EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2026851231
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 August) (no pagination), 2023. Article Number: e0289412.
Date of Publication: August 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.; Neto
A.S.; Schultz M.J.
Institution
(Nijbroek, Roozeman, Ettayeby, Rosenberg, van Meenen, Cherpanath, Lagrand,
Tepaske, 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
(Neto) Australian and New Zealand Intensive Care Research Centre (ANZIC-
RC), School of Public Health and Preventive Medicine, Monash University,
Melbourne, Australia
(Neto) Laboratory of Experimental Intensive Care and Anesthesiology (L E I
C A), Amsterdam University Medical Centers, Location AMC, Amsterdam,
Netherlands
(Neto) Department of Critical Care, Austin Hospital, Melbourne Medical
School, University of Melbourne, Melbourne, Australia
(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
Public Library of Science
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. Methods 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. Results 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 to1]; P = 0.116 for
non-inferiority). The proportion of breaths with hypoxemia was higher in
the sidestream capnography group versus the mainstream capnography group.
Conclusions 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. 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.

<2>
Accession Number
2026626121
Title
Physicians' perspectives on percutaneous left atrial appendage occlusion
for patients with atrial fibrillation.
Source
American Heart Journal. 266 (pp 14-24), 2023. Date of Publication:
December 2023.
Author
Kir D.; Van Houten H.K.; Walvatne K.N.; Behnken E.M.; Alkhouli M.A.;
Graff-Radford J.; Melduni R.M.; Gersh B.J.; Friedman P.A.; Shah N.D.;
Noseworthy P.A.; Yao X.
Institution
(Kir, Alkhouli, Melduni, Gersh, Friedman, Noseworthy, Yao) Department of
Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
(Van Houten, Walvatne, Noseworthy, Yao) Robert D. and Patricia E. Kern
Center for the Science of Health Care Delivery, Mayo Clinic, Rochester,
MN, United States
(Behnken) Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester,
MN, United States
(Graff-Radford) Department of Neurology, Mayo Clinic, Rochester, MN,
United States
(Shah) Delta Airlines, Atlanta, GA, United States
Publisher
Elsevier Inc.
Abstract
Background: There has been an increasing uptake of transcatheter left
atrial appendage occlusion (LAAO) for stroke reduction in atrial
fibrillation. Objective(s): To investigate the perceptions and
approaches among a nationally representative sample of physicians.
 Method(s): Using the American Medical Association Physician
Masterfile, we selected a random sample of 500 physicians from each of the
specialties: general cardiologists, interventional cardiologists,
electrophysiologists, and vascular neurologists. The participants received
the survey by mail up to three times from November 9, 2021 to January 14,
2022. In addition to the questions about experiences, perceptions, and
approaches, physicians were randomly assigned to 1 of the 4 versions of a
patient vignette: white man, white woman, black man, and black woman, to
investigate potential bias in decision-making. Result(s): The top
three reasons for considering LAAO were: a history of intracranial
bleeding (94.3%), a history of major extracranial bleeding (91.8%), and
gastrointestinal lesions (59.0%), whereas the top three reasons for
withholding LAAO were: other indications for long-term oral
anticoagulation (87.7%), a low bleeding risk (77.0%), and a low stroke
risk (65.6%). For the reasons limiting recommendations for LAAO, 59.8%
mentioned procedural risks, 42.6% mentioned "limiting efficacy data
comparing LAAO to NOAC" and 32.8% mentioned "limited safety data comparing
LAAO to NOAC." There was no difference in physicians' decision-making by
patients' race, gender, or the concordance between patients' and
physicians' race or gender. Conclusion(s): In the first U.S. national
physician survey of LAAO, individual physicians' perspectives varied
greatly, which provided information that will help customize future
educational activities for different audiences. Condensed Abstract:
Although diverse practice patterns of LAAO have been documented, little is
known about the reasoning or perceptions that drive these variations.
Unlike prior surveys that were directed to Centers that performed LAAO,
the current survey obtained insights from individual physicians, not only
those who perform the procedures (interventional cardiologists and
electrophysiologists) but also those who are closely involved in the
decision-making and referral process (general cardiologists and vascular
neurologists). The findings identify key evidence gaps and help prioritize
future studies to establish a consistent and evidence-based best practice
for AF stroke prevention. Copyright © 2023 Elsevier Inc.

<3>
Accession Number
2025917490
Title
Routine cerebral embolic protection in transcatheter aortic valve
implantation: rationale and design of the randomised British Heart
Foundation PROTECT-TAVI trial.
Source
EuroIntervention. 18(17) (pp 1428-1435), 2023. Date of Publication: April
2023.
Author
Kharbanda R.K.; Perkins A.D.; Kennedy J.; Banning A.; Baumbach A.;
Blackman D.J.; Dodd M.; Evans R.; Hildick-Smith D.; Jamal Z.; Ludman P.;
Palmer S.; Stables R.; Clayton T.
Institution
(Kharbanda, Banning) NIHR Oxford Biomedical Research Centre, Oxford
University Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Kharbanda, Dodd, Evans, Jamal, Clayton) Department of Cardiovascular
Medicine, University of Oxford, Oxford, United Kingdom
(Perkins) Clinical Trials Unit, Department of Medical Statistics, London
School of Hygiene and Tropical Medicine, London, United Kingdom
(Kennedy) Acute Vascular Imaging Centre, Radcliffe Department of Medicine,
University of Oxford, Oxford, United Kingdom
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London, London, United
Kingdom
(Baumbach) Barts Heart Centre, London, United Kingdom
(Blackman) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Hildick-Smith) Cardiac Surgery, Cardiac Center, Royal Sussex County
Hospital, Brighton, United Kingdom
(Hildick-Smith) Sussex University Hospitals Trust, Brighton, United
Kingdom
(Ludman) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Palmer) Centre for Health Economics, University of York, York, United
Kingdom
(Stables) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool, United Kingdom
(Stables) Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
Publisher
Europa Group
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment
for aortic stenosis. Cerebral embolic protection (CEP) devices may impact
periprocedural stroke by capturing debris destined for the brain. However,
there is a lack of high-quality randomised trial evidence supporting the
use of CEP during TAVI. The British Heart Foundation (BHF) PROTECT-TAVI
trial will address whether the routine use of CEP reduces the incidence of
stroke in patients undergoing TAVI. BHF PROTECT-TAVI is a prospective,
open-label, outcome-adjudicated, multicentre randomised controlled trial.
The trial is open to all adult patients scheduled for TAVI at
participating specialist cardiac centres across the United Kingdom who are
able to receive the CEP device. The trial will recruit 7,730 participants.
Participants will be randomised in a 1:1 ratio to undergo TAVI with CEP or
TAVI without CEP (standard of care). The primary outcome is the incidence
of stroke at 72 hours post-TAVI. Key secondary outcomes include the
incidence of stroke and all-cause mortality up to 12 months post-TAVI,
disability and cognitive outcomes, stroke severity, access site
complications and a health economics analysis. The sample size of 7,730
participants has 80% power to detect a 33% relative risk reduction from a
3% incidence of the primary outcome in the controls. Trial recruitment
commenced in October 2020. As of October 2022, 3,068 patients have been
enrolled. BHF PROTECT-TAVI is designed to provide definitive evidence on
the clinical efficacy and cost-effectiveness of using routine CEP with the
SENTINEL device to reduce stroke in TAVI. Copyright © Europa
Digital & Publishing 2023.

<4>
Accession Number
2025692292
Title
Long-term outcomes of valve-sparing aortic root versus composite aortic
valve graft replacement for aortic root aneurysm: Meta-analysis of
reconstructed time-to-event data.
Source
American Journal of Surgery. 226(3) (pp 371-378), 2023. Date of
Publication: September 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Chu D.; Serna-Gallegos D.;
Coselli J.S.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Coselli) Division of Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
(Coselli) Texas Heart Institute, Houston, TX, United States
(Coselli) CHI St Luke's-Baylor St. Luke's Medical Center, Houston, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background: We aimed to evaluate the long-term outcomes of valve-sparing
aortic root replacement (VSARR) versus composite aortic valve graft
replacement (CAVGR) for aortic root aneurysms. Method(s):
Meta-analysis of Kaplan-Meier-derived time-to-event data from studies with
follow-up including propensity-score matching or propensity-score
adjustment. Result(s): Six studies met our eligibility criteria,
comprising 3215 patients (1770 patients treated with VSARR and 1445
patients with CAVGR). We observed a statistically significant difference
for overall survival favoring VSARR (HR 0.63, 95%CI 0.49-0.82, P = 0.001),
but no statistically significant difference in the risk of reoperation (HR
0.77, 95%CI 0.51-1.14, P = 0.187) in the overall follow-up. Landmark
analyses revealed that, in the first 10 years after the procedure,
reoperation rates were comparable between VSARR and CAVGR (HR 0.96, 95%CI
0.62-1.48, p = 0.861), but the results beyond 10 years showed improved
rates of freedom from reoperation in patients undergoing VSARR (HR 0.10,
95%CI 0.01-0.78; p = 0.027). Conclusion(s): VSARR seems to confer
better long-term survival and lower risk of reoperation in the follow-up
of patients treated for aortic root aneurysm when compared with
CAVGR. Copyright © 2023 Elsevier Inc.

<5>
Accession Number
2025482333
Title
Pulmonary valve stenosis: From diagnosis to current management techniques
and future prospects.
Source
Vascular Health and Risk Management. 19 (pp 379-390), 2023. Date of
Publication: 2023.
Author
Marchini F.; Meossi S.; Passarini G.; Campo G.; Pavasini R.
Institution
(Marchini, Meossi, Passarini, Campo, Pavasini) Cardiology Unit, Azienda
Ospedaliero Universitaria di Ferrara, Ferrara, Italy
Publisher
Dove Medical Press Ltd
Abstract
Pulmonary stenosis (PS) is mainly a congenital defect that accounts for
7-12% of congenital heart diseases (CHD). It can be isolated or, more
frequently, associated with other congenital defects (25-30%) involving
anomalies of the pulmonary vascular tree. For the diagnosis of PS an
integrated approach with echocardiography, cardiac computed tomography and
cardiac magnetic resonance (CMR) is of paramount importance for the
planning of the interventional treatment. In recent years, transcatheter
approaches for the treatment of PS have increased however, meaning surgery
is a possible option for complicated cases with anatomy not suitable for
percutaneous treatment. The present review aims to summarize current
knowledge regarding diagnosis and treatment of PS. Copyright ©
2023 Marchini et al.

<6>
Accession Number
2024796774
Title
A vanguard randomised feasibility trial comparing three regimens of
peri-operative oxygen therapy on recovery after major surgery.
Source
Anaesthesia. 78(10) (pp 1272-1284), 2023. Date of Publication: October
2023.
Author
Frei D.R.; Beasley R.; Campbell D.; Forbes A.; Leslie K.; Mackle D.;
Martin C.; Merry A.; Moore M.R.; Myles P.S.; Ruawai-Hamilton L.; Short
T.G.; Young P.J.
Institution
(Frei, Ruawai-Hamilton) Department of Anaesthesia and Pain Management,
Wellington Hospital, Wellington, New Zealand
(Frei, Beasley, Mackle) Medical Research Institute of New Zealand,
Wellington, New Zealand
(Campbell, Merry, Moore, Short, Young) Department of Anaesthesiology,
University of Auckland, Auckland, New Zealand
(Campbell) Department of Anaesthesia and Peri-operative Medicine, Auckland
City Hospital, Auckland, New Zealand
(Forbes, Martin) Biostatistics Unit, Division of Research Methodology,
School of Public Health and Preventive Medicine, Faculty of Medicine,
Nursing, and Health Sciences, Monash University, Melbourne, VIC, Australia
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Leslie) Department of Critical Care, Melbourne Medical School, University
of Melbourne, Melbourne, VIC, Australia
(Myles) Department of Anaesthesiology and Peri-operative Medicine, Alfred
Hospital, Melbourne, VIC, Australia
(Myles) Department of Anaesthesiology and Peri-operative Medicine, Central
Clinical School, Faculty of Medicine, Nursing, and Health Sciences, Monash
University, Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
International recommendations encourage liberal administration of oxygen
to patients having surgery under general anaesthesia, ostensibly to reduce
surgical site infection. However, the optimal oxygen regimen to minimise
postoperative complications and enhance recovery from surgery remains
uncertain. The hospital operating theatre randomised oxygen (HOT-ROX)
trial is a multicentre, patient- and assessor-blinded, parallel-group,
randomised clinical trial designed to assess the effect of a restricted,
standard care, or liberal peri-operative oxygen therapy regimen on days
alive and at home after surgery in adults undergoing prolonged non-cardiac
surgery under general anaesthesia. Here, we report the findings of the
internal vanguard feasibility phase of the trial undertaken in four large
metropolitan hospitals in Australia and New Zealand that included the
first 210 patients of a planned overall 2640 trial sample, with eight
pre-specified endpoints evaluating protocol implementation and safety. We
screened a total of 956 participants between 1 September 2019 and 26
January 2021, with data from 210 participants included in the analysis.
Median (IQR [range]) time-weighted average intra-operative
F<inf>i</inf>O<inf>2</inf> was 0.30 (0.26-0.35 [0.20-0.59]) and 0.47
(0.44-0.51 [0.37-0.68]) for restricted and standard care, respectively
(mean difference (95%CI) 0.17 (0.14-0.20), p < 0.001). Median
time-weighted average intra-operative F<inf>i</inf>O<inf>2</inf> was 0.83
(0.80-0.85 [0.70-0.91]) for liberal oxygen therapy (mean difference
(95%CI) compared with standard care 0.36 (0.33-0.39), p < 0.001). All
feasibility endpoints were met. There were no significant patient adverse
events. These data support the feasibility of proceeding with the HOT-ROX
trial without major protocol modifications. Copyright © 2023
Association of Anaesthetists.

<7>
Accession Number
2024290075
Title
Patients' expectations, experience and acceptability of postoperative
analgesia: a nested qualitative study within a randomised controlled trial
comparing rectus sheath catheter and thoracic epidural analgesia.
Source
Anaesthesia. 78(10) (pp 1249-1255), 2023. Date of Publication: October
2023.
Author
Brearley S.G.; Varey S.; Krige A.
Institution
(Brearley, Varey) Division of Heath Research, Faculty of Health and
Medicine, Lancaster University, Lancaster, United Kingdom
(Krige) Department of Anaesthesia and Critical Care, Royal Blackburn
Teaching Hospital, Blackburn, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Adequate postoperative analgesia is a key element of enhanced recovery
programmes. Thoracic epidural analgesia is associated with superior
postoperative analgesia but can lead to complications. Rectus sheath
catheter analgesia may provide an alternative. In a nested qualitative
study (within a two-year randomised controlled trial) focussing on the
acceptability, expectations and experiences of receiving the
interventions, participants (n = 20) were interviewed 4 weeks
post-intervention using a grounded theory approach. Constant comparative
analysis, with patient and public involvement, enabled emerging findings
to be pursued through subsequent data collection. We found no notable
differences regarding postoperative acceptability or the experience of
pain management. Pre-operatively, however, thoracic epidural analgesia was
a source of anticipatory fear and anxiety. Both interventions resulted in
some experienced adverse events (proportionately more with thoracic
epidural analgesia). Participants had negative experiences of the
insertion of thoracic epidural analgesia; others receiving the rectus
sheath catheter lacked confidence in staff members' ability to manage the
local anaesthetic infusion pump. The anticipation of the technique of
thoracic epidural analgesia, and concerns about its impact on mobility,
represented an additional, unpleasant experience for patients already
managing an illness experience, anticipating a life-changing operation and
dealing with concerns about the future. The anticipation of rectus sheath
catheter analgesia was not associated with such anxieties. Patients'
experiences start far earlier than the experience of the intervention
itself through anticipatory anxieties and fears about receiving a
technique and its potential implications. Complex pain packages can take
on greater meaning than their actual efficacy in relieving postoperative
pain. Future research into patient acceptability and experience should not
focus solely on efficacy of pain relief but should include anticipatory
fears, anxieties and experiences. Copyright © 2023 The Authors.
Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists.

<8>
Accession Number
2026835748
Title
Aspirin Versus Warfarin after Transcatheter Aortic Valve Replacement in
Low-Risk Patients: 2-Year Follow-Up.
Source
American Journal of Cardiology. 206 (pp 108-115), 2023. Date of
Publication: 01 Nov 2023.
Author
Merdler I.; Rogers T.; Case B.C.; Bhogal S.; Reddy P.K.; Ben-Dor I.; Zhang
C.; Satler L.F.; Weissman G.; Waksman R.
Institution
(Merdler, Rogers, Case, Bhogal, Reddy, Ben-Dor, Zhang, Satler, Weissman,
Waksman) MedStar Heart & Vascular Institute, MedStar Washington Hospital
Center, Washington, DC, United States
(Merdler, Rogers, Case, Bhogal, Reddy, Ben-Dor, Zhang, Satler, Weissman,
Waksman) MedStar Heart & Vascular Institute, MedStar Georgetown University
Hospital, Washington, DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung and Blood Institute, National Institutes of Health, Bethesda,
Maryland, United States
Publisher
Elsevier Inc.
Abstract
Subclinical leaflet thrombosis occurs with transcatheter heart valves
(THVs) and could be associated with structural valve deterioration. The
current guidelines recommend the use of antiplatelet agents after
transcatheter aortic valve replacement (TAVR) but not the routine use of
oral anticoagulation. Our study examines the effects of short-term
warfarin therapy on THV hemodynamics at 24 months after TAVR in low-risk
patients. Low-risk patients who underwent TAVR were randomly allocated 1:1
to receive low-dose aspirin (n = 50) or low-dose aspirin plus warfarin (n
= 44). After 30 days of treatment, ongoing medication regimens, including
anticoagulation, were at the physicians' discretion. Follow-up after a
period of 24 months was available for clinical and echocardiographic
outcomes. At the 24-month mark, follow-up echocardiography of the randomly
allocated patients revealed just 1 additional case of new structural valve
deterioration in the aspirin group (compared with the occurrence within 30
days), based on the Valve Academic Research Consortium 3 definitions.
There were also no differences in mean pressure gradients (11.5 +/- 0.5 mm
Hg vs 11.05 +/- 4.0 mm Hg, p = 0.6) or peak velocity (2.2 +/- 0.5 m/s vs
2.1 +/- 0.4 m/s, p = 0.7) between the groups. A composite end point
(mortality, stroke, and myocardial infarction) did not show any difference
between the groups at long-term follow-up (p = 0.07). In conclusion, in
low-risk patients who underwent TAVR, short-term anticoagulation with
warfarin did not impact clinical outcomes or THV hemodynamics by
echocardiography at 24 months. Copyright © 2023 Elsevier Inc.

<9>
Accession Number
2024852877
Title
Viscoelastic testing: Critical appraisal of new methodologies and current
literature.
Source
International Journal of Laboratory Hematology. 45(5) (pp 643-658), 2023.
Date of Publication: October 2023.
Author
Wool G.D.; Carll T.
Institution
(Wool, Carll) Department of Pathology, University of Chicago, Chicago, IL,
United States
Publisher
John Wiley and Sons Inc
Abstract
United States Food and Drug Administration (FDA)-approved viscoelastic
testing (VET) methodologies have significantly changed in the last 10
years, with the availability of cartridge-based VET. Some of these
cartridge-based methodologies use harmonic resonance-based clot detection.
While VET has always allowed for the evaluation of real-time clot
formation, cartridge-based VET provides increased ease of use as well as
greater portability and robustness of results in out-of-laboratory
environments. Here we review the use of VET in a variety of clinical
contexts, including cardiac surgery, trauma, liver transplant, obstetrics,
and hypercoagulable states such as COVID-19. As of now, high quality
randomized trial evidence for new generation VET (TEG 6s, HemoSonics
Quantra, ROTEM sigma) is limited. Nevertheless, the use of VET-guided
transfusion algorithms appears to result in reduced blood usage without
worsening of patient outcomes. Future work comparing the new generation
VET instruments and continuing to validate clinically important cut-offs
will help move the field of point-of-care coagulation monitoring forward
and increase the quality of transfusion management in bleeding
patients. Copyright © 2023 The Authors. International Journal of
Laboratory Hematology published by John Wiley & Sons Ltd.

<10>
Accession Number
2024622463
Title
Transcatheter edge-to-edge repair for mitral regurgitation using PASCAL or
MitraClip.
Source
Catheterization and Cardiovascular Interventions. 102(3) (pp 521-527),
2023. Date of Publication: 01 Sep 2023.
Author
Elbadawi A.; Dang A.T.; Hamed M.; Ali A.; Saad M.; Jneid H.; Chhatriwalla
A.K.; Goel S.; Bhatt A.; Mani P.; Bavry A.; Kumbhani D.J.
Institution
(Elbadawi, Bhatt, Mani, Bavry, Kumbhani) Division of Cardiology,
University of Texas Southwestern Medical Center, Dallas, TX, United States
(Dang) Department of Internal Medicine, University of Texas Medical
Branch, Galveston, TX, United States
(Hamed) Department of Internal Medicine, Florida Atlantic University, Boca
Raton, FL, United States
(Ali) Division of Internal Medicine, Department of Cardiology, The
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(Saad) Department of Medicine' Division of Cardiology, Alpert Medical
School of Brown University, Lifespan Cardiovascular Institute, Providence,
RI, United States
(Jneid) Division of Cardiology, University of Texas Medical Branch,
Galveston, TX, United States
(Chhatriwalla) Division of Cardiology, Saint Luke's Mid America Heart
Institute and University of Missouri-Kansas City, Kansas City, MO, United
States
(Goel) Division of Cardiology, Houston Methodist, Houston, TX, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: There is a paucity of data regarding the comparative efficacy
and safety of Mitral valve transcatheter edge-to-edge repair (MTEER) using
the PASCAL or MitraClip systems for patients with mitral regurgitation
(MR). Method(s): An electronic search was conducted for MEDLINE,
COCHRANE, and EMBASE, through February 2023, for studies comparing the
clinical outcomes of MTEER using PASCAL versus MitraClip systems among
patients with severe MR. The primary study outcome was residual MR <= 2 at
discharge. Data were pooled using a random-effects model. Result(s):
The final analysis included six studies with a total of 1581 patients,
with a weighted follow-up period of 3.5 months. Two studies only included
patients with degenerative MR, while the remaining studies included both
degenerative and functional MR. There was no significant difference in
procedure duration between MTEER with the PASCAL or MitraClip systems.
There was no difference in residual MR <= 2 at discharge (94.7% vs. 91.9%;
odds ratio [OR]: 1.44; 95% confidence interval [CI]: 0.92-2.27) or
residual MR <= 2 at the mid-term follow-up (94.6% vs. 91.0%, p = 0.05)
among the PASCAL versus MitraClip systems. There was no difference between
both groups in residual MR <= 1 at discharge (73.1% vs. 63.8%, p = 0.12),
while there was greater incidence of residual MR <= 1 at midterm follow-up
with the PASCAL system (71.3% vs. 56.2%, p < 0.001). There was no
difference between the PASCAL and MitraClip MTEER systems in technical
success (97.0% vs. 97.9%, p = 0.15), procedural success (89.1% vs. 87.1%,
p = 0.78), single leaflet detachment (1.8% vs. 1.4%, p = 0.55), or
all-cause mortality (3.6% vs. 4.6%, p = 0.71). Conclusion(s): In this
meta-analysis, we demonstrated comparable efficacy and safety between the
PASCAL and MitraClip MTEER systems at short- and mid-term assessments.
Randomized trials are warranted to evaluate the comparative long-term
outcomes between both MTEER systems. Copyright © 2023 Wiley
Periodicals LLC.

<11>
Accession Number
642227623
Title
The impact of telenursing on level of depression, stress and anxiety in
discharged patients after coronary artery bypass graft surgery: A
randomized clinical trial.
Source
Journal of vascular nursing : official publication of the Society for
Peripheral Vascular Nursing. 41(3) (pp 89-94), 2023. Date of Publication:
01 Sep 2023.
Author
Bikmoradi A.; Omidvar S.; Roshanaei G.; Khatiban M.; Harorani M.
Institution
(Bikmoradi, Khatiban) Healthcare Management, Hamedan University of Medical
Science, Iran, Islamic Republic of
(Omidvar) School of Nursing and Midwifery, Hamedan University of Medical
Science, Iran, Islamic Republic of
(Roshanaei) Modelling Non-Communicable Diseases Research Center and
Department of Biostatistics and Epidemiology, School of Public Health,
Hamedan University of Medical Science, Iran, Islamic Republic of
(Harorani) Department of Nursing, Shazand School of Nursing, Arak
University of Medical Sciences, Arak, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: After coronary artery bypass graft surgery patients are
susceptible to mental disorders such as stress, anxiety, and depression
following discharge from the hospital and often require post-discharge
support and follow-up. Telenursing is an accessible method that may reduce
stress, anxiety, and depression experienced by patients. This study aimed
to investigate the impact of telenursing on depression, stress, and
anxiety in discharged patients after CABG surgery. MATERIALS AND METHODS:
A randomized clinical trial was carried out. Eligible patients were
divided randomly into intervention (n=40) and control (n=40) groups.
Depression Anxiety Stress Scale-21 (DASS21) questionnaire was filled out
by both groups one day before discharge from the hospital. The
intervention group received SMS reminders of their treatment plan,
referrals to the cardiac rehabilitation clinic, and routine care three
times a week for six weeks, while the control group received routine care
provided by the hospital only. In the week following the completion of the
intervention period, both groups returned to fill out the questionnaire,
and the data were analyzed using SPSS version 16.0, descriptive and
inferential statistics, and independent and paired T-tests.
 RESULT(S): The mean scores of depression, stress, and anxiety before
intervention in the intervention group were 11.95, 18.75, and 18.17, and
in the control group were 11.55, 18.37, and 17.4 respectively. The mean
scores of depression, stress, and anxiety after intervention in the
intervention group were 7.85, 10.5, and 10.45, and in the control group
were 10.56, 17.9, and 16.5 respectively. No significant differences were
seen between the two groups before the intervention (P>0.05), but the
results showed significant differences between the two groups' mean scores
of depression, stress, and anxiety after intervention (P<0.001).
 CONCLUSION(S): Telenursing can reduce stress, anxiety, and depression
in discharged patients after coronary artery bypass graft surgery by
providing proper and cost-effective follow-up. Copyright © 2023.
Published by Elsevier Inc.

