaeckle, Bergau, Hindricks,
Dagres, Sossalla, Schramm, Fink, El Hamriti, Moersdorf, Sciacca,
Konietschke, Rudolph, Gummert, Tijssen, Sommer) From the Clinics for
Electrophysiology (C.S., L.B., T.F., M.E.H., M.M., V.S., P.S.), Thoracic
and Cardiovascular Surgery (H.F., A.C.-J., R.S., J.G.), and General and
Interventional Cardiology-Angiology (V.R.) and the Center for
Interdisciplinary Management of Advanced Heart Failure (H.F., A.C.J.,
R.S., J.G.), Herz- und Diabeteszentrum Nordrhein-Westfalen,
Ruhr-Universitat Bochum, Bad Oeynhausen, the Department of Cardiology,
Angiology, and Intensive Care Medicine, Charite Campus Mitte, German Heart
Center of Charite-University Medicine Berlin (G.H.), and the Institute of
Biometry and Clinical Epidemiology, Charite-Universitatsmedizin Berlin,
Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu
Berlin (F.K.), Berlin, the Department of Electrophysiology, Heart Center
Leipzig, Leipzig (N.D.), and the Department of Cardiology and Angiology,
University of Giessen and Kerckhoff Heart Center, Bad Nauheim (S.S.) - all
in Germany; the Cardiology Department, Tulane University School of
Medicine, New Orleans (N.F.M.); and the Department of Cardiology and
Cardiovascular Research Institute Maastricht, Maastricht University,
Maastricht (H.J.G.M.C.), and the Department of Cardiology, Amsterdam
University Medical Centers, University of Amsterdam, Amsterdam (J.G.P.T.)
- both in the Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: The role of catheter ablation in patients with symptomatic
atrial fibrillation and end-stage heart failure is unknown.
 METHOD(S): We conducted a single-center, open-label trial in Germany
that involved patients with symptomatic atrial fibrillation and end-stage
heart failure who were referred for heart transplantation evaluation.
Patients were assigned to receive catheter ablation and guideline-directed
medical therapy or medical therapy alone. The primary end point was a
composite of death from any cause, implantation of a left ventricular
assist device, or urgent heart transplantation. RESULT(S): A total of
97 patients were assigned to the ablation group and 97 to the
medical-therapy group. The trial was stopped for efficacy by the data and
safety monitoring board 1 year after randomization was completed. Catheter
ablation was performed in 81 of 97 patients (84%) in the ablation group
and in 16 of 97 patients (16%) in the medical-therapy group. After a
median follow-up of 18.0 months (interquartile range, 14.6 to 22.6), a
primary end-point event had occurred in 8 patients (8%) in the ablation
group and in 29 patients (30%) in the medical-therapy group (hazard ratio,
0.24; 95% confidence interval [CI], 0.11 to 0.52; P<0.001). Death from any
cause occurred in 6 patients (6%) in the ablation group and in 19 patients
(20%) in the medical-therapy group (hazard ratio, 0.29; 95% CI, 0.12 to
0.72). Procedure-related complications occurred in 3 patients in the
ablation group and in 1 patient in the medical-therapy group.
 CONCLUSION(S): Among patients with atrial fibrillation and end-stage
heart failure, the combination of catheter ablation and guideline-directed
medical therapy was associated with a lower likelihood of a composite of
death from any cause, implantation of a left ventricular assist device, or
urgent heart transplantation than medical therapy alone. (Funded by Else
Kroner-Fresenius-Stiftung; CASTLE-HTx ClinicalTrials.gov number,
NCT04649801.). Copyright © 2023 Massachusetts Medical Society.

<20>
Accession Number
642125328
Title
Five-year major cardiovascular events are increased when coronary
revascularization is guided by instantaneous wave-free ratio compared to
fractional flow reserve: a pooled analysis of iFR-SWEDEHEART and
DEFINE-FLAIR trials.
Source
European heart journal. (no pagination), 2023. Date of Publication: 27
Aug 2023.
Author
Eftekhari A.; Holck E.N.; Westra J.; Olsen N.T.; Bruun N.H.; Jensen L.O.;
Engstrom T.; Christiansen E.H.
Institution
(Eftekhari) Dept. Cardiology Aalborg University Hospital, Denmark
(Holck, Westra, Christiansen) Dept. Cardiology Aarhus University Hospital,
Denmark
(Holck, Christiansen) Dept. Clinical Medicine, Health, Aarhus University,
Denmark
(Westra) Dept. Cardiology Linkoping University Hospital Sweden, Sweden
(Olsen) Dept. Cardiology, Gentofte University Hospital, Denmark
(Bruun) Unit of Clinical Biostatistics, Aalborg University Hospital,
Denmark
(Jensen) Dept. Cardiology Odense University Hospital, Denmark
(Engstrom) Dept. Cardiology Rigshospitalet Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: Guidelines recommend revascularization of
intermediate epicardial artery stenosis to be guided by evidence of
ischemia. Fractional flow reserve (FFR) and instantaneous wave-free ratio
(iFR) are equally recommended. Individual 5-year results of two major
randomized trials comparing FFR with iFR-guided revascularization
suggested increased all-cause mortality following iFR-guided
revascularization. The aim of this study was a study-level meta-analysis
of the 5-year outcome data in iFR-SWEDEHEART (NCT02166736) and
DEFINE-FLAIR (NCT02053038). METHOD(S): Composite of major adverse
cardiovascular events (MACE) and its individual components [all-cause
death, myocardial infarction (MI), and unplanned revascularisation] were
analysed. Raw Kaplan-Meier estimates, numbers at risk and number of events
were extracted at 5-year follow-up and analysed using the ipdfc package
(Stata version 18, StataCorp College Station, TX USA). RESULT(S): In
total, iFR and FFR-guided revascularization was performed in 2,254 and
2,257 patients, respectively. Revascularization was more often deferred in
the iFR-group [n = 1,128 (50.0 %)] vs. the FFR-group [n = 1021 (45.2 %);
p=0.001]. In the iFR-guided group the number of deaths, MACE, unplanned
revascularization, and MI were 188 (8.3%), 484 (21.5%), 235 (10.4%), and
123 (5.5%) vs. 143 (6.3%), 420 (18.6%), 241 (10.7%), and 123 (5.4%) in the
FFR-group. Hazard ratio [95% confidence interval (CI)] estimates for MACE
were 1.18 [1.035; 1.34], all-cause mortality 1.34 [1.08; 1.67], unplanned
revascularization 0.99 [0.83; 1.19], and MI 1.02 [0.80; 1.32].
 CONCLUSION(S): Five-year all-cause mortality and MACE rates were
increased with revascularization guided by iFR compared to FFR. Rates of
unplanned revascularization and MI were equal in the two
groups. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<21>
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.

<22>
Accession Number
2025455346
Title
Effects of Inspiratory Muscle Training Using an Electronic Device on
Patients Undergoing Cardiac Surgery: A Randomized Controlled Trial.
Source
International Journal of Cardiovascular Sciences. 34(1) (pp 44-52), 2021.
Date of Publication: 2021.
Author
Fortes J.V.S.; Borges M.G.B.; Silva Marques M.J.D.; Oliveira R.L.; Rocha
L.R.D.; Castro E.M.; Esquive M.S.; Borges D.L.
Institution
(Fortes, Borges, Silva Marques, Oliveira, Rocha, Castro, Borges)
Cardiology Intensive Care Unit, Hospital Universitario da Universidade
Federal do Maranhao Rua, Barao de Itapary, 227, Centro, MA, Sao Luis
65020-070, Brazil
(Esquive) Research Group in Cardiovascular Physiotherapy, BA, Salvador,
Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: Cardiac surgery causes pathophysiological changes that favor
the occurrence of pulmonary and functional complications.
 Objective(s): To investigate the effects of inspiratory muscle
training (IMT) with an electronic device on patients undergoing cardiac
surgery. Method(s): A randomized controlled trial was conducted with
30 adult patients undergoing elective cardiac surgery. A control group
(CG) received conventional physical therapy care, and an intervention
group (IG) received IMT using the POWERbreathe K5 electronic
device. Two daily sessions of physical therapy were performed at the
intensive care unit and one daily session at the ward until the sixth
postoperative day. The following variables were measured preoperatively
and on the sixth postoperative day, in both groups: inspiratory muscle
strength, dynamic inspiratory muscle strength, and peak inspiratory flow.
Data distribution was evaluated by the Shapiro-Wilk test. Analysis of
variance was used, and the results were considered statistically
significant when p < 0.05. Result(s): Maximal inspiratory pressure
(71.7 +/- 17.1 cmH2O vs 63.3 +/- 21.3 cmH2O; p = 0.11], S-index (52.61 +/-
18.61 vs 51.08 +/- 20.71), and peak inspiratory flow [(2.94 +/- 1.09 vs
2.79 +/- 1.26)] were maintained in the IG but had a significant reduction
in the CG. Conclusion(s): IMT performed with an electronic device was
effective at maintaining inspiratory muscle strength, dynamic inspiratory
muscle strength, and peak inspiratory flow when compared to conventional
physical therapy. (Int J Cardiovasc Sci. 2021; 34(1):44-52) Copyright
© 2021, Sociedade Brasileira de Cardiologia. All rights reserved.

<23>
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.

<24>
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.

<25>
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.

<26>
Accession Number
2026251086
Title
Therapeutic Outcomes Following Isolated Transcatheter Tricuspid Valve
Repair: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(12) (no pagination), 2023. Article
Number: 101985. Date of Publication: December 2023.
Author
Siddiqui H.F.; Khan A.B.; Nasir M.M.; Latif F.; Siddiqui A.F.; Akhtar P.;
Hamza M.; Barmanwalla A.
Institution
(Siddiqui, Khan, Nasir, Latif) Department of Internal Medicine, Dow
University of Health Sciences, Sindh, Karachi, Pakistan
(Siddiqui) Department of Internal Medicine, Aga Khan University Hospital,
Sindh, Karachi, Pakistan
(Akhtar) Department of Cardiology, National Institute of Cardiovascular
Diseases, Sindh, Karachi, Pakistan
(Hamza) Department of Internal Medicine, Albany Medical Center, Albany,
NY, United States
(Barmanwalla) MD Brigham and Women's Hospital and Cape Cod Hospital,
Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid regurgitation (TR) is traditionally treated surgically, but
isolated transcatheter tricuspid valve repair (ITTVR) offers a less
invasive option. This study conducts a meta-analysis and systematic review
to evaluate ITTVR outcomes in patients with TR. Database searches until
March 2023 identified studies assessing ITTVR safety and efficacy in
moderate/severe TR patients. Primary outcomes analyzed were severe TR,
NYHA functional class improvement, and 6-minute walking distance.
Meta-analyses used Risk ratio (RR) or mean difference with a random
effects model. The review included 25 studies with 2421 patients. ITTVR
improved NYHA functional class (RR: 3.262), reduced TR severity (RR:
0.303), and enhanced 6-minute walking distance (MD: +47.077 m).
Echocardiographic parameters improved, including reductions in TR vena
contracta, TR EROA, septolateral tricuspid annular diameter, RVEDD, RV
FAC, and TAPSE. LVEF and PASP showed no significant changes. ITTVR
improves functional outcomes and echocardiographic parameters in TR
patients. Copyright © 2023 Elsevier Inc.

<27>
Accession Number
2025687089
Title
Percutaneous Mitral-Valve Intervention for Secondary Mitral Regurgitation:
Data From Real-Life.
Source
Current Problems in Cardiology. 48(10) (no pagination), 2023. Article
Number: 101889. Date of Publication: October 2023.
Author
Kaddoura R.; Al-Badriyeh D.; Abushanab D.; Al-Hijji M.
Institution
(Kaddoura, Al-Hijji) Heart Hospital, Hamad Medical Corporation, Doha,
Qatar
(Al-Badriyeh) College of Pharmacy, QU Health, Qatar University, Doha,
Qatar
(Abushanab) Drug Information Center, Hamad Medical Corporation, Doha,
Qatar
Publisher
Elsevier Inc.
Abstract
Many questions were raised due to the divergent results between
cardiovascular outcomes assessment of the MitraClip percutaneous therapy
for heart failure patients with functional mitral regurgitation (COAPT)
and multicenter study of percutaneous mitral valve Repair MitraClip device
in patients with severe secondary mitral regurgitation (MITRA-FR) trials
on the use of percutaneous mitral valve repair for secondary mitral
regurgitation. This paper examined pooled patients' characteristics and
outcomes from real-life experience compared with those in the 2 landmark
trials. A comprehensive search identified eligible studies published in
2020 and 2021. Mean difference and odds ratio (OR) were used to compare
continuous and categorical data. Thirty-three studies included more than
9200 patients. Patients in landmark trials were younger than in real-life,
less likely to present with severe heart failure symptoms ([COAPT: OR
0.25; 95% CI: 0.21, 0.31]; [MITRA-FR: OR 0.32; 95% CI: 0.23, 0.45]) or
severe mitral regurgitation grade (COAPT only: OR 0.57; 95% CI: 0.45,
0.71) with larger left ventricular end diastolic volume. Procedure success
(OR 1.94; 95% CI: 1.10, 3.40) was more frequent with lower all-cause
mortality (OR 0.73; 95% CI: 0.54, 0.99) in COAPT. Real-life patients
experienced more favorable procedural and clinical outcomes compared with
MITRA-FR patients. Real-life data on percutaneous mitral valve repair in
secondary mitral regurgitation showed important variations in patient
selection and procedural outcomes. Rates of death and heart failure
hospitalization in observational studies were lower than MITRA-FR but
higher than COAPT trial. Copyright © 2023 The Author(s)

<28>
Accession Number
2024958150
Title
Adipokines are possible risk markers for aortic stenosis requiring
surgery.
Source
Scandinavian Cardiovascular Journal. 57(1) (no pagination), 2023. Article
Number: 2247193. Date of Publication: 2023.
Author
Hansen N.; Ljungberg J.; Bergdahl I.A.; Hultdin J.; Naslund U.; Johansson
B.; Soderberg S.
Institution
(Hansen, Ljungberg, Naslund, Johansson, Soderberg) Department of Public
Health and Clinical Medicine, Medicine, Umea University, Umea, Sweden
(Bergdahl) Department of Biobank Research, Umea University, Sweden
(Hultdin) Department of Medical Biosciences, Clinical Chemistry, Umea
University, Umea, Sweden
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Aortic stenosis (AS) is the most prevalent valvular heart
disease among adults. The adipocyte-derived hormones, leptin and
adiponectin, have profound metabolic actions. We examined whether these
adipokines are independently associated with future aortic valve
replacement (AVR). Design(s): In this longitudinal case-control
study, we identified 336 cases who had undergone AVR due to AS, and who
had previously participated in population-based health surveys. Two
referents were matched to each case and leptin and adiponectin
concentrations were analysed from stored baseline survey samples. Uni- and
multivariable logistic regression analyses were used to estimate the risk
of future AVR. An additional cohort was identified for validation
including 106 cases with AVR and 212 matched referents. Result(s):
Median age (interquartile range (IQR)) in years at survey was 59.9 (10.4)
and at surgery 68.3 (12.7), and 48% were women. An elevated concentration
of leptin was not associated with future AVR (odds ratio [95% confidence
interval]) (1.10 [0.92-1.32]), although leptin was associated with a
higher risk in patients with coronary artery disease (CAD) having more
than 5 years between survey and AVR (1.41 [1.08-1.84]). Adiponectin was
not associated with higher risk for future AVR (0.95 [0.82-1.11]),
although after stratification for age, higher levels were associated with
reduced risk for AVR in persons aged >=60 years at surgery (0.79
[0.64-0.98]). In the validation study, leptin was associated with future
AVR whereas adiponectin was not. None of the associations remained
significant after adjustment for body mass index (BMI).
 Conclusion(s): The adipokine leptin may promote the development of
AS. Copyright © 2023 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<29>
Accession Number
2023481062
Title
Mobile health technology integrated care in atrial fibrillation patients
with diabetes mellitus in China: A subgroup analysis of the mAFA-II
cluster randomized clinical trial.
Source
European Journal of Clinical Investigation. 53(9) (no pagination), 2023.
Article Number: e14031. Date of Publication: September 2023.
Author
Guo Y.; Corica B.; Romiti G.F.; Proietti M.; Zhang H.; Lip G.Y.H.
Institution
(Guo, Zhang, Lip) Department of Pulmonary Vessel and Thrombotic Disease,
Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing,
China
(Guo, Corica, Romiti, Proietti, Lip) Liverpool Centre for Cardiovascular
Sciences at University of Liverpool, Liverpool John Moores University and
Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Corica, Romiti) Department of Translational and Precision Medicine,
Sapienza - University of Rome, Rome, Italy
(Proietti) Department of Clinical Sciences and Community Health,
University of Milan, Milan, Italy
(Proietti) Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri,
Milan, Italy
(Lip) Danish Center for Clinical Health Services Research, Aalborg
University, Aalborg, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: The Mobile Health Technology for Improved Screening and
Optimized Integrated Care in AF (mAFA-II) prospective randomized trial
showed the efficacy of a mobile health (mHealth) implemented 'Atrial
fibrillation Better Care' (ABC) pathway for the integrated care management
of patients with atrial fibrillation (AF). In this ancillary analysis, we
evaluated the effect of mAFA intervention according to the history of
diabetes mellitus (DM). Method(s): The mAFA-II trial enrolled 3324 AF
patients across 40 centres in China, between June 2018 and August 2019. In
this analysis, we assessed the interaction between history of DM and the
effect of mAFA intervention on the risk of the primary composite outcome
of stroke, thromboembolism, all-cause death and rehospitalizations.
Results were expressed as adjusted hazard ratio (aHR) and 95% confidence
intervals (95%CI). The effect of mAFA intervention on exploratory
secondary outcomes was also assessed. Result(s): Overall, 747 (22.5%)
patients had DM (mean age: 72.7 +/- 12.3, 39.6% females; 381 allocated to
mAFA intervention). mAFA intervention was associated with a significant
risk reduction for the primary composite outcome both in patients with and
without DM (aHR [95%CI]:.36 [.18-.73] and.37 [.23-.61], respectively, p
for interaction =.941). A significant interaction was found only for the
composite of recurrent AF, heart failure and acute coronary syndromes
(p<inf>int</inf> =.025), with lower effect of mAFA intervention in
patients with DM. Conclusion(s): A mHealth-technology implemented ABC
pathway showed a consistent effect in reducing the risk of the primary
composite outcome in AF patients with and without DM. Trial Registration:
WHO International Clinical Trials Registry Platform (ICTRP) Registration
number: ChiCTR-OOC-17014138. Copyright © 2023 The Authors.
European Journal of Clinical Investigation published by John Wiley & Sons
Ltd on behalf of Stichting European Society for Clinical Investigation
Journal Foundation.

<30>
Accession Number
2026553753
Title
Combination prophylactic amiodarone with beta-blockers versus
beta-blockers in atrial fibrillation after cardiac surgery: A
systematic-review and meta-analysis.
Source
Heart and Lung. 62 (pp 256-263), 2023. Date of Publication: 01 Nov 2023.
Author
Polintan E.T.; Monsalve R.; Menghrajani R.H.; Sirilan K.Y.; Nayak S.S.;
Abdelmaseeh P.; Patarroyo-Aponte G.; Lo K.B.; Dani S.S.
Institution
(Polintan) Department of Internal Medicine, SSM-Health St. Mary's
Hospital, St. Louis, MO, United States
(Monsalve) College of Medicine, Our Lady of Fatima University, Valenzuela
City, Philippines
(Menghrajani, Sirilan) Department of Internal Medicine, Lincoln Medical
Center, Bronx, NY, United States
(Nayak) Division of Hospital Medicine, Department of Internal Medicine,
Yale New Haven Bridgeport Hospital, Bridgeport, CT, United States
(Abdelmaseeh) Department of Medicine, Christiana Care Hospital, Delaware,
United States
(Patarroyo-Aponte) Division of Pulmonary, Critical Care and Sleep
Medicine, Department of Internal Medicine, McGovern Medical School, The
University of Texas Health Science Center at Houston, Houston, TX, United
States
(Lo) Department of Medicine, Einstein Medical Center, Sidney Kimmel
College of Medicine Thomas Jefferson University, Philadelphia, PA, United
States
(Dani) Department of Cardiology, Lahey Hospital & Medical Center,
Burlington, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Guideline recommendations regarding the preferred preventive
measures for postoperative atrial fibrillation (POAF) are unclear, nor
have we found any review articles addressing the combination of amiodarone
and beta-blockers for the prevention of POAF. Objective(s): To
investigate the efficacy and safety of combination beta-blockers and
amiodarone in the prevention of POAF while also comparing the use of
amiodarone and beta-blockers individually. Method(s): We used Pubmed
as the primary resource. POAF incidence was the primary outcome of this
study. The secondary outcomes were hospital length of stay (LOS), ICU LOS,
treatment-related drug discontinuation (TRDD), and mortality. The
random-effects model assessed all pooled outcomes with 95% confidence
intervals. Statistical significance was set at p<=0.05. Result(s):
The amiodarone subgroup of POAF incidence saw a Risk Ratio (RR) of 0.81
[0.63, 1.06], p=0.12, while the combination subgroup resulted in a RR of
0.63 [0.49, 0.80], p <0.001. TRDD for the amiodarone subgroup resulted in
a RR of 0.68 [0.25, 1.82], p=0.44, while the combination subgroup saw a RR
of 0.84 [0.57, 1.23], p=0.36. For mortality, the amiodarone subgroup
resulted in a RR of 0.97 [0.48, 1.98], p=0.93, while the combination
subgroup resulted in a RR of 1.04 [0.27, 4.05], p=0.96. Both hospital and
ICU LOS saw no significant difference between treatment arms for both the
combination subgroup and amiodarone alone. Except for the incidence of
postoperative atrial fibrillation (POAF) in the combination prophylaxis
group, most of the measured outcomes did not meet the optimized
information size (OIS) that was estimated. Conclusion(s): Combination
prophylaxis with amiodarone and beta-blockers significantly lowered risks
of POAF incidence in comparison to beta-blockers alone while also having
comparative mortality and TRDD outcomes. Copyright © 2023
Elsevier Inc.

<31>
Accession Number
642100938
Title
Closed-Loop ventilation using sidestream versus mainstream capnography for
automated adjustments of minute ventilation-A randomized clinical trial in
cardiac surgery patients.
Source
PloS one. 18(8) (pp e0289412), 2023. Date of Publication: 2023.
Author
Nijbroek S.G.L.H.; Roozeman J.-P.; Ettayeby S.; Rosenberg N.M.; van Meenen
D.M.P.; Cherpanath T.G.V.; Lagrand W.K.; Tepaske R.; Klautz R.J.M.; Serpa
Neto A.; Schultz M.J.
Institution
(Nijbroek, Roozeman, Ettayeby, Rosenberg, van Meenen, Cherpanath, Lagrand,
Tepaske, Serpa Neto, Schultz) Department of Intensive Care, Amsterdam
University Medical Centers, Location AMC, Amsterdam, Netherlands
(Nijbroek, Roozeman, van Meenen) Department of Anesthesiology, Amsterdam
University Medical Centers, Location AMC, Amsterdam, Netherlands
(Rosenberg) Department of Internal Medicine, Spaarne Hospital, Haarlem,
Netherlands
(Klautz) Department of Cardiothoracic Surgery, Amsterdam University
Medical Centers, Location AMC, Amsterdam, Netherlands
(Klautz) Department of Cardiothoracic Surgery, Leiden University Medical
Center, Leiden, Netherlands
(Serpa Neto) Australian and New Zealand Intensive Care Research Centre
(ANZIC-RC), School of Public Health and Preventive Medicine, Monash
University, Melbourne, Australia
(Serpa Neto) Laboratory of Experimental Intensive Care and Anesthesiology
(L.E.I.C.A), Amsterdam University Medical Centers, Location AMC,
Amsterdam, Netherlands
(Serpa Neto) Department of Critical Care, Austin Hospital, Melbourne
Medical School, University of Melbourne, Melbourne, Australia
(Serpa Neto) Department of Critical Care Medicine, Hospital Israelita
Albert Einstein, Sao Paolo, Brazil
(Schultz) Nuffield Department of Medicine, University of Oxford, Oxford,
United Kingdom
(Schultz) Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol
University, Bangkok, Thailand
Publisher
NLM (Medline)
Abstract
BACKGROUND: INTELLiVENT-Adaptive Support Ventilation (ASV) is a
closed-loop ventilation mode that uses capnography to adjust tidal volume
(VT) and respiratory rate according to a user-set end-tidal CO2 (etCO2)
target range. We compared sidestream versus mainstream capnography with
this ventilation mode with respect to the quality of breathing in patients
after cardiac surgery. METHOD(S): Single-center, single-blinded,
non-inferiority, randomized clinical trial in adult patients scheduled for
elective cardiac surgery that were expected to receive at least two hours
of postoperative ventilation in the ICU. Patients were randomized 1:1 to
closed-loop ventilation with sidestream or mainstream capnography. Each
breath was classified into a zone based on the measured VT, maximum airway
pressure, etCO2 and pulse oximetry. The primary outcome was the proportion
of breaths spent in a predefined 'optimal' zone of ventilation during the
first three hours of postoperative ventilation, with a non-inferiority
margin for the difference in the proportions set at -20%. Secondary
endpoints included the proportion of breaths in predefined 'acceptable'
and 'critical' zones of ventilation, and the proportion of breaths with
hypoxemia. RESULT(S): Of 80 randomized subjects, 78 were included in
the intention-to-treat analysis. We could not confirm the non-inferiority
of closed-loop ventilation using sidestream with respect to the proportion
of breaths in the 'optimal' zone (mean ratio 0.87 [0.77 to ]; P = 0.116
for non-inferiority). The proportion of breaths with hypoxemia was higher
in the sidestream capnography group versus the mainstream capnography
group. CONCLUSION(S): We could not confirm that INTELLiVENT-ASV using
sidestream capnography is non-inferior to INTELLiVENT-ASV using mainstream
capnography with respect to the quality of breathing in subjects receiving
postoperative ventilation after cardiac surgery. TRIAL REGISTRATION:
NCT04599491 (clinicaltrials.gov). Copyright: © 2023 Nijbroek 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.

