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<1>
Accession Number
2027890602
Title
Effect of sexual counseling on sexual function and sexual quality of life
for women undergoing open heart surgery: a pilot randomized controlled
trial.
Source
Journal of Sexual Medicine. 20(7) (pp 1010-1017), 2023. Date of
Publication: 01 Jul 2023.
Author
Tuncer M.; Yesiltepe Oskay U.
Institution
(Tuncer) Department of Women's Health and Diseases Nursing, Istanbul
University, School of Nursing, Istanbul, Turkey
(Yesiltepe Oskay) Department of Women's Health and Diseases Nursing,
Florence Nightingale Faculty of Nursing, Istanbul, Turkey
Publisher
Oxford University Press
Abstract
Background: Sexual counseling can improve or may have benefit to patients'
sexual function after open heart surgery. Aim(s): The study aims to
determine the effect of sexual counseling on sexual function and quality
of sexual life with the PLISSIT model (ie, permission, limited
information, specific suggestions, intensive therapy) for women undergoing
open heart surgery. Method(s): The study was a pilot randomized
controlled trial. Seventy women who planned open heart surgery were
randomly divided into the control group or the sexual counseling group
between November 2020 and November 2021. In addition to routine care,
sexual counseling with the PLISSIT model was given to women in the sexual
counseling group for 12 weeks after the operation. During the research, 6
PLISSIT sessions were conducted. Women in the control group received
routine postoperative care, which included hospital-provided postoperative
home care practices (medication, nutrition, physical activity).
 Outcome(s): Data were obtained with an information form, the Beck
Depression Inventory, the Female Sexual Function Index, and the Sexual
Quality of Life Questionnaire-Female. Result(s): The women in the
sexual counseling and control groups were similar in terms of
sociodemographic, obstetric, gynecologic, general health, current heart
disease, and sexual function data (P .05). After sexual counseling with
the PLISSIT model, scores on the Female Sexual Function Index and Sexual
Quality of Life Questionnaire-Female significantly increased in the sexual
counseling group while Beck Depression Inventory scores decreased (P .05).
Comparisons were made within and between groups. Clinical Implications:
Sexual counseling with the PLISSIT model is a useful and effective model
for health professionals to improve the sexual function and sexual quality
of life of women's who will undergo open heart surgery. Strengths and
Limitations: The limitations of the study were as follows: only 1
assessment after the intervention ended, no short- or longterm follow-up,
and a small sample size. Other limitations include the absence of controls
for therapeutic context or positive expectations in the experimental
group. Conclusion(s): Sexual counseling with the PLISSIT model after
open heart surgery increased the sexual function and sexual quality of
life of women while reducing the symptoms of depression. Copyright
© 2023 Elsevier B.V.. All rights reserved.

<2>
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

<3>
Accession Number
2025362657
Title
ASA Allergy and Desensitization Protocols in the Management of CAD: A
Review of Literature.
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5627. Date of Publication: September 2023.
Author
Verdoia M.; Gioscia R.; Nardin M.; De Luca G.
Institution
(Verdoia, Gioscia) Division of Cardiology, Nuovo Ospedale degli Infermi,
ASL Biella, Biella 13900, Italy
(Nardin) Division of Internal Medicine, Spedali Civili, Brescia 13900,
Italy
(De Luca) Divisione di Cardiologia, AOU "Policlinico G. Martino", Messina
98122, Italy
(De Luca) Dipartimento di Medicina Clinica e Sperimentale, Universita di
Messina, Messina 98122, Italy
(De Luca) Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio,
Milan 20151, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Acetylsalicylic acid (ASA) hypersensitivity still represents one of the
major deals for patients with atherosclerotic cardiovascular disease
(ASHD), especially for those requiring percutaneous coronary interventions
in the absence of validated alternative options. Despite symptoms after
ASA administration being reported in 6-20% of cases, true ASA allergy only
represents a minority of the patients, pointing to the importance of
challenge tests and potential strategies for tolerance induction. ASA
desensitization protocols were proposed several decades ago, with
accumulating the literature on their use in patients undergoing PCI either
for chronic disease or acute coronary syndromes. Nevertheless, the
promising results of the studies and meta-analyses have not been validated
so far by the support of large-scale randomized trials or unique
indications from guidelines. Therefore, ASA desensitization is still
largely unapplied, leaving the management of ASA hypersensitivity to the
individualized approach of cardiologists. Copyright © 2023 by the
authors.

<4>
Accession Number
2025313184
Title
Protocol Study for the Evaluation of Non-Opioid Balanced General
Anaesthesia in Cardiac Surgery with Cardiopulmonary Bypass: A Randomised,
Controlled, Multicentric Superiority Trial (OFACAR Study).
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5473. Date of Publication: September 2023.
Author
Guinot P.-G.; Besch G.; Hameury B.; Grelet T.; Mertes P.M.; Nguyen M.;
Bouhemad B.
Institution
(Guinot, Hameury, Nguyen, Bouhemad) Department of Anaesthesiology and
Critical Care Medicine, Dijon University Medical Centre, Dijon 21000,
France
(Besch, Grelet) Department of Anaesthesiology and Critical Care Medicine,
Besancon Regional University Medical Centre, Besancon 25030, France
(Besch) EA3920, University of Franche-Comte, Besancon 25000, France
(Mertes) Department of Anesthesia and Critical Care, University Hospital
of Strasbourg, Strasbourg 67200, France
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Opioid-free anaesthesia (OFA) is general anaesthesia based on the use of
several non-opioid molecules that aim to have an analgesic effect,
decrease the sympathetic response, decrease hormonal stress, and decrease
the inflammatory response during surgery. Although this approach to
anaesthesia is regularly used in clinical practice, it remains a novel
approach. The literature on this anaesthesia modality finds a number of
positive effects on cardiac, respiratory, and cognitive function but no
randomised study evaluated these effects during cardiac surgery where
there is a high incidence of postoperative complications. The main aim of
the study is to compare OFA vs. standard balanced opioid general
anaesthesia on the incidence of postoperative complications and the length
of stay in intensive care and hospital. OFACAR is a multicentric,
randomised, controlled, superiority, single-blind, two parallel-arm
clinical trial in patients undergoing cardiac surgery with cardiopulmonary
bypass. We compared a balanced general anaesthesia without opioids (OFA
group) vs. a balanced opioid general anaesthesia with sufentanil (control
group). One hundred and sixty patients will be enrolled in each treatment
group. The primary endpoint is a composite one which corresponds to the
occurrence of at least one of the postoperative complications, defined
according to European standards within 30 days after surgery. Recruitment
started in September 2019, and data collection is expected to end in
November 2024. Copyright © 2023 by the authors.

<5>
Accession Number
2024862208
Title
Efficacy and Safety of Ticagrelor versus Clopidogrel in Dialysis Patients
with Coronary Syndromes: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(15) (no pagination), 2023. Article
Number: 5011. Date of Publication: August 2023.
Author
Burlacu A.; Floria M.; Brinza C.; Covic A.
Institution
(Burlacu, Brinza) Institute of Cardiovascular Diseases "Prof. Dr. George
I.M. Georgescu", Iasi 700503, Romania
(Burlacu, Floria, Brinza, Covic) Faculty of Medicine, University of
Medicine and Pharmacy "Grigore T Popa", Iasi 700115, Romania
(Floria) Medical Clinic, "Sf. Spiridon" Emergency Hospital, Iasi 700111,
Romania
(Covic) Nephrology Clinic, Dialysis and Renal Transplant Center, "C.I.
Parhon" University Hospital, Iasi 700503, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
(1) Background: The optimal antiplatelet therapy for end-stage kidney
disease (ESKD) patients on chronic dialysis presenting with acute or
chronic coronary syndromes (ACS or CCS) remains uncertain. This
meta-analysis aimed to compare the efficacy and safety endpoints of
ticagrelor and clopidogrel in ESKD patients requiring dialysis and
presenting with ACS or CCS. (2) Methods: Studies were included comparing
ticagrelor and clopidogrel in ESKD patients on chronic dialysis with ACS
or CCS. The primary composite efficacy outcome was a combination of
all-cause and cardiovascular mortality, recurrent myocardial infarction or
coronary revascularization, and ischemic or hemorrhagic stroke. The
primary safety outcome was major and non-major bleeding events. (3)
Results: Five observational studies met the eligibility criteria. The
pooled analysis showed no significant difference in the primary composite
efficacy outcome between ticagrelor and clopidogrel (p = 0.40). Similarly,
the 2 groups had no significant differences in all-cause mortality (p =
0.82) or cardiovascular mortality (p = 0.79). Ticagrelor did not show a
significantly different risk of coronary revascularization (p = 0.35) or
recurrent myocardial infarction (p = 0.41) compared to clopidogrel. Also,
the risk of stroke was similar (p = 0.21). The 2 groups had no significant
difference in the primary composite safety outcome (p = 0.22) or major
bleeding events (p = 0.27). (4) Conclusion(s): In ESKD patients on
chronic dialysis with ACS or CCS, there was no significant difference in
efficacy or safety outcomes between ticagrelor and clopidogrel. Further
randomized controlled trials are needed to establish the optimal
antiplatelet therapy in this population. Copyright © 2023 by the
authors.

<6>
Accession Number
2024665648
Title
The diagnostic accuracy of procalcitonin in infectious patients after
cardiac surgery: A systematic review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 22(4) (pp 305-312), 2021. Date of
Publication: 01 Apr 2021.
Author
Li Q.; Zheng S.; Zhou P.Y.; Xiao Z.; Wang R.; Li J.
Institution
(Li, Zheng, Zhou, Xiao, Wang) Department of the Cardiovascular Surgery,
China
(Li) School of Nursing, Southern Medical University, Guangzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiac surgery with cardiopulmonary bypass (CPB) induces an acute
inflammatory response that may lead to a systemic inflammatory response
syndrome. The interest in procalcitonin (PCT) in the diagnosis of
bacterial infection in patients after cardiac surgery remains less
defined. The aim of this meta-analysis is to prospectively examine the
discriminatory power of PCT as markers of infection in hospitalized
patients with after cardiac surgery. The bivariate generalized nonlinear
mixed-effect model and the hierarchical summary receiver operating
characteristic model were used to estimate the pooled sensitivity,
specificity and summary receiver operating characteristic curve. The
pooled sensitivity and specificity were 0.81 (95% CI 0.75-0.87) and 0.78
(95% CI 0.73-0.83), respectively. The pooled positive likelihood ratio,
and negative likelihood ratio of PCT were 3.74 (95% CI 2.98-4.69) and 0.24
(95% CI 0.17-0.32), respectively. The pooled area under the summary
receiver operating characteristic curve of PCT using the HSROC method was
0.87 (95% CI 0.84- 0.90). This study indicated that PCT is a promising
marker for the diagnosis of sepsis for those patients who undergo cardiac
surgery. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<7>
Accession Number
642535357
Title
Effect of remote ischemic preconditioning on lung function after surgery
under general anesthesia: a systematic review and meta-analysis.
Source
Scientific reports. 13(1) (pp 17720), 2023. Date of Publication: 18 Oct
2023.
Author
Kashiwagi S.; Mihara T.; Yokoi A.; Yokoyama C.; Nakajima D.; Goto T.
Institution
(Kashiwagi, Goto) Department of Anesthesiology, Yokohama City University
Graduate School of Medicine, Yokohama, Japan
(Kashiwagi) Department of Anesthesiology, Yokohama City University
Hospital, Kanazawa-Ku, 3-9 Fukuura 236-0004, Japan
(Mihara) Department of Health Data Science, Yokohama City University
Graduate School of Data Science, Yokohama, Japan
(Yokoi) Department of Anesthesiology and Intensive Care Medicine, Nagoya
City University Graduate School of Medical Sciences, Nagoya, Japan
(Yokoyama) Department of Anesthesia, Chiba Children's Hospital, Chiba,
Japan
(Nakajima) Department of Anesthesiology, Yokohama City University Medical
Center, Japan
Abstract
Remote ischemic preconditioning (RIPC) protects organs from
ischemia-reperfusion injury. Recent trials showed that RIPC improved gas
exchange in patients undergoing lung or cardiac surgery. We performed a
systematic search to identify randomized controlled trials involving RIPC
in surgery under general anesthesia. The primary outcome was the PaO2/FIO2
(P/F) ratio at 24 h after surgery. Secondary outcomes were A-a DO2, the
respiratory index, duration of postoperative mechanical ventilation (MV),
incidence of acute respiratory distress syndrome (ARDS), and serum
cytokine levels. The analyses included 71 trials comprising 7854 patients.
Patients with RIPC showed higher P/F ratio than controls (mean difference
[MD] 36.6, 95% confidence interval (CI) 12.8 to 60.4, I2=69%). The cause
of heterogeneity was not identified by the subgroup analysis. Similarly,
A-a DO2 (MD 15.2, 95% CI - 29.7 to - 0.6, I2=87%) and respiratory index
(MD - 0.17, 95% CI - 0.34 to - 0.01, I2=94%) were lower in the RIPC group.
Additionally, the RIPC group was weaned from MV earlier (MD - 0.9 h, 95%
CI - 1.4 to - 0.4, I2=78%). Furthermore, the incidence of ARDS was lower
in the RIPC group (relative risk 0.73, 95% CI 0.60 to 0.89, I2=0%). Serum
TNFalpha was lower in the RIPC group (SMD - 0.6, 95%CI - 1.0 to - 0.3
I2=87%). No significant difference was observed in interleukin-6, 8 and
10. Our meta-analysis suggested that RIPC improved oxygenation after
surgery under general anesthesia.Clinical trial number: This study
protocol was registered in the University Hospital Medical Information
Network (registration number: UMIN000030918),
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000035
305. Copyright © 2023. Springer Nature Limited.

<8>
Accession Number
642533873
Title
Systematic review and meta-analysis of topical tranexamic acid in spine
surgery.
Source
Neurosurgical focus. 55(4) (pp E18), 2023. Date of Publication: 01 Oct
2023.
Author
Izima C.; Sampath S.G.; Tang A.J.; Ambati V.S.; Chou D.; Chan A.K.
Institution
(Izima, Sampath, Tang, Chou, Chan) Department of Neurological Surgery,
Columbia University Vagelos College of Physicians and Surgeons, NY, United
States
(Ambati) 2School of Medicine, University of California, San Francisco,
California; and
(Chou, Chan) 3The Och Spine Hospital at NewYork-Presbyterian, NY, United
States
Abstract
OBJECTIVE: Tranexamic acid (TXA) is an antifibrinolytic drug associated
with reduced blood loss in a range of surgical specialties, including
neurosurgery, orthopedic surgery, and cardiac surgery. Concerns about
venous thromboembolism and seizures from intravenous (IV) TXA have led to
increased use of topical TXA. Given the relative scarcity of the
literature on topical TXA compared with that on IV TXA within
neurosurgery, the authors aimed to conduct a systematic review and
meta-analysis on the safety, efficacy, and optimal administration of
topical TXA in a wide range of spinal procedures and pathologies.
 METHOD(S): The PRISMA guidelines, Cochrane risk of bias tool, and
Newcastle-Ottawa Scale were used to extract randomized controlled trials
and high-quality case-control and cross-sectional/cohort studies (adult
studies only) from PubMed, Web of Science, Cochrane Library, and Embase
published between 2016 and 2023. Studies were analyzed by two independent
reviewers for variables including dosage, TXA administration route, type
of spine procedure, blood loss, adverse events including thromboembolism
and infection, postoperative hemoglobin level, and hospitalization length.
Pooled analysis comparing intraoperative and postoperative blood loss,
postoperative hemoglobin levels, and hospitalization length of stay on the
basis of route of TXA administration was conducted. RESULT(S): Four
cohort studies, 1 cross-sectional study, 1 case-control study, and 12
randomized controlled trials, together involving 2045 patients, were
included. The most common route of topical TXA administration was via TXA
in saline solution. Other routes of topical TXA included retrograde
injection and TXA-soaked Gelfoam. In pooled analysis, topical TXA
significantly reduced visible blood loss (standardized mean difference
[SMD] -0.22, 95% CI -0.45 to -0.00001), postoperative blood loss (SMD
-1.63, 95% CI -2.03 to -1.22), and length of hospital stay (SMD -1.02, 95%
CI -1.42 to -0.61), as well as higher postoperative hemoglobin (SMD 0.59,
95% CI 0.34-0.83), compared with non-TXA controls. No significant
differences in outcomes were found between topical and IV TXA or between
combined (topical and IV) and IV TXA. Thromboembolism and infection rates
did not significantly differ between any TXA administration group and
non-TXA controls. CONCLUSION(S): In pooled analyses, topical TXA was
associated with decreased perioperative blood loss in a wide range of
scenarios, including cervical spine surgery and thoracolumbar trauma, as
well as in patients with a thromboembolic history.