<12>
Accession Number
642217409
Title
Effects of Remote Ischemic Preconditioning on Delirium and Neurological
Function in Patients Undergoing Cardiac Surgery: A Multicenter Randomized
Controlled Trial.
Source
The heart surgery forum. 26(4) (pp E408-E416), 2023. Date of Publication:
31 Aug 2023.
Author
Liu T.; Liu X.; Wan R.
Institution
(Liu) Department of Quality Management, 904th Hospital of Joint Logistic
Support Force, Wuxi, Jiangsu 214044, China
(Liu) Department of Quality Management, 904th Hospital of Joint Logistic
Support Force, Wuxi, Jiangsu 214044, China
(Wan) Department of Quality Management, 904th Hospital of Joint Logistic
Support Force, Wuxi, Jiangsu 214044, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative delirium (POD) and neurological dysfunction are
very common following cardiac surgery and deteriorate the patient's
prognosis and the outcome of surgical procedures. A clinically effective
management strategy or drug is not yet available for POD. Additionally, it
is unknown whether remote ischemic preconditioning (RIPC) has
neuroprotective and anti-delirium benefits in patients who undergo cardiac
surgery. METHOD(S): This study examined whether RIPC can improve POD
and neurological function in cardiac surgery patients. We screened 510
consecutive adult patients aged 18 and older who underwent cardiac surgery
between January 2018 and December 2022. Then, 448 of these patients were
recruited in the trial as the intention to treat (ITT) group, who were
then randomly assigned to receive either a control (n = 223) or RIPC
treatment (n = 225). The primary outcome measures were hospitalization
postoperative delirium, six-month modified Rankins scale (mRS), hospital
cerebral infarction, 30-day overall mortality, neuron-specific enolase
(NSE) and S-100b levels, related adverse effects, hospital costs, and
hospital stay. RESULT(S): A statistically significant variation was
not observed between the two groups in terms of the baseline clinical
data. In contrast to the control group, the POD in the RIPC group was
considerably alleviated. RIPC treatment also decreased the levels of NSE
and S-100b, which alleviated nerve injury. The adverse impacts of
RIPC-induced objective indicators of tissue or neurovascular damage were
similar in both groups, showing no significant variations between the two.
The hospital stays and hospitalization costs also decreased significantly
in the RIPC-treated patients. CONCLUSION(S): The study findings
suggested that RIPC may benefit cardiac surgery patients by reducing POD,
alleviating injury, and lowering hospital expenditures and length of stay.
Cardiac surgery patients can be treated with RIPC, which is an effective
and safe technique.

<13>
Accession Number
641885032
Title
Nociception level index-guided antinociception versus routine care during
remifentanil-propofol anaesthesia for moderate-to-high risk cardiovascular
surgery: A randomized trial.
Source
European journal of anaesthesiology. 40(10) (pp 790-793), 2023. Date of
Publication: 01 Oct 2023.
Author
Coeckelenbergh S.; Sessler D.I.; Doria S.; Patricio D.; Jaubert L.;
Huybrechts I.; Stefanidis C.; Kapessidou P.; Tuna T.; Engelman E.; Barvais
L.; Perrin L.
Institution
(Coeckelenbergh) From the Department of Anaesthesia and Resuscitation,
Erasme University Hospital, Universite Libre de Bruxelles, Brussels,
Belgium (SC, SD, DP, LJ, IH, TT, EE, LB, LP), Department of
Anaesthesiology and Intensive Care, Paul Brousse Hospital - Hepatobiliary
Centre, Assistance Publique - Hopitaux de Paris, Universite Paris-Saclay,
Villejuif, France (SC), Outcomes Research Consortium, Cleveland, OH,
United States (SC, DIS), Department of Outcomes Research, Anesthesiology
Institute, Cleveland Clinic, Cleveland, Ohio, United States (DIS),
Department of Cardiac Surgery, Erasme University Hospital, Universite
Libre de Bruxelles, Brussels, Belgium (CS), Department of Anaesthesiology,
Saint Pierre University Hospital, Universite Libre de Bruxelles, Brussels,
Belgium (PK), EW Data Analysis, Brussels, Belgium (EE)
Publisher
NLM (Medline)

<14>
Accession Number
640226732
Title
Nutritional markers accompanying acquired chylothorax in infants: a
systematic review.
Source
Nutrition reviews. 81(10) (pp 1321-1328), 2023. Date of Publication: 11
Sep 2023.
Author
Marzotto K.N.; Choudhary T.; Wright L.A.; Howell M.P.; Kimball T.R.;
Pigula F.A.; Piggott K.D.
Institution
(Marzotto, Choudhary) Tulane University School of Medicine, New Orleans,
LA, United States
(Wright) Matas Library, Tulane University School of Medicine, New Orleans,
LA, United States
(Howell) Department of Pediatrics, Tulane University School of Medicine,
New Orleans, LA, United States
(Kimball, Pigula) Department of Pediatrics, Louisiana State University
Health, New Orleans, LA, United States
(Piggott) Department of Surgery, Louisiana State University Health, New
Orleans, LA, United States
Publisher
NLM (Medline)
Abstract
CONTEXT: Chylothorax is a well-established acquired complication of
thoracic surgery in infants. Current data suggest acquired chylothorax may
affect infant growth and nutrition because of a loss of essential
nutrients via chylous effusion. OBJECTIVE(S): The 3 objectives for
this study were: (1) identify nutritional markers affected by the
development of acquired chylothorax in infants; (2) highlight the
variability in methods used to assess nutritional status and growth in
this patient population; and (3) highlight nutritional deficits that can
serve as treatment targets during postoperative feeding protocols. DATA
SOURCES: A systematic literature search was conducted between May 31,
2021, and June 21, 2022, using the PubMed, Embase, CINAHL, and Web of
Science databases. Search terms included, but were not limited to,
"chylothorax," "infants," and "nutrition." DATA EXTRACTION: Inclusion
criteria required studies that measured quantitative markers of nutrition
in >=10 participants aged <1 year with acquired chylothorax. A total of
575 studies were screened and all but 4 were eliminated. Nutritional
markers were categorized into 4 different groups: total serum protein
level, triglyceride levels, growth velocity, and weight for length. DATA
ANALYSIS: The variation in methods, time points, interventional groups,
and nutritional markers did not facilitate a meta-analysis. Risk of bias
was assessed using the Cochrane Risk of Bias in Nonrandomized Studies
assessment tool. CONCLUSION(S): This review highlights the need for
reliable quantitative markers of nutrition that will enable providers to
assess the nutritional needs of infants with chylothorax. Future studies
must focus on measuring markers of nutrition at regular intervals in
larger study populations. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of the International Life
Sciences Institute. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<15>
Accession Number
636343553
Title
Transcatheter aortic valve implantation results are not superimposable to
surgery in patients with aortic stenosis at low surgical risk.
Source
Cardiology journal. 30(4) (pp 595-605), 2023. Date of Publication: 2023.
Author
Acconcia M.C.; Perrone M.A.; Sergi D.; Di Luozzo M.; Marchei M.; De Vico
P.; Sili Scavalli A.; Pannarale G.; Chiocchi M.; Gaudio C.; Romeo F.;
Caretta Q.; Barilla F.
Institution
(Acconcia, Sili Scavalli, Pannarale, Gaudio, Barilla) Department of
Cardiovascular Disease, University of Rome La Sapienza, Rome, Italy
(Perrone, Sergi, Di Luozzo, Marchei, De Vico, Romeo) Department of
Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy
(Chiocchi) Department of Diagnostic Imaging, Molecular Imaging,
Interventional Radiology and Radiotherapy, University of Rome Tor Vergata,
Rome, Italy
(Caretta) Department of Experimental and Clinical Medicine, University of
Florence, Florence, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: The aim of this meta-analysis was to compare the impact of
transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve
replacement (SAVR) in patients with severe aortic valve stenosis (AS) at
low surgical risk. METHOD(S): All randomized controlled trials (RCTs)
and observational studies (Obs) published from January 2014 until March
31st, 2020 were retrieved through the PubMed computerized database and at
the site https://www. CLINICALTRIALS: com. The relative risk (RR) with the
95% confidence interval (CI) was used to evaluate the effect of the
intervention under comparison. The primary endpoints were all-cause 30-day
mortality and 1-year mortality. The 30-day safety endpoints were: stroke,
acute kidney injury stage 2 or 3, major bleeding, moderate/severe
paravalvular leak, need for new permanent pacemaker (PM) implantation.
 RESULT(S): After detailed review 9 studies, related to 4 RCTs and 5
Obs, were selected. The overall analysis of RCTs plus Obs showed a
significantly lower 30-day mortality for TAVI (RR = 0.55; 95% CI
0.45-0.68, p < 0.00001; I2 = 0%). However, an increased risk of new PM
implantation (RR = 2.87; 95% CI 2.01-3.67, p < 0.00001, I2 = 0%) and of
paravalvular leak (RR = 7.28; 95% CI 3.83-13.81, p < 0.00001, I2 = 0%) was
observed in TAVI compared to SAVR. On the contrary, a lower incidence of
major bleeding (RR = 0.38; 95% CI 0.27-0.54, p < 0.00001, I2 = 0%) and of
acute kidney injury was observed (RR = 0.33; 95% CI 0.19-0.56, p < 0.0001,
I2 = 0%) in TAVI. CONCLUSION(S): TAVI and SVAR in the treatment of AS
in the patients at low surgical risk are not superimposable. In
particular, if 30-day and 1-year mortality, major bleeding and acute
kidney injury were significantly lower for TAVI, the need of new PM
implantation and paravalvular leak were significantly lower in SAVR.
Consequently, we suggest the need of more trials to evaluate the
effectiveness of TAVI as routine therapeutic procedure in the treatment of
patients with low surgical risk AS.

<16>
Accession Number
2026918148
Title
Transcatheter Edge-to-Edge Repair in 5,000 Patients With Secondary Mitral
Regurgitation: COAPT Post-Approval Study.
Source
Journal of the American College of Cardiology. 82(13) (pp 1281-1297),
2023. Date of Publication: 26 Sep 2023.
Author
Goel K.; Lindenfeld J.; Makkar R.; Naik H.; Atmakuri S.; Mahoney P.; Morse
M.A.; Thourani V.H.; Yadav P.; Batchelor W.; Rogers J.; Whisenant B.;
Rinaldi M.; Hermiller J.; Lindman B.R.; Barker C.M.
Institution
(Goel, Lindenfeld, Lindman, Barker) Vanderbilt University Medical Center,
Nashville, TN, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Naik) Arizona Cardiovascular Research Center, Phoenix, AZ, United States
(Atmakuri) Tricity Cardiology Consultants, Phoenix, AZ, United States
(Mahoney) Sentara Norfolk General Hospital, Norfolk, VA, United States
(Morse) St Thomas Hospital, Nashville, TN, United States
(Thourani, Yadav) Piedmont Heart Institute, Atlanta, GA, United States
(Batchelor) Inova Fairfax Hospital, Falls Church, VA, United States
(Rogers) University of California, Davis Medical Center, Sacramento, CA,
United States
(Whisenant) Intermountain Medical Center, Murray Utah, United States
(Rinaldi) Carolinas Medical Center, Charlotte, SC, United States
(Hermiller) Ascension St Vincent Heart Center at Indiana, Indianapolis,
IN, United States
Publisher
Elsevier Inc.
Abstract
Background: Real-world applicability of the COAPT (Cardiovascular Outcomes
Assessment of the MitraClip Percutaneous Therapy for Heart Failure
Patients with Functional Mitral Regurgitation) randomized controlled trial
(RCT) has been debated because of careful patient selection and the
contrasting results of the MITRA-FR (Multicentre Study of Percutaneous
Mitral Valve Repair MitraClip Device in Patients with Severe Secondary
Mitral Regurgitation) RCT. Objective(s): The COAPT-PAS (COAPT
Post-Approval Study) was initiated to assess the safety and effectiveness
of the MitraClip in patients with secondary mitral regurgitation (SMR).
 Method(s): COAPT-PAS is a prospective, single-arm, observational
study of 5,000 consecutive patients with SMR treated with the MitraClip at
406 U.S. centers participating in the TVT (Transcatheter Valve Therapy)
registry from 2019 to 2020. The 1-year outcomes from the COAPT-PAS full
cohort and the COAPT-like and MITRA-FR-like subgroups who met RCT
inclusion/exclusion criteria are reported. Result(s): Patients in the
COAPT-PAS had more comorbidities, more severe HF and functional
limitations, and less guideline-directed medical therapy than those in the
COAPT or MITRA-FR RCTs. Patients in the COAPT-PAS full cohort and the
COAPT-like (n = 991) and MITRA-FR-like (n = 917) subgroups achieved a
97.7% MitraClip implant rate, a similar and durable reduction of mitral
regurgitation to <=2+ at 1 year (90.7%, 89.7%, and 86.6%, respectively), a
large improvement in quality of life at 1 year (Kansas City Cardiomyopathy
Questionnaire +29 COAPT-PAS, +27 COAPT-like, and +33 MITRA-FR-like),
faster procedure times, similar or lower clinical event rates compared
with the RCTs' MitraClip arms, and lower clinical event rates than the
RCTs' guideline-directed medical therapy only arms. One-year heart failure
hospitalizations was 18.9% in COAPT-PAS, 19.7% in COAPT-like compared with
24.9% in COAPT-RCT, and 28.7% in COAPT-PAS-MITRA-FR-like compared with
47.4% in MITRA-FR-RCT. Conclusion(s): This large, contemporary,
real-world study reinforces the safety and effectiveness of the MitraClip
System in patients with SMR, including those who met the COAPT or MITRA-FR
RCT inclusion/exclusion criteria and patients excluded from the
RCTs. Copyright © 2023 American College of Cardiology Foundation

<17>
[Use Link to view the full text]
Accession Number
2026884716
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: Cancer Clinical Trials. 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, The First Affiliated
Hospital of Dalian Medical University, Liaoning, Dalian, China
(Li, Zhao, Guo, Gu) Lung Cancer Diagnosis and Treatment Center, Liaoning,
Dalian, China
(Lv) Department of Oncology, The First Affiliated Hospital of Dalian
Medical University, Liaoning, Dalian, China
(Lv, Wang) Graduate School, Dalian Medical University, Liaoning, Dalian,
China
(Wang) Institute of Neurology, General Hospital of Shenyang Military
Command, Liaoning, Shenyang, China
Publisher
Lippincott Williams and Wilkins
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.

<18>
Accession Number
2025367476
Title
Establishment of a national quality improvement process on oxygen delivery
index during cardiopulmonary bypass.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
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,
SpecialtyCare, Brentwood, TN, United States
(Mosca) Mountain Perfusion Team, SpecialtyCare, Denver, CO, United States
(Varsamis) Southern Florida ECMO Team, SpecialtyCare, West Palm Beach, FL,
United States
(Petterson) Kansas City Perfusion Team, SpecialtyCare, Kansas City, MO,
United 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
SAGE Publications Ltd
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 (DO<inf>2</inf>i) 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 DO<inf>2</inf>i, which yielded a target nadir value
(272 mL/min/m2) and an area under the curve
(DO<inf>2</inf>i272AUC) 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, DO<inf>2</inf>i data from 91 hospitals and 11,165 coronary
artery bypass graft procedures were collected. During this period the
monthly proportion of DO<inf>2</inf>i measurements above the target nadir
DO<inf>2</inf>i272 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 DO<inf>2</inf>i performance reporting has shown a
statistically significant positive linear trend in the probability of
achieving the target DO<inf>2</inf>i272 (p <.001), with a crude
increase of approximately 7.8% for DO<inf>2</inf>i272AUC, 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
DO<inf>2</inf>i272 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. Copyright © The Author(s) 2023.

<19>
Accession Number
2025300252
Title
Five-year outcomes of off and on-pump CABG: Insights from PROMOTE Patency
Trial.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2023. Date of
Publication: 2023.
Author
Sajja L.R.; Sarkar K.; Mannam G.; Padmanabhan C.; Narayan P.; Kamtam
D.N.H.; 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, G 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, DDMM Heart Institute, Nadiad,
India
Publisher
SAGE Publications Inc.
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. Copyright © The Author(s) 2023.

<20>
Accession Number
2025299710
Title
Video-assisted thoracoscopic epicardial pacing: A contemporary overview.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2023. Date
of Publication: 2023.
Author
Marini M.; Pannone L.; Branzoli S.; Quintarelli S.; Coser A.; Guarracini
F.; Bonmassari R.; La Meir M.; de Asmundis C.
Institution
(Marini, Quintarelli, Coser, Guarracini, Bonmassari) Department of
Cardiology, S. Chiara Hospital, Trento, Italy
(Marini, Pannone, de Asmundis) Heart Rhythm Management Centre,
Postgraduate program in Cardiac Electrophysiology and Pacing, Vrije
Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
(Branzoli) Department of Cardiac Surgery, S. Chiara Hospital, Trento,
Italy
(Branzoli, La Meir) Cardiac Surgery Department, Vrije Universiteit
Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Video-assisted thoracoscopic surgery (VATS) has revolutionized the
approach and management of pulmonary and cardiac diseases, and its
applications have significantly expanded in the last two decades. Beyond
its established role in thoracic procedures, VATS has also emerged as a
valuable technique for various electrophysiological procedures, including
pacemaker implantations, ablation procedures, and left atrial appendage
exclusion. This paper presents a thorough review of the existing
literature on pacing procedures performed using a VATS approach. By
analyzing and synthesizing the available studies, we aim to provide an
in-depth understanding of the current knowledge and advancements in
VATS-based pacing procedures. A key focus of this review is the detailed
description of implantation techniques via a VATS approach. Copyright
© 2023 Wiley Periodicals LLC.

<21>
[Use Link to view the full text]
Accession Number
2026833495
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in dialysis-dependent patients: a meta-analysis.
Source
Journal of Cardiovascular Medicine. 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, United Kingdom
(Asopa) Southwest Cardiothoracic Centre, Plymouth, United Kingdom
Publisher
Lippincott Williams and Wilkins
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.

<22>
[Use Link to view the full text]
Accession Number
2026833494
Title
Natural history and clinical burden of moderate aortic stenosis: a
systematic review and explorative meta-analysis.
Source
Journal of Cardiovascular Medicine. 24(9) (pp 659-665), 2023. Date of
Publication: 01 Sep 2023.
Author
Morelli M.; Galasso M.; Esposito G.; Soriano F.S.; Nava S.; Da Pozzo C.;
Bossi I.; Piccaluga E.; Bruschi G.; Maloberti A.; Oliva F.; Oreglia J.A.;
Giannattasio C.; Montalto C.
Institution
(Morelli, Galasso, Maloberti, Giannattasio) School of Medicine and
Surgery, University of Milano-Bicocca, Milan, Italy
(Esposito, Soriano, Nava, Bossi, Piccaluga, Oliva, Oreglia, Montalto)
Interventional Cardiology, Division of Cardiology, De Gasperis Cardio
Center, Niguarda Hospital, Milan, Italy
(Da Pozzo) School of Medicine and Surgery, University of Milan, Milan,
Italy
(Bruschi) Department of Cardiac Surgery, Niguarda Hospital, Milan, Italy
(Maloberti, Giannattasio) Division of Cardiology, De Gasperis Cardio
Center, Niguarda Hospital, Milan, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Aims: The mortality risk of patients with moderate aortic stenosis is not
well known, but recent studies suggested that it might negatively affect
prognosis. We aimed to assess the natural history and clinical burden of
moderate aortic stenosis and to investigate the interaction of patients'
baseline characteristics with prognosis. Method(s): Systematic
research was conducted on PubMed. The inclusion criteria were inclusion of
patients with moderate aortic stenosis; and report of the survival at
1-year follow-up (minimum). Incidence ratios related to all-cause
mortality in patients and controls of each study were estimated and then
pooled using a fixed effects model. All patients with mild aortic stenosis
or without aortic stenosis were considered controls. Meta-regression
analysis was performed to assess the impact of left ventricular ejection
fraction and age on the prognosis of patients with moderate aortic
stenosis. Result(s): Fifteen studies and 11 596 patients with
moderate aortic stenosis were included. All-cause mortality was
significantly higher among patients with moderate aortic stenosis than in
controls in all timeframes analysed (all P < 0.0001). Left ventricular
ejection fraction and sex did not significantly impact on the prognosis of
patients with moderate aortic stenosis (P = 0.4584 and P = 0.5792), while
increasing age showed a significant interaction with mortality (estimate =
0.0067; 95% confidence interval: 0.0007-0.0127; P = 0.0323).
 Conclusion(s): Moderate aortic stenosis is associated with reduced
survival. Further studies are necessary to confirm the prognostic impact
of this valvulopathy and the possible benefit of aortic valve
replacement. Copyright © 2023 Italian Federation of Cardiology -
I.F.C. All rights reserved.

<23>
Accession Number
2026600455
Title
Autoimmune disorders of platelet function: systematic review of cases of
acquired glanzmann thrombasthenia and acquired delta storage pool disease.
Source
Blood Transfusion. 20(5) (pp 420-432), 2022. Date of Publication:
September 2022.
Author
Bacci M.; Ferretti A.; Marchetti M.; Alberelli M.A.; Falanga A.; Lodigiani
C.; De Candia E.
Institution
(Bacci, Lodigiani, De Candia) Thrombosis and Haemorrhagic Diseases Unit,
Humanitas Clinical and Research Center IRCCS, MI, Rozzano, Italy
(Ferretti, Alberelli) Haemorrhagic and Thrombotic Diseases Unit,
Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
(Marchetti, Falanga) Departement of Immunohaematology and Transfusion
Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
(Falanga) Universita di Milano Bicocca, School of Medicine and Surgery,
Monza, Italy
(Lodigiani) Humanitas University Department of Biomedical Sciences,
Milano, Italy
(De Candia) Departement of Traslational Medicine and Surgery, Universita
Cattolica del Sacro Cuore, Rome, Italy
Publisher
Edizioni SIMTI
Abstract
Acquired platelet function disorders (PFD) are rare bleeding diseases that
should be suspected in all patients with unexplained mucocutaneous
bleedings of recent onset, with no previous history of haemorrhages, and
with normal coagulation test and platelet count. Drug-induced platelet
function bleeding disorders are the most frequent PFDs and can easily be
identified on the basis of recent administration of platelet-inhibiting
drugs. Apart from these, the most challenging acquired PFDs are those
caused by autoimmune mechanisms. In fact, demonstration of autoantibodies
inhibiting platelet function may be difficult in most non-specialised
centres. Among autoimmune PFDs (aPFDs), acquired Glanzmann thrombasthenia
(aGT), which is caused by autoantibodies that bind to platelet
alphaIIbbeta3 integrin, inhibiting its function, is the most frequent. aGT
can be associated with underlying haematological malignancies or
autoimmune diseases but can also be idiopathic. More rarely, other
immune-mediated PFDs can occur, such as acquired delta storage pool
disease (adeltaSPD). Treatment of aPFDs must rely on the control of acute
and chronic bleedings,
treatmentoftheunderlyingdiseaseinsecondaryforms,andimmunosuppressive
treatment for autoantibody reduction or eradication. aPFDs may completely
resolve upon treatment of any underlying disease that may be present. In
primary aPFDs, and in the majority of secondary forms, treatment relies on
immunosuppressive therapies. Here we present a systematic review of
previously described immune-mediated aGT and adeltaSPD cases. Clinical and
laboratory characteristics, treatments for the control of bleedings and
for the eradication of autoantibodies, and responses to treatments are
also discussed. Although no guidelines are available for the management of
these very rare conditions, presentation of all cases reported so far can
help clinicians in the diagnosis and treatment of these life-threatening
diseases. Copyright © 2022 Edizioni SIMTI. All rights reserved.

<24>
Accession Number
2025917499
Title
Quantitative flow ratio versus fractional flow reserve for guiding
percutaneous coronary intervention: design and rationale of the randomised
FAVOR III Europe Japan trial.
Source
EuroIntervention. 18(16) (pp E1357-E1364), 2023. Date of Publication:
April 2023.
Author
Andersen B.K.; Sejr-Hansen M.; Westra J.; Campo G.; Efterkhari A.; Tu S.;
Escaned J.; Koltowski L.; Stahli B.; Erglis A.; Jarusevicius G.; Ziubryte
G.; Ramunddal T.; Liu T.; Wijns W.; Landmesser U.; Maillard L.; Matsuo H.;
Christiansen E.H.; Holm N.R.
Institution
(Andersen, Sejr-Hansen, Westra, Christiansen, Holm) Department of
Cardiology, Aarhus University Hospital, Skejby, Denmark
(Campo) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Ferrara, Italy
(Campo) Maria Cecilia Hospital, GVM Care & Research, RA, Cotignola, Italy
(Efterkhari) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Tu) School of Biomedical Engineering, Shanghai Jiao Tong University,
Shanghai, China
(Escaned) Hospital Clinico San Carlos IdISSC, Complutense University of
Madrid, Madrid, Spain
(Koltowski) Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Stahli) Department of Cardiology, University Heart Center, University
Hospital Zurich, Zurich, Switzerland
(Erglis) Department of Cardiology, Riga Stradins University, Riga, Latvia
(Jarusevicius, Ziubryte) Department of Cardiology, Hospital of Lithuanian
University of Health Sciences Kauno Klinikos, Kaunas, Lithuania
(Jarusevicius, Ziubryte) Institute of Cardiology,, Lithuanian University
of Health Sciences, Kaunas, Lithuania
(Ramunddal) Department of Cardiology, Sahlgrenska University Hospital,
Goteborg, Sweden
(Liu) Department of Cardiology, HagaZiekenhuis, The Hague, Netherlands
(Wijns) The Lambe Institute for Translational Medicine and Curam, National
University of Ireland, Galway, Ireland
(Landmesser) Department of Cardiology (CBF), Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Maillard) GCS ES Axium Rambot, Clinique Axium, Aix-enProvence, France
(Matsuo) Department of Cardiovascular Medicine, Gifu Heart Center, Gifu,
Japan
Publisher
Europa Group
Abstract
Quantitative flow ratio (QFR) is a computation of fractional flow reserve
(FFR) based on invasive coronary angiographic images. Calculating QFR is
less invasive than measuring FFR and may be associated with lower costs.
Current evidence supports the call for an adequately powered randomised
comparison of QFR and FFR for the evaluation of intermediate coronary
stenosis. The aim of the FAVOR III Europe Japan trial is to investigate if
a QFR-based diagnostic strategy yields a non-inferior 12-month clinical
outcome compared with a standard FFR-guided strategy in the evaluation of
patients with intermediary coronary stenosis. FAVOR III Europe Japan is an
investigator-initiated, randomised, clinical outcome, non-inferiority
trial scheduled to randomise 2,000 patients with either 1) stable angina
pectoris and intermediate coronary stenosis, or 2) indications for
functional assessment of at least 1 non-culprit lesion after acute
myocardial infarction. Up to 40 international centres will randomise
patients to either a QFR-based or a standard FFR-based diagnostic
strategy. The primary endpoint of major adverse cardiovascular events is a
composite of all-cause mortality, any myocardial infarction, and any
unplanned coronary revascularisation at 12 months. QFR could emerge as an
adenosine- and wire-free alternative to FFR, making the functional
evaluation of intermediary coronary stenosis less invasive and more
cost-effective. Copyright © 2023 Europa Group. All rights
reserved.