<32>
Accession Number
641723489
Title
Prognostic Value of Pretreatment Serum Carcinoembryonic Antigen Level in
1130 Patients With Non-small Cell Lung Cancer: A Propensity Score Matching
Cohort Study and Cumulative Meta-analysis.
Source
American journal of clinical oncology. 46(9) (pp 399-408), 2023. Date of
Publication: 01 Sep 2023.
Author
Li F.; Lv Q.; Wang Y.; Zhao S.; Guo T.; Wang G.; Gu C.
Institution
(Li, Zhao, Guo, Gu) Department of Thoracic Surgery, First Affiliated
Hospital of Dalian Medical University, Dalian, Liaoning, China
(Li, Zhao, Guo, Gu) Lung Cancer Diagnosis and Treatment Center, Dalian,
Liaoning, China
(Lv) Department of Oncology, First Affiliated Hospital of Dalian Medical
University, Dalian, Liaoning, China
(Lv, Wang) Graduate school, Dalian Medical University, Dalian, Liaoning,
China
(Wang) Institute of Neurology, General Hospital of Shenyang Military
Command, Shenyang, Liaoning, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Carcinoembryonic antigen (CEA) is the most frequently used
tumor marker for non-small cell lung cancer (NSCLC). The current study
aimed to provide the highest-level evidence of the prognostic value of
pretreatment serum CEA level for NSCLC through the appropriate statistical
methodology and large-sample cohorts. METHOD(S): The current
retrospective cohort study with 1130 patients with NSCLC treated by
thoracic surgery with pretreatment serum CEA concentrations above/below 5
ng/mL. Propensity score matching, Kaplan-Miere survival analysis, and Cox
proportional hazard regression models were used to study the intergroup
variance. The overall/disease-free hazard ratios (HRs) of the current
study were combined with the previously published studies using cumulative
meta-analysis to provide the highest-level evidence. RESULT(S):
Intergroup confounding variables were well controlled by propensity score
matching, and the survival differences were statistically significant. The
Cox univariate analysis showed that the overall and disease-free HRs of
the high CEA towards patients with low CEA were 1.595 (95% CI:
1.329-1.863, P = 0.004) and 1.498 (95% CI: 1.271-1.881, P = 0.004). The
HRs of multivariate analysis were adjusted to 1.586 (95% CI: 1.398-1.812,
P = 0.016) and 1.413 (95% CI: 1.22-1.734, P = 0.022) respectively. The
cumulative meta-analysis showed that the cumulative overall HR was in
accord with previous studies, and the cumulative disease-free HR turn to
be statistically significant. CONCLUSION(S): Pretreatment serum CEA
level was an independent influence factor of overall/disease-free survival
of patients with NSCLC, and even for patients with the same pTNM stages or
pathologic stages, it is used for prognosis. Copyright © 2023
Wolters Kluwer Health, Inc. All rights reserved.

<33>
Accession Number
642110152
Title
Transcatheter tricuspid valve repair: results according to TV morphology.
Source
European Heart Journal Cardiovascular Imaging. Conference: European
Association of Cardiovascular Imaging Congress, EACVI 2023. Barcelona
Spain. 24(Supplement 1) (pp i613-i614), 2023. Date of Publication: June
2023.
Author
Barreiro Perez M.; Sanchis Ruiz L.; Chi Hion L.; Monivas Palomero V.;
Garrote C.; Diaz Pelaez E.; Mesa Rubio D.; Arzamendi D.; Freixa X.;
Estevez Loureiro R.
Institution
(Barreiro Perez, Sanchis Ruiz, Chi Hion, Monivas Palomero, Garrote, Diaz
Pelaez, Mesa Rubio, Arzamendi, Freixa, Estevez Loureiro) 1Hospital
Universitario Alvaro Cunqueiro, Vigo, Spain Barcelona Hospital Clinic,
Cardiology, Barcelona, Spain Sant Pau Hospital, Cardiology, Barcelona,
Spain Puerta de Hierro Majadahonda University Hospital, Cardiology,
Majadahonda, Madrid, Spain Hospital of Leon, Cardiology, Leon, Spain
University Hospital of Salamanca - IBSAL, Cardiology, Salamanca, Spain
University Hospital Reina Sofia, Cardiology, Cordoba, Spain
Publisher
Oxford University Press
Abstract
Introduction: Tricuspid regurgitation is a prevalent and undertreated
condition. Transcatheter edge-to-edge tricuspid valve repair (TTVR E2E) is
an emergent option with promising procedural results in clinical trial and
selected high-experienced centres. Tricuspid valve (TV) anatomy is highly
variable. Whether different morphologies have a clinical or procedural
impact over TTVR results are unclear. Purpose(s): Our aim is to
define the procedural, clinical and echocardiographic results of TTVR E2E
technique in a "real-world" population according to TV anatomy.
 Method(s): We collected all TTVR E2E cases from 8 University
Hospitals with large experience in SHDI from 2017 to 2022. It was a
prospective inclusion, not randomized (real-world clinical practice). The
TV morphology according to Hahn R. et al classification. Different devices
(Mitraclip, Triclip and PASCAL) were employed. Clinical and
echocardiographic follow-up were collected at 3 and 12 months after index
procedure. We defined a combined clinical endpoint of all-cause death, HF
admission and TV reintervention Results: 147 consecutive patients were
recruited (74 years old, 74% female). The baseline profile was HTN 68%,
DM-2 21%, DLP 44%, atrial fibrillation 91%, previous CAD 19% and previous
cardiac surgery 42%, COPD 19% and CKD 42%, STS mean 5,8 pts. The TR was
>=severe in all patients (vena contracta mean 12mm, gap size 7mm).
According to the procedure, the most employed device was Triclip XT (70%,
1,7 devices/ patient, 89% in anteroseptal commissure), with a procedural
success of 99% and 93% without clinical complications. In our cohort, TV
anatomy was conformed by 3 leaflets in 56% and 4 leaflets in 37% of cases.
The morphology distribution was type I (50%), IIIB (31%), and a much lower
frequent distribution of the other types (Figure 1). A significant TR
reduction was accomplished in all TV morphologies without significant
differences between them (Figure 2). The most frequent morphology (type I)
versus the rest of morphologies, not revealed differences in terms of TR
reduction or combined clinical endpoint. Restrictive septal leaflet
presence (39%) is related with higher partial detachment prevalence (87 vs
17%, p 0,03). No other morphology parameters were related with procedural
or clinical endpoint. Conclusion(s): TV morphology was highly
variable (50% of patients are non-Type I) being type I and IIIB the most
prevalent. Posterior leaflet anatomy was the highest variable. Not
differences were noted in TR reduction or clinical outcomes according to
TV morphology. A restrictive septal leaflet were related with higher
prevalence of partial detachment.

<34>
Accession Number
642110054
Title
Prognostic value of left atrial strain by speckle tracking
echocardiography in acute and chronic heart failure: a meta-analysis and
meta-regression analysis.
Source
European Heart Journal Cardiovascular Imaging. Conference: European
Association of Cardiovascular Imaging Congress, EACVI 2023. Barcelona
Spain. 24(Supplement 1) (pp i674-i675), 2023. Date of Publication: June
2023.
Author
Pastore M.C.; Mandoli G.E.; Stefanini A.; Iuliano M.A.; Saglietto A.;
Vigna M.; Carrucola C.; Fusini L.; Cavigli L.; D'ascenzi F.; Focardi M.;
Valente S.; Cameli M.
Institution
(Pastore, Mandoli, Stefanini, Iuliano, Saglietto, Vigna, Carrucola,
Fusini, Cavigli, D'ascenzi, Focardi, Valente, Cameli) 1University of
Siena, Siena, Italy Hospital Citta Della Salute e della Scienza di Torino,
Division of Cardiology, Cardiovascular and thoracic Department, Turin,
Italy IRCCS Monzino Cardiology Center, Milan, Italy
Publisher
Oxford University Press
Abstract
Background: Heart failure (HF) is a global health burden which prognostic
assessment is currently challenging. Speckle tracking echocardiography
(STE) has gained increasing importance for the diagnostic and prognostic
assessment of HF. Left atrial (LA) strain by STE is widely recognized as
an index of diastolic function and left ventricular (LV) filling pressures
and fibrosis. Moreover, many studies have investigated its prognostic
value in HF with reduced, mildly reduced and preserved ejection fraction
(HFrEF, HFmrEF and HFpEF). Objective(s): our aim was to
systematically investigate the prognostic value of peak atrial
longitudinal strain (PALS) for cardiovascular (CV) events in HF and its
variation in acute/chronic HF and according to LV function, age and
gender. Method(s): A systematic literature search of medical
databases including Pubmed, Scopus, Ovid Online, EMBASE, Web of Science,
Cochrane Central Register, Scopus was performed using PRISMA principles.
All relevant studies in English language reporting the predictive value of
LA strain for mortality and/or CV events (CV death, hospitalization for
HF, cardiac transplant, ventricular assist device implant) in HFrEF,
HFmrEF and HFpEF, with follow up >6 months were identified. All-cause
mortality and HF hospitalizations were considered as primary endpoint.
Hazard ratios (HR) were performed using a random effect model reporting on
the association of global PALS and outcome and described as pooled
estimates with 95% confidence intervals (CI). Result(s): Eight
studies (5767 patients, median [IQR] age=66.3 [65;68.6], 37% female)
satisfied the inclusion criteria (5 studies chronic HF, 2 studies acute
HF, 1 study in acute and chronic HF). Overall, 6 studies included patients
with HFrEF, 3 studies patients with HFmrEF and 5 patients with HFpEF.
Median global PALS value was 17.6 [14.9;26.8]%, median LVEF was 36
[30;56]% and median LV global longitudinal strain (GLS) was -9
[-7;-16.9]%. Over a median follow up of 903 [321;1062] months, 2688
patients reached the primary endpoint (944 all-cause mortality, 1963 HF
hospitalization). Each unit decrease in Global PALS was independently
associated with a 5% increase for the primary endpoint (meta-analytic HR
1.05; 95% CI [1.02-1.07]; p<0.01). Subgroup analysis conducted in patients
with acute and chronic HF showed no differences (p = 0.18).
Meta-regression analysis showed that the prognostic value of global PALS
was higher for lower LVEF values (beta=-0.0023), a similar trend was
observed for worse LV GLS and lower age without reaching statistical
significance. Funnel plot analysis showed no publication bias (Egger's p =
0.45). Conclusion(s): Global PALS may be used as a useful prognostic
tool in HF, both in acute and chronic setting and especially in patients
with HFrEF, providing an additional independent value for risk
stratification of these patients in clinical practice.

<35>
Accession Number
2025066157
Title
Femoral or Axillary Cannulation for Extracorporeal Circulation during
Minimally Invasive Heart Valve Surgery (FAMI): Protocol for a Multi-Center
Prospective Randomized Trial.
Source
Journal of Clinical Medicine. 12(16) (no pagination), 2023. Article
Number: 5344. Date of Publication: August 2023.
Author
Kruse J.; Silaschi M.; Velten M.; Wittmann M.; Alaj E.; Ahmad A.E.-S.;
Zimmer S.; Borger M.A.; Bakhtiary F.
Institution
(Kruse, Silaschi, Alaj, Ahmad, Bakhtiary) Department of Cardiac Surgery,
University Hospital Bonn, Bonn 53127, Germany
(Velten, Wittmann) Department of Anesthesiology and Intensive Care
Medicine, University Hospital Bonn, Bonn 53127, Germany
(Zimmer) Department of Cardiology, University Hospital Bonn, Bonn 53127,
Germany
(Borger) Department of Cardiac Surgery, Leipzig Heart Center, Leipzig
04289, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Minimally invasive heart valve surgery via anterolateral
mini-thoracotomy with full endoscopic 3D visualization (MIS) has become
the standard treatment of patients with valvular heart disease and low
operative risk over the past two decades. It requires extracorporeal
circulation and cardioplegic arrest. The most established form of arterial
cannulation for MIS is through the femoral artery and is used by most
surgeons, but it is suspected to increase the risk of stroke through
retrograde blood flow. An alternative route of cannulation is the axillary
artery, producing antegrade blood flow during extracorporeal circulation.
 Method(s): Femoral or axillary cannulation for extracorporeal
circulation during minimally invasive heart valve surgery (FAMI) is a
multicenter randomized controlled trial designed to determine whether
axillary cannulation is superior to femoral cannulation for the outcome of
a manifest stroke within 7 days postoperatively. The target sample size
was 848 participants. Patients >= 18 years of age, with valvular
regurgitation or stenosis scheduled for minimally invasive surgery via
anterolateral mini-thoracotomy, were randomized to axillary cannulation
(treatment group) or to femoral cannulation (standard care). Patients were
followed up for seven days postoperatively. A CT scan was performed
pre-operatively to screen patients for vascular calcifications and to
assess the safety of femoral cannulation. The standard of care is femoral
artery cannulation, but is performed only in patients without significant
vascular calcifications or severe kinking of the iliac arteries and in
patients with sufficient vessel diameter. The cannulation is performed via
Seldinger's technique, and the vessel closed percutaneously using a
plug-based vascular closure device. Only patients without significant
vascular calcifications are considered for femoral cannulation, as an
increased risk of stroke is assumed. In patients with vascular
calcifications, axillary cannulation is the standard of care to avoid
these risks. Retrospective studies have hinted that, even in patients
without vascular calcifications, there may be a lower stroke risk with
axillary cannulation compared to femoral cannulation. We present a
protocol for a multi-center randomized trial to investigate this
hypothesis. Discussion(s): To date, evidence on the best access for
peripheral artery cannulation during minimally invasive heart valve
surgery has been scarce. Patients may benefit from axillary cannulation
for extracorporeal circulation in terms of stroke risk and other
neurological and vascular complications, though femoral cannulation is the
gold standard. The aim of this study is to determine the risks of
peri-operative stroke in a prospective randomized comparison of femoral
vs. axillary cannulation. Copyright © 2023 by the authors.

<36>
Accession Number
2025062969
Title
The Effects of Exercise Training on Exercise Capacity and Vascular
Function after Transcatheter Aortic Valve Implantation-A Pilot Study.
Source
Journal of Cardiovascular Development and Disease. 10(8) (no pagination),
2023. Article Number: 343. Date of Publication: August 2023.
Author
Vitez L.; Bunc M.; Jug B.
Institution
(Vitez, Bunc) Department of Cardiology, Division of Internal Medicine,
University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
(Vitez, Bunc, Jug) Faculty of Medicine, University of Ljubljana, Ljubljana
1000, Slovenia
(Jug) Department of Vascular Diseases, Division of Internal Medicine,
University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transcatheter aortic valve implantation (TAVI) improves event-free
survival in patients with severe aortic stenosis, but patients' exercise
capacity remains poor after the procedure. Therefore, we sought to compare
the effects of a supervised center-based exercise training program and
unsupervised exercise routine on exercise capacity and vascular function
in patients after TAVI. Patients were randomized to either center-based
exercise training (12-24 sessions of combined aerobic and low-weight
resistance training twice weekly for 8-12 weeks) or an unsupervised
home-based exercise routine (initial appraisal with detailed
recommendations and monthly follow-up). Exercise capacity (cardiopulmonary
testing) and vascular function (ultrasonographic measurement of
flow-mediated vasodilation (FMD) and arterial stiffness) were assessed at
the baseline and after the study period. We included 23 patients (mean age
of 81 years, 61% women), with higher-than-expected drop-out rates (41%)
because of the coronavirus-19 pandemic outbreak. Exercise capacity
improved over time, irrespective of the intervention group: 0.09 mL/min/kg
increase in peak oxygen uptake (95% CI [0.01-0.16]; p = 0.02), 8.2 Watts
increase in workload (95% CI [0.6-15.8]; p = 0.034), and 47 s increase in
cumulative exercise time (95% CI [5.0-89.6]; p = 0.029). A between-group
difference in change over time (treatment effect) was detected only for
FMD (4.49%; 95% CI [2.35; 6.63], p < 0.001), but not for other outcome
variables. Both supervised and unsupervised exercise training improve
exercise capacity and vascular function in patients after TAVI, with
supervised exercise training possibly yielding larger improvements in
vascular function, as determined by FMD. Copyright © 2023 by the
authors.

<37>
Accession Number
642118016
Title
Clinical Benefit of Bempedoic Acid in Randomized Clinical Trials.
Source
The American journal of cardiology. 205 (pp 321-324), 2023. Date of
Publication: 24 Aug 2023.
Author
Cordero A.; Fernandez Olmo R.; Santos-Gallego C.G.; Facila L.; Bonanad C.;
Castellano J.M.; Rodriguez-Manero M.; Seijas-Amigo J.; Gonzalez-Juanatey
J.R.; Badimon J.J.
Institution
(Cordero) Cardiology Department, Hospital IMED Elche, Elche, Spain; Grupo
de Investigacion Cardiovascular (GRINCAVA), Universidad Miguel Hernandez,
Elche, Spain; Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Fernandez Olmo) Cardiology Department, Hospital General Jaen, Jaen, Spain
(Santos-Gallego) Atherothrombosis Research Unit. Mount Sinai School of
Medicine, New York, New York; Atherothrombosis Research Unit Mount Sinai
Health, Icahn School of Medicine at Mount Siani, New York City, New York
(Facila) Cardiology Department, Hospital General, Valencia, Spain
(Bonanad) Cardiology Department, Hospital Clinico, Valencia, Spain
(Castellano) Centro Integral de Enfermedades Cardiovasculares (CIEC),
Hospital Universitario HM Monteprincipe, Grupo HM Hospitales, Madrid,
Spain
(Rodriguez-Manero, Seijas-Amigo, Gonzalez-Juanatey) Centro de
Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV),
Madrid, Spain; Cardiology Department, Complejo Hospitalario de la
Universidad de Santiago de Compostela, Santiago, Spain
(Badimon) Cardiology Department, Hospital General Jaen, Jaen, Spain;
Atherothrombosis Research Unit. Mount Sinai School of Medicine, New York,
New York
Publisher
NLM (Medline)
Abstract
Bempedoic acid is a selective inhibitor of the adenosine triphosphate
citrate lyase that reduces low-density lipoprotein cholesterol (LDLc)
levels by 17% to 28%. Although the Evaluation of Major Cardiovascular
Events in Patients With, or at High Risk for, Cardiovascular Disease Who
Are Statin Intolerant Treated With Bempedoic Acid (CLEAR-OUTCOMES) trials
demonstrated the efficacy on cardiovascular outcomes there is a
controversy related to the possible net clinical benefit. Thereafter, we
performed an intention-to-treat meta-analysis in line with recommendations
from the Cochrane Collaboration and the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary
outcome of the metanalysis was the incidence of major adverse
cardiovascular events, defined by each study protocol. Secondary outcomes
for the analyses were myocardial infarction, stroke, myocardial
revascularization, cardiovascular death, and all-cause death. Results of 4
clinical trials evaluated contained a total of 17,324 patients; 9,236
received bempedoic acid for a median of 46.6 months. The mean baseline
LDLc was 129.4 (22.8) mg/100 ml and treatment was associated with a mean
LDLc reduction of 26.0 (12.6) mg/100 ml. Treatment with bempedoic acid
significantly reduced the incidence of major adverse cardiovascular events
(hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.81 to 0.96),
myocardial infarction (HR 0.76, 95% CI 0.66 to 0.89) and myocardial
revascularization (HR 0.82, 95% CI 0.73 to 0.92); the crude incidence of
stroke, cardiovascular or all-cause mortality were lower in patients in
the bempedoic acid groups although no significant risk reduction was
observed. No heterogeneity was observed in any of the end points. In
conclusion, the metanalysis of the 4 clinical trials currently available
with bempedoic acid provides reliable evidence of its clinical benefit
with no signs of heterogeneity or harm. Copyright © 2023 Elsevier
Inc. All rights reserved.

<38>
Accession Number
642116883
Title
The Prognostic Value of Qualitative and Quantitative Stress CMR in
Patients with Known or Suspected CAD.
Source
JACC. Cardiovascular imaging. (no pagination), 2023. Date of Publication:
14 Aug 2023.
Author
Yarahmadi P.; Forouzannia S.M.; Forouzannia S.A.; Malik S.B.; Yousefifard
M.; Nguyen P.K.
Institution
(Yarahmadi, Nguyen) Department of Medicine, Division of Cardiovascular
Medicine, Stanford University, Stanford, California, USA; Stanford
Cardiovascular Institute, Stanford, California, USA
(Forouzannia) Department of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Forouzannia) Department of Medicine, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Malik) Department of Radiology, Division of Cardiovascular Imaging,
Stanford University, Stanford, CA, United States
(Yousefifard) Physiology Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: Recent studies suggest that quantitative cardiac magnetic
resonance (CMR) may have more accuracy than qualitative CMR in coronary
artery disease (CAD) diagnosis. However, the prognostic value of
quantitative and qualitative CMR has not been compared systematically.
 OBJECTIVE(S): The objective was to conduct a systematic review and
meta-analysis assessing the utility of qualitative and quantitative stress
CMR in the prognosis of patients with known or suspected CAD.
 METHOD(S): A comprehensive search was performed through Embase,
Scopus, Web of Science, and Medline. Studies that used qualitative
vasodilator CMR or quantitative CMR assessments to compare the prognosis
of patients with positive and negative CMR results were extracted. A
meta-analysis was then performed to assess: 1) major adverse
cardiovascular events (MACE) including cardiac death, nonfatal myocardial
infarction (MI), unstable angina, and coronary revascularization; and 2)
cardiac hard events defined as the composite of cardiac death and nonfatal
MI. RESULT(S): Forty-one studies with 38,030 patients were included
in this systematic review. MACE occurred significantly more in patients
with positive qualitative (HR: 3.86; 95% CI: 3.28-4.54) and quantitative
(HR: 4.60; 95% CI: 1.60-13.21) CMR assessments. There was no significant
difference between qualitative and quantitative CMR assessments in
predicting MACE (P = 0.75). In studies with qualitative CMR assessment,
cardiac hard events (OR: 7.21; 95% CI: 4.99-10.41), cardiac death (OR:
5.63; 95% CI: 2.46-12.92), nonfatal MI (OR: 7.46; 95% CI: 3.49-15.96),
coronary revascularization (OR: 6.34; 95% CI: 3.42-1.75), and all-cause
mortality (HR: 1.66; 95% CI: 1.12-2.47) were higher in patients with
positive CMR. CONCLUSION(S): The presence of myocardial ischemia on
CMR is associated with worse clinical outcomes in patients with known or
suspected CAD. Both qualitative and quantitative stress CMR assessments
are helpful tools for predicting clinical outcomes. Copyright ©
2023 American College of Cardiology Foundation. Published by Elsevier Inc.
All rights reserved.