<9>
Accession Number
642521793
Title
Comparisons of procedural characteristics and clinical outcomes between
SMARTTOUCH SURROUNDFLOW catheter and other catheters for atrial
fibrillation radiofrequency catheter ablation: a systematic literature
review.
Source
BMJ open. 13(10) (pp e075579), 2023. Date of Publication: 17 Oct 2023.
Author
Li J.; Zhou G.; Li X.; Huang S.; Lin H.; Lin S.; Tan L.; Chen W.; Huang
X.; Wang Y.
Institution
(Li, Zhou, Li, Huang, Lin, Lin, Wang) Department of Cardioloqy, Southern
Medical University Nanfang Hospital, Guangzhou, Guangdong, China
(Tan) Changsha Normin Health Technology Ltd, Changsha, China
(Chen) Normin Health Consulting Ltd, Mississauga, ON, Canada
(Chen) THETA Collaborative, University of Toronto, Toronto, ON, Canada
(Huang) Department of Cardioloqy, Southern Medical University Nanfang
Hospital, Guangzhou, Guangdong, China
Abstract
BACKGROUND: SMARTTOUCH SURROUNDFLOW (STSF) catheter is the new generation
of SMARTTOUCH (ST) catheter with an upgraded irrigation system for
radiofrequency catheter ablation (RFCA) in patients with atrial
fibrillation (AF). METHOD(S): This systematic literature review
searched the major English and Chinese bibliographic databases from 2016
to 2022 for any original clinical studies assessing the STSF catheter for
RFCA in AF patients. Meta-analysis with a random effects model was used
for evidence synthesis. RESULT(S): Pooled outcomes from 19 included
studies indicated that STSF catheter was associated with a significantly
shorter procedure time (weighted mean difference (WMD): -17.4min,
p<0.001), shorter ablation time (WMD: -6.6min, p<0.001) and lower catheter
irrigation fluid volume (WMD: -492.7mL, p<0.001) than ST catheter. Pooled
outcomes from four included studies with paroxysmal AF patients reported
that using the STSF catheter for RFCA was associated with a significantly
shorter ablation time (WMD: -5.7min, p<0.001) and a lower risk of 1-year
postablation arrhythmia recurrence (rate ratio: 0.504, p<0.001) than the
SURROUNDFLOW (SF) catheter. Significant reductions in procedure time and
ablation time associated with the STSF catheter were also reported in the
other four studies using non-ST/SF catheters as the control. Overall
complications of STSF catheter and control catheters were comparable.
 CONCLUSION(S): Using the STSF catheter was superior to using the ST
catheter to conduct RFCA for AF by significantly reducing procedure time,
ablation time, fluoroscopy time and irrigation fluid volume. The
superiority of the STSF catheter over the SF catheter and other non-ST/SF
catheters for RFCA needs further confirmation. Copyright ©
Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<10>
Accession Number
642489787
Title
Systematic review of physiological and psychological outcomes of surgery
for pectus excavatum supporting commissioning of service in the UK.
Source
BMJ open respiratory research. 10(1) (no pagination), 2023. Date of
Publication: 01 Oct 2023.
Author
Walsh J.; Walsh R.; Redmond K.
Institution
(Walsh, Walsh) Department of Cardiothoracic Surgery, Fiona Stanley
Hospital, Murdoch, WA, Australia
(Redmond) Cardiothoracic Surgery, Mater Misericordiae University Hospital,
Dublin, Ireland
Abstract
BACKGROUND: Pectus excavatum (PEx) is the most common congenital chest
wall abnormality affecting 1 in 400 births in the UK. PEx is associated
with significant physiological and psychological impairment. While readily
surgically correctable, the benefits that surgery can bring have been
debated and proven difficult to objectively measure. In the UK, this has
led to the decommissioning of PEx surgery. The aim of this review is to
conduct a systematic search of the literature on PEx surgery to assess
physiological and psychological outcomes. METHOD(S): A systematic
review of the MEDLINE (PubMed), Embase and Cochrane databases was
performed. Articles were sought which included patients undergoing surgery
for PEx and reported on changes in cardiopulmonary measures, symptoms,
quality of life and psychological assessments before and after surgical
repair. Last search was performed in July 2022 and relevant findings were
synthesised by narrative review. RESULT(S): Fifty-one articles were
included in qualitative synthesis, with 34 studies relating to
physiological outcomes and 17 studies relating to psychological and
quality of life measures. Twenty-one studies investigated pulmonary
function at rest. There was no change in forced vital capacity or forced
expiratory volume in 1 second following open repair and transient
reductions followed closed repair. In the 11 studies investigating
echocardiography, transthoracic rarely demonstrated cardiac compression;
however, transoesophageal demonstrated intraoperative relief in cardiac
compression in severe cases. Sixteen studies investigated exercise testing
(cardiopulmonary exercise testing, CPET), 12 of which demonstrated
significant improvement following surgery, both in maximal oxygen
consumption and oxygen pulse. Seventeen studies investigated quality of
life, all but one of which showed improvement following repair of PEx. All
papers that reported on patient satisfaction following surgery found high
rates, between 80% and 97%. DISCUSSION: While the majority of studies to
date have been small and data heterogeneous, the literature shows that for
many patients with PEx, there exists a cardiopulmonary limitation that
while difficult to objectify, is likely to improve with surgical repair.
Resting parameters offer little yield in aiding this except in the most
severe cases. CPET therefore offers a better option for dynamic assessment
of this limitation and improvements following repair. Surgery
significantly improves psychological well-being and quality of life for
patients with PEx. 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.

<11>
Accession Number
641954198
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
The Annals of thoracic surgery. 116(4) (pp 659-674), 2023. Date of
Publication: 01 Oct 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, NY, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Aldea) Division of Cardiothoracic Surgery, University of Washington
School of Medicine, 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, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Firestone, Kisson) Society of Thoracic Surgeons, Chicago, IL, United
States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre, the
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), 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, NY, United States
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University, Baltimore, MD, Liberia
(Navia) Department of Cardiac Surgery, ICBA Instituto Cardiovascular,
Buenos Aires, Argentina
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
NY, 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, OH, United States
(Schwann) Division of Cardiac Surgery, Baystate Health, Springfield, MA,
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, TX, United States

<12>
Accession Number
641617038
Title
Regional disparity in continuously measured time-domain cerebrovascular
reactivity indices: a scoping review of human literature.
Source
Physiological measurement. 44(7) (no pagination), 2023. Date of
Publication: 24 Jul 2023.
Author
Sainbhi A.S.; Marquez I.; Gomez A.; Stein K.Y.; Amenta F.; Vakitbilir N.;
Froese L.; Zeiler F.A.
Institution
(Sainbhi, Stein, Vakitbilir, Froese, Zeiler) Department of Biomedical
Engineering, Price Faculty of Engineering, University of Manitoba,
Winnipeg, Canada
(Marquez, Amenta) Undergraduate Engineering, Price Faculty of Engineering,
University of Manitoba, Winnipeg, Canada
(Gomez, Zeiler) Section of Neurosurgery, Department of Surgery, Rady
Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
(Gomez, Zeiler) Department of Human Anatomy and Cell Science, Rady Faculty
of Health Sciences, University of Manitoba, Winnipeg, Canada
(Zeiler) Centre on Aging, University of Manitoba, Winnipeg, Canada
(Zeiler) Division of Anaesthesia, Department of Medicine, Addenbrooke's
Hospital, University of Cambridge, Cambridge, United Kingdom
(Zeiler) Department of Clinical Neurosciences, Stockholm, Sweden
Abstract
Objective: Cerebral blood vessels maintaining relatively constant cerebral
blood flow (CBF) over wide range of systemic arterial blood pressure (ABP)
is referred to as cerebral autoregulation (CA). Impairments in CA expose
the brain to pressure-passive flow states leading to hypoperfusion and
hyperperfusion. Cerebrovascular reactivity (CVR) metrics refer to
surrogate metrics of pressure-based CA that evaluate the relationship
between slow vasogenic fluctuations in cerebral perfusion pressure/ABP and
a surrogate for pulsatile CBF/cerebral blood volume.Approach: We performed
a systematically conducted scoping review of all available human
literature examining the association between continuous CVR between more
than one brain region/channel using the same CVR index. Main
Result(s): In all the included 22 articles, only handful of transcranial
doppler (TCD) and near-infrared spectroscopy (NIRS) based metrics were
calculated for only two brain regions/channels. These metrics found no
difference between left and right sides in healthy volunteer, cardiac
surgery, and intracranial hemorrhage patient studies. In contrast,
significant differences were reported in endarterectomy, and subarachnoid
hemorrhage studies, while varying results were found regarding regional
disparity in stroke, traumatic brain injury, and multiple population
studies. Significance: Further research is required to evaluate
regional disparity using NIRS-based indices and to understand if
NIRS-based indices provide better regional disparity information than
TCD-based indices. Copyright Creative Commons Attribution license.

<13>
Accession Number
641491312
Title
Outcomes of coronary revascularization vs. optimal medical therapy alone
for ischemic left ventricular dysfunction: A meta-analysis of randomized
controlled trials.
Source
Kardiologia polska. 81(9) (pp 909-912), 2023. Date of Publication: 2023.
Author
Bujak K.; Hudzik B.; Pyka L.; Skrzypek M.; Brugaletta S.; Sabate M.;
Tajstra M.; Legutko J.; Wojakowski W.; Gasior M.
Institution
(Bujak, Hudzik, Pyka, Tajstra, Gasior) 3rd Department of Cardiology,
Faculty of Medical Sciences in Zabrze, Medical University of Silesia,
Katowice, Poland
(Bujak, Brugaletta, Sabate) Hospital Clinic, Cardiovascular Clinic
Institute, Institut d'Investigacions Biomediques August Pi i Sunyer
(IDIBAPS), University of Barcelona, Barcelona, Spain
(Skrzypek) Department of Biostatistics, Faculty of Health Sciences in
Bytom, Medical University of Silesia, Katowice, Poland
(Legutko) Clinical Department of Interventional Cardiology, John Paul II
Hospital, Krakow, Poland
(Legutko) Department of Interventional Cardiology, Institute of
Cardiology, Jagiellonian University Medical College, Krakow, Poland
(Wojakowski) Department of Cardiology and Structural Heart Diseases,
Medical University of Silesia, Katowice, Poland

<14>
Accession Number
2027864551
Title
Comparison of ultrasound guidance and palpation technique for femoral
artery catheterization in children undergoing cardiac surgery.
Source
Cirugia y Cirujanos (English Edition). 91(5) (pp 633-640), 2023. Date of
Publication: 2023.
Author
Aktiz-Bicak E.; Kilic Y.; Elmastas D.; Bicak M.; Aldudak B.; Salik F.
Institution
(Aktiz-Bicak, Elmastas, Bicak) Anesthesiology and Reanimation Clinic, Gazi
Yasargil Training and Research Hospital, Diyarbakir, Turkey
(Kilic) Department of Pediatric Cardiac Surgery, Gazi Yasargil Training
and Research Hospital, Diyarbakir, Turkey
(Aldudak) Department of Pediatric Cardiology, Gazi Yasargil Training and
Research Hospital, Turkey
(Salik) Anesthesiology and Reanimation Clinic, Dicle University Medicine
Faculty, Diyarbakir, Turkey
Publisher
Permanyer Publications
Abstract
Objective: The aim of this study was compare the palpation technique and
ultrasound-guidance for femoral artery catheterization in pediatric
patients undergoing surgery for congenital heart disease. Material(s)
and Method(s): This prospective and randomized controlled study included
American Society of Anesthesiologists III-IV 40 children who underwent
congenital heart surgery. The patients were divided into two groups;
ultrasound-guided catheterization group and palpation-guided
catheterization group. Demographic and clinical characteristics of the
patients, access time, success rate, number of attempts, first-attempt
success, number of trials, and failed cannulations were recorded.
 Result(s): The diameter of the femoral artery was significantly
shorter, access time and numbers of trials were significantly lower, and
first-attempt success rate was significantly higher in the US group. The
complication rate was significantly higher in the P group. The number of
failed catheterization was higher in the P group. Total cost required for
the procedure was significantly lower in the US group. Conclusion(s):
We found that ultrasound-guided arterial catheterization increases the
success rate and the number of successful catheterizations, while reducing
the overall procedure time, incidence of complications, and cost.
Therefore, we believe that the use of ultrasound guidance in arterial
catheterization in pediatric cardiac surgery would be a better
choice. Copyright © 2023 Publicaciones Permanyer. All rights
reserved.

<15>
Accession Number
2027805924
Title
Efficacy of olaparib in advanced cancers with germline or somatic
mutations in BRCA1, BRCA2, CHEK2 and ATM, a Belgian Precision
tumor-agnostic phase II study.
Source
ESMO Open. 8(6) (no pagination), 2023. Article Number: 102041. Date of
Publication: December 2023.
Author
Joris S.; Denys H.; Collignon J.; Rasschaert M.; T'Kint de Roodenbeke D.;
Duhoux F.P.; Canon J.-L.; Tejpar S.; Mebis J.; Decoster L.; Aftimos P.; De
Greve J.
Institution
(Joris, Decoster, De Greve) Department of Medical Oncology, UZ Brussel,
Brussels, Belgium
(Denys) Department of Medical Oncology, University Hospital Ghent, Ghent,
Belgium
(Collignon) CHU Sart Tilman, Liege, Belgium
(Rasschaert) UZA, Antwerpen, Belgium
(T'Kint de Roodenbeke, Aftimos) Institut Jules Bordet-Universite libre de
Bruxelles, Brussels, Belgium
(Duhoux) Cliniques universitaires Saint-Luc, Brussels, Belgium
(Canon) GHdC, Charlerloi, Belgium
(Tejpar) UZ Leuven, Leuven, Belgium
(Mebis) Jessa Ziekenhuizen, Hasselt, Belgium
(De Greve) Department of Medical Genetics, UZ Brussel, Brussels, Belgium
Publisher
Elsevier B.V.
Abstract
Background: The Belgian Precision initiative aims to maximize the
implementation of tumor-agnostic next-generation sequencing in patients
with advanced cancer and enhance access to molecularly guided treatment
options. Academic tumor-agnostic basket phase II studies are part of this
initiative. The current investigator-driven trial aimed to investigate the
efficacy of olaparib in advanced cancers with a (likely) pathogenic
mutation (germline or somatic) in a gene that plays a role in homologous
recombination (HR). Patients and Methods: This open-label,
multi-cohort, phase II study examines the efficacy of olaparib in patients
with an HR gene mutation in their tumor and disease progression on
standard of care. Patients with a somatic or germline mutation in the same
gene define a cohort. For each cohort, a Simon minimax two-stage design
was used. If a response was observed in the first 13 patients, 14
additional patients were included. Here, we report the results on four
completed cohorts: patients with a BRCA1, BRCA2, CHEK2 or ATM mutation.
 Result(s): The overall objective response rate across different tumor
types was 11% in the BRCA1-mutated (n = 27) and 21% in the BRCA2-mutated
(n = 27) cohorts. Partial responses were seen in pancreatic cancer,
gallbladder cancer, endocrine carcinoma of the pancreas and parathyroid
cancer. One patient with a BRCA2 germline-mutated colon cancer has an
ongoing complete response with 19+ months on treatment. Median
progression-free survival in responding patients was 14+ months (5-34+
months). The clinical benefit rate was 63% in the BRCA1-mutated and 46% in
the BRCA2-mutated cohorts. No clinical activity was observed in the ATM (n
= 13) and CHEK2 (n = 14) cohorts. Conclusion(s): Olaparib showed
efficacy in different cancer types harboring somatic or germline mutations
in the BRCA1/2 genes but not in ATM and CHEK2. Patients with any cancer
type harboring BRCA1/2 mutations should have access to
olaparib. Copyright © 2023 The Author(s)

<16>
Accession Number
2027354959
Title
Immediate versus staged complete revascularization in acute coronary
syndrome: A meta-analysis of randomized controlled trials.
Source
International Journal of Cardiology. 393 (no pagination), 2023. Article
Number: 131397. Date of Publication: 15 Dec 2023.
Author
Bujak K.; Rinaldi R.; Vidal-Cales P.; Montone R.A.; Diletti R.; Gasior M.;
Crea F.; Sabate M.; Brugaletta S.
Institution
(Bujak, Rinaldi, Vidal-Cales, Sabate, Brugaletta) Hospital Clinic,
Cardiovascular Clinic Institute, Institut d'Investigacions Biomediques
August Pi i Sunyer (IDIBAPS), Barcelona, Spain
(Bujak, Gasior) 3rd Department of Cardiology, Faculty of Medical Sciences
in Zabrze, Medical University of Silesia, Katowice, Poland
(Rinaldi, Montone, Crea) Department of Cardiovascular and Pulmonary
Sciences, Catholic University of the Sacred Heart, Rome, Italy
(Diletti) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: Clinical guidelines recommend a complete revascularization
(CR) in patients with acute coronary syndromes (ACS) and multivessel
disease (MVD). However, its optimal timing is unclear. The aim of this
meta-analysis was to compare the clinical outcomes following immediate
versus staged CR in ACS. Method(s): PubMed and Scopus were searched
until March 2023 for randomized controlled trials (RCTs) comparing
immediate versus staged CR. The primary endpoint was major adverse
cardiovascular event (MACE) at the longest follow-up. Secondary outcomes
were all-cause death, cardiovascular death, myocardial infarction (MI),
any unplanned revascularization, target-vessel revascularization (TVR),
and stent thrombosis. Safety outcomes were major bleeding, contrast
volume, procedure duration, and length of hospitalization. Result(s):
Eight RCTs were included (3559 patients, weighted mean follow-up 12.5
months). There were no differences in the primary endpoint (OR 0.74,
95%CI: 0.54-1.01) and in the secondary endpoints of death, and stent
thrombosis between the two CR strategies. Immediate CR was associated with
a lower risk of recurrent MI (OR 0.51, 95% CI 0.34-0.76), any unplanned
revascularization (OR 0.59, 95%CI: 0.43-0.80), and TVR (OR 0.61, 95% CI
0.45-0.84) compared to staged CR. Immediate CR was also associated with
lower total contrast volume and shorter total procedure duration and
hospitalization length compared to staged CR without differences in major
bleedings. Conclusion(s): No difference was found between immediate
and staged CR regarding MACE, or deaths rates at one year. Immediate CR
may be associated with a lower risk of recurrent MI and unplanned coronary
revascularization than staged CR. Copyright © 2023

<17>
Accession Number
2026097198
Title
Complement-activating donor-specific anti-HLA antibodies in solid organ
transplantation: systematic review, meta-analysis, and critical appraisal.
Source
Frontiers in Immunology. 14 (no pagination), 2023. Article Number:
1265796. Date of Publication: 2023.
Author
Al-Awadhi S.; Raynaud M.; Louis K.; Bouquegneau A.; Taupin J.-L.; Aubert
O.; Loupy A.; Lefaucheur C.
Institution
(Al-Awadhi, Raynaud, Louis, Bouquegneau, Aubert, Loupy, Lefaucheur)
Universite de Paris Cite, Institut National de la Sante et de la Recherche
Medicale (INSERM) Unite Mixte de Recherche (UMR)-S970, Paris
Cardiovascular Research Center (PARCC), Paris Translational Research
Centre for Organ Transplantation, Paris, France
(Louis, Lefaucheur) Kidney Transplant Department, Saint-Louis Hospital,
Assistance Publique - Hopitaux de Paris, Paris, France
(Bouquegneau) Department of Nephrology, Dialysis and Transplantation,
Centre Hospitalier Universitaire (CHU) de Liege, Liege, Belgium
(Taupin) Department of Immunology and Histocompatibility, Centre
Hospitalier Universitaire (CHU) Paris-GH St-Louis Lariboisiere, Paris,
France
(Aubert, Loupy) Kidney Transplant Department, Necker Hospital, Assistance
Publique - Hopitaux de Paris, Paris, France
Publisher
Frontiers Media SA
Abstract
Introduction: Several studies have investigated the impact of circulating
complement-activating anti-human leukocyte antigen donor-specific
antibodies (anti-HLA DSAs) on organ transplant outcomes. However, a
critical appraisal of these studies and a demonstration of the prognostic
value of complement-activating status over anti-HLA DSA mean fluorescence
intensity (MFI) level are lacking. Method(s): We conducted a
systematic review, meta-analysis and critical appraisal evaluating the
role of complement-activating anti-HLA DSAs on allograft outcomes in
different solid organ transplants. We included studies through Medline,
Cochrane, Scopus, and Embase since inception of databases till May 05,
2023. We evaluated allograft loss as the primary outcome, and allograft
rejection as the secondary outcome. We used the Newcastle-Ottawa Scale and
funnel plots to assess risk of bias and used bias adjustment methods when
appropriate. We performed multiple subgroup analyses to account for
sources of heterogeneity and studied the added value of complement assays
over anti-HLA DSA MFI level. Result(s): In total, 52 studies were
included in the final meta-analysis (11,035 patients).
Complement-activating anti-HLA DSAs were associated with an increased risk
of allograft loss (HR 2.77; 95% CI 2.33-3.29, p<0.001; I2=46.2%), and
allograft rejection (HR 4.98; 95% CI 2.96-8.36, p<0.01; I2=70.9%). These
results remained significant after adjustment for potential sources of
bias and across multiple subgroup analyses. After adjusting on pan-IgG
anti-HLA DSA defined by the MFI levels, complement-activating anti-HLA
DSAs were significantly and independently associated with an increased
risk of allograft loss. Discussion(s): We demonstrated in this
systematic review, meta-analysis and critical appraisal the significant
deleterious impact and the independent prognostic value of circulating
complement-activating anti-HLA DSAs on solid organ transplant risk of
allograft loss and rejection. Copyright © 2023 Al-Awadhi,
Raynaud, Louis, Bouquegneau, Taupin, Aubert, Loupy and Lefaucheur.