<25>
Accession Number
2025312588
Title
Cognitive outcomes in patients treated with neuromuscular electrical
stimulation after coronary artery bypass grafting.
Source
Frontiers in Neurology. 14 (no pagination), 2023. Article Number: 1209905.
Date of Publication: 2023.
Author
Lo Re V.; Russelli G.; Lo Gerfo E.; Alduino R.; Bulati M.; Iannolo G.;
Terzo D.; Martucci G.; Anzani S.; Panarello G.; Sparacia G.; Parla G.;
Avorio F.; Raffa G.; Pilato M.; Speciale A.; Agnese V.; Mamone G.;
Tuzzolino F.; Vizzini G.B.; Conaldi P.G.; Ambrosio F.
Institution
(Lo Re, Lo Gerfo, Anzani, Avorio) Neurology Service, Department of
Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo
per i Trapianti e Terapie ad Alta Specializzazione), University of
Pittsburgh Medical Center (UPMC), Palermo, Italy
(Russelli, Lo Gerfo, Alduino, Bulati, Iannolo, Anzani, Agnese, Tuzzolino,
Conaldi) Department of Research, IRCCS ISMETT, UPMC, Palermo, Italy
(Terzo, Speciale) Rehabilitation Service, IRCCS ISMETT, Palermo, Italy
(Martucci, Panarello) Department of Anesthesiology and Intensive Care,
IRCCS ISMETT, UPMC, Palermo, Italy
(Sparacia, Parla, Mamone) Radiology Unit, Department of Diagnostic and
Therapeutic Services, IRCCS ISMETT, Palermo, Italy
(Raffa, Pilato) Cardiac Surgery Unit, Department for the Treatment and
Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS
ISMETT, Palermo, Italy
(Vizzini) Salvator Mundi International Hospital, UPMC, Rome, Italy
(Ambrosio) Discovery Center for Musculoskeletal Recovery, Schoen Adams
Research Institute at Spaulding, Boston, MA, United States
(Ambrosio) Department of Physical Medicine and Rehabilitation, Spaulding
Rehabilitation Hospital, Charlestown, MA, United States
(Ambrosio) Department of Physical Medicine and Rehabilitation, Harvard
Medical School, Boston, MA, United States
Publisher
Frontiers Media SA
Abstract
Objective: Mechanisms of neurocognitive injury as post-operative sequelae
of coronary artery bypass grafting (CABG) are not understood. The systemic
inflammatory response to surgical stress causes skeletal muscle
impairment, and this is also worsened by immobility. Since evidence
supports a link between muscle vitality and neuroprotection, there is a
need to understand the mechanisms by which promotion of muscle activity
counteracts the deleterious effects of surgery on long-term cognition.
 Method(s): We performed a clinical trial to test the hypothesis that
adding neuromuscular electrical stimulation (NMES) to standard
rehabilitation care in post-CABG patients promotes the maintenance of
skeletal muscle strength and the expression of circulating neuroprotective
myokines. Result(s): We did not find higher serum levels of
neuroprotective myokines, except for interleukin-6, nor better long-term
cognitive performance in our intervention group. However, a greater
increase in functional connectivity at brain magnetic resonance was seen
between seed regions within the default mode, frontoparietal, salience,
and sensorimotor networks in the NMES group. Regardless of the treatment
protocol, patients with a Klotho increase 3 months after hospital
discharge compared to baseline Klotho values showed better scores in
delayed memory tests. Significance: We confirm the potential
neuroprotective effect of Klotho in a clinical setting and for the first
time post-CABG. Copyright © 2023 Lo Re, Russelli, Lo Gerfo,
Alduino, Bulati, Iannolo, Terzo, Martucci, Anzani, Panarello, Sparacia,
Parla, Avorio, Raffa, Pilato, Speciale, Agnese, Mamone, Tuzzolino,
Vizzini, Conaldi and Ambrosio.

<26>
Accession Number
2025134614
Title
Ocular microtremor: a structured review.
Source
Experimental Brain Research. 241(9) (pp 2191-2203), 2023. Date of
Publication: September 2023.
Author
Graham L.; Das J.; Vitorio R.; McDonald C.; Walker R.; Godfrey A.; Morris
R.; Stuart S.
Institution
(Graham, Das, Vitorio, Morris, Stuart) Department of Sport, Exercise and
Rehabilitation, Northumbria University, Newcastle upon Tyne, United
Kingdom
(Graham, McDonald) Gateshead Health NHS Foundation Trust, Gateshead,
United Kingdom
(Das, Walker, Morris, Stuart) Northumbria Healthcare NHS Foundation Trust,
North Shields, United Kingdom
(Godfrey) Department of Computer and Information Science, Northumbria
University, Newcastle upon Tyne, United Kingdom
(Stuart) Department of Neurology, Oregon Health & Science University,
Portland, OR, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Ocular microtremor (OMT) is the smallest of three involuntary fixational
micro eye movements, which has led to it being under researched in
comparison. The link between OMT and brain function generates a strong
rationale for further study as there is potential for its use as a
biomarker in populations with neurological injury and disease. This
structured review focused on populations previously studied,
instrumentation used for measurement, commonly reported OMT outcomes, and
recommendations concerning protocol design and future studies. Current
methods of quantifying OMT will be reviewed to analyze their efficacy and
efficiency and guide potential development and understanding of novel
techniques. Electronic databases were systematically searched and compared
with predetermined inclusion criteria. 216 articles were identified in the
search and screened by two reviewers. 16 articles were included for
review. Findings showed that piezoelectric probe is the most common method
of measuring OMT, with fewer studies involving non-invasive approaches,
such as contact lenses and laser imaging. OMT frequency was seen to be
reduced during general anesthesia at loss of consciousness and in
neurologically impaired participants when compared to healthy adults. We
identified the need for a non-invasive technique for measuring OMT and
highlight its potential in clinical applications as an objective biomarker
for neurological assessments. We highlight the need for further research
on the clinical validation of OMT to establish its potential to identify
or predict a meaningful clinical or functional state, specifically,
regarding accuracy, precision, and reliability of OMT. Copyright
© 2023, The Author(s).

<27>
Accession Number
2018949577
Title
Double-lung versus heart-lung transplantation for end-stage
cardiopulmonary disease: a systematic review and meta-analysis.
Source
Surgery Today. 53(9) (pp 1001-1012), 2023. Date of Publication: September
2023.
Author
Yan H.-J.; Zheng X.-Y.; Huang H.; Xu L.; Tang H.-T.; Wang J.-J.; Li C.-H.;
Zhang S.-X.; Fu S.-Y.; Wen H.-Y.; Tian D.
Institution
(Yan, Tian) Department of Thoracic Surgery, West China Hospital, Sichuan
University, 37 Guo Xue Xiang, Chengdu 610041, China
(Yan, Zheng, Huang, Xu, Tang, Wang, Li, Zhang, Fu, Tian) Heart and Lung
Transplant Research Laboratory, Affiliated Hospital of North Sichuan
Medical College, Nanchong 637000, China
(Wen) Department of Cardiothoracic Intensive Care Unit, Affiliated
Hospital of North Sichuan Medical College, Nanchong 637000, China
Publisher
Springer
Abstract
We compared posttransplant outcomes following double-lung transplantation
(DLTx) and heart-lung transplantation (HLTx), based on a search of PubMed,
Cochrane Library, and Embase, from inception to March 8, 2022, for studies
that report outcomes of these procedures. We then performed a
meta-analysis of baseline characteristics and posttransplant outcomes.
Subgroup analyses were implemented according to indication, publication
year, and center. This study was registered on PROSPERO (number
CRD42020223493). Ten studies were included in this meta-analysis,
involving 1230 DLTx patients and 1022 HLTx patients. The DLTx group was
characterized by older donors (P = 0.04) and a longer allograft ischemia
time (P < 0.001) than the HLTx group. The two groups had comparable
1-year, 3-year, 5-year, 10-year survival rates (all P > 0.05), with
similar results identified in subgroup analyses. We found no significant
differences in 1-year, 5-year, and 10-year chronic lung allograft
dysfunction (CLAD)-free survival, length of intensive care unit stay and
hospital stay, length of postoperative ventilation, in-hospital mortality,
or surgical complications between the groups (all P > 0.05). Thus, DLTx
provides similar posttransplant survival to HLTx for end-stage
cardiopulmonary disease. These two procedures have a comparable risk of
CLAD and other posttransplant outcomes. Copyright © 2022, The
Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

<28>
Accession Number
2020248260
Title
Racial Disparity Among Patients Undergoing Surgical Aortic Valve
Replacement and Transcatheter Aortic Valve Replacement in the United
States.
Source
Angiology. 74(9) (pp 812-821), 2023. Date of Publication: October 2023.
Author
Kulkarni A.; Arafat M.; Hou L.; Liang S.; Kassotis J.
Institution
(Kulkarni) Rutgers Robert Wood Johnson Medical School, Piscataway, NJ,
United States
(Arafat, Hou, Liang) Department of Medicine, Rutgers Robert Wood Johnson
Medical School, New Brunswick, NJ, United States
(Kassotis) Department of Cardiology, Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, United States
Publisher
SAGE Publications Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) has emerged as a minimally
invasive alternative to surgical aortic valve replacement (SAVR). However,
racial disparities in the utilization of TAVR persist. This meta-analysis
attempts to determine whether the prevalence of adverse outcomes
(procedure-related complications) represent barriers to the use of TAVR
among African Americans (AA). The TAVR cohort consisted of 89.6% Caucasian
(C) and 4.7% AA, while the SAVR cohort included 86.9% C and 6.4% AA. The
utilization rate (UR) of TAVR was 1.48 and.35 among C and AA,
respectively, while the UR of SAVR was 1.44 and.48 among C and AA,
respectively. Following TAVR, for AA the odds ratio (OR) was greater for
stroke (OR = 1.22, P =.02) and transient ischemic attack (TIA) (OR = 1.57,
P <.001) and lower for undergoing the insertion of a permanent pacemaker
(OR =.81, P <.001). While there was a significant difference between C and
AA in TAVR and SAVR utilization, outcomes between groups following TAVR
are comparable; therefore, adverse outcomes do not appear to be a barrier
to the use of TAVR among eligible AA. Copyright © The Author(s)
2022.

<29>
Accession Number
2025364755
Title
Three Ablation Techniques for Atrial Fibrillation during Concomitant
Cardiac Surgery: A Systematic Review and Network Meta-Analysis.
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5716. Date of Publication: September 2023.
Author
Hanafy D.A.; Erdianto W.P.; Husen T.F.; Nathania I.; Vidya A.P.; Angelica
R.; Suwatri W.T.; Lintangella P.; Prasetyo P.; Sugisman
Institution
(Hanafy, Suwatri, Lintangella, Prasetyo, Sugisman) Division of
Cardiothoracic and Vascular Surgery, Department of Surgery, Faculty of
Medicine, University of Indonesia, Jl. Salemba Raya No. 6, Kenari, Jakarta
10430, Indonesia
(Hanafy, Erdianto, Suwatri, Sugisman) Division of Adult Cardiac Surgery,
Department of Surgery, National Cardiovascular Center, Harapan Kita,
Jakarta 11420, Indonesia
(Husen, Nathania, Vidya, Angelica) Faculty of Medicine, University of
Indonesia, Pondok Cina, Beji, Depok 16424, Indonesia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Atrial fibrillation (AF) ablation is a frequent procedure used in
concomitant cardiac surgery. However, uncertainty still exists concerning
the optimal extent of lesion sets. Hence, the objective of this study was
to assess the results of various ablation techniques, aiming to offer a
reference for clinical decision making. This review is listed in the
prospective register of systematic reviews (PROSPERO) under ID
CRD42023412785. A comprehensive search was conducted across eight
databases (Scopus, Google Scholar, EBSCOHost, PubMed, Medline, Wiley,
ProQuest, and Embase) up to 18 April 2023. Studies were critically
appraised using the Cochrane Risk of Bias 2.0 for randomized control
trials (RCTs) and the Newcastle Ottawa Scale adapted by the Agency for
Healthcare Research and Quality (AHRQ) for cohort studies. Forest plots of
pooled effect estimates and surface under the cumulative ranking (SUCRA)
were used for the analysis. Our analysis included 39 studies and a total
of 7207 patients. Both bi-atrial ablation (BAA) and left atrial ablation
(LAA) showed similar efficacy in restoring sinus rhythm (SR; BAA (77.9%) >
LAA (76.2%) > pulmonary vein isolation (PVI; 66.5%); LAA: OR = 1.08 (CI
0.94-1.23); PVI: OR = 1.36 (CI 1.08-1.70)). However, BAA had higher
pacemaker implantation (LAA: OR = 0.51 (CI 0.37-0.71); PVI: OR = 0.52 (CI
0.31-0.86)) and reoperation rates (LAA: OR = 0.71 (CI 0.28-1.45); PVI: OR
= 0.31 (CI 0.1-0.64)). PVI had the lowest efficacy in restoring SR and a
similar complication rate to LAA, but had the shortest procedure time
(Cross-clamp (Xc): PVI (93.38) > LAA (37.36) > BAA (13.89));
Cardiopulmonary bypass (CPB): PVI (93.93) > LAA (56.04) > BAA (0.03)). We
suggest that LAA is the best surgical technique for AF ablation due to its
comparable effectiveness in restoring SR, its lower rate of pacemaker
requirement, and its lower reoperation rate compared to BAA. Furthermore,
LAA ranks as the second-fastest procedure after PVI, with a similar CPB
time. Copyright © 2023 by the authors.

<30>
Accession Number
2026914030
Title
Complications of Endoscopic Thoracic Spine Surgery: Overview and
Complication Avoidance.
Source
World Neurosurgery. 179 (pp 127-132), 2023. Date of Publication: November
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
Elsevier Inc.
Abstract
In 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 or thoracic ossified ligamentum flavum (OLF) has
been performed via 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. Thoracic OLF
removal via a biportal endoscopic technique has been developed recently
and is described in a few studies. Although endoscopic thoracic spine
surgery has significant advantages, complications often occur with this
approach. 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 is potentially
associated with serious complications. To minimize the risk of avoidable
complications, surgeons should be familiar with prevention methods and
pitfalls. Copyright © 2023 Elsevier Inc.

<31>
Accession Number
2025668069
Title
The effects of St. Thomas I and St. Thomas II Cardioplegia solutions on
coronary sinus lactate in mitral valve surgery; A Randomized,
Double-blinded, Clinical Trial.
Source
Razavi International Journal of Medicine. 11(3) (pp 12-16), 2023. Article
Number: e1276. Date of Publication: August 2023.
Author
Arki M.; Moeinipour A.A.; Fathi M.; Teshnizi M.A.; Pasandi H.; Heydari M.;
Nejad A.K.; Moghaddam S.I.; Yaghubi M.
Institution
(Arki, Pasandi, Heydari) Department of Extra-Corporeal Circulation (ECC),
Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
(Moeinipour, Teshnizi, Nejad) Department of Cardiac Surgery, Imam Reza
Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Fathi) Department of Anesthesiology, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Moghaddam) Department of Critical Care, Razavi Hospital, Mashhad, Iran,
Islamic Republic of
(Yaghubi) Department of Extra-Corporeal Circulation (ECC), Razavi
Hospital, Mashhad, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Background: Cardiac protection strategies in different methods are
challenging and crucial, affecting postoperative morbidity and mortality.
 Objective(s): We compared the cardio-protective effect of two
cardioplegia solutions based on coronary sinus lactate levels.
 Method(s): This randomized, double-blinded clinical trial study was
performed on 46 candidates for mitral valve replacement between June 2020
and January 2021. The patients were categorized via block randomization
method: 1) St. Thomas I cardioplegia (n=23) and St. Thomas II cardioplegia
(n=23). The coronary sinus lactate levels at different times were
measured. In addition, some intra-operative and clinical characteristics
after cardiac surgery were recorded. Data were analyzed in SPSS software
(version 26.0) using paired and independent t-tests, repeated measure
ANOVA, and Pearson correlation test at a significance level of P < 0.05.
 Result(s): In the time trend, the lactate levels in patients with St.
Thomas II cardioplegia solution had a significantly lower rate than in St.
Thomas I (P=0.001). The two groups displayed no statistical difference
between the aortic cross-clamp time (P=0.069) and the CPB time (P=0.091).
Furthermore, the weaning from mechanical ventilation (P=0.078) and ICU
stay (P=0.061) demonstrated no statistical difference between the study
groups. Conclusion(s): Based on significantly lower measures of the
coronary sinus lactate, the St. Thomas II cardioplegia solution showed a
better cardio-protective effect in patients undergoing mitral valve
surgery. Copyright © 2023, Razavi International Journal of
Medicine.

<32>
Accession Number
2024103264
Title
Coronary revascularization for heart failure with coronary artery disease:
A systematic review and meta-analysis of randomized trials.
Source
European Journal of Heart Failure. 25(7) (pp 1094-1104), 2023. Date of
Publication: July 2023.
Author
Iaconelli A.; Pellicori P.; Dolce P.; Busti M.; Ruggio A.; Aspromonte N.;
D'Amario D.; Galli M.; Princi G.; Caiazzo E.; Rezig A.O.M.; Maffia P.;
Pecorini G.; Crea F.; Cleland J.G.F.
Institution
(Iaconelli, Pellicori, Cleland) School of Cardiovascular and Metabolic
Health, University of Glasgow, Glasgow, United Kingdom
(Iaconelli, Ruggio, Aspromonte) Department of Cardiovascular Medicine,
Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
(Dolce) Department of Public Health, University of Naples Federico II,
Naples, Italy
(Busti, Princi, Crea) Department of Cardiovascular Sciences, Catholic
University of the Sacred Heart, Rome, Italy
(D'Amario) Department of Translational Medicine, University of Eastern
Piedmont, Novara, Italy
(D'Amario) Division of Cardiology, Azienda Ospedaliero Universitaria
'Maggiore della Carita', Novara, Italy
(Galli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Caiazzo, Maffia) Department of Pharmacy, School of Medicine and Surgery,
University of Naples Federico II, Naples, Italy
(Caiazzo, Rezig, Maffia) School of Infection and Immunity, College of
Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow,
United Kingdom
(Pecorini) Cardiovascular Internal Medicine Unit, Department of
Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli
IRCCS, Rome, Italy
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Coronary artery disease (CAD) is a common cause of heart failure
(HF). Whether coronary revascularization improves outcomes in patients
with HF receiving guideline-recommended pharmacological therapy (GRPT)
remains uncertain; therefore, we conducted a systematic review and
meta-analysis of relevant randomized controlled trials (RCTs).
 Methods and Results: We searched in public databases for RCTs
published between 1 January 2001 and 22 November 2022, investigating the
effects of coronary revascularization on morbidity and mortality in
patients with chronic HF due to CAD. All-cause mortality was the primary
outcome. We included five RCTs that enrolled, altogether, 2842 patients
(most aged <65 years; 85% men; 67% with left ventricular ejection fraction
<=35%). Overall, compared to medical therapy alone, coronary
revascularization was associated with a lower risk of all-cause mortality
(hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.79-0.99; p =
0.0278) and cardiovascular mortality (HR 0.80, 95% CI 0.70-0.93; p =
0.0024) but not the composite of hospitalization for HF or all-cause
mortality (HR 0.87, 95% CI 0.74-1.01; p = 0.0728). There were insufficient
data to show whether the effects of coronary artery bypass graft surgery
or percutaneous coronary intervention were similar or differed.
 Conclusion(s): For patients with chronic HF and CAD enrolled in RCTs,
the effect of coronary revascularization on all-cause mortality was
statistically significant but neither substantial (HR 0.88) nor robust
(upper 95% CI close to 1.0). RCTs were not blinded, which may bias
reporting of the cause-specific reasons for hospitalization and mortality.
Further trials are required to determine which patients with HF and CAD
obtain a substantial benefit from coronary revascularization by either
coronary artery bypass graft surgery or percutaneous coronary
intervention. Copyright © 2023 The Authors. European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<33>
Accession Number
2026367244
Title
Rationale and Design of the Randomized Bayesian Multicenter COME-TAVI
Trial in Patients With a New Onset Left Bundle Branch Block.
Source
CJC Open. 5(8) (pp 611-618), 2023. Date of Publication: August 2023.
Author
Rivard L.; Nault I.; Krahn A.D.; Daneault B.; Roux J.-F.; Natarajan M.;
Healey J.S.; Quadros K.; Sandhu R.K.; Kouz R.; Greiss I.; Leong-Sit P.;
Gourraud J.B.; Ben Ali W.; Asgar A.; Aguilar M.; Bonan R.; Cadrin-Tourigny
J.; Cartier R.; Dorval J.-F.; Dubuc M.; Durrleman N.; Dyrda K.; Guerra P.;
Ibrahim M.; Ibrahim R.; Macle L.; Mondesert B.; Moss E.; Raymond-Paquin
A.; Roy D.; Tadros R.; Thibault B.; Talajic M.; Nozza A.; Guertin M.-C.;
Khairy P.
Institution
(Rivard, Asgar, Aguilar, Bonan, Cadrin-Tourigny, Dorval, Dubuc, Dyrda,
Guerra, Ibrahim, Macle, Mondesert, Raymond-Paquin, Roy, Tadros, Thibault,
Talajic, Khairy) Department of Cardiology, Montreal Heart Institute,
Universite de Montreal, Montreal, QC, Canada
(Nault) Department of Cardiology, Quebec Heart and Lung Institute, Quebec
City, QC, Canada
(Krahn) Centre for Cardiovascular Innovation, University of British
Columbia, Vancouver, BC, Canada
(Daneault, Roux) Department of Cardiology, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Natarajan, Healey) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
(Quadros, Sandhu) Division of Cardiology, Department of Medicine,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB,
Canada
(Kouz) Department of Cardiology, Hopital Sacre-Coeur de Montreal,
Montreal, QC, Canada
(Greiss) Department of Cardiology, Centre Hospitalier de Universite de
Montreal, Montreal, QC, Canada
(Leong-Sit) Department of Cardiology, Western University, London, ON,
Canada
(Gourraud) Department of Cardiology, Centre Hospitalier Nantes, Nantes,
France
(Ben Ali, Cartier, Durrleman, Ibrahim, Moss) Department of Cardiac
Surgery, Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Nozza, Guertin) Montreal Health Innovations Coordinating Center, Montreal
Heart Institute, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Patients with new-onset left bundle branch block (LBBB) after
transcatheter aortic valve implantation (TAVI) are at risk of developing
delayed high-degree atrioventricular block. Management of new-onset LBBB
post-TAVI remains controversial. In the Comparison of a Clinical
Monitoring Strategy Versus Electrophysiology-Guided Algorithmic Approach
in Patients With a New LBBB After TAVI (COME-TAVI) trial, consenting
patients with new-onset LBBB that persists on day 2 after TAVI, meeting
exclusion/inclusion criteria, are randomized to an electrophysiological
study (EPS)-guided approach or 30-day electrocardiographic monitoring. In
the EPS-guided approach, patients with a His to ventricle (HV) interval >=
65 ms undergo permanent pacemaker implantation. Patients randomized to
noninvasive monitoring receive a wearable continuous electrocardiographic
recording and transmitting device for 30 days. Follow-up will be performed
at 3, 6, and 12 months. The primary endpoint is a composite outcome
designed to capture net clinical benefit. The endpoint incorporates major
consequences of both strategies in patients with new-onset LBBB after
TAVI, as follows: (i) sudden cardiac death; (ii) syncope; (iii)
atrioventricular conduction disorder requiring a pacemaker (for a class I
or IIa indication); and (iv) complications related to the pacemaker or
EPS. The trial incorporates a Bayesian design with a noninformative prior,
outcome-adaptive randomization (initially 1:1), and 2 prespecified interim
analyses once 25% and 50% of the anticipated number of primary endpoints
are reached. The trial is event-driven, with an anticipated upper limit of
452 patients required to reach 77 primary outcome events over 12 months of
follow-up. In summary, the aim of this Bayesian multicentre randomized
trial is to compare 2 management strategies in patients with new-onset
LBBB post-TAVI-an EPS-guided approach vs noninvasive 30-day monitoring.
Trial registration number: NCT03303612. Copyright © 2023 The
Authors

<34>
Accession Number
2026171202
Title
Comparison of the Outcomes of Oral Versus Nasal Endotracheal Intubation in
Neonates and Infants Undergoing Cardiac Surgery: A Randomized Controlled
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(10) (pp 2012-2019),
2023. Date of Publication: October 2023.
Author
Abdelbaser I.; Abourezk A.R.; Magdy M.; Elnegerey N.; Sabry R.; Tharwat
M.; Sayedalahl M.
Institution
(Abdelbaser, Abourezk, Magdy, Elnegerey, Sayedalahl) Department of
Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura
University, Mansoura, Egypt
(Sabry, Tharwat) Department of Cardiothoracic Surgery, Faculty of
Medicine, Mansoura University, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: The choice of oral or nasal endotracheal intubation in children
undergoing cardiac surgery is affected by several factors. This study
compared the outcomes of oral versus nasal intubation in neonates and
infants who underwent open cardiac surgery. Design(s): A randomized,
controlled, open-labeled study. Setting(s): At a university hospital.
 Participant(s): A total of 220 infants and neonates who underwent
cardiac surgery. Intervention(s): Patients were allocated randomly to
oral or nasal intubation. Measurements and Main Results: The primary
outcome measure was postoperative fentanyl consumption (microg/kg/h) by
intubated patients. Secondary outcome measures were the increase in heart
rate (HR) from baseline during intubation, the time consumed for
intubation, accidental intraoperative extubation, the occurrence of
epistaxis, time to extubation, the onset of full oral feeding, intensive
care unit (ICU) and hospital lengths of stay, and the incidence of
postoperative complications (the need for reintubation, stridor,
pneumonia, wound infection). The mean (SD) postoperative fentanyl
consumption of intubated patients (the primary outcome) was significantly
lower (p < 0.001) in the nasal intubation group (0.53 +/- 0.48)
microg/kg/h compared with the oral intubation group (0.82 +/- 0.20)
microg/kg/h. The median (IQR) time needed for the intubation (31.5, 27-35
v 16, 14.8-18 seconds) was significantly (p < 0.001) longer, and the mean
(SD) increase in HR (beats/min) from baseline during intubation (18 +/- 5
v 26 +/- 7) was significantly (p < 0.001) lower in the nasal intubation
group compared to the oral intubation group. The incidence of inadvertent
intraoperative extubation was significantly (p = 0.029) higher in the oral
(n = 6, 6.1%) than in the nasal (n = 0, 0%) intubation group. The median
(IQR) time to extubation (14, 12.6-17.2 v 20.5, 16.4-25.4 hours) and the
ICU length of stay (27, 26-28 v 30, 28-34 hours) were significantly (p <
0.05) shorter in the nasal group compared to the oral group. The median
(IQR) time to onset of full oral feeding was significantly (p = 0.031)
shorter in the nasal intubation group (3, 1-6 days) compared to the oral
intubation group (4, 2-7 days). There were no significant differences
between the oral and nasal groups in the duration of hospital stay and the
indices for reintubation, postintubation stridor, pneumonia, and surgical
wound infection. Conclusion(s): The nasal route for intubation is
associated with less postoperative fentanyl consumption, earlier
extubation, lower incidence of accidental extubation, and earlier full
oral feeding than oral intubation. The nasal route is not associated with
an increased risk of postoperative pneumonia or surgical wound
infection. Copyright © 2023 Elsevier Inc.

