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<1>
Accession Number
2026792697
Title
Prophylactic antibiotic use for infective endocarditis: a systematic
review and meta-analysis.
Source
BMJ Open. 13(8) (no pagination), 2023. Article Number: e077026. Date of
Publication: 22 Aug 2023.
Author
Lean S.S.H.; Jou E.; Ho J.S.Y.; Jou E.G.L.
Institution
(Lean, Jou) Department of Dental Medicine, Wei Gong Memorial Hospital,
Miaoli, Taiwan (Republic of China)
(Jou) Queens' College, University of Cambridge, Cambridge, United Kingdom
(Ho) Department of Medicine, National University Health System, Singapore
Publisher
BMJ Publishing Group
Abstract
Objectives Infective endocarditis (IE) is a devastating disease with a 50%
1-year mortality rate. In recent years, medical authorities across the
globe advised stricter criteria for antibiotic prophylaxis in patients
with high risk of IE undergoing dental procedures. Whether such
recommendations may increase the risk of IE in at-risk patients must be
investigated. Design Prospectively registered systematic review and
meta-analysis. Data sources Medline, Embase, Scopus and ClinicalTrials.gov
were searched through 23 May 2022, together with an updated search on 5
August 2023. Eligibility criteria All primary studies reporting IE within
3 months of dental procedures in adults >18 years of age were included,
while conference abstracts, reviews, case reports and case series
involving fewer than 10 cases were excluded. Data extraction and synthesis
All studies were assessed by two reviewers independently, and any
discrepancies were further resolved through a third researcher. Results Of
the 3771 articles screened, 38 observational studies fit the inclusion
criteria and were included in the study for subsequent analysis. Overall,
11% (95% CI 0.08 to 0.16, I 2 =100%) of IE are associated with recent
dental procedures. Streptococcus viridans accounted for 69% (95% CI 0.46
to 0.85) of IE in patients who had undergone recent dental procedures,
compared with only 21% (95% CI 0.17 to 0.26) in controls (p=0.003). None
of the high-risk patients developed IE across all studies where 100% of
the patients were treated with prophylactic antibiotics, and IE patients
are 12% more likely to have undergone recent dental manipulation compared
with matched controls (95% CI 1.00 to 1.26, p=0.048). Conclusions Although
there is a lack of randomised control trials due to logistic difficulties
in the literature on this topic, antibiotic prophylaxis are likely of
benefit in reducing the incidence of IE in high-risk patients after dental
procedures. Further well-designed high-quality case-control studies are
required. Trial registration number CRD42022326664. Copyright ©
2023 BMJ Publishing Group. All rights reserved.

<2>
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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.

<3>
Accession Number
2025770451
Title
IMPACT OF CARDIAC SURGERY ON MORTALITY RATES IN PRE-DIABETICS WITH HEART
FAILURE: A COMPARATIVE STUDY.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 30(17) (pp
1084-1092), 2023. Date of Publication: 30 Jun 2023.
Author
Ullah Z.; Ammar M.; Arshad W.; Ahmad S.; Tufail N.; Shah D.J.Z.; Ashraf
S.R.; Shahzad K.
Institution
(Ullah) Lincoln University College, Malaysia
(Ammar) Azra Naheed Medical College, Lahore, Pakistan
(Arshad) PGT Cardiac Surgery, Rawalpindi Institute of Cardiology,
Rawalpindi, Pakistan
(Ahmad) Cardiac surgery Rawalpindi Institute of Cardiology, Rawalpindi,
Pakistan
(Tufail) Obstetrics and Gynaecology SKBZH/CMH Muzaffarabad, Pakistan
(Shah) Consultant Cardiologist, Heart Hospital, HMC, Doha, Qatar
(Ashraf) Department of Biochemistry, University of Gujrat, Pakistan
(Shahzad) HIESS, Hamdard University, Karachi, Pakistan
Publisher
Codon Publications
Abstract
Background: Heart failure is a major public health concern affecting
millions of individuals worldwide. Patients with pre-diabetes face an
elevated risk of developing heart failure due to their impaired glucose
metabolism. Cardiac surgery has been a vital therapeutic intervention for
managing heart failure in this population; however, the extent of its
impact on mortality rates remains a subject of ongoing research and
debate. Aim(s): This study aims to assess the effect of cardiac
surgery on mortality rates in pre-diabetic patients with heart failure
through a comprehensive meta-analysis of relevant literature. A systematic
search was conducted across various databases, identifying a total of 15
observational studies and randomized controlled trials that met the
inclusion criteria. These studies encompassed a combined sample size of
5,000 pre-diabetic patients with heart failure, who underwent different
types of cardiac surgeries, including coronary artery bypass grafting
(CABG) and valve repair/replacement procedures. Method(s): The
meta-analysis revealed a statistically significant reduction in mortality
rates following cardiac surgery in pre-diabetic patients with heart
failure. The overall pooled mortality rate post-surgery was 30% lower
compared to pre-surgery mortality rates. Subgroup analyses also
demonstrated that CABG procedures were associated with a more pronounced
reduction in mortality compared to valve repair/replacement surgeries.
 Result(s): Furthermore, the meta-analysis explored potential
modifiers of the surgery-mortality relationship, such as age, gender, and
left ventricular ejection fraction. These analyses provided insights into
patient characteristics that could influence the surgical outcomes in this
vulnerable population. However, this study has certain limitations,
including the heterogeneity of the included studies, variable follow-up
periods, and potential publication bias. Additional research is needed to
address these limitations and gain a deeper understanding of the
mechanisms underlying the observed mortality reduction.
 Conclusion(s): In conclusion, cardiac surgery demonstrates a
significant impact on reducing mortality rates in pre-diabetic patients
with heart failure. This finding underscores the importance of considering
surgical interventions as part of a comprehensive treatment approach for
managing heart failure in pre-diabetic individuals. By improving patient
outcomes and survival, cardiac surgery holds promise as a valuable
therapeutic strategy in this high-risk population. Nevertheless, further
investigations and long-term studies are warranted to consolidate these
findings and inform evidence-based clinical decision-making. Copyright
© 2023, Codon Publications. All rights reserved.

<4>
Accession Number
2025456425
Title
Cardiovascular effects of auricular stimulation -a systematic review and
meta-analysis of randomized controlled clinical trials.
Source
Frontiers in Neuroscience. 17 (no pagination), 2023. Article Number:
1227858. Date of Publication: 2023.
Author
Hua K.; Cummings M.; Bernatik M.; Brinkhaus B.; Usichenko T.; Dietzel J.
Institution
(Hua, Brinkhaus, Dietzel) Institute for Social Medicine, Epidemiology and
Health Economics, Berlin Institute of Health, Charite - University
Medicine, Freie Universitat Berlin, Humboldt-Universitat zu Berlin,
Berlin, Germany
(Cummings) British Medical Acupuncture Society, London, United Kingdom
(Bernatik) International Society for Chinese Medicine, Munich, Germany
(Usichenko) Department for Anesthesiology, University Hospital Greifswald,
Greifswald, Germany
(Usichenko) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
Publisher
Frontiers Media SA
Abstract
Background: The number of randomized controlled trials using auricular
stimulation (AS) such as transauricular vagus nerve stimulation, or other
auricular electrostimulation or auricular acupuncture or acupressure, in
experimental and clinical settings, has increased markedly over the last
three decades. This systematic review focusses on cardiovascular effects
of auricular stimulation. Methods and analysis: The following databases
were searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of
Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs
were reviewed that had been published in English and European languages.
Data collection and analysis was conducted by two reviewers independently.
Quality and risk assessment of included studies was performed and the
meta-analysis of the effect of the most frequently assessed biomarkers.
 Result(s): Altogether, 78 trials were included. 38 studies assessed
heart rate (HR), 19 studies analyzed heart rate variability (HRV), 31
studies analyzed blood pressure (BP) and 7 studies were identified that
measured oxygen saturation (O2), 2 studies on baroreflex sensitivity and 2
studies on skin conductance were evaluated in this review. 26 studies
contained continuous data and were eligible for meta-analysis, 50 trials
reported non continuous data and were evaluated descriptively. The overall
quality of the studies was moderate to low. AS leads to a significant
reduction of HR, the changes though were not considered an adverse
reaction. Furthermore, when looking at HRV, AS was able to reduce the
LF/HF ratio significantly compared to control procedures. No other
cardiovascular parameters (blood pressure, oxygen saturation, baroreflex
sensitivity) were changed significantly. AS produced only minor side
effects in all trials. Conclusion(s): AS can lead to clinically safe
reduction of HR and changes in the LF/HF ratio of the HRV, which is
presumably via an increase in vagal activity. More research is needed to
clarify whether AS can be used to modulate tachycardia or indications with
autonomic imbalance. Systematic review registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=231885
PROSPERO, ID CRD42021231885. Copyright © 2023 Hua, Cummings,
Bernatik, Brinkhaus, Usichenko and Dietzel.

<5>
Accession Number
2024929393
Title
Distribution of transpulmonary pressure during one-lung ventilation in
pigs at different body positions.
Source
Frontiers in Physiology. 14 (no pagination), 2023. Article Number:
1204531. Date of Publication: 2023.
Author
Wittenstein J.; Scharffenberg M.; Yang X.; Bluth T.; Kiss T.; Schultz
M.J.; Rocco P.R.M.; Pelosi P.; Gama de Abreu M.; Huhle R.
Institution
(Wittenstein, Scharffenberg, Yang, Bluth, Kiss, Gama de Abreu, Huhle)
Department of Anesthesiology and Intensive Care Medicine, Pulmonary
Engineering Group, University Hospital Carl Gustav Carus Dresden at
Technische Universitat Dresden, Dresden, Germany
(Yang) Department of Anesthesiology, First Affiliated Hospital of Anhui
Medical University, Hefei, China
(Kiss) Department of Anaesthesiology, Intensive-Pain- and Palliative Care
Medicine, Radebeul Hospital, Academic Hospital of the Technische
Universitat Dresden, Radebeul, Germany
(Schultz) Department of Intensive Care and Laboratory of Experimental
Intensive Care and Anaesthesiology, Academic Medical Center, University of
Amsterdam, Amsterdam, Netherlands
(Rocco) Laboratory of Pulmonary Investigation, Carlos Chagas Filho
Institute of Biophysics, Federal University of Rio de Janeiro, Rio de
Janeiro, Brazil
(Pelosi) Department of Surgical Sciences and Integrated Diagnostics,
University of Genoa, Genoa, Italy
(Pelosi) Anesthesia and Critical Care, San Martino Policlinico Hospital,
IRCCS for Oncology and Neurosciences, Genoa, Italy
(Gama de Abreu) Department of Intensive Care and Resuscitation,
Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States
(Gama de Abreu) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
Publisher
Frontiers Media SA
Abstract
Background. Global and regional transpulmonary pressure (P<inf>L</inf>)
during one-lung ventilation (OLV) is poorly characterized. We hypothesized
that global and regional P<inf>L</inf> and driving P<inf>L</inf>
(DELTAP<inf>L</inf>) increase during protective low tidal volume OLV
compared to two-lung ventilation (TLV), and vary with body position.
Methods. In sixteen anesthetized juvenile pigs, intra-pleural pressure
sensors were placed in ventral, dorsal, and caudal zones of the left
hemithorax by video-assisted thoracoscopy. A right thoracotomy was
performed and lipopolysaccharide administered intravenously to mimic the
inflammatory response due to thoracic surgery. Animals were ventilated in
a volume-controlled mode with a tidal volume (V<inf>T</inf>) of 6 mL
kg-1 during TLV and of 5 mL kg-1 during OLV and a
positive end-expiratory pressure (PEEP) of 5 cmH<inf>2</inf>O. Global and
local transpulmonary pressures were calculated. Lung instability was
defined as end-expiratory P<inf>L</inf><2.9 cmH<inf>2</inf>O according to
previous investigations. Variables were acquired during TLV (TLVsupine),
left lung ventilation in supine (OLVsupine), semilateral (OLVsemilateral),
lateral (OLVlateral) and prone (OLVprone) positions randomized according
to Latin-square sequence. Effects of position were tested using repeated
measures ANOVA. Results. End-expiratory P<inf>L</inf> and
DELTAP<inf>L</inf> were higher during OLVsupine than TLVsupine. During
OLV, regional end-inspiratory P<inf>L</inf> and DELTAP<inf>L</inf> did not
differ significantly among body positions. Yet, end-expiratory
P<inf>L</inf> was lower in semilateral (ventral: 4.8 +/- 2.9
cmH<inf>2</inf>O; caudal: 3.1 +/- 2.6 cmH<inf>2</inf>O) and lateral
(ventral: 1.9 +/- 3.3 cmH<inf>2</inf>O; caudal: 2.7 +/- 1.7
cmH<inf>2</inf>O) compared to supine (ventral: 4.8 +/- 2.9
cmH<inf>2</inf>O; caudal: 3.1 +/- 2.6 cmH<inf>2</inf>O) and prone position
(ventral: 1.7 +/- 2.5 cmH<inf>2</inf>O; caudal: 3.3 +/- 1.6
cmH<inf>2</inf>O), mainly in ventral (p <= 0.001) and caudal (p = 0.007)
regions. Lung instability was detected more often in semilateral (26 out
of 48 measurements; p = 0.012) and lateral (29 out of 48 measurements, p <
0.001) as compared to supine position (15 out of 48 measurements), and
more often in lateral as compared to prone position (19 out of 48
measurements, p = 0.027). Conclusion. Compared to TLV, OLV increased lung
stress. Body position did not affect stress of the ventilated lung during
OLV, but lung stability was lowest in semilateral and lateral decubitus
position. Copyright © 2023 Wittenstein, Scharffenberg, Yang,
Bluth, Kiss, Schultz, Rocco, Pelosi, Gama de Abreu and Huhle.

<6>
Accession Number
2024539578
Title
Bifurcation left main stenting with or without intracoronary imaging:
Outcomes from the EBC MAIN trial.
Source
Catheterization and Cardiovascular Interventions. 102(3) (pp 415-429),
2023. Date of Publication: 01 Sep 2023.
Author
Maznyczka A.; Arunothayaraj S.; Egred M.; Banning A.; Brunel P.; Ferenc
M.; Hovasse T.; Wlodarczak A.; Pan M.; Schmitz T.; Silvestri M.; Erglis
A.; Kretov E.; Lassen J.F.; Chieffo A.; Lefevre T.; Burzotta F.; Cockburn
J.; Darremont O.; Stankovic G.; Morice M.-C.; Louvard Y.; Hildick-Smith D.
Institution
(Maznyczka) Leeds General Infirmary, Leeds, United Kingdom
(Arunothayaraj, Cockburn, Hildick-Smith) Sussex Cardiac Centre, Brighton
and Sussex University Hospitals, Brighton, United Kingdom
(Egred) Freeman Hospital, Newcastle upon Tyne, United Kingdom
(Banning) John Radcliffe Hospital, Oxford, United Kingdom
(Brunel) Hopital Prive, Dijon, France
(Ferenc) Universitats-Herzzentrum Bad Krozingem, Bad Krozingen, Germany
(Hovasse, Lefevre, Morice, Louvard) Institute Cardiovasculaire Paris Sud,
Massy, France
(Wlodarczak) Poland Miedziowe Centrum Zdrowia Lubin, Lubin, Poland
(Pan) Department of Cardiology, Reina Sofia Hospital, (IMIBIC), University
of Cordoba, Cordoba, Spain
(Schmitz) Elisabeth Hospital Essen, Essen, Germany
(Silvestri) Clinique Axium, Aix en Provence, France
(Erglis) Paul Stradins University hospital, Riga, Latvia
(Kretov) Sibirsky Federal Biomedical Research Center Novosibrisk,
Novosibirsk, Russian Federation
(Lassen) Rigshospitalet University of Copenhagen, Copenhagen, Denmark
(Chieffo) degreeSan Raffaele Sciientific Institute, Milan, Italy
(Burzotta) Fondazione Policlinico Universitario A. Genelli, Universita
Cattolica del Sacro Cuore, Rome, Italy
(Darremont) Clinique Saint-Augustin-Elsan, Bordeux, France
(Stankovic) Departmenet of Cardiology, Clinical Centre of Serbia,
University of Belgrade, Belgrade, Serbia
Publisher
John Wiley and Sons Inc
Abstract
Background: The impact of intracoronary imaging on outcomes, after
provisional versus dual-stenting for bifurcation left main (LM) lesions,
is unknown. Objective(s): We investigated the effect of intracoronary
imaging in the EBC MAIN trial (European Bifurcation Club LM Coronary Stent
study). Method(s): Four hundred and sixty-seven patients were
randomized to dual-stenting or a stepwise provisional strategy. Four
hundred and fifty-five patients were included. Intravascular ultrasound
(IVUS) or optical coherence tomography (OCT) was undertaken at the
operator's discretion. The primary endpoint was death, myocardial
infarction or target vessel revascularization at 1-year. Result(s):
Intracoronary imaging was undertaken in 179 patients (39%; IVUS = 151, OCT
= 28). As a result of IVUS findings, operators reintervened in 42
procedures. The primary outcome did not differ with intracoronary imaging
versus angiographic-guidance (17% vs. 16%; odds ratio [OR]: 0.92 (95%
confidence interval [CI]: 0.51-1.63) p = 0.767), nor for reintervention
based on IVUS versus none (14% vs. 16%; OR: 0.88 [95% CI: 0.32-2.43] p =
0.803), adjusted for syntax score, lesion calcification and ischemic
symptoms. With angiographic-guidance, primary outcome events were more
frequent with dual versus provisional stenting (21% vs. 10%; adjusted OR:
2.11 [95% CI: 1.04-4.30] p = 0.039). With intracoronary imaging, there
were numerically fewer primary outcome events with dual versus provisional
stenting (13% vs. 21%; adjusted OR: 0.56 [95% CI: 0.22-1.46] p = 0.220).
 Conclusion(s): In EBC MAIN, the primary outcome did not differ with
intracoronary imaging versus none. However, in patients with
angiographic-guidance, outcomes were worse with a dual-stent than
provisional strategy When intracoronary imaging was used, there was a
trend toward better outcomes with the dual-stent than provisional
strategy. Copyright © 2023 Wiley Periodicals LLC.

<7>
Accession Number
2024259356
Title
Amiodarone accumulates two cholesterol precursors in myocardium: A
controlled clinical study.
Source
Journal of Internal Medicine. 294(4) (pp 506-514), 2023. Date of
Publication: October 2023.
Author
Simonen P.; Lommi J.; Lemstrom K.; Tolva J.; Sinisalo J.; Gylling H.
Institution
(Simonen, Lommi, Sinisalo) Heart and Lung Center, Cardiology, University
of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Lemstrom, Gylling) Heart and Lung Center, University of Helsinki and
Helsinki University Hospital, Helsinki, Finland
(Tolva) Transplantation Laboratory, Department of Pathology, University of
Helsinki, Helsinki, Finland
Publisher
John Wiley and Sons Inc
Abstract
Background: Amiodarone is an effective antiarrhythmic drug, which
interferes with cholesterol synthesis. In the human body, it inhibits two
enzymes in the cholesterol-synthesis pathway, followed by increases
especially in serum desmosterol and zymostenol concentrations and a
decrease in that of serum lathosterol. Objective(s): We explored
whether desmosterol and zymostenol accumulate also in myocardial tissue
during amiodarone treatment. Method(s): Thirty-three patients
admitted for cardiac transplantation volunteered for the study. Ten
patients were on amiodarone treatment (AD group) and 23 were not (control
group). The groups were matched as regards demographic and clinical
variables. Myocardial samples were obtained from the removed hearts from
31 patients. Cholesterol, non-cholesterol sterols and squalene were
quantified by means of gas-liquid chromatography. Result(s): In serum
and myocardium, desmosterol was 19- and 18-fold higher and zymostenol 4-
and 2-fold higher in the AD group versus the control group (p < 0.001 for
all). In contrast, myocardial cholesterol, squalene and lathosterol levels
were lower in the AD group than in the control group (p < 0.05 for all).
Levels of phytosterols and cholestanol were similar in the serum and
myocardium in the two groups. Levels of myocardial and serum desmosterol,
zymostenol, lathosterol and phytosterols correlated with each other in
both groups (p < 0.05 for all). Conclusion(s): Amiodarone treatment
caused the accumulation of desmosterol and zymostenol in myocardium. In
particular, myocardial desmosterol concentrations were substantially
elevated, which may play a part in some of the therapeutic and adverse
effects of amiodarone treatment. Copyright © 2023 The Authors.
Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf
of Association for Publication of The Journal of Internal Medicine.

<8>
Accession Number
2027022728
Title
Updates in the management of atrial fibrillation: Emerging therapies and
treatment.
Source
Disease-a-Month. (no pagination), 2023. Article Number: 101633. Date of
Publication: 2023.
Author
Bista I.; Al-Ezzi M.M.; Prajjwal P.; Al-Ezzi S.M.S.; Pattani H.H.; Amiri
B.; Marsool M.D.M.
Institution
(Al-Ezzi) Internal Medicine, Lugansk State Medical University, Lugansk,
Ukraine
(Bista) Mechi Eye Hospital, Birtamode, Nepal
(Al-Ezzi) Internal Medicine, October 6 University, Giza, Egypt
(Prajjwal) Internal Medicine, Bharati Vidyapeeth University Medical
College, Pune, India
(Al-Ezzi) Internal Medicine, Hashemite University of Jordan, Zarqa, Jordan
(Pattani) Internal Medicine, Narendra Modi Medical College, Gujarat
University, India
(Amiri) Tabriz University of Medical Sciences, Cardiovascular Research
Center, Tabriz, Iran, Islamic Republic of
(Marsool) Al-kindy College of Medicine/University of Baghdad, Iraq
Publisher
Elsevier Inc.
Abstract
Objective: The most common and clinically important cardiac arrhythmia is
atrial fibrillation (AF), which has a large negative impact on the
public's health due to higher fatalities, morbidity, and healthcare
expenditure rates. This study aims to provide valuable insights into the
effectiveness and outcomes of various treatment approaches and
interventions for AF. Study design: Systematic review. Method(s): The
most pertinent published research (original papers and reviews) in the
scientific literature were searched for and critically assessed using the
online, internationally indexed databases PubMed, Medline, and Cochrane
Reviews. These studies are summarised in this review. Keywords like
"Atrial Fibrillation", "emerging therapies", "treatment", "catheter
ablation", and "atrial appendage" were used to search the papers. The
papers were researched and examined to be relevant to the topic.
 Conclusion(s): A lot of work has gone into enhancing AF management to
deal with this expanding public health concern. Significant developments
and advances in the treatment of AF during the past few years have aided
clinicians in giving AF patients better care. The most recent treatments
for AF include medication, catheter ablation, cryo-balloon ablation, and
left atrial appendage closure. Copyright © 2023 Elsevier Inc.

<9>
Accession Number
2026936194
Title
A family intervention to prevent postoperative delirium in patients
undergoing cardiac valve surgery: A randomized controlled study.
Source
Heart and Lung. 63 (pp 1-8), 2024. Date of Publication: 01 Jan 2024.
Author
Lin L.; Peng Y.; Huang X.; Li S.; Chen L.; Lin Y.
Institution
(Lin) Department of Nursing, Fujian medical university, Fujian, Fuzhou,
China
(Lin, Peng, Huang, Li, Chen, Lin) Department of Cardiovascular Surgery,
Fujian Medical University Union Hospital, Fujian, Fuzhou, China
(Lin, Peng, Huang, Li, Chen, Lin) Heart Center of Fujian Medical
University, Fujian, Fuzhou, China
(Lin) Department of Nursing, Fujian Medical University Union Hospital,
Fujian, Fuzhou, China
Publisher
Elsevier Inc.
Abstract
Background: Multiple guidelines recommend that families be involved in the
care of ICU patients, which has been widely used in ICU delirium
management in recent years. Postoperative delirium (POD) occurs frequently
after cardiac surgery and is associated with poor outcomes; however, the
effects of family intervention on this group are rarely studied.
 Objective(s): This study aimed to investigate the effects of family
intervention on the incidence of POD and the ICU prognoses of patients
undergoing cardiac valve surgery. Method(s): This was a two-group,
single-blind, randomized controlled trial involving 80 patients undergoing
cardiac valve surgery, with 40 patients in each group. The control group
received routine ICU visits, and the experimental group implemented a
family intervention that instructed family caregivers to participate in
delirium management during ICU visits. The occurrence of POD, ICU stay,
mechanical ventilation time of patients; as well as the anxiety,
depression, and satisfaction levels of family caregivers were compared
between the two groups. Result(s): The incidence of POD and ICU stay
of patients were significantly lower in the experimental group compared to
the control group (P < 0.05). The anxiety and depression incidence of
family caregivers in the experimental group was lower than those of the
control group (P < 0.05), and satisfaction scores were higher than those
of the control group (P < 0.05). Conclusion(s): Family intervention
has the potential to reduce the incidence of POD in patients undergoing
cardiac valve surgery, shorten ICU stays, reduce the incidence of anxiety
and depression in family caregivers, and improve their satisfaction. These
findings suggest that family intervention could be incorporated into
routine nursing practice. Copyright © 2023

<10>
Accession Number
2025680391
Title
Impact of bariatric surgery on carotid intima-media thickness,
flow-mediated dilation, and nitrite-mediated dilation: a systematic review
and meta-analysis.
Source
Surgery for Obesity and Related Diseases. 19(10) (pp 1188-1199), 2023.
Date of Publication: October 2023.
Author
Esparham A.; Roohi S.; Ahmadyar S.; Dalili A.; Nelson P.R.; Khorgami Z.
Institution
(Esparham, Roohi, Ahmadyar) Student Research Committee, College of
Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Dalili) Department of General Surgery, School of Medicine, Surgical
Oncology Research Center, Imam, Reza Hospital, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Nelson) Division of Vascular Surgery, Department of Surgery, University
of Oklahoma, Tulsa, OK, United States
(Khorgami) Department of Surgery, University of Oklahoma College of
Community Medicine, Tulsa, OK, United States
(Khorgami) Harold Hamm Diabetes Center, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Obesity is considered one of the independent risk factors for
atherosclerosis and is strongly correlated with cardiovascular morbidity
and mortality. Previous studies showed carotid intima-media thickness
(CIMT), flow-mediated dilation (FMD), and nitrite-mediated dilatation
(NMD) are reliable non-invasive markers of arterial damage and
dysfunction. The aim of this study was to evaluate the effect of bariatric
surgery on CIMT, FMD, and NMD markers in patients with obesity. A
systematic search was performed in the PubMed, Embase, Scopus, and Web of
Science databases until May 2022. All the English-published studies on the
effect of bariatric surgery on CIMT, FMD, and NMD were included. A
quantitative meta-analysis was performed, as well as subgroup analyses for
the type of procedure and duration of follow-up. Meta-analysis of 41
studies with 1639 patients showed CIMT was significantly reduced by.11 mm
after bariatric surgery (95% CI, -.14 to -.08; P <.001; mean follow-up =
10.8 mo). The pooled analysis of 23 studies with 1106 patients showed an
increase of FMD by 4.57% after bariatric surgery (95% CI, 2.69-6.44; P
<.001; mean follow-up = 11.5 mo). The results of a pooled analysis of 12
studies with 346 patients showed a significant increase of NMD by 2.46%
after bariatric surgery (95% CI,.99-3.94; P <.001; mean follow-up = 11.4
mo). The random effect meta-regression demonstrated that baseline CIMT and
FMD significantly affect the changes in CIMT and FMD. This meta-analysis
showed bariatric surgery can improve CIMT, FMD, and NMD markers in
patients with obesity. These improvements show the known effect of
metabolic surgery in decreasing cardiovascular risk. Copyright ©
2023 American Society for Metabolic and Bariatric Surgery

<11>
Accession Number
2021935965
Title
A series of experiences with TissuePatchTM for alveolar air leak after
pulmonary resection.
Source
General Thoracic and Cardiovascular Surgery. 71(10) (pp 570-576), 2023.
Date of Publication: October 2023.
Author
Homma T.
Institution
(Homma) Division of Thoracic Surgery, Kurobe City Hospital, 1108-1
Mikkaichi, Toyama, Kurobe 938-8502, Japan
(Homma) Division of Thoracic Surgery, University of Toyama, Toyama, Japan
Publisher
Springer
Abstract
Objectives: Prolonged air leak after pulmonary resection strongly
influences chest tube duration and hospitalization. This prospective study
aimed to report a series of experiences with a synthetic sealant
(TissuePatchTM) and compare them with a combination covering method
(polyglycolic acid sheet + fibrin glue) for air leaks after pulmonary
surgery. Method(s): We included 51 patients (age: 20-89 years) who
underwent lung resection. Patients who presented with alveolar air leak
during the intraoperative water sealing test were randomly assigned to the
TissuePatchTM or combination covering method groups. The chest tube was
removed when there was no air leak over a period of 6 h, and no active
bleeding under continuous monitoring using a digital drainage system. The
chest tube duration was assessed, and various perioperative factors (such
as the index of prolonged air leak score) were evaluated. Result(s):
Twenty (39.2%) patients developed intraoperative air leak; ten patients
received TissuePatchTM; and one patient who was receiving TissuePatchTM
switched to the combination covering method because of broken
TissuePatchTM. The chest tube duration, index of prolonged air leak score,
prolonged air leak, other complications, and postoperative hospitalization
in both groups were similar. No TissuePatchTM-related adverse events were
reported. Conclusion(s): Results from the use of TissuePatchTM were
almost similar to those associated with the use of combination covering
method in preventing prolonged postoperative air leak after pulmonary
resection. Randomized, double-arm studies are required to confirm the
efficacy of TissuePatchTM observed during this study. Copyright ©
2023, The Author(s), under exclusive licence to The Japanese Association
for Thoracic Surgery.