<39>
Accession Number
642114391
Title
Five-year outcomes of off and on-pump CABG: Insights from PROMOTE Patency
Trial.
Source
Asian cardiovascular & thoracic annals. (pp 2184923231197642), 2023. Date
of Publication: 25 Aug 2023.
Author
Sajja L.R.; Sarkar K.; Mannam G.; Padmanabhan C.; Narayan P.; Kamtam D.N.;
Balakrishna N.; Kodali V.K.K.; Mulay A.; Peter S.; Beri P.
Institution
(Sajja, Mannam) Division of Cardiothoracic Surgery, Star Hospitals,
Hyderabad, India
(Sajja, Kamtam, Beri) Division of Clinical Research in Cardiovascular
Medicine/Surgery, Sajja Heart Foundation, Hyderabad, India
(Sarkar) Division of Cardiothoracic Surgery, Medica Superspeciality
Hospital, Kolkata, India
(Padmanabhan) Division of Cardiothoracic Surgery, Kuppuswamy Naidu
Memorial Hospital, Coimbatore, India
(Narayan) Division of Cardiothoracic Surgery, Rabindranath Tagore
International Institute of Cardiac Sciences, Kolkata, India
(Balakrishna) Department of Biostatistics, Sajja Heart Foundation,
Hyderabad, India
(Kodali) Division of Cardiothoracic Surgery, Krishna Institute of Medical
Sciences, Secunderabad, India
(Mulay) Division of Cardiothoracic Surgery, Sir H. N. Reliance Foundation
Hospital and Research Centre, Mumbai, India
(Peter) Division of Cardiothoracic Surgery, Nadiad, India
Publisher
NLM (Medline)
Abstract
BACKGROUND: There are limited studies reporting follow-up outcome data
comparing of off-pump coronary artery bypass (OPCAB) with on-pump (ONCAB)
technique. The aim of the study was to report the 5-year clinical outcomes
of OPCAB and ONCAB in a post hoc analysis of the PROMOTE patency trial.
 METHOD(S): From March 2016 through March 2017, a total of 321
patients undergoing coronary artery bypass grafting (CABG) were randomised
to either the off-pump or the on-pump technique. Data on all-cause
mortality, myocardial infarction (MI), cerebrovascular accident (CVA),
repeat revascularisation and need for renal replacement therapy (RRT) were
recorded. The composite and each of these individual outcomes are reported
at 5-year interval. RESULT(S): The mean follow-up period was 65.9
months (+/-3.39). A total of 275 (85.93%) patients followed up at the
5-year interval who underwent CABG by the off-pump (n=158) and the on-pump
(n=162) technique. The all-cause mortality was 8.9% and 5.7% in ONCAB and
OPCAB, respectively (hazard ratio [HR]=0.62; 95% confidence interval [CI]
0.25-1.57, p=0.31). The composite of all-cause mortality, non-fatal MI,
non-fatal CVA, RRT and need for repeat revascularisation was comparable in
both groups (7.1% vs. 11.9%, HR=0.57; 95% CI 0.25-1.31, p=0.18 in OPCAB
and ONCAB, respectively). The rates of 5-year non-fatal MI (p=0.2),
non-fatal CVA (p=0.36) and need for repeat revascularisation (p=1) were
similar in both groups. A sub-group analysis did not show any significant
interaction or effect modification with either of the techniques.
 CONCLUSION(S): The 5-year clinical outcomes of OPCAB are comparable
to ONCAB in low-risk patients undergoing CABG. Off-pump coronary artery
bypass had no additional benefit in any subgroup.

<40>
Accession Number
642114207
Title
Establishment of a national quality improvement process on oxygen delivery
index during cardiopulmonary bypass.
Source
Perfusion. (pp 2676591231198366), 2023. Date of Publication: 26 Aug 2023.
Author
Stammers A.H.; Chores J.B.; Tesdahl E.A.; Patel K.P.; Baeza J.; Mosca
M.S.; Varsamis M.; Petterson C.M.; Firstenberg M.S.; Jacobs J.P.
Institution
(Stammers, Chores, Tesdahl, Patel, Baeza) Medical Department, Brentwood,
TN, United States
(Mosca) DenverCOUnited States
(Varsamis) West Palm Beach, FL, United States
(Petterson) Kansas CityMOUnited States
(Firstenberg) William Novick Global Cardiac Alliance, Memphis, TN, United
States
(Jacobs) Division of Cardiovascular Surgery, Departments of Surgery and
Pediatrics, University of Florida, Gainesville, FL, United States
Publisher
NLM (Medline)
Abstract
Targeted oxygen delivery during cardiopulmonary bypass (CPB) has received
significant attention due to its influence on patient outcomes, especially
in mitigating acute kidney injury. While it has gained popularity in
select institutions, there remains a gap in establishing it globally
across multiple centers. The purpose of this investigation was to describe
the development of a quality improvement process of targeted oxygen
delivery during CPB across hospitals throughout the United States. A
systematic approach to utilize oxygen delivery index (DO2i) as a key
performance indicator within hospitals serviced by a national provider of
perfusion services. The process included a review of the current
literature on DO2i, which yielded a target nadir value (272 mL/min/m2) and
an area under the curve (DO2i272AUC) cut off of 632. All data is displayed
on a dashboard with results categorized across multiple levels from
system-wide to individual clinician performance. From January 2020 through
December 2022, DO2i data from 91 hospitals and 11,165 coronary artery
bypass graft procedures were collected. During this period the monthly
proportion of DO2i measurements above the target nadir DO2i272 ranged from
60.5% to 78.4% with a mean+/-SD of 70.8 +/- 4.2%. Binary logistic
regression for the first 7 months following monthly DO2i performance
reporting has shown a statistically significant positive linear trend in
the probability of achieving the target DO2i272 (p < .001), with a crude
increase of approximately 7.8% for DO2i272AUC, and a 73.8% success rate (p
< .001). A survey was sent to all individuals measuring oxygen delivery
during CPB to assess why a target DO2i272 could not be reached. The two
most common responses were an 'inability to improve CPB flow rates' and
'restrictive allogeneic red blood cell transfusion policies'. This study
demonstrates that targeting a minimum level of oxygen delivery can serve
as a key performance indicator during CPB using a structured quality
improvement process.

<41>
Accession Number
642108862
Title
Complications of endoscopic thoracic spine surgery: Overview and
complication avoidance.
Source
World neurosurgery. (no pagination), 2023. Date of Publication: 22 Aug
2023.
Author
Park M.-K.; Park J.-Y.; Son S.-K.
Institution
(Park) Department of Neurosurgery, Good GangAn Hospital, Busan, South
Korea
(Park) Department of Neurosurgery, Spine and Spinal cord Institute,
Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
South Korea
(Son) Department of Neurosurgery, Good Moonhwa Hospital, Busan, South
Korea
Publisher
NLM (Medline)
Abstract
Regarding the development of endoscopic thoracic spine surgery,
adaptations of thoracic surgical techniques such as full-endoscopic
uniportal and biportal surgical techniques have been developed.
Full-endoscopic uniportal surgery for thoracic disc herniation (TDH) or
thoracic ossified ligamentum flavum (OLF) has been performed via the
transforaminal and interlaminar approaches. In the case of thoracic OLF or
thoracic spinal stenosis, the uniportal interlaminar approach is
appropriate. The uniportal interlaminar approach has been used to treat
thoracic OLF and has shown good surgical results. Recently, thoracic OLF
removal via a biportal endoscopic technique has been developed and is
described in few studies. Although endoscopic thoracic spine surgery has
significant advantages, this endoscopic thoracic spine approach often
comes with complications. Herein, we reviewed the literature to date on
the complications associated with endoscopic spine surgery in thoracic
pathology. This review emphasizes how to avoid and manage complications.
Based on the results of several previous studies, endoscopic thoracic
spine surgery could be associated with fewer potential complications than
conventional surgery. Endoscopic spine surgery has remarkable advantages;
however, endoscopic thoracic surgery is technically challenging and
potentially comes with serious complications. To minimize the risk of
avoidable complications, surgeons should be familiar with prevention
methods and pitfalls. Copyright © 2023 Elsevier Inc. All rights
reserved.

<42>
Accession Number
2023599380
Title
Rationale and design of the colchicine for the prevention of perioperative
atrial fibrillation in patients undergoing major noncardiac thoracic
noncardiac thoracic surgery (COP-AF) trial.
Source
American Heart Journal. 259 (pp 87-96), 2023. Date of Publication: May
2023.
Author
Conen D.; Popova E.; Wang M.K.; Chan M.T.V.; Landoni G.; Reimer C.;
Srinathan S.K.; Cata J.P.; McLean S.R.; Reyes J.C.T.; Grande A.M.; Sessler
D.I.; Fleischmann E.; Maziak D.E.; Kabon B.; Voltolini L.;
Gutierrez-Soriano L.; Tandon V.; DuMerton D.; Kidane B.; Rajaram R.;
Shargall Y.; Neary J.D.; Wells J.R.; McIntyre W.F.; Blum S.; Ofori S.N.;
Vincent J.; Xu L.; Li Z.; Healey J.S.; Garg A.X.; Devereaux P.J.; Reiterer
C.; Taschner A.; Horvath K.; Adamowitsch N.; Zotti O.; Hantakova N.;
Hochreiter B.; Schmartz D.; Huybrechts I.; Cappeliez S.; Finley C.;
Agzarian J.; Hanna W.; Abdulrahman M.; Lawrence K.; Gregus K.; Quraishi
F.; Wikkerink S.; Wallace C.; Prine M.; Gregus E.; Hare J.; Lombardo K.;
Fezia B.; Columbus T.; Reid K.; Parlow J.; Chung W.; Karizhenskaia M.;
Malik A.; Liu R.; Tan L.; Gowing S.; Buduhan G.; Enns S.; Poole E.; Graham
K.; McGuire A.; Lohser J.; Lim S.; Grey R.; Grant K.; Lee A.L.; Choi J.J.;
Dewar L.R.; Yee J.; Andrew J.E. Seely; Gilbert S.; Villeneuve P.J.;
Sundaresan S.; Moffatt-Bruce S.D.; Gingrich M.; Fazekas A.; Bucciero K.;
Malthaner R.A.; Lewis D.; Fortin D.; Qiabi M.; Nayak R.; Plourde M.M.;
Sellers D.; Donahoe L.; Lefebvre M.; Lanthier L.; Schieman C.; Bessissow
A.; Joynt G.M.; Wong R.H.L.; Lau R.W.H.; Wong W.T.; Choi G.Y.S.; Lee E.;
Hui K.Y.; Fung B.; Chan C.S.; Montes F.R.; Castaneda L.C.; Tellez L.J.;
Ortiz-Ramirez L.M.; De Santis S.; Favaro G.; Muriana P.; Nakhnoukh C.;
Novellis P.; Turi S.; Veronesi G.; Angelini M.; Bongiolatti S.; Salvicchi
A.; Gatteschi L.; Indino R.; Tombelli S.; Ravasin A.; Salimbene O.;
Rosboch G.L.; Balzani E.; Massullo D.; Fiorelli S.; Londero F.; Grossi W.;
Wang C.Y.; Ng T.Y.; See W.S.; Amir M.; Nawaz M.A.; Tellez E.M.; Sanchis
J.B.; Canovas G.P.; Ruiz A.P.; Gutierrez E.C.; Guarino M.; Cuchi G.U.;
Nogues M.A.; Juan A.R.; Guerra-Ramos J.M.; Alvarez-Garcia J.;
Gonzalez-Osuna A.; Medina-Aedo M.; Roux D.P.; Martin L.G.; De Pablo
Pajares A.; Toha A.M.C.; Mata N.M.; Molina G.M.; Silva U.C.; Cabanero A.;
Fernandez S.F.; Tallada A.G.; Suarez S.G.; Ball M.R.; De Nadal Clanchet
M.; Ruiz-Villa L.; M.M. Marti-Ejarque; Gili-Bueno M.; Ferrandez J.H.;
Llobet N.P.; Cruz P.; Sanchez-Pedrosa G.; Duque P.; Azcarate L.;
Martin-Albo L.; Rodriguez-Fuster A.; Bermejo-Martinez S.; Carraminana A.;
Bossard M.; Minervini F.; Corrales G.; Guerra-Londono J.J.; Mehran R.;
Sepesi B.; Walsh G.; Rice D.; Cukierman D.S.; Marchant B.E.; Harris L.C.;
Cusson B.D.; Miller S.A.; Minear S.C.; Teixeira C.; Pimentel M.; Popoff
A.M.; Cheung W.L.; Marsack K.; Ayad S.; Araujo J.; Chen T.H.; Essandoh M.;
Poppers J.S.
Institution
(Conen, Wang, Wells, McIntyre, Blum, Ofori, Vincent, Xu, Li, Healey, Garg,
Devereaux) Population Health Research Institute, Hamilton, ON, Canada
(Conen, Wang, Tandon, Neary, McIntyre, Ofori, Xu, Healey, Devereaux)
Department of Medicine, McMaster University, Hamilton, ON, Canada
(Conen, Wang, McIntyre, Healey, Garg, Devereaux) Department of Health
Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON,
Canada
(Popova) Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
(Popova) Iberoamerican Cochrane Centre, Barcelona, Spain
(Chan, Joynt, Wong, Lau, Wong, Choi, Lee, Hui, Fung, Chan) The Chinese
University of Hong Kong, Shatin, Hong Kong
(Landoni, De Santis, Favaro, Muriana, Nakhnoukh, Novellis, Turi, Veronesi,
Angelini) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Reimer, DuMerton, Reid, Parlow, Chung, Karizhenskaia, Malik) Kingston
Health Sciences Centre, Kingston, ON, Canada
(Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB,
Canada
(Cata) Department of Anesthesiology and Perioperative Medicine, The
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(McLean) Department of Anesthesia, Vancouver Acute (Vancouver General
Hospital and UBC Hospital), The University of British Columbia, Vancouver,
BC, Canada
(McLean) Department of Anesthesia, Pharmacology and Therapeutics, The
University of British Columbia, Vancouver, BC, Canada
(Popova, Reyes, Tellez, Sanchis, Canovas, Ruiz, Gutierrez, Guarino, Cuchi,
Nogues, Juan, Guerra-Ramos, Alvarez-Garcia, Gonzalez-Osuna, Medina-Aedo)
Department of Thoracic Surgery, Hospital de la Santa Creu i Sant Pau,
Barcelona, Spain
(Grande, Roux, Martin, De Pablo Pajares, Toha, Mata, Molina, Silva,
Cabanero, Fernandez) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Tallada) Department of Anesthesiology, Hospital Universitari Vall
d'Hebron, Barcelona, Spain
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Fleischmann, Kabon, Reiterer, Taschner, Horvath, Adamowitsch, Zotti,
Hantakova, Hochreiter) Department of Anesthesia, Intensive Care Medicine
and Pain Medicine, Medical University of Vienna, Vienna, Austria
(Maziak) University of Ottawa, Ottawa, ON, Canada
(Voltolini, Bongiolatti, Salvicchi, Gatteschi, Indino, Tombelli, Ravasin,
Salimbene) Thoracic Surgery Unit, Careggi University Hospital, Florence,
Italy
(Gutierrez-Soriano) Department of Anesthesiology, Fundacion CardioInfantil
- Instituto de Cardiologia, Bogota, Colombia
(Kidane) Departments of Surgery, Physiology and Pathophysiology,
University of Manitoba, Winnipeg, MB, Canada
(Rajaram) Department of Cardiothoracic Surgery, The University of Texas MD
Anderson Cancer Center, Houston, TX, United States
(Shargall) Division of Thoracic Surgery, Department of Surgery, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
(Blum) Cardiovascular Research Institute Basel, University Hospital Basel,
Basel, Switzerland
(Ofori) University of Port Harcourt, Choba, Nigeria
(Garg) Departments of Medicine, Epidemiology and Biostatistics, Western
University, London, ON, Canada
(Ayad, Araujo) United Fairview Hospital, Cleveland Clinic, United States
(Schmartz) CHU Brugmann, Universitelibre de Bruxelle, Belgium
(Huybrechts) CUB Hopital Erasme, Universitelibrede Bruxell, Belgium
(Cappeliez) University Hospital of Charlero, Belgium
(Conen, Tandon, Shargall, Neary, Finley, Agzarian, Hanna, Abdulrahman,
Lawrence, Gregus, Quraishi, Wikkerink, Wallace, Prine, Gregus, Hare,
Lombardo, Fezia, Columbus) St. Joseph's Healthcare Hamilton, Canada
(Essandoh) United The Ohio State University Wexner Medical Center, United
States
(Srinathan, Kidane, Liu, Tan, Gowing, Buduhan, Enns, Poole, Graham) Health
Sciences Centre, Winnipeg, Canada
(McLean, McGuire, Lohser, Lim, Grey, Grant, Lee, Choi, Dewar, Yee)
Vancouver General Hospital, Canada
(Maziak, Andrew J.E. Seely, Gilbert, Villeneuve, Sundaresan,
Moffatt-Bruce, Gingrich, Fazekas, Bucciero) The Ottawa Hospital, Canada
(Malthaner, Lewis, Fortin, Qiabi, Nayak) London Health Sciences Centre,
Canada
(Plourde) Victoria General Hospital, Canada
(Sellers, Donahoe) Toronto General Hospital, Canada
(Lefebvre, Lanthier) CIUSSS de l'Estrie CHUS, Canada
(Schieman) Foothills Medical Centr, Canada
(Bessissow) Montreal General Hospital, Canada
(Poppers) United Stony Brook University Hospital, United States
(Gutierrez-Soriano, Montes, Castaneda, Tellez, Ortiz-Ramirez) Fundacion
Cardioinfantil Instituto de Cardiologia, Colombia
(Popoff, Cheung, Marsack) United Henry Ford Health, United States
(Minear, Teixeira, Pimentel) United Cleveland Clinic Florida, United
States
(Rosboch, Balzani) A.O.U. Cittadella Salute e della Scienza di Torino,
Italy
(Massullo, Fiorelli) Sant'Andrea Hospital, Italy
(Londero, Grossi) S. Maria della Misericordia University Hospital, Italy
(Wang, Ng) University Malaya Medical Centre, Malaysia
(See) Serdang Hospital, Malaysia
(Amir, Nawaz) Shifa International Hospital, Pakistan
(Marchant, Harris, Cusson, Miller) United Atrium Health Wake Forest
Baptist, United States
(Chen) United Rhode Island Hospital, United States
(Tallada, Suarez, Ball, De Nadal Clanchet) Hospital Universitari Vall
d'Hebron, Spain
(Ruiz-Villa, M.M. Marti-Ejarque, Gili-Bueno, Ferrandez, Llobet) Hospital
Universitari Sagrat Cor, Grupo Quironsalud, Spain
(Cruz, Sanchez-Pedrosa, Duque, Azcarate, Martin-Albo) Hospital
Universitary Gregorio Maranon, Spain
(Rodriguez-Fuster, Bermejo-Martinez) Hospital del Mar, Spain
(Carraminana) Hospital Clinic, Barcelon, Spain
(Bossard, Minervini) Luzerner Kantonsspita, Switzerland
(Cata, Rajaram, Corrales, Guerra-Londono, Mehran, Sepesi, Walsh, Rice,
Cukierman) United The University of Texas MD Anderson Cancer Center,
United States
Publisher
Elsevier Inc.
Abstract
Background: Perioperative atrial fibrillation (AF) and myocardial injury
after noncardiac surgery (MINS) are common complications after noncardiac
surgery. Inflammation has been implicated in the pathogenesis of both
disorders. The COP-AF trial tests the hypothesis that colchicine reduces
the incidence of perioperative AF and MINS in patients undergoing major
noncardiac thoracic surgery. Methods and Results: The 'COlchicine for
the Prevention of Perioperative Atrial Fibrillation' (COP-AF) trial is an
international, blinded, randomized trial that compares colchicine to
placebo in patients aged at least 55 years and undergoing major noncardiac
thoracic surgery with general anesthesia. Exclusion criteria include a
history of AF and a contraindication to colchicine (eg, severe renal
dysfunction). Oral colchicine at a dose of 0.5 mg or matching placebo is
given within 4 hours before surgery. Thereafter, patients receive
colchicine 0.5 mg or placebo twice daily for a total of 10 days. The 2
independent co-primary outcomes are clinically important perioperative AF
(including atrial flutter) and MINS during 14 days of follow-up. The main
safety outcomes are sepsis or infection and non-infectious diarrhea. We
aim to enroll 3,200 patients from approximately 40 sites across 11
countries to have at least 80% power for the independent evaluation of the
2 co-primary outcomes. The COP-AF main results are expected in 2023.
 Conclusion(s): COP-AF is a large randomized and blinded trial
designed to determine whether colchicine reduces the risk of perioperative
AF or MINS in patients who have major noncardiac thoracic
surgery. Copyright © 2023 Elsevier Inc.

<43>
Accession Number
2010126569
Title
Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence
after ischaemic stroke: Systematic review and meta-analysis.
Source
European Stroke Journal. 6(1) (pp 62-71), 2021. Date of Publication: March
2021.
Author
McCabe J.J.; O'Reilly E.; Coveney S.; Collins R.; Healy L.; McManus J.;
Mulcahy R.; Moynihan B.; Cassidy T.; Hsu F.; Worrall B.; Murphy S.;
O'Donnell M.; Kelly P.J.
Institution
(McCabe, O'Reilly, Coveney, Collins, Healy, McManus, Mulcahy, Moynihan,
Murphy, O'Donnell, Kelly) Health Research Board (HRB) Stroke Clinical
Trials Network Ireland (SCTNI), Dublin, Ireland
(McCabe, Coveney, Murphy, Kelly) Neurovascular Unit for Applied
Translational and Therapeutics Research, Catherine McAuley Centre, Dublin,
Ireland
(McCabe, Cassidy, Murphy) School of Medicine, University College Dublin,
Dublin, Ireland
(McCabe, Murphy) Medicine for the Elderly Department/Stroke Medicine,
Mater Misericordiae University Hospital, Dublin, Ireland
(Coveney, Collins) Department of Geriatric Medicine, Tallaght University
Hospital, Dublin, Ireland
(Healy) Department of Geriatric Medicine, Cork University Hospital, Cork,
Ireland
(McManus) Department of Geriatric Medicine, University Hospital Limerick,
Ireland
(Mulcahy) Department of Geriatric Medicine, Waterford University Hospital,
Waterford, Ireland
(Moynihan) Department of Medicine, Royal College of Surgeons in Ireland,
Dublin, Ireland
(Cassidy) Department of Geriatric and Stroke Medicine, St Vincent's
University Hospital, Dublin, Ireland
(Hsu) The Department of Biostatistical Sciences, Division of Public Health
Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
(Worrall) Departments of Neurology and Public Health Sciences, University
of Virginia, Charlottesville, VA, United States
(O'Donnell) Department of Geriatric Medicine, University Hospital Galway,
Galway, Ireland
(O'Donnell) Department of Translational Medicine, National University of
Ireland Galway, Ireland
(Kelly) Department of Neurology/Stroke Medicine, Mater Misericordiae
University Hospital, Dublin, Ireland
Publisher
SAGE Publications Ltd
Abstract
Background: Recent randomised trials showed benefit for anti-inflammatory
therapies in coronary disease but excluded stroke. The prognostic value of
blood inflammatory markers after stroke is uncertain and guidelines do not
recommend their routine measurement for risk stratification.
 Method(s): We performed a systematic review and meta-analysis of
studies investigating the association of C-reactive protein (CRP),
interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major
vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19.
Random-effects meta-analysis was performed for studies reporting
comparable effect measures. Result(s): Of 2,515 reports identified,
39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n =
16). An association with recurrent stroke was reported in 12/26 studies
(CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis
of comparable studies, CRP was associated with an increased risk of
recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD)
increase in log<inf>e</inf>-CRP (1.14, 95% CI 1.06-1.22, p < 0.01)] and
MVEs (pooled HR 1.21, CI 1.10-1.34, p < 0.01). Fibrinogen was also
associated with recurrent stroke (HR 1.26, CI 1.07-1.47, p < 0.01) and
MVEs (HR 1.31, 95% CI 1.15-1.49, p < 0.01). Trends were identified for
IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97-1.41, p =
0.10) and MVEs (HR 1.22, CI 0.96-1.55, p = 0.10). Conclusion(s):
Despite evidence suggesting an association between inflammatory markers
and post-stroke vascular recurrence, substantial methodological
heterogeneity was apparent between studies. Individual-patient pooled
analysis and standardisation of methods are needed to determine the
prognostic role of blood inflammatory markers and to improve patient
selection for randomised trials of inflammatory therapies. Copyright
© European Stroke Organisation 2021.

<44>
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.

<45>
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.

<46>
Accession Number
2026393850
Title
Cardiovascular Outcomes in Adults with Coronary Artery Disease and
Obstructive Sleep Apnea with versus without Excessive Daytime Sleepiness
in the RICCADSA Clinical Trial.
Source
Annals of the American Thoracic Society. 20(7) (pp 1048-1056), 2023. Date
of Publication: July 2023.
Author
Eulenburg C.; Celik Y.; Redline S.; Thunstrom E.; Glantz H.; Strollo P.J.;
Peker Y.
Institution
(Eulenburg) Department for Medical Biometry and Epidemiology, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Celik, Peker) Koc University Research Center for Translational Medicine,
Istanbul, Turkey
(Redline, Peker) Division of Sleep and Circadian Disorders, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Thunstrom, Peker) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Glantz) Department of Internal Medicine, Skaraborg Hospital, Lidkoping,
Sweden
(Strollo, Peker) Division of Pulmonary, Allergy, and Critical Care
Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,
United States
(Peker) Department of Pulmonary Medicine, Koc University, School of
Medicine, Istanbul, Turkey
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, Faculty of Medicine, Lund University, Lund, Sweden
Publisher
American Thoracic Society
Abstract
Rationale: Recent randomized controlled trials did not show cardiovascular
benefits of continuous positive airway pressure (CPAP) in adults with
coronary artery disease (CAD) and obstructive sleep apnea (OSA) in
intention-to-treat analyses. It has been argued that exclusion of patients
with OSA with excessive daytime sleepiness (EDS), who may be most likely
to benefit from CPAP treatment, may be a reason for the null results.
 Objective(s): We addressed 1) the effect of concomitant EDS on
adverse outcomes in patients with CAD and OSA; and 2) whether the
cardiovascular benefit of CPAP adherence differs between individuals with
versus without EDS. Method(s): This was a secondary analysis of the
RICCADSA (Randomized Intervention with CPAP in CAD and Obstructive Sleep
Apnea) trial, conducted in Sweden between 2005 and 2013. Data were
analyzed from 155 patients with CAD with OSA (apnea-hypopnea index > 15/h)
and EDS (Epworth Sleepiness Scale score > 10), who were allocated to CPAP
and 244 patients without EDS (ESS, 10), who were randomized to CPAP or no
CPAP. Patients who were allocated to no CPAP or were nonadherent (CPAP
usage, 4 h/night) were compared with adherent patients (CPAP usage > 4
h/night) at 1-year follow-up. Inverse probability of treatment weighting
was applied to mimic randomization of EDS. The primary endpoint was the
first event of repeat revascularization, myocardial infarction, stroke, or
cardiovascular mortality. Result(s): The median follow-up was 52.2
months. The incidence of the primary endpoint did not differ significantly
between the EDS versus no-EDS groups in the entire cohort. Within the
adherent group, patients without EDS had a significantly decreased risk
compared with patients with EDS (adjusted hazard ratio, 0.41; 95%
confidence interval, 0.20-0.85; P = 0.02). Conclusion(s): Adverse
cardiovascular outcomes did not differ by degrees of EDS for patients with
CAD with OSA who were untreated or nonadherent to treatment. CPAP use, at
least 4 h/night, was associated with reduced adverse outcomes in
participants without EDS. Clinical trial registered with
www.clinicaltrials.gov (NCT 00519597). Copyright © 2023 by the
American Thoracic Society.