<18>
Accession Number
2026077759
Title
Dual antiplatelet management in the perioperative period: updated and
expanded systematic review.
Source
Systematic Reviews. 12(1) (no pagination), 2023. Article Number: 197. Date
of Publication: December 2023.
Author
Premji A.M.; Blegen M.B.; Corley A.M.; Ulloa J.; Booth M.S.; Begashaw M.;
Larkin J.; Shekelle P.; Girgis M.D.; Maggard-Gibbons M.
Institution
(Premji, Blegen, Ulloa, Begashaw, Shekelle, Girgis, Maggard-Gibbons)
Veterans Health Administration, Greater Los Angeles Healthcare System,
11301 Wilshire Blvd., Los Angeles, CA 90073, United States
(Blegen) National Clinician Scholars Program, University of California,
Los Angeles, 1100 Glendon Ave., Suite 900, Los Angeles, CA 90024, United
States
(Corley) Duke University School of Medicine, DUMC Box 104002, Durham, NC
27710, United States
(Ulloa, Girgis, Maggard-Gibbons) David Geffen School of Medicine at
University of California, Los Angeles, 885 Tiverton Dr., Los Angeles, CA
90095, United States
(Booth, Larkin) Southern California Evidence-Based Practice Center, RAND
Corporation, 1776 Main Street, Santa Monica, CA 90401, United States
Publisher
BioMed Central Ltd
Abstract
Background: Antiplatelet agents are central in the management of vascular
disease. The use of dual antiplatelet therapy (DAPT) for the management of
thromboembolic complications must be weighed against bleeding risk in the
perioperative setting. This balance is critical in patients undergoing
cardiac or non-cardiac surgery. The management of patients on DAPT for any
indication (including stents) is not clear and there is limited evidence
to guide decision-making. This review summarizes current evidence since
2015 regarding the occurrence of major adverse events associated with
continuing, suspending, or varying DAPT in the perioperative period.
 Method(s): A research librarian searched PubMed and Cochrane from
November 30, 2015 to May 17, 2022, for relevant terms regarding adult
patients on DAPT for any reason undergoing surgery, with a perioperative
variation in DAPT strategy. Outcomes of interest included the occurrence
of major adverse cardiac events, major adverse limb events, all-cause
death, major bleeding, and reoperation. We considered withdrawal or
discontinuation of DAPT as stopping either aspirin or a P2Y12 inhibitor or
both agents; continuation of DAPT indicates that both drugs were given in
the specified timeframe. Result(s): Eighteen observational studies
met the inclusion criteria. No RCTs were identified, and no studies were
judged to be at low risk of bias. Twelve studies reported on CABG.
Withholding DAPT therapy for more than 2 days was associated with less
blood loss and a slight trend favoring less transfusion and surgical
re-exploration. Among five observational CABG studies, there were no
statistically significant differences in patient death across DAPT
management strategies. Few studies reported cardiac outcomes. The
remaining studies, which were about procedures other than exclusively
CABG, demonstrated mixed findings with respect to DAPT strategy, bleeding,
and ischemic outcomes. Conclusion(s): The evidence base on the
benefits and risks of different perioperative DAPT strategies for patients
with stents is extremely limited. The strongest signal, which was still
judged as low certainty evidence, is that suspension of DAPT for greater
than 2 days prior to CABG surgery is associated with less bleeding,
transfusions, and re-explorations. Different DAPT strategies' association
with other outcomes of interest, such as MACE, remains uncertain.
Systematic review registration: A preregistered protocol for this review
can be found on the PROSPERO International Prospective Register of
systematic reviews (http://www.crd.york.ac.uk/PROSPERO/ ; registration
number: CRD42022371032). Copyright © 2023, BioMed Central Ltd.,
part of Springer Nature.

<19>
Accession Number
2024843029
Title
Stem cell Derived Extracellular Vesicles to Alleviate ischemia-reperfusion
Injury of Transplantable Organs. A Systematic Review.
Source
Stem Cell Reviews and Reports. 19(7) (pp 2225-2250), 2023. Date of
Publication: October 2023.
Author
Blondeel J.; Gilbo N.; De Bondt S.; Monbaliu D.
Institution
(Blondeel, Gilbo, Monbaliu) Department of Microbiology, Immunology and
Transplantation, Laboratory of Abdominal Transplantation, KU Leuven,
Leuven, Belgium
(Blondeel, Monbaliu) Department of Abdominal Transplant Surgery and
Coordination, University Hospitals Leuven, Herestraat 49, Leuven 3000,
Belgium
(Gilbo) Department of Abdominal Surgery and Transplantation, CHU Liege,
Liege, Belgium
(De Bondt) Faculty of Medicine, KU Leuven, Leuven, Belgium
Publisher
Springer
Abstract
Background: The possible beneficial effects of stem cell-derived EV on
ischemia-reperfusion injury (IRI) in organ transplantation have been
frequently investigated; however, the source of EV, as well as the methods
of isolation and administration vary widely. We conducted a systematic
review to summarize current pre-clinical evidence on stem cell-derived EV
therapy for IRI of transplantable organs. Method(s): PubMed, Embase
and Web of Science were searched from inception until August 19th, 2022,
for studies on stem cell-derived EV therapy for IRI after heart, kidney,
liver, pancreas, lung and intestine transplantation. The Systematic Review
Center for Laboratory animal Experiments (SYRCLE) guidelines were followed
to assess potential risk of bias. Result(s): The search yielded 4153
unique articles, of which 96 were retained. We identified 32 studies on
cardiac IRI, 38 studies on renal IRI, 21 studies on liver IRI, four
studies on lung IRI and one study on intestinal IRI. Most studies used
rodent models of transient ischemic injury followed by in situ
reperfusion. In all studies, EV therapy was associated with improved
outcome albeit to a variable degree. EV-therapy reduced organ injury and
improved function while displaying anti-inflammatory-, immunomodulatory-
and pro-regenerative properties. Conclusion(s): A multitude of animal
studies support the potential of stem cell-derived EV-therapy to alleviate
IRI after solid organ transplantation but suffer from low reporting
quality and wide methodological variability. Future studies should focus
on determining optimal stem cell source, dosage, and timing of treatment,
as well as long-term efficacy in transplant models. Copyright ©
2023, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC, part of Springer Nature.

<20>
Accession Number
2024683463
Title
A meta-analysis evaluating efficacy and safety of colchicine for
prevention of major cardiovascular events in patients with coronary artery
disease.
Source
Clinical Research in Cardiology. 112(11) (pp 1487-1505), 2023. Date of
Publication: November 2023.
Author
Chen T.; Liu G.; Yu B.
Institution
(Chen, Yu) Department of Cardiology, The First Affiliated Hospital of
China Medical University, Nanjing North Street No. 155, Heping District,
Shenyang 110001, China
(Liu) Department of Oncology, West China Hospital, Sichuan University,
Sichuan, Chengdu, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Inflammatory plays a key role in the development of coronary
artery disease (CAD). Colchicine as an anti-inflammatory treatment for CAD
has attracted much attention, its efficacy and safety are controversial
and deserved further exploration. Methods and Results: To evaluate
the efficacy and safety of colchicine for patients with CAD, relevant
randomized controlled trials (RCTs) were identified by searching several
databases including PubMed, Web of Science, and EMBASE from January 1992
to May 2022. Fourteen eligible trials of colchicine therapy include
populations with chronic coronary syndrome (CCS) (N = 2), acute coronary
syndrome (ACS) (N = 5), and percutaneous coronary intervention (PCI) or
coronary artery bypass grafting (CABG) (N = 7), and involve a total of
13,235 patients which include 6654 subjects in colchicine group and 6581
subjects in the respective control arms. The outcome was reported as odds
ratio (OR) and 95% confidence interval (CI), as the relative measure of
association. Overall, the incidences of major adverse cardiovascular
events (MACEs) (OR 0.65; 95% CI 0.54-0.77, p < 0.01), new ACS (OR 0.68;
95% CI 0.57-0.81, p < 0.01), coronary revascularization (OR 0.65; 95% CI
0.53-0.78, p < 0.01), and stroke (OR 0.51; 95% CI 0.32-0.82, p < 0.01),
were lower in the colchicine group than in the placebo arm. We did not
find a significant reduction in the incidence of atrial fibrillation (OR
0.84; 95% CI 0.68-1.04, p = 0.11), all-cause mortality (OR 1.06; 95% CI
0.83-1.35, p = 0.83), cardiovascular mortality (OR 0.77; 95% CI 0.52-1.15,
p = 0.21). However, we found that colchicine did increase
non-cardiovascular mortality (OR 1.44; 95% CI 1.04-2.01, p = 0.03).
Although the incidence of gastrointestinal events in the colchicine
treatment group was higher than that in the placebo arms (OR 2.08; 95% CI
1.39-3.12, p < 0.01), the symptoms disappeared rapidly after drug
withdrawal and could be tolerated by most patients. Colchicine did not
increase the incidence of infections (OR 1.42; 95% CI 0.82-2.46, p =
0.22), pneumonia (OR 1.55; 95% CI 0.58-4.18, p = 0.39), cancers (OR 0.98;
95% CI 0.79-1.22, p = 0.88), bleeding (OR 1.14; 95% CI 0.41-3.14, p =
0.80). Conclusion(s): Colchicine is an effective, relatively safe
drug that could be considered for the treatment of CAD. However, we need
to pay attention to the increasing occurrence of non-cardiovascular
mortality and infection especially pneumonia possibly caused by
colchicine. Graphical abstract: Efficacy and safety of colchicine for
patients with CAD. CAD coronary artery disease; RCTs randomized controlled
trials; OR odds ratio; MACEs major adverse cardiovascular events; ACS
acute coronary syndrome; NNT number needed to treat; NNH number needed to
harm [Figure not available: see fulltext.]. Copyright © 2023, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

<21>
Accession Number
2024189834
Title
External stenting for saphenous vein grafts in coronary artery bypass
grafting: A meta-analysis.
Source
European Journal of Clinical Investigation. 53(11) (no pagination), 2023.
Article Number: e14046. Date of Publication: November 2023.
Author
Chen H.; Si K.; Wu X.; Ni H.; Tang Y.; Liu W.; Wang Z.
Institution
(Chen, Wang, Wang) Department of Neurosurgery & Brain and Nerve Research
Laboratory, The First Affiliated Hospital of Soochow University, Jiangsu
Province, China
(Chen) Department of Neurology, The First Affiliated Hospital of Soochow
University, Suzhou, China
(Si) Department of Cardiovascular Surgery, The First Affiliated Hospital
of Soochow University, Suzhou, China
(Wu, Ni, Tang) Suzhou Medical College of Soochow University, Suzhou, China
(Liu) Department of Medicine, The Tianjin North China Hospital, Tianjin,
China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Autologous saphenous vein grafts (SVGs) are the most commonly
used bypass conduits in coronary artery bypass grafting (CABG) with
multivessel coronary artery disease. Although external support devices for
SVGs have shown promising outcomes, the overall efficacy and safety
remains controversial. We aimed to evaluate external stenting for SVGs in
CABG versus non-stented SVGs. Method(s): MEDLINE, EMBASE, Cochrane
Library and clinicaltrails.gov were searched for randomized controlled
trials (RCTs) to evaluate external-stented SVGs versus non-stented SVGs in
CABG up to 31 August 2022. The risk ratio and mean difference with 95%
confidence interval were analysed. The primary efficacy outcomes included
intimal hyperplasia area and thickness. The secondary efficacy outcomes
were graft failure (>=50% stenosis) and lumen diameter uniformity.
 Result(s): We pooled 438 patients from three RCTs. The external
stented SVGs group showed significant reductions in intimal hyperplasia
area (MD: -0.78, p < 0.001, I2 = 0%) and thickness (MD: -0.06,
p < 0.001, I2 = 0%) compared to the non-stented SVGs group.
Meanwhile, external support devices improved lumen uniformity with
Fitzgibbon I classification (risk ratio (RR):1.1595, p = 0.05,
I2 = 0%). SVG failure rates were not increased in the external
stented SVGs group during the short follow-up period (RR: 1.14, p = 0.38,
I2 = 0%). Furthermore, the incidences of mortality and major
cardiac and cerebrovascular events were consistent with previous reports.
 Conclusion(s): External support devices for SVGs significantly
reduced the intimal hyperplasia area and thickness, and improved the lumen
uniformity, assessed with the Fitzgibbon I classification. Meanwhile, they
did not increase the overall SVG failure rate. Copyright © 2023
Stichting European Society for Clinical Investigation Journal Foundation.
Published by John Wiley & Sons Ltd.