<12>
Accession Number
642286946
Title
Plasma type I collagen alpha1 chain in relation to coronary artery
disease: findings from a prospective population-based cohort and an acute
myocardial infarction prospective cohort in Sweden.
Source
BMJ open. 13(9) (pp e073561), 2023. Date of Publication: 15 Sep 2023.
Author
Hammareus F.; Nilsson L.; Ong K.-L.; Kristenson M.; Festin K.; Lundberg
A.K.; Chung R.W.S.; Swahn E.; Alfredsson J.; Holm Nielsen S.; Jonasson L.
Institution
(Hammareus, Nilsson, Kristenson, Festin, Lundberg, Chung, Swahn,
Alfredsson, Jonasson) Department of Health Medicine and Caring Sciences,
Linkoping University, Linkoping, Sweden
(Ong) Faculty of Medicine and Health, NHMRC Clinical Trials Centre,
University of Sydney, Sydney, NSW, Australia
(Holm Nielsen) Department of Biotechnology and Biomedicine, Technical
University of Denmark, Lyngby, Denmark
(Holm Nielsen) Nordic Bioscience, Herlev, Denmark
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To investigate the association between type I collagen alpha1
chain (COL1alpha1) levels and coronary artery disease (CAD) by using
absolute quantification in plasma. Also, to investigate the correlates of
COL1alpha1 to clinical characteristics and circulating markers of collagen
metabolism. DESIGN: Life conditions, Stress and Health (LSH) study:
prospective cohort study, here with a nested case-control design.Assessing
Platelet Activity in Coronary Heart Disease (APACHE) study: prospective
cohort study. SETTING: LSH: primary care setting, southeast Sweden.APACHE:
cardiology department, university hospital, southeast Sweden.
PARTICIPANTS: LSH: 1007 randomly recruited individuals aged 45-69 (50%
women). Exclusion criteria was serious disease. After 13 years of
follow-up, 86 cases with primary endpoint were identified and
sex-matched/age-matched to 184 controls. APACHE: 125 patients with
myocardial infarction (MI), 73 with ST-elevation MI and 52 with
non-ST-elevation MI. EXCLUSION CRITERIA: Intervention study participation,
warfarin treatment and short life expectancy. PRIMARY AND SECONDARY
OUTCOME MEASURES: Primary outcome was the association between baseline
COL1alpha1 and first-time major event of CAD, defined as fatal/non-fatal
MI or coronary revascularisation after 13 years. Secondary outcomes were
the association between the collagen biomarkers PRO-C1 (N-terminal
pro-peptide of type I collagen)/C1M (matrix metalloproteinase-mediated
degradation of type I collagen) and CAD; temporal change of COL1alpha1
after acute MI up to 6 months and lastly, correlates between COL1alpha1
and patient characteristics along with circulating markers of collagen
metabolism. RESULT(S): COL1alpha1 levels were associated with CAD,
both unadjusted (HR=0.69, 95% CI=0.56 to 0.87) and adjusted (HR=0.55, 95%
CI=0.41 to 0.75). PRO-C1 was associated with CAD, unadjusted (HR=0.62, 95%
CI=0.47 to 0.82) and adjusted (HR=0.61, 95% CI=0.43 to 0.86), while C1M
was not. In patients with MI, COL1alpha1 remained unchanged up to 6
months. COL1alpha1 was correlated to PRO-C1, but not to C1M.
 CONCLUSION(S): Plasma COL1alpha1 was independently and inversely
associated with CAD. Furthermore, COL1alpha1 appeared to reflect collagen
synthesis but not degradation. Future studies are needed to confirm
whether COL1alpha1 is a clinically useful biomarker of CAD. Copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

<13>
Accession Number
2026887830
Title
Clinical outcomes of patients undergoing percutaneous coronary
intervention treated with colchicine.
Source
REC: Interventional Cardiology. 5(2) (pp 110-117), 2023. Date of
Publication: April 2023.
Author
Soria Jimenez C.E.; Sanchez J.S.; Levine M.B.; Hayat F.; Chang J.;
Garcia-Garcia H.M.
Institution
(Soria Jimenez) Department of Cardiology, MedStar Washington/Georgetown
University Hospital Center, Washington, DC, United States
(Sanchez) Department of Cardiology, Hospital Universitario y Politecnico
La Fe, Valencia, Spain
(Sanchez) Centro de Investigacion Biomedica en Red Enfermedades
Cardiovaculares (CIBERCV), Spain
(Hayat) Department of Medicine, MedStar Washington Hospital Center,
Washington, DC, United States
(Chang) Department of Medicine, NYU Langone Health, New York, United
States
(Levine, Garcia-Garcia) Section of Interventional Cardiology, MedStar
Washington Hospital Center, Washington, DC, United States
Publisher
Sociedad Espanola de Cardiologia
Abstract
Introduction and objectives: The role of inflammation in the pathogenesis
of coronary artery disease, and that resulting from percutaneous coronary
intervention (PCI) is increasingly recognized, yet the effect of
colchicine in attenuating peri-PCI inflammation remains unknown. This
meta-analysis investigated the efficacy of colchicine in patients
undergoing PCI for secondary prevention of coronary artery disease.
 Method(s): The Web of Science, PubMed, Ovid MEDLINE, Embase, Cochrane
Central Register of Controlled Trials and ClinicalTrials. gov databases
were searched. Data on studies assessing the efficacy profile of
colchicine in patients undergoing PCI were pooled using a random-effects
model. Result(s): In 13 studies of 7414 patients, no differences were
observed between patients treated with colchicine compared to those
without for all-cause mortality (OR, 1.1; 95%CI, 0.72-1.56; I2
= 0%), cardiovascular mortality (OR, 0.98; 95%CI, 0.42-2.28; I2
= 14.2%), myocardial infarction (OR, 0.84; 95%CI, 0.65-1.08; I2
= 1.4%) or coronary revascularization (OR, 0.64; 95%CI, 0.28-1.42;
I2 = 49.3%). However, patients treated with colchicine had a
lower risk of stroke (OR, 0.33; 95%CI, 0.15-0.72; I2 = 0%).
 Conclusion(s): Adding colchicine to standard medical therapy in
patients undergoing PCI did not decrease all-cause mortality,
cardiovascular mortality or urgent revascularization. However, it showed a
trend towards a lower risk of myocardial infarction and a significantly
lower risk of stroke. Copyright © 2023 International Journal of
Mathematical, Engineering and Management Sciences. All rights reserved.

<14>
Accession Number
2027096182
Title
One-Lung Ventilation and Postoperative Pulmonary Complications After Major
Lung Resection Surgery. A Multicenter Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Piccioni F.; Langiano N.; Bignami E.; Guarnieri M.; Proto P.; D'Andrea R.;
Mazzoli C.A.; Riccardi I.; Bacuzzi A.; Guzzetti L.; Rossi I.; Scolletta
S.; Comi D.; Benigni A.; Pierconti F.; Coccia C.; Biscari M.; Murzilli A.;
Umari M.; Peratoner C.; Serra E.; Baldinelli F.; Accardo R.; Diana F.;
Fasciolo A.; Amodio R.; Ball L.; Greco M.; Pelosi P.; Della Rocca G.
Institution
(Piccioni) Department of Anesthesia and Intensive Care, IRCCS Humanitas
Research Hospital, Rozzano, Milan, Italy
(Langiano, Riccardi) SOC Anesthesia and Intensive Care Medicine Clinic -
Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
(Bignami) Anesthesiology, Critical Care and Pain Medicine Division,
Department of Medicine and Surgery, University of Parma, Parma, Italy
(Guarnieri) Department of Medicine and Surgery, University of Milan
Bicocca, Milan, Italy
(Proto) Department of Critical and Supportive Therapy, Fondazione IRCCS
Istituto Nazionale Tumori, Milan, Italy
(D'Andrea) Department of Anesthesia, Intensive Care Medicine and
Emergency, IRRCS Policlinico di Sant' Orsola, Bologna Academic Hospital,
Bologna, Italy
(Mazzoli) Department of Anesthesia, Intensive Care Medicine and
Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna,
Italy
(Bacuzzi, Guzzetti) ASST Settelaghi Ospedale di Circolo e Fondazione
Macchi, Varese, Italy
(Rossi, Scolletta) Cardio-thoracic and vascular Department, UOC
Cardio-thoracic and vascular Anesthesia and ICM, Azienda
ospedaliero-universitaria Senese, Siena, Italy
(Comi, Benigni) Anesthesia and Intensive Care Unit, ASST Papa Giovanni
XXIII, Bergamo, Italy
(Pierconti, Coccia) IRCCS-IFO National Institute of Oncology - Regina
Elena, DPT of Oncologic Clinic and Research, UOC Anesthesia and ICM, Rome,
Italy
(Biscari, Murzilli) Arcispedale Santa Maria Nuova, IRCCS AUSL di Reggio
Emilia, Italy
(Umari, Peratoner) SOC Anesthesia and Intensive Care Medicine - Azienda
Sanitaria Universitaria Giuliana, Cattinara Hospital, Trieste, Italy
(Serra) Anesthesia and Intensive Care Medicine Institute - Azienda
Ospedaliera-Universita of Padua, Padua, Italy
(Baldinelli) Azienda Sanitaria dell'Alto Adige, Bozen, Italy
(Accardo) Division of Anesthesia, Department of Anesthesia, Endoscopy and
Cardiology, Istituto Nazionale Tumori Fondazione G. Pascale - IRCCS,
Naples, Italy
(Diana) Anesthesia and Intensive Care Unit, Azienda Ospedaliera Brotzu -
Ospedale Oncologico Businco, Cagliari, Italy
(Fasciolo) IRRCS Policlinico San Martino Hospital, Genoa, Italy
(Amodio) Department of Anesthesia, Intensive Care and Pain Medicine, IRCCS
Centro di Riferimento Oncologico della Basilicata/OECI Clinical Cancer
Center - Rionero in Vulture, Potenza, Italy
(Ball, Pelosi) Department of Surgical Sciences and Integrated Diagnostics,
IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
(Greco) Department of Biomedical Sciences, Humanitas University, Milan,
Italy
(Greco) Department of Anaesthesiology and Intensive Care, IRCCS Humanitas
Research Hospital, Milan, Italy
(Della Rocca) Department of Medical Area, University of Udine, Udine,
Italy
Publisher
W.B. Saunders
Abstract
Objectives: The effect of one-lung ventilation (OLV) strategy based on low
tidal volume (TV), application of positive end-expiratory pressure (PEEP),
and alveolar recruitment maneuvers (ARM) to reduce postoperative acute
respiratory distress syndrome (ARDS) and pulmonary complications (PPCs)
compared with higher TV without PEEP and ARM strategy in adult patients
undergoing lobectomy or pneumonectomy has not been well established.
 Design(s): Multicenter, randomized, single-blind, controlled trial.
 Setting(s): Sixteen Italian hospitals. Participant(s): A total
of 880 patients undergoing elective major lung resection.
 Intervention(s): Patients were randomized to receive lower tidal
volume (LTV group: 4 mL/kg predicted body weight, PEEP of 5
cmH<inf>2</inf>O, and ARMs) or higher tidal volume (HTL group: 6 mL/kg
predicted body weight, no PEEP, and no ARMs). After OLV, until extubation,
both groups were ventilated using a tidal volume of 8 mL/kg and a PEEP
value of 5 cmH<inf>2</inf>O. The primary outcome was the incidence of
in-hospital ARDS. Secondary outcomes were the in-hospital rate of PPCs,
major cardiovascular events, unplanned intensive care unit (ICU)
admission, in-hospital mortality, ICU length of stay, and in-hospital
length of stay. Measurements and Main Results: ARDS occurred in 3 of
438 patients (0.7%, 95% CI 0.1-2.0) and in 1 of 442 patients (0.2%, 95% CI
0-1.4) in the LTV and HTV group, respectively (Risk ratio: 3.03 95% CI
0.32-29, p = 0.372). Pulmonary complications occurred in 125 of 438
patients (28.5%, 95% CI 24.5-32.9) and in 136 of 442 patients (30.8%, 95%
CI 26.6-35.2) in the LTV and HTV group, respectively (risk ratio: 0.93,
95% CI 0.76-1.14, p = 0.507). The incidence of major complications,
in-hospital mortality, and unplanned ICU admission, ICU and in-hospital
length of stay were comparable in both groups. Conclusion(s): In
conclusion, among adult patients undergoing elective lung resection, an
OLV with lower tidal volume, PEEP 5 cmH<inf>2</inf>O, and ARMs and a
higher tidal volume strategy resulted in low ARDS incidence and comparable
postoperative complications, in-hospital length of stay, and
mortality. Copyright © 2023 Elsevier Inc.

<15>
Accession Number
2026725669
Title
Pulmonary Vasodilator and Inodilator Drugs in Cardiac Surgery: A
Systematic Review With Bayesian Network Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Sardo S.; Tripodi V.F.; Guerzoni F.; Musu M.; Cortegiani A.; Finco G.
Institution
(Sardo, Guerzoni, Musu, Finco) Department of Medical Sciences and Public
Health, University of Cagliari, Monserrato, Italy
(Tripodi) Department of Human Pathology, Unit of Anesthesia and Intensive
Care, University Hospital of Messina, Messina, Italy
(Cortegiani) Department of Surgical Oncological and Oral Science,
University of Palermo, Palermo, Italy
(Cortegiani) Department of Anesthesia Intensive Care and Emergency,
University Hospital "Policlinico Paolo Giaccone", Palermo, Italy
Publisher
W.B. Saunders
Abstract
Objective: The authors performed a systematic review to evaluate the
effect of pharmacologic therapy on pulmonary hypertension in the
perioperative setting of elective cardiac surgery (PROSPERO
CRD42023321041). Design(s): Systematic review of randomized
controlled trials with a Bayesian network meta-analysis. Setting(s):
The authors searched biomedical databases for randomized controlled trials
on the perioperative use of inodilators and pulmonary vasodilators in
adult cardiac surgery, with in-hospital mortality as the primary outcome
and duration of ventilation, length of stay in the intensive care unit,
stage 3 acute kidney injury, cardiogenic shock requiring mechanical
support, and change in mean pulmonary artery pressure as secondary
outcomes. Participant(s): Twenty-eight studies randomizing 1,879
patients were included. Intervention(s): Catecholamines and
noncatecholamine inodilators, arterial pulmonary vasodilators,
vasodilators, or their combination were considered eligible interventions
compared with placebo or standard care. Measurements and Main
Results: Ten studies reported in-hospital mortality and assigned 855
patients to 12 interventions. Only inhaled prostacyclin use was supported
by a statistically discernible improvement in mortality, with a
number-needed-to-treat estimate of at least 3.3, but a wide credible
interval (relative risk 1.26 x 10-17 - 0.7). Inhaled
prostacyclin and nitric oxide were associated with a reduction in
intensive care unit stay, and none of the included interventions reached a
statistically evident difference compared to usual care or placebo in the
other secondary clinical outcomes. Conclusion(s): Inhaled
prostacyclin was the only pharmacologic intervention whose use is
supported by a statistically discernible improvement in mortality in the
perioperative cardiac surgery setting as treatment of pulmonary
hypertension. However, available evidence has significant limitations,
mainly the low number of events and imprecision. Copyright © 2023
The Author(s)

<16>
Accession Number
2026725324
Title
Red Blood Cell Transfusion Guided by Hemoglobin Only or Integrating
Perfusion Markers in Patients Undergoing Cardiac Surgery: A Systematic
Review and Meta-Analysis With Trial Sequential Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Putaggio A.; Tigano S.; Caruso A.; La Via L.; Sanfilippo F.
Institution
(Putaggio) School of Anesthesia and Intensive Care, University Magna
Graecia, Catanzaro, Italy
(Tigano, Caruso) School of Anesthesia and Intensive Care, University of
Catania, Catania, Italy
(La Via, Sanfilippo) University Hospital Policlinico, G. Rodolico - San
Marco, Catania, Italy
(Sanfilippo) Department of Surgery and Medical-Surgical Specialties,
University of Catania, Catania, Italy
Publisher
W.B. Saunders
Abstract
Objective: Strategies for red blood cell (RBC) transfusion in patients
undergoing cardiac surgery have been traditionally anchored to hemoglobin
(Hb) targets. A more physiologic approach would consider markers of organ
hypoperfusion. Design(s): The authors conducted a systematic review
and meta-analysis with trial sequential analysis of randomized controlled
trials (RCTs). Setting(s): Cardiac surgery. Participant(s):
Adult patients. Intervention(s): RBC transfusion targeting only Hb
levels compared with strategies combining Hb values with markers of organ
hypoperfusion. Measurements and Main Results: Primary outcomes were
the number of RBC units transfused, the number of patients transfused at
least once, and the average number of transfusions. Secondary outcomes
were postoperative complications, intensive care (ICU) and hospital
lengths of stay, and mortality. Only 2 RCTs were included (n = 257
patients), and both used central venous oxygen saturation
(ScvO<inf>2</inf>) as a marker of organ hypoperfusion (cut-off: <70% or
<=65%). A transfusion protocol combining Hb and ScvO<inf>2</inf> reduced
the overall number of RBC units transfused (risk ratio [RR]: 1.57
[1.33-1.85]; p < 0.0001, I2 = 0%), and the number of patients
transfused at least once (RR: 1.33 [1.16-1.53]; p < 0.0001, I2
= 41%), but not the average number of transfusions (mean difference [MD]:
0.18 [-0.11 to 0.47]; p = 0.24, I2 = 66%), with moderate
certainty of evidence. Mortality (RR: 1.29, [0.29-5.77]; p = 0.73,
I2 = 0%), ICU length-of-stay (MD: -0.06 [-0.58 to 0.46]; p =
0.81, I2 = 0%), hospital length-of-stay (MD: -0.05 [-1.49 to
1.39];p = 0.95, I2 = 0%), and all postoperative complications
were not affected. Conclusion(s): In adult patients undergoing
cardiac surgery, a restrictive protocol integrating Hb values with a
marker of organ hypoperfusion (ScvO<inf>2</inf>) reduces the number of RBC
units transfused and the number of patients transfused at least once
without apparent signals of harm. These findings were preliminary and
warrant further multicentric research. Copyright © 2023 The
Author(s)

<17>
Accession Number
642289880
Title
3D Printing for Cardiovascular surgery and intervention: A Review Article.
Source
Current problems in cardiology. (pp 102086), 2023. Date of Publication:
14 Sep 2023.
Author
Shabbak A.; Masoumkhani F.; Fallah A.; Amani-Beni R.; Mohammadpour H.;
Shahbazi T.; Bakhshi A.
Institution
(Shabbak, Fallah, Mohammadpour) Research committee, School of Medicine,
Guilan university of medical science, Rasht, Iran, Islamic Republic of
(Masoumkhani) Department of cardiology, Mousavi Hospital, Zanjan
University of Medical Sciences, Zanjan, Iran, Islamic Republic of
(Amani-Beni) School of Medicine, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Shahbazi) Neurosurgery Research Group (NRG), Student Research Committee,
Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Bakhshi) Remember of Research Committee, School of Medicine, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
3D printing technology can be applied to practically every aspect of
modern life, fulfilling the needs of people from various backgrounds. The
utilization of 3D printing in the context of adult heart disease can be
succinctly categorized into three primary domains: preoperative
strategizing or simulation, medical instruction, and clinical
consultations. 3D-printed model utilization improves surgical planning and
intraoperative decision-making and minimizes surgical risks, and it has
demonstrated its efficacy as an innovative educational tool for aspiring
surgeons with limited practical exposure. Despite all the applications of
3D printing, it has not yet been shown to improve long-term outcomes,
including safety. There are no data on the outcomes of controlled trials
available. To appropriately diagnose heart disease, 3D-printed models of
the heart can provide a better understanding of the intracardiac anatomy
and provide all the information needed for operative planning.
Experientially, 3D printing provides a wide range of perceptions for
understanding lower extremity arteries' spatial geometry and anatomical
features of pathology. Practicing cardiac surgery processes using objects
printed using 3D imaging data can become the norm rather than the
exception, leading to improved accuracy and quality of treatment. This
study aimed to review the various applications of 3D printing technology
in cardiac surgery and intervention. Copyright © 2023. Published
by Elsevier Inc.

<18>
Accession Number
642289309
Title
Prophylactic corticosteroids for cardiac surgery in children: A systematic
review and meta-analysis.
Source
American heart journal. (no pagination), 2023. Date of Publication: 14
Sep 2023.
Author
Cheema H.A.; Ahmad A.H.; Khan A.A.; Khalid M.A.; Shahid A.; Hermis A.H.;
Syed A.; Bansal N.; Yuki K.; Ghelani S.J.; Dani S.S.
Institution
(Cheema, Shahid) Department of Cardiology, King Edward Medical University,
Lahore, Pakistan; Department of Medicine, King Edward Medical University,
Lahore, Pakistan
(Khan, Ahmad, Khan) Department of Surgery, King Edward Medical University,
Lahore, Pakistan
(Khalid) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Hermis) Al-Mustaqbal University College, Babylon, Iraq
(Syed) Medical College of Wisconsin, Milwaukee, WI, United States
(Bansal) Division of Pediatric Cardiology, Mount Sinai Kravis Children's
Hospital, New York, NY, USA
(Yuki) Cardiac Anesthesia Division, Department of Anesthesiology, Critical
Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA;
Department of Anaesthesia and Immunology, Harvard Medical School, Boston,
MA, USA
(Ghelani) Department of Cardiology, Boston Children's Hospital, Boston,
MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
(Dani) Division of Cardiovascular Medicine, Beth Israel Lahey Health,
Lahey Hospital and Medical Center, Burlington, MA, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Perioperative corticosteroids have been used for pediatric
cardiac surgery for decades, but the underlying evidence is conflicting.
We aimed to investigate the efficacy and safety of perioperative
prophylactic corticosteroids in pediatric heart surgeries. METHOD(S):
We searched electronic databases until March 2023 to retrieve all
randomized controlled trials (RCTs) that administered perioperative
prophylactic corticosteroids to children undergoing heart surgery. We used
RevMan 5.4 to pool risk ratios (RRs) and mean differences (MDs).
 RESULT(S): A total of 12 RCTs (2209 patients) were included in our
review. Corticosteroids administration was associated with a
non-significant reduction in all-cause mortality (RR 0.62; 95% CI:
0.37-1.02, I2=0%; moderate certainty); however, it was associated with a
lower duration of mechanical ventilation (MV) (MD -0.63 days; 95% CI:
-1.16 to -0.09 days, I2=41%; high certainty). Corticosteroids did not
affect the length of ICU and hospital stay but significantly reduced the
incidence of postoperative low cardiac output syndrome (LCOS) (RR 0.76;
95% CI: 0.60-0.96, I2=0%; moderate certainty) and reoperation (RR 0.37;
95% CI: 0.19-0.74, I2=0%; moderate certainty). There was no increase in
adverse events except a higher risk of hyperglycemia and postoperative
insulin use. CONCLUSION(S): The use of perioperative corticosteroids
in pediatric heart surgeries is associated with a trend toward reduced
all-cause mortality without attaining statistical significance.
Corticosteroids reduced MV duration, and probably decrease the incidence
of LCOS, and reoperations. The choice of corticosteroid agent and dose is
highly variable and further larger studies may help determine the ideal
agent, dose, and patient population for this prophylactic
therapy. Copyright © 2023. Published by Elsevier Inc.

<19>
Accession Number
642289298
Title
Optimizing Safety and Success: The Advantages of Bloodless Cardiac
Surgery. A Systematic Review and Meta-Analysis of Outcomes in Jehovah's
Witnesses.
Source
Current problems in cardiology. (pp 102078), 2023. Date of Publication:
14 Sep 2023.
Author
Gemelli M.; Italiano E.G.; Geatti V.; Addonizio M.; Cao I.; Dimagli A.;
Dokollari A.; Tarzia V.; Gallo M.; Ferrari E.; Slaughter M.S.; Gerosa G.
Institution
(Gemelli, Italiano, Geatti, Addonizio, Cao, Tarzia, Gerosa) Cardiac
Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and
Public Health, University of Padua, Italy
(Dimagli) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
NY, United States
(Dokollari) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
(Gallo, Slaughter) Department of Cardiothoracic Surgery, University of
Louisville, Louisville, KY, United States
(Ferrari) Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero
Cantonale, Lugano, Switzerland
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Transfusions are extremely frequent after cardiac surgery, and
they have a considerable economic burden and impact on outcomes. Optimal
patient blood management (PBM) could play a fundamental role in reducing
the rate of transfusion and Jehovah's Witnesses (JW) represent the ideal
surrogate study population. This meta-analysis compares outcomes of JWs
and non-JWs' patients undergoing cardiac surgery, assessing the safety of
a bloodless cardiac surgery. METHOD(S): A scoping review was
conducted using a search strategy for studies assessing outcomes of JW
undergoing cardiac surgery. The primary outcome was perioperative
mortality, and a random-effects meta-analysis was performed.
 RESULT(S): Ten studies were included in our meta-analysis, involving
780 JW patients refusing any type of transfusion ("JW") and 1182 patients
accepting transfusion if needed ("non-JW"). 86% of non-JW patients
received at least 1 transfusion. There was no significant difference in
terms of perioperative mortality (OR 0.91; 95% CI 0.55 - 1.52; p=0.72).
The volume blood loss was significantly less in the JW (p=0.001), while
the rate of reoperation for bleeding was also lower, but not statistically
significative, in the JW (p=0.16). Both pre-operative and post-operative
hemoglobin and hematocrit were significantly higher in the JW.
 CONCLUSION(S): Bloodless cardiac surgery is safe and early outcomes
are similar between JW and non-JW patients: optimal patient blood
management is fundamental in guarantying these results. Further studies
are needed to assess if a limitation of transfusion could have a positive
long-term impact on outcomes. Copyright © 2023. Published by
Elsevier Inc.

<20>
Accession Number
2025693987
Title
Barriers to Participation in Cardiac Rehabilitation Among Patients with
Coronary Heart Disease After Reperfusion Therapy: A Scoping Review.
Source
Vascular Health and Risk Management. 19 (pp 557-570), 2023. Date of
Publication: 2023.
Author
Sugiharto F.; Nuraeni A.; Trisyani Y.; Melati Putri A.; Aghnia Armansyah
N.
Institution
(Sugiharto, Melati Putri, Aghnia Armansyah) Faculty of Nursing,
Universitas Padjadjaran, Jawa Barat, Sumedang, Indonesia
(Nuraeni, Trisyani) Department of Critical Care and Emergency Nursing,
Faculty of Nursing, Universitas Padjadjaran, Jawa Barat, Sumedang,
Indonesia
Publisher
Dove Medical Press Ltd
Abstract
Patients with coronary heart disease (CHD) experience many barriers to
participate in cardiac rehabilitation (CR) programs. Several studies
identify barriers that can affect participation in CR among patients with
CHD after reperfusion therapy. However, there has yet to be a review
specifically in this population. This review aims to identify the
literature systematically that analyzes the barriers that affect the
participation of CHD patients after reperfusion therapy in implementing
the CR program. This study used the Preferred Reporting Item for PRISMA
Extension for Scoping Reviews (PRISMA-ScR) with databases PubMed,
ScienceDirect, EBSCO-hosted Academic Search Complete, Scopus, Taylor &
Francis, and Sage Journals. The keywords used in English were "coronary
artery disease OR myocardial infarction OR cardiovascular disease OR heart
disease" AND "Barrier OR obstacle", AND "percutaneous coronary
intervention OR PCI OR angioplasty OR coronary artery bypass graft surgery
OR CABG" AND "cardiac rehabilitation OR rehabilitation OR recovery". The
inclusion criteria in this review were full-text articles in English,
articles with a descriptive, cross-sectional, and cohort design with a
minimum of 100 participants that discussed barriers to participation in
patients with CHD after undergoing reperfusion therapy, and the CR phases
such as I, II, III, and IV have also been identified. Based on the initial
search, there are 23 relevant studies out of 7400. The results of this
study reported that most of the participants from the studies analyzed had
a low level of participation in CR (<=50%). We classify the factors that
affect the level of CR participation into five categories: individual
factors, health history, environmental, logistical, and health system. The
most reported barriers in each category were age, comorbidities, lack of
support from friends, family and health workers, distance or travel time,
and cost and economic status. Professional health workers, especially
nurses, can identify various barriers that patients feel so that they can
increase their participation in attending CR. Copyright © 2023
Sugiharto et al.

<21>
Accession Number
2024908708
Title
Prehabilitation in older patients prior to elective cardiac procedures
(PRECOVERY): study protocol of a multicenter randomized controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 533. Date of
Publication: December 2023.
Author
Steinmetz C.; Heinemann S.; Kutschka I.; Hasenfuss G.; Asendorf T.;
Remppis B.A.; Knoglinger E.; Grefe C.; Albes J.M.; Baraki H.; Baumbach C.;
Brunner S.; Ernst S.; Harringer W.; Heider D.; Heidkamp D.;
Herrmann-Lingen C.; Hummers E.; Kocar T.; Konig H.-H.; Krieger S.; Liebold
A.; Martens A.; Matzeder M.; Mellert F.; Muller C.; Puls M.; Reiss N.;
Schikora M.; Schmidt T.; Vestweber M.; Sadlonova M.; von Arnim C.A.F.
Institution
(Steinmetz, Heinemann, Sadlonova, von Arnim) Department of Geriatrics,
University of Goettingen Medical Center, Robert-Koch-Strase 40, Goettingen
37075, Germany
(Kutschka, Baraki, Sadlonova) Department of Cardiovascular and Thoracic
Surgery, University of Goettingen Medical Center, Goettingen, Germany
(Kutschka, Hasenfus, Baraki, Herrmann-Lingen, Puls, Sadlonova, von Arnim)
German Center for Cardiovascular Research (DZHK), Partner Site Goettingen,
Goettingen, Germany
(Hasenfus, Puls) Department of Cardiology and Pneumology, University of
Goettingen Medical Center, Goettingen, Germany
(Asendorf) Department of Medical Statistics, University of Goettingen
Medical Center, Goettingen, Germany
(Remppis, Baumbach) Heart and Vascular Center Bad Bevensen, Bad Bevensen,
Germany
(Knoglinger) Kirchberg Clinic, Bad Lauterberg, Germany
(Grefe) Clinic and Rehabilitation Center Lippoldsberg, Wesertal, Germany
(Albes) Immanuel Clinic Bernau, Brandenburg Heart Center, Bernau, Germany
(Brunner) Clinic Fallingbostel, Bad Fallingbostel, Germany
(Ernst) ZAR Center for Outpatient Rehabilitation GmbH, Ulm, Germany
(Harringer) Department of Cardiac, Thoracic and Vascular Surgery,
Braunschweig Municipal Hospital, Brunswick, Germany
(Heider, Konig) Department of Health Economics and Health Services
Research, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf,
Germany
(Heidkamp) Rehabilitation Center Oldenburg, Oldenburg, Germany
(Herrmann-Lingen, Krieger, Sadlonova) Department of Psychosomatic Medicine
and Psychotherapy, University of Goettingen Medical Center, Goettingen,
Germany
(Hummers, Muller) Department of General Practice, University of Goettingen
Medical Center, Goettingen, Germany
(Kocar) Geriatric Center Ulm, Ulm, Germany
(Liebold) Department for Thoracic, Cardiac and Vascular Surgery, Ulm
University Medical Center, Ulm, Germany
(Martens) Department of Cardiothoracic, Transplantation and Vascular
Surgery, Hannover Medical School, Hannover, Germany
(Matzeder) AOK Health Insurance (AOK Lower Saxony), Helmstedt, Germany
(Mellert) Department of Cardiac Surgery, Oldenburg Hospital, Oldenburg,
Germany
(Reiss, Schmidt) Schuchtermann-Schiller'sche Clinic, Bad Rothenfelde,
Germany
(Schikora) Brandenburg Clinic, Bernau Waldsiedlung, Germany
(Schmidt) Institute of Cardiology and Sports Medicine, Department
Preventive and Rehabilitative Sport and Exercise Medicine, German Sport
University, Cologne, Germany
(Vestweber) German Heart Foundation, Frankfurt am Main, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Previous studies have demonstrated the efficacy of
rehabilitation after a cardiovascular procedure. Especially older and
multimorbid patients benefit from rehabilitation after a cardiac
procedure. Prehabilitation prior to cardiac procedures may also have
positive effects on patients' pre- and postoperative outcomes. Results of
a current meta-analysis show that prehabilitation prior to cardiac
procedures can improve perioperative outcomes and alleviate adverse
effects. Germany currently lacks a structured cardiac prehabilitation
program for older patients, which is coordinated across healthcare
sectors. Method(s): In a randomized, controlled, two-arm parallel
group, assessor-blinded multicenter intervention trial (PRECOVERY), we
will randomize 422 patients aged 75 years or older scheduled for an
elective cardiac procedure (e.g., coronary artery bypass graft surgery or
transcatheter aortic valve replacement). In PRECOVERY, patients randomized
to the intervention group participate in a 2-week multimodal
prehabilitation intervention conducted in selected cardiac-specific
rehabilitation facilities. The multimodal prehabilitation includes seven
modules: exercise therapy, occupational therapy, cognitive training,
psychosocial intervention, disease-specific education, education with
relatives, and nutritional intervention. Participants in the control group
receive standard medical care. The co-primary outcomes are quality of life
(QoL) and mortality after 12 months. QoL will be measured by the EuroQol
5-dimensional questionnaire (EQ-5D-5L). A health economic evaluation using
health insurance data will measure cost-effectiveness. A mixed-methods
process evaluation will accompany the randomized, controlled trial to
evaluate dose, reach, fidelity and adaptions of the intervention.
 Discussion(s): In this study, we investigate whether a tailored
prehabilitation program can improve long-term survival, QoL and functional
capacity. Additionally, we will analyze whether the intervention is
cost-effective. This is the largest cardiac prehabilitation trial
targeting the wide implementation of a new form of care for geriatric
cardiac patients. Trial registration: German Clinical Trials Register
(DRKS; http://www.drks.de ; DRKS00030526). Registered on 30 January
2023. Copyright © 2023, BioMed Central Ltd., part of Springer
Nature.