<47>
Accession Number
2026164372
Title
Comparing postoperative analgesia of bilateral serratus anterior plane
block and thoracic paravertebral block for children following the Nuss
procedure: Protocol for a randomised, double-blind, non-inferiority
clinical trial.
Source
BMJ Paediatrics Open. 7(1) (no pagination), 2023. Article Number:
bmjpo-2023-002128. Date of Publication: 25 Jul 2023.
Author
He Y.; Xu M.; Jiang X.; Li Z.; Du B.
Institution
(He, Xu, Jiang, Du) Department of Anesthesiology, The Research Units of
West China (2018RU012), Chinese Academy of Medical Sciences, West China
Hospital of Sichuan University, Sichuan, Chengdu, China
(Li) Department of Critical Care Medicine, Cheng du Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Sichuan, Chengdu,
China
Publisher
BMJ Publishing Group
Abstract
Introduction The Nuss procedure, despite being a minimally invasive
surgery, is regarded as one of the most painful surgical procedures in
children, and postoperative pain control remains a major clinical issue in
this population. Thoracic paravertebral nerve block (TPVB) is reported as
excellent pain relief for the Nuss procedure despite its challenging
performance and associated adverse effects. Serratus anterior plane block
(SAPB) is a simplified and effective method for managing thoracic pain as
an alternative to TPVB. However, whether SAPB can provide analgesia
comparable with that provided by the TPVB approach in children undergoing
the Nuss procedure is unknown. Methods and analysis This will be a
prospective, randomised, double-blind, single-centre, non-inferiority
trial that will enrol children aged 7-16 years subjected to the Nuss
operation for pectus excavatum. In total, 74 paediatric patients will be
randomly assigned to either the SAPB or TPVB group after general
anaesthesia to receive ultrasound-guided regional nerve blocks (0.25%
ropivacaine 2.5 mg/kg). The primary outcome will be the assessment of
postoperative pain intensity at predetermined time points. The secondary
outcomes will include assessing intraoperative opioid intake, consumption
of analgesics within 24 hours postoperatively, time of first use of rescue
analgesics, extubation time, perioperative adverse events and plasma
ropivacaine concentrations across the block groups. Demographic and
clinical characteristics (eg, pectus severity and the number of bars used)
of the patients will be recorded. All data will be collected by
investigators who are blinded to the treatment. Ethics and dissemination
Ethical approval was obtained from the Ethics Committee on Biomedical
Research of the West China Hospital of Sichuan University (2021-1275).
During the period of the study, all procedures will be conducted following
the principles of the Declaration of Helsinki. The results of the trial
will be published in a peer-reviewed scientific journal. Trial
registration number ChiCTR2200056596. Copyright © 2023 BMJ
Publishing Group. All rights reserved.

<48>
Accession Number
2025379533
Title
Transcatheter Aortic Valve Implantation: What has Happened and What is Yet
to Come.
Source
Arquivos Brasileiros de Cardiologia. 120(7) (no pagination), 2023. Article
Number: e20230401. Date of Publication: 2023.
Author
Le Bihan D.C.S.; Barretto R.B.M.; Mathias Junior W.
Institution
(Le Bihan, Barretto, Mathias Junior) Instituto do Coracao do Hospital das
Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, SP, Sao
Paulo, Brazil
(Le Bihan, Mathias Junior) Fleury Medicina e Saude, SP, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cardiologia

<49>
Accession Number
2025379456
Title
Comment on: "Risk Factors of Thrombocytopenia After Cardiac Surgery with
Cardiopulmonary Bypass".
Source
Brazilian Journal of Cardiovascular Surgery. 38(5) (no pagination), 2023.
Article Number: e20230010. Date of Publication: 2023.
Author
Bedel C.; Selvi F.; Yildiz G.; Uysal A.S.
Institution
(Bedel, Selvi, Yildiz, Uysal) Department of Emergency Medicine, Health
Science University, Antalya Training and Research Hospital, Antalya,
Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular

<50>
Accession Number
2025255544
Title
Tricuspid Regurgitation and Mortality in Patients Undergoing Transcatheter
Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Arquivos Brasileiros de Cardiologia. 120(7) (no pagination), 2023. Article
Number: e20220319. Date of Publication: 2023.
Author
Erbano B.O.; Schio N.A.; Lopes R.D.; Bignoto T.C.; Olandoski M.; da Luz
R.S.B.; de Carvalho G.D.; Erbano L.H.O.; Ramos A.I.O.; Feres F.; Faria
Neto J.R.; Baena C.P.; Siqueira D.A.A.
Institution
(Erbano, Feres) Programa de Pos-Graduacao, Instituto Dante Pazzanese de
Cardiologia associado a Universidade de Sao Paulo, SP, Sao Paulo, Brazil
(Schio, Olandoski, Erbano, Faria Neto, Baena) Pontificia Universidade
Catolica do Parana, PR, Curitiba, Brazil
(Lopes) Duke University Hospital, Durham, NC, United States
(Bignoto, da Luz, de Carvalho, Ramos, Siqueira) Instituto Dante Pazzanese
de Cardiologia, SP, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: The extent of cardiac damage associated with aortic stenosis
has important prognostic implications after transcatheter aortic valve
replacement (TAVR). However, the role of tricuspid regurgitation (TR) in
this clinical setting is still unclear. Objective(s): To explore the
association between TR and mortality in patients undergoing TAVR and
assess changes in TR severity post TAVR and its relationship with short
and mid-term mortality. Method(s): Relevant databases were searched
for articles published from inception until August 2020. Out of 414
screened studies, we selected 24 that reported the degree of TR pre or
post TAVR. The primary outcome was all-cause mortality, and random effects
meta-analysis models were conducted (at a significance level of 5%).
 Result(s): Seventeen studies reported associations between pre-TAVR
TR and all-cause mortality (> 45,000 participants) and thirteen accessed
TR severity post TAVR (709 participants). Moderate/severe baseline TR was
associated to higher all-cause mortality both at 30 days (HR 1.65; 95% CI,
1.20-2.29) and 1.2 years (HR 1.56; 95% CI, 1.31-1.84). After TAVR, 43% of
patients presented a decrease of at least one grade in TR (30 days, 95%
CI, 30-56%), sustained at 12.5 months in 44% of participants (95% CI,
35-52%). Persistence of significant TR was associated with a two-fold
increase in all-cause mortality (HR 2.12; 95% CI, 1.53-2.92).
 Conclusion(s): Significant TR pre TAVR is associated with higher
mortality. Although TR severity may improve, the persistence of
significant TR post TAVR is strongly associated with increased mortality.
Our findings highlight the importance of a detailed assessment of TR pre
and post TAVR and might help identify patients who may benefit from more
careful surveillance in this scenario. Copyright © 2023,
Sociedade Brasileira de Cardiologia. All rights reserved.

<51>
Accession Number
2025143468
Title
Virtual Reality and Cardiac Diseases: A Systematic Review of Applications
and Effects.
Source
Journal of Healthcare Engineering. 2023 (no pagination), 2023. Article
Number: 8171057. Date of Publication: 2023.
Author
Bouraghi H.; Mohammadpour A.; Khodaveisi T.; Ghazisaeedi M.; Saeedi S.;
Familgarosian S.
Institution
(Bouraghi, Mohammadpour, Khodaveisi, Saeedi) Department of Health
Information Technology, School of Allied Medical Sciences, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Ghazisaeedi) Department of Health Information Management and Medical
Informatics, School of Allied Medical Sciences, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Saeedi) Clinical Research Development Unit of Farshchian Hospital,
Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Familgarosian) School of Medicine, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
Publisher
Hindawi Limited
Abstract
Introduction. Cardiac diseases have grown significantly in recent years,
causing many deaths globally. Cardiac diseases can impose a significant
economic burden on societies. The development of virtual reality
technology has attracted the attention of many researchers in recent
years. This study aimed to investigate the applications and effects of
virtual reality (VR) technology on cardiac diseases. Methods. A
comprehensive search was carried out in four databases, including Scopus,
Medline (through PubMed), Web of Science, and IEEE Xplore to identify
related articles published until May 25, 2022. Preferred Reporting Items
for Systematic Reviews and Meta-Analyzes (PRISMA) guideline for systematic
reviews was followed. All randomized trials that investigated the effects
of virtual reality on cardiac diseases were included in this systematic
review. Results. Twenty-six studies were included in this systematic
review. The results illustrated that virtual reality applications in
cardiac diseases can be classified in three categories of physical
rehabilitation, psychological rehabilitation, and education/training. This
study revealed that the use of virtual reality in psychological and
physical rehabilitation can reduce stress, emotional tension, Hospital
Anxiety and Depression Scale (HADS) total score, anxiety, depression,
pain, systolic blood pressure, and length of hospitalization. Finally, the
use of virtual reality in education/training can enhance technical
performance, increase the speed of procedures, and improve the user's
skills, level of knowledge, and self-confidence as well as facilitate
learning. Also, the most limitations mentioned in the studies included
small sample size and lack of or short duration of follow-up. Conclusions.
The results showed that the positive effects of using virtual reality in
cardiac diseases are much more than its negative effects. Considering that
the most limitations mentioned in the studies were the small sample size
and short duration of follow-up, it is necessary to conduct studies with
adequate methodological quality to report their effects in the short term
and long term. Copyright © 2023 Hamid Bouraghi et al.

<52>
Accession Number
2024953949
Title
Colchicine efficacy comparison at varying time points in the
peri-operative period for coronary artery disease: a systematic review and
meta-analysis of randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1156980. Date of Publication: 2023.
Author
Wei Z.-Y.; Lai J.-Y.; Li Y.-T.; Yu X.-Y.; Liu Y.-H.; Hu J.-X.; Gao B.-B.;
Wu J.-G.
Institution
(Wei, Li, Yu, Liu, Hu, Gao) Department of Postgraduate, Jiangxi University
of Traditional Chinese Medicine, Nanchang, China
(Lai, Wu) Cardiology Department, Affiliated Hospital of Jiangxi University
of Traditional Chinese Medicine, Nanchang, China
Publisher
Frontiers Media SA
Abstract
Objectives: Over the years, it has been found that colchicine offers
substantial benefits in secondary prevention in patients with coronary
artery disease (CAD). We studied the effects of colchicine timing because
there are no guidelines about when to provide it during the perioperative
period for patients with CAD. Method(s): Up to January 1, 2023, seven
electronic literature databases were screened (including three English
databases and four Chinese databases). Randomized controlled trials
included only treatment with colchicine in the perioperative period of
CAD. The Cochrane Evaluation Tool was used to judge the risk of bias in
research. Statistical analysis was performed by Stata 16.0 software.
 Result(s): We evaluated twelve studies that found colchicine to be
effective in decreasing the occurrence of major adverse cardiac events
(MACEs) (p < 0.00001), but it also raised the rate of adverse events (p =
0.001). Subgroup analysis showed the same benefit in lowering the
incidence of MACE with continuous administration of a total daily dose of
0.5 mg postoperatively while minimizing drug-related side effects in the
patients (p = 0.03). When it comes to preventing surgical stroke
occurrences, postoperative administration is more effective (p = 0.006).
While the effect of simultaneous preoperative and postoperative
administration was marginally greater than other periods in reducing
postoperative hs-CRP levels (p = 0.02). Conclusion(s): Colchicine, a
traditional anti-inflammatory drug, also reduces the risk of MACE by
reducing inflammation after PCI. Administration at different periods had
no significant effect on decreasing the occurrence of MACE, but when
administered postoperatively, we advise continuous administration with a
total daily dose of 0.5 mg to obtain the same benefit while minimizing the
drug's side effects. Postoperative administration is the better measure to
prevent postoperative stroke events. Due to the effective
anti-inflammatory effect of colchicine, we recommend its use as early as
possible in the perioperative period and its continued use at low doses in
the postoperative period. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316751,
identifier CRD42022316751. Copyright 2023 Wei, Lai, Li, Yu, Liu, Hu,
Gao and Wu.

<53>
Accession Number
2023616076
Title
Guiding future paediatric drug studies based on existing pharmacokinetic
and efficacy data: Cardiovascular drugs as a proof of concept.
Source
British Journal of Clinical Pharmacology. 89(9) (pp 2888-2901), 2023. Date
of Publication: September 2023.
Author
Smeets N.J.L.; Raaijmakers L.P.M.; van der Zanden T.M.; Male C.; de Wildt
S.N.
Institution
(Smeets, Raaijmakers, van der Zanden, de Wildt) Department of Pharmacology
and Toxicology, Radboud Institute for Health Sciences, Radboud University
Medical Center, Nijmegen, Netherlands
(Smeets, van der Zanden, de Wildt) Intensive Care and Department of
Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam,
Netherlands
(van der Zanden, de Wildt) Dutch Knowledge Center Pharmacotherapy for
Children, The Hague, Netherlands
(Male) Department of Paediatrics and Adolescent Medicine, Medical
University of Vienna, Vienna, Austria
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Off-label drug use in the paediatric population is common,
and the lack of high-quality efficacy studies poses patients at risk for
failing pharmacotherapy. Next to efficacy studies, pharmacokinetic (PK)
studies are increasingly used to inform paediatric dose selection. As
resources for paediatric trials are limited, we aimed to summarize
existing PK and efficacy studies to identify knowledge gaps in available
evidence supporting paediatric dosing recommendations, thereby taking
paediatric cardiovascular drugs as proof of concept. Method(s): For
each cardiovascular drug, paediatric indication and prespecified age
group, together comprising one record, the authorized state was assessed.
Next, for off-label records, the highest level of evidence was scored.
High-quality efficacy studies were defined as meta-analysis or randomized
controlled trials. Other comparative research, noncomparative research or
consensus-based expert opinions were considered low quality. The level of
evidence for PK studies was scored per drug and per age group, but
regardless of indication. Result(s): A total of 58 drugs included 417
records, of which 279 (67%) were off-label. Of all off-label records, the
majority (81%) were not supported by high-quality efficacy studies, but
for 140 of these records (62%) high-quality PK studies were available.
 Conclusion(s): We demonstrated that for the majority of off-label
cardiovascular drugs, only low-quality efficacy studies were available.
However, high-quality PK studies were frequently available. Combining
these PK data with extrapolation of efficacy data from adults may help to
close the current information gap and prioritize the drugs for which
clinical studies and safety data are urgently needed. Copyright ©
2023 The Authors. British Journal of Clinical Pharmacology published by
John Wiley & Sons Ltd on behalf of British Pharmacological Society.

<54>
Accession Number
2023483359
Title
A review of frequently used Kampo prescriptions: Part 2-Hangekobokuto.
Source
Traditional and Kampo Medicine. 10(2) (pp 103-119), 2023. Date of
Publication: August 2023.
Author
Suzuki T.; Kikuchi A.; Kaneko A.; Arita R.; Nogami T.; Saito N.; Takayama
S.
Institution
(Suzuki) Department of General Internal Medicine, Saitama Medical
University Hospital, Saitama, Japan
(Kikuchi, Arita, Takayama) Department of Kampo and Integrative Medicine,
Tohoku University Graduate School of Medicine, Sendai, Japan
(Kikuchi, Arita, Saito, Takayama) Department of Education and Support for
Regional Medicine, Department of Kampo Medicine, Tohoku University
Hospital, Sendai, Japan
(Kaneko) Saiwaitsurumi Hospital, Yokohama, Japan
(Nogami) Department of Kampo Medicine, Tokai University School of
Medicine, Isehara, Japan
Publisher
John Wiley and Sons Inc
Abstract
Background: The origin of hangekobokuto (HKT) is from Jin Gui Yao Lue
(Kinkiyoryaku in Japanese), and it has been indicated for treating throat
discomfort in women. Key Findings: HKT consists of five crude drugs.
Clinical studies have shown that HKT can improve the swallowing reflex by
increasing the substance P level in saliva; improve the cough reflex;
reduce pneumonia in patients with dementia, cerebrovascular disease,
Alzheimer's disease, or Parkinson's disease; reduce postoperative
aspiration pneumonia in patients who undergo cardiovascular surgery; and
improve depression and anxiety scores in patients with globus hystericus.
Furthermore, HKT has been reported to increase serotonin (5-HT) and
noradrenaline levels in the hypothalamus, and dopamine (DA) levels in the
striatum in a healthy rodent model; improve 5-HT levels in the striatum
and hippocampus, and ameliorate 5-HT and DA reductions in the whole brain
in an acute stress model; improve 5-HT levels in the striatum, and
ameliorate 5-HT and DA reductions in the prefrontal cortex in a chronic
stress model; and decrease corticosterone and corticotropin-releasing
factor levels in a chronic stress model. Reported adverse events of HKT
include interstitial pneumonia (0.38 per 100 000 cases) and liver damage
(0.89 per 100 000 cases), which are rare. Conclusion(s): HKT is
widely used and shows a low rate of adverse events. Several clinical
studies have reported its effects in reducing aspiration pneumonia and
improving depression and anxiety, some of which may be explained by the
regulation of monoamines and stress hormones in the brain and substance P
levels in the oral cavity. Copyright © 2023 The Authors.
Traditional & Kampo Medicine published by John Wiley & Sons Australia, Ltd
on behalf of Japan Society for Oriental Medicine and Japan Society of
Medical and Pharmaceutical Sciences for Traditional Medicine.

<55>
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.

<56>
Accession Number
2026541580
Title
Coronary Embolism After Transcatheter Aortic Valve Replacement-Case Series
and Review of Literature.
Source
American Journal of Cardiology. 205 (pp 234-240), 2023. Date of
Publication: 15 Oct 2023.
Author
Akuka A.; Landes U.; Manevich L.; Rubinshtein R.; Danenberg H.D.
Institution
(Akuka, Landes, Manevich, Rubinshtein, Danenberg) Department of
Cardiology, Wolfson Medical Center, Holon, Israel
(Akuka, Landes, Manevich, Rubinshtein, Danenberg) School of Medicine,
Tel-Aviv University, Tel Aviv, Israel
Publisher
Elsevier Inc.
Abstract
Periprocedural systemic embolism is a well-documented complication of
transcatheter aortic valve replacement (TAVR). Although the most focus was
given to cerebral embolism (which remains unpredictable, difficult to
prevent, and a source of increased morbidity and mortality after TAVR),
coronary embolism remains less investigated and potentially overlooked.
This study provides a case series of 3 patients diagnosed with coronary
embolism after TAVR in our institution over a 2-year period (3 of 297
cases, 1%) and a systematic literature review (4 studies; 19 case
reports). Overall, coronary embolism associated with TAVR is frequently
characterized by proximal vessel occlusion causing ST-elevation myocardial
infarction and hemodynamic instability with lower mortality in the acute
phase as compared with late coronary embolism. However, it often presents
with distal vessel occlusion and minor symptoms that may be overlooked in
the periprocedural period. In conclusion, we suggest that TAVR-associated
coronary embolism has a much higher prevalence than previously documented.
Further studies are warranted to properly assess the prevalence and impact
of this phenomenon. Copyright © 2023 Elsevier Inc.

<57>
Accession Number
2025014121
Title
Management of priming fluids in cardiopulmonary bypass for adult cardiac
surgery: network meta-analysis.
Source
Annals of Medicine. 55(2) (no pagination), 2023. Article Number: 2246996.
Date of Publication: 2023.
Author
Xian-Yu C.-Y.; Xu J.-B.; Ma Y.-T.; Deng N.-J.; Tao Y.-T.; Li H.-J.; Gao
T.-Y.; Yang J.-Y.; Zhang C.
Institution
(Xian-Yu, Ma, Deng, Tao, Li, Gao, Zhang) Center for Evidence-Based
Medicine and Clinical Research, Taihe Hospital, Hubei University of
Medicine, Hubei, Shiyan, China
(Xu) Department of Emergency, Renmin Hospital, Hubei University of
Medicine, Hubei, Shiyan, China
(Yang) Department of Anesthesia Surgery, Zhongnan Hospital of Wuhan
University, Wuhan University, Hubei, Wuhan, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Cardiopulmonary bypass (CPB) is frequently employed for
cardiac surgery, and selecting a suitable priming fluid is a prerequisite
for CPB. Currently, the commonly used priming fluids in clinics are
classified as crystalloids and colloids, including balanced crystalloids,
albumin, dextran, gelatin and hydroxyethyl starch (HES). This network
meta-analysis compared the effects of eight fluids used during CPB in
adults to determine optimal priming fluid during CPB surgery.
 Method(s): Randomised controlled trials assessing priming fluids for
CPB in adult cardiac surgery published before 13 April 2023 were searched
across Ovid MEDLINE(R) ALL, OVID EMbase, and Cochrane Central Register of
Controlled Trials. Various priming fluids were classified into eight
categories, including balanced crystalloids, 0.9% NaCl, iso-oncotic human
albumin, hyperoncotic human albumin, HES with molecular weight 130k, HES
with molecular weight 200k, gelatin and dextran. Result(s): The NMA
of platelet counts revealed no significant differences in any result. In
direct comparison results, only the comparison of HES with molecular
weight 130k vs. gelatin (standard mean difference = -0.40, 95% confidence
interval [95%CI: -0.63, -0.16) revealed a significant difference.
According to the SUCRA, balanced crystalloids had the highest platelet
count, followed by gelatin, and HES with a molecular weight of 130k had
the lowest platelet, followed by HES with a molecular weight of 200k.
 Conclusion(s): Patients using dextran have a low mortality rate and a
short mean CPB time, the use of balanced crystalloids is beneficial in
terms of platelet count, and HES with molecular weight 130k is beneficial
for postoperative urine volume at 24h. However, all priming fluids have
pros and cons quite, and the optimal choice of priming fluids remains
unsupported by current evidences. When performing CPB surgery, the type of
priming fluid should be selected according to the actual situation in CPB
for adult cardiac surgery. Copyright © 2023 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<58>
Accession Number
2024388532
Title
Vascular access for transcatheter aortic valve replacement: A network
meta-analysis.
Source
Journal of Cardiology. 82(4) (pp 227-233), 2023. Date of Publication:
October 2023.
Author
Yokoyama Y.; Sakata T.; Mikami T.; Misumida N.; Scotti A.; Takagi H.;
Sugiura T.; Kuno T.; Latib A.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Sakata) Cardiovascular Research Institute, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Mikami) Department of Neurology, Tufts Medical Center, Medford and
Somerville, MA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, United States
(Scotti, Kuno, Latib) Department of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shimizu, Shizuoka, Japan
(Sugiura) Department of Cardiothoracic & Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, New York,
United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: The choice of an alternative access for transcatheter aortic
valve replacement (TAVR) remains controversial when transfemoral (TF)
access is not feasible. Method(s): We conducted a network
meta-analysis to compare the outcomes of TAVR via various peripheral
vascular accesses. MEDLINE and EMBASE were searched through July 2022 to
identify studies that investigated outcomes in patients who underwent TAVR
via TF, trans-subclavian (Tsc), transcarotid (TC), or transcaval (Tcav)
access. A network meta-analysis was conducted via random-effects model.
Outcomes of interest were major or life-threatening bleeding, stroke,
major vascular complication, and 30-day mortality. Result(s): No
randomized trial was identified. Our analysis included 33 observational
studies that enrolled a total of 43,455 patients who underwent TAVR via TF
(n = 36,202), Tsc (n = 3869), TC (n = 3066), or Tcav (n = 318) access. The
risk of major or life-threatening bleeding was higher via Tsc compared
with TF [odds ratio (OR); 95 % confidence interval (CI) =1.51 (1.03-2.23),
p = 0.034]. The risk of stroke was higher via Tsc compared with TF and
Tcav [OR (95 % CI) =2.00 (1.14-3.52), p = 0.018, OR (95 % CI) =2.43
(1.03-5.74), p = 0.044, respectively]. The risk of major vascular
complications was lower via TC compared with Tsc, and Tcav and higher with
Tcav compared with TF and Tsc. 30-day mortality was higher via Tsc
compared with TF. Tsc was associated with higher risk of major or
life-threatening bleeding compared with TF, and higher risk of stroke
compared to TF and Tcav. Tcav had the highest risk of major vascular
complications. Conclusion(s): In patients who underwent TF, Tsc, TC,
or Tcav TAVR, Tsc had a higher rate of stroke compared to TF and Tcav, and
major or life-threatening bleeding compared to TF. The rate of major
vascular complications in Tcav was the highest among the four
approaches. Copyright © 2023 Elsevier Ltd

<59>
Accession Number
642096470
Title
Investigation of the Effects of Acupuncture on Post-Operative Chest Pain
after Open Heart Surgery.
Source
Journal of acupuncture and meridian studies. 16(4) (pp 133-138), 2023.
Date of Publication: 31 Aug 2023.
Author
Roshanzamir S.; Haririan Y.; Ghaderpanah R.; Jahromi L.S.M.; Dabbaghmanesh
A.
Institution
(Roshanzamir, Haririan, Jahromi) Department of Physical Medicine and
Rehabilitation, Shiraz Medical School, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Ghaderpanah) Students Research Committee, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Dabbaghmanesh) Department of Internal Medicine, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
Background: Coronary artery bypass grafting (CABG) accounts for more than
half of all adult cardiac surgeries worldwide. Post-operative chest pain
is a common CABG complication and can cause significant discomfort.
 Objective(s): Because taking large amounts of analgesics can have
many side effects, we evaluated whether acupuncture effectively reduces
pain and the use of analgesics by CABG patients. Method(s): In this
clinical trial, 30 patients who had recently undergone CABG were randomly
allocated to two groups. For both groups, exercise therapy and routine
analgesics were recommended. The intervention group underwent bilateral
acupuncture in distinct acupoints, including the HT3, HT4, HT5, HT6, HT7,
PC3, PC5, PC6, and PC7 for 10 daily sessions constantly. Visual analog
scale (VAS) and analgesic use were evaluated in both groups at baseline
and after completing the 10-day treatment. Result(s): Our analysis
revealed significant decreases in the mean VAS scores in both the
intervention and the control group, and that the reduction was more
significant in the acupuncture group (p < 0.001). Moreover, analgesic use
was significantly lower in the acupuncture group when compared with the
control group (p < 0.001). Conclusion(s): Our findings highlight
acupuncture as an alternative method of controlling CABG-associated
post-operative chest pain and reducing the use of analgesics, which might
have many side effects.