<35>
Accession Number
2024696105
Title
Comparison of Procedural Sedation With Propofol and Dexmedetomidine During
Transcatheter Aortic Valve Replacement Using the Transfemoral Approach.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(10) (pp 1894-1900),
2023. Date of Publication: October 2023.
Author
Vovk Racman P.; Ksela J.; Racman M.; Zerjav U.; Sostaric M.
Institution
(Vovk Racman, Zerjav, Sostaric) Clinical Department of Anaesthesiology and
Perioperative Intensive Care, University Medical Centre Ljubljana,
Ljubljana, Slovenia
(Ksela, Racman) Clinical Department of Cardiovascular Surgery, University
Medical Centre Ljubljana, Ljubljana, Slovenia
(Ksela, Sostaric) University of Ljubljana Faculty of Medicine, Ljubljana,
Slovenia
Publisher
W.B. Saunders
Abstract
Objectives: Although procedural sedation is an established method of
anesthesia for transcatheter aortic valve replacement (TAVR), reliable
evidence to guide the choice of a suitable sedative agent remains scarce.
Accordingly, this trial aimed to compare the effect of procedural sedation
with dexmedetomidine versus propofol on postoperative neurocognitive and
related clinical outcomes in patients undergoing TAVR. Design(s):
Prospective, randomized, double-blind clinical trial. Setting(s): The
study was conducted at the University Medical Centre Ljubljana, Slovenia.
 Participant(s): The study enrolled 78 patients who underwent TAVR
under procedural sedation between January 2019 and June 2021. Seventy-one
patients randomized into the propofol group (n = 34) and dexmedetomidine
group (n = 37) were included in the final analysis. Intervention(s):
Patients in the propofol group received sedation with propofol (continuous
intravenous infusion of 0.5-2.5 mg/kg/h), whereas patients in the
dexmedetomidine group received sedation with dexmedetomidine (loading dose
of 0.5 microg/kg over 10 minutes followed by continuous intravenous
infusion of 0.2-1.0 microg/kg/h). Measurements and Main Results:
Minimental state examination (MMSE) was performed before and 48 hours
after TAVR. There was no statistically significant difference in MMSE
scores between groups before TAVR (p = 0.253), but the MMSE after the
procedure revealed a significantly lower incidence of delayed
neurocognitive recovery (p = 0.005) and thus better cognitive outcomes in
the dexmedetomidine group (p = 0.022). Conclusion(s): Compared with
propofol, procedural sedation with dexmedetomidine in TAVR was associated
with a significantly lower incidence of delayed neurocognitive
recovery. Copyright © 2023 Elsevier Inc.

<36>
Accession Number
2024696035
Title
Impact of Lower Tidal Volumes During One-Lung Ventilation: A 2022 Update
of the Meta-analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(10) (pp 1983-1992),
2023. Date of Publication: October 2023.
Author
El Tahan M.R.; Samara E.; Marczin N.; Landoni G.; Pasin L.
Institution
(El Tahan) Anesthesiology Department, College of Medicine, Imam
Abdulrahman Bin Faisal University, Al Khubar, Dammam, Saudi Arabia
(Samara) Department of Anesthesiology and Postoperative Intensive Care,
Faculty of Medicine, School of Health Sciences, University of Ioannina,
Ioannina, Greece
(Marczin) The Royal Brompton and Harefield NHS Foundation Trust, London,
United Kingdom
(Marczin) Section of Anesthesia, Pain Medicine, and Intensive Care,
Imperial College London, London, United Kingdom
(Marczin) Semmelweis University, Budapest, Hungary
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milano, Italy
(Pasin) Department of Anesthesia and Intensive Care, Azienda
Ospedale-Universita di Padova, Padua, Italy
Publisher
W.B. Saunders
Abstract
Objectives: To clarify the influence of lower tidal volume (4-7 mL/kg)
compared with higher tidal volume (8-15 mL/kg) during one-lung ventilation
(OLV) on gas exchange and postoperative clinical outcome. Design(s):
Meta-analysis of randomized trials. Setting(s): Thoracic surgery.
 Participant(s): Patients receiving OLV. Intervention(s): Lower
tidal volume during OLV. Measurements and Main Results: Primary
outcome was PaO<inf>2</inf><inf>-</inf>to-the oxygen fraction
(PaO<inf>2</inf>/FIO<inf>2</inf>) ratio at the end of the surgery, after
the reinstitution of two-lung ventilation. Secondary endpoints included
perioperative changes in PaO<inf>2</inf>/FIO<inf>2</inf> ratio and carbon
dioxide (PaCO<inf>2</inf>) tension, airway pressure, the incidence of
postoperative pulmonary complications, arrhythmia, and length of hospital
stay. Seventeen randomized controlled trials (1,463 patients) were
selected. Overall analysis showed that the use of low tidal volume during
OLV was associated with a significantly higher
PaO<inf>2</inf>/FIO<inf>2</inf> ratio 15 minutes after the start of OLV
and at the end of surgery (mean difference 33.7 mmHg [p = 0.02] and mean
difference 18.59 mmHg [p < 0.001], respectively). The low tidal volume
also was associated with higher PaCO<inf>2</inf> values 15 minutes and 60
minutes after the start of OLV and with lower airway pressure, which was
maintained during two-lung ventilation after surgery. Moreover, the
application of lower tidal volume was associated with fewer postoperative
pulmonary complications (odds ratio 0.50; p < 0.001) and arrhythmias (odds
ratio 0.58; p = 0.009), with no difference in length of hospital stay.
 Conclusion(s): The use of lower tidal volume, a component of
protective OLV, increases the PaO<inf>2</inf>/FIO<inf>2</inf> ratio,
reduces the incidence of postoperative pulmonary complications, and should
be considered strongly in daily practice. Copyright © 2023
Elsevier Inc.

<37>
Accession Number
641691785
Title
Paediatric aortic valve replacement: a meta-analysis and microsimulation
study.
Source
European heart journal. 44(34) (pp 3231-3246), 2023. Date of Publication:
07 Sep 2023.
Author
Notenboom M.L.; Schuermans A.; Etnel J.R.G.; Veen K.M.; van de Woestijne
P.C.; Rega F.R.; Helbing W.A.; Bogers A.J.J.C.; Takkenberg J.J.M.
Institution
(Notenboom, Etnel, Veen, van de Woestijne, Bogers, Takkenberg) Department
of Cardiothoracic Surgery, Erasmus University Medical Centre, Erasmus MC,
Rotterdam 3015 GD, Netherlands
(Schuermans, Rega) Department of Cardiac Surgery, University Hospitals
Leuven, UZ Leuven Gasthuisberg, Herestraat 49, Leuven, Flanders 3000,
Belgium
(Schuermans) Cardiovascular Research Center, Massachusetts General
Hospital, 149 13th Street, 4th floor, Boston, MA 02129, USA
(Schuermans) Program in Medical and Population Genetics and the
Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT,
Merkin Building, 415 Main St., Cambridge MA 02142, United States
(Helbing) Department of Paediatrics, Division of Paediatric Cardiology,
Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, Rotterdam 3015 CN,
Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: To support decision-making in children undergoing aortic valve
replacement (AVR), by providing a comprehensive overview of published
outcomes after paediatric AVR, and microsimulation-based age-specific
estimates of outcome with different valve substitutes. METHODS AND
RESULTS: A systematic review of published literature reporting clinical
outcome after paediatric AVR (mean age <18 years) published between
1/1/1990 and 11/08/2021 was conducted. Publications reporting outcome
after paediatric Ross procedure, mechanical AVR (mAVR), homograft AVR
(hAVR), and/or bioprosthetic AVR were considered for inclusion. Early
risks (<30d), late event rates (>30d) and time-to-event data were pooled
and entered into a microsimulation model. Sixty-eight studies, of which
one prospective and 67 retrospective cohort studies, were included,
encompassing a total of 5259 patients (37 435 patient-years; median
follow-up: 5.9 years; range 1-21 years). Pooled mean age for the Ross
procedure, mAVR, and hAVR was 9.2 +/- 5.6, 13.0 +/- 3.4, and 8.4 +/- 5.4
years, respectively. Pooled early mortality for the Ross procedure, mAVR,
and hAVR was 3.7% (95% CI, 3.0%-4.7%), 7.0% (5.1%-9.6%), and 10.6%
(6.6%-17.0%), respectively, and late mortality rate was 0.5%/year
(0.4%-0.7%/year), 1.0%/year (0.6%-1.5%/year), and 1.4%/year
(0.8%-2.5%/year), respectively. Microsimulation-based mean life-expectancy
in the first 20 years was 18.9 years (18.6-19.1 years) after Ross
(relative life-expectancy: 94.8%) and 17.0 years (16.5-17.6 years) after
mAVR (relative life-expectancy: 86.3%). Microsimulation-based 20-year risk
of aortic valve reintervention was 42.0% (95% CI: 39.6%-44.6%) after Ross
and 17.8% (95% CI: 17.0%-19.4%) after mAVR. CONCLUSION(S): Results of
paediatric AVR are currently suboptimal with substantial mortality
especially in the very young with considerable reintervention hazards for
all valve substitutes, but the Ross procedure provides a survival benefit
over mAVR. Pros and cons of substitutes should be carefully weighed during
paediatric valve selection. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<38>
Accession Number
640836105
Title
Effect of intraoperative low vs. conventional tidal volume on the
incidence of postoperative acute kidney injury after noncardiac surgery: a
two-center randomized clinical trial.
Source
Minerva anestesiologica. 89(9) (pp 762-772), 2023. Date of Publication: 01
Sep 2023.
Author
Jia X.-Y.; Wang X.-R.; Jiang Y.-Y.; An M.-Z.; Pei D.-Q.; Li Z.-P.; Zhou
Q.-H.
Institution
(Jia, Wang, An) Department of Anesthesia Medicine, Zhejiang Chinese
Medical University, Hangzhou, China
(Jia, Wang, Jiang, An, Li) Department of Anesthesiology and Pain Medicine,
Affiliated Hospital of Jiaxing University, Jiaxing, China
(Jiang) Department of Anesthesia Medicine, Bengbu Medical College, Bengbu,
China
(Pei) Department of Anesthesiology, Second Affiliated Hospital of Jiaxing
University, Jiaxing, China
(Zhou) Department of Anesthesiology and Pain Medicine, Affiliated Hospital
of Jiaxing University, Jiaxing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: In adults undergoing noncardiac surgery, the correlation
between intraoperative tidal volume and postoperative acute kidney injury
(AKI) is unclear. This study aimed to investigate the effects of low tidal
volume ventilation on the incidence of postoperative AKI compared with
conventional tidal volume in adults undergoing noncardiac surgery.
 METHOD(S): This was a two-center prospective randomized controlled
trial on adult patients who underwent noncardiac surgery and had a
mechanical ventilation of >60 min. Patients were randomized to receive
either a tidal volume of 6 mL/kg pre-predicted body weight (PBW, low tidal
volume) or a tidal volume of 10 mL/kg pre-predicted body weight
(conventional tidal volume). The primary outcome was the incidence of AKI
after non-cardiac surgery. Appropriate statistical methods were used for
this study. RESULT(S): Among the 1982 randomized patients, 943 with
low tidal volume and 958 with conventional tidal volume were evaluable for
the primary outcome. Postoperative AKI occurred in 12 patients (1.3%) in
the low tidal volume group and 11 patients (1.1%) in the conventional
tidal volume group, with an odds ratio of 0.889 (95%CI, 0.391-2.03) and a
relative risk of 0.999 ([95%CI, 0.989-1.01]; P=0.804). Postoperative serum
creatinine levels increased in 284 (30.0%) patients with low tidal volume
compared to 316 (32.0%) patients with conventional tidal volume (P=0.251).
No difference in postoperative serum creatinine levels was found between
the two groups (57.5 [49.0-68.2] mumol/L vs. 58.8[50.4-69.5] mumol/L,
P=0.056). CONCLUSION(S): Among adults undergoing noncardiac surgery,
low tidal volume mechanical ventilation did not significantly reduce the
incidence of postoperative AKI compared with conventional tidal volume.

<39>
Accession Number
2025313184
Title
Protocol Study for the Evaluation of Non-Opioid Balanced General
Anaesthesia in Cardiac Surgery with Cardiopulmonary Bypass: A Randomised,
Controlled, Multicentric Superiority Trial (OFACAR Study).
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5473. Date of Publication: September 2023.
Author
Guinot P.-G.; Besch G.; Hameury B.; Grelet T.; Mertes P.M.; Nguyen M.;
Bouhemad B.
Institution
(Guinot, Hameury, Nguyen, Bouhemad) Department of Anaesthesiology and
Critical Care Medicine, Dijon University Medical Centre, Dijon 21000,
France
(Besch, Grelet) Department of Anaesthesiology and Critical Care Medicine,
Besancon Regional University Medical Centre, Besancon 25030, France
(Besch) EA3920, University of Franche-Comte, Besancon 25000, France
(Mertes) Department of Anesthesia and Critical Care, University Hospital
of Strasbourg, Strasbourg 67200, France
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Opioid-free anaesthesia (OFA) is general anaesthesia based on the use of
several non-opioid molecules that aim to have an analgesic effect,
decrease the sympathetic response, decrease hormonal stress, and decrease
the inflammatory response during surgery. Although this approach to
anaesthesia is regularly used in clinical practice, it remains a novel
approach. The literature on this anaesthesia modality finds a number of
positive effects on cardiac, respiratory, and cognitive function but no
randomised study evaluated these effects during cardiac surgery where
there is a high incidence of postoperative complications. The main aim of
the study is to compare OFA vs. standard balanced opioid general
anaesthesia on the incidence of postoperative complications and the length
of stay in intensive care and hospital. OFACAR is a multicentric,
randomised, controlled, superiority, single-blind, two parallel-arm
clinical trial in patients undergoing cardiac surgery with cardiopulmonary
bypass. We compared a balanced general anaesthesia without opioids (OFA
group) vs. a balanced opioid general anaesthesia with sufentanil (control
group). One hundred and sixty patients will be enrolled in each treatment
group. The primary endpoint is a composite one which corresponds to the
occurrence of at least one of the postoperative complications, defined
according to European standards within 30 days after surgery. Recruitment
started in September 2019, and data collection is expected to end in
November 2024. Copyright © 2023 by the authors.

<40>
Accession Number
2025313156
Title
Sarcopenia Adversely Affects Outcomes following Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5573. Date of Publication: September 2023.
Author
Ansaripour A.; Arjomandi Rad A.; Koulouroudias M.; Angouras D.; Athanasiou
T.; Kourliouros A.
Institution
(Ansaripour, Kourliouros) Department of Cardiothoracic Surgery, John
Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust,
Oxford OX3 9DU, United Kingdom
(Arjomandi Rad) Medical Sciences Division, University of Oxford, Oxford
OX1 3AZ, United Kingdom
(Koulouroudias) Department of Cardiac Surgery, Nottingham University
Hospitals NHS Trust, Nottingham NG5 1PB, United Kingdom
(Angouras) Department of Cardiac Surgery, Attikon University Hospital,
National and Kapodistrian University of Athens, Athens 10679, Greece
(Athanasiou) Department of Surgery and Cancer, Imperial College London,
London SW7 2BX, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Sarcopenia is a degenerative condition characterised by the
loss of skeletal muscle mass and strength. Its impact on cardiac surgery
outcomes remains poorly investigated. This meta-analysis aims to provide a
comprehensive synthesis of the available evidence to determine the effect
of sarcopenia on cardiac surgery outcomes. Method(s): A systematic
review and meta-analysis followed PRISMA guidelines from inception to
April 2023 in EMBASE, MEDLINE, Cochrane database, and Google Scholar.
Twelve studies involving 2717 patients undergoing cardiac surgery were
included. Primary outcomes were early and late mortality; secondary
outcomes included surgical time, infection rates, and functional outcomes.
Statistical analyses were performed using appropriate methods.
 Result(s): Sarcopenic patients (906 patients) had a significantly
higher risk of early mortality (OR: 2.40, 95% CI: 1.44 to 3.99, p =
0.0007) and late mortality (OR: 2.65, 95% CI: 1.57 to 4.48, p = 0.0003)
compared to non-sarcopenic patients (1811 patients). There were no
significant differences in overall surgical time or infection rates.
However, sarcopenic patients had longer ICU stays, higher rates of renal
dialysis, care home discharge, and longer intubation times.
 Conclusion(s): Sarcopenia significantly increases the risk of early
and late mortality following cardiac surgery, and sarcopenic patients also
experience poorer functional outcomes. Copyright © 2023 by the
authors.

<41>
Accession Number
2026806209
Title
COMPARISON OF PROTAMINE SULPHATE DOSE BY EXISTING FIXED DOSE METHOD AND
CALCULATED DOSE METHOD ACCORDING TO ACTIVATED CLOTTING TIME OF PATIENTS
UNDERGOING VALVULAR HEART SURGERIES.
Source
Journal of Cardiovascular Disease Research. 13(5) (pp 3349-3358), 2022.
Date of Publication: 2022.
Author
Dubey S.; Evane N.; Yona A.; Kaur D.; Kaushal R.P.; Agarwal A.
Institution
(Dubey) Department of Emergency Medicine, People's College of Medical
Sciences, Bhopal, India
(Evane) Vaishnavi Hospital & Research Centre, Betul, India
(Yona) Department of Anaesthesia, Mahaveer Institute of Medical Sciences
and Research, Bhopal, India
(Kaur) Ruban Memorial Hospital Patliputra, Patna, India
(Kaushal) Department of Anaesthesia, GMC, Bhopal, India
(Agarwal) Department of Anaesthesia, People's College of Medical Sciences
& Research Centre, Bhopal, India
Publisher
EManuscript Technologies
Abstract
Background: To compare the fixed dose v/s calculated dose of Protamine
Sulphate to achieve reversal of ACT (Activated clotting time) value after
full dose of heparinization by protamine sulphate administration to as
near as normal levels during valvular heart surgeries. Material(s)
and Method(s): The study was done on 60 patients of ASA grade II & III
scheduled for valvular heart surgery. All the patients were subjected to
detailed pre-anaesthetic evaluation with clinical history and systemic
examination. Routine investigations were done. All the patients were
divided randomly into two groups, Group A and Group B. In Group A,
protamine dose was given according to the calculated formula based on ACT.
In Group B, Fixed dose of Protamine Sulphate, 1 mg protamine for each mg
of heparin was given. Result(s): Group A and B showed significant
difference in terms of protamine dose. In Group A the mean dose of
protamine was 119.9 mg while in Group B the protamine dose given was
133.4mg (SD +/- 17.98) based on fixed dose method. This difference in
protamine dose was statistically significant (p-0.0104) .Using fixed dose
method in Group B patients would have resulted in administration of extra
protamine dose of 21 mg. There was increased amount of bleeding in Group B
than in Group A patients. The average amount of total blood loss in group
B was 1252.59ml (SD +/- 267.95) and in group A was 1114.5ml (SD +/-
212.02), which was significantly less in Group A patients. The amount of
blood products transfused was also less in Group A than in Group B.
 Conclusion(s): ACT as a measure to calculate protamine dose for
reversal of heparin resulted in reduced dose of protamine as compared to
fixed dose of protamine used. This method can calculate protamine dose
necessary to neutralise heparin more accurately. It also led to reduced
amount of blood loss and decreased requirements of blood transfusion in
perioperative period. Copyright © 2022 EManuscript Technologies.
All rights reserved.

<42>
Accession Number
2026850642
Title
COMPARISON OF FENTANYL AND DEXMEDETOMIDINE FOR ATTENUATION OF HAEMODYNAMIC
RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION IN VALVULAR HEART
SURGERY.
Source
Journal of Cardiovascular Disease Research. 13(8) (pp 573-581), 2022. Date
of Publication: 2022.
Author
Meena J.K.; Yadav J.; Singh A.V.; Rathee A.
Institution
(Meena, Yadav, Singh, Rathee) Department Of Anaesthesia, National
Institute Of Medical Sciences And Research Hospital, Jaipur, India
Publisher
EManuscript Technologies
Abstract
OBJECTIVE-Endotracheal intubation & Laryngoscopy is an integral part of
anesthesiologist's contribution to patient care, but the procedure results
in changes of various hemodynamic parameters. The aim of study was to
access the efficacy of Fentanyl and Dexmedetomidine in blocking the
cardiovascular response to laryngoscopy and intubation and ensuring stable
hemodynamics. METHOD-A randomized , double blind, comparative study was
conducted with patients divided randomly into two groups, Group Fentanyl
and Group Dexmedetomidine. Baseline parameters of the patients were
recorded before drug administration . Injection Etomidate 0.6 mg\kg i.v
slowly followed by Injection Rocuronium 2mg\kg i.v given . Hemodynamic
parameters NIBP, HR , SPO2 measured after intubation 1,3,5,7,10 min.
RESULT- Hemodynamic parameters were increased just after laryngoscopy and
intubation compared to baseline. After few minutes hemodynamic parameter
were stabilized. CONCLUSION- Fentanyl and Dexmedetomidine blunts the
hemodynamic response to endotracheal intubation in patients undergoing
valvular heart surgery under general anesthesia and can be safely used at
induction of general anesthesia. Dexmedetomidine shows more attenuated
pressure response to laryngoscopy and intubation compared to
Fentanyl. Copyright © 2022 EManuscript Technologies. All rights
reserved.

<43>
Accession Number
2026913308
Title
Minimally invasive, surgical, and transcatheter aortic valve replacement:
A network meta-analysis.
Source
Journal of Cardiology. (no pagination), 2023. Date of Publication: 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, United States
(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
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
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 10.4 years, 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 Elsevier Ltd

<44>
Accession Number
642219180
Title
Long-Term Outcomes of Patients Undergoing Aortic Root Replacement With
Mechanical Versus Bioprosthetic Valves: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. (pp e030629), 2023. Date of
Publication: 08 Sep 2023.
Author
Sa M.P.; Tasoudis P.; Jacquemyn X.; Van den Eynde J.; Caranasos T.G.;
Ikonomidis J.S.; Chu D.; Serna-Gallegos D.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery
University of Pittsburgh Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center Pittsburgh PA
(Tasoudis, Caranasos, Ikonomidis) Division of Cardiothoracic Surgery,
Department of Surgery University of North Carolina Chapel Hill NC
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, Belgium
Publisher
NLM (Medline)
Abstract
Background An aspect not so clear in the scenario of aortic surgery is how
patients fare after composite aortic valve graft replacement (CAVGR)
depending on the type of valve (bioprosthetic versus mechanical). We
performed a study to evaluate the long-term outcomes of both strategies
comparatively. Methods and Results Pooled meta-analysis of
Kaplan-Meier-derived time-to-event data from studies with follow-up for
overall survival (all-cause death), event-free survival (composite end
point of cardiac death, valve-related complications, stroke, bleeding,
embolic events, and/or endocarditis), and freedom from reintervention.
Twenty-three studies met our eligibility criteria, including 11428
patients (3786 patients with mechanical valves and 7642 patients with
bioprosthetic valve). The overall population was mostly composed of men
(mean age, 45.5-75.6years). In comparison with patients who underwent
CAVGR with bioprosthetic valves, patients undergoing CAVGR with mechanical
valves presented no statistically significant difference in the risk of
all-cause death in the first 30days after the procedure (hazard ratio
[HR], 1.24 [95% CI, 0.95-1.60]; P=0.109), but they had a significantly
lower risk of all-cause mortality after the 30-day time point (HR, 0.89
[95% CI, 0.81-0.99]; P=0.039) and lower risk of reintervention (HR, 0.33
[95% CI, 0.24-0.45]; P<0.001). Despite its increased risk for the
composite end point in the first 6years of follow-up (HR, 1.41 [95% CI,
1.09-1.82]; P=0.009), CAVGR with mechanical valves is associated with a
lower risk for the composite end point after the 6-year time point (HR,
0.46 [95% CI, 0.31-0.67]; P<0.001). Conclusions CAVGR with mechanical
valves is associated with better long-term outcomes in comparison with
CAVGR with bioprosthetic valves.