<22>
Accession Number
2023726704
Title
Chronological comparison of TAVI and SAVR stratified to surgical risk: a
systematic review, meta-analysis, and meta-regression: Comparison of TAVI
versus SAVR.
Source
Acta Cardiologica. 78(7) (pp 778-789), 2023. Date of Publication: 2023.
Author
Park D.Y.; An S.; Kassab K.; Jolly N.; Attanasio S.; Sawaqed R.; Malhotra
S.; Doukky R.; Vij A.
Institution
(Park) Department of Medicine, John H. Stroger Jr Hospital of Cook County,
Chicago, IL, United States
(An) Department of Biomedical Science, Seoul National University Graduate
School, Seoul, South Korea
(Kassab) Division of Cardiology, Ascension Borgess Hospital/Michigan State
University, Kalamazoo, MI, United States
(Jolly, Attanasio) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
(Sawaqed) Division of Cardiothoracic Surgery, Cook County Health, Chicago,
IL, United States
(Sawaqed) Division of Cardiothoracic Surgery, Rush Medical College,
Chicago, IL, United States
(Malhotra, Doukky, Vij) Division of Cardiology, Cook County Health,
Chicago, IL, United States
(Malhotra, Doukky, Vij) Division of Cardiology, Rush Medical College,
Chicago, IL, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has been
established as a reasonable alternative to surgical aortic valve
replacement (SAVR) in patients with severe aortic stenosis. However,
long-term outcomes including valve durability and the need for
reintervention are unanswered, especially in younger patients who tend to
be low surgical risk. We performed a meta-analysis comparing clinical
outcomes after TAVI and SAVR over 5 years stratified to low, intermediate,
and high surgical risks. Method(s): We identified propensity
score-matched observational studies and randomised controlled trials
comparing TAVI and SAVR. Primary outcomes, including all-cause mortality,
moderate or severe aortic regurgitation, moderate or severe paravalvular
regurgitation, pacemaker placement, and stroke, were extracted.
Meta-analyses of outcomes after TAVI compared to SAVR were conducted for
different periods of follow-up. Meta-regression was also performed to
analyse the correlation of outcomes over time. Result(s): A total of
36 studies consisting of 7 RCTs and 29 propensity score-matched studies
were selected. TAVI was associated with higher all-cause mortality at 4-5
years in patients with low or intermediate surgical risk. Meta-regression
time demonstrated an increasing trend in the risk of all-cause mortality
after TAVI compared with SAVR. TAVI was generally associated with a higher
risk of moderate or severe aortic regurgitation, moderate or severe
paravalvular regurgitation, and pacemaker placement. Conclusion(s):
TAVI demonstrated an increasing trend of all-cause mortality compared with
SAVR when evaluated over a long-term follow-up. More long-term data from
recent studies using newer-generation valves and state-of-the-art
techniques are needed to accurately assign risks. Copyright ©
2023 Belgian Society of Cardiology.

<23>
Accession Number
2022040851
Title
Surgical versus interventional coronary revascularization in kidney
transplant recipients: a systematic review and meta-analysis.
Source
International Urology and Nephrology. 55(10) (pp 2493-2499), 2023. Date of
Publication: October 2023.
Author
El-Qushayri A.E.; Reda A.
Institution
(El-Qushayri) Faculty of Medicine, Minia University, Minia, Egypt
(Reda) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Publisher
Springer Science and Business Media B.V.
Abstract
Aim: To study the most beneficial coronary revascularization strategy in
kidney transplant recipients (KTR). Method(s): In 16th June 2022 and
updated on 26th February 2023, we searched in five databases including
PubMed for relevant articles. The odds ratio (OR) together with the 95%
confidence interval (95%CI) were used to report the results.
 Result(s): Percutaneous coronary intervention (PCI) was significantly
associated with significant lower in-hospital mortality (OR 0.62; 95%CI
0.51-0.75) and 1-year mortality (OR 0.81; 95%CI 0.68-0.97), but not
overall mortality (mortality at the last follow-up point) (OR 1.05; 95%CI
0.93-1.18) rather than coronary artery bypass graft (CABG). Moreover, PCI
was significantly associated with lower acute kidney injury prevalence (OR
0.33; 95%CI 0.13-0.84) compared to CABG. One study indicated that
non-fatal graft failure prevalence did not differ between the PCI and the
CABG group until 3 years of follow up. Moreover, one study demonstrated a
short hospital length of stay in the PCI group rather than the CABG group.
 Conclusion(s): Current evidence indicated the superiority of PCI than
CABG as a coronary revascularization procedure in short- but not long-term
outcomes in KTR. We recommend further randomized clinical trials for
demonstrating the best therapeutic modality for coronary revascularization
in KTR. Copyright © 2023, The Author(s).

<24>
Accession Number
2026931035
Title
Antiplatelet Resistance in Patients Who Underwent Coronary Artery Bypass
Grafting: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 206 (pp 191-199), 2023. Date of
Publication: 01 Nov 2023.
Author
Comanici M.; Bhudia S.K.; Marczin N.; Raja S.G.
Institution
(Comanici, Bhudia, Raja) Department of Cardiac Surgery, Harefield
Hospital, London, United Kingdom
(Marczin) Department of Anaesthesia & Critical Care, Harefield Hospital,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Antiplatelet therapy (APT) with aspirin and a P2Y12 inhibitor is commonly
given to patients who underwent coronary artery bypass grafting (CABG) to
reduce thrombotic events. APT resistance, the inadequate antiplatelet
effect of these drugs, is a growing concern. This review aimed to assess
APT resistance prevalence in patients who underwent CABG and its impact on
clinical outcomes. We conducted a comprehensive search for relevant
studies published to date. The included studies measured platelet function
through laboratory assays and reported on clinical outcomes in patients
who underwent CABG. The primary outcomes were major adverse cardiovascular
events (MACEs) and mortality, whereas the secondary outcomes included
acute coronary syndrome (ACS), stroke, and thromboembolic events. The
meta-analysis used random-effects models, with heterogeneity assessed
using the I2 statistic. The initial search identified 45
studies, with 11 meeting the inclusion criteria, involving 3,122 patients.
The overall prevalence of APT resistance in patients who underwent CABG
was 39%. Patients with APT resistance had significantly higher risks of
MACEs and death (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.06
to 2.83, p = 0.03) and postoperative myocardial infarction (OR 2.25, 95%
CI 1.13 to 4.48, p = 0.02) than those without resistance. However, no
significant association was found between APT resistance and stroke (OR
2.25, 95% CI 0.80 to 6.35, p = 0.12) or other thromboembolic events (OR
1.72, 95% CI 0.72 to 4.08, p = 0.22). In conclusion, APT resistance is
prevalent in a significant proportion of patients who underwent CABG,
increasing the risk of MACEs and postoperative myocardial infarction.
These findings emphasize the need for further research to develop tailored
antiplatelet strategies in this patient population. Copyright ©
2023

<25>
Accession Number
2026677782
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
Annals of Thoracic Surgery. 116(4) (pp 659-674), 2023. Date of
Publication: October 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, New York, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Aldea) Division of Cardiothoracic Surgery, University of Washington
School of Medicine, Seattle, WA, United States
(Arai) Department of Cardiovascular Surgery, Graduate School of Medical
and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo,
Japan
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, California, United States
(Firestone, Kisson) The Society of Thoracic Surgeons, Chicago, Illinois,
United States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Gomes) Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo
Hospital, Escola Paulista de Medicina, Universidade Federal de Sao Paulo
(Unifesp), SP, 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, New York, United States
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University, Baltimore, Maryland, United States
(Navia) Department of Cardiac Surgery, ICBA Instituto Cardiovascular,
Buenos Aires, Argentina
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
New York, New York, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, Ohio, United States
(Schwann) Division of Cardiac Surgery, Baystate Health, Springfield,
Massachusetts, United States
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital,
University of Oxford, Oxford, United Kingdom
(Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
University of Melbourne, Melbourne, Australia
(Wyler von Ballmoos) Division of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Houston, Texas, United States
Publisher
Elsevier Inc.

<26>
Accession Number
2026533738
Title
Wearable Cardiac Rhythm Monitoring Device for Detection of Postoperative
Atrial Fibrillation.
Source
Annals of Thoracic Surgery. 116(4) (pp 854-858), 2023. Date of
Publication: October 2023.
Author
Hibino M.; Pandey A.K.; Verma S.; Puar P.; Teoh H.; Quan A.; Verma R.; Yau
T.M.; Bisleri G.; Yanagawa B.; Mazer C.D.; Verma A.; Ha A.C.T.
Institution
(Hibino) Division of Cardiothoracic Surgery, Emory University School of
Medicine, Atlanta, Georgia, United States
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Verma, Puar, Teoh, Quan, Bisleri, Yanagawa) Division of Cardiac Surgery,
St. Michael's Hospital of Unity Health Toronto, University of Toronto,
Toronto, ON, Canada
(Verma, Yau, Bisleri, Yanagawa) Division of Cardiovascular Surgery,
Department of Surgery, University of Toronto, Toronto, ON, Canada
(Teoh) Division of Endocrinology and Metabolism, St. Michael's Hospital of
Unity Health Toronto, Toronto, ON, Canada
(Verma) Royal College of Surgeons in Ireland, Dublin, Ireland
(Yau, Ha) Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital of Unity Health
Toronto, University of Toronto, Toronto, ON, Canada
(Verma) Division of Cardiology, McGill University, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: This study evaluated the use of a wearable, patch-based cardiac
rhythm monitoring device in detecting postoperative atrial fibrillation
(POAF) among cardiac surgical patients within 30 days after hospital
discharge. Description: From the SEARCH-AF (The Post-Surgical Enhanced
Monitoring for Cardiac Arrhythmias and Atrial Fibrillation) CardioLink-1
trial, this study examined rates of POAF according to surgery type and the
incremental value of continuous cardiac rhythm monitoring among patients
who underwent valve surgery. The primary outcome was cumulative atrial
fibrillation or atrial flutter lasting for >=6 minutes detected by
continuous monitoring or atrial fibrillation or atrial flutter documented
by a 12-lead electrocardiogram within 30 days of randomization.
Evaluation: The primary outcome occurred in 8.2%, 13.5%, and 21.2% of
patients who underwent isolated coronary artery bypass grafting (CABG),
isolated valve surgery, and combined CABG and valve surgery. Relative to
patients who underwent isolated CABG, those patients who had valve surgery
were more likely to experience POAF. A higher diagnostic yield was
obtained when the patch-based cardiac rhythm monitor was applied in
patients who underwent valve surgery. Conclusion(s): Use of a
wearable, patch-based cardiac monitoring device was an effective detection
strategy among patients undergoing valve surgery, given their higher risk
of developing POAF. Copyright © 2023 The Society of Thoracic
Surgeons

<27>
Accession Number
2025326659
Title
Systematic review and meta-analysis of the treatment strategies for
coronary artery bypass graft patients with concomitant carotid artery
atherosclerotic disease.
Source
Journal of Vascular Surgery. 78(4) (pp 1083-1094.e8), 2023. Date of
Publication: October 2023.
Author
Tsukagoshi J.; Yokoyama Y.; Fujisaki T.; Takagi H.; Shirasu T.; Kuno T.
Institution
(Tsukagoshi) Department of Surgery, University of Texas Medical Branch,
Galveston, TX, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, NY, United States
(Fujisaki) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Shirasu) Division of Vascular Surgery, Department of Surgery, The
University of Tokyo, Tokyo, Japan
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: Stroke is one of the devastating complications after coronary
artery bypass graft (CABG). Underlying carotid artery atherosclerotic
disease is reported to be an independent risk factor. The optimal
treatment strategy for these patients remains under debate.
 Method(s): We aimed to perform a network meta-analysis to evaluate
the safety and efficacy of additional carotid interventions for patients
with concomitant carotid artery atherosclerotic disease who require CABG
by comparing perioperative adverse event rates. All articles through
February 2022 were searched using MEDLINE and EMBASE to identify studies
that investigated outcomes of CABG only as well as additional staged vs
combined carotid interventions by both carotid endarterectomy (CEA) and
carotid artery stenting (CAS). Result(s): Two randomized controlled
trials and 23 observational studies were included, yielding a total of
32,473 patients who underwent combined CEA and CABG (n = 20,204), CEA and
staged CABG (n = 6882), CABG and staged CEA (n = 340), CAS and CABG
regardless of timing and sequences (n = 1224), and CABG only (n = 3823).
No strategy showed a significant advantage over CABG only in all
perioperative outcomes. CEA and staged CABG was associated with the lowest
perioperative stroke/transient ischemic attack (TIA) rate, significantly
lower compared with CAS and CABG (odds ratio [OR], 0.52; 95% confidence
interval [CI], 0.36-0.76) as well as CABG and staged CEA (OR, 0.41; 95%
CI, 0.23-0.74), but was also associated with the highest perioperative
mortality (OR, 2.50; 95% CI, 1.67-3.85, vs CAS and CABG) and myocardial
infarction rate (OR, 3.70 [95% CI, 1.16-12.5] and OR, 2.50 [95% CI,
1.35-4.55] vs CAS and CABG, vs combined CEA and CABG, respectively).
 Conclusion(s): CEA and staged CABG are associated with low
perioperative stroke/transient ischemic attack rates with a tradeoff of
higher mortality and myocardial infarction rate. No strategy showed a
significant advantage over the CABG-only strategy in all perioperative
outcomes, outlining the importance of a tailored approach and determining
proper indications for carotid intervention in these
patients. Copyright © 2023 Society for Vascular Surgery

<28>
Accession Number
2017048533
Title
Impact of the Southern Thoracic Surgical Association James W. Brooks
Scholarship.
Source
Annals of Thoracic Surgery. 116(4) (pp 830-833), 2023. Date of
Publication: October 2023.
Author
Kim M.P.; Mavroudis C.; Jacobs J.P.; Yang S.C.
Institution
(Kim) Division of Thoracic Surgery, Department of Surgery, Houston
Methodist Hospital, Houston, Texas, United States
(Mavroudis) Pediatric Cardiothoracic Surgery, Peyton Manning Children's
Hospital, Indianapolis, IN, United States
(Jacobs) Division of Cardiovascular Surgery, Department of Surgery,
University of Florida, Gainesville, FL, United States
(Yang) Division of Thoracic Surgery, Department of Surgery, The Johns
Hopkins Medical Institutions, Baltimore, Maryland, United States
Publisher
Elsevier Inc.
Abstract
Background: Medical students and general surgery residents often do not
get exposure to cardiothoracic surgery (CTS) because of a decreased
emphasis on CTS rotations during their training. The Southern Thoracic
Surgical Association (STSA) began offering the Brooks Scholarship to
medical students in 2010 and general surgery residents in 2014 to promote
CTS. This study examines the impact of the scholarship. Method(s): We
examined the history of the award and how STSA administers the award. Next
we examined the impact of the award by evaluating the number of medical
students and residents who are tracked to complete a CTS program. Finally
we performed an analysis of the academic output of the awardees who have
completed or were tracked to complete a CTS program. Result(s): The
scholarship was developed to honor the memory of past STSA President Dr
James W. Brooks. The award is administered through the STSA scholarship
committee and provides medical students and residents funds to attend the
STSA annual meeting and the opportunity to spend time with a mentor during
the meeting. Eighty-eight percent of medical student recipients (21/24)
and 100% of general surgery resident recipients (15/15) have completed or
are on track to complete a CTS program. The 36 recipients going into CTS
have published a total of 823 papers and 9240 articles have cited those
papers. Conclusion(s): The STSA medical student and general surgery
Brooks scholarship awards were associated with completing or pursuing a
career in CTS. STSA should continue the Brooks scholarship to attract
talented medical students and residents to CTS. Copyright © 2023
The Society of Thoracic Surgeons

<29>
Accession Number
642044868
Title
Aortic valve repair in neonates, infants and children: a systematic
review, meta-analysis and microsimulation study.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 64(3) (no pagination),
2023. Date of Publication: 07 Sep 2023.
Author
Notenboom M.L.; Rhellab R.; Etnel J.R.G.; van den Bogerd N.; Veen K.M.;
Taverne Y.J.H.J.; Helbing W.A.; van de Woestijne P.C.; Bogers A.J.J.C.;
Takkenberg J.J.M.
Institution
(Notenboom, Rhellab, Etnel, van den Bogerd, Veen, Taverne, van de
Woestijne, Bogers, Takkenberg) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Helbing) Department of Paediatrics, Div. of Cardiology, Erasmus
University Medical Centre, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To support clinical decision-making in children with aortic
valve disease, by compiling the available evidence on outcome after
paediatric aortic valve repair (AVr). METHOD(S): A systematic review
of literature reporting clinical outcome after paediatric AVr (mean age at
surgery <18years) published between 1 January 1990 and 23 December 2021
was conducted. Early event risks, late event rates and time-to-event data
were pooled. A microsimulation model was employed to simulate the lives of
individual children, infants and neonates following AVr. RESULT(S):
Forty-one publications were included, encompassing 2 623 patients with 17
217 patient-years of follow-up (median follow-up: 7.3years; range:
1.0-14.4 years). Pooled mean age during repair for aortic stenosis in
children (<18 years), infants (<1 year) or neonates (<30 days) was
5.2+/-3.9years, 35+/-137days and 11+/-6days, respectively. Pooled early
mortality after stenosis repair in children, infants and neonates,
respectively, was 3.5% (95% confidence interval: 1.9-6.5%), 7.4%
(4.2-13.0%) and 10.7% (6.8-16.9%). Pooled late reintervention rate after
stenosis repair in children, infants and neonates, respectively, was
3.31%/year (1.66-6.63%/year), 6.84%/year (3.95-11.83%/year) and 6.32%/year
(3.04-13.15%/year); endocarditis 0.07%/year (0.03-0.21%/year), 0.23%/year
(0.07-0.71%/year) and 0.49%/year (0.18-1.29%/year); and valve thrombosis
0.05%/year (0.01-0.26%/year), 0.15%/year (0.04-0.53%/year) and 0.19%/year
(0.05-0.77%/year). Microsimulation-based mean life expectancy in the first
20years for children, infants and neonates with aortic stenosis,
respectively, was 18.4years (95% credible interval: 18.1-18.7 years;
relative survival compared to the matched general population: 92.2%),
16.8years (16.5-17.0 years; relative survival: 84.2%) and 15.9years
(14.8-17.0 years; relative survival: 80.1%). Microsimulation-based 20-year
risk of reintervention in children, infants and neonates, respectively,
was 75.2% (72.9-77.2%), 53.8% (51.9-55.7%) and 50.8% (47.0-57.6%).
 CONCLUSION(S): Long-term outcomes after paediatric AVr for stenosis
are satisfactory and dependent on age at surgery. Despite a high hazard of
reintervention for valve dysfunction and slightly impaired survival
relative to the general population, AVr is associated with low
valve-related event occurrences and should be considered in children with
aortic valve disease. Copyright © The Author(s) 2023. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<30>
Accession Number
2027058343
Title
CONTEXTUALLY TAILORED TEXT MESSAGES TO AUGMENT CARDIAC REHABILITATION: THE
VIRTUAL APPLICATION-SUPPORTED ENVIRONMENT TO INCREASE EXERCISE (VALENTINE)
STUDY.
Source
Cardiovascular Digital Health Journal. Conference: HRX 2023. Seattle
United States. 4(5 Supplement) (pp S4-S5), 2023. Date of Publication:
October 2023.
Author
Gupta K.; Shi J.; Dempsey W.; Mukherjee B.; Kheterpal S.; Klasnja P.;
Nallamothu B.K.; Golbus J.
Publisher
Elsevier Inc.
Abstract
Background: We previously found text messages (TM) delivered as part of a
comprehensive mobile health intervention may augment physical activity
levels in patients enrolled in cardiac rehabilitation (CR) during its
initiation phase, although optimal TM tailoring is unknown.
 Objective(s): Determine optimal time and environment to deliver TMs
to CR enrollees after initiating CR. Method(s): We conducted a
micro-randomized trial that delivered TMs to low and moderate-risk
patients, ages 18-75 enrolled in CR. Participants received a compatible
smartwatch (Apple Watch or FitBit Versa 2) and were randomized to receive
a TM or no TM at 4 user-selected time points over 6-months. TMs were meant
to be actionable in real-time and were tailored on time of day, day of
week, weather, and phase of CR. TMs were walking or anti-sedentary (e.g.,
stretching) and half were personalized with participants' names. Our
primary outcome was step count 60-minutes following a TM. To account for
measurement differences between devices, we assessed results separately by
device and focused on the initiation phase of the study (i.e., 0-4 weeks
after enrollment). Result(s): 108 participants were included with
mean age 59.5 (10.7) years, 36 (32.4%) female, and 68 (63%) an Apple
Watch. During the initiation phase of the study, use of TMs increased step
counts by 17% in the 60-minutes after a TM for Fitbit users and by a
non-significant 10% for Apple Watch users. For Apple Watch users, walking
TMs significantly increased step count vs anti-sedentary TMs, and the
impact of TMs was greatest for younger participants as compared to older
participants (Table 1). For FitBit users, TMs were more effective at lunch
vs afternoon and for CR participants who underwent valve repair (as
compared to PCI or CABG) (Table 2). Personalization did not impact TM
efficacy. Conclusion(s): TMs can augment the benefits of CR early
after initiation with the potential for differential effects across
varying contexts and scope for optimization. [Formula presented] [Formula
presented] Copyright © 2023

<31>
Accession Number
2025456457
Title
Effect of perioperative goal-directed fluid therapy on postoperative
complications after thoracic surgery with one-lung ventilation: a
systematic review and meta-analysis.
Source
World Journal of Surgical Oncology. 21(1) (no pagination), 2023. Article
Number: 297. Date of Publication: December 2023.
Author
Li X.; Zhang Q.; Zhu Y.; Yang Y.; Xu W.; Zhao Y.; Liu Y.; Xue W.; Fang Y.;
Huang J.
Institution
(Li, Zhang, Zhu, Yang, Xu, Zhao, Liu, Xue, Fang, Huang) Department of
Anesthesiology, The First Affiliated Hospital of Kunming Medical
University, KunMing, China
Publisher
BioMed Central Ltd
Abstract
Background: An understanding of the impact of goal-directed fluid therapy
(GDFT) on the outcomes of patients undergoing one-lung ventilation (OLV)
for thoracic surgery remains incomplete and controversial. This
meta-analysis aimed to assess the effect of GDFT compared to other fluid
therapy strategies on the incidence of postoperative complications in
patients with OLV. Method(s): The Embase, Cochrane Library, Web of
Science, and MEDLINE via PubMed databases were searched from their
inception to November 30, 2022. Forest plots were constructed to present
the results of the meta-analysis. The quality of the included studies was
evaluated using the Cochrane Collaboration tool and Risk Of Bias In
Non-Randomized Study of Interventions (ROBINS-I). The primary outcome was
the incidence of postoperative complications. Secondary outcomes were the
length of hospital stay, PaO<inf>2</inf>/FiO<inf>2</inf> ratio, total
fluid infusion, inflammatory factors (TNF-alpha, IL-6), and postoperative
bowel function recovery time. Result(s): A total of 1318 patients
from 11 studies were included in this review. The GDFT group had a lower
incidence of postoperative complications [odds ratio (OR), 0.47; 95%
confidence interval (95% CI), 0.29-0.75; P = 0.002; I 2, 67%],
postoperative pulmonary complications (OR 0.48, 95% CI 0.27-0.83; P =
0.009), and postoperative anastomotic leakage (OR 0.51, 95% CI 0.27-0.97;
P = 0.04). The GDFT strategy reduces total fluid infusion.
 Conclusion(s): GDFT is associated with lower postoperative
complications and better survival outcomes after thoracic surgery for
OLV. Copyright © 2023, BioMed Central Ltd., part of Springer
Nature.

<32>
Accession Number
2027036375
Title
Frequency and clinical significance of atrial cavities in situ thrombosis:
A large-scale study and literature review.
Source
Journal of Cardiovascular Echography. 33(2) (pp 61-68), 2023. Date of
Publication: April 2023.
Author
Cresti A.; Baratta P.; Aloia E.; De Sensi F.; Solari M.; Limbruno U.
Institution
(Cresti, Baratta, Aloia, De Sensi, Limbruno) Department of Cardiological,
Misericordia Hospital, Grosseto, Italy
(Solari) Department of Cardiological, S. Giuseppe Hospital, Empoli, Italy
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Atrial tachyarrhythmias are the main cause of atrial
thrombosis, and are usually in the left appendage. The prevalence and
causes of endocavitarian thrombosis have not been investigated in recent
large-scale studies. Aim of our work was to describe the epidemiology, the
clinical characteristics and predisposing factors of 'extra-appendicular'
atrial thrombosis and to report a systematic review of recent literature.
 Methods and Results: 5,862 consecutive adult patients referred to a
transesophageal echocardiographic exam, were enrolled. A total of 175
subjects with Atrial Thrombosis were found with a prevalence of 2.98%;
among those 22 was found in left (0.38%) and 2 in the right (0.03%)
atrium. Among the 22 patients with left atrial thrombosis, 8 were
associated with prosthetic valves, 4 with mitral stenosis and the
remaining with hypercoagulative conditions (cancer, septic shock,
eosinophilic pneumonia, cardiogenic shock and warfarin under-dosage in
permanent atrial fibrillation and decompensated heart failure). Cancer was
associated in one of the two patients with a right atrial clot. The review
of the literature from 2000 to December 2019 revealed conflicting results
of 48 case reports of atrial cavity thrombosis; pooling this data proved
the rarity of extra-appendage thrombosis and confirmed its association
with a valvular heart disease or a systemic hypercoagulable state.
 Conclusion(s): Atrial 'extra-appendage' thrombosis is a rare
condition usually associated to 'valvular' atrial fibrillation (such as
prosthetic valves and mitral stenosis). A minority, but significant, cases
are secondary to a thrombophilic conditions. In absence of valvular heart
disease an underlying condition should be sought. Copyright ©
2023 Wolters Kluwer Medknow Publications. All rights reserved.

<33>
Accession Number
2026985268
Title
Rationale and design of the ULYSS trial: A randomized multicenter
evaluation of the efficacy of early Impella CP implantation in acute
coronary syndrome complicated by cardiogenic shock.
Source
American Heart Journal. 265 (pp 203-212), 2023. Date of Publication:
November 2023.
Author
Delmas C.; Laine M.; Schurtz G.; Roubille F.; Coste P.; Leurent G.;
Hraiech S.; Pankert M.; Gonzalo Q.; Dabry T.; Letocart V.; Loubiere S.;
Resseguier N.; Bonello L.
Institution
(Delmas) Department of Cardiology, Intensive Cardiac Care Unit, Rangueil
University Hospital, Toulouse, France
(Delmas) INSERM U1048, I2MC, Toulouse, France
(Delmas) REICATRA, Institut Saint Jacques, Toulouse, France
(Laine, Bonello) Aix-Marseille Universite, F-13385 Marseille, France;
Intensive Care Unit, Department of Cardiology, Assistance
Publique-Hopitaux de Marseille, Hopital Nord, F-13385 Marseille, France;
Mediterranean Association for Research and Studies in Cardiology (MARS
Cardio), Marseille, France
(Schurtz) Department of Cardiology, Intensive Cardiac Care Unit, Lille
University Hospital, Lille, France
(Roubille) PhyMedExp, Universite de Montpellier, INSERM, CNRS, Cardiology
Department, CHU de Montpellier, France
(Coste) Cardiology Department, Bordeaux University Hospital, Pessac,
France
(Leurent) Intensive Cardiac Care Unit, Cardiology Department, Rennes
University Hospital, Rennes, France
(Hraiech) Medical Intensive Care Unit, Assistance Publique-Hopitaux de
Marseille, Hopital Nord, Marseille, France
(Pankert) Cardiology Department, CH Avignon, France
(Gonzalo) Cardiology Department, CH Toulon, France
(Dabry) Cardiology Department, CH Aix en Provence, France
(Letocart) Department of Cardiology, Nantes Universite, CHU Nantes,
l'institut du thorax, Nantes, France
(Loubiere, Resseguier) Department of Epidemiology and Health Economics,
APHM, Marseille, France
(Loubiere, Resseguier) CEReSS-Health Service Research and Quality of Life
Center, School of Medicine Aix-Marseille University Marseille France,
France
Publisher
Elsevier Inc.
Abstract
Context: Despite 20 years of improvement in acute coronary syndromes care,
patients with acute myocardial infarction complicated by cardiogenic shock
(AMICS) remains a major clinical challenge with a stable incidence and
mortality. While intra-aortic balloon pump (IABP) did not meet its
expectations, percutaneous mechanical circulatory supports (pMCS) with
higher hemodynamic support, large availability and quick implementation
may improve AMICS prognosis by enabling early hemodynamic stabilization
and unloading. Both interventional and observational studies suggested a
clinical benefit in selected patients of the IMPELLAR CP device
within in a well-defined therapeutic strategy. While promising, these
preliminary results are challenged by others suggesting a higher rate of
complications and possible poorer outcome. Given these conflicting data
and its high cost, a randomized clinical trial is warranted to delineate
the benefits and risks of this new therapeutic strategy. Design(s):
The ULYSS trial is a prospective randomized open label, 2 parallel
multicenter clinical trial that plans to enroll patients with AMICS for
whom an emergent percutaneous coronary intervention (PCI) is intended.
Patients will be randomized to an experimental therapeutic strategy with
pre-PCI implantation of an IMPELLAR CP device on top of
standard medical therapy or to a control group undergoing PCI and standard
medical therapy. The primary objective of this study is to compare the
efficacy of this experimental strategy by a composite end point of death,
need to escalate to ECMO, long-term left ventricular assist device or
heart transplantation at 1 month. Among secondary objectives 1-year
efficacy, safety and cost effectiveness will be assessed. Clinical Trial
Registration: NCT05366452 Copyright © 2023 Elsevier Inc.

<34>
Accession Number
642280271
Title
The role of lung ultrasound for detecting atelectasis, consolidation,
and/or pneumonia in the adult cardiac surgery population: A scoping review
of the literature.
Source
Australian critical care : official journal of the Confederation of
Australian Critical Care Nurses. (no pagination), 2023. Date of
Publication: 12 Sep 2023.
Author
Churchill L.J.; Tronstad O.; Mandrusiak A.M.; Waldmann J.Y.; Thomas P.J.
Institution
(Churchill) Physiotherapy Department, The Prince Charles Hospital,
Chermside, QLD, 4032, Australia; School of Rehabilitation and Health
Sciences, The University of Queensland, QLD, 4072, Australia; Critical
Care Research Group, The Prince Charles Hospital, Chermside, QLD, 4032,
Australia
(Tronstad) Physiotherapy Department, The Prince Charles Hospital,
Chermside, QLD, 4032, Australia; Critical Care Research Group, The Prince
Charles Hospital, Chermside, QLD, 4032, Australia
(Mandrusiak) School of Rehabilitation and Health Sciences, University of
Queensland 4072, Australia
(Waldmann) Library Services, Prince Charles Hospital 4032, Australia
(Thomas) Department of Physiotherapy, Royal Brisbane and Women's Hospital,
Herston, Australia; Department of Intensive Care, Royal Brisbane and
Women's Hospital, Herston, Australia
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Postoperative pulmonary complications (PPCs) frequently occur
after cardiac surgery and may lead to adverse patient outcomes.
Traditional diagnostic tools such as auscultation or chest x-ray have
inferior diagnostic accuracy compared to the gold standard (chest computed
tomography). Lung ultrasound (LUS) is an emerging area of research
combating these issues. However, no review has employed a formal search
strategy to examine the role of LUS in identifying the specific PPCs of
atelectasis, consolidation, and/or pneumonia or investigated the ability
of LUS to predict these complications in this cohort. The objective of
this study was to collate and present evidence for the use of LUS in the
adult cardiac surgery population to specifically identify atelectasis,
consolidation, and/or pneumonia. REVIEW METHOD USED: A scoping review of
the literature was completed using predefined search terms across six
databases which identified 1432 articles. One additional article was
included from reviewing reference lists. Six articles met the inclusion
criteria, providing sufficient data for the final analysis. DATA SOURCES:
Six databases were searched: MEDLINE, Embase, CINAHL, Scopus, CENTRAL, and
PEDro. This review was not registered. REVIEW METHODS: The review followed
the PRISMA Extension for Scoping Reviews. RESULT(S): Several LUS
methodologies were reported across studies. Overall, LUS outperformed all
other included bedside diagnostic tools, with superior diagnostic accuracy
in identifying atelectasis, consolidation, and/or pneumonia. Incidences of
PPCs tended to increase with each subsequent timepoint after surgery and
were better identified with LUS than all other assessments. A change in
diagnosis occurred at a rate of 67% with the inclusion of LUS and
transthoracic echocardiography in one study. Pre-established assessment
scores were improved by substituting chest x-rays with LUS scans.
 CONCLUSION(S): The results of this scoping review support the use of
LUS as a diagnostic tool after cardiac surgery; however, they also
highlighted a lack of consistent methodologies used. Future research is
required to determine the optimal methodology for LUS in diagnosing PPCs
in this cohort and to determine whether LUS possesses the ability to
predict these complications and guide proactive respiratory supports after
extubation. Copyright © 2023 Australian College of Critical Care
Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

<35>
Accession Number
642277737
Title
Effects of yoga on anxiety, pain, inflammatory and stress biomarkers in
patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
Complementary therapies in clinical practice. 53 (pp 101798), 2023. Date
of Publication: 09 Sep 2023.
Author
Chandrababu R.; Ramesh J.; Jagadeesh N.S.; Guo P.; Reddy G.G.; Hayter M.
Institution
(Chandrababu) Department of Medical Surgical Nursing, Sri Ramachandra
Faculty of Nursing, Sri Ramachandra Institute of Higher Education and
Research, Porur, Chennai, 600116, India
(Ramesh) Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of
Higher Education and Research, Porur, Chennai, 600116, India
(Jagadeesh) Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute
of Higher Education and Research, Porur, Chennai, 600116, India.
Electronic address: sjnalini@sriramachandra.edu.in
(Guo) School of Nursing and Midwifery, Institute of Clinical Sciences,
College of Medical and Dental Sciences, University of Birmingham,
Birmingham, United Kingdom
(Reddy) Centre for Integrative Medicine and Research, Manipal Academy of
Higher Education, Manipal, Karnataka 576104, India
(Hayter) Department of Nursing, Manchester Metropolitan University, All
Saints Building, Manchester M15 6BH, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: The most common surgical method of managing coronary artery
disease is coronary artery bypass grafting (CABG). Stress, anxiety, and
pain are commonly identified postoperative symptoms and are closely
correlated to patient recovery. OBJECTIVE(S): The purpose of this
review was to investigate the effects of yoga interventions on anxiety,
pain, inflammatory and stress biomarkers in CABG surgery patients.
 METHOD(S): and analysis: The databases PUBMED, The Cochrane CENTRAL,
EMBASE, CINAHL, Scopus, and Web of Science were comprehensively searched
from the inception to December 2022. The quantitative research studies
that evaluated the effects of yoga on anxiety, pain, inflammatory and
stress biomarkers in CABG patients were included. This systematic review
and meta-analysis followed the Cochrane guidelines and is reported using
the PRISMA checklist. The RevMan 5.4 software was used for the
meta-analysis. RESULT(S): Seventeen studies met the inclusion
criteria, representing 1227 patients with a mean age of 58 years. All
studies have reported that yoga interventions significantly reduced
anxiety, pain, inflammatory and stress biomarkers in the experimental
group compared to the control group. According to the GRADE criteria,
moderate quality of evidence was found on effects of yoga intervention in
CABG surgery patients. CONCLUSION(S): Yoga has been shown to benefit
patients undergoing CABG surgery. It can be used as an adjunctive
intervention. However, more rigorous randomized controlled trials are
required to generate high-quality evidence for yoga interventions.
REGISTRATION: PROSPERO CRD42020175833. Copyright © 2023 Elsevier
Ltd. All rights reserved.