<22>
Accession Number
2022207793
Title
A prospective randomized controlled study to assess the effectiveness of
super FIXSORB WAVE for sternal stabilization after sternotomy.
Source
General Thoracic and Cardiovascular Surgery. 71(11) (pp 665-673), 2023.
Date of Publication: November 2023.
Author
Oishi K.; Arai H.; Kuroki H.; Fujioka T.; Tomita M.; Tasaki D.; Oi K.;
Nagaoka E.; Fujiwara T.; Takeshita M.; Yoshizaki T.; Someya T.; Mizuno T.
Institution
(Oishi, Arai, Oi, Nagaoka, Fujiwara, Takeshita, Mizuno) Department of
Cardiovascular Surgery, Graduate School of Medical and Dental Science,
Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo
113-8519, Japan
(Kuroki, Someya) Department of Thoracic Surgery, Ome Municipal General
Hospital, Tokyo, Japan
(Fujioka) Department of Diagnostic Radiology, Tokyo Medical and Dental
University, Tokyo, Japan
(Tomita) School of Data Science, Yokohama City University, Kanagawa, Japan
(Tasaki, Yoshizaki) Department of Cardiovascular Surgery, Musashino Red
Cross Hospital, Tokyo, Japan
Publisher
Springer
Abstract
Background: We developed a new sternal fixation device, Super FIXSORB
WAVE, a corrugated plate made of u-HA/PLLA, to improve sternal
stability after sternotomy. This present study aimed to evaluate the new
device clinically. Method(s): This prospective, single-blinded,
multicenter trial randomized 69 patients to either wire cerclage only
(group C, n = 30) or wire cerclage plus Super FIXSORB WAVE
(group W, n = 39). The primary endpoint was a degree of sternal
displacement at six months. Displacement of the sternal halves in the
anteroposterior and lateral directions was measured using computed
tomography horizontal section images at the third costal and fourth
intercostal levels. The secondary endpoints were sternal pain and
quality-of-life over 6 months. Result(s): Group W showed
significantly reduced sternal anteroposterior displacement at both the
third costal (0 [0-1.9] mm vs. 1.1 [0-2.1] mm; P = 0.014) and fourth
intercostal (0 [0-1.0] mm) vs. 1.0 [0-1.8] mm; P = 0.015) levels than
group C. In group W, lateral displacement was suppressed without a
significant increase from 2 weeks to 6 months, while it increased in group
C. There was no significant difference in postoperative sternal pain and
quality-of-life between the two groups. No adverse events, such as
infection, inflammation, or foreign body reaction, were observed with this
device. Conclusion(s): Using Super FIXSORB WAVE, sternal
displacement was significantly suppressed in both the anteroposterior and
lateral directions. The use of this device results in safe and easy
sternal reinforcement without any adverse events, and sternal healing can
be accelerated. Clinical trial registry number: This study was registered
in the Japan Registry of Clinical Trials (February 21, 2019;
jRCTs032180146). Copyright © 2023, The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<23>
[Use Link to view the full text]
Accession Number
2022080804
Title
Survival after Invasive or Conservative Management of Stable Coronary
Disease.
Source
Circulation. 147(1) (pp 8-19), 2023. Date of Publication: 03 Jan 2023.
Author
O'Brien S.M.; Rosenberg Y.; Kirby R.; Lopez-Sendon J.; Newman J.D.; Berger
J.S.; Sidhu M.S.; White H.D.; Harrington R.A.; Boden W.E.; Stone G.W.;
Mark D.B.; Spertus J.A.; Hochman J.S.; Maron D.J.; Reynolds H.R.;
Bangalore S.; Mavromichalis S.; Chang M.; Contreras A.; Esquenazi-Karonika
S.; Gilsenan M.; Gwiszcz E.; Mathews P.; Mohamed S.; Naumova A.; Roberts
A.; Vanloo K.; Anthopolos R.; Xu Y.; Troxel A.B.; Lu Y.; Huang Z.;
Broderick S.; Selvanayagam J.; Lopes R.D.; Goodman S.G.; Steg G.; Juliard
J.-M.; Doerr R.; Keltai M.; Bhargava B.; Thomas B.; Sharir T.; Nikolsky
E.; Maggioni A.P.; Kohsaka S.; Escobedo J.; Pracon R.; Bockeria O.; Senior
R.; Banfield A.; Shaw L.J.; Phillips L.; Berman D.; Kwong R.Y.; Picard
M.H.; Chaitman B.R.; Ali Z.; Min J.; Mancini G.B.J.; Leipsic J.; Guzman
L.; Hillis G.; Thambar S.; Joseph M.; Selvnayagam J.; Beltrame J.; Lang
I.; Schuchlenz H.; Huber K.; Goetschalckx K.; Hueb W.; Caramori P.R.; De
Quadros A.; Smanio P.; Mesquita C.; Lopas R.D.; Vitola J.; Marin-Neto J.;
Da Silva E.R.; Tumelero R.; Andrade M.; Alves A.R.; Dall'Orto F.;
Polanczyk C.; Figueiredo E.; Howarth A.; Gosselin G.; Cheema A.; Bainey
K.; Phaneuf D.; Diaz A.; Garg P.; Mehta S.; Wong G.; Lam A.; Cha J.;
Galiwango P.; Uxa A.; Chow B.; Hameed A.; Udell J.; Chema A.; Hamid M.;
Hauguel-Moreau M.; Furber A.; Goube P.; Steg P.-G.; Barone-Rochette G.;
Thuaire C.; Slama M.; Doer R.; Nickenig G.; Bekeredjian R.; Schulze P.C.;
Merkely B.; Fontos G.; Vertes A.; Varga A.; Bhargva B.; Kumar A.; Nair
R.G.; Grant P.; Manjunath C.; Moorthy N.; Satheesh S.; Nath R.K.; Wander
G.; Christopher J.; Dwivedi S.; Oomman A.; Mathur A.; Gadkari M.; Naik S.;
Punnoose E.; Kachru R.; Christophar J.; Kaul U.; Sharer T.; Kerner A.;
Tarantini G.; Perna G.P.; Racca E.; Mortara A.; Monti L.; Briguori C.;
Leone G.; Amati R.; Salvatori M.; Di Chiara A.; Calabro P.; Galvani M.;
Provasoli S.; Fukuda K.; Koshaka S.; Nakano S.; Laucevicius A.; Kedev S.;
Khairuddin A.; Escobdo J.; Riezebos R.; Timmer J.; Heald S.; Stewart R.;
Ramos W.M.; Demkow M.; Mazurek T.; Drozdz J.; Szwed H.; Witkowski A.;
Ferreira N.; Pinto F.; Ramos R.; Popescu B.; Pop C.; Bockeria L.; Bockerya
O.; Demchenko E.; Romanov A.; Bershtein L.; Jizeeri A.; Stankovic G.;
Apostolovic S.; Adjic N.C.; Zdravkovic M.; Beleslin B.; Dekleva M.;
Davidovic G.; Chua T.; Foo D.; Poh K.K.; Ntsekhe M.; Sionis A.; Marin F.;
Miro V.; Blancas M.G.; Gonzalez-Juanatey J.; Fernandez-Aviles F.; Peteiro
J.; Luena J.E.C.; Held C.; Aspberg J.; Rossi M.; Kuanprasert S.; Yamwong
S.; Johnston N.; Donnelly P.; Moriarty A.; Roxy R.; Elghamaz A.;
Gurunathan S.; Karogiannis N.; Shah B.N.; Trimlett R.H.J.; Rubens M.B.;
Nicol E.D.; Mittal T.K.; Hampson R.; Gamma R.; De Belder M.; Nageh T.;
Lindsay S.; Mavromatis K.; Miller T.; Banerjee S.; Reynolds H.; Nour K.;
Stone P.
Institution
(Hochman, Anthopolos, Reynolds, Bangalore, Xu, Mavromichalis, Chang,
Contreras, Newman, Berger, Troxel) NYU Grossman School of Medicine, New
York, NY, United States
(O'Brien, Lopes, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Rosenberg, Kirby) National Institutes of Health, Bethesda, MD, United
States
(Bhargava) All India Institute of Medical Sciences, New Delhi, India
(Senior, Banfield) Northwick Park Hospital, London, United Kingdom
(Senior) Imperial College London, Royal Brompton Hospital, United Kingdom
(Goodman) St Michael's Hospital, University of Toronto, Canada
(Pracon) Department of Coronary and Structural Heart Diseases, National
Institute of Cardiology, Warsaw, Poland
(Lopez-Sendon) IdiPaz Research Institute and Hospital, Universitario la
Paz, Madrid, Spain
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Sidhu) Albany Medical College, NY, United States
(White) Te Whatu Ora Health New Zealand, Te Toki Tumai, Green Lane
Cardiovascular Services, University of Auckland, New Zealand
(Harrington, Maron) Stanford University, Department of Medicine, CA,
United States
(Boden) Veterans Affairs New England Healthcare System, Boston University
School of Medicine, MA, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) compared an initial
invasive versus an initial conservative management strategy for patients
with chronic coronary disease and moderate or severe ischemia, with no
major difference in most outcomes during a median of 3.2 years. Extended
follow-up for mortality is ongoing. Method(s): ISCHEMIA participants
were randomized to an initial invasive strategy added to
guideline-directed medical therapy or a conservative strategy. Patients
with moderate or severe ischemia, ejection fraction >=35%, and no recent
acute coronary syndromes were included. Those with an unacceptable level
of angina were excluded. Extended follow-up for vital status is being
conducted by sites or through central death index search. Data obtained
through December 2021 are included in this interim report. We analyzed
all-cause, cardiovascular, and noncardiovascular mortality by randomized
strategy, using nonparametric cumulative incidence estimators, Cox
regression models, and Bayesian methods. Undetermined deaths were
classified as cardiovascular as prespecified in the trial protocol.
 Result(s): Baseline characteristics for 5179 original ISCHEMIA trial
participants included median age 65 years, 23% women, 16% Hispanic, 4%
Black, 42% with diabetes, and median ejection fraction 0.60. A total of
557 deaths accrued during a median follow-up of 5.7 years, with 268 of
these added in the extended follow-up phase. This included a total of 343
cardiovascular deaths, 192 noncardiovascular deaths, and 22 unclassified
deaths. All-cause mortality was not different between randomized treatment
groups (7-year rate, 12.7% in invasive strategy, 13.4% in conservative
strategy; adjusted hazard ratio, 1.00 [95% CI, 0.85-1.18]). There was a
lower 7-year rate cardiovascular mortality (6.4% versus 8.6%; adjusted
hazard ratio, 0.78 [95% CI, 0.63-0.96]) with an initial invasive strategy
but a higher 7-year rate of noncardiovascular mortality (5.6% versus 4.4%;
adjusted hazard ratio, 1.44 [95% CI, 1.08-1.91]) compared with the
conservative strategy. No heterogeneity of treatment effect was evident in
prespecified subgroups, including multivessel coronary disease.
 Conclusion(s): There was no difference in all-cause mortality with an
initial invasive strategy compared with an initial conservative strategy,
but there was lower risk of cardiovascular mortality and higher risk of
noncardiovascular mortality with an initial invasive strategy during a
median follow-up of 5.7 years. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04894877. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<24>
Accession Number
2027806499
Title
Postoperative Delirium and Dementia in Patients Undergoing Cardiac
Surgery: A Review of Randomized Controlled Trials.
Source
Galen Medical Journal. 12 (no pagination), 2023. Article Number: e3045.
Date of Publication: 2023.
Author
Raberi V.S.; Qazi M.S.K.; Gol A.Z.; Nia R.G.; Kahourian O.; Zadeh R.F.
Institution
(Raberi, Kahourian, Zadeh) Seyed-Al-Shohada cardiology Hospital, Urmia
University of Medical Sciences, Urmia, Iran, Islamic Republic of
(Qazi) School of Nursing and Midwifery, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Gol) Department of Pediatric Cardiology, Shahid Motahari Hospital, Urmia
University of Medical Sciences, Urmia, Iran, Islamic Republic of
(Nia) Noncommunicable Diseases Research Center, Bam University of Medical
Sciences, Bam, Iran, Islamic Republic of
Publisher
Salviapub
Abstract
Delirium and dementia are considered to be the most significant
postoperative neurocognitive complications in patients undergoing cardiac
surgery, particularly those aged 60 years and older, which reduces the
post-surgery quality of life, prolongs hospitalization, increases costs,
and elevated the rates of mortality. Nevertheless, the etiology, risk
factors, and predictive biomarkers, have not been well elucidated
particularly, in patients with unmanifested underline cognitive
impairments. The present study aimed to review the findings on the
etiology, factors increasing the risk of incidence, and predictive
biomarkers of postoperative delirium and dementia after cardiac surgery,
and to describe the suggested pharmacological and non-pharmacological
interventions. Copyright © 2021, Galen Medical Journal.

<25>
Accession Number
2027803698
Title
Placing patient-reported outcomes at the centre of cardiovascular clinical
practice: implications for quality of care and management.
Source
European Heart Journal. 44(36) (pp 3405-3422), 2023. Date of Publication:
21 Sep 2023.
Author
Moons P.; Norekval T.M.; Arbelo E.; Borregaard B.; Casadei B.; Cosyns B.;
Cowie M.R.; Fitzsimons D.; Fraser A.G.; Jaarsma T.; Kirchhof P.; Mauri J.;
Mindham R.; Sanders J.; Schiele F.; Torbica A.; Zwisler A.D.
Institution
(Moons) KU Leuven Department of Public Health and Primary Care, KU Leuven
- University of Leuven, Kapucijnenvoer 35 PB7001, Leuven 3000, Belgium
(Moons) Institute of Health and Care Sciences, University of Gothenburg,
Arvid Wallgrens backe 1, Gothenburg 413 46, Sweden
(Moons) Department of Paediatrics and Child Health, University of Cape
Town, Klipfontein Rd, Rondebosch, Cape Town 7700, South Africa
(Norekval) Department of Heart Disease, Haukeland University Hospital,
Haukelandsveien 22, Bergen 5009, Norway
(Norekval) Department of Clinical Science, Faculty of Medicine, University
of Bergen, Jonas Lies veg, Bergen 875021, Norway
(Arbelo) Cardiology Department, Hospital Clinic, Universitat de Barcelona,
C/Villarroel 170, Barcelona 08036, Spain
(Arbelo) Institut d'Investigacio August Pi i Sunyer (IDIBAPS), Rossello
149-153, Barcelona 08036, Spain
(Arbelo) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares (CIBERCV), Av. Monforte de Lemos, 3-5. Pabellon 11.
Planta 0, Madrid 28029, Spain
(Borregaard, Zwisler) Department of Cardiology, Odense University
Hospital, J.B. Winslows Vej 4, Odense 5000, Denmark
(Borregaard) Department of Clinical Research, University of Southern
Denmark, J.B. Winslows Vej 19, Odense 5000, Denmark
(Casadei) Division of Cardiovascular Medicine, RDM, University of Oxford,
Headley Way, Oxford OX3 9DU, United Kingdom
(Casadei) NIHR Biomedical Research Centre, Headley Way, Oxford OX3 9DU,
United Kingdom
(Cosyns) Department of Cardiology, University Hospital Brussels,
Laarbeeklaan 101, Jette 1090, Belgium
(Cowie) Royal Brompton Hospital & School of Cardiovascular Medicine,
Faculty of Medicine & Lifesciences, King's College London, Sydney St,
London SW3 6NP, United Kingdom
(Fitzsimons) School of Nursing & Midwifery, Queens University Belfast, 97
Lisburn Road, Belfast BT9 7BL, United Kingdom
(Fraser) School of Medicine, Cardiff University, Heath Park, Cardiff CF14
4XW, United Kingdom
(Jaarsma) Department of Medicine, Health and Caring Sciences, Linkoping
University, Campus Norrkoping, Norrkoping 601 74, Sweden
(Jaarsma) Nursing Science, Julius Center, University Medical Centre
Utrecht, Universiteitsweg 100, Utrecht 3584 CG, Netherlands
(Kirchhof) Department of Cardiology, University Heart and Vascular Center
Hamburg, Martinistrasse 52, Hamburg D-20246, Germany
(Kirchhof) German Center for Cardiovascular Research (DZHK), Partner site
Hamburg/Kiel/Lubeck, Martinistrasse 52, Hamburg D-20246, Germany
(Kirchhof) Institute of Cardiovascular Sciences, College of Medical and
Dental Sciences, University of Birmingham, Birmingham B15 2TT, United
Kingdom
(Mauri) Department of Cardiology, Hospital Universitari Germans Trias i
Pujol, Carretera de Canyet, s/n, Barcelona 08916, Spain
(Mindham) European Society of Cardiology (ESC) Patient Forum, 2035 route
des colles, CS 80179 Biot, Sophia Antipolis Cedex 06903, France
(Sanders) St Bartholomew's Hospital, Barts Health NHS Trust, West
Smithfield, London EC1A 7BE, United Kingdom
(Sanders) William Harvey Research Institute, Queen Mary University of
London, Charterhouse Square, London EC1M 6BQ, United Kingdom
(Schiele) Department of Cardiology, University Hospital Besancon, 3 Bd
Alexandre Fleming, Besancon 25030, France
(Torbica) Centre for Research on Health and Social Care Management
(CERGAS), Bocconi University, Via Sarfatti, 10, Milan 20136, Italy
(Zwisler) REHPA, The Danish Knowledge Centre for Rehabilitation and
Palliative Care, Odense University Hospital, Vestergade 17, Nyborg 5800,
Denmark
(Zwisler) Department of Clinical Research, University of Southern Denmark,
Campusvej 55, Odense DK-5230, Denmark
Publisher
Oxford University Press
Abstract
Patient-reported outcomes (PROs) provide important insights into patients'
own perspectives about their health and medical condition, and there is
evidence that their use can lead to improvements in the quality of care
and to better-informed clinical decisions. Their application in
cardiovascular populations has grown over the past decades. This statement
describes what PROs are, and it provides an inventory of disease-specific
and domain-specific PROs that have been developed for cardiovascular
populations. International standards and quality indices have been
published, which can guide the selection of PROs for clinical practice and
in clinical trials and research; patients as well as experts in
psychometrics should be involved in choosing which are most appropriate.
Collaborations are needed to define criteria for using PROs to guide
regulatory decisions, and the utility of PROs for comparing and monitoring
the quality of care and for allocating resources should be evaluated. New
sources for recording PROs include wearable digital health devices,
medical registries, and electronic health record. Advice is given for the
optimal use of PROs in shared clinical decision-making in cardiovascular
medicine, and concerning future directions for their wider
application. Copyright © 2023 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<26>
Accession Number
2027754694
Title
DEL NIDO CARDIOPLEGIA: A 'MAGIC BULLET' FOR CARDIAC SURGEON- A
MULTIVARIATE PROSPECTIVE COMPARATIVE STUDY.
Source
Journal of Cardiovascular Disease Research. 14(2) (pp 567-578), 2023. Date
of Publication: 2023.
Author
Sahoo S.P.; Sahoo A.K.; Thatei C.R.; Pattnaik M.K.
Institution
(Sahoo) Dept. of CTVS, S.C.B.Medical College, Mangalabagh, Odisha, Cuttack
753007, India
(Sahoo, Thatei) Dept. of Anaesthesiology S.C.B.Medical College,
Mangalabagh, Odisha, Cuttack 753007, India
(Pattnaik) Dept of CTVS, S.C.B.Medical College, Mangalabagh, Odisha,
Cuttack 753007, India
Publisher
EManuscript Technologies
Abstract
Introduction-Cardioplegia remains an essential component of myocardial
protection during cardiac surgeries. Main purpose-This is a single centre
prospective study that compares the better cardioprotective effect between
del Nido(DN) and modified St. Thomas(mST) cardioplegia solution during
intraoperative and immediate post-operative period. MethodThis is a
prospective randomised double blind study conducted over a period of one
year from among the patients admitted for different cardiac surgeries. The
selected patients were divided into two groups. Surgical procedures
included in this study: coronary artery bypass graft(CABG)(multiple
graft), mitral valve repair / replacement+ tricuspid ring annuloplasty
(MVR+TVR), mitral + aortic valve replacement (DVR), ventricular septal
defect(VSD) repair, intra-cardiac repair for Tetralogy of Fallot (TOF).
Surgical procedures excluded in this study were: isolated mitral valve
replacement, aortic valve replacement (AVR), atrial septal defect (ASD),
CABG (single graft). Primary end point was to compare the cardioprotective
factors in DN and mST group. ResultIn comparison to modified St Thomas
group, del Nido group had lesser cardiopulmonarybypass time(76.50 min vs
67.16 min), aortic cross clamp time(60.60 min vs 53.52 min) and
comparatively lesser rise in post-operative Troponin T level (1.027 ng/dl
vs 0.719 ng/dl) and earlier appearance of first cardiac rhythm after
removal of aortic cross clamp(39.88 sec vs 29.52 sec) and lesser
incidence(n=8) of re-dosing of cardioplegia administration, lower rate of
post-operative defibrillation(six vs twenty) and lower post-operative
complication rate (three vs ten). ConclusionOur study demonstrated that by
using del Nido cardioplegia, there is in better myocardial protection and
improved cardiac output in comparison to other standard cardioplegic
solutions along with improved haemo-concentration. Hence, the del Nido
cardioplegia can be a 'magic bullet' for cardiac surgeons. Copyright
© 2023 EManuscript Technologies. All rights reserved.