<45>
Accession Number
642217336
Title
Survival With Favorable Neurologic Outcome and Quality of Cardiopulmonary
Resuscitation Following In-Hospital Cardiac Arrest in Children With
Cardiac Disease Compared With Noncardiac Disease.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. (no pagination), 2023. Date of Publication: 07 Sep 2023.
Author
Federman M.; Sutton R.M.; Reeder R.W.; Ahmed T.; Bell M.J.; Berg R.A.;
Bishop R.; Bochkoris M.; Burns C.; Carcillo J.A.; Carpenter T.C.; Dean
J.M.; Diddle J.W.; Fernandez R.; Fink E.L.; Franzon D.; Frazier A.H.;
Friess S.H.; Graham K.; Hall M.; Hehir D.A.; Horvat C.M.; Huard L.L.;
Kirkpatrick T.; Maa T.; Maitoza L.A.; Manga A.; McQuillen P.S.; Meert
K.L.; Morgan R.W.; Mourani P.M.; Nadkarni V.M.; Notterman D.; Palmer C.A.;
Pollack M.M.; Sapru A.; Schneiter C.; Sharron M.P.; Srivastava N.; Tilford
B.; Viteri S.; Wessel D.; Wolfe H.A.; Yates A.R.; Zuppa A.F.; Naim M.Y.
Institution
(Federman, Huard, Kirkpatrick, Maitoza, Sapru, Srivastava) Department of
Pediatrics, Mattel Children's Hospital, University of California Los
Angeles, Los Angeles, CA, United States
(Sutton, Berg, Graham, Hehir, Morgan, Nadkarni, Wolfe, Zuppa, Naim)
Department of Anesthesiology and Critical Care Medicine, Children's
Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA,
United States
(Reeder, Dean, Palmer) Department of Pediatrics, University of Utah, Salt
Lake City, UT, United States
(Ahmed, Meert, Tilford) Department of Pediatrics, Children's Hospital of
Michigan, Central Michigan University, Detroit, MI, United States
(Bell, Diddle, Pollack, Sharron, Wessel) Department of Pediatrics,
Children's National Hospital, George Washington University School of
Medicine, WA, United States
(Bishop, Carpenter, Schneiter) Department of Pediatrics, University of
Colorado School of Medicine, Aurora, CO, United States
(Bishop, Carpenter, Schneiter) Department of Pediatrics, Children's
Hospital Colorado, Aurora, CO, United States
(Bochkoris, Carcillo, Fink, Horvat) Department of Critical Care Medicine,
UPMC Children's Hospital of Pittsburgh, University of Pittsburgh,
Pittsburgh, PA, United States
(Burns) Department of Pediatrics and Human Development, Michigan State
University, Grand Rapids, MI, United States
(Fernandez, Hall, Maa, Yates) Department of Pediatrics, Ohio State
University, Nationwide Children's Hospital, Columbus, OH, United States
(Franzon, McQuillen) Department of Pediatrics, Benioff Children's s,
University of California, San Francisco, CA, United States
(Frazier) Nemours Cardiac Center, Nemours Children's Hospital, Delaware,
Wilmington, DE
(Frazier) Department of Pediatrics, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA, United States
(Friess, Manga, Mourani) Department of Pediatrics, Washington University
School of Medicine, St. Louis, MO, United States
(Notterman) Department of Molecular Biology, Princeton University,
Princeton, NJ, United States
(Viteri) Department of Pediatrics, Nemours Children's Hospital, Delaware
and Thomas Jefferson University, Wilmington, DE, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To assess associations between outcome and cardiopulmonary
resuscitation (CPR) quality for in-hospital cardiac arrest (IHCA) in
children with medical cardiac, surgical cardiac, or noncardiac disease.
DESIGN: Secondary analysis of a multicenter cluster randomized trial, the
ICU-RESUScitation Project (NCT02837497, 2016-2021). SETTING: Eighteen
PICUs. PATIENTS: Children less than or equal to 18 years old and greater
than or equal to 37 weeks postconceptual age receiving chest compressions
(CC) of any duration during the study.None. MEASUREMENTS AND MAIN RESULTS:
Of 1,100 children with IHCA, there were 273 medical cardiac (25%), 383
surgical cardiac (35%), and 444 noncardiac (40%) cases. Favorable
neurologic outcome was defined as no more than moderate disability or no
worsening from baseline Pediatric Cerebral Performance Category at
discharge. The medical cardiac group had lower odds of survival with
favorable neurologic outcomes compared with the noncardiac group (48% vs
55%; adjusted odds ratio [aOR] [95% CI], aOR 0.59 [95% CI, 0.39-0.87], p =
0.008) and surgical cardiac group (48% vs 58%; aOR 0.64 [95% CI,
0.45-0.9], p = 0.01). We failed to identify a difference in favorable
outcomes between surgical cardiac and noncardiac groups. We also failed to
identify differences in CC rate, CC fraction, ventilation rate,
intra-arrest average target diastolic or systolic blood pressure between
medical cardiac versus noncardiac, and surgical cardiac versus noncardiac
groups. The surgical cardiac group had lower odds of achieving target CC
depth compared to the noncardiac group (OR 0.15 [95% CI, 0.02-0.52], p =
0.001). We failed to identify a difference in the percentage of patients
achieving target CC depth when comparing medical cardiac versus noncardiac
groups. CONCLUSION(S): In pediatric IHCA, medical cardiac patients
had lower odds of survival with favorable neurologic outcomes compared
with noncardiac and surgical cardiac patients. We failed to find
differences in CPR quality between medical cardiac and noncardiac
patients, but there were lower odds of achieving target CC depth in
surgical cardiac compared to noncardiac patients. Copyright ©
2023 by the Society of Critical Care Medicine and the World Federation of
Pediatric Intensive and Critical Care Societies.

<46>
Accession Number
2026808396
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: 01 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, 5, Naples 80131, Italy
(Cittadini) Department of Translational Medical Sciences, University of
Naples 'Federico II', Via S Pansini, 5, 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, Sudring, 15, Bad Krozingen 79189, Germany
(Czerny) Faculty of Medicine, Albert-Ludwigs University Freiburg,
Freiburg, Germany
Publisher
Oxford University Press
Abstract
Background: In acute aortic dissection (AAD) sex heterogeneity reports are
not exhaustive and in part even conflicting. Aim(s): 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. Copyright ©
The Author(s) 2023.

<47>
Accession Number
2026676831
Title
Impact of coronary bifurcation angle on stent malapposition in a
randomized comparison between proximal optimization technique followed by
side branch dilatation and kissing balloon inflation.
Source
IJC Heart and Vasculature. 48 (no pagination), 2023. Article Number:
101265. Date of Publication: October 2023.
Author
Yamawaki M.; Murasato Y.; Watanabe Y.; Kinoshita Y.; Okubo M.; Yumoto K.;
Masuda N.; Otake H.; Aoki J.; Nakazawa G.; Numasawa Y.; Ito T.; Shite J.;
Okamura T.; Takagi K.; Lefevre T.; Chevalier B.; Louvard Y.; Suzuki N.;
Kozuma K.
Institution
(Yamawaki) Department of Cardiology, Saiseikai Yokohama City Eastern
Hospital, Yokohama, Japan
(Murasato) Department of Cardiology and Clinical Research Center, National
Hospital Organization Kyushu Medical Center, Fukuoka, Japan
(Watanabe, Kozuma) Department of Medicine, Division of Cardiology, Teikyo
University School of Medicine, Tokyo, Japan
(Kinoshita) Department of Cardiology, Toyohashi Heart Center, Toyohashi,
Japan
(Okubo) Department of Cardiovascular Medicine, Gifu Heart Center, Gifu,
Japan
(Yumoto) Department of Cardiology, Yokohama Rosai Hospital, Yokohama,
Japan
(Masuda) Department of Cardiology, Ageo Central General Hospital, Ageo,
Japan
(Otake) Department of Cardiology, Kobe University Graduate School of
Medicine, Kobe, Japan
(Aoki) Department of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
(Nakazawa) Department of Cardiology, Tokai University School of Medicine,
Isehara, Japan
(Numasawa) Department of Cardiology, Japanese Red Cross Ashikaga Hospital,
Ashikaga, Japan
(Ito) Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
(Shite) Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka,
Japan
(Okamura) Department of Medicine and Clinical Science, Yamaguchi
University Graduate School of Medicine, Ube, Japan
(Takagi) Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
(Kozuma) Department of Biostatistics, Division of Health Sciences and
Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo,
Japan
(Lefevre, Chevalier, Louvard) Department of Cardiology, Ramsay Generale de
Sante, Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques Cartier,
Massy, France
(Suzuki) Division of Cardiology, Teikyo University Mizonokuchi Hospital,
Kawasaki, Japan
Publisher
Elsevier Ireland Ltd
Abstract
Background: The impact of coronary bifurcation angle (BA) on incomplete
stent apposition (ISA) after crossover stenting followed by side branch
(SB) intervention has not been established. Method(s): A total of 100
crossover stentings randomly treated with proximal optimization technique
followed by short balloon dilation in the SB (POT-SBD group, 48 patients)
and final kissing balloon technique (KBT group, 52 patients) were analyzed
in the PROPOT trial. Major ISA with maximum distance > 400 mum and its
location was determined using optical coherence tomography before SB
intervention and at the final procedure. The BA was defined as the angle
between the distal main vessel and SB. Optimal POT was determined when the
difference in stent volume index between the proximal and distal
bifurcation was greater than the median value (0.86 mm3/mm)
before SB intervention. Result(s): Major ISA was more frequently
observed in the POT-SBD than in the KBT group (35% versus 17%, p < 0.05).
In the POT-SBD group, worsening ISA after SBD was prominent at the distal
bifurcation. The BA was an independent predictor of major ISA (odds ratio
1.04, 95% confidence interval 1.00-1.07, p < 0.05) with a cut-off value of
59.5degree (p < 0.05). However, the cases treated with optimal POT in the
short BA (<60degree) indicated the lowest incidence of major ISA. In the
KBT group, BA had no significant impact. Conclusion(s): A wide BA has
a potential risk for the occurrence of major ISA after POT followed by SBD
in coronary bifurcation stenting. Copyright © 2023 The Author(s)

<48>
Accession Number
2026545382
Title
Intraoperative hypotension and postoperative complications in noncardiac
surgery: a narrative review.
Source
Acta Anaesthesiologica Belgica. 73 (pp 141-147), 2022. Date of
Publication: December 2022.
Author
Vossen R.; Lauweryns J.
Institution
(Vossen, Lauweryns) Department of Anesthesiology, University Hospitals
Leuven, Herestraat 49, Leuven 3000, Belgium
Publisher
BeSARPP
Abstract
Background: The incidence of IOH varies between 5% and 99%, depending on
which definition is used. There have been numerous reports on the
association between IOH and different postoperative outcomes.
 Objective(s): The goal of this study was to evaluate the association
between intraoperative hypotension (IOH) and common postoperative
outcomes, namely acute kidney injury, myocardial injury, cerebral
ischemia, and postoperative delirium. Method(s): For this review, we
developed a search strategy and searched all relevant medical databases.
We searched for cohorts focusing on IOH and the different postoperative
outcomes conducted in the past ten years. Eventually we were able to
include 16 articles. Result(s): Regarding acute kidney injury (AKI),
there is sufficient high-quality evident that IOH is an independent risk
factor for developing AKI. We identified three studies evaluating the
association between IOH and myocardial injury. They found a high incidence
of myocardial injury, up to 30%. Furthermore, we found an independent
association between IOH and myocardial injury. Regarding cerebral
ischemia, we identified four cohorts. For now, there has not been a
consensus regarding the association between IOH and cerebral ischemia. A
few, but not all,studies find an association between IOH and cerebral
ischemia. Conflicting evidence regarding a possible association between
IOH and postoperative delirium was found. Discussion and conclusion: There
seems to be enough evidence that episodes of IOH might be associated with
both AKI and myocardial ischemia. The data regarding IOH and cerebral
ischemia and POD however are inconsistent. There is a lot of variety
between studies regarding the definition of IOH as the study population,
so no hard conclusion can be drawn from this review. Copyright ©
2022 ARSMB-KVBMG. All rights reserved.

<49>
Accession Number
2026518333
Title
An empirical investigation into the impact of winner's curse on estimates
from Mendelian randomization.
Source
International Journal of Epidemiology. 52(4) (pp 1209-1219), 2023. Date of
Publication: 01 Aug 2023.
Author
Jiang T.; Gill D.; Butterworth A.S.; Burgess S.
Institution
(Jiang, Butterworth, Burgess) BHF Cardiovascular Epidemiology Unit,
Department of Public Health and Primary Care, University of Cambridge,
Cambridge, United Kingdom
(Jiang, Butterworth, Burgess) Heart and Lung Research Institute,
University of Cambridge, Cambridge, United Kingdom
(Gill) Department of Epidemiology and Biostatistics, School of Public
Health, Imperial College London, London, United Kingdom
(Gill) Chief Scientific Advisor Office, Research and Early Development,
Novo Nordisk, Copenhagen, Denmark
(Butterworth) British Heart Foundation Centre of Research Excellence,
University of Cambridge, Cambridge, United Kingdom
(Butterworth) National Institute for Health Research Blood, Transplant
Research Unit in Donor Health and Behaviour, University of Cambridge,
Cambridge, United Kingdom
(Butterworth) Health Data Research UK Cambridge, University of Cambridge,
Wellcome Genome Campus, Cambridge, United Kingdom
(Burgess) MRC Biostatistics Unit, University of Cambridge, Cambridge,
United Kingdom
Publisher
Oxford University Press
Abstract
Introduction: Genetic associations for variants identified through
genome-wide association studies (GWASs) tend to be overestimated in the
original discovery data set as, if the association was underestimated, the
variant may not have been detected. This bias, known as winner's curse,
can affect Mendelian randomization estimates, but its severity and
potential impact are unclear. Method(s): We performed an empirical
investigation to assess the potential bias from winner's curse in
practice. We considered Mendelian randomization estimates for the effect
of body mass index (BMI) on coronary artery disease risk. We randomly
divided a UK Biobank data set 100 times into three equally sized subsets.
The first subset was treated as the 'discovery GWAS'. We compared genetic
associations estimated in the discovery GWAS to those estimated in the
other subsets for each of the 100 iterations. Result(s): For variants
associated with BMI at P < 5 x 10-8 in at least one iteration,
genetic associations with BMI were up to 5-fold greater in iterations in
which the variant was associated with BMI at P < 5 x 10-8
compared with its mean association across all iterations. If the minimum
P-value for association with BMI was P 1/4 10-13 or lower, then
this inflation was <25%. Mendelian randomization estimates were affected
by winner's curse bias. However, bias did not materially affect results;
all analyses indicated a deleterious effect of BMI on coronary artery
disease risk. Conclusion(s): Winner's curse can bias Mendelian
randomization estimates, although its practical impact may not be
substantial. If avoiding sample overlap is infeasible, analysts should
consider performing a sensitivity analysis based on variants strongly
associated with the exposure. Copyright © The Author(s) 2022.
Published by Oxford University Press on behalf of the International
Epidemiological Association.

<50>
Accession Number
2026232423
Title
A Randomized Controlled Trial Comparing BioMime Sirolimus-Eluting Stent
With Everolimus-Eluting Stent: Two-Year Outcomes of the meriT-V Trial.
Source
Cardiology Research. 14(4) (pp 291-301), 2023. Date of Publication: 2023.
Author
Abizaid A.; Costa R.; Kedev S.; Kedhi E.; Talwar S.; Erglis A.; Hlinomaz
O.; Masotti M.; Fath-Ordoubadi F.; Milewski K.; Lemos P.; Botelho R.;
Ijsselmuiden A.; Koolen J.; Kala P.; Janssens L.; Chandra U.
Institution
(Abizaid, Lemos) Heart Institute-InCor, University of Sao Paulo, Sao
Paulo, Brazil
(Costa) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Kedev) University Clinic of Cardiology, Skopje, North Macedonia
(Kedhi) Isala Hospital, Zwolle, Netherlands
(Talwar) Royal Bournemouth Hospital, Bournemouth, United Kingdom
(Erglis) Latvian Research Institute of Cardiology, Riga, Latvia
(Hlinomaz) ICRC, St. Anne's University Hospital, Brno, Czechia
(Masotti) University Hospital Clinic de Barcelona, Barcelona, Spain
(Fath-Ordoubadi) Manchester Heart Centre, Manchester, United Kingdom
(Milewski) Academy of Silesia, Faculty of Medicine, Katowice, Poland
(Botelho) Eurolatino Pesquisas Medicas, Uberlandia, Brazil
(Ijsselmuiden) Albert Schweitzer Hospital, Dordrecht, Netherlands
(Koolen) Catharina Cardiac Centre, Eindhoven, Netherlands
(Kala) University Hospital, Brno, Czechia
(Janssens) Imelda Ziekenhuis Cardiology, Bonheiden, Belgium
(Chandra) Meril Life Sciences Pvt. Ltd., Vapi, India
Publisher
Elmer Press
Abstract
Background: Drug-eluting stents (DESs) based on biodegradable polymers
(BPs) have been introduced to reduce the risk for late and very late stent
thrombosis (ST), which were frequently observed with earlier generations
of DES designs based on durable polymers (DPs); however, randomized
controlled trials on these DES designs are scarce. The meriT-V trial is a
randomized, active-controlled, noninferiority trial with a prospective,
multicenter design that evaluated the 2-year efficacy of a novel
third-generation, ultra-thin strut, BPbased BioMime sirolimus-eluting
stent (SES) versus the DP-based XIENCE everolimus-eluting stent (EES) for
the treatment of de novo lesions. Method(s): The meriT-V is a
randomized trial that enrolled 256 patients at 15 centers across Europe
and Brazil. Here, we report the outcomes of the extended follow-up period
of 2 years. The randomization of enrolled patients was in a 2:1 ratio; the
enrolled patients received either the BioMime SES (n = 170) or the XIENCE
EES (n = 86). The three-point major adverse cardiac event (MACE), defined
as a composite of cardiac death, myocardial infarction (MI), or
ischemiadriven target vessel revascularization (ID-TVR), was considered as
the composite safety and efficacy endpoint. Ischemia-driven target lesion
revascularization (ID-TLR) was evaluated as well as the frequency of
definite/probable ST, based on the first Academic Research Consortium
definitions. Result(s): The trial had a 2-year follow-up completion
rate of 98.44% (n = 252/256 patients), and the clinical outcomes
assessment showed a nonsignificant difference in the cumulative rate of
three-point MACE between both arms (BioMime vs. XIENCE: 7.74% vs. 9.52%, P
= 0.62). Even the MI incidences in the BioMime arm were insignificantly
lower than those of the XIENCE arm (1.79% vs. 5.95%, P = 0.17). Late ST
was observed in 1.19% cases of the XIENCE arm, while there were no such
cases in the BioMime arm (P = 0.16). Conclusion(s): The objective
comparisons between the novel BP-based BioMime SES and the
well-established DP-based XIENCE EES in this randomized controlled trial
show acceptable outcomes of both the devices in the cardiac deaths, MI,
ID-TVR, and ST. Moreover, since there were no incidences of cardiac death
in the entire study sample over the course of 2 years, we contend that the
findings of the study are highly significant for both these DES designs.
In this preliminary comparative trial, the device safety of BioMime SES
can be affirmed to be acceptable, considering the lower three-point MACE
rate and absence of late ST in the BioMime arm over the 2-year
period. Copyright © Cardiol Res and Elmer Press IncTM

<51>
Accession Number
2026227295
Title
A Theory-Based, Technology-Assisted Intervention in a Hybrid Cardiac
Rehabilitation Program for Patients with Coronary Heart Disease: A
Feasibility Study.
Source
Asian Nursing Research. 17(3) (pp 180-190), 2023. Date of Publication:
August 2023.
Author
Chong M.S.; Sit J.W.H.; Choi K.C.; Suhaimi A.; Chair S.Y.
Institution
(Chong, Sit, Choi, Chair) The Nethersole School of Nursing, Faculty of
Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
(Suhaimi) Department of Rehabilitation Medicine, University Malaya Medical
Centre, Malaysia
Publisher
Korean Society of Nursing Science
Abstract
Purpose: To assess the feasibility of a technology-assisted intervention
in a hybrid cardiac rehabilitation program among patients with coronary
heart disease. Method(s): This study was a two-arm parallel
randomized controlled trial. Twenty-eight patients with coronary heart
disease were randomly assigned to either the intervention group, receiving
a 12-week technology-assisted intervention (n = 14), or the control group
(n = 14), receiving usual care. Guided by the Health Belief Model, the
intervention group received three center-based, supervised exercise
training sessions, a fitness watch that served as a cue to action, six
educational videos, and a weekly video call. The Self-efficacy for
Exercise, exercise capacity, and Health Promoting Lifestyle Profile II
were assessed at baseline and immediately post-intervention (12-weeks).
 Result(s): Among the 28 patients who participated in this study,
85.7% completed the program, with a relatively low attrition rate (14.3%).
The number of exercise training sessions accomplished by the participants
in the intervention group was 51.27 +/- 19.41 out of 60 sessions (85.5%)
compared to 36.46 +/- 23.05 (60.8%) in the control group. No cardiac
adverse events or hospitalizations were reported throughout the study.
Participants in the intervention group showed greater improvement in
health-promoting behaviors when compared with the control group at 12
weeks. Within-group effects demonstrated improvement in exercise
self-efficacy and exercise capacity among participants in the intervention
group. A participant satisfaction survey conducted immediately
post-intervention revealed that participants were "very satisfied" (23.1%)
and "satisfied" (76.9%) with the technology-assisted intervention.
 Conclusion(s): The findings demonstrated that technology-assisted
intervention in a hybrid cardiac rehabilitation program was feasible and
suggested to be beneficial in improving exercise self-efficacy, exercise
capacity, and health promoting behavior among patients with coronary heart
disease. A full-scale study is needed to determine its effectiveness in
the long term. Trial and protocol registration: ClinicalTrials.gov
NCT04862351.
https://clinicaltrials.gov/ct2/show/NCT04862351. Copyright © 2023

<52>
Accession Number
2025903289
Title
Prognostic value of sarcopenia in older adults with transcatheter aortic
valve implantation: A systematic review and meta-analysis.
Source
Archives of Gerontology and Geriatrics. 115 (no pagination), 2023. Article
Number: 105125. Date of Publication: December 2023.
Author
Yang Y.-W.; Pan P.; Xia X.; Zhou Y.-W.; Ge M.-L.
Institution
(Yang, Pan, Zhou) The Emergency Department, West China Hospital, Sichuan
University, Sichuan, Chengdu 610041, China
(Xia, Ge) The Center of Gerontology and Geriatrics (National Clinical
Research Center for Geriatrics), West China Hospital, Sichuan University,
Sichuan, Chengdu 610041, China
Publisher
Elsevier Ireland Ltd
Abstract
Objective: We conducted this systematic review and meta-analysis to
summarize the prevalence of sarcopenia and its impact on mortality in
patients undergoing TAVI. Method(s): Medline, EMBASE, and PubMed were
searched from inception to October 14, 2022 to retrieve eligible studies
that assessed sarcopenia in patients undergoing TAVI. Pooled sarcopenia
prevalence was calculated with 95% confidence interval (CI), and
heterogeneity was estimated using the I2 test. Associations of
sarcopenia with mortality of post-TAVI were expressed as hazard ratio (HR)
or odds ratios (OR) and 95% CI. Result(s): 13 studies involving 5248
patients (mean age from 78.1 to 84.9 years) undergoing TAVI were included.
There were eleven studies defined sarcopenia based on loss of skeletal
muscle mass index (SMI), while only two studies used low muscle mass plus
low muscle strength and/or low physical performance. Overall, the pooled
prevalence of sarcopenia in patients undergoing TAVI was 49% (95% CI
41%-58%). Sarcopenia was associated with an increased risk of long-term
(>=1 year) mortality in patients after TAVI (HR 1.57, 95% CI 1.33-1.85, P
< 0.001), with similar findings in the subgroups stratified by follow-up
time, definition of sarcopenia, study location, and study design.
Furthermore, the 1-, 2-, and 3-year cumulative probabilities of survival
in patients with sarcopenia were significantly lower than non-sarcopenia
(74.0% vs 91.0%, 68.3% vs 78.0%, and 72.6% vs 79.8%, all P < 0.05).
 Conclusion(s): Although there are substantial differences in
diagnostic criteria, sarcopenia is highly prevalent in patients undergoing
TAVI and its linked to increased long-term mortality after
TAVI. Copyright © 2023 The Author(s)

<53>
Accession Number
2025617792
Title
Comparison of Analgesic Effects of Ketorolac Plus Apotel to Meperidine in
Patients Undergoing Right Thoracotomy: A Double-Blind Randomized Clinical
Trial.
Source
Anesthesiology and Pain Medicine. 13(4) (no pagination), 2023. Article
Number: e136822. Date of Publication: August 2023.
Author
Aliabad M.S.; Sheibani S.; Mehrad-Majd H.; Atar A.S.
Institution
(Aliabad, Sheibani, Atar) Department of Anesthesiology, Faculty of
Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Mehrad-Majd) Cancer Molecular Pathology Research Center, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Background: Postoperative pain management using nonsteroidal
anti-inflammatory drugs with no narcotic-attributed adverse effects, such
as respiratory depression, nausea, and vomiting, is still the subject of
extensive research. However, concerns about bleeding and nephrotoxicity
have limited routine use. Objective(s): The present trial aimed to
compare the effects of ketorolac/apotel and meperidine on postoperative
pain relief in patients undergoing thoracotomy. Method(s): This
randomized controlled trial enrolled 122 patients who were candidates for
right thoracotomy. The patients were randomly divided into two groups that
received ketorolac (30 mg)/apotel (1 g) or meperidine (0.5 - 1 mg/kg) at
the beginning of recovery, respectively. This study assessed the Numeric
Rating Scale pain score immediately and 30 and 60 minutes after the
surgery in the recovery room, blood pressure, oxygen saturation
(SpO<inf>2</inf>), sweating, and pulse rate. Result(s): The average
pain score at recovery time was significantly lower in the
ketorolac/apotel group (2.06 +/- 1.40) than in the meperidine group (2.76
+/- 1.61) (P = 0.011). In contrast to the ketorolac/apotel group, an
increasing trend was observed in pain scores in the meperidine group
throughout the time sequence (P < 0.05). However, a slight non-significant
increase was also observed in the ketorolac/apotel group. No statistical
differences were observed in blood pressure (P = 0.826), SpO<inf>2</inf>
(P = 0.826), and pulse rate (P = 0.811) between the two study groups.
 Conclusion(s): This study provides support that the combination of
ketorolac/apotel offers a slightly superior analgesic effect for patients
undergoing thoracotomy, compared to meperidine. Pain management is crucial
during recovery, and the current study's findings suggest that
administering ketorolac/apotel provides effective analgesia during
recovery after thoracic surgery. Copyright © 2023, Brieflands.
All rights reserved.