<60>
Accession Number
641750958
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in dialysis-dependent patients: a meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 24(9) (pp 666-673),
2023. Date of Publication: 01 Sep 2023.
Author
Burton S.; Reynolds A.; King N.; Modi A.; Asopa S.
Institution
(Burton) Faculty of Medicine and Dentistry, University of Plymouth,
Plymouth, United Kingdom
(Reynolds) Swansea University Medical School, Wales, United Kingdom
(King) Faculty of Health, University of Plymouth, Plymouth, United Kingdom
(Modi) Wessex Cardiac Centre, Southampton, Bermuda
(Asopa) Southwest Cardiothoracic Centre, Plymouth, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This meta-analysis aims to compare the clinical outcomes of
transcatheter aortic valve implantation (TAVI) versus aortic valve
replacement (AVR) for aortic stenosis in dialysis-dependent patients.
 METHOD(S): Literature searches employed PubMed, Web of Science,
Google Scholar and Embase to identify relevant studies. Bias-treated data
were prioritized, isolated and pooled for analysis; raw data were utilized
where bias-treated data were unavailable. Outcomes were analysed to assess
for study data crossover. RESULT(S): Literature search identified 10
retrospective studies; following data source analysis, five studies were
included. Upon pooling of bias-treated data, TAVI was significantly
favoured in early mortality [odds ratio (OR), 0.42; 95% confidence
interval (95% CI), 0.19-0.92; I2 = 92%; P = 0.03], 1-year mortality (OR,
0.88; 95% CI 0.80-0.97; I2 = 0%; P = 0.01), rates of
stroke/cerebrovascular events (OR, 0.71; 95% CI 0.55-0.93; I2 = 0%; P =
0.01) and blood transfusions (OR, 0.36; 95% CI 0.21-0.62; I2 = 86%; P =
0.0002). Pooling demonstrated fewer new pacemaker implantations in the AVR
group (OR, 3.33; 95% CI 1.94-5.73; I2 = 74%; P <= 0.0001) and no
difference in the rate of vascular complications (OR, 2.27; 95% CI
0.60-8.59; I2 = 83%; P = 0.23). Analysis including raw data revealed the
length of hospital stay to favour TAVI with a mean difference of -9.20
days (95% CI -15.58 to -2.82; I2 = 97%; P = 0.005). CONCLUSION(S):
Bias-treated meta-analysis comparing surgical AVR and TAVI favoured TAVI
in early mortality, 1-year mortality, rates of stroke/cerebrovascular
events and blood transfusions. There was no difference in the rates of
vascular complications; however, TAVI required more pacemaker
implantations. Data pooling including raw data revealed that the length of
hospital admission favours TAVI. Copyright © 2023 Italian
Federation of Cardiology - I.F.C. All rights reserved.

<61>
Accession Number
640014353
Title
Sex differences in type A acute aortic dissection: a systematic review and
meta-analysis.
Source
European journal of preventive cardiology. 30(11) (pp 1074-1089), 2023.
Date of Publication: 21 Aug 2023.
Author
Carbone A.; Ranieri B.; Castaldo R.; Franzese M.; Rega S.; Cittadini A.;
Czerny M.; Bossone E.
Institution
(Carbone) Unit of Cardiology, University of Campania 'Luigi Vanvitelli',
Naples 80138, Italy
(Ranieri, Castaldo, Franzese) IRCCS SYNLAB SDN, Via Emanuele Gianturco,
113, Naples 80143, Italy
(Rega, Bossone) Department of Public Health, University of Naples
'Federico II', Via Pansini, Naples 80131, Italy
(Cittadini) Department of Translational Medical Sciences, University of
Naples 'Federico II', Via S Pansini, Naples 80131, Italy
(Cittadini) Italian Clinical Outcome Research and Reporting Program
(I-CORRP), Naples 80131, Italy
(Czerny) University Heart Center Freiburg Bad Krozingen, University
Hospital Freiburg, 15, Bad Krozingen 79189, Germany
(Czerny) Faculty of Medicine, Albert-Ludwigs University Freiburg,
Freiburg, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: In acute aortic dissection (AAD) sex heterogeneity reports are
not exhaustive and in part even conflicting. AIMS: To explore sex
differences in clinical features, management, and outcomes among patients
with type A AAD. METHODS AND RESULTS: A systematic review and
meta-analysis of the literature were conducted for studies (2004-2022)
reporting type A AAD sex differences. Among the 1938 studies retrieved, 16
(16 069 patients, 7142 women, and 8927 men) fulfilled all eligibility
criteria. Data were aggregated used the random-effects model as pooled
risk ratio and mean difference. Due to information reported by considered
manuscripts, analysis were performed only among surgically treated type A
AAD patients. At the time of hospital presentation type A AAD women were
older than men but had lower body mass index (BMI), body surface area
(BSA), and creatinine plasma levels. Active smoking, bicuspid aortic
valve, and previous cardiac surgery were less common in women while
diabetes mellitus was more frequent. Furthermore, women experienced more
frequently pericardial effusion/cardiac tamponade than men. Interestingly,
in-hospital surgical mortality did not differ between sexes [risk ratio
(RR), 1.02; 95% confidence interval (CI), 0.53-1.99; P = 0.95], whereas 5
(RR 0.94; 95% CI: 0.92-0.97; P < 0.001) and 10-year survival (RR 0.82; 95%
CI: 0.74-0.92; P = 0.004) was higher among men. A descriptive analysis of
in-hospital outcomes among medically treated type A AAD patients confirmed
prohibitive high mortality for both sexes (men 58.6% vs. women 53.8%, P =
0.59). CONCLUSION(S): A female sex phenotype appears to be evident in
type A AAD implying the need for a personalized management patient
approach along with tailored preventive strategies. PROSPERO REGISTRY ID:
CRD42022359072. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<62>
Accession Number
642088131
Title
DISCUSSION OF THE INCREASED INCIDENCE OF PROSTATE CANCER IN PATIENTS
UNDERGOING ISCHEMIC AND DISTAL ISCHEMIC POST-TREATMENT CARDIOPULMONARY
BYPASS.
Source
Journal of Investigative Medicine. Conference: 5th International
Conference on Advances in Biological Science and Technology, ICABST 2022.
Xicheng China. 71(1 Supplement) (pp 16), 2023. Date of Publication:
October 2023.
Author
Li Q.; Wu C.; Liang Y.; Zhang C.; Liao H.; Liu S.; Cui W.
Institution
(Li, Wu, Liang, Liao, Liu, Cui) Department of Cardiac Surgery, Second
Hospital of Hebei Medical University, Shijiazhuang, China
(Zhang) Hebei Medical University, Shijiazhuang, China
Publisher
SAGE Publications Inc.
Abstract
Objective: To investigate whether ischemia-reperfusion injury and
myocardial cell protection can be alleviated by ischemia-reperfusion
injury in patients undergoing cardiopulmonary bypass after cardiac
surgery, and to compare the protective effects of the two measures and
whether inflammation in the presence of inadequate blood supply increases
the incidence of prostate cancer. Method(s): 183 adult patients who
received open-heart surgery were assigned randomly to the postcondition
group, the remote postcondition group and the control group. Blood samples
were collected at 3-4 time points after the surgery and postoperative
measures were documented during hospitalization. Abstract 34 Figure2 The
levels of cTnI during 48 hours after the cardiac surgery Result: The
patients were followed up one year after surgery. There were no
significant differences in NT-proBNP, CK, Cre, or the diameters of LA, LV
one week after surgery between the three groups. Patients in the
postcondition group have significantly lower cTnI at each time point after
surgery (p<0.01) and lower CK-MB 12 h and 24 h after surgery (p<0.05) than
those in other groups. There are the higher rate of automatic heart
resuscitation and the higher LVEF (one week after the surgery) in the
postcondition group (p<0.01), while there was no difference between the
remote postcondition group and the control group(p>0.05). Based on the
lower levels of postoperative cTnI and CK-MB, postcondition has some
protective effects to reduce myocardial injury in patients undergoing
cardiac surgery under cardiopulmonary bypass, which is superior to the
remote postcondition group. But there was no significantly difference in
oneyear-follow-up, and no protective effect on postoperative acute kidney
injury was found. Conclusion(s): In patients undergoing
cardiopulmonary bypass surgery, IPOC group had a higher rate of automatic
cardiac resuscitation, and postoperative cTnI and CK-MB levels were
significantly lower than those in RIPOC group and control group. And found
that surgery can cause tissue damage and inflammation. These inflammatory
responses can stimulate cell growth and division, which may increase the
risk of cancer, such as prostate cancer.

<63>
Accession Number
642093065
Title
Percutaneous Coronary Intervention vs Repeat Surgical Revascularization in
Patients With Prior CABG: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. Conference: 60th Annual Meeting of Eastern Cardiothoracic
Surgical Society, ECTSS. Miami Beach, FL United States. 18(2 Supplement)
(pp 43S-44S), 2023. Date of Publication: July 2023.
Author
Dimagli A.; Cancelli G.; Soletti G.; Olaria R.P.; Chadow D.; Rahouma M.;
Girardi L.; Gaudino M.
Institution
(Dimagli, Cancelli, Soletti, Olaria, Chadow, Rahouma, Girardi, Gaudino)
Weill Cornell Medicine, New York City, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Repeat coronary artery bypass grafting (RCABG) and percutaneous
coronary intervention (PCI) are both used for the treatment of symptomatic
patients with coronary artery disease and prior CABG, but the optimal
treatment strategy remains unknown. We sought to perform a systematic
review and meta-analysis to compare operative and follow- up outcomes
following RCABG vs PCI in patients with prior CABG. Method(s):
MEDLINE and EMBASE were searched for studies comparing RCABG vs PCI. The
primary outcome was follow-up mortality, and secondary outcomes were
follow-up repeat revascularization, operative mortality, periprocedural
stroke and myocardial infarction (MI). Time-toevent outcomes were
summarized as incidence rate ratios (IRR), while operative outcomes were
summarized as odds ratios (OR). A random effect meta-analysis was
performed. Individual patient survival data was extracted from available
survival curves and reconstructed using restricted mean survival time.
 Result(s): Among 2982 articles, 7 studies (9945 patients) were
included. In the aggregated data meta-analysis, there was no difference in
follow-up survival between RCABG and PCI (IRR 1.02; 95%CI 0.83-1.25),
however restricted mean survival time analysis of individual data showed a
survival benefit for RCABG over PCI (0.7 years (95%CI 0.23-1.19; P =
0.004)). PCI was found to have a higher incidence rate of follow- up need
for repeat revascularization (IRR 1.61; 95%CI 1.16-2.23), but lower odds
for operative mortality and stroke. No difference in the odds for MI was
found. Conclusion(s): In patients with prior CABG, PCI is associated
with better operative outcomes, but RCABG is be associated with better
survival and freedom from repeat revascularization at follow-up.

<64>
Accession Number
2025922592
Title
Comparing Multimodal Imaging Methods To Assess Left Atrial Appendage
Sizing For Closure: A Metanalysis.
Source
Journal of Cardiovascular Computed Tomography. Conference: Society of
Cardiovascular Computed Tomography - 18th Annual Scientific Meeting.
Boston United States. 17(4 Supplement) (pp S19-S20), 2023. Date of
Publication: 01 Jul 2023.
Author
kohli V.; Chopra R.; Patel D.
Institution
(Chopra) Advent Health Gordon, Calhoun, GA, United States
(kohli, Patel) UTCOM chattanooga, Chattanooga, TN, United States
Publisher
Elsevier Inc.
Abstract
Introduction: There are discrepancies in the measurement of LAA dimensions
between various imaging modalities. The aim of this study is to find the
imaging modality that best correlates with the device size implanted with
good seal. Method(s): PubMed, Cochran, Clinicaltrials.gov, and Google
Scholar databases were searched to identify comparative studies between
various imaging modalities in the assessment of left atrial appendage
size. Metanalysis was performed by comparing two imaging techniques each
time. Effect size of each study was computed and compared using the
random-effect, inverse variance method. Result(s): 15 comparative
studies were included. There was a total of 991 patients included in the
study. Multiple imaging modalities including Cardiac CTA, 2D TEE,3D TEE,
Conventional Cardiac angiogram (CCA), and intra-operative cardiac
echocardiogram (ICE) were performed. Cardiac CTA has significantly larger
size of LAA ostial diameter when compared with TEE and CCA but is
comparable with 3D TEE. 3D TEE was also noted to have significantly larger
size than 2D TEE. 2D TEE was comparable with CCA with no significant
differences in the measurements. There were significantly more occlusion
devices correctly sized using Cardiac CTA when compared to TEE. 3D CT was
even more significant in determining adequate size when compared with TEE.
 Conclusion(s): Cardiac CTA or 3D TEE/CT should be considered for
pre-procedure planning for LAA occlusion device sizing. [Formula
presented] [Formula presented] Copyright © 2023

<65>
Accession Number
2025922579
Title
Low-density Non-calcified Plaque Burden Derived From Artificial
Intelligence-guided CCTA Quantification Is Associated With 1-year
Cardiovascular Outcomes.
Source
Journal of Cardiovascular Computed Tomography. Conference: Society of
Cardiovascular Computed Tomography - 18th Annual Scientific Meeting.
Boston United States. 17(4 Supplement) (pp S57-S58), 2023. Date of
Publication: 01 Jul 2023.
Author
Nurmohamed N.; Aquino M.; Crabtree T.; Earls J.; Hoffmann U.; Min J.; Choi
A.; Chang H.
Institution
(Aquino, Crabtree, Hoffmann, Min) Cleerly, Inc., Denver, CO, United States
(Chang) Severance Cardiovascular Hospital, Seoul, South Korea
(Nurmohamed, Earls, Choi) The George Washington University School of
Medicine, Washington, DC, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Low-attenuation or non-calcified plaque volume from coronary
CT angiography (CCTA) assessed with labor-intensive manual quantitative
analysis have been associated with cardiovascular events. Recent studies
have shown that artificial intelligence-guided quantitative coronary
computed tomography angiography (AI-QCT) achieves superior diagnostic
accuracy for stenosis quantification compared to human readers. This study
investigated the use of plaque burden derived from AI-QCT for short-term
risk stratification of major adverse cardiovascular events in patients
suspected of stable CAD. Method(s): We performed a post-hoc analysis
of the multicenter Coronary Computed Tomographic Angiography for Selective
Cardiac Catheterization (CONSERVE; NCT01810198), which randomized
participants to direct referral to invasive coronary angiography (ICA) or
selective ICA referral with upfront CCTA. For this study, we included a
total of 745 patients from the selective arm who had CCTA data available.
All scans were analyzed using artificial intelligence-guided quantitative
CCTA (AI-QCT; Cleerly Inc., Denver, CO), quantifying volumes of total
plaque, calcified plaque non-calcified plaque and low-density plaque. The
relationship with the primary study outcome, defined as death, nonfatal
myocardial tinfarction, unstable angina, stroke, urgent or emergent
coronary revascularization, and cardiovascular hospitalization, was
evaluated in a multivariate linear regression model adjusted for clinical
risk characteristics and presence of obstructive stenosis (>50%).
 Result(s): The included participants had a mean age of 60+/-12 years
and 362 (49%) patients were female. Follow-up duration was 1.1+/-0.4 years
during which 3.6% patients experienced the primary outcome. Low-density
non-calcified plaque volume (HR 2.05 [1.16-3.64] per IQR increase; p =
0.014) was significantly associated with the primary outcome, whereas
there was a trend towards association for non-calcified plaque volume (HR
1.62 [0.94-2.79] per IQR increase; p = 0.0797) and total plaque volume (HR
1.81 [1.00-3.00] per IQR increase; p = 0.0511). [Formula presented]
 Conclusion(s): AI-guided plaque quantification, especially
low-density non-calcified plaque volume can effectively stratify patients
for MACE in the near-term follow-up. These data suggest that risk
stratification using CCTA in patients suspected of CAD could benefit from
implementation of AI-QCT analysis of plaque burden. Copyright ©
2023

<66>
Accession Number
2026561391
Title
Data standards for transcatheter aortic valve implantation: The European
Unified Registries for Heart Care Evaluation and Randomised Trials
(EuroHeart).
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 9(5) (pp
529-536), 2023. Date of Publication: 01 Aug 2023.
Author
Aktaa S.; Batra G.; James S.K.; Blackman D.J.; Ludman P.F.; Mamas M.A.;
Abdel-Wahab M.; Angelini G.D.; Czerny M.; Delgado V.; De Luca G.; Agricola
E.; Foldager D.; Hamm C.W.; Iung B.; Mangner N.; Mehilli J.; Murphy G.J.;
Mylotte D.; Parma R.; Petronio A.S.; Popescu B.A.; Sondergaard L.; Teles
R.C.; Sabate M.; Terkelsen C.J.; Testa L.; Wu J.; Maggioni A.P.; Wallentin
L.; Casadei B.; Gale C.P.
Institution
(Aktaa, Blackman, Gale) Leeds Institute of Cardiovascular and Metabolic
Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom
(Aktaa, Wu, Gale) Leeds Institute for Data Analytics, University of Leeds,
Leeds LS2 9JT, United Kingdom
(Aktaa, Blackman, Gale) Department of Cardiology, Leeds Teaching Hospitals
NHS Trust, Leeds LS1 3EX, United Kingdom
(Batra, James, Wallentin) Department of Medical Sciences Cardiology and
Uppsala Clinical Research Center, Uppsala University, Uppsala 38 751 85,
Sweden
(Ludman) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham B15 2SQ, United Kingdom
(Mamas) Keele Cardiovascular Research Group, Keele University, Stoke on
Trent ST5 5BG, United Kingdom
(Abdel-Wahab) Heart Center Leipzig, University of Leipzig, Leipzig 04109,
Germany
(Angelini) Bristol Heart Institute, Bristol University, Bristol BS8 1TH,
United Kingdom
(Czerny) Department of Cardiovascular Surgery, Faculty of Medicine,
Albert-Ludwigs-University of Freiburg, University Heart Center Freiburg,
Freiburg 79189, Germany
(Delgado) Heart Institute; Department of Cardiology, Cardiovascular
Imaging Section, Hospital University Germans Trias i Pujol, Badalona
08916, Spain
(De Luca) Clinical and Experimental Cardiology Unit, AOU Sassari, Sassari
07100, Italy
(Agricola) Cardiovascular Imaging Unit, San Raffaele Hospital, Milan,
Vita-Salute University, San Raffaele, Milan 20132, Italy
(Foldager) ESC Patient Forum, Denmark
(Hamm) Medical Clinic I, University of Giessen, Giessen 35390, Germany
(Hamm) Kerckhoff Heart Center, Bad Nauheim 61231, Germany
(Iung) Cardiology Department, Bichat Hospital, APHP and Universite
Paris-Cite, Paris 75006, France
(Mangner) Heart Centre Dresden, Department of Internal Medicine and
Cardiology, Technische Universitaet, Dresden 01069, Germany
(Mehilli) Department: Medizinische Klinik I, Landshut-Achdorf Hospital,
Landshut 84036, Germany
(Mehilli) Klinikum der Universitat Munchen,
Ludwig-Maximilians-Universitat, Munich 80539, Germany
(Mehilli) German Centre for Cardiovascular Research (DZHK), Munich Heart
Alliance, Munich 80539, Germany
(Murphy) NIHR Biomedical Research Unit, University of Leicester, Leicester
LE1 7RH, United Kingdom
(Mylotte) Department of Cardiology, University Hospital and National
University of Ireland Galway, Galway H91 YR71, Ireland
(Parma) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice 40-055, Poland
(Petronio) Cardiothoracic and Vascular Dpt. University of Pisa, Pisa
56126, Italy
(Popescu) Department of Cardiology, University of Medicine and Pharmacy
Carol Davila -Euroecolab, Emergency Institute for Cardiovascular Diseases,
Bucharest 050474, Romania
(Sondergaard) Department of Cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen 2100, Denmark
(Teles) Centro de Documentacao, Centro Hospitalar de Lisboa Ocidental,
Nova Medical School, Hospital de Santa Cruz, Lisbon 1169056, Portugal
(Sabate) Department of Interventional Cardiology, Cardiovascular
Institute, Hospital Clinic, Institut d'Investigacions Biomediques August
Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
(Terkelsen) Aarhus University Hospital and the Danish Heart Foundation
8200, Denmark
(Testa) IRCCS San Donato Hospital, Milan 20097, Italy
(Casadei) ANMCO Research Center-Heart Care Foundation, Florence 50121,
Italy
Publisher
Oxford University Press
Abstract
Aims: Standardized data definitions are necessary for the quantification
of quality of care and patient outcomes in observational studies and
randomised controlled trials (RCTs). The European Unified Registries for
Heart Care Evaluation and Randomised Trials (EuroHeart) project of the
European Society of Cardiology (ESC) aims to create pan-European data
standards for cardiovascular diseases and interventions, including
transcatheter aortic valve implantation (TAVI). Methods and Results:
We followed the EuroHeart methodology for cardiovascular data standard
development. A Working Group of 29 members representing 12 countries was
established and included a patient representative, as well as experts in
the management of valvular heart disease from the European Association of
Percutaneous Cardiovascular Interventions (EAPCI), the European
Association of Cardiovascular Imaging (EACVI) and the Working Group on
Cardiovascular Surgery. We conducted a systematic review of the literature
and used a modified Delphi method to reach consensus on a final set of
variables. For each variable, the Working Group provided a definition,
permissible values, and categorized the variable as mandatory (Level 1) or
additional (Level 2) based on its clinical importance and feasibility. In
total, 93 Level 1 and 113 Level 2 variables were selected, with the level
1 variables providing the dataset for registration of patients undergoing
TAVI on the EuroHeart IT platform. Conclusion(s): This document
provides details of the EuroHeart data standards for TAVI processes of
care and in-hospital outcomes. In the context of EuroHeart, this will
facilitate quality improvement, observational research, registry-based
RCTs and post-marketing surveillance of devices, and pharmacotherapies.
One-sentence summary: The EuroHeart data standards for transcatheter
aortic valve implantation (TAVI) are a set of internationally agreed data
variables and definitions that once implemented will facilitate
improvement of quality of care and outcomes for patients receiving
TAVI. Copyright © 2022 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology.