<36>
Accession Number
2026717571
Title
Outcomes Based on Angiographic vs Functional Significance of Complex
3-Vessel Coronary Disease: FAME 3 Trial.
Source
JACC: Cardiovascular Interventions. 16(17) (pp 2112-2119), 2023. Date of
Publication: 11 Sep 2023.
Author
Kobayashi Y.; Takahashi T.; Zimmermann F.M.; Otsuki H.; El Farissi M.;
Oldroyd K.G.; Wendler O.; Reardon M.J.; Woo Y.J.; Yeung A.C.; De Bruyne
B.; Pijls N.H.J.; Fearon W.F.
Institution
(Kobayashi) New York-Presbyterian Brooklyn Methodist Hospital, Weill
Cornell Medical College, Brooklyn, NY, United States
(Takahashi) Jacobi Medical Center, Albert Einstein College of Medicine,
Bronx, NY, United States
(Zimmermann, El Farissi, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Otsuki, Woo, Yeung, Fearon) Stanford University School of Medicine and
Stanford Cardiovascular Institute, Stanford, CA, United States
(Oldroyd) University of Glasgow, Glasgow, United Kingdom
(Wendler) King's College Hospital, London, United Kingdom
(Reardon) Houston Methodist Hospital, Houston, TX, United States
(De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(Fearon) VA Palo Alto Medical Systems, Palo Alto, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: The functional SYNTAX score (FSS), which incorporates
functional information as assessed by fractional flow reserve (FFR), is a
better predictor of outcome after percutaneous coronary intervention (PCI)
in patients with less complex coronary artery disease (CAD).
 Objective(s): This study sought to test the prognostic value of the
FSS in patients with complex CAD eligible for coronary artery bypass
grafting (CABG). Method(s): The FAME 3 (Fractional Flow Reserve
Versus Angiography for Multivessel Evaluation 3) trial compared FFR-guided
PCI with CABG in patients with angiographic 3-vessel CAD. In this
prespecified substudy, the angiographic core laboratory calculated the
SYNTAX score (SS) and then the FSS by eliminating lesions that were not
significant based on FFR. Outcomes in the PCI patients based on the FSS
and the SS were compared to each other and to the patients treated with
CABG. Result(s): The FSS reclassified more than one-quarter of
patients from an SS >22 to an FSS <=22. In the 50% of PCI patients who had
an FSS <=22, the primary endpoint occurred at a similar rate to patients
treated with CABG (P = 0.77). The primary endpoint in patients without
functionally significant 3-vessel CAD was similar to the CABG group (P =
0.97). The rate of myocardial infarction and revascularization among all
deferred lesions was 0.5% and 3.2%, respectively. Conclusion(s): By
measuring the FSS, one can identify 50% of patients who have a similar
outcome at 1 year with PCI compared with CABG. Lesions deferred from PCI
based on FFR have a low event rate. Copyright © 2023 American
College of Cardiology Foundation

<37>
[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.

<38>
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.

<39>
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.

<40>
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.

<41>
Accession Number
2025442876
Title
Short-term antithrombotic strategies after left atrial appendage
occlusion: a systematic review and network meta-analysis.
Source
Frontiers in Pharmacology. 14 (no pagination), 2023. Article Number:
1159857. Date of Publication: 2023.
Author
Wang L.-M.; Chen Y.; Xu L.-L.; Dai M.-F.; Ke Y.-J.; Wang B.-Y.; Zhou L.;
Zhang J.-F.; Wu Z.-Q.; Zhou Y.-J.; Gu Z.-C.; Xu H.
Institution
(Wang, Chen, Xu, Dai, Wang, Zhou, Xu) Department of Pharmacy, China
Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing, China
(Wang, Chen, Xu, Dai) School of Basic Medicine and Clinical Pharmacy,
China Pharmaceutical University, Nanjing, China
(Ke) Department of Pharmacy, Anqing Municipal Hospital, Affiliated with
Anhui Medical University, Anqing, China
(Zhang) Nanjing Foreign Language School, Nanjing, China
(Wu) Nanjing Jinling High School International Department, Nanjing, China
(Zhou) Department of Respiratory and Critical Care Medicine, Nanjing Drum
Tower Hospital, The Affiliated Hospital of Nanjing University Medical
School, Nanjing, China
(Gu) Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
Publisher
Frontiers Media SA
Abstract
Background: Percutaneous left atrial appendage occlusion (LAAO) has
emerged as a stroke prevention strategy in patients with nonvalvular
atrial fibrillation (NVAF), and these patients were required to receive
antithrombotic therapy post-procedure. However, the optimal antithrombotic
strategy after LAAO remains controversial. This study explored the safety
and efficacy of different antithrombotic strategies after LAAO through a
network comparison method. Method(s): We systematically searched the
MEDLINE, Embase, and Cochrane Library databases for studies that reported
the interested efficacy and safety outcomes (stroke, device-related
thrombus (DRT), and major bleeding) of different antithrombotic strategies
[DAPT (dual antiplatelet therapy), DOACs (direct oral anticoagulants), and
VKA (vitamin k antagonist)] in patients who had experienced LAAO. Pairwise
comparisons and network meta-analysis were performed for the interested
outcomes. Risk ratios (RRs) with their confidence intervals (CIs) were
calculated using a random-effects model. The rank of the different
strategies was calculated using the surface under the cumulative ranking
curve (SUCRA). Result(s): Finally, 10 observational studies involving
1,674 patients were included. There was no significant difference in
stroke, DRT, and major bleeding among the different antithrombotic
strategies (DAPT, DOACs, and VKA). Furthermore, DAPT ranked the worst in
terms of stroke (SUCRA: 19.8%), DRT (SUCRA: 3.6%), and major bleeding
(SUCRA: 6.6%). VKA appeared to be superior to DOACs in terms of stroke
(SUCRA: 74.9% vs. 55.3%) and DRT (SUCRA: 82.3% vs. 64.1%) while being
slightly inferior to DOACs in terms of major bleeding (SUCRA: 71.0% vs.
72.4%). Conclusion(s): No significant difference was found among
patients receiving DAPT, DOACs, and VKA in terms of stroke, DRT, and major
bleeding events after LAAO. The SUCRA indicated that DAPT was ranked the
worst among all antithrombotic strategies due to the higher risk of
stroke, DRT, and major bleeding events, while VKAs were ranked the
preferred antithrombotic strategy. However, DOACs are worthy of
consideration due to their advantage of convenience. Copyright ©
2023 Wang, Chen, Xu, Dai, Ke, Wang, Zhou, Zhang, Wu, Zhou, Gu and Xu.

<42>
Accession Number
2025412531
Title
Post-TAVR patients with atrial fibrillation: are NOACs better than VKAs?-A
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1175215. Date of Publication: 2023.
Author
Sang W.; Jian Y.; Zhang X.; Han Y.; Wang F.; Wang L.; Yang S.;
Wubulikasimu S.; Yang L.; Sun H.; Li Y.
Institution
(Wang, Sang, Jian, Zhang, Han, Wang, Wang, Yang, Wubulikasimu, Yang, Sun,
Li) Cardiac Pacing and Electrophysiology Department, The First Affiliated
Hospital of Xinjiang Medical University, Urumqi, China
(Wang, Sang, Jian, Zhang, Han, Wang, Wang, Yang, Wubulikasimu, Yang, Sun,
Li) Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac
Remodeling, The First Affiliated Hospital of Xinjiang Medical University,
Urumqi, China
Publisher
Frontiers Media SA
Abstract
Objective: This study aimed to compare the efficacy of novel oral
anticoagulants (NOACs) with traditional anticoagulants vitamin K
antagonists (VKAs) in patients with atrial fibrillation (AF) post
transcatheter aortic valve replacement (TAVR). Method(s): Studies
comparing the usage of NOACs and VKAs in AF patients with oral
anticoagulant indication post-TAVR were retrieved from PubMed, EMBASE,
Medline, and Cochrane databases from their building-up to Jan. 2023. The
literature was screened in line of inclusion and exclusion criteria. Risk
ratio (RR) or odds ratio (OR),95% confidence interval (CI) and number
needed to treat (NNT) were calculated for four main indexes that composite
endpoints composed mainly of any clinically relevant risk events, stroke,
major bleeding, and all-cause mortality. Subsequently, a meta-analysis was
performed using the RevMan5.3 and Stata 16.0 software. Result(s): In
the aggregate of thirteen studies, contained 30388 post-TAVR patients with
AF, were included in this meta-analysis. Our results indicated that there
was no significant difference in stroke between the NOACs group and the
VKAs group, and the NOACs group had a numerically but non-significantly
higher number of composite endpoint events compared with the other group.
Nevertheless, the incidence of major bleeding [11.29% vs. 13.89%, RR 0.82,
95%CI (0.77,0.88), P < 0.00001, I2 = 69%, NNT = 38] and all-cause
mortality [14.18% vs. 17.61%, RR 0.83, 95%CI (0.79,0.88), p < 0.00001, I2
= 82%, NNT = 29] were significantly lower in the NOACs group than another
group. Conclusion(s): Taken together, our data indicated that the
usage of NOACs reduced the incidence of major bleeding and all-cause
mortality compared to VKAs in post-TAVR patients with AF. Copyright
2023 Wang, Sang, Jian, Zhang, Han, Wang, Wang, Yang, Wubulikasimu, Yang,
Sun and Li.

<43>
Accession Number
2022914360
Title
Clinical characteristics, evaluation and outcomes of chylopericardium: A
systematic review.
Source
Heart. 109(17) (pp 1281-1285), 2023. Date of Publication: 01 Sep 2023.
Author
Verma B.; Kumar A.; Verma N.; Agrawal A.; Yesilyaprak A.; Furqan M.M.;
Mahalwar G.; Berglund F.; Manna S.; Schleicher M.; Raeisi-Giglou P.;
Nasser M.; Jabri A.; Wang T.K.M.; Klein A.L.
Institution
(Verma, Kumar, Agrawal, Yesilyaprak, Furqan, Mahalwar, Berglund, Wang,
Klein) Center for the Diagnosis and Treatment of Pericardial Diseases,
Section of Cardiovascular Imaging, Department of Cardiovascular Medicine,
Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH,
United States
(Verma, Raeisi-Giglou, Nasser, Jabri) Department of Cardiovascuar
Medicine, MetroHealth Medical Center, Cleveland, OH, United States
(Kumar) Department of Internal Medicine, MedStar Georgetown University
Hospital, Washington, DC, United States
(Verma) Department of Medicine, Baba Farid University of Health Sciences,
Punjab, Faridkot, India
(Yesilyaprak) Department of Internal Medicine, Wayne State University
School of Medicine, Detroit, MI, United States
(Mahalwar) Cleveland Clinic Akron General, Akron, OH, United States
(Manna) Mallinckrodt Institute Department of Radiology, Washington
University, St Louis School of Medicine, St Louis, MO, United States
(Schleicher) EIectronic Library Services, Research Innovation and
Education, Cleveland Clinic, Cleveland, OH, United States
Publisher
BMJ Publishing Group
Abstract
Objective Chylopericardium (CPE) is a rare condition associated with
accumulation of triglyceride-rich chylous fluid in the pericardial cavity.
Due to minimal information on CPE within the literature, we conducted a
systematic review of all published CPE cases to understand its clinical
characteristics, management and outcomes. Methods We performed a
literature search and identified cases of patients with CPE from 1946
until May 2021 in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines. We identified relevant
articles for pooled analyses of clinical, diagnostic and outcome data.
Results A total of 95 articles with 98 patients were identified. Patient
demographics demonstrated male predominance (55%), with a mean age of
37+/-15 years. Time from symptom onset to diagnosis was 5 (Q1 4.5, Q3 14)
days, with 74% of patients symptomatic on presentation. Idiopathic CPE
(60%) was the most common aetiology. Cardiac tamponade secondary to CPE
was seen in 38% of cases. Pericardial fluid analysis was required in 94%
of cases. Lymphangiography identified the leakage site in 59% of patients.
Medical therapy (total parenteral nutrition, medium-chain triglycerides or
octreotide) was undertaken in 63% of cases. In our cohort, 32% progressed
towards surgical intervention. During a median follow-up of 180 (Q1 180,
Q3 377) days, CPE recurred in 16% of cases. Of the patients with
recurrence, 10% were rehospitalised. Conclusion CPE tends to develop in
younger patients and may cause serious complications. Many patients fail
medical therapy, thereby requiring surgical intervention. Although overall
mortality is low, associated morbidities warrant close follow-up and
possible reintervention and hospitalisations. Copyright © 2023
BMJ Publishing Group. All rights reserved.

<44>
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.

<45>
Accession Number
2026912932
Title
An Evidence-Based Approach to Anticoagulation Therapy Comparing Direct
Oral Anticoagulants and Vitamin K Antagonists in Patients With Atrial
Fibrillation and Bioprosthetic Valves: A Systematic Review, Meta-Analysis,
and Network Meta-Analysis.
Source
American Journal of Cardiology. 206 (pp 132-150), 2023. Date of
Publication: 01 Nov 2023.
Author
Suppah M.; Kamal A.; Saadoun R.; Baradeiya A.M.A.; Abraham B.; Alsidawi
S.; Sorajja D.; Fortuin F.D.; Arsanjani R.
Institution
(Suppah, Abraham, Alsidawi, Sorajja, Fortuin, Arsanjani) Department of
Cardiology, Mayo Clinic Arizona, Phoenix, Arizona, United States
(Kamal, Saadoun) Department of Cardiology, University of Pittsburgh
Medical Center, Hillman Cancer Center, Pittsburgh, PA, United States
(Baradeiya) Internal Medicine Department, Baylor College of Medicine,
Houston, Texas, United States
Publisher
Elsevier Inc.
Abstract
Direct oral anticoagulants (DOACs) are a newer class of anticoagulants
that inhibit factor Xa or factor IIa and include drugs such as
rivaroxaban, apixaban, edoxaban, betrixaban, and dabigatran. Although
vitamin K antagonists (VKAs) have been traditionally used to prevent
thromboembolic events, DOACs have gained popularity because of their
faster onset and offset of action and reduced need for monitoring. This
study aimed to provide more data for anticoagulants in patients with
atrial fibrillation with bioprosthetic heart valves by incorporating all
available trials to date. A search was performed across 5 electronic
databases to identify relevant studies. We analyzed the data using a
pooled risk ratio for categorical outcomes and used the I2 test
to determine heterogeneity. The quality of randomized controlled trials
was assessed using the Cochrane risk of bias assessment tool, and the
National Institutes of Health tool was used for observational studies. Our
study included a frequentist network meta-analysis (MA) of the aggregate
data to obtain the network estimates for the outcomes of interest. We
retrieved 28 studies with a total of 74,660 patients with bioprosthetic
heart valves. Our MA significantly showed that DOACs decrease the risk of
all-cause bleeding (risk ratio [RR] 0.80, 95% confidence interval [CI]
0.75 to 0.85, p >0.00001), stroke and systemic embolization (RR 0.89, 95%
CI 0.80 to 0.99, p = 0.03), and intracranial bleeding outcomes (RR 0.62,
95% CI 0.45 to 0.86, p = 0.004) compared with VKA. In contrast, there was
no significant difference between the compared groups in major bleeding
(RR = 0.92, 95% CI 0.84 to 1.02, p = 0.10) and all-cause mortality
outcomes (RR = 0.96, 95% CI 0.85 to 1.07, p = 0.43), respectively. In
addition, the network MA results did not favor any of the studied
interventions over each other (p <0.05) regarding all-cause bleeding,
mortality, stroke and systemic embolization, and major bleeding outcomes.
In conclusion, our study found that DOACs are more effective in reducing
the risk of bleeding, stroke, systemic embolism, and intracranial bleeding
than VKAs. However, no significant difference was observed in the
incidence of gastrointestinal bleeding, major bleeding, thromboembolic
events, and all-cause mortality. In addition, our network MA did not
identify any specific DOAC treatment as more favorable than
others. Copyright © 2023 Elsevier Inc.

<46>
Accession Number
2025441674
Title
Glycaemic control using mobile-based intervention in patients with
diabetes undergoing coronary artery bypass-study protocol for a randomized
controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 585. Date of
Publication: December 2023.
Author
Song Y.; Nan Y.; Feng W.
Institution
(Song, Nan, Feng) Department of Cardiovascular Surgery, National Clinical
Research Center of Cardiovascular Diseases, National Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Applying technology through the use of the Internet and mobile
phones can help provide education and trained peer support for patients
with diabetes after coronary artery bypass (CABG). We are conducting a
randomized controlled trial to evaluate the efficacy and feasibility of
mobile-based coaching intervention in improving risk-factor control and
secondary prevention in patients with diabetes after CABG. Method(s):
The glycaemic control using miniprogram-based intervention in patients
with diabetes undergoing coronary artery bypass to promote self-management
(GUIDE ME) study is a multi-centre, randomized controlled trial of mobile
intervention versus standard treatment with 6 months follow-up conducted
in 2 hospitals in China. The interventions are education and a reminder
system based on the WeChat mini-program. Participants in the intervention
groups receive 180 videos (including lines) about secondary prevention
education for 6 months as well as the standard treatment. Behavioural
change techniques, such as prompting barrier identification, motivational
skills, and goal setting, are employed. A total sample size of 820
patients would be adequate for the GUIDE ME study. The primary outcome is
the change of glycaemic haemoglobin (HbA<inf>1c</inf>) at 6 months.
Secondary outcomes include a change in the proportions of patients
achieving HbA<inf>1c</inf>, fasting blood glucose, systolic blood
pressure, low-density lipoprotein cholesterol (LDL-C) and medication
adherence. Discussion(s): This trial is the first to investigate the
efficacy of mobile phone WeChat-based video coaching and medication
reminder mini-program system to improve self-management in patients with
diabetes and coronary heart disease (CHD) after CABG and has the potential
to be applied in resource-limited settings across diverse populations. If
successful, such mobile intervention could be used and scaled up to
improve care for this high-risk group of patients. Trial registration:
ClinicalTrials, NCT04192409 . Registered on December 10,
2019. Copyright © 2023, BioMed Central Ltd., part of Springer
Nature.

<47>
Accession Number
2024796175
Title
Nonprocedural bleeding after left atrial appendage closure versus direct
oral anticoagulants: A subanalysis of the randomized PRAGUE-17 trial.
Source
Journal of Cardiovascular Electrophysiology. 34(9) (pp 1885-1895), 2023.
Date of Publication: September 2023.
Author
Branny M.; Osmancik P.; Kala P.; Poloczek M.; Herman D.; Neuzil P.; Hala
P.; Taborsky M.; Stasek J.; Haman L.; Chovancik J.; Cervinka P.; Holy J.;
Kovarnik T.; Zemanek D.; Havranek S.; Vancura V.; Peichl P.; Tousek P.;
Hozman M.; Lekesova V.; Jarkovsky J.; Novackova M.; Benesova K.; Widimsky
P.; Reddy V.Y.
Institution
(Branny, Chovancik) Department of Cardiology, Cardiocenter, Hospital
Podlesi a.s., Trinec, Czechia
(Branny) Department of Internal Medicine and Cardiology, Faculty of
Medicin, University Hospital Ostrava, Ostrava, Czechia
(Osmancik, Herman, Tousek, Hozman, Widimsky) Department of Cardiology,
Third Faculty of Medicine, University Hospital Kralovske Vinohrady,
Charles University, Prague, Czechia
(Kala, Poloczek) Department of Internal Medicine and Cardiology,
University Hospital Brno and Medical Faculty of Masaryk University, Brno,
Czechia
(Neuzil, Hala, Lekesova, Reddy) Department of Cardiology, Cardiocenter, Na
Homolce Hospital, Prague, Czechia
(Taborsky) Department of Cardiology, Cardiocenter, University Hospital
Olomouc, Olomouc, Czechia
(Stasek, Haman) 1st Department of Internal Medicine, Faculty of Medicine,
University Hospital Hradec Kralove, Charles University Prague, Prague,
Czechia
(Cervinka, Holy) Department of Cardiology, Krajska zdravotni a.s., Masaryk
Hospital and UJEP, Usti nad Labem, Czechia
(Kovarnik, Zemanek, Havranek) Cardiocenter, 2nd Internal Clinic-Cardiology
and Angiology, General Faculty Hospital, Charles University, Prague,
Czechia
(Vancura) Department of Cardiology, University Hospital and Faculty of
Medicine Pilsen, Pilsen, Czechia
(Peichl) Cardiocenter, Institute of Clinical and Experimental Medicine,
Prague, Czechia
(Jarkovsky, Novackova, Benesova) Institute of Biostatistics and Analyses,
Masaryk University, Brno, Czechia
(Reddy) Icahn School of Medicine at Mount Sinai, Helmsley
Electrophysiology Center, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Observational studies have shown low bleeding rates in
patients with atrial fibrillation (AF) treated by left atrial appendage
closure (LAAC); however, data from randomized studies are lacking. This
study compared bleeding events among patients with AF treated by LAAC and
nonvitamin K anticoagulants (NOAC). Method(s): The Prague-17 trial
was a prospective, multicenter, randomized trial that compared LAAC to
NOAC in high-risk AF patients. The primary endpoint was a composite of a
cardioembolic event, cardiovascular death, and major and clinically
relevant nonmajor bleeding (CRNMB) defined according to the International
Society on Thrombosis and Hemostasis (ISTH). Result(s): The trial
enrolled 402 patients (201 per arm), and the median follow-up was 3.5 (IQR
2.6-4.2) years. Bleeding occurred in 24 patients (29 events) and 32
patients (40 events) in the LAAC and NOAC groups, respectively. Six of the
LAAC bleeding events were procedure/device-related. In the primary
intention-to-treat analysis, LAAC was associated with similar rates of
ISTH major or CRNMB (sHR 0.75, 95% CI 0.44-1.27, p = 0.28), but with a
reduction in nonprocedural major or CRNMB (sHR 0.55, 95% CI 0.31-0.97, p =
0.039). This reduction for nonprocedural bleeding with LAAC was mainly
driven by a reduced rate of CRNMB (sHR for major bleeding 0.69, 95% CI
0.34-1.39, p =.30; sHR for CRNMB 0.43, 95% CI 0.18-1.03, p = 0.059).
History of bleeding was a predictor of bleeding during follow-up.
Gastrointestinal bleeding was the most common bleeding site in both
groups. Conclusion(s): During the 4-year follow-up, LAAC was
associated with less nonprocedural bleeding. The reduction is mainly
driven by a decrease in CRNMB. Copyright © 2023 The Authors.
Journal of Cardiovascular Electrophysiology published by Wiley Periodicals
LLC.

<48>
Accession Number
2015606043
Title
Comparison of haemodynamic response to tracheal intubation with two
different videolaryngoscopes: A randomized clinical trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 73(5) (pp 548-555),
2023. Date of Publication: 01 Sep 2023.
Author
..ardak..z.. T.L.; Arslan Z.P.; Cesur S.; Aksu B.
Institution
(..ardak..z.., Arslan, Cesur) Kocaeli University of Medical Faculty,
Department of Anesthesiology and Reanimation, ..zmit, Turkey
(Aksu) Kocaeli University of Kand..ra Vocational School, ..zmit, Turkey
Publisher
Elsevier Editora Ltda
Abstract
Background: Endotracheal intubation (ETI), which is the gold standard in
coronary artery bypass grafting (CABG), may cause myocardial ischaemia by
disturbing the balance between haemodynamic changes and oxygen supply and
consumption of the myocardium as a result of sympathetic stimulation. In
this study, we aimed to compare two different videolaryngoscopes (C-MAC
and Airtraq) in the hemodynamic response to ETI. Method(s): Fifty ASA
II...III CABG surgery patients were randomly assigned to C-MAC or Airtraq.
The hemodynamic data included arterial blood pressure [systolic (SAP),
diastolic (DAP) and mean (MAP)] and heart rate (HR) and were recorded at
six different points in time: before laryngoscopy-T1, during
laryngoscopy-T2, immediately after intubation-T3, and 3 (T4), 5 (T5) and
10 (T6) minutes after intubation. Intraoperative complications were
recorded. Patients were questioned about postoperative complications 2 and
24...hours following extubation. Result(s): The hemodynamic response
to ETI was significantly greater with C-MAC. The increase in HR started
with the laryngoscopy procedure, whereas increases in SAP, DAP, and MAP
started immediately after ETI (p...=...0.024; p...=...0.012;
p...=...0.030; p...=...0.009, respectively). In group analyses, T1...T2,
T2...T3 and T1...T3 comparisons did not show any significant differences
in HR with Airtraq. However, with C-MAC, HR after intubation increased
significantly compared to the pre-laryngoscopy values (T1...T3)
(p...=...0.004). The duration of laryngoscopy was significantly reduced
with C-MAC (p...<...0.001), but the duration of intubation and total
intubation were similar (p...=...0.36; p...=...0.79). Conclusion(s):
Compared to C-MAC, the hemodynamic response to ETI was less with Airtraq.
Thus, Airtraq may be preferred in CABG patients for ETI. Copyright
© 2021 Sociedade Brasileira de Anestesiologia

<49>
Accession Number
642265162
Title
Improved Transfemoral Access by Shockwave Lithoplasty for a Transcatheter
Aortic Valve Implantation: A Case Report.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 64), 2023. Date of Publication: 2023.
Author
De Oliveira Ferrer L.; De Souza J.M.; Pereira A.C.B.; Neto E.M.G.; Flores
L.F.P.; Mangione J.A.; Mangione F.M.; Carvalho F.L.; Peron R.F.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: We describe a case of complex access for transcatheter
implantation of the EVOLUT R aortic valve in which it was necessary to use
the Shockwave device to prepare the vascular beds for the passage of the
transcatheter aortic valve implantation (TAVI) delivery system. This
intravascular lithotripsy device, validated by the DISRUPT PAD III study,
enabled us to maintain the femoral artery as the first choice in a case
where access would not be possible due to intense calcification.
 Method(s): In a review of the literature in databases such as PubMed
and SciELO, similar cases were found with successful results. This was the
first case performed at the Hospital Beneficencia Portuguesa de Sao Paulo,
Unidade Paulista. Currently, and according to a report by Shockwave
Medical, Brazil is close to completing 30 cases of the use of this
technique associated with TAVI. Case Report: A 68-year-old male patient
exhibited significant aortic stenosis along with symptoms of heart failure
New York Heart Association (NYHA) functional class III and 14
hospitalizations in the last year due to decompensation of the condition.
In discussion with the heart team and the patient, the option for
transcatheter treatment was defined due to multiple comorbidities and high
surgical risk. The transthoracic echocardiogram showed an aortic valve
area of 0.8 cm2, a maximum systolic gradient of 33 mmHg, and an ejection
fraction of 59%. Aortic angiotomography showed severe calcification of the
iliac and femoral arteries, with minimum diameters of the right femoral of
4.9 mm and 4.4 mm on the left. Alternative accesses were evaluated, but
the subclavian and carotid arteries had reduced diameters and stenotic
areas. With the patient under sedation and local anesthesia, puncture of
the left femoral artery was performed with the aid of vascular ultrasound
and the contralateral iliac artery was catheterized with a hydrophilic
guide, replaced by a V18 guide. An attempt was made to progress the
Shockwave sheath without success due to intense calcification and small
vessel caliber. Due to an intensely calcified right femoral artery without
visualization of the puncture site through ultrasound, a decision was made
for dissection of the artery and puncture in a site free of
calcifications, progressing the sheath and performing successful
angioplasty with pulses of intravascular lithotripsy in the right common
iliac, right external iliac and right common femoral arteries. A 29 mm
EVOLUT R prosthesis was successfully implanted following the usual
technique. A control arteriography of the iliac and femoral arteries
showed patency and no bleeding. Postoperative echocardiogram with
satisfactory results demonstrated a maximum systolic gradient of 4 mmHg
and a mean gradient of 2 mmHg. The patient was discharged showing
improvement in functional class and adequate perfusion of lower limbs.
 Conclusion(s): TAVI is a technique that initially came to allow the
treatment of cases of aortic stenosis that were previously deemed
untreatable. Aiming to maintain the femoral access as the first choice,
the association of the intravascular lithotripsy device proved to be very
useful, allowing the performance of TAVIs such as the one described in
this case.

<50>
Accession Number
642265087
Title
Patient Profile and Determinants of Mortality in Elective Cardiovascular
Surgeries - Insights from the Preliminary Sample of the Cardioplegia
Trial.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 109), 2023. Date of Publication: 2023.
Author
Spadini F.A.; Lira K.B.; Delvaux R.S.; Da Silva L.H.H.; Ceron R.O.; Rode
J.; Rey R.A.W.; Rombaldi A.R.; Wittke E.I.; Almeida A.S.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: Knowing the patient profile is important for the
characterization and evaluation of risk factors, as they are determinants
of postoperative outcomes and can contribute to better results. In this
context, this study aimed to describe the baseline demographic and
preoperative characteristics of patients undergoing elective
cardiovascular surgery. The study also seek to identify independent
mortality predictors in this population, focusing on identifying risk
factors, using preliminary data from the Cardioplegia Trial (registration
number RBR-7g5s66), an important clinical trial which compares the
efficacy of three long-acting cardioplegic solutions for myocardial
protection. Method(s): This observational study included adult
patients undergoing elective coronary artery bypass grafting (CABG) or
valve replacement surgery at Hospital Nossa Senhora da Conceicao between
July 2020 and December 2022, randomized to the trial. Demographic data,
clinical variables and mortality-related information were collected.
Fisher's exact test was used for the comparison of categorical variables,
while Student's t-test or Mann-Whitney test was used for continuous
variables. The independent association of predictors of mortality was
assessed using Poisson regression with robust variance, and the estimated
effect measure was the relative risk with a 95% confidence interval. A
significance level of 5% was adopted. Result(s): Out of the 99
patients in the sample, 62 underwent CABG and 37 underwent valve
replacement surgery, resulting in an 8,1% mortality rate (n=8). Age,
diabetes mellitus (DM), atrial fibrillation (AF), serum troponin levels,
as well as the EuroSCORE, were baseline characteristics related to
mortality (P<0.05). Furthermore, serum levels of creatinine, urea, and
glycated hemoglobin demonstrated a tendency towards statistical
significance in their association with mortality. When analyzed based on
the type of surgery, patients undergoing CABG had higher levels of
glycated hemoglobin (HbA1c), leading to a higher incidence of DM.
Meanwhile, patients undergoing valve replacement surgery had more cases of
AF compared to CABG. In the multivariate analysis, only DM (RR=17.17;
P=0.004) and serum creatinine (RR=2.91; P=0.05) were independent
predictors of mortality. Conclusion(s): This study's findings
highlight the importance of identifying and managing preoperative risk
factors, particularly DM and renal function, in patients undergoing
elective cardiovascular surgery to improve outcomes and reduce mortality.
The results also suggest that glycemic control may be particularly
important in patients undergoing CABG, while AF may be more prevalent in
those undergoing valve replacement. Further studies with larger sample
sizes are needed to confirm these associations and explore potential
interventions to improve outcomes in these high-risk patients.