<27>
Accession Number
2027750861
Title
Early Addition of Evolocumab to Statin Treatment in Patients with Acute
Coronary Syndrome and Multivessel Disease Undergoing Percutaneous Coronary
Intervention.
Source
Reviews in Cardiovascular Medicine. 24(9) (no pagination), 2023. Article
Number: rcm2409270. Date of Publication: September 2023.
Author
Zhang A.; Wu Y.; Zhang Y.; Hu W.; Chen P.; Chen K.; Ding J.
Institution
(Zhang, Zhang, Wu, Hu, Ding) Department of Cardiology, Zhongda Hospital,
Southeast University, Jiangsu, Nanjing 210009, China
(Zhang, Chen, Chen) Department of Cardiology, The First Affiliated
Hospital, Zhengzhou University, Henan, Zhengzhou 450052, China
Publisher
IMR Press Limited
Abstract
Background: Evolocumab has been demonstrated to significantly reduce
ischemic cardiovascular events in patients with stable coronary heart
disease. However, it is currently unclear whether this benefit extends to
patients with acute coronary syndrome (ACS) and multivessel disease (MVD)
undergoing percutaneous coronary intervention (PCI). The objective of this
study was to assess the safety, efficacy and feasibility of the early
addition of evolocumab to statin treatment for ACS patients with MVD
undergoing PCI. Method(s): The authors conducted a multicenter,
retrospective cohort study involving 1199 ACS patients with MVD undergoing
PCI and with elevated low-density lipoprotein cholesterol (LDL-C) levels.
Patients were divided into an evolocumab group or a standard-of-care group
based on evolocumab use or not. The 18-month primary efficacy endpoint was
a composite of ischemic stroke, death from cardiac causes, recurrent
myocardial infarction (MI), unplanned coronary revascularization or
unstable angina requiring hospitalization. The principal secondary
efficacy endpoint was a composite of ischemic stroke, death from cardiac
causes or recurrent MI. Result(s): After propensity score matching,
the addition of evolocumab to statin treatment lowered LDL-C levels by
42.62% compared with statin therapy alone at 18 months, from a mean
baseline level of 3.37-0.75 mmol/L (p < 0.001). Relative to standard
therapy, evolocumab added to statins was associated with significant
reductions in the primary efficacy endpoint (8.3% vs. 13.3%; adjusted
hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.39 to 0.91; p =
0.017) and the principal secondary efficacy endpoint (6.1% vs. 10.2%;
adjusted HR, 0.61; 95% CI, 0.37 to 0.99; p = 0.048) after multivariable
Cox regression adjustment. The treatment effect of evolocumab was
consistent across all prespecified subgroups. There were no significant
between-group differences in terms of adverse events. Conclusion(s):
In ACS patients with MVD taken for PCI, early initiation of evolocumab
along with statin treatment was associated with a significant reduction in
LDL-C levels and a reduced risk of recurrent cardiovascular
events. Copyright © 2023 The Author(s).

<28>
[Use Link to view the full text]
Accession Number
2027748522
Title
Effect of opioid-free anesthesia on the incidence of postoperative nausea
and vomiting: A meta-analysis of randomized controlled studies.
Source
Medicine (United States). 102(38) (pp E35126), 2023. Date of Publication:
22 Sep 2023.
Author
Zhang Y.; Ma D.; Lang B.; Zang C.; Sun Z.; Ren S.; Chen H.
Institution
(Zhang, Zang, Sun, Ren) School of Anesthesiology, Weifang Medical
University, Weifang, China
(Ma, Chen) Department of Anesthesiology, Yidu Central Hospital, Weifang
Medical University, Weifang, China
(Lang) Department of Anesthesiology, Weifang People's Hospital, Weifang,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Research on opioid-free anesthesia has increased in recent
years; however, it has never been determined whether it is more beneficial
than opioid anesthesia. This meta-analysis was primarily used to assess
the effect of opioid-free anesthesia compared with opioid anesthesia on
the incidence of postoperative nausea and vomiting. Method(s): We
searched the electronic databases of PubMed, the Cochrane Library, Web of
Science and Embase from 2014 to 2022 to identify relevant articles and
extract relevant data. The incidence of postoperative nausea and vomiting,
time to extubation, pain score at 24 hours postoperatively, and time to
first postoperative rescue analgesia were compared between patients
receiving opioid-free anesthesia and those receiving standard opioid
anesthesia. Differences in the incidence of postoperative nausea and
vomiting were evaluated using risk ratios (95% confidence interval [CI]).
The significance of the differences was assessed using mean differences
and 95% CI. The heterogeneity of the subject trials was evaluated using
the I2test. Statistical analysis was performed using the RevMan
5.4 software. Result(s): Fourteen randomized controlled trials,
including 1354 participants, were evaluated in the meta-analysis. As seen
in the forest plot, the OFA group had a lower risk of postoperative nausea
and vomiting than the control group (risk ratios = 0.41, 95% CI:
0.33-0.51, P <.00001; n = 1354), and the meta-analysis also found that the
OFA group had lower postoperative analgesia scores at 24 hours (P
<.000001), but time to extubation (P =.14) and first postoperative
resuscitation analgesia time (P <.54) were not significantly different.
 Conclusion(s): Opioid-free anesthesia reduces the incidence of
postoperative nausea and vomiting while providing adequate analgesia
without interfering with postoperative awakening. Copyright ©
2023 Lippincott Williams and Wilkins. All rights reserved.

<29>
[Use Link to view the full text]
Accession Number
2027748480
Title
Effect of ondansetron compared to lidocaine and placebo for reducing
propofol injection pain: A systematic review and meta-analysis of
randomized controlled trials.
Source
Medicine (United States). 102(38) (pp E35021), 2023. Date of Publication:
22 Sep 2023.
Author
Zaazouee M.S.; Mahmoud A.M.; Elfar W.H.; Hana K.; Shamshoon K.F.; Adly
M.H.; Hussein T.A.; Hamza M.M.; Aly A.A.; Eguzo M.A.; Farhat A.M.;
Elsnhory A.B.; Morsy M.H.; Ammar M.F.; Alnaji A.A.; Elshanbary A.A.; Shah
J.; Abdelqadir Y.H.
Institution
(Zaazouee) Faculty of Medicine, Al-Azhar University, Assiut, Egypt
(Mahmoud) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Elfar, Elsnhory) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Hana, Shamshoon, Adly, Hussein) Faculty of Medicine, Assiut University,
Assiut, Egypt
(Hamza) Faculty of Medicine, Hashemite University, Zarqa, Jordan
(Aly, Eguzo, Morsy, Elshanbary, Abdelqadir) Faculty of Medicine,
Alexandria University, Alexandria, Egypt
(Farhat) Faculty of Medicine, Fayoum University, Fayoum, Egypt
(Ammar) Faculty of Medicine, Tanta University, Tanta, Egypt
(Alnaji) Faculty of Medicine, Fajr College for Science and Technology,
Khartoum, Sudan
(Shah) Kateb University, Medical Research Center, Kateb University, Kabul,
Afghanistan
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Propofol is the most commonly used intravenous anesthetic
medication and is most commonly associated with post-operative pain.
Several drugs are investigated to reduce post-operative pain caused by
propofol injection. Ondansetron is a potent anti-emetic drug showing
promising results as an analgesic. This meta-analysis aims to compare the
efficacy of ondansetron to placebo and lidocaine in reducing
post-operative pain caused by propofol injection. Method(s): PubMed,
Embase, Cochrane Library, Web of Science, and Scopus were searched for
relevant randomized controlled trials (RCTs) till May 2022. We conducted a
meta-analysis using RevMan software version 5.4, and we assessed the
quality of included RCTs using the Cochrane risk of bias tool.
 Result(s): In our study, we included 23 RCTs with 2957 participants.
Compared to placebo, ondansetron significantly increased the rate of no
pain [risk ratio (RR) = 2.36, 95% confidence interval (CI) (1.39-4.01)],
and reduced moderate [RR = 0.39, 95% CI (0.30-0.52)] and severe pain [RR =
0.34, 95% CI (0.24-0.50)]. Furthermore, ondansetron significantly reduced
PONV [RR = 0.73, 95% CI (0.58, 0.91)]. On the other hand, ondansetron
showed an inferior efficacy to lidocaine regarding the incidence of no,
moderate, and severe pain. Conclusion(s): Ondansetron is effective in
reducing post-operative propofol-induced pain. However, lidocaine is more
effective than it. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<30>
Accession Number
2027746394
Title
Index hospital cost of adverse events following thoracic surgery: A
systematic review of economic literature.
Source
BMJ Open. 13(9) (no pagination), 2023. Article Number: e069382. Date of
Publication: 28 Sep 2023.
Author
Jones D.; Kumar S.; Anstee C.; Gingrich M.; Simone A.; Ahmadzai Z.;
Thavorn K.; Seely A.
Institution
(Jones) Department of Surgery, University of Ottawa, Ottawa, ON, Canada
(Jones, Kumar, Anstee, Gingrich, Simone) Methods Centre, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Ahmadzai) Department of Surgery, OHRI, Ottawa, ON, Canada
(Thavorn) Clinical Epidemiology Program, Ottawa Hospital Research
Institute, Ottawa, ON, Canada
(Seely) Department of Epidemiology, Ottawa Hospital Research Institute,
Ottawa, ON, Canada
(Seely) Department of Surgery, Ottawa Hospital, Ottawa, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objectives Adverse events (AEs) following thoracic surgery place
considerable strain on healthcare systems. A rigorous evaluation of the
economic impact of thoracic surgical AEs remains lacking and is required
to understand the value of money of formal quality improvement
initiatives. Our objective was to conduct a systematic review of all
available literature focused on specific cost of postoperative AEs
following thoracic surgery. Design Systematic review of the economic
literature was performed, following recommendations from the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses statement. Data
sources An economic search filter developed by the Canadian Agency for
Drugs and Technologies in Health was applied, and MEDLINE, Embase and The
Cochrane Library were searched from inception to January 2022. Eligibility
criteria We included English articles involving adult patients who
underwent a thoracic surgical procedure with estimated costs of
postoperative complications. Eligible study designs included comparative
observational studies, randomised control trials, decision analytic or
cost-prediction models, cost analyses, cost or burden of illness studies,
economic evaluation studies and systematic reviews and/or meta-analyses of
cost analyses and cost of illness studies. Data extraction and synthesis
Two reviewers independently screened titles and abstracts in the first
stage and full-text articles of included studies in the second stage.
Disagreements during abstract and full-text screening stages were resolved
via discussion until a consensus was reached. Studies were appraised for
methodological quality using the Critical Appraisal Skills Program
checklist. Results 3349 studies were identified: 20 met inclusion
criteria. Most were conducted in the USA (12/20), evaluating AE impact on
hospital expenditures (18/20). 68 procedure-specific AE mean costs were
characterised (USD$). The most commonly described were anastomotic leak
(mean:range) (USD$49 278:$6 176-$133 002) and pneumonia ($12 258:$2608-$34
591) following esophagectomy, and prolonged air leak ($2556:$571-$3573),
respiratory failure ($19 062:$11 841-$37 812), empyema ($30 189:$23
784-$36 595), pneumonia ($15 362:$2542-$28 183), recurrent laryngeal nerve
injury ($16 420:$4224-$28 616) and arrhythmia ($6835:$5833-$8659)
following lobectomy. Conclusions Hospital costs associated with AEs
following thoracic surgery are substantial and varied. Quantifying costs
of AEs enable future economic evaluation studies, which could help
prioritising value-directed quality improvement to optimally improve
outcomes and reduce costs. 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.

<31>
Accession Number
2027128515
Title
Invited commentary on: Myocardial recovery in children supported with a
durable ventricular assist device - a systematic approach.
Source
European Journal of Cardio-thoracic Surgery. 64(2) (no pagination), 2023.
Article Number: ezad277. Date of Publication: 01 Aug 2023.
Author
Fleck T.; Bobrowski A.
Institution
(Fleck, Bobrowski) Department of Congenital Heart Disease and Pediatric
Cardiology, University Heart Center Freiburg - Bad Krozingen, Medical
Center, University of Freiburg, Faculty of Medicine, University of
Freiburg, Freiburg, Germany
Publisher
European Association for Cardio-Thoracic Surgery

<32>
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

<33>
Accession Number
2024833246
Title
Current Status of Simulation in Thoracic Surgical Training.
Source
Annals of Thoracic Surgery. 116(5) (pp 1107-1115), 2023. Date of
Publication: November 2023.
Author
Whittaker G.; Ghita I.-A.; Taylor M.; Salmasi M.Y.; Granato F.; Athanasiou
T.
Institution
(Whittaker, Salmasi, Athanasiou) Department of Surgery and Cancer,
Imperial College London, London, United Kingdom
(Whittaker, Taylor, Granato) Department of Cardiothoracic Surgery,
Manchester University NHS Foundation Trust, Manchester, United Kingdom
(Ghita) Faculty of Medicine, University of Medicine and Pharmacy of
Craiova, Craiova, Romania
Publisher
Elsevier Inc.
Abstract
Background: Simulation is playing an increasingly important role in
surgical training but is not yet a mandatory part of most surgical
curricula. A simulator must undergo rigorous validation to verify it as a
reliable tool. The aim of this study was to review the literature to
identify simulators that are currently available to augment thoracic
surgical training and to analyze any evidence supporting or validating
them. Method(s): A literature search of the MEDLINE (1946 to November
2022) and Embase (1947 to November 2022) databases was performed to
identify simulators for basic skills and procedures in thoracic surgery. A
selection of keywords were used to perform the literature search. After
identification of appropriate articles, data were extracted and analyzed.
 Result(s): Thirty-three simulators were found in 31 articles.
Simulators for basic skills (n = 13) and thoracic lobectomy (n = 13) were
most commonly described, followed by miscellaneous (n = 7). Most models
were of a hybrid modality (n = 18). Evidence of validity was established
in 48.5% (n = 16) of simulators. In total, 15.2% (n = 5) of simulators had
3 or more elements of validity demonstrated, and only 3.0% (n = 1)
accomplished full validation. Conclusion(s): Numerous simulators of
varying modality and fidelity exist for a variety of thoracic surgical
skills and procedures, although validation evidence is frequently
inadequate. Simulation models may be able to provide training in basic
surgical and procedural skills; however, further assessment of validity
needs to be undertaken before consideration of their integration into
training programs. Copyright © 2023 The Society of Thoracic
Surgeons

<34>
Accession Number
2027145770
Title
Intraoperative hypotension and postoperative outcomes: a meta-analysis of
randomised trials.
Source
British Journal of Anaesthesia. 131(5) (pp 823-831), 2023. Date of
Publication: November 2023.
Author
D'Amico F.; Fominskiy E.V.; Turi S.; Pruna A.; Fresilli S.; Triulzi M.;
Zangrillo A.; Landoni G.
Institution
(D'Amico, Fominskiy, Turi, Pruna, Fresilli, Triulzi, Zangrillo, Landoni)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
Publisher
Elsevier Ltd
Abstract
Introduction: Intraoperative hypotension is associated with adverse
postoperative outcomes; however these findings are supported only by
observational studies. The aim of this meta-analysis of randomised trials
was to compare the postoperative effects permissive management with
targeted management of intraoperative blood pressure. Method(s): We
searched PubMed, Cochrane, and Embase up to June 2023 for studies
comparing permissive (mean arterial pressure <=60 mm Hg) with targeted
(mean arterial pressure >60 mm Hg) intraoperative blood pressure
management. Primary outcome was all-cause mortality at the longest
follow-up available. Secondary outcomes were atrial fibrillation,
myocardial infarction, acute kidney injury, delirium, stroke, number of
patients requiring transfusion, time on mechanical ventilation, and length
of hospital stay. Result(s): We included 10 randomised trials
including a total of 9359 patients. Mortality was similar between
permissive and targeted blood pressure management groups (89/4644 [1.9%]
vs 99/4643 [2.1%], odds ratio 0.88, 95% confidence interval [CI],
0.65-1.18, P=0.38, I2=0% with nine studies included). Atrial
fibrillation (102/3896 [2.6%] vs 130/3887 [3.3%] odds ratio 0.71, 95% CI
0.53-0.96, P=0.03, I2=0%), and length of hospital stay (mean
difference -0.20 days, 95% CI -0.26 to -0.13, P<0.001, I2=0%)
were reduced in the permissive management group. No significant
differences were found in subgroup analysis for cardiac and noncardiac
surgery. Conclusion(s): Pooled randomised evidence shows that a
target intraoperative mean arterial pressure <=60 mm Hg is not associated
with increased mortality; nevertheless it is surprisingly associated with
a reduced rate of atrial fibrillation and of length of hospital stay.
Systematic review protocol: PROSPERO CRD42023393725. Copyright ©
2023 British Journal of Anaesthesia