<67>
Accession Number
2026561387
Title
Impact of residual angina on long-Term clinical outcomes after
percutaneous coronary intervention or coronary artery bypass graft for
complex coronary artery disease.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 9(5) (pp
490-501), 2023. Date of Publication: 01 Aug 2023.
Author
Ono M.; Serruys P.W.; Kawashima H.; Lunardi M.; Wang R.; Hara H.; Gao C.;
Garg S.; O'Leary N.; Wykrzykowska J.J.; Piek J.J.; Holmes D.R.; Morice
M.-C.; Kappetein A.P.; Noack T.; Davierwala P.M.; Spertus J.A.; Cohen
D.J.; Onuma Y.
Institution
(Ono, Kawashima, Hara, Wykrzykowska, Piek) Department of Cardiology,
Amsterdam UMC, Academic Medical Centre, University of Amsterdam,
Meibergdreef 9, Amsterdam, Netherlands
(Ono, Serruys, Kawashima, Lunardi, Wang, Hara, Gao, O'Leary, Onuma)
Department of Cardiology, National University of Ireland Galway (NUIG),
Galway, Ireland
(Serruys, Onuma) C RAM-SFI Centre for Research in Medical Devices, Galway,
Ireland
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Wang, Gao) Department of Cardiology, Radboud University, Nijmegen,
Netherlands
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Wykrzykowska) Department of Cardiology, University Medical Center
Groningen, Groningen, Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Departement of Cardiologie, Hopital Prive Jacques Cartier, Ramsay
Generale de Sante Massy, France
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Noack, Davierwala) University Department of Cardiac Surgery, Heart Centre
Leipzig, Leipzig, Germany
(Davierwala) Department of Surgery, University of Toronto, Toronto, Canada
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, 15 University Health Network, Toronto,
ON, Canada
(Spertus) Department of Cardiology, Saint Luke's Mid America Heart
Institute/UMKC, Kansas City, MO, United States
(Cohen) Clinical and Outcomes Research, Cardiovascular Research
Foundation, New York NY and St. Francis Hospital, Roslyn, NY, United
States
Publisher
Oxford University Press
Abstract
Aims: The aim of this study was to investigate the impact on 10-year
survival of patient-reported anginal status at 1 year following
percutaneous coronary intervention (PCI) or coronary artery bypass graft
(CABG) in patients with left main coronary artery disease (LMCAD) and/or
three-vessel CAD (3VD). Methods and Results: In this post hoc
analysis of the randomized SYNTAX Extended Survival study, patients were
classified as having residual angina (RA) if their self-reported Seattle
Angina Questionnaire angina frequency (SAQ-AF) scale was <=90 at the
1-year follow-up post-revascularization with PCI or CABG. The primary
endpoint of all-cause death at 10 years was compared between the RA and
no-RA groups. A sensitivity analysis was performed using a 6-month SAQ-AF.
At 1 year, 373 (26.1%) out of 1428 patients reported RA. Whilst RA at 1
year was an independent correlate of repeat revascularization at 5 years
[18.3 vs. 11.5%; adjusted hazard ratio (HR): 1.54; 95% confidence interval
(CI): 1.10-2.15], it was not associated with all-cause death at 10 years
(22.1 vs. 21.6%; adjusted HR: 1.11; 95% CI: 0.83-1.47). These results were
consistent when stratified by the modality of revascularization (PCI or
CABG) or by anginal frequency. The sensitivity analysis replicating the
analyses based on 6-month angina status resulted in similar findings.
 Conclusion(s): Among patients with LMCAD and/or 3VD, patient-reported
RA at 1 year post-revascularization was independently associated with
repeat revascularization at 5 years; however, it did not significantly
increase 10-year mortality, irrespective of the primary modality of
revascularization or severity of RA. Copyright © 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Society of Cardiology.

<68>
Accession Number
2026561386
Title
De-frailing intervention for hospitalized cardiovascular patients in the
TARGET-EFT randomized clinical trial.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 9(5) (pp
482-489), 2023. Date of Publication: 01 Aug 2023.
Author
Ahmad F.; Fountotos R.; Goldfarb M.; Bharaj N.; Munir H.; Marsala J.;
Rudski L.G.; Afilalo J.
Institution
(Ahmad, Fountotos, Goldfarb, Munir, Afilalo) Division of Experimental
Medicine, McGill University, Montreal, QC H4A 3J1, Canada
(Ahmad, Fountotos, Bharaj, Munir, Afilalo) Centre for Clinical
Epidemiology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
(Goldfarb, Marsala, Rudski, Afilalo) Division of Cardiology, Jewish
General Hospital, McGill University, Montreal, QC H3T 1E2, Canada
(Bharaj) Department of Kinesiology and Physical Education, McGill
University, Montreal, QC H2W 1S4, Canada
Publisher
Oxford University Press
Abstract
Aims: Frailty is disproportionately prevalent in cardiovascular disease
patients and exacerbated during hospital admissions, heightening the risk
for adverse events and functional decline. Using the Essential Frailty
Toolset (EFT) to target physical weakness, cognitive impairment,
malnourishment, and anaemia, we tested a multicomponent targeted
intervention to de-frail older adults with acute cardiovascular conditions
during their hospital admission. Methods and Results: The TARGET-EFT
trial was a single-center randomized clinical trial at the Jewish General
Hospital, Montreal, Canada. We compared a multicomponent de-frailing
intervention with usual clinical care. Intervention group patients
received exercise, cognitive stimulation, protein supplementation, and
iron replacement, as required. In this study, the primary outcome was
frailty, as assessed by the SPPB score (Short Physical Performance
Battery) at discharge, and the secondary outcome was the SARC-F score
(Strength, Assistance walking, Rising from chair, Climbing, Falls)
assessed 30 days later. The analysis consisted of 135 patients (mean age
of 79.3 years; 54% female) who survived and completed the frailty
assessments. Compared with control patients, intervention group patients
had a 1.52-point superior SPPB score and a 0.74-point superior SARC-F
score. Subgroup analysis suggested that patients with low left ventricular
ejection fraction may have attenuated benefits, and that patients who
underwent invasive cardiac procedures had the greatest benefits from the
intervention. Conclusion(s): We achieved our objective of de-frailing
older cardiac inpatients on a short-Term basis by improving their physical
performance and functioning using a pragmatic multicomponent intervention.
This could have positive impacts on their clinical outcomes and ability to
maintain independent living in the future. One sentence summary: The
multicomponent intervention targeted to the deficits of vulnerable older
adults hospitalized with acute cardiovascular diseases successfully
de-frailed them on a short-Term basis, which can have positive
implications on their post-discharge health outcomes. Copyright
© 2022 The Author(s). Published by Oxford University Press on behalf
of the European Society of Cardiology.

<69>
Accession Number
2026484312
Title
The effect of nanocurcumin on the incidence of atrial fibrillation, and
markers of inflammation and oxidative stress level after coronary artery
bypass graft surgery: A randomized, double-blind, placebo-controlled
clinical study.
Source
Avicenna Journal of Phytomedicine. 12(5) (pp 503-513), 2022. Date of
Publication: October 2022.
Author
Alhashemi S.H.; Mohammadpour A.H.; Heidari R.; Nikoo M.H.; Nemati M.H.;
Vazin A.
Institution
(Alhashemi, Vazin) Department of Clinical Pharmacy, School of Pharmacy,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Mohammadpour) Department of Clinical Pharmacy, School of Pharmacy,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Mohammadpour) Pharmaceutical Research Center, Pharmaceutical Technology
Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Heidari) Pharmaceutical Sciences Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Nikoo) Department of Cardiology, Medical School, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Nikoo) Non-Communicable Diseases Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Nemati) Department of Cardiac Surgery, Medical School, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Mashhad University of Medical Sciences
Abstract
Objective: Postoperative atrial fibrillation (POAF) is the most frequent
dysrhythmias observed following coronary artery bypass graft (CABG)
surgery. Several studies have shown the beneficial effects of curcumin on
cardiovascular diseases; however, there is no clinical trial to examine
its effect on POAF. This randomized, double-blind, placebo-controlled
clinical study was designed to evaluate the prophylactic effects of a
nano-formulation of curcumin (SinaCurcuminTM) versus placebo on POAF and
levels of biomarkers of inflammation and oxidative stress in patients
undergoing CABG surgery. Material(s) and Method(s): A total of 234
eligible patients were randomized to receive 240 mg curcumin
nano-formulation or placebo three days prior to the surgery and on the
first four postoperative days. The occurrence of POAF was monitored for at
least 96 hr after the surgery. Also, C-reactive protein (hs-CRP),
malondialdehyde (MDA) and glutathione (GSH) levels were assessed at
baseline and the end of the study. Result(s): Analyses were done in
the intention-to-treat population. No significant difference was observed
in the occurrence of POAF between the treatment (9.5%) and placebo (11.5%)
groups. Also, curcumin intervention did not alter serum concentration of
the hs-CRP, MDA, or GSH in comparison with placebo. Conclusion(s): In
conclusion, it seems that perioperative treatment with SinaCurcuminTM did
not prevent POAF after CABG surgery. Copyright © 2022 Mashhad
University of Medical Sciences. All rights reserved.

<70>
Accession Number
2026549224
Title
The impact of COVID-19 on the practice of pediatric cardiology: a
narrative review.
Source
Pediatric Medicine. 5 (no pagination), 2022. Article Number: 6559. Date of
Publication: 28 Nov 2022.
Author
Chen C.K.; Grignani R.T.; Lim Y.P.; Quek S.C.
Institution
(Chen, Grignani, Lim, Quek) Department of Paediatrics, Yong Loo Lin School
of Medicine, National University of Singapore, Singapore, Singapore
(Chen, Grignani, Quek) Khoo Teck Puat-National University Children's
Medical Institute, National University Health System, Singapore, Singapore
Publisher
AME Publishing Company
Abstract
Background and Objective: Coronavirus disease 2019 (COVID-19), caused by
the severe acute respiratory syndrome virus 2 (SARS-CoV-2), is a global
pandemic evolving in real time and affecting persons of all ages.
Contemporary pediatric data demonstrate that children of all ages are
susceptible to SARSCoV- 2, and that infants under 1 year of age are at
risk for severe disease although this still is a relatively rare outcome.
This narrative overview discusses the impact of the COVID-19 pandemic on
various aspects of pediatric cardiology, and proposes strategies to
mitigate disruptions, so as to better future-proof our practice.
 Method(s): PubMed, EMBASE and Google Scholar databases were searched
for literature in English from year 2020 through April 2021. Key Content
and Findings: There is an overall decreased in ambulatory clinic volume
with clinical visits restricted for emergency purposes. Cardiovascular
services including transthoracic echocardiography, fetal echocardiography,
cardiac catheterization and intervention, and cardiac surgeries have been
reported to have declined and performed on a priority basis. Infants and
young children with hemodynamically significant congenital heart disease,
cyanosis and pulmonary hypertension may constitute a vulnerable group with
known susceptibility to acute infectious viral illnesses, and could be
considered high-risk for complications related to COVID-19 infection.
Associated with SARS-CoV-2, the newly described multisystem inflammatory
syndrome in children have led to serious and life-threatening illness in
previously healthy children and adolescents. Conclusion(s): COVID-19
has had a profound impact on the practice of pediatric cardiology and will
continue to affect all aspects of patient care. As pediatric cardiologists
play an important role in the care and outcomes of these patients, the
approach to the evaluation and management of children with heart disease
in the COVID-19 era, will evolve as the pandemic rages on. Strategies
incorporating new technologyenabled options, maintaining staff well-being,
both physically and mentally, and ensuring adequate supply of consumables
including personal protective equipment (PPE) and machines are imperative
for us to fight the challenge. Copyright © 2022 Pediatric
Medicine.All rights reserved.

<71>
Accession Number
2026589143
Title
Impact of leaflet thrombosis on valve haemodynamic status after
transcatheter aortic valve replacement.
Source
Heart. (no pagination), 2023. Article Number: heartjnl-2023-322946. Date
of Publication: 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) Asan Image Metrics, 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, Hong Kong
(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, Hsin-Chu Branch, National Taiwan University Hospital,
Hsin-Chu, Taiwan (Republic of China)
(Kim) Cardiology, CHA Ilsan Medical Center, Gyeonggi-do, Goyang-si, South
Korea
(Kang) Cardiology, CHA Bundang Medical Center, Gyeonggi-do, Seongnam,
South Korea
(Ko) Cardiology, Kokura Memorial Hospital, Fukuoka, Kitakyushu, Japan
Publisher
BMJ Publishing Group
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.clinicaltrials.gov). Copyright © Author(s) (or
their employer(s)) 2023. No commercial re-use. See rights and permissions.
Published by BMJ.

<72>
Accession Number
2025066117
Title
Osteophyte Bridge Formation Correlates with Vascular Calcification and
Cardiovascular Disease in Diffuse Idiopathic Skeletal Hyperostosis.
Source
Journal of Clinical Medicine. 12(16) (no pagination), 2023. Article
Number: 5412. Date of Publication: August 2023.
Author
Hirota R.; Teramoto A.; Yoshimoto M.; Takashima H.; Yasuda N.; Tsukamoto
A.; Iesato N.; Emori M.; Iba K.; Kawaharada N.; Yamashita T.
Institution
(Hirota, Teramoto, Yoshimoto, Tsukamoto, Iesato, Emori, Iba, Yamashita)
Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical
University, Sapporo 060-8556, Japan
(Takashima) Faculty of Health Sciences, Hokkaido University, Sapporo
060-0808, Japan
(Yasuda, Kawaharada) Department of Cardiovascular Surgery, School of
Medicine, Sapporo Medical University, Sapporo 060-8556, Japan
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory
spondyloarthropathy characterized by ectopic calcification of spinal cord
tissue. Its etiology is possibly polygenic. However, its pathogenesis and
systemic effects remain unclear. Recent studies have reported a high
prevalence of DISH in heart failure patients. The authors investigated how
the incidence and severity of DISH are associated with vascular
calcification and the occurrence of cardiovascular events. In this
retrospective chart review study, 500 patients with cardiovascular disease
who underwent surgery (cardiovascular events group) and 500 patients with
non-cardiovascular disease who underwent computed tomography scans
(non-cardiovascular events group) were randomly selected to investigate
the degree of ossification of the anterior longitudinal ligament and the
incidence of DISH. We found that the incidence of DISH was higher in
patients with cardiovascular events and that patients with DISH had more
calcification of the coronary arteries and aorta. Next, we examined the
relationship between the degree of coronary and aortic calcification, the
incidence of DISH, and the degree of ossification of the anterior
longitudinal ligament in the non-cardiovascular event group. The
prevalence of DISH in the cardiovascular and non-cardiovascular groups was
31.4% and 16.5%, respectively (p = 0.007). Aortic calcification and a
predominant degree of vascular calcification with a certain level of
ossification of the anterior longitudinal ligament suggest some
correlation between DISH and cardiovascular events. This study is
important in understanding the pathophysiology and pathogenesis of
DISH. Copyright © 2023 by the authors.

<73>
Accession Number
2024908708
Title
Prehabilitation in older patients prior to elective cardiac procedures
(PRECOVERY): study protocol of a multicenter randomized controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 533. Date of
Publication: December 2023.
Author
Steinmetz C.; Heinemann S.; Kutschka I.; Hasenfuss G.; Asendorf T.;
Remppis B.A.; Knoglinger E.; Grefe C.; Albes J.M.; Baraki H.; Baumbach C.;
Brunner S.; Ernst S.; Harringer W.; Heider D.; Heidkamp D.;
Herrmann-Lingen C.; Hummers E.; Kocar T.; Konig H.-H.; Krieger S.; Liebold
A.; Martens A.; Matzeder M.; Mellert F.; Muller C.; Puls M.; Reiss N.;
Schikora M.; Schmidt T.; Vestweber M.; Sadlonova M.; von Arnim C.A.F.
Institution
(Steinmetz, Heinemann, Sadlonova, von Arnim) Department of Geriatrics,
University of Goettingen Medical Center, Robert-Koch-Strase 40, Goettingen
37075, Germany
(Kutschka, Baraki, Sadlonova) Department of Cardiovascular and Thoracic
Surgery, University of Goettingen Medical Center, Goettingen, Germany
(Kutschka, Hasenfus, Baraki, Herrmann-Lingen, Puls, Sadlonova, von Arnim)
German Center for Cardiovascular Research (DZHK), Partner Site Goettingen,
Goettingen, Germany
(Hasenfus, Puls) Department of Cardiology and Pneumology, University of
Goettingen Medical Center, Goettingen, Germany
(Asendorf) Department of Medical Statistics, University of Goettingen
Medical Center, Goettingen, Germany
(Remppis, Baumbach) Heart and Vascular Center Bad Bevensen, Bad Bevensen,
Germany
(Knoglinger) Kirchberg Clinic, Bad Lauterberg, Germany
(Grefe) Clinic and Rehabilitation Center Lippoldsberg, Wesertal, Germany
(Albes) Immanuel Clinic Bernau, Brandenburg Heart Center, Bernau, Germany
(Brunner) Clinic Fallingbostel, Bad Fallingbostel, Germany
(Ernst) ZAR Center for Outpatient Rehabilitation GmbH, Ulm, Germany
(Harringer) Department of Cardiac, Thoracic and Vascular Surgery,
Braunschweig Municipal Hospital, Brunswick, Germany
(Heider, Konig) Department of Health Economics and Health Services
Research, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf,
Germany
(Heidkamp) Rehabilitation Center Oldenburg, Oldenburg, Germany
(Herrmann-Lingen, Krieger, Sadlonova) Department of Psychosomatic Medicine
and Psychotherapy, University of Goettingen Medical Center, Goettingen,
Germany
(Hummers, Muller) Department of General Practice, University of Goettingen
Medical Center, Goettingen, Germany
(Kocar) Geriatric Center Ulm, Ulm, Germany
(Liebold) Department for Thoracic, Cardiac and Vascular Surgery, Ulm
University Medical Center, Ulm, Germany
(Martens) Department of Cardiothoracic, Transplantation and Vascular
Surgery, Hannover Medical School, Hannover, Germany
(Matzeder) AOK Health Insurance (AOK Lower Saxony), Helmstedt, Germany
(Mellert) Department of Cardiac Surgery, Oldenburg Hospital, Oldenburg,
Germany
(Reiss, Schmidt) Schuchtermann-Schiller'sche Clinic, Bad Rothenfelde,
Germany
(Schikora) Brandenburg Clinic, Bernau Waldsiedlung, Germany
(Schmidt) Institute of Cardiology and Sports Medicine, Department
Preventive and Rehabilitative Sport and Exercise Medicine, German Sport
University, Cologne, Germany
(Vestweber) German Heart Foundation, Frankfurt am Main, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Previous studies have demonstrated the efficacy of
rehabilitation after a cardiovascular procedure. Especially older and
multimorbid patients benefit from rehabilitation after a cardiac
procedure. Prehabilitation prior to cardiac procedures may also have
positive effects on patients' pre- and postoperative outcomes. Results of
a current meta-analysis show that prehabilitation prior to cardiac
procedures can improve perioperative outcomes and alleviate adverse
effects. Germany currently lacks a structured cardiac prehabilitation
program for older patients, which is coordinated across healthcare
sectors. Method(s): In a randomized, controlled, two-arm parallel
group, assessor-blinded multicenter intervention trial (PRECOVERY), we
will randomize 422 patients aged 75 years or older scheduled for an
elective cardiac procedure (e.g., coronary artery bypass graft surgery or
transcatheter aortic valve replacement). In PRECOVERY, patients randomized
to the intervention group participate in a 2-week multimodal
prehabilitation intervention conducted in selected cardiac-specific
rehabilitation facilities. The multimodal prehabilitation includes seven
modules: exercise therapy, occupational therapy, cognitive training,
psychosocial intervention, disease-specific education, education with
relatives, and nutritional intervention. Participants in the control group
receive standard medical care. The co-primary outcomes are quality of life
(QoL) and mortality after 12 months. QoL will be measured by the EuroQol
5-dimensional questionnaire (EQ-5D-5L). A health economic evaluation using
health insurance data will measure cost-effectiveness. A mixed-methods
process evaluation will accompany the randomized, controlled trial to
evaluate dose, reach, fidelity and adaptions of the intervention.
 Discussion(s): In this study, we investigate whether a tailored
prehabilitation program can improve long-term survival, QoL and functional
capacity. Additionally, we will analyze whether the intervention is
cost-effective. This is the largest cardiac prehabilitation trial
targeting the wide implementation of a new form of care for geriatric
cardiac patients. Trial registration: German Clinical Trials Register
(DRKS; http://www.drks.de ; DRKS00030526). Registered on 30 January
2023. Copyright © 2023, BioMed Central Ltd., part of Springer
Nature.

<74>
Accession Number
2024992316
Title
Clinical outcomes and the impact of valve morphology for transcatheter
aortic valve replacement in bicuspid aortic valves: A systematic review
and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Gupta R.; Mahmoudi E.; Behnoush A.H.; Malik A.H.; Mahajan P.; Lin M.;
Bandyopadhyay D.; Goel A.; Chakraborty S.; Aedma S.K.; Gupta H.B.; Vyas
A.V.; Combs W.G.; Mathur M.; Yakubov S.J.; Patel N.C.
Institution
(Gupta, Vyas, Combs, Patel) Lehigh Valley Heart Institute, Lehigh Valley
Health Network, Allentown, PA, United States
(Mahmoudi) Universal Scientific Education and Research Network, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Behnoush) School of Medicine, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Malik, Bandyopadhyay, Goel, Chakraborty) Department of Cardiology,
Westchester Medical Center and New York Medical College, Valhalla, NY,
United States
(Mahajan, Aedma) Department of Medicine, Carle Foundation Hospital,
Urbana, IL, United States
(Lin) Morsani College of Medicine, University of South Florida, Tampa, FL,
United States
(Gupta) Guru Nanak Dev Hospital, Department of medicine, Government
Medical College, Punjab, Amritsar, India
(Mathur) Heart & Vascular Institute, Penn State Health, Milton S. Hershey
Medical Center, Hershey, PA, United States
(Yakubov) Department of Interventional Cardiology, Riverside
Methodist-Ohio Health, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Bicuspid aortic valve (BAV) is present in approximately
0.5%-2% of the general population, causing significant aortic stenosis
(AS) in 12%-37% of affected individuals. Transcatheter aortic valve
replacement (TAVR) is being considered the treatment of choice in patients
with symptomatic AS across all risk spectra. Aim(s): Aim Our study
aims to compare TAVR outcomes in patients with BAV versus tricuspid aortic
valves (TAV). Method(s): A comprehensive literature search was
performed in PubMed, Web of Science, and Cochrane trials. Studies were
included if they included BAV and TAV patients undergoing TAVR with
quantitative data available for at least one of our predefined outcomes.
Meta-analysis was performed by the random-effects model using Stata
software. Result(s): Fifty studies of 203,288 patients were included.
BAV patients had increased 30-day all-cause mortality (odds ratio [OR] =
1.23 [1.00-1.50], p = 0.05), in-hospital stroke (OR = 1.39 [1.01-1.93], p
= 0.05), in-hospital and 30-day PPI (OR = 1.13 [1.00-1.27], p = 0.04; OR =
1.16 [1.04-1.13], p = 0.01) and in-hospital, 30-day and 1-year aortic
regurgitation (AR) (OR = 1.48 [1.19-1.83], p < 0.01; OR = 1.79
[1.26-2.52], p < 0.01; OR = 1.64 [1.03-2.60], p = 0.04). Subgroup analysis
on new-generation valves showed a reduced 1-year all-cause mortality (OR =
0.86 [CI = 0.75-0.98], p = 0.03), despite higher in-hospital and 30-day
PPI (OR = 0.1.21 [1.04-1.41], p = 0.01; OR = 1.17 [1.05-1.31], p = 0.01)
and in-hospital AR (OR = 1.62 [1.14-2.31], p = 0.01) in the BAV group. The
quality of included studies was moderate-to-high, and only three analyses
presented high heterogeneity. Conclusion(s): TAVR is associated with
comparable outcomes in patients with BAV and TAV. Careful selection of BAV
cases by preprocedural assessment of valve anatomy and burden of
calcification, pre- and post-procedural dilation, and implementing newer
generations of valves may improve the safety and efficacy of TAVR in BAV
patients. Copyright © 2023 Wiley Periodicals LLC.