<54>
Accession Number
2025591173
Title
A drinking straw as an alternative device for creating positive expiratory
pressure in people who have undergone thoracic surgery.
Source
Pneumon. 36(3) (no pagination), 2023. Article Number: 21. Date of
Publication: July-September 2023.
Author
Grigoriadou A.; Grigoriadis K.; Mourikis S.; Scamagkoulis F.; Pepera G.
Institution
(Grigoriadou) Theseus Rehabilitation Center, Athens, Greece
(Grigoriadis) Intensive Care Unit Department, Attikon University Hospital,
Athens, Greece
(Pepera) Department of Physiotherapy, Faculty of Health Sciences,
University of Thessaly, Lamia, Greece
Publisher
European Publishing
Abstract
INTRODUCTION Positive expiratory pressure (PEP) is commonly applied to
people who have undergone thoracic surgery; however, PEP devices are not
always available. This experimental study investigated if a simple
drinking straw could be used as an alternative PEP device in thoracic
surgery patients. It was therefore considered necessary to define the
validity, reliability, safety and clinical feasibility of this new
alternative PEP device in both healthy people and thoracic surgery
patients. METHODS Twenty-five healthy adults and twenty people who
underwent thoracic surgery were asked to exhale into a
mouthpiece-manometer-drinking straw 'temporary' device following
standardized verbal instructions for generating pressures within
therapeutic limits (Stage I). In this part of the study, three straws and
two exhalation instructions were assessed to ensure the validity of the
drinking straw as an alternative PEP device. A group of people that
underwent thoracic surgery performed 3 sets of 10 exhalations though a
drinking straw following a specific instruction (Stage II). Peak cough
flow (PCF) was assessed before and after the intervention. RESULTS The
validation assessment demonstrated that instruction B generated pressures
within the therapeutic limits of 10-20 cmH<inf>2</inf> O through a
drinking straw of 5 mm inner diameter (Stage I). The mean difference +/-
SD of the PCF before and after the intervention was 43.0 +/- 36.8 L/min
(p<0.05) (Stage II). Four patients increased their PCF over 160 L/min
after the intervention. CONCLUSIONS One simple drinking straw could be an
alternative PEP device suitable for people who have undergone thoracic
surgery. Exhalations through a drinking straw by following the appropriate
exhalation instruction seem to increase patients' PCF. Copyright
© 2023, European Publishing. All rights reserved.

<55>
Accession Number
2025199654
Title
Sternomanubrial reduction with plating for fully displaced sternal
fracture: A systematic review.
Source
Clinical Case Reports. 11(9) (no pagination), 2023. Article Number: e7740.
Date of Publication: September 2023.
Author
Samat S.H.; Yelleswarapu K.; Zakharov K.
Institution
(Samat) Department of Surgery, Michigan State University, Lansing, MI,
United States
(Yelleswarapu) Michigan State University College of Osteopathic Medicine,
East Lansing, MI, United States
(Zakharov) Thoracic and Cardiac Surgery, Sparrow Hospital, Lansing, MI,
United States
Publisher
John Wiley and Sons Inc
Abstract
Key Clinical Message: Sternal fractures are commonly due to blunt force
trauma and reduction is an invasive surgical procedure typically indicated
for refractory pain sternal instability. There were various modalities
used for treatment and fixation of the sternal fractures. Sternal
displacement fractures are traumatic injuries that may require surgical
correction. Copyright © 2023 The Authors. Clinical Case Reports
published by John Wiley & Sons Ltd.

<56>
Accession Number
2024918387
Title
Incidence, Predictors, and Outcomes Associated With Worsening Renal
Function in Patients With Heart Failure and Secondary Mitral
Regurgitation: The COAPT Trial.
Source
Journal of the American Heart Association. 12(14) (no pagination), 2023.
Article Number: e029504. Date of Publication: 2023.
Author
Kong J.; Zaroff J.G.; Ambrosy A.P.; Fitzpatrick J.K.; Ku I.A.; Mishell
J.M.; Kotinkaduwa L.N.; Redfors B.; Beohar N.; Ailawadi G.; Lindenfeld J.;
Abraham W.T.; Mack M.J.; Kar S.; Lim D.S.; Whisenant B.K.; Stone G.W.
Institution
(Kong, Zaroff, Ambrosy, Fitzpatrick, Ku, Mishell) Kaiser Permanente
Department of Cardiology, San Francisco, CA, United States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Kotinkaduwa, Redfors) Clinical Trials Center Cardiovascular Research
Foundation, New York City, NY, United States
(Redfors) NewYork-Presbyterian Hospital, Columbia University Medical
Center, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Beohar) Mount Sinai Medical Center Columbia University Division of
Cardiology, Miami Beach, FL, United States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Lindenfeld) Vanderbilt University Division of Cardiology, Nashville, TN,
United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Mack) Baylor Scott and White Healthcare, Dallas, TX, United States
(Kar) Cardiovascular Institute, Los Robles Health System, Thousand Oaks,
CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The incidence and implications of worsening renal function
(WRF) after mitral valve transcatheter edge-to-edge repair (TEER) in
patients with heart failure (HF) are unknown. Therefore, the aim of this
study was to determine the propor-tion of patients with HF and secondary
mitral regurgitation who develop persistent WRF within 30 days following
TEER, and whether this development portends a worse prognosis. METHODS AND
RESULTS: In the COAPT (Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients With Functional Mitral
Regurgitation) trial, 614 patients with HF and severe secondary mitral
regurgitation were randomized to TEER with the MitraClip plus
guideline-directed medical therapy (GDMT) versus GDMT alone. WRF was
defined as serum creatinine increase >=1.5x or >=0.3 mg/dL from baseline
persisting to day 30 or requiring renal replacement therapy. All-cause
death and HF hospitalization rates between 30 days and 2 years were
compared in patients with and without WRF. WRF at 30 days was present in
11.3% of patients (9.7% in the TEER plus GDMT group and 13.1% in the GDMT
alone group; P=0.23). WRF was associated with all-cause death (hazard
ratio [HR], 1.98 [95% CI, 1.3-3.03]; P=0.001) but not HF hospitalization
(HR, 1.47 [ 95% CI, 0.97-2.24]; P=0.07) between 30 days and 2 years.
Compared with GDMT alone, TEER reduced both death and HF hospitalization
consistently in patients with and without WRF (P<inf>interaction</inf>
=0.53 and 0.57, respectively). CONCLUSION(S): Among patients with HF
and severe secondary mitral regurgitation, the incidence of WRF at 30 days
was not increased after TEER compared with GDMT alone. WRF was associated
with greater 2-year mortality but did not attenuate the treatment benefits
of TEER in reducing death and HF hospitalization compared with GDMT
alone. Copyright © 2023 The Authors. Published on behalf of the
American Heart Association, Inc., by Wiley.

<57>
Accession Number
2024543853
Title
The efficacy of various Enoxaparin dosing regimens in general surgery
patients: A systematic review.
Source
Surgery (United States). 174(2) (pp 315-323), 2023. Date of Publication:
August 2023.
Author
Al Tannir A.H.; Biesboer E.A.; Pokrzywa C.J.; Figueroa J.; Harding E.; de
Moya M.A.; Morris R.S.; Murphy P.B.
Institution
(Al Tannir, Biesboer, Pokrzywa, Figueroa, Harding, de Moya, Morris,
Murphy) Division of Trauma and Acute Care Surgery, Department of Surgery,
Medical College of Wisconsin, Milwaukee, WI, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients undergoing surgical procedures are at an increased
risk of venous thromboembolism events. A fixed Enoxaparin dosing regimen
is the standard of care for chemoprophylaxis in most institutions;
however, breakthrough venous thromboembolism events are still reported. We
aimed to systematically review the literature to determine the ability of
various Enoxaparin dosing regimens to achieve adequate prophylactic
anti-Xa levels for venous thromboembolism prevention in hospitalized
general surgery patients. Additionally, we aimed to assess the correlation
between subprophylactic anti-Xa levels and the development of clinically
significant venous thromboembolism events. Method(s): A systematic
review was conducted using major databases from January 1, 1993, to
February 17, 2023. Two independent researchers screened titles and
abstracts, followed by a full-text review. Articles were included if
Enoxaparin dosing regimens were evaluated by anti-Xa levels. Exclusion
criteria included systematic reviews, pediatric population, nongeneral
surgery (defined as trauma, orthopedics, plastics, and neurosurgery), and
non-Enoxaparin chemoprophylaxis. The primary outcome was peak Anti-Xa
level measured at steady state concentration. The risk of bias was
assessed using the Risk of Bias in Nonrandomized studies-of Intervention
tool. Result(s): A total of 6,760 articles were extracted, of which
19 were included in the scoping review. Nine studies included bariatric
patients, whereas 5 studies explored abdominal surgical oncology patients.
Three studies assessed thoracic surgery patients, and 2 studies included
patients undergoing "general surgery" procedures. A total of 1,502
patients were included. The mean age was 47 years, and 38% were males. The
percentages of patients reaching adequate prophylactic anti-Xa levels were
39%, 61%, 15%, 50%, and 78% across the 40 mg daily, 40 mg twice daily, 30
mg twice daily, and weight-tiered, and body mass index-based groups,
respectively. The overall risk of bias was low to moderate.
 Conclusion(s): Fixed Enoxaparin dosing regimens are not correlated
with adequate anti-Xa levels in general surgery patients. Additional
research is warranted to assess the efficacy of dosing regimens based on
novel physiologic parameters (such as estimated blood
volume). Copyright © 2023 Elsevier Inc.

<58>
Accession Number
2024383089
Title
Effects of intraoperative inspired oxygen fraction (FiO<inf>2</inf> 0.3 vs
0.8) on patients undergoing off-pump coronary artery bypass grafting: the
CARROT multicenter, cluster-randomized trial.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 286. Date of
Publication: December 2023.
Author
Nam K.; Nam J.-S.; Kim H.-B.; Chung J.; Hwang I.E.; Ju J.-W.; Bae J.; Lee
S.; Cho Y.J.; Shim J.-K.; Kwak Y.-L.; Chin J.-H.; Choi I.-C.; Lee E.-H.;
Jeon Y.
Institution
(Nam, Chung, Hwang, Ju, Bae, Lee, Cho, Jeon) Department of Anesthesiology
and Pain Medicine, Seoul National University Hospital, Seoul National
University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080,
South Korea
(Nam, Chin, Choi, Lee) Department of Anesthesiology and Pain Medicine,
Asan Medical Center, University of Ulsan College of Medicine, 88
Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
(Kim, Shim, Kwak) Department of Anesthesiology and Pain Medicine,
Severance Hospital, Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Chung) Medical Service Corps of the First Logistics Support Command,
Gangwon State, Wonju, South Korea
(Bae) Department of Anesthesiology and Pain Medicine, Ajou University
Medical Center, Ajou University School of Medicine, Gyeonggi Province,
Suwon, South Korea
(Lee) Hana Anesthesia Clinic, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: To maintain adequate oxygenation is of utmost importance in
intraoperative care. However, clinical evidence supporting specific oxygen
levels in distinct surgical settings is lacking. This study aimed to
compare the effects of 30% and 80% oxygen in off-pump coronary artery
bypass grafting (OPCAB). Method(s): This multicenter trial was
conducted in three tertiary hospitals from August 2019 to August 2021.
Patients undergoing OPCAB were cluster-randomized to receive either 30% or
80% oxygen intraoperatively, based on the month when the surgery was
performed. The primary endpoint was the length of hospital stay.
Intraoperative hemodynamic data were also compared. Result(s): A
total of 414 patients were cluster-randomized. Length of hospital stay was
not different in the 30% oxygen group compared to the 80% oxygen group
(median, 7.0 days vs 7.0 days; the sub-distribution hazard ratio, 0.98;
95% confidence interval [CI] 0.83-1.16; P = 0.808). The incidence of
postoperative acute kidney injury was significantly higher in the 30%
oxygen group than in the 80% oxygen group (30.7% vs 19.4%; odds ratio,
1.94; 95% CI 1.18-3.17; P = 0.036). Intraoperative time-weighted average
mixed venous oxygen saturation was significantly higher in the 80% oxygen
group (74% vs 64%; P < 0.001). The 80% oxygen group also had a
significantly greater intraoperative time-weighted average cerebral
regional oxygen saturation than the 30% oxygen group (56% vs 52%; P =
0.002). Conclusion(s): In patients undergoing OPCAB, intraoperative
administration of 80% oxygen did not decrease the length of hospital stay,
compared to 30% oxygen, but may reduce postoperative acute kidney injury.
Moreover, compared to 30% oxygen, intraoperative use of 80% oxygen
improved oxygen delivery in patients undergoing OPCAB. Trial registration
ClinicalTrials.gov (NCT03945565; April 8, 2019). Copyright ©
2023, The Author(s).

<59>
Accession Number
2023425870
Title
Primary Cardiac Schwannoma: A Meta-Analysis of Individual Case Reports.
Source
Journal of Clinical Medicine. 12(10) (no pagination), 2023. Article
Number: 3356. Date of Publication: May 2023.
Author
Rahouma M.; Baudo M.; Khairallah S.; Dabsha A.; Tafuni A.; El-Sayed Ahmed
M.M.; Lau C.; Iannacone E.; Naka Y.; Girardi L.; Gaudino M.; Lorusso R.;
Mick S.L.
Institution
(Rahouma, Baudo, Khairallah, Dabsha, Lau, Iannacone, Naka, Girardi,
Gaudino, Mick) Cardiothoracic Surgery Department, Weill Cornell Medicine,
New York, NY 10065, United States
(Rahouma, Khairallah, Dabsha) Surgical Oncology Department, National
Cancer Institute, Cairo University, Cairo 11796, Egypt
(Baudo) Cardiac Surgery Department, Spedali Civili di Brescia, University
of Brescia, Brescia 25123, Italy
(Tafuni) Unit of Pathology, Department of Medicine and Surgery, University
of Parma, Parma 43126, Italy
(El-Sayed Ahmed) Cardiothoracic Surgery Department, Mayo Clinic,
Jacksonville, FL 32224, United States
(El-Sayed Ahmed) Department of Surgery, Faculty of Medicine, Zagazig
University, Zagazig 44519, Egypt
(Lorusso) Department of Cardio-Thoracic Surgery, Maastricht University
Medical Centre, Maastricht University, Maastricht 6202 AZ, Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht, Maastricht 6229
ER, Netherlands
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Primary cardiac schwannoma (PCS) is a neurogenic tumor that arises from
Schwann cells. Malignant schwannoma (MSh) is an aggressive cancer
comprising 2% of all sarcomas. Information on the proper management of
these tumors is limited. Four databases were searched for case
reports/series of PCS. The primary outcome was overall survival (OS).
Secondary outcomes included therapeutic strategies and the corresponding
outcomes. Among 439 potentially eligible studies, 53 met the inclusion
criteria. The patients included had 43.72 +/- 17.76 years and 28.3% were
males. Over 50% of patients had MSh, with 9.4% also demonstrating
metastases. Schwannoma commonly occurs in the atria (66.0%). Left-sided
PCS were more common than right-sided ones. Surgery was performed in
almost 90% of the cases; chemotherapy and radiotherapy were used in 16.9%
and 15.1% of cases, respectively. Compared to benign cases, MSh occurs at
a younger age and is commonly located on the left side. OS of the entire
cohort at 1 and 3 years were 60.7%, and 54.0%, respectively. Females and
males OS were similar up to 2 years follow-up. Surgery was associated with
higher OS (p < 0.01). Surgery is the primary treatment option for both
benign and malignant cases and was the only factor associated with a
relative improvement in survival. Copyright © 2023 by the
authors.

<60>
Accession Number
2025326884
Title
Bariatric surgery and left ventricular assist device in patients with
heart failure: A systematic review and meta-analysis.
Source
American Journal of Surgery. 226(3) (pp 340-349), 2023. Date of
Publication: September 2023.
Author
Sharma I.; Nakanishi H.; Hage K.; Marrero K.; Diwan T.S.; daSilva-deAbreu
A.; Davis Jr S.S.; Clapp B.; Ghanem O.M.
Institution
(Sharma, Hage, Ghanem) Department of Surgery, Mayo Clinic, Rochester, MN,
United States
(Nakanishi) St George's University of London, London SW17 0RE, United
Kingdom
(Marrero) Carle Foundation Hospital General Surgery Residency, Champaign,
IL, United States
(Diwan) Division of Transplantation, Department of Surgery, Mayo Clinic,
Rochester, MN, United States
(daSilva-deAbreu) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Davis Jr) Department of Surgery, Emory University School of Medicine,
Atlanta, GA, United States
(Clapp) Department of Surgery, Texas Tech HSC Paul Foster School of
Medicine, El Paso, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of metabolic and bariatric surgery (MBS), in synergy
with left ventricular assist device (LVAD) implantation, in the scope of
end-stage heart failure management for patients with severe obesity is not
well elucidated. Method(s): We conducted a meta-analysis using
Cochrane, Embase, PubMed, and Scopus databases to include articles from
their inception to November 2022. Result(s): A total of 271 patients
who underwent MBS during or after the LVAD implantation were included from
eleven separate studies. After surgery, 67.4% of patients were listed on
the heart transplant waitlist with 32.5% undergoing a successful
transplant. We reported a mean listing time of 13.8 months. Finally, the
pooled postoperative complication rate, 30-day readmission rate, and
one-year mortality rate were 47.6%, 23.6% and 10.2% respectively.
 Conclusion(s): MBS and LVAD is a safe and effective approach to
bridge patients with severe obesity and end-stage heart failure for
definitive heart transplantation. Copyright © 2023 Elsevier Inc.

<61>
Accession Number
642071985
Title
Can language enhance physical therapists' willingness to follow Choosing
Wisely recommendations? A best-worst scaling study.
Source
Brazilian journal of physical therapy. 27(4) (pp 100534), 2023. Date of
Publication: 01 Jul 2023.
Author
Kharel P.; Zadro J.R.; Ferreira G.; Howell M.; Howard K.; Wortley S.;
McLennan C.; Maher C.G.
Institution
(Kharel, Zadro, Ferreira, Maher) Institute for Musculoskeletal Health,
Sydney Local Health District, Sydney, Australia; School of Public Health,
Faculty of Medicine and Health, The University of Sydney, Sydney,
Australia
(Howell, Howard, Wortley) School of Public Health, Faculty of Medicine and
Health, University of Sydney, Sydney, Australia
(McLennan) Institute for Musculoskeletal Health, Sydney Local Health
District, Sydney, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Choosing Wisely recommendations could reduce physical
therapists' use of low-value care. OBJECTIVE(S): To investigate
whether language influences physical therapists' willingness to follow the
Australian Physiotherapy Association's (APA) Choosing Wisely
recommendations. DESIGN: Best-worst Scaling survey METHODS: The six
original APA Choosing Wisely recommendations were modified based on four
language characteristics (level of detail, strength-
qualified/unqualified, framing, and alternatives to low-value care) to
create 60 recommendations. Physical therapists were randomised to a block
of seven choice tasks, which included four recommendations. Participants
indicated which recommendation they were most and least willing to follow.
A multinomial logistic regression model was used to create normalised
(0=least preferred; 10=most preferred) and marginal preference scores.
 RESULT(S): 215 physical therapists (48.5% of 443 who started the
survey) completed the survey. Participants' mean age (SD) was 38.7 (10.6)
and 47.9% were female. Physical therapists were more willing to follow
recommendations with more detail (marginal preference score of 1.1) or
that provided alternatives to low-value care (1.3) and less willing to
follow recommendations with negative framing (-1.3). The use of qualified
('don't routinely') language (vs. unqualified - 'don't') did not affect
willingness. Physical therapists were more willing to follow
recommendations to avoid imaging for non-specific low back pain (3.9) and
electrotherapy for low back pain (3.8) vs. recommendation to avoid
incentive spirometry after upper abdominal and cardiac surgery.
 CONCLUSION(S): Physical therapists were more willing to follow
recommendations that provided more detail, alternatives to low-value care,
and were positively framed. These findings can inform the development of
future Choosing Wisely recommendations and could help reduce low-value
physical therapy. Copyright © 2023 The Author(s). Publicado por
Elsevier Espana, S.L.U. All rights reserved.

<62>
Accession Number
2026791829
Title
How robust are recommended waiting times to pacing after cardiac surgery
that are derived from observational data?.
Source
Europace. 25(9) (no pagination), 2023. Date of Publication: 01 Sep 2023.
Author
Tindale A.; Cretu I.; Haynes R.; Gomez N.; Bhudia S.; Lane R.; Mason M.J.;
Francis D.P.
Institution
(Tindale, Francis) National Heart and Lung Institute, Imperial College
London, London W12 0HS, United Kingdom
(Tindale, Haynes, Gomez, Lane, Mason) Department of Cardiology, Harefield
Hospital, Guy's and St Thomas' NHS Foundation Trust, Hill End Road, London
UB9 6JH, United Kingdom
(Cretu, Mason) College of Engineering, Design and Physical Sciences,
Brunel University London, Kingston Lane, Uxbridge UB8 3PH, United Kingdom
(Bhudia) Department of Cardiothoracic Surgery, Harefield Hospital, Guy's
and St Thomas' NHS Foundation Trust, Hill End Road, London UB9 6JH, United
Kingdom
Publisher
Oxford University Press
Abstract
Aims For bradycardic patients after cardiac surgery, it is unknown how
long to wait before implanting a permanent pacemaker (PPM). Current
recommendations vary and are based on observational studies. This study
aims to examine why this variation may exist. Methods We conducted first a
study of patients in our institution and second a systematic review of
studies examining conduction and results disturbance and pacing after
cardiac surgery. Of 5849 operations over a 6-year period, 103 (1.8%)
patients required PPM implantation. Only pacing dependence at implant and
time from surgery to implant were associated with 30-day pacing
dependence. The only predictor of regression of pacing dependence was time
from surgery to implant. We then applied the conventional procedure of
receiver operating characteristic (ROC) analysis, seeking an optimal time
point for decision-making. This suggested the optimal waiting time was
12.5 days for predicting pacing dependence at 30 days for all patients
(area under the ROC curve (AUC) 0.620, P = 0.031) and for predicting
regression of pacing dependence in patients who were pacing-dependent at
implant (AUC 0.769, P < 0.001). However, our systematic review showed that
recommended optimal decision-making time points were strongly correlated
with the average implant time point of those individual studies (R = 0.96,
P < 0.001). We further conducted modelling which revealed that in any such
study, the ROC method is strongly biased to indicate a value near to the
median time to implant as optimal. Conclusion When commonly used automated
statistical methods are applied to observational data with the aim of
defining the optimal time to pacing after cardiac surgery, the suggested
answer is likely to be similar to the average time to pacing in that
cohort. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<63>
Accession Number
2026785343
Title
Is Closed Mitral Valvotomy Obsolete? A Comparitive Study between
Percutaneous Balloon Mitral Valvotomy (PBMV) and Closed Mitral Valvotomy
(CMV).
Source
Systematic Reviews in Pharmacy. 14(1) (pp 29-31), 2022. Date of
Publication: 2022.
Author
Yadav R.; Pathak S.
Institution
(Yadav, Pathak) Department of Cardiovascular and Thoracic Surgery,
Institute of Medical Sciences BHU, Uttar Pradesh, India
Publisher
EManuscript Technologies
Abstract
Purpose: As compared to developed nations, in developing countries
especially Indian subcontinent population overload, mal-nutrition, poor
socio-economic status of affected group and health care facilities affect
the outcome of treatment. A surgical intervention with comparable short
and long term results along with low cost and wider group of patient
population included (pregnant females, young adults and restenosis cases)
is definitely need of the time. Closed Mitral Valvotomy (CMV) therefore
essentially remains modality of treating the Mitral stenosis of favourable
morphology as it caters to above challenges. Where percutaneous procedures
are unavailable due to financial con-straints and open surgical management
cannot be offered due to overburdened and limited resources CMV provides
an excellent choice with convincing immediate and late outcomes in
favourable mitral valve pathology. Method(s): We reviewed the
literature for various valvotomy techniques done for mitral valve stenosis
and restenosis. Immediate and late outcomes were compared between the
patients receiving Percutaneous Balloon Mitral Valvotomy (PBMV) and Closed
Mitral Valvotomy (CMV). Result(s): The immediate and late term
results are comparable for PBMV and CMV. Complications developing in both
the techniques are also nearly similar. CMV holds important role in
excellent palliation provided to child bearing age mothers and young
adults suffering from mitral valve pathology of favourable morphology
because its cost effectiveness and freedom from hazardous side effects of
anticoagulation are promising. Conclusion(s): With excellent
immediate and late outcomes, CMV stands as procedure of choice for
favourable mitral valve morphology where our resources are limited and
overburdened. It is life saving and definitely not obsolete Copyright
© 2022 EManuscript Technologies. All rights reserved.

<64>
Accession Number
2026770455
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. (no pagination), 2023. Date
of Publication: 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, North
Metropolitan Clinical Laboratory, Germans Trias i Pujol University
Hospital, 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
Cambridge University Press
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. Copyright © The
Author(s), 2023. Published by Cambridge University Press on behalf of The
Society for Healthcare Epidemiology of America.