<35>
Accession Number
2021570254
Title
Influence of Dexmedetomidine on Myocardial Injury in Patients with
Simultaneous Pancreas-Kidney Transplantation.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 7196449. Date of Publication: 2022.
Author
Dong A.; Zhang Y.; Lu S.; Yu W.
Institution
(Dong, Lu, Yu) Tianjin First Center Hospital, Tianjin 300192, China
(Zhang) First Teaching Hospital, Tianjin University of Traditional Chinese
Medicine, National Clinical Research Center for Chinese Medicine
Acupuncture and Moxibustion, Tianjin 300193, China
Publisher
Hindawi Limited
Abstract
Background. Diabetes is one of the most common chronic diseases in the
world. End-stage renal disease (ESRD) caused by diabetes is the most
serious long-term complication. The main cause of death in patients with
simultaneous pancreas-kidney transplantation (SPKT) is cardiovascular
disease. Although dexmedetomidine (Dex) has unique advantages in heart
protection against ischaemic/reperfusion injury, few clinical studies have
been conducted on its cardioprotective effect in SPKT. This study aimed to
explore the influence of Dex on myocardial injury in patients undergoing
SPKT and to analyze its possible mechanism. Methods. A randomized
controlled trial (RCT) was performed from July 1, 2018 to December 1,
2020. Eighty patients, regardless of gender, scheduled for SPKT were
randomly allocated into a Dex group (D group) receiving Dex at a rate of 1
mug/kg for 10 minutes before anaesthesia induction and then continuous
infusion at 0.5 mug/kg/hour until the end of surgery and control group (C
group) receiving equivalent capacity of saline. Serum cardiac troponin I
(cTnI), creatine kinase isoenzyme (CK-MB), tumour necrosis factor-alpha
(TNF-alpha), and interleukin-6 (IL-6) were recorded at 5 minutes after
anaesthesia induction (baseline,T0), 5 minutes before renal arteriovenous
opening (T1), 30 minutes after renal arteriovenous opening (T2), 30
minutes after pancreatic related arteriovenous opening (T3), immediately
after surgery (T4), 4 hours after surgery (T5), and 24 hours after surgery
(T6). Adverse cardiovascular events were recorded during the perioperative
period. Changes in ECG S-T segments and T waves were monitored at T0-T6.
Myocardial infarction and percutaneous coronary intervention were recorded
with an average follow-up of one year. Results. Compared with T0,
TNF-alpha and IL-6 concentrations significantly increased at T1-T6 in the
C and D groups (P<0.05). IL-6 concentration increased significantly after
renal artery opening and reached the peak after the opening of pancreatic
blood vessels. Compared with the C group, TNF-alpha, and IL-6
concentrations were significantly reduced in group D at T2-T6 (P<0.05).
Compared with T0, cTnI and CK-MB concentrations were significantly
increased at T3-T6 in the C and D groups (P<0.05). cTnI and CK-MB
concentrations increased significantly after the opening of renal artery,
and reached the peak after the opening of pancreatic blood vessels.
Compared with the C group, cTnI and CK-MB concentrations were
significantly reduced in the D group at T3-T6 (P<0.05). There was no
significant difference in patient characteristics amongst groups,
including the proportion of intraoperative vasoactive drug use and adverse
cardiovascular events during the follow-up period. Heart rate, mean blood
pressure, central venous pressure, and cardiac output were not remarkably
different between the two groups at any time point. Conclusions.
Perioperative reperfusion could aggravate myocardial injury in SPKT. Dex
may be considered a way to reduce myocardial injury caused by inflammatory
action by decreasing the release of inflammatory factors. Trial
Registration Number: Chinese Clinical Trial Registry ID:
ChiCTR2200060084. Copyright © 2022 Aili Dong et al.

<36>
[Use Link to view the full text]
Accession Number
2027748560
Title
Analgesic comparison of erector spinae plane block with intercostal nerve
block for thoracoscopic surgery: A meta-analysis of randomized controlled
trials.
Source
Medicine (United States). 102(38) (pp E35093), 2023. Date of Publication:
22 Sep 2023.
Author
Ma G.; Gou J.; Chen L.; Qiao X.
Institution
(Ma, Gou, Chen, Qiao) Department of Thoracic and Cardiac Surgery, Tianshui
Second People's Hospital, Gansu Province, China
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The analgesic efficacy of erector spinae plane block (ESPB)
versus intercostal nerve block (ICNB) for thoracoscopic surgery remains
controversial. We conducted a systematic review and meta-analysis to
explore the impact of ESPB versus ICNB on thoracoscopic surgery.
 Method(s): We searched PubMed, EMbase, Web of Science, EBSCO, and
Cochrane library databases through May 2023 for randomized controlled
trials (RCTs) assessing the effect of ESPB versus ICNB on thoracoscopic
surgery. This meta-analysis was performed using the random-effect model or
fixed-effect model based on the heterogeneity. Result(s): Four RCTs
and 203 patients are included in the meta-analysis. Overall, compared with
ICNB for thoracoscopic surgery, ESPB results in significantly reduced pain
scores at 48 hours (SMD [standard mean difference]=-3.49; 95% CI
[confidence interval]=-6.76 to-0.21; P=.04), but demonstrated no impact on
pain scores at 24 hours (SMD=-0.04; 95% CI=-1.24 to 1.16; P=.95), pain
scores at 4 to 6 hours (SMD=-0.16; 95% CI=-2.02 to 1.71; P=.87), pain
scores at 12 hours (SMD=-0.16; 95% CI=-2.38 to 2.05; P=.88) or analgesic
consumption (SMD=0.27; 95% CI=-0.80 to 1.35; P=.62). Conclusion(s):
ESPB may be comparable with ICNB for the postoperative pain control of
thoracoscopic surgery. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<37>
Accession Number
2027159265
Title
Clinical efficacy and safety outcomes of bempedoic acid: An updated
systematic review and meta-analysis after CLEAR Outcomes trial.
Source
Health Sciences Review. 9 (no pagination), 2023. Article Number: 100116.
Date of Publication: December 2023.
Author
Bhandari A.; Oli P.R.; Shrestha D.B.; Dawadi S.; Pathak B.D.; Bhandari M.;
Sedhai Y.R.; Basnet B.; Regmi L.; Singh A.; Patel N.K.
Institution
(Bhandari) Department of Internal Medicine, Saint Johns' Hospital, HSHS
Medical Group, Springfield, IL, United States
(Oli, Regmi) Department of Internal Medicine, Province Hospital, Surkhet,
Birendranagar, Nepal
(Shrestha) Department of Internal Medicine, Mount Sinai Hospital, Chicago,
IL, United States
(Dawadi) Department of Internal Medicine, Nepalese Army Institute of
Health Sciences, Kathmandu, Nepal
(Pathak) Department of Internal Medicine, Jibjibe Primary Health Care
Center, Rasuwa, Nepal
(Bhandari) Department of Internal Medicine, Division of Cardiology, Cape
Fear Valley Medical Center, 1638 Owen Drive, Fayetteville, NC, United
States
(Sedhai) Department of Internal Medicine, Division of Pulmonary Disease
and Critical Care, University of Kentucky College of Medicine-Bowling
Green Campus, Bowling Green, KY, United States
(Basnet) Department of Internal Medicine, Frye Regional Medical Center,
Hickory, NC, United States
(Singh) Department of Internal Medicine, Division of Cardiology, Tower
Health Program, 420 S. Fifth Avenue, West Reading, PA, United States
(Patel) Department of Internal Medicine, Division of Cardiology, Virginia
Commonwealth University, School of Medicine, Richmond, VA, United States
Publisher
Elsevier Ltd
Abstract
Purpose: Statins are the cornerstone therapy for primary or secondary
prevention of atherosclerotic cardiovascular disease (ASCVD). However, a
significant portion of patients are intolerant to statin or show
inadequate lipid-lowering. Bempedoic acid (BA) has been shown to decrease
low-density lipoprotein cholesterol (LDL-C) in clinical trials. However,
the evidence on the effect of BA on clinical cardiovascular outcomes was
limited until the CLEAR Outcomes trial. Thus, to fully appraise the
available data, we performed this meta-analysis. Method(s): PubMed,
Pubmed Central, Embase, and Scopus databases were searched for relevant
articles published before May 1, 2023. Pertinent data from the included
studies were extracted and analyzed using RevMan v5.4. Result(s): Out
of 2209 studies evaluated, five randomized control trials with 17,384
patients with established ASCVD or at high risk of ASCVD were included for
analysis. The BA therapy reduced major adverse cardiovascular events (OR
0.85, CI 0.77-0.93; <0.0001), non-fatal myocardial infarction (OR 0.75, 95
% CI 0.64-0.88; p <0.0001), hospitalization for unstable angina (OR 0.69,
CI 0.53-0.89; p = 0.005) and coronary revascularization (OR 0.80, CI
0.61-0.91; <0.0001) significantly without decreasing the risk of all-cause
death (OR 1.19, CI 0.73-1.94; p = 0.49), cardiovascular death (OR 1.04, CI
0.87-1.25; p = 0.68) and non-fatal stroke (OR 0.84, CI 0.66-1.06; p =
0.15). Conclusion(s): Based on our analysis the bempedoic acid
addition to therapy reduced cardiovascular events in selective patients
who are either intolerant to statins or do not achieve recommended LDL-C
levels despite being on a maximum dose of statins and/or
ezetimibe. Copyright © 2023 The Author(s)

<38>
Accession Number
2026613001
Title
Extrathoracic Against Intrathoracic Vascular Accesses for Transcatheter
Aortic Valve Replacement: A Systematic Review With Meta-Analysis.
Source
American Journal of Cardiology. 203 (pp 473-483), 2023. Date of
Publication: 15 Sep 2023.
Author
Abellan C.; Antiochos P.; Fournier S.; Skali H.; Shah P.; Maurizi N.;
Eeckhout E.; Roguelov C.; Monney P.; Tzimas G.; Kirsch M.; Muller O.; Lu
H.
Institution
(Abellan) Service of Internal Medicine, Lausanne University Hospital and
University of Lausanne, Switzerland, Lausanne, Switzerland
(Antiochos, Fournier, Maurizi, Eeckhout, Roguelov, Monney, Tzimas, Muller,
Lu) Service of Cardiology, Lausanne University Hospital and University of
Lausanne, Switzerland, Lausanne, Switzerland
(Skali, Shah, Lu) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, Massachusetts, United States
(Kirsch) Service of Cardiovascular Surgery, Lausanne University Hospital
and University of Lausanne, Lausanne, Switzerland
Publisher
Elsevier Inc.
Abstract
Alternative vascular accesses to transfemoral access for transcatheter
aortic valve replacement (TAVR) can be divided into intrathoracic
(IT)-transapical and transaortic- and extrathoracic (ET)-transcarotid,
transsubclavian, and transaxillary. This study aimed to compare the
outcomes and safety of IT and ET accesses for TAVR as alternatives to
transfemoral access. A systematic review with meta-analysis was performed
by searching PubMed/MEDLINE and EMBASE databases for all studies comparing
IT-TAVR with ET-TAVR published until April 2023. Outcomes included
in-hospital or 30-day all-cause mortality (ACM), 1-year ACM, postoperative
and 30-day complications. A total of 18 studies with 6,800 IT-TAVR
patients and 5,032 ET-TAVR patients were included. IT accesses were
associated with a significantly higher risk of in-hospital or 30-day ACM
(relative risk 1.99, 95% confidence interval 1.67 to 2.36, p <0.001), and
1-year ACM (relative risk 1.31, 95% confidence interval 1.21 to 1.42, p
<0.001). IT-TAVR patients presented more often with postoperative
life-threatening bleeding, 30-day new-onset atrial fibrillation or
flutter, and 30-day acute kidney injury needing renal replacement therapy.
The risks of postoperative permanent pacemaker implantation and
significant paravalvular leak were lower with IT-TAVR. ET-TAVR patients
were more likely to be directly discharged home. There was no
statistically significant difference regarding the 30-day risk of stroke.
Compared with ET-TAVR, IT-TAVR was associated with higher risks of
in-hospital or 30-day ACM, 1-year ACM and higher risks for some critical
postprocedural and 30-day complications. Our results suggest that ET-TAVR
could be considered as the first-choice alternative approach when
transfemoral access is contraindicated. Copyright © 2023 The
Author(s)

<39>
Accession Number
2024009250
Title
Glutamate infusion associated with reduced rises of p-Copeptin after
coronary surgery: Substudy of GLUTAMICS II.
Source
Acta Anaesthesiologica Scandinavica. 67(10) (pp 1373-1382), 2023. Date of
Publication: November 2023.
Author
Svedjeholm R.; Ferrari G.; Vanky F.; Friberg O.; Holm J.
Institution
(Svedjeholm, Vanky, Holm) Department of Thoracic and Vascular Surgery,
Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular
Medicine, Linkoping University, Linkoping, Sweden
(Ferrari, Friberg) Department of Cardiothoracic and Vascular Surgery,
Faculty of Medicine and Health, Health Care Research Centre, Orebro
University, Orebro, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Glutamate plays a key role for post-ischaemic recovery of
myocardial metabolism. According to post hoc analyses of the two GLUTAMICS
trials, patients without diabetes benefit from glutamate with less
myocardial dysfunction after coronary artery bypass surgery (CABG).
Copeptin reflects activation of the Arginine Vasopressin system and is a
reliable marker of heart failure but available studies in cardiac surgery
are limited. We investigated whether glutamate infusion is associated with
reduced postoperative rises of plasma Copeptin (p-Copeptin) after CABG.
 Method(s): A prespecified randomised double-blind substudy of
GLUTAMICS II. Patients had left ventricular ejection fraction <=0.30 or
EuroSCORE II >=3.0 and underwent CABG +/- valve procedure. Intravenous
infusion of 0.125 M L-glutamic acid or saline at 1.65 mL/kg/h was
commenced 10-20 min before the release of the aortic cross-clamp and then
continued for another 150 min P-Copeptin was measured preoperatively and
postoperatively on day one (POD1) and day three. The primary endpoint was
an increase in p-Copeptin from the preoperative level to POD1.
Postoperative stroke <=24 h and mortality <=30 days were safety outcomes.
 Result(s): We included 181 patients of whom 48% had diabetes. The
incidence of postoperative mortality <=30 days (0% vs. 2.1%; p =.50) and
stroke <=24 h (0% vs. 3.2%; p =.25) did not differ between the glutamate
group and controls. P-Copeptin increased postoperatively with the highest
values recorded on POD1 without significant inter-group differences. Among
patients without diabetes, p-Copeptin did not differ preoperatively but
postoperative rise from preoperative level to POD1 was significantly
reduced in the glutamate group (73 +/- 66 vs. 115 +/- 102 pmol/L; p =.02).
P-Copeptin was significantly lower in the Glutamate group on POD1 (p =.02)
and POD 3 (p =.02). Conclusion(s): Glutamate did not reduce rises of
p-Copeptin significantly after moderate to high-risk CABG. However,
glutamate was associated with reduced rises of p-Copeptin among patients
without diabetes. These results agree with previous observations
suggesting that glutamate mitigates myocardial dysfunction after CABG in
patients without diabetes. Given the exploratory nature of these findings,
they need to be confirmed in future studies. Copyright © 2023 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<40>
Accession Number
2023677357
Title
Influence of preoperative frailty on quality of life after cardiac
surgery: A systematic review and meta-analysis.
Source
Journal of the American Geriatrics Society. 71(10) (pp 3278-3286), 2023.
Date of Publication: October 2023.
Author
Fehlmann C.A.; Bezzina K.; Mazzola R.; Visintini S.M.; Guo M.H.; Rubens
F.D.; Wells G.A.; McGuinty C.; Huang A.; Khoury L.; Boczar K.E.
Institution
(Fehlmann, Rubens, Wells, Boczar) School of Epidemiology and Public
Health, University of Ottawa, Ottawa, ON, Canada
(Fehlmann) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Fehlmann) Division of Emergency Medicine, Geneva University Hospitals,
Geneva, Switzerland
(Bezzina) Care of the Elderly Program, Elisabeth Bruyere Hospital, Ottawa,
ON, Canada
(Mazzola, McGuinty, Boczar) University of Ottawa Heart Institute, Ottawa,
ON, Canada
(Visintini) Berkman Library, University of Ottawa Heart Institute, Ottawa,
ON, Canada
(Guo, Rubens) Department of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Wells) Research Methods Centre, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Huang, Khoury) Division of Geriatric Medicine, The Ottawa Hospital,
Ottawa, ON, Canada
(Boczar) Division of Cardiology, Department of Medicine, University of
Pennsylvania, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Frailty has emerged as an important prognostic marker of
increased mortality after cardiac surgery, but its association with
quality of life (QoL) and patient-centered outcomes is not fully
understood. We sought to evaluate the association between frailty and such
outcomes in older patients undergoing cardiac surgery. Method(s):
This systematic review included studies evaluating the effect of
preoperative frailty on QoL outcomes after cardiac surgery amongst
patients 65 years and older. The primary outcome was patient's perceived
change in QoL following cardiac surgery. Secondary outcomes included
residing in a long-term care facility for 1 year, readmission in the year
following the intervention, and discharge destination. Screening,
inclusion, data extraction, and quality assessment were performed
independently by two reviewers. Meta-analyses based on the random-effects
model were conducted. The evidential quality of findings was assessed with
the GRADE profiler. Result(s): After the identification of 3105
studies, 10 observational studies were included (1580 patients) in the
analysis. Two studies reported on the change in QoL following cardiac
surgery, which was higher for patients with frailty than for patients
without. Preoperative frailty was associated with both hospital
readmission (pooled odds ratio [OR] 1.48 [0.80-2.74], low GRADE level) as
well as non-home discharge (pooled OR 3.02 [1.57-5.82], moderate GRADE
level). Conclusion(s): While evidence in this field is limited by
heterogeneity of frailty assessment and non-randomized data, we
demonstrated that baseline frailty may possibly be associated with
improved QoL, but with increased readmission as well as discharge to a
non-home destination following cardiac surgery. These patient-centered
outcomes are important factors when considering interventional options for
older patients. Study Registration: OSF registries
(https://osf.io/vm2p8). Copyright © 2023 The Authors. Journal of
the American Geriatrics Society published by Wiley Periodicals LLC on
behalf of The American Geriatrics Society.