<75>
Accession Number
642103363
Title
Hygiene with wet wipes in bedridden patients to prevent
catheter-associated urinary tract infection in cardiac surgery: A
randomized controlled trial.
Source
Infection control and hospital epidemiology. (pp 1-4), 2023. Date of
Publication: 24 Aug 2023.
Author
Castella L.; Casas I.; Gimenez M.; Reina D.; Sopena N.; Garcia-Quesada
M.-J.
Institution
(Castella, Reina, Garcia-Quesada) Infection Control Nursing, Infection
Control Team, Germans Trias i Pujol University Hospital, Badalona, Spain
(Castella, Casas, Sopena, Garcia-Quesada) Germans Trias i Pujol Research
Institute (IGTP), Germans Trias i Pujol University Hospital, Badalona,
Spain
(Castella, Reina, Garcia-Quesada) NURECARE-IGTP Nursing Research Group,
Germans Trias i Pujol Research Institute, Badalona, Spain
(Casas) Preventive Medicine Department, Infection Control Team, Germans
Trias i Pujol University Hospital, Badalona, Spain
(Casas, Sopena) Universitat Autonoma de Barcelona, Cerdanyola del Valles,
Barcelona, Spain
(Gimenez, Sopena) Microbiology Department, Infection Control Team, Germans
Trias i Pujol University Hospital, North Metropolitan Clinical Laboratory,
Badalona, Spain
(Gimenez, Sopena) Infectious Diseases Department, Infection Control Team,
Germans Trias i Pujol University Hospital, Badalona, Spain
(Gimenez, Sopena) CIBERES Instituto de Salud Carlos III, Madrid, Spain
Publisher
NLM (Medline)
Abstract
We assessed hygiene with wet wipes in bedridden patients with urinary
catheters for catheter-associated urinary tract infection (CAUTI)
prevention. CAUTIs occurred in 16.5% of the control group compared to 5.9%
of the intervention group (P = .035). Hygiene with wet wipes can
substitute for conventional hygiene for preventing CAUTI.

<76>
Accession Number
642100695
Title
Minimally invasive, surgical, and transcatheter aortic valve replacement:
Network meta-analysis.
Source
Journal of cardiology. (no pagination), 2023. Date of Publication: 21 Aug
2023.
Author
Awad A.K.; Ahmed A.; Mathew D.M.; Varghese K.S.; Mathew S.M.; Khaja S.;
Newell P.C.; Okoh A.K.; Hirji S.
Institution
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Ahmed, Mathew, Varghese, Mathew, Khaja) City University of New York
School of Medicine, New York, NY, USA
(Newell, Hirji) Division of Thoracic and Cardiac Surgery, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Okoh) Emory University, Atlanta, GA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has evolved as
an alternative to surgical aortic valve replacement (SAVR). In addition to
full-sternotomy (FS), recent reports have shown successful
minimally-invasive SAVR approaches, including mini-sternotomy (MS) and
mini-thoracotomy (MT). This network-meta-analysis (NMA) seeks to provide
an outcomes comparison based on these different modalities (MS, MT, TAVR)
compared with FS as a reference arm for the management of aortic valve
disease. METHOD(S): A comprehensive literature search was performed
to identify studies that compared minimally-invasive SAVR (MS/MT) to
conventional FS-SAVR, and/or TAVR. Bayesian NMA was performed using the
random effects model. Outcomes were pooled as risk ratios (RR) with their
95% confidence intervals (CIs). Our primary outcomes included 30-day
mortality, stroke, acute kidney injury (AKI), major bleeding, new
permanent pacemaker (PPM), and paravalvular leak (PVL). We also assessed
long-term mortality at the latest follow-up. RESULT(S): A total of
27,117 patients (56 studies) were included; 10,397 patients had FS SAVR,
9523 had MS, 5487 had MT, and 1710 had TAVR. Compared to FS, MS was
associated with statistically-significantly lower rates of 30-day
mortality (RR, 0.76, 95%CI 0.59-0.98), stroke (RR, 0.84, 95%CI 0.72-0.97),
AKI (RR, 0.76, 95%CI 0.61-0.94), and long-term mortality (RR 0.84, 95%CI
0.72-0.97) at a weighted mean follow-up duration of 10.4years, while MT
showed statistically-significantly higher rates of 30-day PVL (RR, 3.76,
95%CI 1.31-10.85) and major bleeding (RR 1.45; 95%CI 1.08-1.94). TAVR had
statistically significant lower rates of 30-day AKI (RR 0.49, 95%CI
0.31-0.77), but showed statistically-significantly higher PPM (RR 2.50;
95%CI 1.60-3.91) and 30-day PVL (RR 12.85, 95%CI 5.05-32.68) compared to
FS. CONCLUSION(S): MS was protective against 30-day mortality,
stroke, AKI, and long-term mortality compared to FS; TAVR showed higher
rates of 30-day PVL and PPM but was protective against AKI. Conversely, MT
showed higher rates of 30-day PVL and major bleeding. With the emergence
of TAVR, the appropriate benchmarks for SAVR comparison in future trials
should be the minimally-invasive SAVR approaches to provide clinical
equipoise. Copyright © 2023. Published by Elsevier Ltd.

<77>
Accession Number
642099832
Title
Comparison of Initial Antithrombotic Regimens after Left Atrial Appendage
Occlusion: A Systematic Review and Network Meta-analysis.
Source
Journal of the American College of Cardiology. (no pagination), 2023.
Date of Publication: 16 Aug 2023.
Author
Carvalho P.E.P.; Gewehr D.M.; Miyawaki I.A.; Nogueira A.; Felix N.; Garot
P.; Darmon A.; Mazzone P.; Preda A.; Nascimento B.R.; Kubrusly L.F.;
Cardoso R.
Institution
(Carvalho) Department of Medicine, Federal University of Minas Gerais,
Belo Horizonte, Brazil
(Gewehr, Kubrusly) CuritibaBrazil
(Miyawaki) Department of Medicine, Federal University of Parana, Curitiba,
Brazil
(Nogueira) Department of Medicine, Medical and Public Health School of
Bahia, Salvador, Brazil
(Felix) Department of Medicine, Federal University of Campina Grande,
Cajazeiras, Brazil
(Garot) Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques
Cartier, Massy, France
(Darmon) Centre Cardiologique du Nord, Saint-Denis, France
(Mazzone, Preda) Department of Cardiac Electrophysiology and
Arrhythmology, IRCCS San Raffaele Hospital, Milan, Italy
(Nascimento) Department of Internal Medicine, Federal University of Minas
Gerais, Belo Horizonte, Brazil; Interventional Cardiology Department,
Hospital Madre Teresa, Belo Horizonte, Brazil
(Cardoso) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal antithrombotic therapy following left atrial
appendage occlusion (LAAO) in patients with nonvalvular atrial
fibrillation (AF) remains uncertain. OBJECTIVE(S): To compare the
efficacy and safety of various antithrombotic strategies after LAAO.
 METHOD(S): We searched MEDLINE, Cochrane, Embase, LILACS, and
ClinicalTrials.gov databases for studies reporting outcomes after LAAO,
stratified by antithrombotic therapy prescribed at postprocedural
discharge. Direct oral anticoagulants (DOACs), vitamin-K antagonists
(VKAs), single antiplatelet therapy (SAPT), dual antiplatelet therapy
(DAPT), DOAC plus SAPT, VKA plus SAPT, and no antithrombotic therapy were
analyzed. We performed a frequentist random-effects model network
meta-analysis to estimate the odds ratio (OR) with 95% confidence
intervals (CI) for each comparison. The P-scores provided a ranking of
treatments. RESULT(S): Forty-one studies comprising 12,451 patients
with nonvalvular AF were included. DAPT, DOAC, DOAC plus SAPT, and VKA
were significantly superior to no therapy to prevent device-related
thrombosis. DOAC was associated with lower all-cause mortality relative to
VKA (OR 0.39; 95% CI 0.17-0.89; p=0.03). As compared with SAPT, DAPT was
associated with less thromboembolic events (OR 0.50; 95% CI 0.29-0.88;
p=0.02), without a difference in major bleeding. In the analysis of
P-scores, DOAC monotherapy was the strategy most likely to have lower
thromboembolic events and major bleeding. CONCLUSION(S): In this
network meta-analysis comparing initial antithrombotic therapies following
LAAO, monotherapy with DOAC had the highest likelihood of lower
thromboembolic events and major bleeding. DAPT was associated with a lower
incidence of thromboembolic events compared with SAPT and may be a
preferred option in patients unable to tolerate
anticoagulation. Copyright © 2023. Published by Elsevier Inc.

<78>
Accession Number
642096545
Title
Sex differences in permanent pacemaker implantation after transcatheter
aortic valve replacement: a systematic review and meta-analysis.
Source
Expert review of cardiovascular therapy. (no pagination), 2023. Date of
Publication: 22 Aug 2023.
Author
Rivera F.B.; Cha S.W.; Aparece J.P.; Gonzales J.S.T.; Salva W.F.C.;
Bantayan N.R.B.; Carado G.P.; Sharma V.; Al-Abcha A.; Co M.L.; Collado
F.M.S.; Volgman A.S.
Institution
(Rivera) Department of Medicine, Lincoln Medical Center, New York, NY,
USA()
(Cha, Aparece, Gonzales, Salva) Cebu Institute of Medicine, Philippines
(Bantayan) University of the Philippines College of Medicine, Manila,
Philippines
(Carado) University of the East Ramon Magsaysay Memorial Medical Center,
Quezon, Philippines
(Sharma) Department of Cardiology, University of Iowa Hospitals and
Clinics, Iowa City, IA, United States
(Al-Abcha) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Co) Section of Clinical Cardiac Electrophysiology, Thomas Jefferson
University, PA, United States
(Collado, Volgman) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: There is limited evidence on the effect of sex on permanent
pacemaker implantation (PPMI) after transcatheter aortic valve replacement
(TAVR). The primary objective of this meta-analysis was to determine the
role of sex among patients requiring PPMI post-TAVR. METHOD(S): A
literature search was conducted using the SCOPUS, MEDLINE, and CINAHL
databases for studies published until October 2022. Eligible studies
included published randomized controlled trials (RCTs) and Observational
Cohort Studies (OCS) articles that reported PPMI as an outcome of
pacemaker status following TAVR. This study was performed per the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) Guidelines. Publication bias was estimated using a Funnel plot
and Egger's test. Data were pooled using a random-effects model. The
primary endpoint was the sex difference in PPMI after TAVR, with odds
ratios and 95% confidence intervals (CIs) extracted. RESULT(S): Data
was obtained from 63 studies, and a total of 79,655 patients were
included. The cumulative PPMI rate was 15.5% (95% CI, 13.6%-17.7%). The
pooled analysis revealed that while there were more females than males
undergoing TAVR (51.6%, 95% CI 50.4%-52.8%), males have a 14.5% higher
risk for post-TAVR PPMI than females (OR 1.145, 95% CI 1.047 - 1.253,
P<0.01). CONCLUSION(S): Males are more likely to experience PPMI
after TAVR than females. Further research needs to be done to better
explain these observed differences in outcomes.

<79>
Accession Number
642095045
Title
The Effect of CytoSorb on Inflammatory Markers in Critically Ill Patients:
A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Source
Critical care medicine. (no pagination), 2023. Date of Publication: 18
Aug 2023.
Author
Heymann M.; Schorer R.; Putzu A.
Institution
(Heymann) Division of Anesthesiology, Department of Anesthesiology,
Pharmacology, Intensive Care and Emergency Medicine, Geneva University
Hospitals, Geneva, Switzerland
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The effectiveness of CytoSorb at removing inflammatory
mediators in critically ill patients is controversial. DATA SOURCES:
Electronic databases were searched from inception to May 2023. STUDY
SELECTION: Randomized controlled trials reporting the effects of CytoSorb
therapy on inflammatory parameters in critically ill patients with
hyperinflammatory conditions were included. DATA EXTRACTION: Two authors
screened articles for eligibility, extracted data, and assessed the risk
of bias, conflicts of interest, and certainty of evidence (CoE). The
primary outcome was interleukin (IL)-6 at 1 day after initiation of the
therapy. Secondary outcomes included various inflammatory markers at 1, 2,
3, and 5 days and mortality. Data were pooled if at least three trials
reported the outcome of interest. We conducted meta-analyses of the data
using a random-effects model. DATA SYNTHESIS: Seventeen trials (n = 855)
were included. Fourteen trials were judged to have notable concern about
conflicts of interest. Seven trials were performed in medical ICU patients
with hyperinflammatory conditions and 10 in complex cardiovascular surgery
under cardiopulmonary bypass. Hemoadsorption with CytoSorb was not
associated with lower IL-6 at 1 day (mean difference -5.98 [95% CI, -30.44
to 18.48] pg/mL), 2 days, 3 days, or 5 days after initiation of the
treatment, as well as the concentration of procalcitionin. The levels of
C-reactive protein were not lower with CytoSorb at 1, 2, and 3 days. The
use of CytoSorb was associated with higher mortality at latest follow-up
(relative risk = 1.22 [95% CI, 1.02-1.45]) and at 30 days. CoE ranged from
low to very low. CONCLUSION(S): The use of CytoSorb hemoadsorption in
a mixed population of critically ill patients with hyperinflammatory
conditions does not exhibit a consistent decrease in IL-6 and other
inflammatory parameters within the first 5 days of treatment. The
significant uncertainty surrounding these findings highlights the need for
further investigations. Copyright © 2023 The Author(s). Published
by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care
Medicine and Wolters Kluwer Health, Inc.

<80>
Accession Number
2026478570
Title
Achieved systolic blood pressure and cardiovascular outcomes in
60-80-year-old patients: The Strategy of Blood Pressure Intervention in
the Elderly Hypertensive Patients (STEP) trial.
Source
European Journal of Preventive Cardiology. 30(10) (pp 1017-1027), 2023.
Date of Publication: 01 Aug 2023.
Author
Deng Y.; Bai J.; Liu W.; Guo Z.; Zhang J.; Huang R.; Yang X.; Yu C.; Yu
J.; Guo X.; Wu H.; Liu P.; Zhang W.; Cai J.
Institution
(Deng, Bai, Guo, Wu, Liu, Zhang, Cai) Hypertension Center, FuWai Hospital,
State Key Laboratory of Cardiovascular Disease, National Center for
Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of
Medical Sciences, Beilishi Road 167, Xicheng District, Beijing 100037,
China
(Yang) Department of Cardiology, Beijing ChaoYang Hospital, Capital
Medical University, Beijing 100020, China
(Liu) Department of Cardiology, Beijing Hospital, National Center of
Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical
Science, Beijing 100730, China
(Guo) Department of Cardiology, FuWai Yunnan Cardiovascular Hospital,
Kunming, Yunnan 650106, China
(Zhang) Department of Cardiology, The First Hospital of Shanxi Medical
University, Shanxi, Taiyuan 030001, China
(Huang) Department of Cardiology, The First Affiliated Hospital of Guangxi
Medical University, Nanning, Guangxi 530027, China
(Yang) Department of Cardiology, The Second Affiliated Hospital of Baotou
Medical College, Inner Mongolia, Baotou 014030, China
(Yu) Department of Cardiology, The Sixth Hospital of Nanchang, Nanchang,
Jiangxi 330003, China
(Yu) Department of Cardiology, Lanzhou University Second Hospital,
Lanzhou, Gansu 730000, China
Publisher
Oxford University Press
Abstract
Aims: Intensive systolic blood pressure (SBP) lowering has been
increasingly used; however, data is missing on patients who had
target-achieved (TA). This study aims to show the cardiovascular effect of
maintaining SBP at intensive levels. Method(s): The Strategy of Blood
Pressure Intervention in Elderly Hypertensive Patients (STEP) trial was a
multicentre, randomized, controlled trial which enrolled 8511 young-older
(60-80 years) hypertensive patients without prior stroke to compare the
cardiovascular prognosis of the intensive treatment (SBP target, 110 to
<130 mmHg) vs. the standard treatment (130 to <150 mmHg). This secondary
analysis assessed data in patients who achieved a mean SBP within target
values. The association of mean achieved SBP and cardiovascular events was
examined using a cubic spline function. Result(s): In total, 3053
patients (72.0%) in the intensive-treatment group and 3427 (80.3%) in the
standard-treatment group had an SBP target achieved, with mean follow-up
SBP values of 124.2 mmHg and 137.4 mmHg, respectively. Throughout the
median 3.38-year follow-up, the cardiovascular risk was significantly
lower in the TA intensive-treatment group than in the TA
standard-treatment group [adjusted hazard ratio (HR) 0.61, 95% confidence
interval (CI) 0.46-0.80; P < 0.001]. In the intensive-treatment group,
patients failing to achieve SBP targets presented higher cardiovascular
risk than those TA patients (HR 2.04, 95% CI 1.44-2.88; P < 0.001). A
J-shaped relationship was observed between the mean achieved SBP and risk
of cardiovascular events, with the lowest risk at an SBP of 126.9 mmHg.
 Conclusion(s): Maintaining SBP at <130 mmHg offers additional
cardiovascular benefits among young-older patients with hypertension.
Registration: ClinicalTrials.gov: NCT03015311. Copyright © 2023
The Author(s). Published by Oxford University Press on behalf of the
European Society of Cardiology.

<81>
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.

<82>
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.

<83>
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.

<84>
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.

<85>
Accession Number
2024847074
Title
Inspiratory muscle training to reduce risk of pulmonary complications
after coronary artery bypass grafting: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1223619. Date of Publication: 2023.
Author
Xiang Y.; Zhao Q.; Luo T.; Zeng L.
Institution
(Xiang, Zhao, Luo, Zeng) Department of Critical Care Medicine, West China
Hospital, Sichuan University, West China School of Nursing, Sichuan
University, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: Pulmonary complications occur in a substantial proportion of
patients who undergo coronary artery bypass grafting. Inspiratory muscle
training (IMT), a simple, well-tolerated physical therapy, has been
proposed to reduce the risk of complications, but its efficacy remains
controversial. Method(s): Randomized controlled trials (RCTs)
examining the influence of IMT on the risk of pulmonary complications
after coronary artery bypass grafting were identified from PubMed, Embase,
CENTRAL, CINAL, and Web of Science through March 2023. Data were
meta-analyzed for the primary outcomes of pulmonary complications, defined
as pneumonia, pleural effusion, and atelectasis; and in terms of the
secondary outcomes of maximum inspiratory pressure, maximum expiratory
pressure, length of hospitalization, 6 min walk test, and peak expiratory
flow and other outcomes. Risk of bias and quality of evidence assessments
were carried out using the RoB 2.0 and Grading of Recommendations
Assessment, Development and Evaluation (GRADE) applied to primary outcomes
of pulmonary complications. Result(s): Data from eight RCTs involving
755 patients were meta-analyzed. IMT was associated with a significantly
lower risk of postoperative pneumonia [relative risk (RR) 0.39, 95%
confidence interval (CI) 0.25-0.62, P < 0.0001] and atelectasis (RR 0.43,
95% CI 0.27-0.67, P = 0.0002), but not pleural effusion (RR 1.09, 95% CI
0.62-1.93, P = 0.76). IMT was associated with significantly better maximum
inspiratory pressure (preoperative: mean difference (MD) 16.55
cmH<inf>2</inf>O, 95% CI 13.86-19.24, P < 0.00001; postoperative: mean
difference (MD) 8.99 cmH<inf>2</inf>O, 95% CI 2.39-15.60, P = 0.008) and
maximum expiratory pressure (MD 7.15 cmH<inf>2</inf>O, 95% CI: 1.52-12.79,
P = 0.01), and with significantly shorter hospitalization (MD -1.71 days,
95% CI -2.56 to -0.87, P < 0.001). IMT did not significantly affect peak
expiratory flow or distance traveled during the 6 min walk test.
 Conclusion(s): The available evidence from medium and high quality
trials suggests that IMT can significantly decrease the risk of pneumonia
and atelectasis after coronary artery bypass grafting while shortening
hospitalization and improving the strength of respiratory muscles.
Systematic Review Registration: https://www.crd.york.ac.uk/prospero/,
identifier: CRD42023415817. Copyright 2023 Xiang, Zhao, Luo and Zeng.

<86>
Accession Number
2024275460
Title
Sutureless valves versus aortic root enlargement for aortic valve
replacement in small aortic annulus: A systematic review and pooled
analysis.
Source
Asian Cardiovascular and Thoracic Annals. 31(6) (pp 524-532), 2023. Date
of Publication: July 2023.
Author
Agarwal R.; Arnav A.; Ranjan A.; Mudgal S.; Singh D.
Institution
(Agarwal) Department of Cardiothoracic Surgery, All India Institute of
Medical Sciences (AIIMS), Jharkhand, Deoghar, India
(Arnav) Department of Surgical Oncology, All India Institute of Medical
Sciences (AIIMS), Jharkhand, Deoghar, India
(Ranjan) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jharkhand, Deoghar, India
(Mudgal) College of Nursing, All India Institute of Medical Sciences
(AIIMS), Jharkhand, Deoghar, India
(Singh) Department of Radiotherapy, All India Institute of Medical
Sciences (AIIMS), Jharkhand, Deoghar, India
Publisher
SAGE Publications Inc.
Abstract
Background: Very few studies provide direct comparisons between aortic
root enlargement and sutureless valve implantation in patients with a
small aortic annulus who underwent aortic valve replacement. This study
aims to provide comparative outcomes between the two in such a subset of
patients, through a systematic review and pool analysis. Method(s):
The PubMed, Scopus and Embase databases were searched using the
appropriate terms. The data from original articles mentioning aortic root
enlargement and sutureless valves in a single or comparative study with
another group of patients with a small aortic annulus were pooled and
analyzed using descriptive statistics. Result(s): Both
cardiopulmonary bypass (68.4 vs. 125.03 min, p < 0.001) and aortic
cross-clamp times were significantly shorter in the sutureless valve
group, along with a concomitantly higher number of minimally invasive
surgeries. The incidence of permanent pacemaker implantation (9.76% vs.
3.16%, p < 0.00001), patient prosthesis mis-match and paravalvular leak
was significantly higher in the sutureless valve group. In comparison, the
incidence of re-exploration for bleeding was higher in the aortic root
enlargement group (5.27% vs. 3.16%, p < 0.02). The two groups had no
differences in the duration of hospital stays or mortality.
 Conclusion(s): Sutureless valves demonstrated a comparable
hemodynamic outcome with aortic root enlargement in patients with a small
aortic annulus. In addition to this, it greatly facilitated minimally
invasive surgery. However, the high incidence of pacemaker implantation is
still a concern for the widespread recommendation of sutureless valves,
especially in young patients with a small aortic annulus. Copyright
© The Author(s) 2023.

<87>
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

<88>
Accession Number
2026506193
Title
Use of Intravascular Ultrasound and Coronary Angiography to Measure the
Prevalence of Myocardial Bridge in Heart Transplant Patients.
Source
American Journal of Cardiology. 205 (pp 176-181), 2023. Date of
Publication: 15 Oct 2023.
Author
Medina F.; Estrada A.; Fernandez C.; Balkhy H.; Kim G.; Shah A.; Nathan
S.; Paul J.; Kalathiya R.; Blair J.
Institution
(Medina, Estrada) Pritzker School of Medicine, University of Chicago,
Chicago, Illinois, United States
(Fernandez, Kim, Shah, Nathan, Paul, Kalathiya, Blair) Section of
Cardiology, Department of Medicine, University of Chicago Medicine,
Chicago, Illinois, United States
(Balkhy) Section of Cardiology, Department of Surgery, University of
Chicago Medicine, Chicago, Illinois, United States
Publisher
Elsevier Inc.
Abstract
Myocardial bridge (MB) detection rates vary across methods and most
studies that have assessed MB include symptomatic patients. Intravascular
ultrasound (IVUS) is a sensitive tool for MB detection and donor hearts
may serve as a surrogate measure of asymptomatic patients. We used IVUS
and coronary angiography to measure MB prevalence in heart transplant
patients during routine follow-up invasive coronary assessments. This was
a retrospective, single-center study of heart transplant patients who
received follow-up coronary assessments at the University of Chicago Heart
and Vascular Center between December 2014 and December 2021. A single
experienced interventional cardiologist assessed incidental findings of MB
in IVUS and coronary angiography. Detection rates were compared with
meta-analysis-reported prevalence. Of 129 patients, IVUS-detected MB in 87
patients (67.4%), whereas coronary angiography detected 41 (31.8%). All MB
found by coronary angiography were detected by IVUS. Some level of cardiac
allograft vasculopathy was found in 92 patients (71.3%). Our IVUS-detected
MB prevalence was greater than meta-analysis-reported pooled prevalence
across all methods: autopsy, computed tomography angiography, and coronary
angiography (67.4% [95% confidence interval [CI] 59.4 to 75.5] vs 42% [95%
CI 30 to 55]; 22% [95% CI 18 to 25]; 6% [95% CI 5 to 8], p <=0.005). The
difference between our observed IVUS-detected MB prevalence and
meta-analysis autopsy reported MB prevalence was 1.25 (95% CI 1.11 to
1.40). In conclusion, the high prevalence of MB recorded in donor hearts
emphasizes the need to further investigate the causes of chest pain in
patients who are found to have MB. Copyright © 2023

<89>
Accession Number
2022790430
Title
Gender Disparities in Cardiac Surgery Trials: Leadership, Authorship, and
Patient Enrollment.
Source
Annals of Thoracic Surgery. 116(3) (pp 643-649), 2023. Date of
Publication: September 2023.
Author
Soletti G.J.; Perezgrovas-Olaria R.; Dimagli A.; Harik L.; Rong L.Q.;
Bairey Merz C.N.; Rahouma M.; Sandner S.E.; Gelijns A.C.; Gaudino M.
Institution
(Soletti, Perezgrovas-Olaria, Dimagli, Harik, Rahouma, Gaudino) Department
of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York,
United States
(Rong) Department of Anesthesiology, Weill Cornell
Medicine/NewYork-Presbyterian Hospital, New York, New York, United States
(Bairey Merz) Barbra Streisand Women's Heart Center, Smidt Heart
Institute, Cedars-Sinai Medical Center, Los Angeles, California, United
States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Gelijns) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: Studies have highlighted the paucity of women-led randomized
controlled trials (RCTs) in cardiovascular medicine. Whether this finding
also applies to cardiac surgery has not been evaluated. In this study, we
evaluate women authorship, leadership, and women enrollment in cardiac
surgery RCTs. Method(s): A systematic literature search was conducted
to identify RCTs comparing 2 or more adult cardiac surgical procedures
published from 2000 to 2022. Women-led RCTs were defined as those with a
woman as either a first or last author. Linear regression and correlation
analyses were used. Result(s): Of 58 RCTs, 8 (13.8%) were women-led;
17 (29.3%) RCTs had no women authors. Overall, 17.9% of all authors were
women, but only 1.2% of all authors were women cardiac surgeons and only
19% of the RCTs had a women cardiac surgeon among the authors. The median
proportion of women authors was 14.3% by RCT, which was significantly
higher in women-led compared with men-led RCTs (28.6% vs 11.8%; P = .01).
No significant change in the proportion of women authors was observed
during the study period. North American RCTs had a higher proportion of
women authors compared with other geographic regions (28.6% vs 12.5%; P =
.01). No correlation was found between the proportion of women authors and
the proportion of women participants enrolled in individual RCTs.
 Conclusion(s): During the last 2 decades, only a minority of cardiac
surgery RCTs were women-led, and no significant increase in women
authorship occurred. There are important geographic differences in women
authorship. Copyright © 2023 The Society of Thoracic Surgeons

<90>
[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.