<65>
Accession Number
2026751032
Title
Serratus plane block versus standard of care for pain control after
totally endoscopic aortic valve replacement: a double-blind, randomized
controlled, superiority trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2023. Article
Number: rapm-2023-104439. Date of Publication: 2023.
Author
Vandenbrande J.; Jamaer B.; Stessel B.; Van Hilst E.; Callebaut I.; Yilmaz
A.; Packle L.; Sermeus L.; Blanco R.; Jalil H.
Institution
(Vandenbrande, Jamaer, Stessel, Van Hilst, Callebaut, Jalil) Department of
Anaesthesiology and Pain Medicine, Jessa Hospital Campus Virga Jesse,
Hasselt, Belgium
(Vandenbrande, Stessel, Van Hilst, Callebaut) Faculty of Medicine and Life
Sciences, UHasselt, Hasselt, Belgium
(Jamaer) Cardiovascular Sciences, Ku Leuven, Leuven, Belgium
(Yilmaz, Packle) Department of Cardiothoracic Surgery, Jessa Hospital
Campus Virga Jesse, Hasselt, Belgium
(Sermeus) Anesthesiology, University Hospital Saint-Luc, Brussels, Belgium
(Blanco) Anaesthesia and Intensive Care, King's College Hospital Dubai,
Abu Dhabi, United Arab Emirates
Publisher
BMJ Publishing Group
Abstract
Introduction: Serratus anterior plane block has been proposed to reduce
opioid requirements after minimally invasive cardiac surgery, but
high-quality evidence is lacking. Method(s): This prospective,
double-blinded, randomized controlled trial recruited patients undergoing
totally endoscopic aortic valve replacement. Patients in the intervention
arm received a single-injection serratus anterior plane block on arrival
to the intensive care unit added to standard of care. Patients in the
control group received routine standard of care, including
patient-controlled intravenous analgesia. Primary outcome was piritramide
consumption within the first 24 hours after serratus anterior plane block
placement. We hypothesized that compared with no block, patients in the
intervention arm would consume 25% less opioids. Result(s):
Seventy-five patients were analyzed (n=38 in intervention arm, n=37 in
control arm). When comparing the serratus anterior plane group with the
control group, median 24-hour cumulative opioid use was 9 (IQR 6-19.5) vs
15 (IQR 11.3-23.3) morphine milligram equivalents, respectively (p<0.01).
Also, pain scores at 4, 8 and 24 hours were lower in the intervention arm
at 4, 8 and 24 hours, respectively. Conclusion(s): Combined deep and
superficial single-injection serratus anterior plane block is superior to
standard of care in reducing opioid requirements and postoperative pain
intensity up to 24 hours after totally endoscopic aortic valve
replacement. Trial registration number: NCT04699422. Copyright ©
American Society of Regional Anesthesia & Pain Medicine 2023. Re-use
permitted under CC BY-NC. No commercial re-use. Published by BMJ.

<66>
Accession Number
2025296883
Title
Bempedoic Acid can Reduce Cardiovascular Events in Combination with
Statins or As Monotherapy: A Systematic Review and Meta-analysis.
Source
American Journal of Cardiovascular Drugs. (no pagination), 2023. Date of
Publication: 2023.
Author
Zhang J.; Guan X.; Zhang B.; Wang J.; Jin X.; Zhao Y.; Li B.
Institution
(Zhang, Guan, Zhang) School of Clinical Medicine, Affiliated Hospital of
Weifang Medical University, Weifang Medical University, Weifang 261053,
China
(Wang) Department of Cardiology, Binzhou Medical University Hospital, No.
661 Huanghe 2nd Road, Shandong Province, Binzhou City 256603, China
(Jin) Department of Geriatrics, Zibo Central Hospital, No. 10, South
Shanghai Road, Zibo, China
(Zhao, Li) Department of Cardiology, Zibo Central Hospital Affiliated to
Binzhou Medical College, NO.10, South Shanghai Road, Zibo, China
Publisher
Adis
Abstract
Aim: Bempedoic acid has shown noteworthy progress in the prevention and
management of atherosclerotic cardiovascular disease (ASCVD) in recent
years. However, there has been a lack of high-quality evidence regarding
the risk reduction of clinical events with bempedoic acid. Therefore, the
aim of this article is to conduct a comprehensive evaluation of the impact
of bempedoic acid on the incidence of cardiovascular events.
 Method(s): A systematic review and meta-analysis of randomized
controlled trials pertaining to bempedoic acid was carried out. We
conducted a systematic search across the Pubmed, Embase, and Cochrane
Central Register of Controlled Trials databases to identify relevant
studies published from inception to 23 April 2023. A total of four trials
comparing the clinical benefit achieved with bempedoic acid versus placebo
were included. Result(s): Our analysis comprised four trials that
encompassed a total of 17,323 patients. In comparison to the placebo,
bempedoic acid showed a significant reduction in the risk of major adverse
cardiovascular events (MACE) [relative risk (RR), 0.86, 95% confidence
interval (CI) 0.87-0.94]. Additionally, bempedoic acid substantially
lowered the occurrence of fatal or nonfatal myocardial infarction (RR
0.76, 95% CI 0.66-0.89), hospitalization for unstable angina (RR 0.70, 95%
CI 0.55-0.89), and coronary revascularization (RR 0.82, 95% CI 0.73-0.92).
There was also a similar reduction in MACE in patients on the maximally
tolerated statin therapy. Conclusion(s): Bempedoic acid may reduce
the risk of cardiovascular events regardless of whether the patient is
taking stains or not. Registration: PROSPERO registration number
CRD42023422932. Copyright © 2023, The Author(s), under exclusive
licence to Springer Nature Switzerland AG.

<67>
Accession Number
2025280078
Title
Minimally Invasive Versus Transcatheter Aortic Valve Replacement: An
Updated Meta-Analysis and Systematic Review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2023. Date of Publication: 2023.
Author
Ahmed A.; Varghese K.S.; Mathew J.; Huda S.; George J.; Mathew S.;
Abdelnasser O.A.; Awad A.K.; Mathew D.M.
Institution
(Ahmed, Varghese, Mathew, Huda, George, Mathew, Mathew) City University of
New York School of Medicine, NY, United States
(Awad, Abdelnasser) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Awad) Faculty of Medicine, El-Galala University, Suez, Egypt
Publisher
SAGE Publications Ltd
Abstract
Objective: Transcatheter aortic valve replacement (TAVR) has arisen as a
viable alternative to surgery. Similarly, minimally invasive surgical
aortic valve replacement (mini-SAVR), such as ministernotomy and
minithoracotomy, have also gained interest. We conducted a pairwise
meta-analysis to further investigate the efficacy of TAVR versus
mini-SAVR. Method(s): Medical databases were comprehensively searched
for studies comparing TAVR with a mini-SAVR modality, defined as minimally
invasive aortic surgery, ministernotomy, minithoracotomy, or
rapid-deployment or sutureless SAVR. Random-effects meta-analysis was
conducted using the generic inverse variance method. Primary outcomes
included 30-day mortality, midterm mortality, 30-day stroke, acute kidney
injury (AKI), paravalvular leak (PVL), new permanent pacemaker (PPM),
new-onset atrial fibrillation, and postintervention mean and peak valve
pressure gradients and were pooled as risk ratio (RR), mean difference
(MD), or hazard ratio (HR) with 95% confidence interval (CI).
 Result(s): A total of 5,071 patients (2,505 mini-SAVR vs 2,566 TAVR)
from 12 studies were pooled. Compared with TAVR, mini-SAVR showed
significantly lower rates of both 30-day (RR = 0.63, 95% CI: 0.42 to 0.96,
P = 0.03) and midterm mortality at 4 years of follow-up (HR = 0.76, 95%
CI: 0.67 to 0.87, P < 0.001). Furthermore, mini-SAVR was protective
against 30-day PVL (RR = 0.07, 95% CI: 0.04 to 0.13, P < 0.001) and new
PPM (RR = 0.25, 95% CI: 0.11 to 0.57, P < 0.001). Conversely, TAVR was
protective against 30-day AKI (RR = 1.67, 95% CI: 1.20 to 2.32, P = 0.002)
and postinterventional mean gradients (MD = 1.65, 95% CI: 0.25 to 3.05, P
= 0.02). No difference was observed for 30-day stroke (RR = 0.84, 95% CI:
0.56 to 1.24, P = 0.38), new-onset atrial fibrillation (RR = 1.79, 95% CI:
0.93 to 3.44, P = 0.08), or postinterventional peak gradients (MD = 3.24,
95% CI: -1.10 to 7.59, P = 0.14). Conclusion(s): Compared with TAVR,
mini-SAVR was protective against 30-day and midterm mortality, 30-day PVL,
and new permanent pacemaker, while TAVR patients had lower 30-day AKI.
Future randomized trials comparing the efficacy of mini-SAVR approaches
with TAVR are needed. Copyright © The Author(s) 2023.

<68>
Accession Number
642205108
Title
CHARGE syndrome and congenital heart diseases: systematic review of
literature.
Source
Monaldi archives for chest disease = Archivio Monaldi per le malattie del
torace. (no pagination), 2023. Date of Publication: 06 Sep 2023.
Author
Polito M.V.; Ferraioli M.; Nocilla A.; Coppola G.; D'Auria F.; Marzano A.;
Barnabei L.; Malinconico M.; Bossone E.; Ferrara F.
Institution
(Polito, Coppola, D'Auria, Marzano, Barnabei, Malinconico, Ferrara)
Division of Cardiology, "Cava de' Tirreni and Amalfi Coast" Hospital,
Heart Department, University Hospital of Salerno
(Ferraioli, Nocilla) Department of Medicine, Surgery and Dentistry,
University of Salerno, Baronissi (SA)
(Bossone) Department of Public Health, Federico II University of Naples
Publisher
NLM (Medline)
Abstract
CHARGE syndrome (CS) is a rare genetic disease that affects many areas of
the body. The aim of the present systematic review was to evaluate the
prevalence and types of congenital heart diseases (CHDs) in CS and their
impact on clinical outcome. A systematic review from 1981 to September
2022 was conducted. Clinical studies that reported the association between
CS and CHDs were identified, including a case report of a rare congenital
anomaly of the aortic arch (AA) with persistent fifth aortic arch (PFAA).
Demographic, clinical and outcome data were extracted and analyzed.
Sixty-eight studies (44 case reports and 24 case series; n=943 CS
patients) were included. The prevalence of CHDs was 76.6%, patent ductus
arteriosus (PDA) 26%, ventricular (VSD) 21%, atrial septal defects (ASD)
18%, tetralogy of Fallot 11%, aortic abnormalities 24%. PFAA has not been
previously reported in CS. Cardiac surgery was performed in more than half
of CS patients (150/242, 62%). In-hospital mortality rate was about 9.5%
(n=86/900) in case series studies and 12% (n=5/43) in case reports,
including cardiovascular (CV) and non-CV causes. CHDs and feeding
disorders associated with CS may have a substantial impact on prognosis.
CHDs were usually associated with CS and represent important causes of
morbidity and mortality. PFAA, although rare, may also be present. The
prognosis is highly dependent on the presence of cardiac and non-cardiac
developmental abnormalities. Further studies are needed to better identify
the main causes of the long-term outcome of CS patients.

<69>
Accession Number
2026774222
Title
Safety and Efficacy of Ticagrelor versus Clopidogrel in East Asian
Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary
Intervention Treated with Dual Antiplatelet Therapy: A Meta-Analysis of
Randomized Controlled Trials.
Source
Cardiology (Switzerland). 148(4) (pp 363-373), 2023. Date of Publication:
01 Aug 2023.
Author
Li J.; Wang Q.; Wu C.; Qu X.; Zhang L.; He X.; Ma S.; Qiu M.; Wang X.
Institution
(Li, Wang) College of Life Science and Biopharmaceutical, Shenyang
Pharmaceutical University, Shenyang, China
(Li, Wang, Wu, Qu, Zhang, He, Ma, Qiu, Wang) Department of Cardiology,
General Hospital of Northern Theater Command, Shenyang, China
Publisher
S. Karger AG
Abstract
Introduction: The treatment strategy for dual antiplatelet therapy (DAPT)
with ticagrelor has been controversial in East Asian patients with acute
coronary syndrome (ACS) undergoing percutaneous coronary intervention
(PCI). Our meta-analysis aimed to demonstrate whether intensified
antithrombotic regimens with ticagrelor plus aspirin have more beneficial
effects and fewer adverse events compared to those of clopidogrel plus
aspirin in East Asian patients with ACS undergoing PCI. Method(s): We
searched PubMed, Embase, Web of Science, ScienceDirect, Clinical Trials,
Cochrane Library, and Chinese Clinical Trial Registry for randomized
controlled trials (RCTs) comparing the efficacy of DAPT with ticagrelor or
clopidogrel plus aspirin for secondary prevention of ACS in East Asian
patients undergoing PCI. Risk ratios (RRs) and 95% confidence intervals
(CIs) were used as the metrics of choice for assessing treatment effects.
The primary endpoint was bleeding events, and the secondary endpoints were
major adverse cardiovascular and cerebrovascular events (MACCEs, including
cardiovascular death, nonfatal myocardial infarction [MI], and stroke),
all-cause death, and definite/probable/possible stent thrombosis. The
I2 index was used to assess heterogeneity. Result(s): Six
RCTs involving a total of 2,725 patients met the inclusion criteria. The
incidence of all bleeding events with ticagrelor was higher than that with
clopidogrel (RR, 1.65; 95% CI, 1.31-2.07), but the incidence of MACCE was
not significantly different between the two groups (RR, 1.08; 95% CI,
0.54-2.16). All-cause death (RR, 1.10; 95% CI, 0.67-1.79), cardiovascular
death (RR, 1.42; 95% CI, 0.68-2.98), nonfatal MI (RR, 0.92; 95% CI,
0.48-1.78), stroke (RR, 1.00; 95% CI, 0.40-2.50), and stent thrombosis
(RR, 0.76; 95% CI, 0.19-2.98) were not statistically different between the
two groups. Conclusion(s): Ticagrelor increased the risk of bleeding
and did not increase treatment efficacy compared to that of clopidogrel in
the East Asian population who have ACS treated with PCI. Copyright
© 2023 S. Karger AG. All rights reserved.

<70>
Accession Number
2026061975
Title
Omega-3 fatty acid supplements and risk of atrial fibrillation and
'micro-atrial fibrillation': A secondary analysis from the OMEMI trial.
Source
Clinical Nutrition. 42(9) (pp 1657-1660), 2023. Date of Publication:
September 2023.
Author
Myhre P.L.; Berge T.; Kalstad A.A.; Tveit S.H.; Laake K.; Schmidt E.B.;
Solheim S.; Arnesen H.; Seljeflot I.; Tveit A.
Institution
(Myhre, Tveit) Department of Cardiology, Division of Medicine, Akershus
University Hospital, Lorenskog, Norway
(Myhre, Berge, Kalstad, Tveit, Arnesen, Seljeflot, Tveit) Institute of
Clinical Medicine, University of Oslo, Norway
(Berge, Tveit) Department of Medical Research, Vestre Viken Hospital
Trust, Baerum Hospital, Gjettum, Norway
(Kalstad, Laake, Solheim, Arnesen, Seljeflot) Center for Clinical Heart
Research, Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Schmidt) Aalborg University, Aalborg, Denmark
Publisher
Churchill Livingstone
Abstract
Background & aims: Recent randomized clinical trials have raised concerns
regarding potential off target adverse effects from supplementation of n-3
polyunsaturated fatty acids (PUFA) on atrial fibrillation (AF) risk. We
aimed to assess risk and potential mediators of AF and 'micro-AF' from n-3
PUFA in post-myocardial infarction (MI) patients. Method(s): In the
OMEMI trial, 70-82 y. o. patients with a recent MI were randomized to 1.8
g/day of eicosapentaenoic-/docosahexaenoic acid (EPA/DHA) or placebo (corn
oil) for two years. New-onset AF and 'micro-AF' was recorded by clinical
detection and by screening with Zenicor thumb-ECG (adjudicated by blinded
investigators). Serum EPA and DHA were measured at baseline and study end.
 Result(s): At baseline, 759 of 1014 (75%) patients had no AF history.
These patients were aged 75 +/- 4 years and 71% were male. During
follow-up, 43 patients developed new-onset AF (39 clinically-detected and
4 by thumb-ECG screening). In addition, 27 patients had episodes of
micro-AF, yielding a total of 70 patients with new-onset AF or 'micro-AF'.
In the n-3 PUFA group 46 (11.9%) had AF/'micro-AF' (28 AF, 18 'micro-AF')
and in the placebo group 24 (6.5%) had AF/micro-AF (15 AF, 9 micro-AF); HR
1.90 (95%CI 1.16-3.11), P = 0.011. Changes in serum EPA (but not DHA)
mediated the effect from n-3 PUFA on AF risk, explaining 65% of the
association. Conclusion(s): Supplementation of n-3 PUFA post MI
increases the risk of 'micro-AF' and AF, and increases in EPA seems to be
an important mediator of the treatment effect from n-3 PUFA on the risk of
AF. Study registration: OMEMI Study; ClinicalTrails.gov identifier:
NCT0184194. Copyright © 2023 The Author(s)

<71>
Accession Number
2025247156
Title
Drug-coated balloon: an effective alternative to stent strategy in
small-vessel coronary artery disease-a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1213992. Date of Publication: 2023.
Author
Felbel D.; Bozic F.; Mayer B.; Krohn-Grimberghe M.; Paukovitsch M.;
d'Almeida S.; Morike J.; Gonska B.; Imhof A.; Buckert D.; Rottbauer W.;
Markovic S.; Stephan T.
Institution
(Felbel, Bozic, Krohn-Grimberghe, Paukovitsch, d'Almeida, Morike, Gonska,
Imhof, Buckert, Rottbauer, Markovic, Stephan) Department of Cardiology,
Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm,
Germany
(Mayer) Institute for Epidemiology and Medical Biometry, Ulm University,
Ulm, Germany
Publisher
Frontiers Media SA
Abstract
Background: Small-vessel coronary artery disease (CAD) is frequently
observed in coronary angiography and linked to a higher risk of lesion
failure and restenosis. Currently, treatment of small vessels is not
standardized while having drug-eluting stents (DES) or drug-coated
balloons (DCBs) as possible strategies. We aimed to conduct a
meta-analytic approach to assess the effectiveness of treatment strategies
and outcomes for small-vessel CAD. Method(s): Comprehensive
literature search was conducted using PubMed, Embase, MEDLINE, and
Cochrane Library databases to identify studies reporting treatment
strategies of small-vessel CAD with a reference diameter of <=3.0 mm.
Target lesion revascularization (TLR), target lesion thrombosis, all-cause
death, myocardial infarction (MI), and major adverse cardiac events (MACE)
were defined as clinical outcomes. Outcomes from single-arm and randomized
studies based on measures by means of their corresponding 95% confidence
intervals (CI) were compared using a meta-analytic approach. Statistical
significance was assumed if CIs did not overlap. Result(s):
Thirty-seven eligible studies with a total of 31,835 patients with
small-vessel CAD were included in the present analysis. Among those,
28,147 patients were treated with DES (24 studies) and 3,299 patients with
DCB (18 studies). Common baseline characteristics were equally distributed
in the different studies. TLR rate was 4% in both treatment strategies
[0.04; 95% CI 0.03-0.05 (DES) vs. 0.03-0.07 (DCB)]. MI occurred in 3% of
patients receiving DES and in 2% treated with DCB [0.03 (0.02-0.04) vs.
0.02 (0.01-0.03)]. All-cause mortality was 3% in the DES group [0.03
(0.02-0.05)] compared with 1% in the DCB group [0.01 (0.00-0.03)].
Approximately 9% of patients with DES developed MACE vs. 4% of patients
with DCB [0.09 (0.07-0.10) vs. 0.04 (0.02-0.08)]. Meta-regression analysis
did not show a significant impact of reference vessel diameter on
outcomes. Conclusion(s): This large meta-analytic approach
demonstrates similar clinical and angiographic results between treatment
strategies with DES and DCB in small-vessel CAD. Therefore, DES may be
waived in small coronary arteries when PCI is performed with
DCB. Copyright 2023 Felbel, Bozic, Mayer, Krohn-Grimberghe,
Paukovitsch, d'Almeida, Morike, Gonska, Imhof, Buckert, Rottbauer,
Markovic and Stephan.

<72>
Accession Number
2025198416
Title
Efficacy and safety of Qixue Tongzhi Granule in improving the exercise
capacity of stable coronary artery disease: study protocol for a
multicenter, randomized, double-blind, placebo-controlled trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1186018. Date of Publication: 2023.
Author
Chao T.; Sun J.; Huan N.; Ge Y.; Wang C.
Institution
(Chao, Sun, Huan, Ge, Wang) National Clinical Research Center for Chinese
Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical
Sciences, Beijing, China
Publisher
Frontiers Media SA
Abstract
Background: Despite optimal medical therapy, patients with stable coronary
artery disease (SCAD) still have a high risk of recurrent cardiovascular
events. Exercise capacity measured by cardiopulmonary exercise testing
(CPET) is a good surrogate marker for the long-term prognosis of SCAD.
Qixue Tongzhi Granule (QTG) is created by academician Chen Keji and has
the function of tonifying qi, promoting blood circulation, and regulating
qi-flowing. This trial aims to investigate the efficacy and safety of QTG
in improving exercise tolerance, alleviating angina pectoris and
anxiety/depression symptoms, promoting health-related quality of life, and
reducing the risk of adverse cardiovascular events in subjects with SCAD.
 Method(s): This is a randomized, double-blind, placebo-controlled
trial. 150 SCAD patients with qi deficiency, blood stasis, and liver qi
stagnation syndrome are enrolled. Patients will be randomly allocated to
the QTG or placebo groups at a 1:1 ratio. QTG and placebo will be added to
the modern guideline-directed medical therapy for 12 weeks and patients
will be followed up for another 24 weeks. The primary outcome is the
improvement of metabolic equivalents measured by CPET. The secondary
outcomes are cumulative incidence of composite endpoint events, other
indicators in CPET, changes in the Seattle Angina Questionnaire,
traditional Chinese medicine syndrome scale, 12 items of Short Form Health
Survey Questionnaire, Patient Health Questionnaire-9, and Generalized
Anxiety Disorder-7, changes of ST-T segment in the electrocardiogram,
improvement of left ventricular ejection fraction and left ventricular
end-diastolic diameter in echocardiography. In addition, metabolomics
analysis will be performed based on blood samples. Adverse events and
safety evaluations will also be documented. A full analysis set, per
protocol set, and safety analysis set will be conducted.
 Discussion(s): This clinical trial can enrich treatment options for
CHD patients with low cardiorespiratory fitness and psychological
imbalance, and it may also create a new situation for promoting the
application of traditional Chinese medicine in cardiac rehabilitation.
Clinical Trial Registration: [http://www.chictr.org.cn], identifier:
[ChiCTR2200058988]. Copyright 2023 Chao, Sun, Huan, Ge and Wang.

<73>
Accession Number
2024135454
Title
Intraoperative suggestions to prevent postoperative delirium in patients
undergoing transaortic valvular replacement: a randomized
placebo-controlled trial.
Source
Aging Clinical and Experimental Research. 35(9) (pp 1865-1872), 2023. Date
of Publication: September 2023.
Author
Kaufmann C.; Zech N.; Brandt F.; Hilker M.; Debl K.; Creutzenberg M.;
Zeman F.; Graf B.M.; Sinner B.
Institution
(Kaufmann, Zech, Brandt, Creutzenberg, Graf, Sinner) Department of
Anesthesiology, University Hospital Regensburg, Regensburg, Germany
(Hilker) Department of Cardiothoracic Surgery, University Hospital
Regensburg, Regensburg, Germany
(Debl) Department of Cardiology, University Hospital Regensburg,
Regensburg, Germany
(Zeman) Department of Medical Biostatistics, University Hospital
Regensburg, Regensburg, Germany
(Sinner) Department of Anesthesia and Intensive Care, Medical University
Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Postoperative delirium (POD) is a serious complication
following anaesthesia and surgery and significantly influences
postoperative outcome especially in the elderly population. Intraoperative
music and positive suggestions influence postoperative outcomes by
attenuating analgesic demand and increasing patient satisfaction.
 Aim(s): Here, we examined the effect of intraoperative music and
positive suggestions on the development of POD in aged patients undergoing
transcatheter aortic valve replacement (TAVR) procedure under general
anaesthesia. Method(s): For this randomized placebo-controlled study,
eligible patients without cognitive deficit, indicated by a MMSE < 10
points, were anesthetized using remifentanil and sevoflurane. Anaesthetic
depth was guide with bispectral index. An audiotape with positive
suggestions was applied from a MP3 player via headphones. POD, pain and
PONV was assessed. CAM-ICU and Nu-DESC were done twice daily for the first
5 days. Result(s): Of 140 patients 118 patients could be analysed (57
male, 80.6 +/- 5.1 years). POD was diagnosed in 16 patients (12.7%). POD
was significantly more often observed in male (12, 21.1%) than in female
(4, 6.6%, p = 0.02) and in patients with a low MMSE (23.6 +/- 4.5 vs. 26.8
+/- 2.8, p = 0.001). Anaesthetic depth did not influence the incidence of
POD. Intraoperative music and suggestions did not affect the rate of POD,
pain, analgesic requirement or PONV. Discussion(s): In patients
undergoing TAVR male sex and low MMSE scoring are associated with an
increase in POD. Conclusion(s): Intraoperative music and positive
suggestions do not influence the incidence of POD in this patient group.
Study registration: DRKS: 00024444, start of registration: 4.02.202, final
registration: 17.09.2021 Copyright © 2023, The Author(s).

<74>
Accession Number
2025259787
Title
The impact of PECS II blockade in patients undergoing minimally invasive
cardiac surgery-a prospective, randomized, controlled, and triple-blinded
trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 570. Date of
Publication: December 2023.
Author
Hoerner E.; Stundner O.; Naegele F.; Fiala A.; Bonaros N.; Mair P.;
Holfeld J.; Gasteiger L.
Institution
(Hoerner, Stundner, Fiala, Mair, Gasteiger) Department of Anaesthesiology
and Intensive Care Medicine, Medical University of Innsbruck, Anichstrasse
35, Innsbruck 6020, Austria
(Naegele, Bonaros, Holfeld) Department of Cardiac Surgery, Medical
University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
Publisher
BioMed Central Ltd
Abstract
Background: Classic neuraxial techniques, such as thoracic epidural
anesthesia, or alternative approaches like the paravertebral block, are
not indicated in cardiac surgery due to increased bleeding risk. To
provide satisfactory analgesia without the need for excessive opioid use,
novel ultrasound techniques gained popularity and are of growing interest.
The pectoralis nerve block II (PECS II) has been shown to provide good
postoperative analgesia in modified radical mastectomy and might also be
suitable for minimally invasive cardiac surgery. Method(s): In a
single center, prospective, triple-blinded, two-group randomized trial, 60
patients undergoing elective, unilateral minimal invasive cardiac surgery
will be randomized to receive a PECS II with 30 ml of ropivacaine 0.5%
(intervention group) or sodium chloride 0.9% (placebo group). The primary
outcome parameter is the overall opioid demand given as intravenous
morphine milligram equivalents (MME) during the first 24 h after
extubation. Secondary endpoints are the visual analog scale (VAS) 2, 4, 6,
8, 12, and 24 h after extubation, the Overall Benefit of Analgesia Score
(OBAS) after 24 h, the interval until extubation, and intensive care unit
(ICU) discharge within 24 h, as well as the length of hospital stay (LOS).
 Discussion(s): This prospective randomized, controlled, and
triple-blinded trial aims to assess if a PECS II with ropivacaine 0.5%
helps to decrease the opioid demand in the first 24 h and increases
postoperative pain control after minimally invasive cardiac surgery. Trial
registration: www.clinicaltrialsregister.eu ; EudraCT Nr: 2021-005452-11;
Lukas Gasteiger MD, November 18, 2021. Copyright © 2023, BioMed
Central Ltd., part of Springer Nature.