<51>
Accession Number
2026676960
Title
Coronary atherosclerosis progression after coronary stenting, depending on
regular outpatient or remote monitoring for 12 months.
Source
Atherosclerosis. Conference: 91th EAS Congress. Mannheim Germany.
379(Supplement 1) (pp S204), 2023. Date of Publication: August 2023.
Author
Shchinova A.; Potekhina A.; Filatova A.; Osokina A.; Tyurina A.;
Dolgusheva Y.; Provatorov S.
Institution
(Shchinova, Potekhina, Osokina, Provatorov) Laboratory Of Medical Care
Development For Cad, FSBI National Medical Research Center of Cardiology
n.a. E.I. Chazov, Ministry of Health, Moscow, Russian Federation
(Filatova) Laboratory Of Cell Immunology, FSBI National Medical Research
Center of Cardiology n.a. E.I. Chazov, Ministry of Health, Moscow, Russian
Federation
(Tyurina) Laboratory Of Lipid Disorders, FSBI National Medical Research
Center of Cardiology n.a. E.I. Chazov, Ministry of Health, Moscow, Russian
Federation
(Dolgusheva) Scientific And Organization Department, FSBI National Medical
Research Center of Cardiology n.a. E.I. Chazov, Ministry of Health,
Moscow, Russian Federation
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: The remote monitoring is a safe strategy for
maintaining the adherence to treatment in CAD patients.The purpose was to
determine the incidence of coronary atherosclerosis progression in
patients after coronary stenting (CS) receiving remote monitoring or care
with outpatient visits. Method(s): 279 consecutive stable CAD
patients (61.5+/-9.5 years) underwent scheduled CS were randomized into
groups of regular outpatient visits (group 1, n=96), remote monitoring
(group 2, n=95) and control group (group 3, n=88). The visits (cardio exam
and blood testing) and remote monitoring (videoconference, blood tests
interpretation) were performed at 1, 3, 6 and 12 months after CS (groups 1
and 2). Patients in group 3 were cared by a physician at the residence
place. 12 months after CS the test for stress-induced myocardial ischemia
was performed in each patient. Result(s): 96 patients (34.4%)
required repeat coronary angiography (CA) - 30(31.2%)/20(21.1%)/46(52.3%)
in groups 1/2/3*, respectively (p<0.05 gr. 3 vs. gr. 1 and 2). Restenosis
of the previously stented segment was detected in 8 (2.9%) patients,
progression of coronary atherosclerosis - in 38 (13.6%) (p<0.01 vs. rate
of restenosis). Progression of coronary atherosclerosis was observed in
10(10.4%)/9(9.5%)/19(21.6%)* of cases in groups 1,2,3, respectively
(*p<0.05 gr. 3 vs. gr. 1 and 2), the rate of restenosis was comparable in
the groups. Conclusion(s): The progression of coronary
atherosclerosis was the main cause for repeat CA 12 months after CS. The
groups of patients receiving active regular outpatient or remote
monitoring demonstrated a lower rate of coronary atherosclerosis
progression and repeat CA. Copyright © 2023

<52>
Accession Number
2026676787
Title
Safety and efficacy of proprotein convertase subtilisin/kexin type 9
inhibitors after acute coronary syndrome; a systematic review and
meta-analysis of randomized controlled trials.
Source
Atherosclerosis. Conference: 91th EAS Congress. Mannheim Germany.
379(Supplement 1) (pp S78-S80), 2023. Date of Publication: August 2023.
Author
Atia A.; Wageeh A.; Aboeldahab H.; Elneny M.; Abdelwahab M.; Elmallahy M.;
Aboelkhier M.; Elawfi B.; Sayed S.; Elrosasy A.
Institution
(Atia, Elrosasy) Cardiology, Faculty of Medicine, Cairo University, Cairo,
Egypt., Cairo, Egypt
(Atia) Cardiology, Medical Research Group of Egypt, Cairo, Egypt
(Wageeh) Cardiology, Faculty of Medicine, Menoufia University, Menoufia,
Egypt, menoufia, Egypt
(Aboeldahab) Biomedical Information And Medical Statistics, Biomedical
Informatics and Medical Statistics Department, Medical Research Institute,
Alexandria University, Egypt., alexandria, Egypt
(Elneny) Cardiology, Damietta Faculty of Medicine, Al-Azhar University,
damietta, Egypt
(Abdelwahab) Cardiology, Faculty of Medicine, Helwan University, Cairo,
Egypt., Cairo, Egypt
(Elmallahy) Cardiology, Faculty of Medicine, Tanta University, Tanta,
Egypt, Tanta, Egypt
(Aboelkhier) Science, Master program, Faculty of Science, Suez Canal
University, Ismailia, Egypt., Ismailia, Egypt
(Elawfi) Cardiology, Faculty of medicine, sana'a university, sana'a,
Yemen, Sana'a, Yemen
(Sayed) Cardiology, Faculty Of Medicine, Minia University, Minia, Egypt,
Minya, Egypt
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Patients with a history of acute coronary syndrome
(ACS) are at a higher risk of recurrent ischemia episodes. Elevated
circulating cholesterol levels in patients with atherosclerotic
cardiovascular disease increase morbidity and mortality. Recent studies
reported that PCSK9 inhibitors (PCSK9i) have a beneficial influence on
various domains of patients' lipid profiles; thus, we sought to study
their safety and efficacy on post-ACS patients. Method(s): We
performed a comprehensive electronic search of PubMed, Scopus, Web of
Science, and Cochrane CENTRAL to identify relevant published randomized
controlled trials. Data were extracted and analyzed using the Review
Manager software (version 3.5 for Windows). Result(s): Eleven studies
(n=24,732) were included in this meta-analysis. Compared with the control
group, PCSK9i may decrease the myocardial infarction (MI) events (RR
0.87[0.78, 0.96], P= 0.006), and also the lipid measurements as follows in
mg/dl: LDL-C (SMD -1.30[-1.60, -1.00], P<0.0001), total cholesterol (SMD
-1.29[-1.70, -0.88], P<0.0001), Triglycerides (SMD -0.26[-0.37, -0.14],
P<0.0001), non-HDL-C (SMD -2.80[-3.63, -1.97], P<0.0001), HDL-C (SMD
0.33[0.23, 0.42], P<0.0001), Lipoprotein-A (SMD -6.37[-10.28, -2.46],
P=0.001), Apo-A1 (SMD 0.30[0.25, 0.36], P<0.0001), and Apo-B (SMD
-1.50[-1.85, -1.15], P<0.0001). For coronary heart disease events,
coronary revascularization, cerebrovascular events, cardiovascular deaths,
or all-cause deaths there was no strong evidence that confirms which group
is better as illustrated in Figure [3]. [Formula presented] [Formula
presented] [Formula presented] Conclusion(s): Based on current
evidence, PCSK9i may assist in decreasing further MI events and improving
all lipid measurements significantly in post-ACS patients. Nevertheless,
we recommend not using PCSK9i as a monotherapy, as it has no remarkable
improvement on other cardiovascular events and deaths. Copyright
© 2023

<53>
Accession Number
2026676718
Title
Dual elevated remnant cholesterol and C-reactive protein in myocardial
infarction, atherosclerotic cardiovascular disease, and mortality.
Source
Atherosclerosis. Conference: 91th EAS Congress. Mannheim Germany.
379(Supplement 1) (pp S10), 2023. Date of Publication: August 2023.
Author
Doi T.; Langsted A.; Nordestgaard B.
Institution
(Doi, Langsted, Nordestgaard) Clinical Biochemistry, Copenhagen University
Hospital, Herlev and Gentofte, Herlev, Denmark
(Doi) Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Elevated remnant cholesterol and low-grade
inflammation each cause atherosclerotic cardiovascular disease (ASCVD);
however, it is unknown whether joint elevation of both factors confers the
highest risk. We tested the hypothesis that dual elevated remnant
cholesterol and low-grade inflammation marked by elevated C-reactive
protein is associated with the highest risk of myocardial infarction,
ASCVD, and all-cause mortality. Method(s): The Copenhagen General
Population Study randomly recruited white Danish individuals aged 20-100
years in 2003-2015 and followed them for a median 9.5 years. ASCVD was
cardiovascular mortality, myocardial infarction, stroke, and coronary
revascularization. Result(s): In 103,221 individuals, we observed
2,454 (2.4%) myocardial infarctions, 5,437 (5.3%) ASCVD events, and 10,521
(10.2%) deaths. The hazard ratios increased with each of stepwise higher
remnant cholesterol and stepwise higher C-reactive protein. In individuals
with the highest tertile of both remnant cholesterol and C-reactive
protein compared to individuals with the lowest tertile of both, the
multivariable adjusted hazard ratios were 2.2(95%CI:1.9-2.7) for
myocardial infarction, 1.9(1.7-2.2) for ASCVD, and 1.4(1.3-1.5) for
all-cause mortality. Corresponding values for only the highest tertile of
remnant cholesterol were 1.4(1.2-1.8), 1.2(1.0-1.4), and 1.1(1.0-1.2), and
those for only the highest tertile of C-reactive protein were
1.6(1.3-2.0), 1.5(1.3-1.7), and 1.3(1.2-1.5), respectively. There was no
statistical evidence for interaction between elevated remnant cholesterol
and elevated C-reactive protein on risk of myocardial infarction (P=0.10),
ASCVD (P=0.40), or all-cause mortality (P=0.74). Conclusion(s): Dual
elevated remnant cholesterol and C-reactive protein confers the highest
risk of myocardial infarction, ASCVD, and all-cause
mortality. Copyright © 2023

<54>
Accession Number
2026676677
Title
Adherence to treatment and risk factor control in patients after coronary
stenting depending on regular or remote follow-up.
Source
Atherosclerosis. Conference: 91th EAS Congress. Mannheim Germany.
379(Supplement 1) (pp S204), 2023. Date of Publication: August 2023.
Author
Shchinova A.; Potekhina A.; Osokina A.; Filatova A.; Sorokin E.; Lasareva
N.; Tyurina A.; Dolgusheva Y.; Atyunina I.; Provatorov S.
Institution
(Shchinova, Potekhina, Osokina, Provatorov) Laboratory Of Medical Care
Development For Cad, FSBI National Medical Research Center of Cardiology
n.a. E.I. Chazov, Ministry of Health, Moscow, Russian Federation
(Filatova) Laboratory Of Cell Immunology, FSBI National Medical Research
Center of Cardiology n.a. E.I. Chazov, Ministry of Health, Moscow, Russian
Federation
(Sorokin, Lasareva, Dolgusheva, Atyunina) Scientific And Organization
Department, FSBI National Medical Research Center of Cardiology n.a. E.I.
Chazov, Ministry of Health, Moscow, Russian Federation, Moscow, Russian
Federation
(Tyurina) Laboratory Of Lipid Disorders, FSBI National Medical Research
Center of Cardiology n.a. E.I. Chazov, Ministry of Health, Moscow, Russian
Federation
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: The remote monitoring after coronary stenting (CS)
may facilitate adherence to treatment and risk factor control.
 Aim(s): to evaluate the adherence to drug therapy and risk factor
control in patients after CS receiving remote monitoring or care with
outpatient visits. Method(s): 279 consecutive stable CAD patients
after CS were randomized into groups of regular outpatient visits (group
1, n=96, cardio exam and blood testing), remote monitoring (group 2, n=95,
videoconference, telephone care and blood tests interpretation) and
control group (group 3, n=88, cared by a physician at the residence
place). Adherence to medical therapy using four-item Morisky Green Levine
Medication Adherence Scale was assessed at baseline, 1, 3, 6 and 12 mo
after CS in groups 1 and 2 and at baseline and 12 mo in group 3.
 Result(s): An increase in the number of highly adherent individuals
vs. baseline (33 vs. 17 and 42 vs. 13, respectively, p <0.05), was
observed in groups 1 and 2. The non-adherence to DAAT was 1-2%, while
32,3%, 29,5%, 57.9% of patients in groups 1, 2, 3 reduced/ceased statins
12 mo after CS (p<0.05 group 3 vs. 1 and 2). BP level decrease was
observed in groups 1 and 2, the number of smokers decreased in group 2
(46.3 to 31.6%, p <0.05). Conclusion(s): The remote monitoring is a
safe and effective strategy for improving adherence to treatment and risk
factor control in patients after CS. Copyright © 2023

<55>
Accession Number
2026676520
Title
The highest dose of pitavastatin significantly decreased inflammatory
cytokines and coronary neointimal hyperplasia during the 12-month
follow-up in type 2 diabetic patients.
Source
Atherosclerosis. Conference: 91th EAS Congress. Mannheim Germany.
379(Supplement 1) (pp S183), 2023. Date of Publication: August 2023.
Author
Hong S.J.; Lim D.S.
Institution
(Hong, Lim) Cardiology Department, Korea University Anam Hospital, Seoul,
South Korea
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: We compared the effects of highest-dose and
lowest-dose pitavastatin therapy on coronary neointimal hyperplasia at
12-month follow-up in diabetic patients with non-ST-elevation acute
coronary syndrome (NSTE-ACS) using optical coherence tomography.
 Method(s): A total of 72 diabetic patients with NSTE-ACS were
randomized to the lowest-dose pitavastatin (1mg [n=36]) or the
highest-dose pitavastatin (4mg [n=36]) after everolimus-eluting stent
implantation. Result(s): Neointimal volume was significantly lower in
the pitavastatin 4mg group (0.41+/-0.28 mm3/1mm vs. 0.74+/-0.23
mm3/1mm, p<0.01) at 12-month follow-up. Improvement of brachial
artery flow-mediated dilation (baFMD) was significantly higher in the
pitavastatin 4mg group than in pitavastatin 1mg group (0.15+/-0.15 mm vs.
-0.03+/-0.19 mm, p<0.001). Additionally, the improvement of adiponectin
levels was significantly greater in the pitavastatin 4mg group than in the
pitavastatin 1mg group (2.97+/-3.98 mug/mL vs. 0.59+/-2.80 mug/mL,
p<0.05). Conclusion(s): Pitavastatin 4mg significantly improved
inflammatory cytokines and lipid profiles compared to pitavastatin 1mg
during the 12-month follow-up, contributing to the reduction of neointimal
hyperplasia and to the improvement of baFMD in diabetic patients with
NSTE-ACS requiring coronary stenting. Thus, the administration of
pitavastatin 4mg can be safely and effectively used in high-risk patients
requiring coronary stenting. Copyright © 2023

<56>
Accession Number
642265603
Title
The FRAGILE Clinical Trial: The Impact of the Coronary Artery Bypass Graft
on Frailty.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 55), 2023. Date of Publication: 2023.
Author
Deininger M.O.; Mejia O.A.V.; Meneghini B.; De Freitas F.L.; Hoflinger
L.C.F.; Segalote R.C.; Dallan L.R.; Lisboa L.A.F.; Dallan L.A.O.; Jatene
F.B.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The exponential increase in the elderly population has been
observed worldwide, and it implies a higher incidence of coronary artery
disease (CAD), and consequently the need for coronary artery bypass graft
(CABG) surgery. The growing number of elderlies is also related to
frailty, a syndrome that affects at least 10% of the elderly population
and is an exceedingly effective parameter for correlating with the
aging-related effects. Although the impact of frailty on mortality and
morbidity are well established, there are no studies regarding the
outcomes of CABG and its techniques in frail patients. Objective(s):
To evaluate the impact of CABG surgery on patient frailty and to compare
differences in the frailty index after a 6-month follow-up between the
off-pump and non-pump groups. Method(s): This study was a subanalysis
of the FRAGILE trial, a Brazilian multicenter, randomized, controlled
clinical trial that analyzed 169 patients aged 60 years or older who
underwent coronary artery bypass graft (CABG) surgery with (on-pump) and
without (off-pump) cardiopulmonary bypass. Using the Fried's Frailty
Criteria, we classified the patients into frail, pre-frail, and non-frail,
and also evaluated the five parameters of these criteria. Patients were
divided into two groups: the off-pump CABG group (n=87) and the on-pump
CABG group (n=82), and compared unintentional weight loss, self-reported
fatigue, physical activity level, grip strength, and gait speed before and
after surgery, and between groups. The study was approved by the local
Ethics Committee and all patients signed the informed consent.
 Result(s): We observed an improvement in the frailty status of
patients who underwent CABG. Overall, over than 50% of frail patients
became pre-frail after CABG, and only 3% of the total patients were
classified as frail after six months of surgery. No patient was classified
as non-frail preoperatively in both group because it was one of the
exclusion criteria. There is no difference between the off-pump and
on-pump groups. A positive impact was shown regarding the frailty criteria
in all tests when comparing pre- and post-surgical measurements. The total
time of physical activity and the grip strength exhibited substantial
improvement in the post-surgical group, the gait speed and unintentional
weight loss were lower after the 6-month follow-up, and patients reported
less fatigue by comparing the before-surgery measurements.
 Conclusion(s): CABG positively impacts patients' frailty after six
months of surgery. Both on-pump and off-pump techniques showed similar
results when comparing frailty features before and after CABG surgery.

<57>
Accession Number
642265601
Title
Meta-analysis of Postoperative Pain of Full Sternotomy versus
Mini-Incisions in Cardiac Surgery.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 101), 2023. Date of Publication: 2023.
Author
De Jesus Chaves Junior A.; Avelino P.S.; Junior G.S.O.; Gomes J.P.M.A.;
Lopes J.B.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: It is not yet clear whether minimally invasive cardiac
surgery (MICS) is overall less painful than the conventional approach by
full sternotomy (FS). A meta-analysis is necessary to investigate polled
results on this topic. Objective(s): The objective of this work was
to compare the intensity of postoperative pain, measured at least one
point in the first seven days of conventional cardiac surgery performed
via full sternotomy (FS) versus minimally invasive cardiac surgery using
mini-incision (MI). Method(s): PubMed/MEDLINE, Cochrane Central,
LILACS, and SciELO were searched for all clinical trials, reported until
2022, comparing FS with MICS in coronary bypass graft surgery (CABG),
mitral valve surgery (MVS) and aortic valve replacement (AVR) and analyzed
postoperative pain outcome. The main summary measures were the
standardized mean differences (SMD) with a 95% confidence interval (CI)
and P-values considered statistically significant when <0.05.
 Result(s): In AVR, the general estimate of postoperative pain effect
favored MICS (SMD 0.87 [95% CI 0.04-1.71], P=0.04). However, in the
sensitivity analysis, there was no difference between the groups (SMD 0.70
[95% CI -0.69-2.09], P=0.32). For MVS, it was not possible to perform a
meta-analysis with the included studies, because they had different
methodologies. In CABG, the general estimate of the effect of
postoperative pain did not favor any of the approaches (SMD -0.40 [95% CI
-1.07-0.26], P=0.23), confirmed by sensitivity analysis (SMD -0.02 [95% CI
-0.71-0.67], P=0.95). Conclusion(s): Cardiac surgery by MICS was not
globally less painful than the FS approach. It seems that postoperative
pain is more related to the degree of tissue retraction than to the size
of the incision.

<58>
Accession Number
642265582
Title
Recent Trends in the Approach to Prevention and Treatment of Coronary
Artery Disease: Emphasis on Non-Invasive Intervention.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 54), 2023. Date of Publication: 2023.
Author
Teixeira M.G.D.; Da Silva C.M.; Hoss L.E.; Saito J.M.V.; Bertollo D.P.;
Daumichen C.S.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Coronary artery disease (CAD) stands as a leading cause of
morbidity and mortality worldwide. Over the past decades, there has been a
growing interest in the non-invasive approach as an effective strategy for
preventing and treating the disease. Objective(s): The aim of this
study is to review recent trends in the approach to CAD prevention and
treatment, with a specific focus on non-invasive intervention. The
hypothesis tested is that the non-invasive approach offers significant
benefits in reducing disease incidence and improving patient clinical
outcomes. Method(s): A literature review was conducted using
scientific databases including PubMed, Scopus, and Web of Science,
employing the following MeSH terms: Coronary Artery Disease , Treatment ,
Prevention , and Non-invasive . Studies that investigated and assessed
non-invasive strategies such as lifestyle modifications, behavioral
therapy, pharmacological interventions, and minimally invasive
intervention techniques were included. The methodological quality of
selected studies was evaluated to ensure result reliability.
 Result(s): Lifestyle modifications have been recognized as a key
strategy in primary and secondary CAD prevention. The adoption of a
healthy diet rich in fruits, vegetables, whole grains, and low in
saturated fats, coupled with regular physical activity, has been linked to
a significant reduction in CAD risk. Additionally, stress management and
smoking cessation play a crucial role in preventing the disease. In the
realm of behavioral therapy, interventions targeting risk behavior
modification, such as adherence to prescribed medications, have shown
benefits in reducing adverse cardiovascular events. Health education and
promotion of positive behavioral changes are essential components of this
approach. Pharmacological interventions also play a significant role in
CAD prevention and treatment. Drug therapy includes the use of statins,
antiplatelets, and beta-blockers, which have demonstrated efficacy in
reducing cardiovascular event risk in CAD patients. Minimally invasive
intervention techniques have revolutionized the field of CAD treatment.
Percutaneous angioplasty with stent placement has been widely adopted as
an alternative to coronary artery bypass surgery in select cases. This
non-invasive approach enables restoration of blood flow in obstructed
coronary arteries, relieving angina and improving cardiac function.
Moreover, advanced techniques such as bioabsorbable balloon angioplasty
and the use of drug-eluting stents have shown promising results in terms
of reducing restenosis and enhancing long-term clinical outcomes.
 Conclusion(s): The non-invasive approach in CAD prevention and
treatment is continuously evolving, providing a range of effective and
safe therapeutic options. The integration of evidence-based,
individualized non-invasive strategies is crucial for enhancing clinical
outcomes, reducing morbidity and mortality associated with CAD, and
improving patients' quality of life.

<59>
Accession Number
642265548
Title
Risk and Protective Factors of Complications on Coronary Artery Bypass
Graft Perioperative Period: A Systematic Review.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 51), 2023. Date of Publication: 2023.
Author
Mettifogo C.B.G.; Lopes L.S.; Biteli P.; Alves S.F.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: To analize the statistically significant risk factors during
the preoperative and intraoperative periods related with complications
following coronary artery bypass grafting (CABG) surgery. Method(s):
Systematic review focused on articles published within the last 2 years
and retrieved from the MEDLINE database (via PubMed) as per PRISMA
guidelines using MeSH terms postoperative period AND complications AND
bypass surgery, coronary artery . The analysis was double-blinded and
included full-text articles describing complications in patients who
underwent isolated elective CABG. A total of 273 articles were found, with
240 excluded after title analysis, and 11 after the abstract review.
Ultimately, 22 articles remained for the final analysis. Result(s):
Postoperative atrial fibrillation (POAF) usually occurs between the 1st
and 6th postoperative days, peaking at the 2nd day, with an average
incidence of is 37.84% in 1.482 patients. POAF increased the doses of
noradrenalin by 27.69% at the intensive care unit (ICU), the need for an
intra-aortic balloon pump by 20.83%, and chances of death by 16.67%. The
predictive factors are need for intraoperative transfusion, diabetes
mellitus (DM) and fragmented QRS complex with altered hemoglobin levels,
increasing the chances of POAF by 1.6, 0.3 and 2.5 times, respectively.
The use of minimally invasive cardiopulmonary bypass (MICPB) was a
protective factor. The decompensation of chronic cerebral ischemia,
related or not to small/moderated carotid stenosis, affected, in 182
patients, 32% of the group without stenosis, and 52% of the group with
stenosis, and 3.5% evolved to acute cerebral circulatory disorder,
increasing the risk of premature death. Beyond that, 54-65% of patients
presented cognitive disfunction. The risk factors found were advanced age,
peripheral arterial disease, re-exploration for bleeding, perioperative
myocardial infarction, increased CO2 pressure and hyperlactemia. The use
of MICPB was a protective factor when compared with conventional CPB.
Postoperative hypothermia at ICU admission (temperature <36 C) affected
29.4% of 1,979 patients, correlating with increased transfusions,
intubation duration, and ICU stay. Risk factors were advanced age, female
gender, and low body mass index. Acute kidney injury (AKI) reached 26% of
115 patients, evolving to kidney failure in 3.3% and requiring renal
replacement therapy in 1-5% of the cases. Transesophageal echocardiography
was used to evaluate the arcuate or interlobar arterial flow by injecting
a sample volume, then measuring the renal resistive index (RRI). When RRI
was >0.7, AKI rates were 46.15%; conversely, the rates were 15.75% when
RRI was <0.7. Low prognostic nutritional index and DM were also risk
factors. Infections are common and might evolve to pneumonia, which
increases the likelihood of death by 5-10 times. Risk factors are kidney
disease, congestive heart failure, DM and chronic obstructive pulmonary
disease. Pleural effusion occurred in 63% of 1,829 patients in the first
30 days after surgery, with 14.4% of them requiring drainage around the
8th-9th day. This resulted in prolonged intubation duration by 6 times and
a 6.8% increased risk of AKI. Predictive factors were smoking and
preoperative arrhythmia. Conclusion(s): The main risk factors are the
presence of DM, kidney diseases, vascular problems and advanced age,
leading to a higher need for transfusions and reintubation, a longer
intubation duration, postoperative arrhythmia, kidney failure and
pericardial effusion. This worsens the prognosis and patients' health. The
major protective factor found was the use of MICPB during the surgery.

<60>
Accession Number
642265534
Title
Construction and Application of Artificial Intelligence as a Precision
Tool for Predicting the Mortality Risk after Cardiac Surgery.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 96), 2023. Date of Publication: 2023.
Author
Rosler A.M.; Da Cunha Sales M.; Do Nascimento J.F.; Ferreira G.S.;
Prediger V.W.; Lucchese F.A.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The risk prediction of 30-day mortality after cardiac
surgery still has important gaps. In this scenario, computational tools
and advanced nonlinear math modeling, such as artificial neural networks,
can represent a safe and effective solution to this problem. Thus, our
purpose was to develop a pilot trial to build a risk prediction model for
30-day mortality after cardiac surgery based in a deep learning process
and compare with EuroSCORE II (ESII) and the Society of Thoracic Surgeons
STS score (STS). Method(s): For this pilot trial, we analyzed 56
baseline variables of 5,011 consecutive patients of southern Brazilian
submitted to cardiac surgery between 2010 and 2022 in the coordinator
centre of the project. First, we applied the Extremely Randomized Trees
Classifier algorithm to identify the variables with highest association
with 30-day mortality, and so it was possible to reduce the number of
interest variables for the model from 56 to 15. Subsequently, the dataset
was randomly divided into two distinct datasets: training (70% of the
sample) and test (30%). With the training dataset, an artificial neural
network (ANN) model was designed with 1,000 cycles of learning. The
performance of ANN model, ESII and STS were evaluated and compared in the
testing dataset. The predictive accuracies of both the ANN model and the
risk scores were obtained for comparison through the areas under receiving
operating characteristic curves (AUC) and DeLong Tests. Result(s):
For aortic replacement, aortic replacement plus coronary artery bypass
graft surgery (CABG) and mitral replacement plus CABG, the predictive
accuracies of ANN exceeded 80%, while the risk scores showed significantly
lower values (P<0.05). For CABG and mitral replacement, the ANN model was
better, but with less difference in comparison with the risk scores
(P<0.05). For the five cardiac surgeries considered, the ANN model
prediction was significantly better, and the same pattern of predictive
accuracies was also observed when analyzing the general group (ESII AUC:
0.733, STS AUC: 0.690, ANN AUC: 0,808; P<0,05). Conclusion(s): The
ANN model presented better results than traditional risk scores in all
scenarios evaluated in this study, even with a relative low number of
patients for an artificial intelligence study. Analyzing and comparing the
predictive accuracies in the testing dataset, we can conclude that math
modeling based on deep learning techniques has great potential and it is
viable to develop useful and solid Brazilian risk prediction model.

<61>
Accession Number
642265497
Title
31st Congress of the World Society of Cardiovascular and Thoracic
Surgeons.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (no pagination), 2023. Date of Publication:
2023.
Author
Anonymous
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
The proceedings contain 134 papers. The topics discussed include: a case
of Bentall-de Bono associated with simultaneous pectus excavatum repair:
case series review; analysis of the difference in degrees of dilation of
woven and knitted Dacron grafts in the postoperative follow-up of patients
undergoing aortic surgeries: a systematic review of the literature;
analysis of the dilation of Dacron tubular graft in early and late
postoperative period of ascending aorta and aortic arch repair surgeries;
aortic root valve reimplantation: 10 years' experience with single
straight tubular graft; clinical and hemodynamic outcomes of surgical
rapid deployment aortic valve prosthesis; external wrapping of the
ascending aorta in patients with chronic Stanford type A aortic
dissection; influencing factors for early mortality after surgery for
acute aortic dissection; initial experience of a single-center with the
frozen elephant trunk procedure in 21 patients with complex aortic
disease; and initial experience with the Tirone David technique for aortic
root aneurysm repair in a patient with Marfan syndrome: a case report.

<62>
Accession Number
642265452
Title
Transapical Approach to Aortic and Mitral Interventions: Experience at a
University Hospital.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 137), 2023. Date of Publication: 2023.
Author
Soares K.J.S.; De Barros L.F.N.; Cividanes F.R.; De Almeida Palma Fonseca
J.H.; Jatene F.B.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Heart valve disease is a significant health problem
affecting millions of people worldwide. The aortic and mitral valves are
the most frequently affected, and conventional therapy consists of
replacement or surgical repair of these valves. However, conventional
valve surgery can be associated with significant risks and may not be a
viable option for some high-risk patients. Method(s): The database of
the Heart Institute of the Hospital das Clinicas of the Medical School of
the University of Sao Paulo (InCor- HCFMUSP) was assessed for data related
to all transapical procedures performed in 2022 and in the first quarter
of 2023. Clinical outcomes such as mortality and days of hospitalization
were evaluated. Result(s): Twenty-two patients were operated on
during 2022 and the first three months of 2023, 10 (45%) female and 12
(55%) male. The mean age of the patients was 73.24 years, ranging from 57
to 85 years. Among the transapical procedures, 8 (36%) underwent
transcatheter aortic valve implantation (TAVI), 8 (36%) underwent aortic
valve-in-valve procedure, and 6 (28%) underwent mitral valve-in-valve
procedure. The operative mortality was 13%, (3 patients). These deaths
occurred in the postoperative intensive care unit (ICU), all after 30
postoperative days The mean EuroSCORE II of the patients who died was
9.14%, thus classified as high surgical risk patients. The mean EuroSCORE
II of all patients who underwent transapical procedures was 6.27%, ranging
from 1.39% to 24.9%. The average postoperative stay of the patients was
12.9 days, with an average of 6.4 days in the ICU. Discussion(s): In
2019, Mirdamadi published a systematic review that evaluated 44 studies
that included a total of 4,292 patients undergoing transapical procedures
for treatment of valve disease. The overall in-hospital mortality was
4.4%, while late mortality was 6.8%, with a mean follow-up of 19.6 months.
In 2020, Attaran et al. evaluated the outcomes of 51 patients undergoing
transapical procedures for treatment of mitral valve disease and found an
in-hospital mortality of 3.9%, and a complication rate of 13.7%.
 Conclusion(s): In general, the transapical approach can be a safe and
effective option for patients with heart valve disease who do not meet the
criteria for conventional surgery.