<91>
Accession Number
641747021
Title
Relative efficacy and safety of several regional analgesic techniques
following thoracic surgery: a network meta-analysis of randomized
controlled trials.
Source
International journal of surgery (London, England). 109(8) (pp 2404-2413),
2023. Date of Publication: 01 Aug 2023.
Author
Li J.; Sun Q.; Zong L.; Li D.; Jin X.; Zhang L.
Institution
(Li) Department of Thoracic Surgery, Xinjiang Medical University, First
Affiliated Hospital, Urumqi, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: This network meta-analysis was performed to assess the
relative efficacy and safety of various regional analgesic techniques used
in thoracic surgery. MATERIALSAND METHODS: Randomized controlled trials
evaluating different regional analgesic methods were retrieved from
databases, including PubMed, Embase, Web of Science, and the Cochrane
Library, from inception to March 2021. The surface under the cumulative
ranking curve) was estimated to rank the therapies based on the Bayesian
theorem. Moreover, sensitivity and subgroup analyses were performed on the
primary outcomes to obtain more reliable conclusions. RESULT(S):
Fifty-four trials (3360 patients) containing six different methods were
included. Thoracic paravertebral block and erector spinae plane block
(ESPB) were ranked the highest in reducing postoperative pain. As for
total adverse reactions and postoperative nausea and vomiting,
postoperative complications, and duration of hospitalization, ESPB was
found to be superior to other methods. It should be noted that there were
few differences between various methods for all outcomes.
 CONCLUSION(S): Available evidence suggests that ESPB might be the
most effective and safest method for relieving pain after thoracic
surgery, shortening the length of hospital stay and reducing the incidence
of postoperative complications. Copyright © 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<92>
Accession Number
641443999
Title
Transversus thoracic muscle plane block for pain during cardiac surgery: a
systematic review and meta-analysis.
Source
International journal of surgery (London, England). 109(8) (pp 2500-2508),
2023. Date of Publication: 01 Aug 2023.
Author
Xue J.-J.; Cui Y.-Y.; Busse J.W.; Ge L.; Zhou T.; Huang W.-H.; Ding S.-S.;
Zhang J.; Yang K.-H.
Institution
(Xue, Yang) Evidence-based Medicine Center, School of Basic Medical
Science, Lanzhou University
(Xue) Department of Anesthesiology, Gansu Province Hospital of Traditional
Chinese Medicine, China
(Xue) Gansu Clinical Research Center of Integrative Anesthesiology
(Cui, Zhou, Huang, Ding, Zhang) First School of Clinical Medicine, Gansu
University of Chinese Medicine, Chengguan District
(Busse) Department of Anesthesia
(Busse) The Michael G. DeGroote National Pain Centre, McMaster University,
Hamilton, Ontario, Canada
(Ge) Key Laboratory of Evidence Based Medicine and Knowledge Translation
of Gansu Province
(Ge, Yang) Evidence-Based Social Science Research Center, School of Public
Health, Lanzhou University, Lanzhou, China
Publisher
NLM (Medline)
Abstract
STUDY OBJECTIVE: The role of transversus thoracic muscle plane blocks
(TTMPBs) during cardiac surgery is controversial. We conducted a
systematic review to establish the effectiveness of this procedure.
DESIGN: Systematic review. We searched PubMed, Embase, Web of Science,
CENTRAL, WanFang Data, and the China National Knowledge Infrastructure to
June 2022, and followed the GRADE approach to evaluate the certainty of
evidence. STUDY ELIGIBILITY CRITERIA: Eligible studies enrolled adult
patients scheduled to undergo cardiac surgery and randomized them to
receive a TTMPB or no block/sham block. MAIN RESULTS: Nine trials that
enrolled 454 participants were included. Compared to no block/sham block,
moderate certainty evidence found that TTMPB probably reduces
postoperative pain at rest at 12 h [weighted mean difference (WMD) -1.51
cm on a 10 cm visual analogue scale for pain, 95% CI -2.02 to -1.00; risk
difference (RD) for achieving mild pain or less (<=3 cm), 41%, 95% CI
17-65) and 24 h (WMD -1.07 cm, 95% CI -1.83 to -0.32; RD 26%, 95% CI
9-37). Moderate certainty evidence also supported that TTMPB probably
reduces pain during movement at 12 h (WMD -3.42 cm, 95% CI -4.47 to -2.37;
RD 46%, 95% CI 12-80) and at 24 h (WMD -1.73 cm, 95% CI -3.24 to -0.21; RD
32%, 95% CI 5-59), intraoperative opioid use [WMD -28 milligram morphine
equivalent (MME), 95% CI -42 to -15], postoperative opioid consumption
(WMD -17 MME, 95% CI -29 to -5), postoperative nausea and vomiting
(absolute risk difference 255 less per 1000 persons, 95% CI 140-314), and
intensive care unit (ICU) length of stay (WMD -13 h, 95% CI -21 to -6).
 CONCLUSION(S): Moderate certainty evidence showed TTMPB during
cardiac surgery probably reduces postoperative pain at rest and with
movement, opioid consumption, ICU length of stay, and the incidence of
nausea and vomiting. Copyright © 2023 The Author(s). Published by
Wolters Kluwer Health, Inc.

<93>
[Use Link to view the full text]
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.

<94>
Accession Number
641291234
Title
Comparisons of different new-generation transcatheter aortic valve
implantation devices for patients with severe aortic stenosis: a
systematic review and network meta-analysis.
Source
International journal of surgery (London, England). 109(8) (pp 2414-2426),
2023. Date of Publication: 01 Aug 2023.
Author
Yang Y.-X.; Liu X.-M.; Fu Y.; Li C.; Wang H.-J.; Xu L.; Xia K.; Zhang
Z.-Y.; Zhong J.-C.; Chen M.-L.; Su P.-X.; Wang L.-F.
Institution
(Yang) Heart Center and Beijing Key Laboratory of Hypertension, Beijing
Chaoyang Hospital, Capital Medical University, Chaoyang District, Beijing,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether there are differences among the new-generation
transcatheter aortic valve implantation (TAVI) devices for patients with
aortic stenosis remains unclear. The aim of the study was to compare the
efficiency and safety of different new-generation TAVI devices for
patients with aortic stenosis. MATERIALS AND METHODS: A comprehensive
search of PubMed, Embase and Web of Science from their inception to 1
February 2022. Randomized clinical trials and observational studies that
compared two or more different TAVI devices were enroled. Pairwise
meta-analysis and frequentist network meta-analysis were conducted to pool
the outcome estimates of interest. RESULT(S): A total of 79 studies
were finally included. According to the surface under the cumulative
ranking, the top two ranked valves for lower rates of events were as
follows: direct flow medical (DFM) (4.6%) and Lotus (48.8%) for lower rate
of device success; Sapien 3 (16.8%) and DFM (19.7%) for lower mortality;
DFM (8.6%) and Sapien 3 (25.5%) for lower rates of stroke; Evolut (27.6%)
and DFM (35.8%) for lower rates of major and life-threatening bleeding;
Portico (22.6%) and Sapien 3 (41.9%) for lower rates of acute kidney
injury; Acurate (8.6%) and DFM (13.2%) for lower rates of permanent
pacemaker implantation; Lotus (0.3%) and Sapien 3 (22.7%) for lower rates
of paravalvular leak; Evolut (1.4%) and Portico (29.1%) for lower rates of
mean aortic valve gradients. CONCLUSION(S): The findings of the
present study suggested that the device success rates were comparable
among these new-generation valves except for DFM. After excluding DFM,
Sapien 3 might be the best effective for decreased mortality and stroke;
Lotus might be the best effective for decreased paravalvular leak; Evolut
might be the best effective for decreased major and life-threatening
bleeding and mean aortic valve gradients; Acurate and Portico might be the
best effective for decreased permanent pacemaker implantation and acute
kidney injury, respectively. Copyright © 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<95>
Accession Number
2026562206
Title
Comparative effects of off-pump and multiple cardiopulmonary bypass
strategies in coronary artery bypass grafting surgery: Protocol for a
systematic review and network meta-analysis.
Source
BMJ Open. 13(6) (no pagination), 2023. Article Number: e072545. Date of
Publication: 06 Jun 2023.
Author
Tan J.; Gao S.; Li Y.; Li X.; Du L.; Ji B.
Institution
(Tan, Li, Du) Department of Anesthesiology, Sichuan University, Sichuan,
Chengdu, China
(Gao, Ji) Department of Cardiopulmonary Bypass, Fuwai Hospital, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
Xicheng, China
(Li) Department of Cardiac Surgery, Lanzhou University Second Hospital,
Gansu, Lanzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Multiple revascularisation strategies with or without cardiac
arrest have been developed to minimise the negative effects of
cardiopulmonary bypass interventions during coronary artery bypass
grafting (CABG) surgery. Several observational and randomised studies have
evaluated the efficacy of these interventions. This study aims to compare
the efficacy and safety of four prevalent revascularisation strategies
with/without cardiopulmonary bypass interventions in CABG surgery. Methods
and analysis We will search on PubMed, Embase, Cochrane Library, Web of
Science and ClinicalTrials.gov for randomised controlled trials and
observational cohort studies comparing outcomes of CABG surgery under
conventional on-pump, off-pump, on-pump beating heart and minimal
extracorporeal circulation technology. All English articles published
before 30 November 2022 will be considered. The primary outcome will be
30-day mortality. The secondary outcomes will be various early and late
adverse events after CABG surgery. The Revised Cochrane Risk of Bias Tool
and Newcastle-Ottawa Scale will be used to assess the quality of included
articles. A random-effects pairwise meta-analysis will be performed to
report the head-to-head comparison. Then, the network meta-analysis will
be performed using a Bayesian framework with random-effects models. Ethics
and dissemination This research does not require the approval of an ethics
committee as it relies on reviewing literature and does not involve
dealing with humans or animals. The findings of this review will be
published in a peer-reviewed journal. PROSPERO registration number
CRD42023381279. Copyright © Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<96>
[Use Link to view the full text]
Accession Number
2026555827
Title
STICH3C: Rationale and Study Protocol.
Source
Circulation: Cardiovascular Interventions. 16(8) (pp 487-497), 2023. Date
of Publication: 01 Aug 2023.
Author
Fremes S.E.; Marquis-Gravel G.; Gaudino M.F.L.; Jolicoeur E.M.; Bedard S.;
Masterson Creber R.; Ruel M.; Vervoort D.; Wijeysundera H.C.; Farkouh
M.E.; Rouleau J.-L.
Institution
(Fremes, Vervoort, Wijeysundera) Schulich Heart Centre, Sunnybrook Health
Sciences Centre, University of Toronto, ON, Canada
(Marquis-Gravel, Jolicoeur, Rouleau) Montreal Heart Institute, University
of Montreal, QC, Canada
(Gaudino, Jolicoeur) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York City, NY, United States
(Masterson Creber) Division of Health Informatics, Weill Cornell Medicine,
New York City, NY, United States
(Bedard) Centre d'Excellence sur le Partenariat Avec les Patients et le
Public, Montreal, QC, Canada
(Ruel) Division of Cardiac Surgery, University of Ottawa, Heart Institute,
ON, Canada
(Farkouh) Division of Cardiology, Peter Munk Cardiac Centre, Toronto
General Hospital, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Coronary artery bypass grafting (CABG) is the recommended mode
of revascularization in patients with ischemic left ventricular
dysfunction (iLVSD) and multivessel disease. However, contemporary
percutaneous coronary intervention (PCI) outcomes have improved with the
integration of novel technologies and refinement of revascularization
strategies, and PCI is often used in clinical practice in this population.
There is a lack of evidence from randomized trials comparing contemporary
state-of-the-art PCI versus CABG for the treatment of iLVSD and
multivessel disease. This was the impetus for the STICH3C trial (Canadian
CABG or PCI in Patients With Ischemic Cardiomyopathy), described here.
 METHOD(S): The STICH3C trial is a prospective, unblinded,
international, multicenter trial with an expected sample size of 754
participants from =45 centers. Patients with multivessel/left main
coronary artery disease and iLVSD with left ventricular ejection fraction
<=40% considered by the local Heart Team appropriate for and amenable to
revascularization by both modes of revascularization will be randomized in
a 1:1 ratio to state-of-the-art PCI or CABG. RESULT(S): The primary
end point is the composite of death from any cause, stroke, spontaneous
myocardial infarction, urgent repeat revascularization, or heart failure
readmission, summarized as a time-to-event outcome. The key hierarchical
end point is time to death and frequency of hospitalizations for heart
failure. The key safety outcome is a composite of major adverse events.
Disease-specific quality-of-life and health economics measures will be
compared between groups. Participants will be followed for a median of 5
years, with a minimum follow-up of 4 years. CONCLUSION(S): STICH3C
will directly inform patients, clinicians, and international practice
guidelines about the efficacy and safety of CABG versus PCI in patients
with iLVSD. The results will provide novel and broad evidence, including
clinical events, health status, and economic assessments, to guide care
for patients with iLVSD and severe coronary artery disease. REGISTRATION:
URL: https://clinicaltrials.gov/; Unique identifier:
NCT05427370. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<97>
Accession Number
642086545
Title
Periprocedural continuation versus interruption of oral anticoagulant
drugs during transcatheter aortic valve implantation: rationale and design
of the POPular PAUSE TAVI trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 22 Aug 2023.
Author
van Ginkel D.-J.; Bor W.L.; Dubois C.L.F.; Aarts H.M.; Rooijakkers M.J.P.;
van Bergeijk K.H.; Rosseel L.; Veenstra L.; De Backer O.; Van Mieghem
N.M.; van der Kley F.; Wilgenhof A.; Leonora R.; Halim J.; Schotborgh
C.E.; Barbato E.; Van Der Heyden J.A.S.; Frambach P.; Ferdinande B.;
Mylotte D.; Fabris E.; Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Brouwer
J.; Nijenhuis V.J.; Peper J.; Vriesendorp P.A.; de Laat B.; Ninivaggi M.;
Stragier H.; Voskuil M.; IJsselmuiden A.J.J.; Hermanides R.S.; Agostoni
P.; van 't Hof A.W.J.; Wykrzykowska J.J.; van Royen N.; Delewi R.; Ten
Berg J.M.
Institution
(van Ginkel, Bor, Rensing, Timmers, Swaans, Brouwer, Nijenhuis, Peper, Ten
Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Dubois) Department of Cardiovascular Medicine, University Hospital
Leuven, Leuven, Belgium
(Aarts, Wilgenhof, Delewi) Department of Cardiology, Amsterdam,
Netherlands
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Rooijakkers, van Royen) Department of Cardiology, Radboud University
Medical Center, Nijmegen, Netherlands
(van Bergeijk, Wykrzykowska) Department of Cardiology, University Medical
Center Groningen, Groningen, Netherlands
(Rosseel) Department of Cardiology, Algemeen Stedelijk Hospital Aalst,
Aalst, Belgium
(Veenstra, Vriesendorp, van 't Hof) Department of Cardiology, Maastricht
University Medical Center, Maastricht, Netherlands
(De Backer) Heart Center, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(van der Kley, Hermanides, Agostoni) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Wilgenhof) Department of Cardiology, Hospital Network Antwerp (ZNA)
Middelheim, Antwerp, Belgium
(Leonora) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Halim, IJsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Barbato) Cardiovascular Center Aalst, Onze Lieve Vrouwe Hospital, Aalst,
Netherlands
(Van Der Heyden) Department of Cardiology, Sint-Jan Hospital, Brugge,
Belgium
(Frambach) Department of Cardiology, Institut National de Chirurgie
Cardiaque et de Cardiologie Interventionnelle, Luxembourg
(Ferdinande) Department of Cardiology, Hospital Oost-Limburg, Genk,
Belgium
(Mylotte) Department of Cardiology, University Hospital Galway, Galway,
Ireland
(Fabris) Cardiothoracovascular Department, University of Trieste, Trieste,
Italy
(de Laat, Ninivaggi) Department of Functional Coagulation, Synapse
Research Institute, Maastricht, Netherlands
(Stragier) Department of Anesthesiology, Intensive Care Medicine,
Emergency Medicine and Pain Therapy, Hospital Oost-Limburg, Genk, Belgium
(Stragier, van 't Hof, Ten Berg) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht, Netherlands
Publisher
NLM (Medline)
Abstract
About one-third of patients undergoing transcatheter aortic valve
implantation (TAVI) use oral anticoagulants (OAC), mainly due to atrial
fibrillation. General guidelines advise interrupting OAC in patients with
a high risk of bleeding undergoing interventions. However, preliminary
observational data suggest that the continuation of OAC during TAVI is
safe and may reduce the risk of periprocedural thromboembolic events. The
Periprocedural Continuation Versus Interruption of Oral Anticoagulant
Drugs During Transcatheter Aortic Valve Implantation (POPular PAUSE TAVI)
is a multicentre, randomised clinical trial with open-label treatment and
blinded endpoint assessment. Patients are randomised 1:1 to periprocedural
continuation versus interruption of OAC and are stratified for vitamin K
antagonist or direct oral anticoagulant use. The primary endpoint is a
composite of cardiovascular mortality, all stroke, myocardial infarction,
major vascular complications and type 2-4 bleeding within 30 days after
TAVI, according to the Valve Academic Research Consortium-3 criteria.
Secondary endpoints include separate individual and composite outcomes,
quality of life and cost-effectiveness. Since continuation of OAC is
associated with the ancillary benefit that it simplifies periprocedural
management, the primary outcome is first analysed for non-inferiority; if
non-inferiority is proven, superiority will be tested. Recruitment started
in November 2020, and the trial will continue until a total of 858
patients have been included and followed for 90 days. In summary, POPular
PAUSE TAVI is the first randomised clinical trial to assess the safety and
efficacy of periprocedural continuation versus interruption of OAC in
patients undergoing TAVI.

<98>
Accession Number
642082206
Title
Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel
Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial.
Source
Circulation. (no pagination), 2023. Date of Publication: 21 Aug 2023.
Author
Zimmermann F.M.; Ding V.Y.; Pijls N.H.J.; Piroth Z.; van Straten A.H.M.;
Szekely L.; Davidavicius G.; Kalinauskas G.; Mansour S.; Kharbanda R.;
Ostlund-Papadogeorgos N.; Aminian A.; Oldroyd K.G.; Al-Attar N.; Jagic N.;
Dambrink J.-H.E.; Kala P.; Angeras O.; MacCarthy P.; Wendler O.; Casselman
F.; Witt N.; Mavromatis K.; Miner S.E.S.; Sarma J.; Engstrom T.;
Christiansen E.H.; Tonino P.A.L.; Reardon M.J.; Otsuki H.; Kobayashi Y.;
Hlatky M.A.; Mahaffey K.W.; Desai M.; Woo Y.J.; Yeung A.C.; De Bruyne B.;
Fearon W.F.
Institution
(Zimmermann, Pijls, van Straten, Tonino) Catharina Hospital, Eindhoven,
Netherlands
(Ding, Otsuki, Desai) Quantitative Sciences Unit, Stanford University, H.O
(Piroth, Szekely) Gottsegen National Cardiovascular Center, Hungary (Z.P.,
Hungary
(Davidavicius, Kalinauskas) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Vilnius University, Lithuania
(Davidavicius, Kalinauskas) Vilnius University Hospital Santaros Klinikos,
Lithuania
(Mansour) Centre Hospitalier de l'Universite de Montreal, Canada
(Kharbanda) Oxford University Hospital NHS Trust
(Ostlund-Papadogeorgos) Danderyd University Hospital and Karolinska
Institutet, Solna, Sweden
(Aminian) Centre Hospitalier Universitaire de Charleroi, Belgium
(Oldroyd, Al-Attar) Golden Jubilee National Hospital, Glasgow, United
Kingdom
(Jagic) Clinical Hospital Centre Zemun, University of Belgrade, Serbia
(Dambrink) Isala Hospital, Zwolle, Netherlands
(Kala) Medical Faculty of Masaryk University and University Hospital Brno,
Czech Republic (P.K.), Czechia
(Angeras) Sahlgrenska University Hospital, Sweden
(MacCarthy, Wendler) Kings College Hospital, London, United Kingdom
(Casselman, De Bruyne) Cardiovascular Center Aalst, Belgium
(Witt) Sodersjukhuset Hospital, Stockholm, Sweden
(Witt) Karolinska Institutet, Solna, Sweden
(Mavromatis) Atlanta VA Healthcare System, Decatur, United States
(Mavromatis) Emory University School of Medicine, Atlanta, United States
(Miner) Southlake Regional Health Centre, Newmarket, United Kingdom
(Sarma) Wythenshawe Hospital, Manchester, Jamaica
(Engstrom) Rigshospitalet, Copenhagen, Denmark
(Christiansen) Aarhus University Hospital, Denmark
(Reardon) Houston Methodist Hospital
(Kobayashi) New York Presbyterian Brooklyn Methodist and Weill Cornell
Medical College (Y.K.)
(Hlatky) Departments of Health Policy and Medicine, Stanford University
(Mahaffey) Stanford Center for Clinical Research, Department of Medicine,
Stanford University School of Medicine
(Woo) Department of Cardiothoracic Surgery, Stanford University
(Yeung, Fearon) Division of Cardiovascular Medicine and Stanford
Cardiovascular Institute, Stanford University
(De Bruyne) Lausanne University Centre Hospital, Switzerland
(Fearon) VA Palo Alto Health Care System
Publisher
NLM (Medline)
Abstract
BACKGROUND: Previous studies comparing percutaneous coronary intervention
(PCI) with coronary artery bypass grafting (CABG) in patients with
multivessel coronary disease not involving the left main have shown
significantly lower rates of death, myocardial infarction (MI), or stroke
after CABG. These studies did not routinely use current-generation
drug-eluting stents or fractional flow reserve (FFR) to guide PCI.
 METHOD(S): FAME 3 (Fractional Flow Reserve versus Angiography for
Multivessel Evaluation) is an investigator-initiated, multicenter,
international, randomized trial involving patients with 3-vessel coronary
artery disease (not involving the left main coronary artery) in 48 centers
worldwide. Patients were randomly assigned to receive FFR-guided PCI using
zotarolimus drug-eluting stents or CABG. The prespecified key secondary
end point of the trial reported here is the 3-year incidence of the
composite of death, MI, or stroke. RESULT(S): A total of 1500
patients were randomized to FFR-guided PCI or CABG. Follow-up was achieved
in >96% of patients in both groups. There was no difference in the
incidence of the composite of death, MI, or stroke after FFR-guided PCI
compared with CABG (12.0% versus 9.2%; hazard ratio [HR], 1.3 [95% CI,
0.98-1.83]; P=0.07). The rates of death (4.1% versus 3.9%; HR, 1.0 [95%
CI, 0.6-1.7]; P=0.88) and stroke (1.6% versus 2.0%; HR, 0.8 [95% CI,
0.4-1.7]; P=0.56) were not different. MI occurred more frequently after
PCI (7.0% versus 4.2%; HR, 1.7 [95% CI, 1.1-2.7]; P=0.02).
 CONCLUSION(S): At 3-year follow-up, there was no difference in the
incidence of the composite of death, MI, or stroke after FFR-guided PCI
with current-generation drug-eluting stents compared with CABG. There was
a higher incidence of MI after PCI compared with CABG, with no difference
in death or stroke. These results provide contemporary data to allow
improved shared decision-making between physicians and patients with
3-vessel coronary artery disease. REGISTRATION: URL: https://www.
CLINICALTRIALS: gov; Unique identifier: NCT02100722.

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