<41>
Accession Number
2026184321
Title
The Impact of Nasal Intubation on Feeding Outcomes in Neonates Requiring
Cardiac Surgery: A Randomized Control Trial.
Source
Pediatric Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Yildirim M.I.; Spaeder M.C.; Castro B.A.; Chamberlain R.; Fuzy L.; Howard
S.; McNaull P.; Raphael J.; Sharma R.; Vizzini S.; Wielar A.; Frank D.U.
Institution
(Yildirim) Division of Pediatric Cardiology, Department of Pediatrics,
Cleveland Clinic Children's Hospital, Cleveland, OH, United States
(Spaeder, Frank) Division of Pediatric Critical Care, Department of
Pediatrics, University of Virginia School of Medicine, Charlottesville,
VA, United States
(Castro, Howard, McNaull, Raphael, Sharma, Vizzini, Wielar) Division of
Pediatric Anesthesiology, Department of Anesthesiology, University of
Virginia School of Medicine, Charlottesville, VA, United States
(Chamberlain, Fuzy) Division of Thoracic and Cardiovascular Surgery,
Department of Surgery, University of Virginia School of Medicine,
Charlottesville, VA, United States
(Raphael) Department of Anesthesiology, Thomas Jefferson University
Hospital, Philadelphia, PA, United States
Publisher
Springer
Abstract
Neonates who require surgery for congenital heart disease (CHD) frequently
have difficulty with oral feeds post-operatively and may require a feeding
tube at hospital discharge. The purpose of this study was to determine the
effect of oral or nasal intubation route on feeding method at hospital
discharge. This was a non-blinded randomized control trial of 62 neonates
who underwent surgery for CHD between 2018 and 2021. Infants in the nasal
(25 patients) and oral (37 patients) groups were similar in terms of
pre-operative risk factors for feeding difficulties including completed
weeks of gestational age at birth (39 vs 38 weeks), birthweight (3530 vs
3100 g), pre-operative PO intake (92% vs 81%), and rate of pre-operative
intubation (22% vs 28%). Surgical risk factors were also similar including
Society of Thoracic Surgeons-European Association for Cardio-Thoracic
Surgery category (3.9 vs 4.1), shunt placement (32% vs 41%),
cardiopulmonary bypass time (181 vs 177 min), and cross-clamp time (111 vs
105 min). 96% of nasally intubated patients took full oral feeds by
discharge as compared with 78% of orally intubated infants (p = 0.05).
Nasally intubated infants reach full oral feeds an average of 3 days
earlier than their orally intubated peers. In this cohort of patients,
nasally intubated infants reach oral feeds more quickly and are less
likely to require supplemental tube feeding in comparison to orally
intubated peers. Intubation route is a potential modifiable risk factor
for oral aversion and appears safe in neonates. The study was approved by
the University of Virginia Institutional Review Board for Health Sciences
Research and was retrospectively registered on clinicaltrials.gov
(NCT05378685) on May 18, 2022. Copyright © 2023, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<42>
Accession Number
2023337193
Title
Brain injury and long-term outcome after neonatal surgery for non-cardiac
congenital anomalies.
Source
Pediatric Research. 94(4) (pp 1265-1272), 2023. Date of Publication:
October 2023.
Author
Aalten M.; Tataranno M.L.; Dudink J.; Lemmers P.M.A.; Lindeboom M.Y.A.;
Benders M.J.N.L.
Institution
(Aalten, Tataranno, Dudink, Lemmers, Benders) Department of Neonatology,
University Medical Center, Utrecht Brain Center and Wilhelmina Children's
Hospital, University Utrecht, Utrecht, Netherlands
(Lindeboom) Department of Pediatric Surgery, Wilhelmina Children's
Hospital, University Medical Center Utrecht, Utrecht, Netherlands
Publisher
Springer Nature
Abstract
Background: There is growing evidence that neonatal surgery for
non-cardiac congenital anomalies (NCCAs) in the neonatal period adversely
affects long-term neurodevelopmental outcome. However, less is known about
acquired brain injury after surgery for NCCA and abnormal brain maturation
leading to these impairments. Method(s): A systematic search was
performed in PubMed, Embase, and The Cochrane Library on May 6, 2022 on
brain injury and maturation abnormalities seen on magnetic resonance
imaging (MRI) and its associations with neurodevelopment in neonates
undergoing NCCA surgery the first month postpartum. Rayyan was used for
article screening and ROBINS-I for risk of bias assessment. Data on the
studies, infants, surgery, MRI, and outcome were extracted.
 Result(s): Three eligible studies were included, reporting 197
infants. Brain injury was found in n = 120 (50%) patients after NCCA
surgery. Sixty (30%) were diagnosed with white matter injury. Cortical
folding was delayed in the majority of cases. Brain injury and delayed
brain maturation was associated with a decrease in neurodevelopmental
outcome at 2 years of age. Conclusion(s): Surgery for NCCA was
associated with high risk of brain injury and delay in maturation leading
to delay in neurocognitive and motor development. However, more research
is recommended for strong conclusions in this group of patients. Impact:
Brain injury was found in 50% of neonates who underwent NCCA surgery.NCCA
surgery is associated with a delay in cortical folding.There is an
important research gap regarding perioperative brain injury and NCCA
surgery. Copyright © 2023, The Author(s), under exclusive licence
to the International Pediatric Research Foundation, Inc.

<43>
Accession Number
2027810182
Title
The Effect Of Passive Leg-Raising Maneuver On Hemodynamic Stability During
Anesthesia Induction For Adult Cardiac Surgery.
Source
Journal of Cardiovascular Disease Research. 14(9) (pp 1014-1023), 2023.
Date of Publication: 2023.
Author
Vali L.F.; Khoja A.; Kujur A.; Vali R.
Institution
(Vali, Vali) Department of Anaesthesia, Government Medical College,
Superspeciality Hospital, Nagpur, India
(Khoja) Department of Anaesthesia, Government Medical College, Trauma Care
Center, Nagpur, India
(Kujur) Department of Anaesthesia, Government Medical College, Gondia,
India
Publisher
EManuscript Technologies
Abstract
Background: Anesthesia-induced hypotension is a common complication among
patients who undergo cardiac surgery. This study investigates/aims to
investigate The present study investigated the efficacy of passive leg
raising maneuver (PLMR) to prevent or modify the severity of
post-anesthesia-induced hypotension during adult cardiac surgery. Method
and sample: A total of 146 subjects were equally randomized into to two
groups. Group 1 (n=73): PLRM group [where PLRM was performed] and Group 2
(n=73): Control group [where PLRM was not performed]. Heart rate, invasive
mean arterial blood pressure (MAP), and central venous pressure (CVP) was
were recorded before PLRM, before anesthetic induction, before
laryngoscopy, and at 5, 10, and 20 minutes after tracheal intubation. The
hypotension episode rate (MAP <70 mmHg) and CVP changes were compared
between the 2 groups. Result(s): Out of total sample size of 146
patients, CAD was found in majority in PLRM group (52.1%) and control
group (57.5%). The mean LVEF was found to be 49.72+/-5.73 in PLRM group
while 48.17+/-5.83 in control group, (p>0.05). The mean hemodynamic
parameters (HR, SBP, DBP and MAP) and CVP of patients from PLRM group was
more stable as compared to that of the control group at different time
intervals after laryngoscopy with statistically significant difference in
SBP, DBP and MAP (P<0.05). Patients in the control group (51) showed
significantly increased requirement of IVD (Inj Noradrenaline) compared to
PRLM group (31). Conclusion(s): This study concludes that PLRM is a
simple, rapid, safe, and effective method of preventing anesthesia-induced
hypotension and helps induce anesthesia in a more stable hemodynamic state
during cardiac operations with simple monitoring of MAP and
CVP. Copyright © 2023 EManuscript Technologies. All rights
reserved.

<44>
Accession Number
2027807214
Title
The role of extracorporeal life support in extended lung resections for
non-small cell lung cancer: a narrative review.
Source
Journal of Thoracic Disease. 15(9) (pp 5232-5238), 2023. Date of
Publication: September 2023.
Author
Lorenzi W.; Mercier O.
Institution
(Lorenzi, Mercier) Department of Thoracic Surgery and Heart-Lung
Transplantation, Universite Paris-Saclay, International Center for
Thoracic Cancers, Marie-Lannelongue Hospital, Le Plessis Robinson, France
Publisher
AME Publishing Company
Abstract
Background and Objective: Extracorporeal membrane oxygenation (ECMO) may
be used as a substitute of traditional cardiopulmonary bypass (CPB) in
thoracic surgeries. Extended resections for the treatment of non-small
cell lung cancer (NSCLC) occasionally require extracorporeal life support.
We present a narrative review of the current clinical uses of
extracorporeal devices in this setting of patients. Method(s): We
searched Medline database/PubMed for "extra-corporeal membrane
oxygenation" and "non-small cell lung carcinoma" in the English language
literature between the years 2000 and 2022. Key Content and Findings: As
opposed to CPB, ECMO is simple, requires minimal or no anticoagulation and
elicits fewer complications. T4 lung cancers are frequently considered for
surgery in marginally operable patients. ECMO may provide the means to
achieve these resections. There are case series of carinal extended
resections safely performed under venovenous (VV) or venoarterial (VA)
support. The main advantages are a clear surgical field, certainty of
proper oxygenation and avoidance of ventilator induced trauma. Left atrial
resections have been described with VA ECMO, but the standard of care is
still CPB. Descending thoracic aorta resections can also benefit from
extracorporeal support, making sure that abdominal organs and lower limbs
are well perfused, the heart is not overloaded, and cross clamping is
safe. Conclusion(s): Surgeons performing extended lung cancer
resections should be familiar with ECMO and are encouraged to report their
experience. Copyright © Journal of Thoracic Disease. All rights
reserved.

<45>
Accession Number
2027042532
Title
Effects of Remote Ischemic Preconditioning on Delirium and Neurological
Function in Patients Undergoing Cardiac Surgery: A Multicenter Randomized
Controlled Trial.
Source
Heart Surgery Forum. 26(4) (pp E408-E416), 2023. Date of Publication:
2023.
Author
Liu T.; Liu X.; Wan R.
Institution
(Liu, Liu, Wan) Department of Quality Management, The 904th Hospital of
Joint Logistic Support Force, Jiangsu, Wuxi 214044, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Postoperative delirium (POD) and neurological dysfunction are
very common following cardiac surgery and deteriorate the patient's
prognosis and the outcome of surgical procedures. A clinically effective
management strategy or drug is not yet available for POD. Additionally, it
is unknown whether remote ischemic preconditioning (PJPC) has
neuroprotective and anti-delirium benefits in patients who undergo cardiac
surgery. Method(s): This study examined whether PJPC can improve POD
and neurological function in cardiac surgery patients. We screened 510
consecutive adult patients aged 18 and older who underwent cardiac surgery
between January 2018 and December 2022. Then. 448 of these patients were
recruited in the trial as the intention to treat (ITT) group, who were
then randomly assigned to receive either a control (n = 223) or PJPC
treatment (n = 225). The primary outcome measures were hospitalization
postoperative delirium, six-month modified Rankins scale (mRS), hospital
cerebral infarction, 30-day overall mortality, neuron-specific enolase
(NSE) and S-lOOb levels, related adverse effects, hospital costs, and
hospital stay. Result(s): A statistically significant variation was
not observed between the two groups in terms of the baseline clinical
data, hi contrast to the control group, the POD in the PJPC group was
considerably alleviated. PJPC treatment also decreased the levels of NSE
and S-lOOb. which alleviated nerve injury. The adverse impacts of
PJPC-induced objective indicators of tissue or neurovascular damage were
similar in both groups, showing no significant variations between the two.
The hospital stays and hospitalization costs also decreased significantly
in the PJPC-treated patients. Conclusion(s): The study findings
suggested that PJPC may benefit cardiac surgery patients by reducing POD,
alleviating injury, and lowering hospital expendinires and length of stay.
Cardiac surgery patients can be treated with PJPC, which is an effective
and safe technique. Copyright © 2023 Forum Multimedia Publishing
LLC. All rights reserved.

<46>
Accession Number
642536546
Title
Dexmedetomidine Withdrawal Syndrome in Children in the PICU: Systematic
Review and Meta-Analysis.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. (no pagination), 2023. Date of Publication: 19 Oct 2023.
Author
Knapp T.; DiLeonardo O.; Maul T.; Hochwald A.; Li Z.; Hossain J.; Lowry
A.; Parker J.; Baker K.; Wearden P.; Nelson J.
Institution
(Knapp) University of Central Florida, College of Medicine, Orlando, FL,
Puerto Rico
(DiLeonardo) Department of Medical Education, Nemours Children's Health,
Orlando, FL, Puerto Rico
(Maul, Lowry, Parker, Baker, Wearden, Nelson) Department of Cardiovascular
Services, Nemours Children's Health, Florida, Orlando, FL
(Hochwald, Li) Division of Clinical Trials and Biostatistics, Mayo Clinic,
Jacksonville, FL, Puerto Rico
(Hossain) Department of Biomedical Research, Nemours Children's Health,
Wilmington, DE, United States
(Nelson) Department of Surgery, University of Central Florida College of
Medicine, Orlando, FL, Puerto Rico
Abstract
OBJECTIVES: To systematically review literature describing the clinical
presentation, risk factors, and treatment for dexmedetomidine withdrawal
in the PICU (PROSPERO: CRD42022307178). DATA SOURCES: MEDLINE/PubMed,
Cochrane, Web of Science, and Scopus databases were searched. STUDY
SELECTION: Eligible studies were published from January 2000 to January
2022 and reported clinical data for patients younger than 21 years old
following discontinuation of dexmedetomidine after greater than or equal
to 24 hours of infusion. DATA EXTRACTION: Abstracts identified during an
initial search were screened and data were manually abstracted after
full-text review of eligible articles. The Newcastle-Ottawa Scale was used
to assess study quality. Summary statistics were provided and Spearman
rank correlation coefficient was used to identify relationships between
covariates and withdrawal signs. A weighted prevalence for each withdrawal
sign was generated using a random-effects model. DATA SYNTHESIS:
Twenty-three studies (22 of which were retrospective cohort studies)
containing 28 distinct cohorts were included. Median cumulative
dexmedetomidine exposure by dose was 105.95 mug/kg (range, 30-232.7
mug/kg), median dexmedetomidine infusion duration was 131.75 hours (range,
20.5-525.6hr). Weighted estimates for proportion (95% CI) of subjects
experiencing withdrawal signs across all cohorts were: hypertension 0.34
(range, 0.0-0.92), tachycardia 0.26 (range, 0.0-0.87), and agitation 0.26
(range, 0.09-0.77). Meta-analysis revealed no correlation between
dexmedetomidine exposure variables and withdrawal signs. A moderate
negative monotonic relationship existed between the proportion of patients
who had undergone cardiac surgery and the proportion experiencing
hypertension (correlation coefficient, -0.47; p = 0.048) and tachycardia
(correlation coefficient, -0.57; p = 0.008), indicating that in cohorts
with a higher proportion of patients who were postcardiac surgery, there
were fewer occurrences of hypertension and or tachycardia.
 CONCLUSION(S): On review of the 2000-2022 literature, dexmedetomidine
withdrawal may be characterized by tachycardia, hypertension, or
agitation, particularly with higher cumulative doses or prolonged
durations. Since most studies included in the review were retrospective,
prospective studies are needed to further clarify risk factors, establish
diagnostic criteria, and identify optimal management
strategies. Copyright © 2023 by the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies.

<47>
Accession Number
642536162
Title
One-Year Comparison of PASCAL vs MitraClip for Mitral Valve Transcatheter
Edge-to-Edge Repair: A Quasi-Randomized Study.
Source
JACC. Cardiovascular interventions. (no pagination), 2023. Date of
Publication: 16 Sep 2023.
Author
Haschemi J.; Haurand J.M.; Oehler D.; Wolff G.; Spieker M.; Polzin A.;
Kelm M.; Horn P.