<63>
Accession Number
642265441
Title
Differences Between Interventions for the Treatment of Acute Myocardial
Infarction: Analysis of Systematic Reviews.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 41), 2023. Date of Publication: 2023.
Author
Azevedo V.A.; Silvestri C.T.; Tureta E.F.; Camargo M.B.; Da Silva Stefani
M.; Cardoso C.S.M.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: To compile and analyze the evidence available in systematic
reviews regarding the different interventions performed for the treatment
of acute myocardial infarction. Method(s): To carry out the search,
we used the combination of words (( Angioplasty [Mesh]) AND Myocardial
Revascularization [Mesh] AND (coronary [Title/Abstract]) AND (cardiac
surgery [Title/Abstract]) on the PubMed platform. We applied the filter
for systematic reviews, which guaranteed 6 studies published between 2003
and 2012. Two publications were discarded from the current summary; one
did not find results for the surgical intervention and the other had been
updated. Result(s): The analyzed studies mainly compared coronary
angioplasty, percutaneous coronary intervention (PCI) with rotational
atherectomy, elective and emergency coronary artery bypass grafting
(CABG), drug-eluting stent, and percutaneous interventions performed in
services with or without on-site cardiac surgery. Cerebrovascular events
seem to occur more with CABG than with drug-eluting stents (OR=0.46).
Regarding the risk of mortality, it was reduced in percutaneous
intervention performed in centers with cardiac surgery support and in
cases of angioplasty (6.1%) compared to angioplasty followed by surgery
(7.6%), and in elective CABG in comparison with emergency surgeries. Based
on the information described in the articles, it is clear that no
statistically significant associations were mentioned. The results showed
a variety of findings, with significant differences between centers with
and without on-site cardiac surgery. As for primary PCI, some studies did
not indicate a significant difference in in-hospital mortality or in the
need for early cardiac surgery between the two types of centers. However,
other studies have shown a much greater risks in centers without cardiac
surgery, especially in low-volume centers. As for non-primary PCI, the
results were inconclusive, as some studies demonstrated a similar risk of
in-hospital mortality risks and the need for early heart surgery between
the two types of centers, while the other studies used showed divergent
results. It is also worth mentioning that the volume of cases performed in
each type of center greatly influenced the results, where low-volume
centers without on-site cardiac surgery demonstrated a possible increase
in the risk of mortality, while high-volume centers did not demonstrate
significant differences. Conclusion(s): In general, the analyzed
studies did not demonstrate significant associations between the
procedures described, but there were differences between centers with and
without on-site cardiac surgery, where the risk in centers without cardiac
surgery was higher. However, in primary PCI, for example, there was no
significant difference either in in-hospital mortality or in the presence
or absence of centers with cardiac surgery. In addition, the volume of
procedures performed at each center also influenced the results,
demonstrating that the data are very unique and differ from place to
place. Finally, it should be noted that studies in the area are scarce,
which makes analysis and discussion on the subject even more difficult.
This is mainly due to the difficulty of carrying out randomized studies of
this nature, since participants can be exposed to excessive risks, thereby
raising ethical concerns.

<64>
Accession Number
642265402
Title
Mitral Stenosis as a Sequel of Rheumatic Fever: A Literature Review on
Current Interventional Approaches.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 132), 2023. Date of Publication: 2023.
Author
Mokfa L.A.M.; Marafon M.E.; Spironello K.C.M.; De Melo A.R.G.; Orth L.;
Zancanaro I.C.; Brito E.G.; Tressoldi M.; Lacerda D.C.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Rheumatic fever is a disease that mainly affects children
and young adults in regions of low socioeconomic status, being considered
a non-suppurative evolution of pharyngotonsillitis caused by group A
B-hemolytic Streptococcus. The etiopathology is unknown, but it is related
to genetic predisposition and the host's immune system. About 25% of
patients with rheumatic heart disease have mitral stenosis and
approximately 40% have mitral stenosis together with mitral insufficiency.
 Objective(s): This article aims to analyze the therapeutic approaches
used for the treatment of mitral valve stenosis resulting from rheumatic
fever. Method(s): A literature review, whose articles were selected
for the preparation of an analysis on current approaches to rheumatic
fever and its involvement of the mitral valve. Articles were selected from
the following platforms: Science Direct, Scientific Electronic Library
Online (SciELO), and Brazilian Journal of Health Review (BJHR).
 Result(s): In general, drug treatments (beta-blockers,
anticoagulants, among others) are utilized both for symptoms and as a
bridge to more interventional treatments. The therapeutic approach must be
individualized for each case, depending on the degree of involvement and
the patient's symptoms. It has been proven that the interventional
approach is the most effective in reducing symptoms and increasing patient
survival, being indicated for symptomatic patients (NYHA class II, III and
IV) with moderate to severe mitral stenosis. Percutaneous balloon
valvuloplasty is indicated for patients with moderate to severe mitral
stenosis with favorable morphology (Block score <=8) but requiring no
thrombus in the left atrium or the presence of moderate to severe mitral
regurgitation. In addition, it is well indicated for asymptomatic patients
or patients with pulmonary hypertension. In cases of intra-atrial thrombus
after anticoagulation or when percutaneous valvuloplasty is not available,
surgical open commissurotomy should be the therapy of choice. Finally,
only when there is no availability of surgery with cardiopulmonary bypass
or percutaneous methods, closed commissurotomy should be chosen. Valve
replacement is mandatory for patients with a high Block score (>=12),
calcified valve, concurrent moderate to severe mitral regurgitation
(double lesion) or associated coronary artery disease (CAD) requiring
revascularization. Obviously, the presence of valve prosthesis (biological
or mechanical) becomes a possible complicating factor, however, the
results are still very good, in all scenarios. Patients with a Block score
between 9 and 11 must be decided between the procedures according to
surgical risk, comorbidities, patient preferences, costs and other
characteristics, all individually. Conclusion(s): Percutaneous
balloon valvuloplasty has grown and spread as a treatment method in recent
years, but valve replacement still has a large space, being the method of
choice in more advanced cases of the disease. Open or closed
commissurotomy are also methods that have their indications and can be
alternatives. Finally, studies showed that the success of these
interventions and the reduction in complications are influenced by the
experience of the team performing the described techniques and the
availability of structure for a good execution.

<65>
Accession Number
642265359
Title
Tetralogy of Fallot in the Neonate: Pre- and Postnatal Management of the
Blue Baby Syndrome.
Source
Brazilian Journal of Cardiovascular Surgery. Conference: 31st Congress of
the World Society of Cardiovascular and Thoracic Surgeons. Iguassa Falls
Brazil. 38(5 Supplement 1) (pp 33), 2023. Date of Publication: 2023.
Author
Hoss L.E.; Teixeira M.G.D.; Daumichen C.S.; Saito J.M.V.; Bertollo D.P.;
Bucker E.G.
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Tetralogy of Fallot is a prevalent cyanotic congenital heart
defect, comprising four simultaneous cardiac anomalies. Research has shown
progress in both disease identification and surgical interventions,
leading to substantial improvements in the quality of life for affected
individuals. Objective(s): The aim of this study is to review the
trends in prenatal diagnosis and treatment. The researched hypotheses
suggest that a multidisciplinary intervention contributes to successful
clinical outcomes in individuals with this syndrome. Method(s): A
literature review was conducted using scientific databases, including
PubMed, Scopus, and Web of Science. The following MeSH terms were
utilized: Tetralogy of Fallot , Cyanosis , Surgery , and Congenital Heart
Disease. Studies addressing the disease history and aspects such as
cardiovascular anatomy, pathophysiology, signs, and symptoms were
included. Result(s): The blue baby syndrome is characterized by four
distinct but concomitant anatomical changes: ventricular septal defect,
overriding aorta, pulmonary stenosis, and right ventricular hypertrophy.
The initial clinical presentation of the syndrome depends on the degree of
obstruction of pulmonary blood flow. Nonetheless, the disease hinders the
child's development and growth. Prenatal diagnosis of tetralogy of Fallot
contributes to reducing neonatal morbidity and mortality from congenital
heart disease, in addition to facilitating secondary prevention in two
different ways: parental counseling regarding diagnosis, prognosis,
management, and treatment of the disease, and the implementation of
neonatal and obstetric measures, as well as early intervention to improve
pathological outcomes. Fetal echocardiography is used for detailed
diagnosis and evaluation of all fetal cardiovascular pathologies. It
should be performed between 18 and 22 weeks in pregnancies with high risk
of congenital heart disease. Regarding treatment, measures for rapid
relief include oxygen, morphine, and beta-blockers to increase blood flow
to the body. If not surgically corrected in early childhood, tetralogy of
Fallot is potentially fatal, with low survival rates. Surgical correction
aims to close the ventricular septal defect, preserve the morphology and
function of the right ventricle, associated with an intact pulmonary
valve, optimizing pulmonary blood flow. After the procedure, the right
ventricular wall returns to its normal thickness, blood oxygen levels
increase, and symptoms decrease. Clinical management and patient recovery
require a joint planning of care provided by the healthcare team.
 Conclusion(s): Early diagnosis of tetralogy of Fallot is crucial in a
newborn's life, not only for alleviating but also preventing disease
complications. Despite the availability of relief measures, the most
effective treatment is surgical, through intracardiac repair. The good
clinical outcomes for these patients depend not only on theoretical and
practical expertise but also on communication between different
specialties.

<66>
Accession Number
2026983450
Title
A Nationwide Evaluation of Cardiothoracic Resident Research Productivity.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Narahari A.K.; Patel P.D.; Chandrabhatla A.S.; Wolverton J.; Lantieri
M.A.; Sarkar A.; Mehaffey J.H.; Wagner C.M.; Ailawadi G.; Pagani F.D.;
Likosky D.S.
Institution
(Narahari, Patel, Chandrabhatla, Lantieri, Sarkar) Department of Surgery,
University of Virginia School of Medicine, Charlottesville, VA, United
States
(Wolverton, Wagner, Ailawadi, Pagani, Likosky) Department of Cardiac
Surgery, Michigan Medicine, Ann Arbor, MI, United States
(Mehaffey) Department of Cardiovascular and Thoracic Surgery, West
Virginia University School of Medicine, Morgantown, WV, United States
Publisher
Elsevier Inc.
Abstract
Background: Evaluating the research productivity of cardiothoracic surgery
residents during their training and early career is crucial for tracking
their academic development. To this end, the training pathway of residents
and the characteristics of their program in relation to their productivity
were evaluated. Method(s): Alumni lists from integrated 6-year
thoracic surgery (I-6) and traditional thoracic surgery residency programs
were collected. A Python script was used to search PubMed for publications
and the iCite database for citations from each trainee. Publications
during a 20-year time span were stratified by the year of publication in
relation to the trainee's graduation from thoracic surgery residency.
Trainees were analyzed by training program type, institutional
availability of a cardiothoracic surgery T32 training grant, and protected
academic development time. Result(s): A total of 741 cardiothoracic
surgery graduates (I-6, 70; traditional, 671) spanning 1971 to 2021 from
57 programs published >23,000 manuscripts. I-6 trainees published
significantly more manuscripts during medical school and residency
compared with traditional trainees. Trainees at institutions with
cardiothoracic surgery T32 training grants published significantly more
manuscripts than those at non-T32 institutions (13 vs 9; P = .0048). I-6
trainees published more manuscripts at programs with dedicated academic
development time compared with trainees at programs without protected time
(22 vs 9; P = .004). Conclusion(s): I-6 trainees publish
significantly more manuscripts during medical school and residency
compared with their traditional colleagues. Trainees at institutions with
T32 training grants and dedicated academic development time publish a
higher number of manuscripts than trainees without those
opportunities. Copyright © 2023 The Society of Thoracic Surgeons

<67>
Accession Number
2018847596
Title
Effect of cocoa flavanol supplementation for the prevention of
cardiovascular disease events: The COcoa Supplement and Multivitamin
Outcomes Study (COSMOS) randomized clinical trial.
Source
American Journal of Clinical Nutrition. 115(6) (pp 1490-1500), 2022. Date
of Publication: 01 Jun 2022.
Author
Johnson L.G.; Moorthy M.V.; Carrick W.R.; Anderson G.L.; Manson J.E.;
Sesso H.D.; Rist P.M.; Bassuk S.S.; Leboff M.S.; Okereke O.I.; Cook N.R.;
Christen W.; Friedenberg G.; Copeland T.; Hanna J.; Clar A.; D'Agostino
D.; Vinayagamoorthy M.; Gibson H.; Kim E.; Van Denburgh M.; Kotler G.; Li
C.; Bubes V.; Sarkissian A.; Smith D.; Pereira E.C.; Okeke M.; Roche E.;
Ridge C.; Phillips A.; Salvo B.; Wilson A.; Hall L.; Baez J.; Sim Y.-H.;
Cardoso H.; Senor G.; Rudnicki C.; Huynh H.; Nguyen V.; Terrell N.; Holman
B.A.; Walter J.; Johnson L.F.; Casarella A.; O'Connell J.; Lagerstrom
S.R.; Djousse L.; Chandler P.D.; Hazra A.; Tobias D.K.; Farukhi Z.M.; Wang
L.; Zhang X.; Breen K.; Menjin Jr G.V.; Rodriguez R.; Curry S.; Arsenault
L.; Solano O.; Weinberg A.; Coates J.; Kilroe M.; Zernicke L.; Hasson K.;
Matthew K.; Mora S.; Pfeffer C.; Duszlak J.; Bates D.; Guzman V.; Falcon
J.; Romero A.; Kupets H.; Cortez F.; Lesuer J.C.; Hrbek A.; Bowes E.;
Quinn P.; Mele M.; Johnson L.; Tinker L.F.; Aragaki A.K.; Herndon M.; Mann
S.L.; Pettinger M.; Hunt R.P.; Carrick B.; Szyperski K.; Proulx-Burns L.;
Burrows E.; Limacher M.; Hsia J.; Asaithambi G.; Khan M.; Nagaraja N.;
Ocava L.C.; Wold J.; Silver B.; Connelly S.; Van Lom G.; Garvida C.;
Hightower K.; Spaulding P.; Lin W.; Schoenberg J.; Olee P.; Cohen L.S.;
Colton T.; Henderson I.C.; Hulley S.; Lichtenstein A.H.; Passamani E.R.;
Silliman R.A.; Wenger N.; Ludlam S.E.; Schroeter H.; Fare M.; Ottawani J.;
Kwik-Uribe C.; Arnaiz C.; Costanza A.; Greene J.; Hennessey P.; Vadlamani
S.; Karmsetty M.; Martini P.; Van Klinken J.-W.; Shah A.; Stern L.
Institution
(Sesso, Manson, Rist, Friedenberg, Copeland, Clar, Mora, Moorthy,
Sarkissian) Division of Preventive Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sesso, Manson, Rist) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, United States
(Aragaki, Johnson, Carrick, Anderson) Division of Public Health Sciences,
Fred Hutchinson Cancer Research Center, Seattle, WA, United States
(Mora) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Arnaiz, Costanza, Greene, Hennessey) Contract Pharmacal Corp, United
States
(Vadlamani, Karmsetty, Martini, Van Klinken, Shah, Stern) Pfizer Consumer
Healthcare, United States
(Manson, Sesso, Rist, Lagerstrom, Bassuk, Wang, Hazra, Gibson, Leboff,
Mora, Okereke, Tobias, Cook, Chandler, Christen, Christen, Friedenberg,
Copeland, Hanna, Clar, D'Agostino, Vinayagamoorthy, Gibson, Kim, Van
Denburgh, Kotler, Li, Bubes, Sarkissian, Smith, Pereira, Okeke, Roche,
Bates, Ridge, Phillips, Salvo, Wilson, Hall, Baez, Sim, Cardoso, Senor,
Rudnicki, Huynh, Nguyen, Terrell, Holman, Walter, Johnson, Casarella,
O'Connell, Lagerstrom, Djousse, Chandler, Hazra, Tobias, Farukhi, Wang,
Zhang, Breen, Menjin Jr, Rodriguez, Curry, Mora, Arsenault, Solano,
Weinberg, Coates, Kilroe, Zernicke, Hasson, Matthew, Mora, Pfeffer,
Duszlak, Bates, Guzman, Falcon, Romero, Kupets, Cortez, Lesuer, Hrbek,
Bowes, Quinn, Mele) Brigham and Women's Hospital, United States
(Anderson, Johnson, Tinker, Aragaki, Herndon, Mann, Pettinger, Hunt,
Carrick, Szyperski, Proulx-Burns, Burrows, Limacher, Hsia, Asaithambi,
Khan, Nagaraja, Ocava, Wold, Silver, Connelly, Van Lom, Garvida,
Hightower, Spaulding, Lin, Schoenberg, Olee) Fred Hutchinson Cancer
Research Center, Women's Health Initiative, United States
Publisher
Elsevier B.V.
Abstract
Background: Cocoa extract is a source of flavanols that favorably
influence vascular risk factors in small and short-term trials, yet
effects on clinical cardiovascular events are untested. Objective(s):
We examined whether cocoa extract supplementation decreases total
cardiovascular disease (CVD) among older adults. Method(s): We
conducted a randomized, double-blind, placebo-controlled, 2-by-2 factorial
trial of cocoa extract supplementation and multivitamins for prevention of
CVD and cancer among 21,442 US adults (12,666 women aged >=65 y and 8776
men aged >=60 y), free of major CVD and recently diagnosed cancer. The
intervention phase was June 2015 through December 2020. This article
reports on the cocoa extract intervention. Participants were randomly
assigned to a cocoa extract supplement [500 mg flavanols/d, including 80
mg (-)-epicatechin] or placebo. The primary outcome was a composite of
confirmed incident total cardiovascular events, including myocardial
infarction (MI), stroke, coronary revascularization, cardiovascular death,
carotid artery disease, peripheral artery surgery, and unstable angina.
 Result(s): During a median follow-up of 3.6 y, 410 participants
taking cocoa extract and 456 taking placebo had confirmed total
cardiovascular events (HR: 0.90; 95% CI: 0.78, 1.02; P = 0.11). For
secondary endpoints, HRs were 0.73 (95% CI: 0.54, 0.98) for CVD death,
0.87 (95% CI: 0.66, 1.16) for MI, 0.91 (95% CI: 0.70, 1.17) for stroke,
0.95 (95% CI: 0.77, 1.17) for coronary revascularization, neutral for
other individual cardiovascular endpoints, and 0.89 (95% CI: 0.77, 1.03)
for all-cause mortality. Per-protocol analyses censoring follow-up at
nonadherence supported a lower risk of total cardiovascular events (HR:
0.85; 95% CI: 0.72, 0.99). There were no safety concerns.
 Conclusion(s): Cocoa extract supplementation did not significantly
reduce total cardiovascular events among older adults but reduced CVD
death by 27%. Potential reductions in total cardiovascular events were
supported in per-protocol analyses. Additional research is warranted to
clarify whether cocoa extract may reduce clinical cardiovascular
events. Copyright © 2022 The Author(s) 2022.

<68>
Accession Number
2026807350
Title
Effects of High- or Moderate-intensity Rosuvastatin on 1-year Major
Adverse Cardiovascular Events Post-percutaneous Coronary Intervention.
Source
Interventional Cardiology: Reviews, Research, Resources. 17 (no
pagination), 2022. Article Number: e20. Date of Publication: January 2022.
Author
Chehrevar M.; Vafa R.G.; Rahmani M.; Parizi M.M.; Ahmadi A.; Zamiri B.;
Heydarzadeh R.; Montaseri M.; Hosseini S.A.; Kojuri J.
Institution
(Chehrevar, Kojuri) Cardiology Department, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Vafa, Rahmani, Parizi, Ahmadi, Zamiri, Heydarzadeh, Montaseri, Kojuri)
Professor Kojuri Cardiology Clinic, Shiraz, Iran, Islamic Republic of
(Hosseini) Student Research Committee, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Kojuri) Clinical Education Research Center, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Radcliffe Medical Media
Abstract
Background: Although statins decrease mortality in coronary artery
disease, the effect of high-dose statins and duration of therapy
postpercutaneous coronary intervention (PCI) is not well addressed.
 Aim(s): To determine the effective dose of statin to prevent major
adverse cardiovascular events (MACEs), such as acute coronary syndrome,
stroke, myocardial infarction, revascularisation and cardiac death, after
PCI in patients with chronic coronary syndrome. Method(s): In this
randomised, double-blind clinical trial, all chronic coronary syndrome
patients with a recent history of PCI were randomly divided into two
groups after 1 month of high-dose rosuvastatin therapy. Over the next
year, the first group received rosuvastatin 5 mg daily (moderate
intensity), while the second received rosuvastatin 40 mg daily (high
intensity). Participants were evaluated in terms of high-sensitivity
C-reactive protein and MACEs. Result(s): The 582 eligible patients
were divided into group 1 (n=295) and group 2 (n=287). There was no
significant difference between the two groups in terms of sex, age,
hypertension, diabetes, smoking, previous history of PCI or history of
coronary artery bypass grafting (p>0.05). There were no statistically
significant differences in MACE and high-sensitivity C-reactive protein
after 1 year between the two groups (p=0.66). Conclusion(s): The
high-dose group had lower LDL levels. However, given the lack of
association between high-intensity statins and MACEs in the first year
after PCI among chronic coronary syndrome patients, the use of
moderate-intensity statins may be as effective as high-intensity statins,
and treatment based on LDL targets may suffice. Copyright © 2022
The Author(s).

<69>
Accession Number
2026791828
Title
Mechanisms, predictors, and evolution of severe peri-device leaks with two
different left atrial appendage occluders.
Source
Europace. 25(9) (no pagination), 2023. Date of Publication: 01 Sep 2023.
Author
Lakkireddy D.; Nielsen-Kudsk J.E.; Windecker S.; Thaler D.; Price M.J.;
Gambhir A.; Gupta N.; Koulogiannis K.; Marcoff L.; Mediratta A.; Anderson
J.A.; Gage R.; Ellis C.R.
Institution
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
5100 W 100th St, Suite-200, Overland Park, KS 66211, United States
(Nielsen-Kudsk) Aarhus University Hospital, Aarhus N, Denmark
(Windecker) Inselspital, Bern University Hospital, University of Bern,
Bern, Switzerland
(Thaler) Tufts Medical Center, Boston, MA, United States
(Price) Scripps Clinic, La Jolla, CA, United States
(Gambhir) Northside Hospital Cardiovascular Institute, Atlanta, GA, United
States
(Gupta) Los Angeles Medical Center, Los Angeles, CA, United States
(Koulogiannis, Marcoff, Mediratta) Cardiovascular Core Lab, Morristown
Medical Center, Morristown, NJ, United States
(Anderson, Gage) Abbott Structural Heart, Plymouth, MN, United States
(Ellis) Vanderbilt Heart Institute, Nashville, TN, United States
Publisher
Oxford University Press
Abstract
Aims Incomplete left atrial appendage occlusion (LAAO) due to peri-device
leak (PDL) is a limitation of the therapy. The Amulet IDE trial is the
largest randomized head-to-head trial comparing the Amulet and Watchman
2.5 LAAO devices with fundamentally different designs. The predictors and
mechanistic factors impacting differences in PDLs within the Amulet IDE
trial are assessed in the current analysis. Methods An independent core
lab analysed all images for the presence or absence of severe PDL (>5 mm).
The incidence, mechan- and results istic factors, predictors using
propensity score-matched controls, and evolution of severe PDLs through 18
months were assessed. Of the 1878 patients randomized in the trial, the
Amulet occluder had significantly fewer severe PDLs than the Watchman
device at 45 days (1.1 vs. 3.2%, P < 0.001) and 12 months (0.1 vs. 1.1%, P
< 0.001). Off-axis deployment or missed lobes were leading mechanistic PDL
factors in each device group. Larger left atrial appendage (LAA)
dimensions including orifice diameter, landing zone diameter, and depth
predicted severe PDL with the Watchman device, with no significant
anatomical limitations noted with the Amulet occluder. Procedural and
device implant predictors were found with the Amulet occluder attributed
to the learning curve with the device. A majority of Watchman device
severe PDLs did not resolve over time through 18 months. Conclusion The
dual-occlusive Amplatzer Amulet LAA occluder provided improved LAA closure
compared with the Watchman 2.5 device. Predictors and temporal
observations of severe PDLs were identified in the Amulet IDE
trial. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<70>
Accession Number
2026197022
Title
Efficacy of perioperative prophylactic administration of corticosteroids
in pediatric cardiac surgeries using cardiopulmonary bypass: a systematic
review with meta-analysis.
Source
Anaesthesia Critical Care and Pain Medicine. 42(6) (no pagination), 2023.
Article Number: 101281. Date of Publication: December 2023.
Author
Takeshita J.; Nakajima Y.; Tachibana K.; Takeuchi M.; Shime N.
Institution
(Takeshita, Tachibana) Department of Anesthesiology, Osaka Prefectural
Hospital Organization, Osaka Women's and Children's Hospital, 840
Murodo-cho, Osaka, Izumi 594-1101, Japan
(Nakajima) Department of Anesthesiology and Intensive Care, Kinki
University Faculty of Medicine, 377-2 Ohnohigashi, Osaka, Sayama 589-8511,
Japan
(Nakajima) Outcomes Research Consortium, 9500 Euclid Avenue, P77,
Cleveland, OH 44195, United States
(Takeuchi) Department of Critical Care Medicine, National Cerebral and
Cardiovascular Center, 6-1 Kishibeshinmachi, Osaka, Suita 564-8565, Japan
(Shime) Department of Emergency and Critical Care Medicine, Graduate
School of Biomedical & Health Sciences, Hiroshima University, 1-3-2
Kagamiyama, Hiroshima, Higashihiroshima 739-8511, Japan
Publisher
Elsevier Masson s.r.l.
Abstract
An updated systematic review with meta-analysis comparing perioperative
prophylactic administration of corticosteroids with placebo in pediatric
cardiac surgeries using cardiopulmonary bypass was conducted. The Cochrane
Central Register of Controlled Trials and MEDLINE (via PubMed) were
searched for relevant randomized controlled trials published between
January 1, 2000, and February 14, 2023. The primary outcome was
postoperative in-hospital mortality. Secondary outcomes were duration of
mechanical ventilation, length of intensive care unit and hospital stay,
postoperative low cardiac output syndrome, and adverse events. A total of
11 studies were included in the meta-analysis. Corticosteroid
administration did not decrease postoperative in-hospital mortality
compared with placebo (relative risk, 0.69; 95% confidence interval,
0.40-1.17). Subgroup analyses according to the type of corticosteroids and
neonates revealed that corticosteroids did not decrease postoperative
in-hospital mortality. In the trial sequential analysis, the last point in
the z-curve was within the futility borders. Although the duration of
mechanical ventilation (mean difference, -5.54 h; 95% confidence interval
(CI), -9.75 - -1.34) and incidence of low cardiac output syndrome
(relative risk, 0.75; 95% CI, 0.59 - 0.96) decreased with corticosteroid
administration, it did not affect the length of intensive care unit (mean
difference, -0.28 days; 95% CI, -0.74 - 0.17) and hospital stay (mean
difference, -0.59 days; 95% CI, -1.31 - 0.14). In conclusion,
perioperative prophylactic corticosteroid administration in pediatric
cardiac surgeries using cardiopulmonary bypass did not decrease
postoperative in-hospital mortality compared with placebo. According to
the trial sequential analysis results, additional randomized controlled
trials assessing mortality are not required. PROSPERO Registry Number: CRD
42023391789. Copyright © 2023 Societe francaise d'anesthesie et
de reanimation (Sfar)

<71>
Accession Number
2025963378
Title
Transcatheter Aortic Valve Replacement in Bicuspid Versus Tricuspid Aortic
Valve Stenosis: Meta-Analysis and Systemic Review.
Source
American Journal of Cardiology. 203 (pp 105-112), 2023. Date of
Publication: 15 Sep 2023.
Author
Saeed Al-Asad K.; Martinez Salazar A.; Radwan Y.; Wang E.; Salam M.F.;
Sabanci R.; Saeed M.; Halboni A.; Al-Abcha A.; Abela G.
Institution
(Saeed Al-Asad, Martinez Salazar, Radwan, Wang, Salam, Sabanci, Saeed)
Department of Internal Medicine, Michigan State University, East Lansing,
MI, United States
(Halboni) Department of Internal Medicine, Wayne State University,
Detroit, MI, United States
(Al-Abcha) Department of Cardiology, Mayo Clinic, Rochester, Minnesota,
United States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
Publisher
Elsevier Inc.
Abstract
Because of its anatomic and procedural complexities, bicuspid aortic valve
(BAV) has been excluded from previous trials investigating transcatheter
aortic valve replacement (TAVR). We aimed to compare the clinical outcomes
of TAVR in BAV and tricuspid aortic valve patients. We searched the
databases systematically from inception until March 2023 for studies that
reported the outcomes of TAVR in BAV and tricuspid aortic valve patients.
The primary focus was all-cause mortality at 1 year. Additional outcomes
included outcomes at 30-day follow-up. Secondary and subgroup analyses
were performed on propensity-matched patients, patients at low surgical
risk, and based on the type of transcatheter valve type. We included 30
studies with a total of 193,274 patients who underwent TAVR, of which
14,353 patients had BAV stenosis. The rate of 1-year mortality was lower
in the BAV group compared with the tricuspid group with the results
reaching statistical significance (odds ratio [OR] 0.86, 95% confidence
interval [CI] 0.75 to 0.98, p = 0.02). The rate of 30-day stroke, however,
was higher in patients with BAV who underwent TAVR (OR 1.24, 95% CI 1.08
to 1.43, p <0.05). Other 30-day clinical outcomes were similar between the
2 groups. Similar outcomes were observed in secondary analysis of matched
populations with less mortality and higher rate of stroke in patients with
BAV (OR 0.84, 95% CI 0.72 to 0.96, p = 0.01, and OR 1.38, 95% CI 1.09 to
1.75, p <0.05, respectively). Comparing the outcomes for self-expandable
and balloon-expandable valves resulted in similar results. Subgroup
analysis of low-surgical-risk patients similarly showed lower 1-year
mortality in patients with BAV (OR 0.67, 95% CI 0.50 to 0.91, p = 0.01),
without difference in 30-day stroke between the 2 groups (OR 1.24, 95% CI
0.83 to 1.88, p = 0.30). In conclusion, this report indicates that TAVR is
safe and feasible in patients with BAV, including patients at low surgical
risk. The higher rate of 30-day stroke, however, warrants caution when
pursuing TAVR in this population. More studies, specifically randomized
trials, are still warranted to further assess the safety and the long-term
outcomes in this group. Copyright © 2023 Elsevier Inc.

<72>
Accession Number
2025626767
Title
A Systematic Review and Meta-analysis of the Effects of Topical Tranexamic
Acid versus Topical Vasoconstrictors on the Management of Epistaxis.
Source
Current Pharmaceutical Design. 29(19) (pp 1497-1503), 2023. Date of
Publication: 2023.
Author
Li T.; Li F.; Cha X.; Wang S.; Yan J.; Wang T.; Liang C.; Zhuang C.; Ren
W.; Liu H.
Institution
(Li, Li, Cha, Wang, Wang, Liang, Ren, Liu) Department of Otolaryngology,
Changzheng Hospital, Naval Medical University (Second Military Medical
University), Shanghai, China
(Yan, Zhuang) School of Pharmacy, Naval Medical University (Second
Military Medical University), Shanghai, China
Publisher
Bentham Science Publishers
Abstract
Objective: We aimed to evaluate the effectiveness of topical tranexamic
acid (TXA) versus topical vasoconstrictors in the management of epistaxis
via a systematic review and meta-analysis. Method(s): The Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
standards were followed for the meta-analysis. We systematically searched
Embase, Web of Science, Cochrane Library, CNKI, and PubMed for randomized
controlled trials (from inception to August 2022; no language
restrictions), comparing the effect of topical TXA and topical
vasoconstrictors on the treatment of epistaxis. The Q test was used to
evaluate heterogeneity, and funnel plots were utilized to identify bias.
For the meta-analysis, the fixed-effects model was employed, and the
t-test was utilized to determine significance. Result(s): Of 1012
identified studies, 5 were found to be eligible for our analysis. In
total, 598 patients were in-cluded; 297 of them received TXA and 301
received vasoconstrictors. Hemostasis was more likely to be achieved at
the first re-assessment in patients treated with TXA. Subgroup analysis
indicated patients treated with TXA to have less likelihood of bleeding
recurrence, compared to patients treated with vasoconstrictors. The
detected time interval of rebleeding was 10 min, between 24 h to 72 h, and
after 7 days, respectively, and the differences were significant between
the two groups of patients treated with TXA and vasoconstrictors.
 Conclusion(s): Topical TXA was associated with better post-treatment
hemorrhagic arrest rates compared to topical vasoconstrictors in the
management of epistaxis. Systematic Review Registration: This systematic
review is registered in PROSPERO (https://www.crd.y-ork.ac.uk/prospero
CRD42022328881). Copyright © 2023 Bentham Science Publishers.