<75>
Accession Number
642191654
Title
Dexmedetomidine vs. propofol sedation reduces the duration of mechanical
ventilation after cardiac surgery - a randomized controlled trial.
Source
European review for medical and pharmacological sciences. 27(16) (pp
7644-7652), 2023. Date of Publication: 01 Aug 2023.
Author
Preveden M.; Zdravkovic R.; Vickovic S.; Vujic V.; Todic M.; Mladenovic
N.; Dracina N.; Drljevic Todic V.; Pantic T.; Okiljevic B.; Markovic N.;
Kovac A.; Zec R.; Preveden A.; Tatic M.
Institution
(Preveden) Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of our study was to compare the clinical effects of
sedation with dexmedetomidine vs. propofol in patients undergoing cardiac
surgery and analyze their effects on the duration of mechanical
ventilation (MV), length of stay in the intensive care unit (ICU), and
total hospital stay. PATIENTS AND METHODS: The study included 120
patients who were randomized in a 1:1 ratio into two groups of 60
patients. The first group was sedated with continuous dexmedetomidine in
doses 0.2-0.7 mcg/kg/h. The second group was sedated with propofol in
doses 1-2 mg/kg/h. RESULT(S): Patients sedated with dexmedetomidine
required 2.2 hours less time on MV (p<0.001). There was a positive
correlation between the duration of MV and the ICU length of stay
(r=0.368; p<0.001), as well as between the duration of MV and the total
hospital stay (r=0.204; p=0.025). Delirium occurred in the postoperative
period in 25% of patients sedated with propofol, while in the
dexmedetomidine group it was only 11.7% (p=0.059). Patients who developed
delirium had a significantly longer duration of MV (12.6+/-5.4 vs.
9.3+/-2.5 hours, p=0.010). CONCLUSION(S): Postoperative sedation with
dexmedetomidine, compared to propofol, reduces the duration of MV, but
does not influence the length of stay in the ICU and length of
hospitalization after open heart surgery.

<76>
Accession Number
2026801344
Title
Indication-Based Guideline for Arterial Blood Gas Analysis after Cardiac
Surgery.
Source
Journal of the Medical Association of Thailand. 100(9) (pp S124-S129),
2017. Date of Publication: September 2017.
Author
Tongsai P.; Suksompong S.; Nicrotha S.; Ajonsre N.; Wongkornrat W.; von
Bormann B.
Institution
(Tongsai) Cardiovascular Surgical Intensive Care Unit, Division of
Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Suksompong, Nicrotha, Ajonsre, von Bormann) Department of Anesthesiology,
Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok,
Thailand
(Wongkornrat) Division of Cardiothoracic Surgery, Department of Surgery,
Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok,
Thailand
Publisher
Medical Association of Thailand
Abstract
Objective: To determine whether an indication-based guideline can decrease
the use of arterial blood gas (ABG) tests in cardio-surgical patients.
 Material(s) and Method(s): This before and after study was conducted
in a university-based national tertiary referral hospital. Postoperative
patient age more than 18 years who were admitted to the cardiac intensive
care unit were included. Seventy patients were randomly selected during
January 2013 to September 2013 and data were retrospectively collected and
recorded as a control group (Group C). Another seventy patients were
prospectively investigated during January 2015 to May 2015 and served as a
guideline group (Group G). Whereas patients in Group C were subjected to
ABG testing every four hours, Group G patients received ABG testing
according to the protocol set forth in a newly developed indication-based
guideline for arterial blood gas analysis. Result(s): There were no
statistically significant differences in demographic and perioperative
data between groups. The median number of ABG tests per patient was 8
(range 4 to 47) in Group C and 4 (range 2 to 15) in Group G (p<0.01).
There were no significant differences between groups for postoperative
course, morbidity, or mortality. Conclusion(s): The indication-based
guideline for arterial blood gas analysis significantly reduced the number
of ABG tests in postoperative cardiac ICU patients without adversely
affecting patient outcomes. Accordingly and based on these findings, this
ABG test guideline should be implemented in daily clinical
practice. Copyright © 2017 Medical Association of Thailand. All
rights reserved.

<77>
[Use Link to view the full text]
Accession Number
2026774448
Title
PRDM16 Deletion Is Associated With Sex-dependent Cardiomyopathy and
Cardiac Mortality: A Translational, Multi-Institutional Cohort Study.
Source
Circulation: Genomic and Precision Medicine. 16(4) (pp 390-400), 2023.
Date of Publication: 01 Aug 2023.
Author
Kramer R.J.; Fatahian A.N.; Chan A.; Mortenson J.; Osher J.; Sun B.;
Parker L.E.; Rosamilia M.B.; Potter K.B.; Moore K.; Atkins S.L.; Rosenfeld
J.A.; Birjiniuk A.; Jones E.; Howard T.S.; Kim J.J.; Scott D.A.; Lalani
S.; Rouzbehani O.M.T.; Kaplan S.; Hathaway M.A.; Cohen J.L.; Yukiko Asaki
S.; Martinez H.R.; Boudina S.; Landstrom A.P.
Institution
(Kramer, Fatahian, Chan, Sun, Parker, Rosamilia, Potter, Moore, Atkins,
Landstrom) Department of Pediatrics, Division of Pediatric Cardiology,
Duke University School of Medicine, Durham, NC, United States
(Kaplan) Medical Center Library & Archives, Duke University School of
Medicine, Durham, NC, United States
(Cohen) Department of Pediatrics, Division of Medical Genetics, Duke
University School of Medicine, Durham, NC, United States
(Landstrom) Department of Cell Biology, Duke University School of
Medicine, Durham, NC, United States
(Rouzbehani, Hathaway, Boudina) Department of Nutrition and Integrative
Physiology, University of Utah, Salt Lake City, United States
(Yukiko Asaki) Department of Pediatrics, Division of Pediatric Cardiology,
University of Utah, Salt Lake City, United States
(Mortenson, Osher, Martinez) Department of Pediatrics, Division of
Pediatric Cardiology, University of Tennessee Health Science Center,
Memphis, United States
(Rosenfeld) Baylor Genetic Laboratories, Baylor College of Medicine,
Houston, TX, United States
(Scott, Lalani) Department of Molecular and Human Genetics, Baylor College
of Medicine, Houston, TX, United States
(Jones, Howard, Kim) Department of Pediatrics, Section of Pediatric
Cardiology, Baylor College of Medicine, Houston, TX, United States
(Birjiniuk) Department of Pediatrics, Division of Pediatric Cardiology,
Northwestern Feinberg School of Medicine, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: 1p36 deletion syndrome can predispose to pediatric-onset
cardiomyopathy. Deletion breakpoints are variable and may delete the
transcription factor PRDM16. Early studies suggest that deletion of PRDM16
may underlie cardiomyopathy in patients with 1p36 deletion; however, the
prognostic impact of PRDM16 loss is unknown. METHOD(S): This
retrospective cohort included subjects with 1p36 deletion syndrome from 4
hospitals. Prevalence of cardiomyopathy and freedom from death, cardiac
transplantation, or ventricular assist device were analyzed. A systematic
review cohort was derived for further analysis. A cardiac-specific Prdm16
knockout mouse (Prdm16 conditional knockout) was generated.
Echocardiography was performed at 4 and 6 to 7 months. Histology staining
and qPCR were performed at 7 months to assess fibrosis. RESULT(S):
The retrospective cohort included 71 patients. Among individuals with
PRDM16 deleted, 34.5% developed cardiomyopathy versus 7.7% of individuals
with PRDM16 not deleted (P=0.1). In the combined retrospective and
systematic review cohort (n=134), PRDM16 deletion-associated
cardiomyopathy risk was recapitulated and significant (29.1% versus 10.8%,
P=0.03). PRDM16 deletion was associated with increased risk of death,
cardiac transplant, or ventricular assist device (P=0.04). Among those
PRDM16 deleted, 34.5% of females developed cardiomyopathy versus 16.7% of
their male counterparts (P=0.2). We find sex-specific differences in the
incidence and the severity of contractile dysfunction and fibrosis in
female Prdm16 conditional knockout mice. Further, female Prdm16
conditional knockout mice demonstrate significantly elevated risk of
mortality (P=0.0003). CONCLUSION(S): PRDM16 deletion is associated
with a significantly increased risk of cardiomyopathy and cardiac
mortality. Prdm16 conditional knockout mice develop cardiomyopathy in a
sex-biased way. Patients with PRDM16 deletion should be assessed for
cardiac disease. Copyright © 2019 Medical Journal of Babylon
 Published by Wolters Kluwer - Medknow.

<78>
[Use Link to view the full text]
Accession Number
2026756267
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) Yong Loo Lin School of Medicine,
National University of Singapore, National University Health System,
Singapore, Singapore
(Zeng) Faculty of Medicine, University of New South Wales, Sydney, NSW,
Australia
(Goh) Lee Kong Chian School of Medicine, Nanyang Technological University,
Singapore, Singapore
(Chen) Agency of Science, Technology and Research, Singapore, Singapore
(Ti) Department of Anaesthesia, National University Hospital, National
University Health System, Singapore, 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, Singapore
Publisher
Lippincott Williams and Wilkins
Abstract
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 Lippincott Williams and Wilkins. All
rights reserved.

<79>
Accession Number
2025625140
Title
Perioperative anaesthesia by local infiltration following median
sternotomy - a study protocol.
Source
Danish Medical Journal. 70(9) (no pagination), 2023. Article Number:
A02230072. Date of Publication: 2023.
Author
Rasmussen J.J.; Bisgaard J.; Juhl-Olsen P.; Honge J.L.; Modrau I.S.
Institution
(Rasmussen, Juhl-Olsen, Honge, Modrau) Department of Cardiothoracic and
Vascular Surgery, Aarhus University Hospital, Denmark
(Bisgaard) Department of Anaesthesiology, Aalborg University Hospital,
Denmark
(Juhl-Olsen, Modrau) Department of Clinical Medicine, Aarhus University,
Denmark
Publisher
Almindelige Danske Laegeforening
Abstract
INTRODUCTION. Post-operative pain following open heart surgery is a
clinical challenge usually requiring significant amounts of opioids.
Long-acting local infiltration anaesthesia may effectively reduce
post-operative opioid consumption and improve recovery. The trial is a
publicly funded, double-blinded, randomised, placebo-controlled trial
evaluating the effect of long-acting local infiltration anaesthesia in
open heart surgery. METHODS. Two Danish centres are planning to randomise
100 patients undergoing coronary artery bypass grafting to treatment with
long-acting infiltration anaesthesia or placebo. We compare an active
solution of bupivacaine, adrenaline, clonidine and dexamethasone with
saline placebo. The primary outcome measure is the accumulated opioid use
within the first 24 post-operative hours. Secondary outcome measures
include evaluation of respiratory function, patient-reported pain scores,
mobilisation, opioid-associated side effects and long-term opioid
consumption. CONCLUSION. This trial will define whether the use of
long-acting infiltration anaesthesia during heart surgery may reduce acute
and prolonged post-operative opioid consumption. Reduction of
opioid-related adverse effects may improve recovery. Copyright ©
2023, Almindelige Danske Laegeforening. All rights reserved.

<80>
Accession Number
2026817276
Title
Stroke risk and anticoagulation in the setting of post-cardiac surgery
atrial fibrillation: a systematic review of the literature.
Source
Vessel Plus. 6 (no pagination), 2022. Article Number: A19. Date of
Publication: 2022.
Author
Rademacher N.; Spellman C.; Almassi G.H.; von Ballmoos M.C.W.
Institution
(Rademacher, Spellman) Medical College of Wisconsin, 8701 Watertown Plank
Rd, Milwaukee, WI 53226, United States
(Almassi) Division of cardiothoracic Surgery, Medical College of
Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, United States
(Almassi) Cardiothoracic Surgery, Zablocki VA Medical Center, 5000 W
National Avenue, Milwaukee, WI 53295, United States
(von Ballmoos) Department of Cardiovascular Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Houston, TX 77030, United States
Publisher
OAE Publishing Inc.
Abstract
Postoperative atrial fibrillation (POAF) affects up to 50% of patients
undergoing cardiac surgery. It remains unclear to what extent POAF
increases the stroke risk and whether anticoagulation is warranted in this
setting. The primary objective of this review was to conduct a systematic
review of the evidence for a correlation between POAF and stroke. Further,
we sought to evaluate the published evidence on anticoagulation in the
setting of POAF to prevent stroke. To this end, we performed a
comprehensive literature search to identify studies on POAF in patients
undergoing cardiac surgery with stroke as an outcome. To date, eight
meta-analyses providing pooled estimates of the stroke risk associated
with POAF in patients undergoing cardiac surgery have been published. The
reported pooled odds ratios range from 1.36 to 4.09 for unadjusted
estimates. Additionally, five studies were identified that evaluated the
impact of anticoagulation on stroke in the setting of POAF. Of these,
three supported the use of anticoagulants, and two studies were
inconclusive. This systematic review did not find strong supporting
evidence that POAF is causally related to stroke, despite a strong
correlation with comorbidities and all-cause mortality in the literature.
Available evidence to date suggests an elevated risk of bleeding with no
clear reduction in stroke or other thromboembolic events when
anticoagulation is initiated in the setting of POAF. An upcoming
randomized clinical trial by the Cardiothoracic Surgery Network group will
hopefully provide clarification on the recommendations for anticoagulation
in the setting of POAF after cardiac surgery. Copyright © The
Author(s) 2022.

<81>
Accession Number
2026676158
Title
Expert systematic review on the choice of conduits for coronary artery
bypass grafting: endorsed by the European Association for Cardio-Thoracic
Surgery (EACTS) and The Society of Thoracic Surgeons (STS).
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Gaudino M.; Bakaeen F.G.; Sandner S.; Aldea G.S.; Arai H.; Chikwe J.;
Firestone S.; Fremes S.E.; Gomes W.J.; Bong-Kim K.; Kisson K.; Kurlansky
P.; Lawton J.; Navia D.; Puskas J.D.; Ruel M.; Sabik J.F.; Schwann T.A.;
Taggart D.P.; Tatoulis J.; Wyler von Ballmoos M.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York-Presbyterian Hospital, New York, NY
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Aldea) Division of Cardiothoracic Surgery, University of Washington
School of Medicine, Wash, Seattle, United States
(Arai) Department of Cardiovascular Surgery, Graduate School of Medical
and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo,
Japan
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Calif, Los Angeles
(Firestone, Kisson) The Society of Thoracic Surgeons, Ill, Chicago
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre, and the
Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Gomes) Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo
Hospital, Universidade Federal de Sao Paulo (Unifesp), Escola Paulista de
Medicina, Sao Paulo, Brazil
(Bong-Kim) Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, South
Korea
(Kurlansky) Division of Cardiac Surgery, Department of Surgery, Columbia
University, New York, NY
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University, Md, Baltimore
(Navia) Department of Cardiac Surgery, ICBA Instituto Cardiovascular,
Buenos Aires, Argentina
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
New York, NY
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
(Schwann) Division of Cardiac Surgery, Baystate Health, Mass, Springfield
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital,
University of Oxford, Oxford, United Kingdom
(Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
University of Melbourne, Melbourne, Australia
(Wyler von Ballmoos) Division of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Tex, Houston
Publisher
Elsevier Inc.

<82>
Accession Number
2025278311
Title
Early left atrial venting versus conventional treatment for left
ventricular decompression during venoarterial extracorporeal membrane
oxygenation support: The EVOLVE-ECMO randomized clinical trial.
Source
European Journal of Heart Failure. (no pagination), 2023. Date of
Publication: 2023.
Author
Park H.; Yang J.H.; Ahn J.-M.; Kang D.-Y.; Lee P.H.; Kim T.O.; Choi K.H.;
Kang P.J.; Jung S.-H.; Yun S.-C.; Park D.-W.; Lee S.-W.; Park S.-J.; Kim
M.-S.
Institution
(Park, Ahn, Kang, Lee, Kim, Park, Lee, Park, Kim) Division of Cardiology,
Department of Internal Medicine, Asan Medical Center Heart Institute,
University of Ulsan College of Medicine, Seoul, South Korea
(Park) Division of Cardiology, Department of Medicine, Gangneung Asan
Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
(Yang, Choi) Division of Cardiology, Department of Internal Medicine,
Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, South Korea
(Kang, Jung) Department of Thoracic and Cardiovascular Surgery, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Yun) Department of Clinical Epidemiology and Biostatistics, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Few studies have reported data on the optimal timing of left
ventricular (LV) unloading during venoarterial extracorporeal membrane
oxygenation (VA-ECMO) for cardiac arrest or shock. This study evaluated
the feasibility of an early LV unloading strategy compared with a
conventional strategy in VA-ECMO. Methods and Results: Between
December 2018 and August 2022, 60 patients at two institutions were
randomized in a 1:1 ratio to receive early (n = 30) or conventional (n =
30) LV unloading strategies. The early LV unloading strategy was defined
as LV unloading performed at the time of VA-ECMO insertion. LV unloading
was performed using a percutaneous transseptal left atrial cannulation via
the femoral vein incorporated into the ECMO venous circuit. The early and
conventional LV unloading groups included 29 (96.7%) and 23 (76.7%)
patients, respectively (median time from VA-ECMO insertion to LV
unloading: 48.4 h, interquartile range 47.8-96.5 h). The groups showed no
significant differences in the rate of VA-ECMO weaning as the primary
endpoint (70.0% vs. 76.7%; relative risk 0.91; 95% confidence interval
0.67-1.24; p = 0.386) and survival to discharge (53.3% vs. 50.0%, p =
0.796). However, the pulmonary congestion score index at 48 h after LV
unloading was significantly improved only in the early LV unloading group
(2.0 +/- 0.7 vs. 1.7 +/- 0.6 at baseline vs. at 48 h; p = 0.008).
 Conclusion(s): Compared with the conventional approach, early LV
unloading did not improve the VA-ECMO weaning rate, despite the rapid
improvement in pulmonary congestion. Therefore, the results of this study
do not support the application of this strategy after VA-ECMO
insertion. Copyright © 2023 European Society of Cardiology.

<83>
Accession Number
642195249
Title
Erector spinae plane block versus paravertebral block for postoperative
pain management in thoracic surgery: a systematic review and
meta-analysis.
Source
Minerva anestesiologica. (no pagination), 2023. Date of Publication: 05
Sep 2023.
Author
Capuano P.; Hileman B.A.; Martucci G.; Raffa G.M.; Toscano A.; Burgio G.;
Arcadipane A.; Kowalewski M.
Institution
(Capuano) Department of Anesthesia and Intensive Care, IRCCS-ISMETT
(Istituto Mediterraneo per i Trapianti e Terapie ad alta
specializzazione), Palermo, Italy
(Hileman) University of Pittsburgh School of Medicine, Pittsburgh, PA,
United States
(Martucci, Burgio, Arcadipane) Department of Anesthesia and Intensive
Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad
alta specializzazione), Palermo, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
(Toscano) Department of Anesthesia, Critical Care and Emergency,
University of Turin, Citta della Salute e della Scienza, Turin, Italy
(Kowalewski) Department of Cardiac Surgery and Transplantology, Central
Clinical Hospital of the Ministry of Interior, Center of Postgraduate
Medical Education, Warsaw, Poland
(Kowalewski) Department of Cardio-Thoracic Surgery, Heart and Vascular
Center, Maastricht University Medical Center, Maastricht, Netherlands
(Kowalewski) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Kowalewski) Thoracic Research Center, Collegium Medicum, Innovative
Medical Forum, Nicolaus Copernicus University, Bydgoszcz, Poland
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The 2018 guidelines for enhanced recovery in thoracic
surgery recommend paravertebral block (PVB) for postoperative pain
management. However, recent studies demonstrate that erector spinae plane
block (ESPB) achieves similar postoperative pain control with reduced
block-related complications. EVIDENCE ACQUISITION: We conducted a
meta-analysis of randomized controlled trials to evaluate the analgesic
efficacy and safety of ESPB versus PVB for pain management after thoracic
surgery. PubMed, Embase, and Scopus were searched through December 2022
(PROSPERO registration - CRD42023395593). Primary outcomes were
postoperative pain scores, resting at 6, 12, 24, and 48 hours, and at
movement at 24 and 48 hours. Secondary outcomes included opioid
consumption at 24 and 48 hours, and incidence of postoperative nausea and
vomiting or block-related complications in the first 48 hours. EVIDENCE
SYNTHESIS: Ten randomized control trials enrolling a total of 624 total
patients were included. There were no significant differences in pain
scores, resting or at movement, at any time points except reduced resting
pain scores at 12 hours with PVB (mean difference [MD]) 0.60, 95%
confidence interval [CI] 0.32 to 0.88). Opioid consumption demonstrated no
significant differences at 24 hours; PVB reduced opioid consumption at 48
hours (MD 0.40, 95% CI -0.09 to 0.89). There were no significant
differences in postoperative nausea or vomiting. ESPB exhibited a
nonsignificant trend toward reduced cumulative block-related complications
(risk difference [RD] 0.05, 95% CI -0.10 to 0.00). CONCLUSION(S):
Compared with PVB, ESPB is safe and demonstrates no clinically significant
differences in pain management after thoracic surgery.

<84>
Accession Number
642193141
Title
Preoperative optimization and rapid discharge after coronary artery bypass
grafting.
Source
Current opinion in cardiology. (no pagination), 2023. Date of
Publication: 25 Aug 2023.
Author
Ponnambalam M.; Alex R.M.
Institution
(Ponnambalam) University of Ottawa Heart Institute, Division of Cardiac
Surgery
(Alex) University of Ottawa Heart Institute, Division of Cardiac
Rehabilitation and Prevention
(Alex) Ottawa Hospital, Department of Psychology, Ottawa, ON, Canada
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: This review discusses current guidelines and
evidence-based care for the preoperative optimization of patients who are
undergoing coronary artery bypass grafting (CABG) and for enabling rapid
discharge after surgery. RECENT FINDINGS: Since the Enhanced Recovery
After Cardiac Surgery Society (ERAS Cardiac) issued guidelines for
perioperative care, in 2019, there has been a significant body of research
that has added to and provided further guidance regarding preoperative
optimization and accelerated recovery after CABG. SUMMARY: A review of the
current literature provides a framework for a pragmatic approach to
preoperative optimization, utilizing the time from referral to surgery to
mitigate multiple aspects of the patient condition, leading to improved
patient outcomes and reduced length of stay and cost to the healthcare
system. Copyright © 2023 Wolters Kluwer Health, Inc. All rights
reserved.

<85>
Accession Number
642191796
Title
The impact of the COVID-19 pandemic on delayed care of cardiovascular
diseases in Europe: a systematic review.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2023. Date of Publication: 04 Sep 2023.
Author
Khan Y.; Verhaeghe N.; Devleesschauwer B.; Cavillot L.; Gadeyne S.;
Pauwels N.; Van den Borre L.; De Smedt D.
Institution
(Khan, Verhaeghe, De Smedt) Department of Public Health and Primary Care,
Ghent University, Ghent, Belgium
(Khan, Devleesschauwer, Cavillot, Van den Borre) Department of
Epidemiology and Public Health, Brussels, Belgium
(Khan, Gadeyne, Van den Borre) Interface Demography, Department of
Sociology, Vrije Universiteit Brussel, Brussels, Belgium
(Verhaeghe) Research Institute for Work and Society, KU Leuven, Leuven,
Belgium
(Verhaeghe) Department of Rehabilitation Sciences, Ghent University,
Ghent, Belgium
(Devleesschauwer) Department of Translational Physiology, Infectiology and
Public Health, Ghent University, Merelbeke, Belgium
(Cavillot) Research Institute of Health and Society, University of
Louvain, Brussels, Belgium
(Pauwels) Faculty of Medicine, Ghent University, Ghent, Belgium
Publisher
NLM (Medline)
Abstract
AIMS: Cardiovascular diseases (CVD) are the leading cause of death
worldwide. The COVID-19 pandemic has disrupted healthcare systems, causing
delays in essential medical services, and potentially impacting CVD
treatment. This study aims to estimate the impact of the pandemic on
delayed CVD care in Europe by providing a systematic overview of the
available evidence. METHODS AND RESULTS: PubMed, Embase and Web of Science
were searched until mid-September 2022 for studies focused on the impact
of delayed CVD care due to the pandemic in Europe among adult patients.
Outcomes were changes in hospital admissions, mortality rates, delays in
seeking medical help after symptom onset, delays in treatment initiation,
and change in the number of treatment procedures. We included 132 studies,
of which all were observational retrospective. Results were presented in
five disease groups: ischemic heart diseases (IHD), cerebrovascular
accidents (CVA), cardiac arrests (CA), heart failures (HF), and others,
including broader CVD groups. There were significant decreases in hospital
admissions for IHD, CVA, HF and urgent and elective cardiac procedures,
and significant increases for CA. Mortality rates were higher for IHD and
CVA. CONCLUSION(S): The pandemic led to reduced acute CVD hospital
admissions and increased mortality rates. Delays in seeking medical help
were observed, while urgent and elective cardiac procedures decreased.
Adequate resource allocation, clear guidelines on how to handle care
during health crises, reduced delays, and healthy lifestyle promotion
should be implemented. The long-term impact of pandemics on delayed CVD
care, and the health-economic impact of COVID-19 should be further
evaluated. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

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