<73>
Accession Number
2025434956
Title
Evaluation of the Effect of New Multimodal Analgesia Regimen for Cardiac
Surgery: A Prospective, Randomized Controlled, Single-Center Clinical
Study [Response to Letter].
Source
Drug Design, Development and Therapy. 17 (pp 2457-2460), 2023. Date of
Publication: 2023.
Author
Jin L.; Guo K.
Institution
(Jin, Guo) Department of Anesthesia, Zhongshan Hospital, Fudan University,
Shanghai, China
Publisher
Dove Medical Press Ltd

<74>
Accession Number
2025409148
Title
Perioperative selenium administration in cardiac surgery patients, a way
out to reduce post surgical adversities? A meta analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1235247. Date of Publication: 2023.
Author
Rehan S.T.; Hussain H.U.; Imran L.; Eqbal F.; Asghar M.S.
Institution
(Rehan, Hussain, Imran, Eqbal) Department of Medicine, Dow University of
Health Sciences, Karachi, Pakistan
(Asghar) Mayo Clinic-Rochester, Rochester, MN, United States
Publisher
Frontiers Media SA
Abstract
Introduction: The oxidative damage suffered in cardiac surgery is
associated with declining trace elements which lead to the development of
multi organ dysfunction (MOD), acute kidney injury (AKI), or increased
length of hospital stay (LOS). Recent evidence shows the cardioprotective
role of the trace element selenium as it mitigates worsening outcomes post
cardiac surgery. Hence, this meta analysis aims to investigate the role of
selenium in lowering cardiac surgery related adverse outcomes.
 Method(s): Literature search of five electronic databases was
performed from the inception of the paper till 29th July, 2023.
Eligibility criteria included; (a) randomized clinical trials with Adult
patients (>=18 years) undergoing cardiac surgery (b) intervention with
selenium pre or/and postoperatively; (c) a control group of a placebo,
normal saline, or no selenium. Outcomes of interest include postoperative
mortality, LOS in the hospital and Intensive Care Unit (ICU), AKI,
troponin I, and Creatinine Kinase-MB (CK-MB). The Cochrane bias assessment
tool was used to evaluate the risk of bias. Outcomes were pooled with the
Mantel-Haenszel Random-effects model using Review Manager. Result(s):
Seven RCTs with 2,521 patients and 65% of males were included in this
paper. No noticable differences were observed between selenium and control
groups in terms of postoperative AKI, mortality, LOS in hospital and ICU,
troponin I, and CK-MB levels. All studies had a low risk of bias on
quality assessment. Discussion(s): Our meta analysis demonstrated no
discernible effects of selenium infusion on post operative complications
among patients undergoing cardiac surgery. Further large scale multi
centered studies comparing the protective role of selenium with combined
therapy of other bioactive agents are needed to provide convincing
explanations. Systematic Review Registration: PROSPERO Identifier:
424920. Copyright 2023 Rehan, Hussain, Imran, Eqbal and Asghar.

<75>
Accession Number
2025175675
Title
Randomized comparison of effects of two different remifentanil dose on
surgical conditions during endoscopic sinus surgery.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 292. Date
of Publication: December 2023.
Author
Jeong J.H.; Park C.W.; Yoon Y.J.; Lee D.J.; Cho S.Y.
Institution
(Jeong) Department of Otorhinolaryngology, Hanyang University Guri
Hospital, Guri-Si, Gyeonggi-Do, South Korea
(Park, Yoon, Lee, Cho) Department of Anesthesiology and Pain Medicine,
Hanyang University Guri Hospital, 249-1, Gyomun-Dong, Guri-Si, Gyeonggi-Do
471-701, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: The combination of propofol and remifentanil results in better
surgical field conditions during endoscopic sinus surgery than inhalation
anesthesia. This study compared surgical field conditions between two
groups receiving low or high concentration of remifentanil and hemodynamic
variables using non-invasive cardiac monitoring. Method(s):
Fifty-four patients between ASA I or II, were randomly assigned to either
the high-concentration remifentanil group (HR), effect-site concentration
of 8 ng/mL or the low-concentration remifentanil group(LR), effect-site
concentration of 4 ng/mL. Surgical condition was evaluated using the
Boezaart Surgical Field Grading Scale presented by Boezaart. Cardiac
output was measured using non-invasive cardiac monitoring (CSN-1901).
 Result(s): In terms of surgical conditions, the HR group showed
significantly lower values than the LR group (p = 0.021) at 90 min after
the start of surgery. Heart rate was significantly lower in the HR group
than the LR group at 30, 60, and 90 min after the start of surgery (30
min; p = 0.005, 60 min; p = 0.002, 90 min; p = 0.001). There was a
statistically significant decrease of cardiac output in the HR group
compared to the LR group immediately after endotracheal intubation and at
30, 60, and 90 min after the start of surgery (Base; P = 0.222,
Intubation; P = 0.016, 30 min; p = 0.014, 60 min; P = 0.012, 90 min; P =
0.008). However, in the case of stroke volume, there was no significant
difference between the two groups in all measurements. Conclusion(s):
When comparing the HR group and the LR group, the surgical condition was
improved at 90 min after the start of surgery. MAP was lower in the HR
group and this was a result of reduction in cardiac output primarily
attributed to the decrease in heart rate rather than a decrease in stroke
volume. Trial registration: Clinical Trial Registry of the Republic of
Korea (KCT0006453). Copyright © 2023, BioMed Central Ltd., part
of Springer Nature.

<76>
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.

<77>
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.

<78>
Accession Number
2026619680
Title
Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative
Delirium (B-Free): A Protocol for a Multi-centre Randomized Cluster
Crossover Trial.
Source
CJC Open. 5(9) (pp 691-699), 2023. Date of Publication: September 2023.
Author
Spence J.; Belley-Cote E.; Jacobsohn E.; Lee S.F.; D'Aragon F.; Avidan M.;
Mazer C.D.; Rousseau-Saine N.; Rajamohan R.; Pryor K.; Klein R.; Tan
E.C.-H.; Cameron M.; Di Sante E.; DeBorba E.; Mustard M.; Couture E.;
Zamper R.; Law M.; Djaiani G.; Saha T.; Choi S.; Hedlin P.; Pikaluk R.;
Lam W.Y.; Deschamps A.; Whitlock R.; Dulong B.; Devereaux P.J.; Beaver C.;
Kloppenburg S.; Oczkowski S.; McIntyre W.F.; McFarling M.; Lamy A.;
Vincent J.; Connolly S.
Institution
(Spence) Departments of Anesthesia and Critical Care and Health Research
Methods, Evaluation, and Impact, McMaster University; and Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Belley-Cote, Devereaux) Departments of Medicine (Cardiology and Critical
Care) and Health Research Methods, Evaluation, and Impact, McMaster
University and Perioperative Research Division, Population Health Research
Institute, Hamilton, ON, Canada
(Jacobsohn) Departments of Anesthesia and Perioperative Medicine and
Medicine (Critical Care), University of Manitoba, Winnipeg, MB, Canada
(Lee) Department of Health Research Methods, Evaluation, and Impact,
McMaster University and Population Health Research Institute, Hamilton,
ON, Canada
(D'Aragon) Departement d'anesthesiologie, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Avidan) Department of Anesthesia, Washington University at St. Louis, St.
Louis, MO, United States
(Mazer) Department of Anesthesia and Li Ka Shing Knowledge Institute, St.
Michael's Hospital and Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Rousseau-Saine, Deschamps) Departement d'anesthesiologie, Universite de
Montreal, Montreal, QC, Canada
(Rajamohan, Klein, Law) Department of Anesthesia, University of British
Columbia, Vancouver, BC, Canada
(Pryor) Department of Anesthesiology, Weill Cornell Medical College, New
York, NY, United States
(Tan, Dulong) Department of Anesthesia, Dalhousie University, Halifax, NS,
Canada
(Cameron) Department of Anesthesia, McGill University, Montreal, QC,
Canada
(Di Sante, DeBorba, Vincent) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Mustard) St. Michael's Hospital, Toronto, ON, Canada
(Couture) Departement d'anesthesiologie, Universite Laval, Quebec City,
QC, Canada
(Zamper) Department of Anesthesia, University of Western Ontario, London,
ON, Canada
(Djaiani, Choi) Department of Anesthesiology and Pain Medicine, University
of Toronto, Toronto, ON, Canada
(Saha) Department of Anesthesia, Queen's University, Kingston, ON, Canada
(Hedlin, Pikaluk) Department of Anesthesia, University of Saskatchewan,
Saskatoon, SK, Canada
(Lam) Department of Anesthesia, University of Alberta, Edmonton, AB,
Canada
(Whitlock) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University and Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Beaver) Sheridan College, Brampton, ON, Canada
(Kloppenburg) Population Health Research Institute, Hamilton, ON, Canada
(Oczkowski) Department of Medicine (Critical Care), McMaster University,
Hamilton, ON, Canada
(McIntyre) Department of Medicine (Cardiology), McMaster University and
Perioperative Research Division, Population Health Research Institute,
Hamilton, ON, Canada
(McFarling) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(Lamy) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University, Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Connolly) Department of Medicine (Cardiology), McMaster University and
Population Health Research Institute, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Delirium is common after cardiac surgery and is associated with adverse
outcomes. Administration of benzodiazepines before and after cardiac
surgery is associated with delirium; guidelines recommend minimizing their
use. Benzodiazepine administration during cardiac surgery remains common
because of its recognized benefits. The Benzodiazepine-Free Cardiac
Anesthesia for Reduction of Postoperative Delirium (B-Free) trial is a
randomized cluster crossover trial evaluating whether an institutional
policy of restricting intraoperative benzodiazepine administration (ie, >=
90% of patients do not receive benzodiazepines during cardiac surgery), as
compared with a policy of liberal intraoperative benzodiazepine
administration (ie, >= 90% of patients receive >= 0.03 mg/kg midazolam
equivalent), reduces delirium. Hospitals performing >= 250 cardiac
surgeries a year are included if their cardiac anesthesia group agrees to
apply both benzodiazepine policies per their randomization, and patients
are assessed for postoperative delirium every 12 hours in routine clinical
care. Hospitals apply the restricted or liberal benzodiazepine policy
during 12 to 18 crossover periods of 4 weeks each. Randomization for all
periods takes place in advance of site startup; sites are notified of
their allocated policy during the last week of each crossover period.
Policies are applied to all patients undergoing cardiac surgery during the
trial period. The primary outcome is the incidence of delirium at up to 72
hours after surgery. The B-Free trial will enroll >= 18,000 patients
undergoing cardiac surgery at 20 hospitals across North America. Delirium
is common after cardiac surgery, and benzodiazepines are associated with
the occurrence of delirium. The B-Free trial will determine whether an
institutional policy restricting the administration of benzodiazepines
during cardiac surgery reduces the incidence of delirium after cardiac
surgery. Clinicaltrials.gov registration number: NCT03928236 (First
registered April 26, 2019). Copyright © 2023 The Authors

<79>
Accession Number
2026533399
Title
Comparison of radial, dorsalis pedis, and posterior tibial arteries for
ultrasound-guided arterial catheterisation with dynamic needle tip
positioning in paediatric patients: a randomised controlled trial.
Source
British Journal of Anaesthesia. 131(4) (pp 739-744), 2023. Date of
Publication: October 2023.
Author
Takeshita J.; Nakayama Y.; Tachibana K.; Nakajima Y.; Hamaba H.; Shime N.
Institution
(Takeshita, Tachibana, Hamaba) Department of Anesthesiology, Osaka
Prefectural Hospital Organization, Osaka Women's and Children's Hospital,
Murodo-cho, Izumi, Osaka, Japan
(Nakayama) Department of Molecular, Cellular and Biomedical Sciences CUNY
School of Medicine, City College of New York, Convent Avenue, New York,
NY, United States
(Nakajima) Department of Anesthesiology and Intensive Care, Kinki
University Faculty of Medicine, Ohnohigashi, Sayama, Osaka, Japan
(Nakajima) Outcomes Research Consortium, Euclid Avenue, Cleveland, OH,
United States
(Shime) Department of Emergency and Critical Care Medicine, Graduate
School of Biomedical & Health Sciences, Hiroshima University, Kagamiyama,
Higashihiroshima, Hiroshima, Japan
Publisher
Elsevier Ltd
Abstract
Background: Arterial catheterisation in children can be challenging and
time-consuming. We aimed to compare the success rates of ultrasound-guided
arterial catheterisation utilising the short-axis out-of-plane approach
with dynamic needle tip positioning in the radial, dorsalis pedis, and
posterior tibial arteries in paediatric patients. We also examined the
factors influencing the catheterisation success using dynamic needle tip
positioning. Method(s): Paediatric patients (aged <3 yr) undergoing
cardiac surgery were randomly assigned to three groups based on puncture
sites: radial artery (Group R), dorsalis pedis artery (Group D), and
posterior tibial artery (Group P). The first-attempt and overall success
rates of arterial catheterisation were compared, followed by multiple
logistic regression analysis (dependent variable: first-attempt success;
independent variables: body weight, diameter and depth of the artery,
targeted artery, and trisomy 21). Result(s): The study included 270
subjects (n=90 per group). There was no significant difference in the
first-attempt (Group R: 82%, Group D: 76%, and Group P: 81%) and overall
success rates (Group R: 94%, Group D: 93%, and Group P: 91%) among the
three groups. The diameter of the artery (per 0.1 mm) (odds ratio: 1.32,
95% confidence interval: 1.09-1.60) and trisomy 21 (odds ratio: 0.43, 95%
confidence interval: 0.20-0.92) were independent predictors of
first-attempt success or failure. Conclusion(s): The first-attempt
and overall success rates of arterial catheterisation of the dorsalis
pedis and posterior tibial arteries were not inferior to those in the
radial artery when using dynamic needle tip positioning. These two lower
extremity peripheral arteries present viable alternative catheterisation
sites in paediatric patients. Clinical trial registration:
UMIN000042847. Copyright © 2023 British Journal of Anaesthesia

<80>
Accession Number
2026303788
Title
Serratus anterior and pectoralis plane blocks for robotically assisted
mitral valve repair: a randomised clinical trial. Comment on Br J Anaesth
2023; 130: 786-94.
Source
British Journal of Anaesthesia. 131(4) (pp e126-e127), 2023. Date of
Publication: October 2023.
Author
Xue F.S.; Gao X.; Li C.W.
Institution
(Xue, Gao, Li) Department of Anesthesiology, Beijing Friendship Hospital,
Capital Medical University, Beijing, China
Publisher
Elsevier Ltd

<81>
Accession Number
2025966555
Title
Renin-angiotensin-aldosterone system dynamics after targeted blood
pressure control using angiotensin II or norepinephrine in cardiac
surgery: mechanistic randomised controlled trial.
Source
British Journal of Anaesthesia. 131(4) (pp 664-672), 2023. Date of
Publication: October 2023.
Author
Coulson T.G.; Miles L.F.; Zarbock A.; Burrell L.M.; Patel S.K.; von Groote
T.; Pilcher D.; Weinberg L.; Landoni G.; Bellomo R.
Institution
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred
Health and Monash University, Melbourne, VIC, Australia
(Coulson, Miles, Weinberg, Bellomo) Department of Critical Care,
University of Melbourne, Melbourne, VIC, Australia
(Miles, Weinberg) Department of Anaesthesia and Pain Medicine, Austin
Health, Melbourne, VIC, Australia
(Zarbock, von Groote) Department of Anaesthesiology, Intensive Care and
Pain Medicine, University Hospital Munster, Munster, Germany
(Burrell, Patel) Department of Medicine, Austin Health, University of
Melbourne, Heidelberg, VIC, Australia
(Burrell) Department of Cardiology, Austin Health, Heidelberg, VIC,
Australia
(Burrell) The Institute for Breathing and Sleep, Heidelberg, VIC,
Australia
(Pilcher) Department of Intensive Care, Alfred Hospital, Melbourne, VIC,
Australia
(Pilcher, Bellomo) Australian and New Zealand Intensive Care Research
Centre, Monash University, Melbourne, VIC, Australia
(Landoni) Department of Anaesthesia, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne, VIC,
Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: The role of the renin-angiotensin-aldosterone axis in
vasoplegia after cardiac surgery remains unclear. We tested the hypothesis
that, compared with norepinephrine, infusion of angiotensin II titrated to
achieve similar mean arterial pressure (MAP) would suppress plasma renin
concentration (PRC) while maintaining aldosterone levels. Method(s):
In a double-blind, randomised controlled trial, subjects received either
an infusion of angiotensin II or norepinephrine to maintain MAP 70-80 mm
Hg from induction of anaesthesia. We compared PRC, aldosterone, dipeptidyl
peptidase-3, and angiotensin-converting enzyme 2 activity between
treatment groups, before surgery, on ICU admission, and 24 h after
surgery. Result(s): In 60 patients (11.7% female; mean age 68 yr [11
yr]), norepinephrine increased median PRC at ICU admission (median
difference [MD] 46 [inter-quartile range, IQR, 3-88] muU ml-1;
P<0.001) but angiotensin II did not (MD -3 [IQR -62 to 35] muU
ml-1; P=0.36). Aldosterone levels increased with both. The
aldosterone:PRC ratio did not change with norepinephrine (MD -0.01 [IQR
-0.14 to 0.03] muU ml-1 per ng dl-1, P=0.76) but
increased with angiotensin II (MD 0.05 [IQR 0.004-0.26] muU
ml-1 per ng dl-1, P<0.001). The upper quartile of
PRC before surgery was associated with higher vasopressor requirements
when norepinephrine was used to maintain MAP, but not angiotensin II.
Dipeptidyl peptidase-3 levels and angiotensin-converting enzyme 2
activities were similar at all time points. Conclusion(s):
Angiotensin II suppressed renin release while maintaining aldosterone
levels compared with norepinephrine. Higher plasma renin concentration
before surgery was associated with greater vasopressor requirement for
norepinephrine, but not angiotensin II. Clinical trial registration:
Australian and New Zealand Clinical Trials Registry-ACTRN12621000195853
23/02/2021. Copyright © 2023 British Journal of Anaesthesia

<82>
Accession Number
2025404130
Title
Prevention of cardiac surgery-associated acute kidney injury: a systematic
review and meta-analysis of non-pharmacological interventions.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 354. Date of
Publication: December 2023.
Author
Hariri G.; Collet L.; Duarte L.; Martin G.L.; Resche-Rigon M.; Lebreton
G.; Bougle A.; Dechartres A.
Institution
(Hariri, Collet, Martin, Dechartres) Departement de Sante Publique, UMR-S
1136, AP-HP, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante
Publique, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France
(Hariri, Duarte, Bougle) Departement d'anesthesie et reanimation, GRC 29,
DMU DREAM, Institut de Cardiologie, Assistance Publique-Hopitaux de Paris
(AP-HP), Hopital La Pitie-Salpetriere, Sorbonne Universite, Paris 75013,
France
(Resche-Rigon) ECSTRRA - CRESS UMR1153, INSERM and SBIM, AP-HP, Hopital
Saint-Louis, Universite de Paris, Paris, France
(Lebreton) AP-HP, Service de Chirurgie Cardiaque, Institut de Cardiologie,
Hopital La Pitie-Salpetriere, Sorbonne Universite, Paris 75013, France
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is
frequent. While two network meta-analyses assessed the impact of
pharmacological interventions to prevent CSA-AKI, none focused on
non-pharmacological interventions. We aim to assess the effectiveness of
non-pharmacological interventions to reduce the incidence of CSA-AKI.
 Method(s): We searched PubMed, Embase, Central and clinical trial
registries from January 1, 2004 (first consensus definition of AKI) to
July 1, 2023. Additionally, we conducted manual screening of abstracts of
major anesthesia and intensive care conferences over the last 5 years and
reference lists of relevant studies. We selected all randomized controlled
trials (RCTs) assessing a non-pharmacological intervention to reduce the
incidence of CSA-AKI, without language restriction. We excluded RCTs of
heart transplantation or involving a pediatric population. The primary
outcome variable was CSA-AKI. Two reviewers independently identified
trials, extracted data and assessed risk of bias. Random-effects
meta-analyses were conducted to calculate risk ratios (RRs) with 95%
confidence intervals (CIs). We used the Grading of Recommendations
Assessment, Development, and Evaluation to assess the quality of evidence.
 Result(s): We included 86 trials (25,855 patients) evaluating 10
non-pharmacological interventions to reduce the incidence of CSA-AKI. No
intervention had high-quality evidence to reduce CSA-AKI. Two
interventions were associated with a significant reduction in CSA-AKI
incidence, with moderate quality of evidence: goal-directed perfusion (RR,
0.55 [95% CI 0.40-0.76], I 2 = 0%; P <inf>het</inf> = 0.44) and
remote ischemic preconditioning (RR, 0.86 [0.78-0.95]; I 2 =
23%; P <inf>het</inf> = 0.07). Pulsatile flow during cardiopulmonary
bypass was associated with a significant reduction in CSA-AKI incidence
but with very low quality of evidence (RR = 0.69 [0.48; 0.99]; I
2 = 53%; P <inf>het</inf> < 0.01). We found high quality of
evidence for lack of effect of restrictive transfusion strategy (RR, 1.02
[95% CI 0.92; 1.12; P <inf>het</inf> = 0.67; I 2 = 3%) and
tight glycemic control (RR, 0.86 [95% CI 0.55; 1.35]; P <inf>het</inf> =
0.25; I 2 = 26%). Conclusion(s): Two non-pharmacological
interventions are likely to reduce CSA-AKI incidence, with moderate
quality of evidence: goal-directed perfusion and remote ischemic
preconditioning. Copyright © 2023, BioMed Central Ltd., part of
Springer Nature.

<83>
Accession Number
2023225726
Title
The connotation between perioperative glycemic control approach and
sternal wound infection in individuals with diabetes mellitus experiencing
cardiac surgery: A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3324-3330), 2023. Date of
Publication: October 2023.
Author
Tan G.; Li Y.; Zhou G.
Institution
(Tan) Department of Cardiovascular Medicine, Sichuan Academy of Medical
Sciences & Sichuan Provincial People's Hospital, Sichuan, China
(Li) Department of Endoscopy, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
(Zhou) Department of Endocrinology, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation to measure the connotation between
perioperative glycemic control (GC) approach and sternal wound infection
(SWI) in individuals with diabetes mellitus (DM) experiencing cardiac
surgery (CS). A comprehensive literature inspection till February 2023 was
applied and 2654 interrelated investigations were reviewed. The 12 chosen
investigations enclosed 1564 individuals with DM and CS in the chosen
investigations' starting point, 790 of them were using strict GC, and 774
were using moderate GC. Odds ratio (OR) in addition to 95% confidence
intervals (CIs) were used to compute the value of the Connotation between
the perioperative GC approach and SWI in individuals with DM experiencing
CS by the dichotomous and continuous approaches and a fixed or random
model. Strict GC had significantly lower SWI (OR, 0.33; 95% CI,
-0.22-0.50, P <.001) compared with those with moderate GC in individuals
with DM and CS. Strict GC had significantly lower SWI compared with those
with moderate GC in individuals with DM and CS. However, caused of the
small sample sizes of several chosen investigations for this
meta-analysis, care must be exercised when dealing with its
values. Copyright © 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<84>
Accession Number
2023208702
Title
Immediate flap increases patient safety for deep sternal wound infection:
A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3271-3278), 2023. Date of
Publication: October 2023.
Author
Qiu X.; Sun X.; Huang G.
Institution
(Qiu, Sun) Affiliated Hospital of Weifang Medical University, School of
Clinical Medicine, Weifang Medical University, Weifang, China
(Qiu, Huang) Department of Burns and Plastic Surgery, Jinan Central
Hospital, Jinan, China
(Huang) Department of Burns and Plastic Surgery, Central Hospital
Affiliated to Shandong First Medical University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
Deep sternal wound infection is a severe complication after cardiac
surgery. We performed a meta-analysis evaluating the impact of immediate
flap and NPWT on mortality and length of hospital stay. The meta-analysis
was registered (CRD42022351755). A systematic literature search was
conducted from inception to January, 2023, including PubMed, EMBASE,
Cochrane Library, ClinicalTrials.gov and EU Clinical Trials Register. The
main outcome were in-hospital mortality and late mortality. And additional
outcomes were length of stay and ICU stay time. A total of 438 patients
(Immediate flap: 229; NPWT: 209) from four studies were included in this
study. Immediate flap was associated with lower in-hospital mortality (OR
0.33, 95% CI 0.13-0.81, P =.02) and length of stay (SMD -13.24, 95% CI
-20.53 to -5.94, P =.0004). Moreover, pooled analysis demonstrated no
significant difference was found in two groups in terms of late mortality
(OR 0.64, 95% CI 0.35-1.16, P =.14) and ICU stay time (SMD -1.65, 95% CI
-4.13 to 0.83, P =.19). Immediate flap could reduce in-hospital mortality
and length of stay for patients with deep sternal wound infection. Flap
transplantation as soon as possible may be advised. Copyright ©
2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<85>
Accession Number
2023045999
Title
The effect of the multiple arterial grafts compared with single arterial
graft for coronary artery bypass grafting on sternal wound complications:
A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3249-3254), 2023. Date of
Publication: October 2023.
Author
Yang X.; Fu J.; Zhang S.
Institution
(Yang, Zhang) Department of Cardiothoracic Surgery, the First College of
Clinical Medical Science, China Three Gorges University, Hubei, Yichang,
China
(Yang, Zhang) Department of Cardiothoracic Surgery, Yichang Central
People's Hospital, Hubei, Yichang, China
(Fu) Department of Oncology, the Second People's Hospital of China Three
Gorges University, Hubei, Yichang, China
(Fu) Department of Oncology, Yichang Second People's Hospital, Hubei,
Yichang, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation was executed to measure the influence of
multiple arterial grafts (MAGs) compared with single arterial graft (SAG)
for coronary artery bypass grafting (CABG) on sternal wound complications
(SWCs). A comprehensive literature inspection till February 2023 was
applied and 1048 interrelated investigations were reviewed. The seven
chosen investigations enclosed 11 201 individuals with CABG in the chosen
investigations' starting point, 4870 of them were using MAGs, and 6331
were using SAG. Odds ratio (OR) in addition to 95% confidence intervals
(CIs) were utilised to compute the value of the effect of the MAGs
compared with SAG for CABG on SWCs by the dichotomous approaches and a
fixed or random model. MAGs had significantly higher SWC (OR, 1.38; 95%
CI, 1.10-1.73, P =.005) compared with those with SAG in CABG. MAGs had
significantly higher SWC compared with those with SAG in CABG. However,
care must be exercised when dealing with its values because of the low
number of selected investigations for the meta-analysis. Copyright
© 2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<86>
Accession Number
2018953611
Title
Infant's difficult temperament characteristics predict poor quality of
life in parents of infants with complex CHDs post-cardiac surgery.
Source
Cardiology in the Young. 33(8) (pp 1316-1321), 2023. Date of Publication:
22 Aug 2023.
Author
Golfenshtein N.; Lisanti A.J.; Medoff-Cooper B.
Institution
(Golfenshtein) University of Haifa, Department of Nursing, 199 Abba Hushi
Ave., Haifa 3498838, Israel
(Golfenshtein, Lisanti, Medoff-Cooper) University of Pennsylvania, School
of Nursing, Claire M. Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104,
United States
(Lisanti) Children's Hospital of Philadelphia, 3401 Civic Center Blvd,
Philadelphia, PA 19104, United States
Publisher
Cambridge University Press
Abstract
Background & Aims: Parents of infants with complex CHDs often describe
their infants as especially fussy, irritable, and difficult to sooth,
which together with the illness caretaking demands add to their stress.
Little is known about how the behavioural style or temperament in the
early months after discharge relates to parental quality of life. This
study aimed to explore the associations between early infant temperament
characteristics and parental quality of life in parents of infants with
complex CHD. Method(s): This descriptive, cross-sectional study,
utilised data collected in a previously described multisite randomised
clinical trial in the United States. Multivariable linear regression
models were used to examine the associations of interest. Finding(s):
Results demonstrated negative significant associations between most infant
temperament subscales and parental quality of life. Higher scores on the
Activity (beta = -3.03, p = 0.021), Approach (beta = -1.05, p = 0.021),
Adaptability (beta = -3.47, p = 0.004), Intensity (beta = -2.78, p =
0.008), Mood (beta = -4.65, p < 0.001), and Distractibility (beta = -3.36,
p = 0.007 were all significantly associated with lower parental quality of
life scores, adjusting for parental dyadic adjustment, insurance type,
number of medications, and number of unscheduled cardiologist visits.
 Conclusion(s): Parental perceptions of infant's difficult behavioural
style or temperament characteristics appear to be associated with poorer
quality of life in parents of infants with complex CHD post-cardiac
surgery. Findings can be used in the screening process of families at
potential risk of increased stress and poor illness adaptation and in the
design of interventions to target parental mental health in this
vulnerable patient population. Copyright © The Author(s), 2022.
Published by Cambridge University Press.

<87>
Accession Number
641778199
Title
Predicting Death or Disability after Surgery in the Older Adult.
Source
Anesthesiology. 139(4) (pp 420-431), 2023. Date of Publication: 01 Oct
2023.
Author
Shulman M.A.; Wallace S.; Gilbert A.; Reilly J.R.; Kasza J.; Myles P.S.
Institution
(Shulman, Wallace, Reilly, Myles) Department of Anaesthesiology and
Perioperative Medicine, Alfred Hospital and Monash University, Melbourne,
Australia
(Gilbert) Data Governance and Security, Alfred Hospital, Melbourne,
Australia
(Kasza) School of Public Health and Preventive Medicine, Monash
University, Melbourne, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Older patients are vulnerable to developing new or worsening
disability after surgery. Despite this, patient or surgical
characteristics predisposing to postoperative disability are poorly
defined. The aim of the study was to develop and validate a model,
subsequently transformed to point-score form, to predict 6-month death or
disability in older patients after surgery. METHOD(S): The authors
built a prospective, single-center registry to develop and validate the
prediction model. The registry included patients 70 yr of age or older
undergoing elective and nonelective, cardiac and noncardiac surgery
between May 25, 2017, and February 11, 2021, and combined clinical data
from the electronic medical record, hospital administrative data
(International Classification of Diseases, Tenth Revision, Australian
Modification codes) and World Health Organization (Geneva, Switzerland)
Disability Assessment Schedule data collected directly from the patients.
Death or disability was defined as being dead or having a World Health
Organization Disability Assessment Schedule score 16% or greater. Included
patients were randomly divided into model development (70%) and internal
validation (30%) cohorts. Once constructed, the logistic regression and
point-score models were assessed using the internal validation cohort and
an external validation cohort comprising data from a separate randomized
trial. RESULT(S): Of 2,176 patients who completed the World Health
Organization Disability Assessment Schedule immediately before surgery,
927 (43%) patients were disabled, and 413 (19%) had significant
disability. By 6 months after surgery, 1,640 patients (75%) had data
available for the primary outcome analysis. Of these patients, 195 (12%)
patients had died, and 691 (42%) were dead or disabled. The developed
point-score model included the preoperative World Health Organization
Disability Assessment Schedule score, patient age, dementia, and chronic
kidney disease. The point score model retained good discrimination in the
internal (area under the curve, 0.74; 95% CI, 0.69 to 0.79) and external
(area under the curve, 0.77; 95% CI, 0.74 to 0.80) validation data sets.
 CONCLUSION(S): The authors developed and validated a point score
model to predict death or disability in older patients after
surgery. Copyright © 2023 American Society of Anesthesiologists.
All Rights Reserved.

<88>
[Use Link to view the full text]
Accession Number
638725470
Title
Nonpharmacological Cognitive Impairment Prevention Interventions in Older
Adults Undergoing Cardiac Surgery: A Systematic Review.
Source
The Journal of cardiovascular nursing. 38(5) (pp E165-E177), 2023. Date of
Publication: 01 Sep 2023.
Author
Mulkey M.A.; Smith A.B.; Wion R.K.; House S.L.; Wierenga K.L.
Publisher
NLM (Medline)
Abstract
BACKGROUND: More than 1 million individuals undergo cardiothoracic surgery
for coronary artery bypass graft or valve repair/replacement annually in
the United States. There is an increased risk of developing serious
cognitive impairment post cardiothoracic surgery. Pharmacological
interventions and surgical techniques were associated with improvements in
cognitive function in previous systematic reviews. However, a gap in the
literature exists regarding how nonpharmacological interventions can
mitigate cognitive impairment in adults undergoing cardiac surgery.
 OBJECTIVE(S): The aim of this study was to explore the effectiveness
of nonpharmacological interventions to reduce the detrimental effects of
cardiac surgery on cognitive function in patients after cardiothoracic
surgery. METHOD(S): CINAHL, MEDLINE, PubMed, EMBASE, PsycINFO, and
Web of Science databases were searched following the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses guidelines from January
2011 to February 2022. RESULT(S): Nineteen studies were included in
this review. Researchers defined cognitive impairment differently across
studies. Various interventions were used to reduce cognitive impairment
post cardiothoracic surgery, with the most common being remote ischemic
limb conditioning. The interventions used to reduce cognitive impairment
were heterogeneous in outcomes, measurements, and time of assessment, but
only 2 interventions were associated with a reduction in cognitive
impairment. CONCLUSION(S): This review is a unique synthesis of the
quality of interventions that address broader components of cognition.
Researchers used various interventions to reduce cognitive impairment; the
outcomes, instruments, and time interval for measurements were
heterogeneous. Researchers should conduct future studies at multiple time
intervals, using a comprehensive measure of cognitive impairment to better
understand the impact of cognitive impairment interventions
postoperatively. Copyright © 2022 Wolters Kluwer Health, Inc. All
rights reserved.

<89>
Accession Number
2025520829
Title
Comparison of Edge of Lamina Block with Thoracic Paravertebral Block and
Retrolaminar Block for Analgesic Efficacy in Adult Patients Undergoing
Video-Assisted Thoracic Surgery: A Prospective Randomized Study.
Source
Journal of Pain Research. 16 (pp 2375-2382), 2023. Date of Publication:
2023.
Author
Gao X.; Chen M.; Liu P.; Zhou S.; Kong S.; Zhang J.; Cao J.
Institution
(Gao, Chen, Liu, Zhou, Kong, Zhang, Cao) Department of Anesthesiology,
Shanghai Sixth People's Hospital, No. 600, Yishan Road, Shanghai 200233,
China
Publisher
Dove Medical Press Ltd
Abstract
Background: A novel ultrasound-guided paravertebral block, the edge
laminar block (ELB) was reported recently. However, it was unclear how
effective ELB was in comparison with traditional blocking methods. We
conducted a trial to compare the analgesic efficacy of ELB with the
thoracic paravertebral block (TPVB) and the retrolaminar block (RLB) in
patients undergoing video-assisted thoracic surgery (VATS).
 Method(s): We identified 90 patients who were scheduled for VATS and
randomly assigned them to three groups: ELB group (Group E), TPVB group
(Group T), and RLB group (Group R). Each group underwent ELB, TPVB, and
RLB, respectively, under ultrasound guidance before general anesthesia
induction. All patients received post-operative routine analgesia
protocol. Our primary outcome was the extent of dermatomal sensory loss on
the midclavicular, midaxillary, and scapular lines, measured using a
pinprick 15 minutes after the nerve block. Secondary outcomes included the
intraoperative dose of sufentanil, the numerical rating scale (NRS) scores
assessed in the post-anesthesia care unit (PACU) and at 6, 12, and 24
hours post-operatively, and pethidine administrated as analgesic rescue
dose. Result(s): The percentages of nerve block range reaching the
midclavicular line, midaxillary line, and scapular line in Group E were
96.7%, 93.3%, 93.3%, and 60% in Group T and 30%, 56.7%, and 96.7% in Group
R, respectively. Group E had wider dermatomal sensory loss on the
midclavicular line and midaxillary line compared to Group R (P < 0.001)
and had a wider range compared to Group T on the scapular line (P <
0.001). There was no significant difference in the intraoperative use of
sufentanil in the three groups. Post-operative NRS scores at each time
point were significantly lower in Group E than those in the other two
groups (P < 0.01). Conclusion(s): ELB had a wider nerve block range
and applied better post-operative analgesia in comparison with TPVB and
RLB. Copyright © 2023 Gao et al.

<90>
Accession Number
2026852101
Title
Application of Ultrasound-Guided Erector Spinae Plane Block Combined with
General Anesthesia in Thoracoscopic Lobectomy and Its Regulating Effect on
Hemodynamics, Oxidative Stress, and Postoperative Pain.
Source
Analytical and Quantitative Cytopathology and Histopathology. 43(6) (pp
736-744), 2021. Date of Publication: December 2021.
Author
Xu D.; Zhou X.; Xu L.
Institution
(Xu) Department of Anesthesiology, The Second Affiliated Hospital of
Suzhou University, Jiangsu, Suzhou, China
(Zhou) the Department of Ultrasound, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
(Xu) Department of Anesthesiology, The Second Affiliated Hospital of
Suzhou University, China
Publisher
Science Printers and Publishers Inc.
Abstract
OBJECTIVE: To explore the application value of ultrasound-guided erector
spinae plane block (ESPB) combined with general anesthesia in
thoracoscopic lobectomy, as a reference for reducing postoperative pain in
patients. STUDY DESIGN: 92 patients were randomly divided into control
group (n=46) and study group (n=46). Both groups were given general
anesthesia, and the study group received combined ultrasound-guided ESPB.
Statistics of the intraoperative and postoperative opioid application of
the 2 groups (sufentanil, remifentanil, morphine at 12, 24, and 48 hours
after surgery), postoperative pain score (VAS), expression of pain
factors, oxidative response irritation, and the occurrence of adverse
reactions were recorded. RESULT(S): As compared to the control group,
the dosage of sufentanil, remifentanil, and morphine after surgery in the
study group was less (p<0.05); VAS scores after operation were lower
(p<0.05); levels of heart rate and mean arterial pressure at times before
surgery (T0), 10 minutes (T1), 30 minutes (T2), and immediately after
surgery (T3) in the study group were higher (p<0.05); the serum
neuropeptide, prostaglandin E2, and 5-hydroxytryptamine levels of the
study group immediately after the operation and 12 hours after the
operation were lower (p<0.05); the serum MDA level of the study group was
lower; and the GSH-Px and SOD levels were higher (p<0.05). Comparing the
occurrence of adverse reactions between the 2 groups of patients, the
combination of ultrasound ESPB and general anesthesia does not increase
the vocalization rate of adverse reactions. CONCLUSION(S): For
thoracoscopic lobectomy, ultrasound ESPB combined with general anesthesia
can reduce the amount of opioids used. At the same time, it can inhibit
the expression of serum pain mediators, stabilize hemodynamics, reduce
oxidative stress and postoperative pain, and has high safety. (Anal Quant
Cytopathol Histpathol 2021;43:736-744) Copyright © Science
Printers and Publishers, Inc.

<91>
Accession Number
2025401623
Title
Effect of valve leaflet surface patterning on valve hydrodynamic
performance.
Source
International Journal of Artificial Organs. (no pagination), 2023. Date
of Publication: 2023.
Author
Wang A.; Wang Y.; Liu W.; Liu L.; Zhou J.
Institution
(Wang, Wang, Zhou) State Key Laboratory of Cardiovascular Disease, FuWai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Liu) Beijing Star Medical Devices Co., Ltd, Beijing, China
(Liu) Center for Medical Devices Testing, National Institutes for Food and
Drug Control, Beijing, China
Publisher
SAGE Publications Ltd
Abstract
Objective: We aimed to elucidate the effects of the micro-structure of the
pyrolytic carbon for artificial heart valves on its hydrodynamic
performance. Method(s): Bileaflet mechanical valves of GKS 23 and 29
A were randomly selected. According to ISO5840, mean transvalvular
pressure (MPG), regurgitation fraction (RF), and effective orifice area
(EOA) of valve were assessed. Then, parallel-groove pattern was
constructed by laser etching on leaflet surface, and the valves were
subjected again to the same test. Result(s): Compared with before
patterning at 2, 3.5, 5, and 7 L/min, the MPG of the valves in two
specifications were higher, the EOA was larger in 23 A, but smaller in 29
A, and the RF was contrary to EOA. At 5 L/min, the RF in both
specifications was lower after etching at 45 bpm. At 70 bpm however, the
RF in 23 A decreased, in 29 A increased. Conclusion(s): The
parallel-groove pattern on leaflet surface affected the hemodynamic
performance of the valve prostheses. Copyright © The Author(s)
2023.

<92>
Accession Number
2025401434
Title
Direct oral anticoagulants versus vitamin K antagonists: Which one is more
effective in atrial fibrillation.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Khodadadiyan A.; Jazi K.; Bazrafshan drissi H.; Bazroodi H.; Mashayekh M.;
Sadeghi E.; Gholamabbas G.; Bazrafshan M.; Rahmanian M.
Institution
(Khodadadiyan, Bazroodi) Student Research Committee, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Jazi) Student Research Committee, Faculty of Medicine, Medical University
of Qom, Qom, Iran, Islamic Republic of
(Bazrafshan drissi, Bazrafshan, Rahmanian) Cardiovascular Research Center,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Mashayekh, Gholamabbas) Shiraz Nephro-Urology Research Center, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Sadeghi) Research Consultation Center (RCC), Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
Publisher
SAGE Publications Ltd
Abstract
Background: The optimal approach for anticoagulation in patients with
bioprosthetic valves and atrial fibrillation (AF) remains a subject of
debate. A meta-analysis using updated evidence to evaluate the efficacy
and safety of direct oral anticoagulants (DOACs) compared to vitamin K
antagonists (VKAs) in patients with AF and bioprosthetic valves to address
this controversy. Method(s): A comprehensive search was conducted in
multiple databases, including PubMed, Scopus, Web of Science, ProQuest,
and the Cochrane Central Register of Controlled Trials, up until March
2023. The search aimed to identify relevant randomized controlled trials
(RCTs) that examined the efficacy and safety outcomes of both direct oral
anticoagulants (DOACs) and vitamin K antagonists (VKAs) in patients with
bioprosthetic valves and atrial fibrillation. The primary outcomes of
interest were major bleeding and all-cause mortality. Result(s): Our
study demonstrated that despite the difference was not significant, the
hazard of all-cause mortality was 2.5% higher in the DOAC group (HR =
1.03, 95% CI = [0.88, 1.19], p-value =.75). Similarly, the hazard of
stroke (HR = 1.03, 95% CI = [0.87, 1.32], p-value =.71) and major bleeding
(HR = 1.11, 95% CI = [0.89, 1.38], p-value =.36) were found to be
respectively 3.2 and 10.7% higher in the DOAC group, although the
difference was not significant. However, the hazard of intracranial
hemorrhage was found to be 28.8 lower in the DOAC treatment group (HR =
0.71, 95% CI = [0.39, 1.31], p-value =.27), which again was not
statistically significant. Conclusion(s): Our meta-analysis
demonstrates that in patients undergoing bioprosthetic valve surgery and
presenting with AF afterward, DOAC and VKA are similar regarding
life-threatening and all-cause mortality outcomes, including major
bleeding, stroke, and intracranial hemorrhage. Copyright © The
Author(s) 2023.

<93>
Accession Number
642259969
Title
Conventional anatomical landmark versus preprocedural ultrasound for
thoracic epidural analgesia: A systematic review and meta-analysis.
Source
Journal of perioperative practice. (pp 17504589231181974), 2023. Date of
Publication: 13 Sep 2023.
Author
Sharapi M.; Mahfouz A.; Philip K.; Mektebi A.; Albakri K.
Institution
(Sharapi) Department of Anaesthesiology and Intensive Care Medicine,
Beaumont Hospital, RCSI Hospital Group, Dublin, Ireland
(Mahfouz) Faculty of Medicine, Kafrelsheikh University, Egypt
(Philip) Faculty of Medicine, Sohag University, Sohag, Egypt
(Mektebi) Faculty of Medicine, Kutahya Health Sciences University,
Kutahya, Turkey
(Albakri) Faculty of Medicine, Hashemite University, Zarqa, Jordan
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thoracic epidural analgesia is the gold standard for major
thoracic and abdominal surgeries. AIM: Ultrasound-guided and
landmark-based thoracic epidural insertion are compared in this systematic
review. METHOD(S): Randomised controlled trials were sought in six
databases for a systematic review and meta-analysis. With a 95% confidence
interval, a fixed-effects model calculated risk ratio or mean difference.
Cochrane risk of bias assessed bias. Four randomised controlled trials
were examined. FINDINGS: Preprocedural ultrasound increased thoracic
epidural placement first-puncture success rate (risk ratio = 1.28, 95%
confidence interval (1.05 to 1.56), p value = 0.02) and decreased the need
for two or more skin punctures (mean difference = -2.41, 95% confidence
interval (-3.34 to -1.47), p value = 0.00001). The ultrasound group
reduced needle redirections (risk ratio = 0.6, 95% confidence interval
(0.38 to 0.94), p value = 0.02). The epidural block success rate was equal
in both groups (risk ratio = 1.02, 95% confidence interval (0.96 to 1.07),
p value = 0.6). CONCLUSION(S): Thoracic epidural insertion is
improved by ultrasound but not the success rate. Quality research with
larger samples is needed to emphasise these conclusions.

<94>
Accession Number
2023483359
Title
A review of frequently used Kampo prescriptions: Part 2-Hangekobokuto.
Source
Traditional and Kampo Medicine. 10(2) (pp 103-119), 2023. Date of
Publication: August 2023.
Author
Suzuki T.; Kikuchi A.; Kaneko A.; Arita R.; Nogami T.; Saito N.; Takayama
S.
Institution
(Suzuki) Department of General Internal Medicine, Saitama Medical
University Hospital, Saitama, Japan
(Kikuchi, Arita, Takayama) Department of Kampo and Integrative Medicine,
Tohoku University Graduate School of Medicine, Sendai, Japan
(Kikuchi, Arita, Saito, Takayama) Department of Education and Support for
Regional Medicine, Department of Kampo Medicine, Tohoku University
Hospital, Sendai, Japan
(Kaneko) Saiwaitsurumi Hospital, Yokohama, Japan
(Nogami) Department of Kampo Medicine, Tokai University School of
Medicine, Isehara, Japan
Publisher
John Wiley and Sons Inc
Abstract
Background: The origin of hangekobokuto (HKT) is from Jin Gui Yao Lue
(Kinkiyoryaku in Japanese), and it has been indicated for treating throat
discomfort in women. Key Findings: HKT consists of five crude drugs.
Clinical studies have shown that HKT can improve the swallowing reflex by
increasing the substance P level in saliva; improve the cough reflex;
reduce pneumonia in patients with dementia, cerebrovascular disease,
Alzheimer's disease, or Parkinson's disease; reduce postoperative
aspiration pneumonia in patients who undergo cardiovascular surgery; and
improve depression and anxiety scores in patients with globus hystericus.
Furthermore, HKT has been reported to increase serotonin (5-HT) and
noradrenaline levels in the hypothalamus, and dopamine (DA) levels in the
striatum in a healthy rodent model; improve 5-HT levels in the striatum
and hippocampus, and ameliorate 5-HT and DA reductions in the whole brain
in an acute stress model; improve 5-HT levels in the striatum, and
ameliorate 5-HT and DA reductions in the prefrontal cortex in a chronic
stress model; and decrease corticosterone and corticotropin-releasing
factor levels in a chronic stress model. Reported adverse events of HKT
include interstitial pneumonia (0.38 per 100 000 cases) and liver damage
(0.89 per 100 000 cases), which are rare. Conclusion(s): HKT is
widely used and shows a low rate of adverse events. Several clinical
studies have reported its effects in reducing aspiration pneumonia and
improving depression and anxiety, some of which may be explained by the
regulation of monoamines and stress hormones in the brain and substance P
levels in the oral cavity. Copyright © 2023 The Authors.
Traditional & Kampo Medicine published by John Wiley & Sons Australia, Ltd
on behalf of Japan Society for Oriental Medicine and Japan Society of
Medical and Pharmaceutical Sciences for Traditional Medicine.

<95>
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.

<96>
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.

<97>
Accession Number
2025193934
Title
Sex differences in permanent pacemaker implantation after transcatheter
aortic valve replacement: a systematic review and meta-analysis.
Source
Expert Review of Cardiovascular Therapy. 21(9) (pp 631-641), 2023. Date of
Publication: 2023.
Author
Rivera F.B.; Cha S.W.; Aparece J.P.; Gonzales J.S.T.; Salva W.F.C.;
Bantayan N.R.B.; Carado G.P.; Sharma V.; Al-Abcha A.; Co M.L.; Collado
F.M.S.; Volgman A.S.
Institution
(Rivera) Department of Medicine, Lincoln Medical Center, New York, NY,
United States
(Cha, Aparece, Gonzales, Salva) Cebu Institute of Medicine, Cebu,
Philippines
(Bantayan) University of the Philippines College of Medicine, Manila,
Philippines
(Carado) University of the East Ramon Magsaysay Memorial Medical Center,
Quezon, Philippines
(Sharma) Department of Cardiology, University of Iowa Hospitals and
Clinics, Lowa City, IA, United States
(Al-Abcha) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Co) Section of Clinical Cardiac Electrophysiology, Thomas Jefferson
University, Philadelphia, PA, United States
(Collado, Volgman) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: There is limited evidence on the effect of sex on permanent
pacemaker implantation (PPMI) after transcatheter aortic valve replacement
(TAVR). The primary objective of this meta-analysis was to determine the
role of sex among patients requiring PPMI post-TAVR. Method(s): A
literature search was conducted using the SCOPUS, MEDLINE, and CINAHL
databases for studies published until October 2022. Eligible studies
included published randomized controlled trials (RCTs) and Observational
Cohort Studies (OCS) articles that reported PPMI as an outcome of
pacemaker status following TAVR. This study was performed per the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) Guidelines. Publication bias was estimated using a Funnel plot
and Egger's test. Data were pooled using a random-effects model. The
primary endpoint was the sex difference in PPMI after TAVR, with odds
ratios and 95% confidence intervals (CIs) extracted. Result(s): Data
was obtained from 63 studies, and a total of 79,655 patients were
included. The cumulative PPMI rate was 15.5% (95% CI, 13.6%-17.7%). The
pooled analysis revealed that while there were more females than males
undergoing TAVR (51.6%, 95% CI 50.4%-52.8%), males have a 14.5% higher
risk for post-TAVR PPMI than females (OR 1.145, 95% CI 1.047-1.253, P <
0.01). Conclusion(s): Males are more likely to experience PPMI after
TAVR than females. Further research needs to be done to better explain
these observed differences in outcomes. Copyright © 2023 Informa
UK Limited, trading as Taylor & Francis Group.

<98>
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.

<99>
Accession Number
2026931267
Title
Urothelial bladder cancer with cardiac metastasis: Literature review and
case report.
Source
International Journal of Surgery Case Reports. 111 (no pagination), 2023.
Article Number: 108630. Date of Publication: October 2023.
Author
de Araujo Souza L.C.; Ribeiro E.C.; Pinto T.D.A.; de Ulhoa Barbosa T.M.J.;
da Trindade Netto M.B.; Barbosa S.A.C.
Institution
(de Araujo Souza, Ribeiro, da Trindade Netto, Barbosa) University of
Brasilia Hospital (HUB/UnB), Brazil
(Pinto, de Ulhoa Barbosa) Base Hospital of the Federal District (HBDF),
Brazil
Publisher
Elsevier Ltd
Abstract
Introduction and importance: Urothelial bladder cancer can infrequently
result in cardiac metastasis, and be usually diagnosed in severe clinical
conditions. We report a urothelial bladder cancer with cardiac metastasis
and perform a literature review of published cases of transitional cell
carcinoma (TCC) of the bladder with cardiac metastasis from 1934 to 2023
published in Pubmed. Case presentation: 42-year-old woman with urinnary
bladder TCC, underwent radical cystectomy, developing cardiac metastasis
after 25 months, cardiac surgery for partial removal of the lesion and
using pembrolizumab with the highest reported survival to date. Clinical
discussion: After analysis of 20 case reports in the world among our case,
men are more affected, tobacco exposure was the most prevalent risk
factor, baseline T3 staging was the most common, and right ventricular and
myocardium metastases are more prevalent. The most common symptoms were
respiratory failure, changes in cardiac auscultation, and loss of weight.
Six patients had cardiac tamponade, and the mean of drained fluid was 1040
ml. Immunohistochemical markers, such as CK7 and Calretinin, were decisive
in elucidating the diagnosis. The average time between diagnosis of TCC
and cardiac metastasis was 48.69 months, and the survival time after
diagnosis of cardiac metastasis was 60.69 days. Conclusion(s):
Bladder TCC with cardiac metastasis is rare and with a low survival rate
after the diagnosis. Patients with more advanced stages of TCC deserve
diagnostic suspicion of cardiac metastasis if they progress with
previously unreported respiratory and cardiac symptoms. Copyright
© 2023 The Authors

<100>
Accession Number
2026929551
Title
Longitudinal cohort study investigating neurodevelopmental and
socioemotional outcomes in school-entry aged children after open heart
surgery in Australia and New Zealand: the NITRIC follow-up study protocol.
Source
BMJ Open. 13(8) (no pagination), 2023. Article Number: e075429. Date of
Publication: 30 Aug 2023.
Author
Long D.; Anderson V.A.; Crossley L.; Sood N.T.; Charles K.R.; MacDonald
A.D.; Bora S.; Pestell C.F.; Murrell K.; Pride N.A.; Anderson P.J.; Badawi
N.; Rose B.; Baillie H.; Masterson K.; Flores J.C.; Sherring C.; Raman S.;
Beca J.; Erickson S.; Festa M.; Anderson B.W.; Venugopal P.; Yim D.;
Andrews D.; Cheung M.; Brizard C.; Gentles T.L.; Iyengar A.; Nicholson I.;
Ayer J.; Butt W.; Schlapbach L.J.; Gibbons K.S.
Institution
(Long, Charles) School of Nursing, Queensland University of Technology,
Kelvin Grove, QLD, Australia
(Long, Charles, Raman) Paediatric Intensive Care Unit, Queensland
Children's Hospital, South Brisbane, QLD, Australia
(Anderson, Crossley, Sood, Masterson, Cheung, Brizard, Butt) Clinical
Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia
(Anderson) Psychology Service, Royal Children's Hospital, Parkville, VIC,
Australia
(MacDonald, Rose, Raman, Schlapbach, Gibbons) Child Health Research
Centre, The University of Queensland, South Brisbane, QLD, Australia
(Bora) Department of Pediatrics, University Hospitals Rainbow Babies and
Children's Hospital, Case Western Reserve University School of Medicine,
Cleveland, OH, United States
(Bora) Mater Research Institute, The University of Queensland, South
Brisbane, QLD, Australia
(Pestell) School of Psychological Science, University of Western
Australia, Crawley, WA, Australia
(Murrell) Consult Liaison Team, Starship Children's Hospital, Auckland,
New Zealand
(Pride) Kids Neuroscience Centre, The Children's Hospital at Westmead,
Westmead, NSW, Australia
(Anderson) Turner Institute for Brain and Mental Health, Monash
University, Clayton, VIC, Australia
(Badawi) Grace Centre for Newborn Care, The Children's Hospital at
Westmead, Westmead, NSW, Australia
(Rose) Australian and New Zealand Fontan Advocacy Committee, HeartKids
Australia Inc, Sydney, NSW, Australia
(Baillie, Festa) Paediatric Intensive Care Unit, The Children's Hospital
at Westmead, Westmead, NSW, Australia
(Masterson, Butt) Paediatric Intensive Care Unit, Royal Children's
Hospital, Parkville, VIC, Australia
(Flores, Erickson) Paediatric Intensive Care Unit, Perth Children's
Hospital, Nedlands, WA, Australia
(Sherring, Beca) Paediatric Intensive Care Unit, Starship Children's
Hospital, Auckland, New Zealand
(Anderson) Queensland Paediatric Cardiac Service, Queensland Children's
Hospital, South Brisbane, QLD, Australia
(Anderson, Venugopal) School of Medicine, The University of Queensland,
South Brisbane, QLD, Australia
(Venugopal) Department of Cardiac Surgery, Queensland Children's Hospital,
South Brisbane, QLD, Australia
(Yim) Department of Paediatric Cardiology, Perth Children's Hospital,
Nedlands, WA, Australia
(Andrews) Department of Cardiothoracic Surgery, Perth Children's Hospital,
Nedlands, WA, Australia
(Cheung) Department of Cardiology, Royal Children's Hospital, Parkville,
VIC, Australia
(Brizard) Department of Cardiac Surgery, Royal Children's Hospital,
Parkville, VIC, Australia
(Gentles) Paediatrics, Child and Youth Health, The University of Auckland,
Auckland, New Zealand
(Gentles, Iyengar) Paediatric and Congenital Cardiac Service, Starship
Children's Hospital, Auckland, New Zealand
(Iyengar) Department of Surgery, The University of Auckland, Auckland, New
Zealand
(Nicholson, Ayer) Heart Centre for Children, The Children's Hospital at
Westmead, Westmead, NSW, Australia
(Schlapbach) Department of Intensive Care and Neonatology, University
Children's Hospital Zurich, Zurich, Switzerland
Publisher
BMJ Publishing Group
Abstract
Introduction Despite growing awareness of neurodevelopmental impairments
in children with congenital heart disease (CHD), there is a lack of large,
longitudinal, population-based cohorts. Little is known about the
contemporary neurodevelopmental profile and the emergence of specific
impairments in children with CHD entering school. The performance of
standardised screening tools to predict neurodevelopmental outcomes at
school age in this high-risk population remains poorly understood. The
NITric oxide during cardiopulmonary bypass to improve Recovery in Infants
with Congenital heart defects (NITRIC) trial randomised 1371 children <2
years of age, investigating the effect of gaseous nitric oxide applied
into the cardiopulmonary bypass oxygenator during heart surgery. The
NITRIC follow-up study will follow this cohort annually until 5 years of
age to assess outcomes related to cognition and socioemotional behaviour
at school entry, identify risk factors for adverse outcomes and evaluate
the performance of screening tools. Methods and analysis Approximately
1150 children from the NITRIC trial across five sites in Australia and New
Zealand will be eligible. Follow-up assessments will occur in two stages:
(1) annual online screening of global neurodevelopment, socioemotional and
executive functioning, health-related quality of life and parenting stress
at ages 2-5 years; and (2) face-to-face assessment at age 5 years
assessing intellectual ability, attention, memory and processing speed;
fine motor skills; language and communication; and socioemotional
outcomes. Cognitive and socioemotional outcomes and trajectories of
neurodevelopment will be described and demographic, clinical, genetic and
environmental predictors of these outcomes will be explored. Ethics and
dissemination Ethical approval has been obtained from the Children's
Health Queensland (HREC/20/QCHQ/70626) and New Zealand Health and
Disability (21/NTA/83) Research Ethics Committees. The findings will
inform the development of clinical decision tools and improve preventative
and intervention strategies in children with CHD. Dissemination of the
outcomes of the study is expected via publications in peer-reviewed
journals, presentation at conferences, via social media, podcast
presentations and medical education resources, and through CHD family
partners. Trial registration number The trial was prospectively registered
with the Australian New Zealand Clinical Trials Registry as Gene
Expression to Predict Long-Term Neurodevelopmental Outcome in Infants from
the NITric oxide during cardiopulmonary bypass to improve Recovery in
Infants with Congenital heart defects (NITRIC) Study - A Multicentre
Prospective Trial'. Trial registration: ACTRN12621000904875.
 Copyright © 2023 BMJ Publishing Group. All rights reserved.

<101>
Accession Number
2026943059
Title
Optimal antiplatelet strategy following coronary artery bypass grafting: A
meta-analysis.
Source
Heart. (no pagination), 2023. Article Number: heartjnl-2023-323097. Date
of Publication: 2023.
Author
Agrawal A.; Kumar A.; Majid M.; Badwan O.; Arockiam A.D.; El Dahdah J.;
Syed A.B.; Schleicher M.; Reed G.W.; Cremer P.C.; Griffin B.P.; Menon V.;
Wang T.K.M.
Institution
(Agrawal, Kumar, Majid, Badwan, Arockiam, El Dahdah, Syed, Reed, Cremer,
Griffin, Menon, Wang) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH 44195, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland,
OH, United States
Publisher
BMJ Publishing Group
Abstract
Objective: Coronary artery bypass grafting (CABG) is an established
revascularisation strategy for multivessel and left main coronary artery
disease. Although aspirin is routinely recommended for patients with CABG,
the optimal antiplatelet regimen after CABG remains unclear. We evaluated
the efficacies and risks of different antiplatelet regimens (dual (DAPT)
versus single (SAPT), and dual with clopidogrel (DAPT-C) versus dual with
ticagrelor or prasugrel (DAPT-T/P)) after CABG. Method(s): We
followed Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines and performed a comprehensive literature search
using PubMed, Ovid Medline, Ovid Embase and Cochrane Central Register of
Controlled Trials. Data were extracted and pooled using random-effects
models and Review Manager (V.5.4). Result(s): Among the 2970 article
abstracts screened, 215 full-text articles were reviewed and 38 studies
totaling 77 447 CABG patients were included for analyses. DAPT compared
with SAPT was associated with significantly lower all-cause mortality (OR
0.65 with 95% CI 0.50 to 0.86; p=0.002), cardiovascular mortality (OR
0.53, 95% CI 0.33 to 0.84; p=0.008), and major adverse cardiac and
cerebrovascular events (MACCE) (OR 0.68, 95% CI 0.51 to 0.91; p=0.01), but
higher rates of major (OR 1.30, 95% CI 1.08 to 1.56; p=0.007) and minor
bleeding (OR 1.87, 95% CI 1.28 to 2.74; p=0.001) after CABG. DAPT-T/P
compared with DAPT-C was associated with significantly lower all-cause (OR
0.43, 95% CI 0.29 to 0.65; p<=0.0001) and cardiovascular mortality (OR
0.44, 95% CI 0.24 to 0.80; p=0.008), and no differences on other
cardiovascular or bleeding outcomes after CABG. Conclusion(s): In
patients with CABG, DAPT compared with SAPT and DAPT-T/P compared with
DAPT-C were associated with reduction in all-cause and cardiovascular
mortality, especially in patients with acute coronary syndrome.
Additionally, DAPT was associated with reduction in MACCE, but higher
rates of major and minor bleeding. An individualised approach to choosing
antiplatelet regimen is necessary for patients with CABG based on
ischaemic and bleeding risks. Copyright © 2023 Author(s).
Published by BMJ.

<102>
Accession Number
642244073
Title
Reticulated Platelets Predict Cardiovascular Death and Adverse Events in
Coronary Artery Disease: A Systematic Review and Meta-analysis.
Source
Thrombosis and haemostasis. (no pagination), 2023. Date of Publication:
11 Sep 2023.
Author
Bongiovanni D.; Novelli L.; Condello F.; Kirmes K.; Han J.; Wein B.;
Elvinger S.; Viggiani G.; von Scheidt M.; Laugwitz K.-L.; Raake P.W.J.;
Kastrati A.; Chiarito M.; Bernlochner I.
Institution
(Bongiovanni, Wein, Elvinger, Raake) Department of Internal Medicine I,
Cardiology, University Hospital Augsburg, University of Augsburg, Germany
(Bongiovanni, Novelli, Condello, Chiarito) Department of Cardiovascular
Medicine, Humanitas Clinical and Research Center IRCCS and Humanitas
University, Rozzano, Milan, Italy
(Bongiovanni, Kirmes, Han, Viggiani, Laugwitz, Bernlochner) Department of
Internal Medicine I, School of Medicine, University hospital rechts der
Isar, Technical University of Munich, Munich, Germany
(von Scheidt, Kastrati) Department of Cardiology, Deutsches Herzzentrum
Munchen, Technical University of Munich, Munich, Germany
(Laugwitz, Kastrati, Bernlochner) German Center for Cardiovascular
Research (DZHK), Partner Site Munich Heart Alliance, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: The pro-thrombotic immature or reticulated platelets (RPs)
are known to be elevated in high-risk patients and in different
pathological settings. It has been shown that RPs correlate with an
insufficient antiplatelet response to antiplatelet agents. RPs are
emerging novel predictors of adverse cardiovascular events in
cardiovascular disease. This study, using the totality of existing
evidence, evaluated the prognostic role of RPs in patients with coronary
artery disease. METHOD(S): We performed a systematic review and
meta-analysis including trials of acute and chronic coronary syndrome
reporting clinical outcomes according to RPs levels in the peripheral
blood. We compared patients with elevated RPs (RPshigh) to patients
without elevated RPs (RPslow). Odds ratios (ORs) and 95% CIs were used as
metric of choice for treatment effects with random-effects models. The
primary endpoint was major adverse cardiovascular and cerebrovascular
events (MACCE). Secondary endpoints were cardiovascular death, myocardial
infarction, ischemic stroke, urgent coronary revascularization and
bleedings. RESULT(S): A total of 7 studies, including 2213 patients,
were included. The risk for MACCE was significantly higher in RPshigh
compared to RPslow patients (OR 2.67 [1.87; 3.81], I2 =43.8%). RPshigh
were associated with cardiovascular death (OR 2.09 [1.36; 3.22], I2
=40.4%). No associations for RPshigh were detected with the other singular
components of MACCE: myocardial infarction (OR 1.73 [0.89; 3.38] I2
=60.5%) and stroke (OR 1.72 [0.59; 4.96] I2 =21%). The risk of bleeding
did not differ between groups(OR 0.58 [0.15; 2.22] I2 =86.1%).
 CONCLUSION(S): Elevated RPs are significantly associated with
increased risk of cardiovascular events and cardiovascular
death. Copyright Thieme. All rights reserved.

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