<48>
Accession Number
642535981
Title
Rosuvastatin versus atorvastatin treatment in adults with coronary artery
disease: secondary analysis of the randomised LODESTAR trial.
Source
BMJ (Clinical research ed.). 383 (pp e075837), 2023. Date of Publication:
18 Oct 2023.
Author
Lee Y.-J.; Hong S.-J.; Kang W.C.; Hong B.-K.; Lee J.-Y.; Lee J.-B.; Cho
H.-J.; Yoon J.; Lee S.-J.; Ahn C.-M.; Kim J.-S.; Kim B.-K.; Ko Y.-G.; Choi
D.; Jang Y.; Hong M.-K.
Institution
(Lee, Hong, Lee, Ahn, Kim, Kim, Ko, Choi, Hong) Division of Cardiology,
Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu,
Seoul 03722, South Korea
(Kang) Gachon University College of Medicine, Incheon, South Korea
(Hong) Gangnam Severance Hospital, Seoul, South Korea
(Lee) Kangbuk Samsung Hospital, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Lee) Daegu Catholic University Medical Centre, Daegu, South Korea
(Cho) Inje University Busan Paik Hospital, Busan, South Korea
(Yoon) Wonju Severance Christian Hospital, Wonju, South Korea
(Jang) CHA University College of Medicine, Seongnam, South Korea
Abstract
OBJECTIVE: To compare the long term efficacy and safety of rosuvastatin
with atorvastatin treatment in adults with coronary artery disease.
DESIGN: Randomised, open label, multicentre trial. SETTING: 12 hospitals
in South Korea, September 2016 to November 2019. PARTICIPANTS: 4400 adults
(age >=19 years) with coronary artery disease. INTERVENTIONS: Participants
were assigned to receive either rosuvastatin (n=2204) or atorvastatin
(n=2196) using 2x2 factorial randomisation. MAIN OUTCOME MEASURES: The
primary outcome was a three year composite of all cause death, myocardial
infarction, stroke, or any coronary revascularisation. Secondary outcomes
were safety endpoints: new onset diabetes mellitus; hospital admissions
due to heart failure; deep vein thrombosis or pulmonary thromboembolism;
endovascular revascularisation for peripheral artery disease; aortic
intervention or surgery; end stage kidney disease; discontinuation of
study drugs owing to intolerance; cataract surgery; and a composite of
laboratory detected abnormalities. RESULT(S): 4341 of the 4400
participants (98.7%) completed the trial. Mean daily dose of study drugs
was 17.1 mg (standard deviation (SD) 5.2 mg) in the rosuvastatin group and
36.0 (12.8) mg in the atorvastatin group at three years (P<0.001). The
primary outcome occurred in 189 participants (8.7%) in the rosuvastatin
group and 178 (8.2%) in the atorvastatin group (hazard ratio 1.06, 95%
confidence interval 0.86 to 1.30; P=0.58). The mean low density
lipoprotein (LDL) cholesterol level during treatment was 1.8 mmol/L (SD
0.5 mmol/L) in the rosuvastatin group and 1.9 (0.5) mmol/L in the
atorvastatin group (P<0.001). The rosuvastatin group had a higher
incidence of new onset diabetes mellitus requiring initiation of
antidiabetics (7.2% v 5.3%; hazard ratio 1.39, 95% confidence interval
1.03 to 1.87; P=0.03) and cataract surgery (2.5% v 1.5%; 1.66, 1.07 to
2.58; P=0.02). Other safety endpoints did not differ between the two
groups. CONCLUSION(S): In adults with coronary artery disease,
rosuvastatin and atorvastatin showed comparable efficacy for the composite
outcome of all cause death, myocardial infarction, stroke, or any coronary
revascularisation at three years. Rosuvastatin was associated with lower
LDL cholesterol levels but a higher risk of new onset diabetes mellitus
requiring antidiabetics and cataract surgery compared with atorvastatin.
TRIAL REGISTRATION: ClinicalTrials.gov NCT02579499. Copyright ©
Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<49>
Accession Number
642535739
Title
The Effect of Fibrates on Lowering Low-Density Lipoprotein Cholesterol and
Cardiovascular Risk Reduction: A Systemic Review and Meta-analysis.
Source
European journal of preventive cardiology. (no pagination), 2023. Date of
Publication: 19 Oct 2023.
Author
Kim K.A.; Kim N.J.; Choo E.-H.
Institution
(Kim, Choo) Division of Cardiology, Department of Internal Medicine, Seoul
St. Mary's Hospital, Catholic University of Korea, Seoul 06591, South
Korea
(Kim) Medical Library, Catholic University of Korea, Seoul 06591, South
Korea
Abstract
AIMS: The effect of fibrate treatment on cardiovascular risk is
inconsistent. This meta-analysis aimed to assess the effect of fibrates on
major adverse cardiovascular outcome (MACE) reduction. METHOD(S):
PubMed, Embase, and Cochrane library databases were searched up to
February 2023 for randomized controlled trials comparing fibrate therapy
against placebo and reporting cardiovascular outcomes and lipid profile
changes. The primary outcome was the clinical outcomes of each trial that
most closely corresponding to MACE, a composite of cardiovascular death,
acute myocardial infarction, stroke, and coronary revascularization. A
pre-specified meta-regression analysis to examine the relationship between
the changes in lipid levels after fibrate treatment and the risk of MACE
was also performed. RESULT(S): Twelve trials were selected for final
analysis, with 25,781 patients and 2,741 MACEs in the fibrate group and
27,450 patients and 3,754 MACEs in the control group. Overall, fibrate
therapy was associated with decreased risk of MACE (RR 0.87, 95%
confidence interval [CI] 0.81-0.94) with moderate heterogeneity (I2=47%).
In meta-regression analysis, each 1 mmol/L reduction in low-density
lipoprotein cholesterol (LDL-C) after fibrate treatment reduced MACE (RR
0.71, 95% CI 0.49-0.94, p=0.01), while triglyceride level changes did not
show a significant association. (RR 0.96, 95% CI 0.53-1.40, p=0.86) A
sensitivity analysis with the composite outcome of cardiovascular death or
acute myocardial infaction produced similar results. CONCLUSION(S):
Treatment with fibrates was associated with decreased risk of MACE. The
reduction in MACE risk with fibrate therapy appears to be attributable to
LDL-C reduction rather than a decrease in triglyceride
levels. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<50>
Accession Number
642533624
Title
Association Between Intraoperative Landiolol Use and In-Hospital Mortality
After Coronary Artery Bypass Grafting: A Nationwide Observational Study in
Japan.
Source
Anesthesia and analgesia. (no pagination), 2023. Date of Publication: 18
Oct 2023.
Author
Iwasaki Y.; Ohbe H.; Nakajima M.; Sasabuchi Y.; Ikumi S.; Kaiho Y.;
Yamauchi M.; Fushimi K.; Yasunaga H.
Institution
(Iwasaki, Ikumi, Kaiho, Yamauchi) From the Department of Anesthesiology
and Perioperative Medicine, Tohoku University Graduate School of Medicine,
Miyagi, Japan
(Ohbe, Nakajima, Yasunaga) Department of Clinical Epidemiology and Health
Economics, School of Public Health, University of Tokyo, Tokyo, Japan
(Nakajima) Emergency Life-Saving Technique Academy of Tokyo, Foundation
for Ambulance Service Development, Tokyo, Japan
(Nakajima) Emergency and Critical Care Center, Tokyo Metropolitan Hiroo
Hospital, Tokyo, Japan
(Sasabuchi) Data Science Center, Jichi Medical University, Tochigi, Japan
(Fushimi) Department of Health Policy and Informatics, Tokyo Medical and
Dental University Graduate School of Medicine, Tokyo, Japan
Abstract
BACKGROUND: Ischemic heart disease is a leading cause of death worldwide,
and coronary artery bypass grafting (CABG) is a major treatment. Landiolol
is an ultra-short-acting beta-antagonist known to prevent postoperative
atrial fibrillation. However, the effectiveness of intraoperative
landiolol on mortality remains unknown. This study aimed to evaluate the
association between intraoperative landiolol use and the in-hospital
mortality in patients undergoing CABG. METHOD(S): To conduct this
retrospective cohort study, we used data from the Japanese Diagnosis
Procedure Combination inpatient database. All patients who underwent CABG
during hospitalization between July 1, 2010, and March 31, 2020, were
included. Patients who received intraoperative landiolol were defined as
the landiolol group, whereas the other patients were defined as the
control group. The primary outcome was in-hospital mortality. Propensity
score matching was used to compare the landiolol and control groups.
 RESULT(S): In total, 118,506 patients were eligible for this study,
including 25,219 (21%) in the landiolol group and 93,287 (79%) in the
control group. One-to-one propensity score matching created 24,893 pairs.
After propensity score matching, the in-hospital mortality was
significantly lower in the landiolol group than that in the control group
(3.7% vs 4.3%; odds ratio 0.85; 95% confidence interval 0.78 to 0.94; P =
.010). CONCLUSION(S): Intraoperative landiolol use was associated
with decreased in-hospital mortality in patients undergoing CABG. Further
randomized controlled trials are required to confirm these
findings. Copyright © 2023 International Anesthesia Research
Society.

<51>
Accession Number
2026184192
Title
Outcomes of tricuspid valve prostheses after heart transplantation: a
systematic review.
Source
Heart Failure Reviews. (no pagination), 2023. Date of Publication: 2023.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Modine T.; Labrousse L.; Pernot M.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Modine, Labrousse, Pernot)
Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Av. Magellan,
Pessac 33604, France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Baudo) Department of Cardiac Surgery, University Hospitals Leuven,
Louvain, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
Springer
Abstract
Tricuspid regurgitation (TR) is the most common valvular pathology after
heart transplantation (HTx) and endomyocardial biopsy (EMB) remains
responsible for the majority of cases due to the high probability of
structural valve damage. The aim of the present review was to describe the
results of surgical management of severe tricuspid regurgitation through
tricuspid valve replacement (TVR) after a previous HTx. A systematic
review was conducted by searching Pubmed, ScienceDirect, SciELO, DOAJ, and
Cochrane databases until June 2023 for publications reporting patients
undergoing TVR surgery after a previous HTx. If no right heart valve
surgery was undertaken, or a heterotopic heart transplant was performed,
or if the concomitant procedure was performed during the transplant
itself, the paper was excluded. Twenty articles met our inclusion criteria
out of 1532 potentially eligible studies, with a total of 300 patients.
Mean age was 55.1 +/- 9.6 years, and 85.1% were male. The mean number of
EMB per patient was 31.1 +/- 5.5 with a mean time between HTx and TVR of
7.64 +/- 3.31 years. Bioprostheses were used in 83.3% of cases and 75.0%
of patients with a bioprosthesis were reported as alive at last follow-up.
Tricuspid valve repair is a valuable option, but these patients will be
susceptible to recurrent TR after EMB. TVR with a bioprosthesis may
provide the optimal solution for this subset of patients, as EMB is not
feasible with a mechanical valve. Copyright © 2023, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<52>
Accession Number
2020742806
Title
Life-threatening cardiac arrhythmia and sudden death during electronic
gaming: An international case series and systematic review.
Source
Heart Rhythm. 19(11) (pp 1826-1833), 2022. Date of Publication: November
2022.
Author
Lawley C.M.; Tester M.; Sanatani S.; Prendiville T.; Beach C.M.; Vinocur
J.M.; Horie M.; Uhm J.-S.; Khongphatthanayothin A.; Ayers M.D.; Starling
L.; Yoshida Y.; Shah M.J.; Skinner J.R.; Turner C.
Institution
(Lawley, Skinner, Turner) The Heart Centre for Children, Sydney Children's
Hospitals Network, Sydney, NSW, Australia
(Lawley) The University of Sydney Children's Hospital Westmead Clinical
School, Faculty of Medicine and Health, The University of Sydney, Sydney,
NSW, Australia
(Lawley, Starling) Department of Paediatric Cardiology, Great Ormond
Street Hospital for Children NHS Foundation Trust, London, United Kingdom
(Tester, Sanatani) Children's Heart Centre, The University of British
Columbia, Vancouver, BC, Canada
(Prendiville) Department of Cardiology and Cardiac Surgery, Children's
Health Ireland at Crumlin, Republic of Ireland, Dublin, Ireland
(Beach, Vinocur) Department of Pediatrics, Division of Pediatric
Cardiology, Yale University School of Medicine, New Haven, Connecticut,
United States
(Vinocur) Department of Pediatrics, University of Rochester School of
Medicine and Dentistry, Rochester, New York, United States
(Horie) Department of Cardiovascular Medicine, Shiga University of Medical
Science, Shiga, Japan
(Uhm) Department of Cardiology, Yongin Severance Hospital, College of
Medicine, Yonsei University, Gyeonggi-do, Yongin, South Korea
(Khongphatthanayothin) Department of Cardiology, Yongin Severance
Hospital, College of Medicine, Yonsei University, Gyeonggi-do, Yongin,
South Korea
(Ayers) Department of Pediatrics, Division of Pediatric Cardiology,
Pediatric Electrophysiology, Indiana University School of Medicine,
Indianapolis, IN, United States
(Yoshida) Department of Pediatric Electrophysiology, Osaka City General
Hospital, Miyakojima-hondori, Osaka, Miyakojima-ku, Japan
(Shah) Department of Pediatrics, University of Pennsylvania Perelman
School of Medicine, Children's Hospital of Philadelphia, Philadelphia,
Pennsylvania, United States
(Khongphatthanayothin) Department of Medicine, Faculty of Medicine,
Chulalongkorn University, Bangkok, Thailand
Publisher
Elsevier B.V.
Abstract
Background: Electronic gaming has recently been reported as a precipitant
of life-threatening cardiac arrhythmia in susceptible individuals.
 Objective(s): The purpose of this study was to describe the
population at risk, the nature of cardiac events, and the type of game
linked to cardiac arrhythmia associated with electronic gaming.
 Method(s): A multisite international case series of suspected or
proven cardiac arrhythmia during electronic gaming in children and a
systematic review of the literature were performed. Result(s):
Twenty-two patients (18 in the case series and 4 via systematic review;
aged 7-16 years; 19 males [86%]) were identified as having experienced
suspected or proven ventricular arrhythmia during electronic gaming; 6
(27%) had experienced cardiac arrest, and 4 (18%) died suddenly. A
proarrhythmic cardiac diagnosis was known in 7 (31%) patients before their
gaming event and was established afterward in 12 (54%). Ten patients (45%)
had catecholaminergic polymorphic ventricular tachycardia, 4 (18%) had
long QT syndrome, 2 (9%) were post-congenital cardiac surgery, 2 (9%) had
"idiopathic" ventricular fibrillation, and 1 (after Kawasaki disease) had
coronary ischemia. In 3 patients (14%), including 2 who died, the
diagnosis remains unknown. In 13 (59%) patients for whom the electronic
game details were known, 8 (62%) were war games. Conclusion(s):
Electronic gaming can precipitate lethal cardiac arrhythmias in
susceptible children. The incidence appears to be low, but syncope in this
setting should be investigated thoroughly. In children with proarrhythmic
cardiac conditions, electronic war games in particular are a potent
arrhythmic trigger. Copyright © 2022

<53>
Accession Number
2005883806
Title
The Effect of Caregiver-Mediated Mobility Interventions in Hospitalized
Patients on Patient, Caregiver, and Health System Outcomes: A Systematic
Review.
Source
Archives of Rehabilitation Research and Clinical Translation. 2(3) (no
pagination), 2020. Article Number: 100053. Date of Publication: September
2020.
Author
Yasmeen I.; Krewulak K.D.; Grant C.; Stelfox H.T.; Fiest K.M.
Institution
(Yasmeen, Krewulak, Grant, Stelfox, Fiest) Department of Critical Care
Medicine, Alberta Health Services and Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Grant) Department of Clinical Neurosciences, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Stelfox, Fiest) Department of Community Health Sciences and O'Brien
Institute for Public Health, University of Calgary, Calgary, AB, Canada
(Fiest) Department of Psychiatry and Hotchkiss Brain Institute, Cumming
School of Medicine, University of Calgary, Calgary, AB, Canada
Publisher
Elsevier Inc.
Abstract
Objective: To synthesize the evidence examining caregiver-mediated
mobility interventions in a hospital setting and whether they improve
patient, caregiver, or health system outcomes. Data Sources: We
searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus databases from
inception to September 7, 2018. Study Selection: Two reviewers
independently selected original research in inpatient settings that
reported on an intervention delivered by a caregiver (eg, family, friend,
paid worker) and directed to the patient's mobility. Mobility
interventions were categorized based on the level of caregiver engagement
using a 3-category framework: inform (provision of education on patient's
condition and management), activate (prompting caregivers to take action
in patient care), and collaborate (encouraging interaction with providers
or other caregivers). Data Extraction: One reviewer extracted data,
and another checked the data. Quality was assessed using the Cochrane
Collaboration's risk of bias tool and Grading of Recommendations,
Assessment, Development and Evaluation approach. Data Synthesis:
Forty studies met the inclusion criteria; most were randomized controlled
trials (n=16/40, 40.0%) and investigated older adults (n=18/40, 45.0%)
with stroke (n=20/40, 50.0%). Inform (n=2) and activate (n=4)
interventions and combined inform-activate (n=5/6, 83.3%) and
inform-activate-collaborate (n=6/10, 60.0%) interventions were reported to
improve patient mobility. Inform-activate and inform-collaborate
interventions were reported to improve caregiver outcomes (eg, burden)
(n=13/19, 68.4%). Studies that engaged caregivers in all 3 strategies
(inform-activate-collaborate) were reported to improve health system
outcomes (eg, hospital readmission) (n=4/6, 66.7%). Most studies were of
unclear (n=22/40, 55.0%) or low risk of bias (n=11/40, 27.5%) for most
domains. Conclusion(s): Engaging caregivers in mobility of
hospitalized patients may improve patient mobility as well as caregiver
and health system outcomes. Copyright © 2020 The Authors

<54>
Accession Number
2027655248
Title
Left Ventricular Unloading With Impella Versus IABP in Patients With
VA-ECMO: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 208 (pp 53-59), 2023. Date of Publication:
01 Dec 2023.
Author
Gandhi K.D.; Moras E.C.; Niroula S.; Lopez P.D.; Aggarwal D.; Bhatia K.;
Balboul Y.; Daibes J.; Correa A.; Dominguez A.C.; Birati E.Y.; Baran D.A.;
Serrao G.; Mahmood K.; Vallabhajosyula S.; Fox A.
Institution
(Gandhi, Moras, Balboul) Department of Internal Medicine, Mount Sinai
Morningside/West, New York, NY, United States
(Niroula) Department of Internal Medicine, Beaumont Hospital, Royal Oak,
MI, United States
(Lopez, Aggarwal, Bhatia, Daibes, Dominguez) Mount Sinai Heart, Mount
Sinai Morningside Hospital, New York, NY, United States
(Correa, Serrao, Mahmood, Fox) Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai
(Birati) Poriya Medical Center, Bar-Ilan University, Israel
(Baran) Heart, Vascular Thoracic Institute, Cleveland Clinic Florida,
Weston, FL, United States
(Vallabhajosyula) Section of Cardiovascular Medicine, Department of
Medicine, Wake Forest University School of Medicine, Winston-Salem, NC,
United States
Publisher
Elsevier Inc.
Abstract
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) use for
circulatory support in cardiogenic shock results in increased left
ventricular (LV) afterload. The use of concomitant Impella or intra-aortic
balloon pump (IABP) have been proposed as adjunct devices for LV
unloading. The authors sought to compare head-to-head efficacy and safety
outcomes between the 2 LV unloading strategies. We conducted a search of
Medline, EMBASE, and Cochrane databases to identify studies comparing the
use of Impella to IABP in patients on VA-ECMO. The primary outcome of
interest was in-hospital mortality. The secondary outcomes included
transition to durable LV assist devices/cardiac transplantation, stroke,
limb ischemia, need for continuous renal replacement therapy, major
bleeding, and hemolysis. Pooled risk ratios (RRs) with 95% confidence
interval and heterogeneity statistic I2 were calculated using a
random-effects model. A total of 7 observational studies with 698 patients
were included. Patients on VA-ECMO unloaded with Impella vs IABP had
similar risk of short-term all-cause mortality, defined as either 30-day
or in-hospital mortality- 60.8% vs 64.9% (RR 0.93 [0.71 to 1.21],
I2 = 71%). No significant difference was observed in transition
to durable LV assist devices/cardiac transplantation, continuous renal
replacement therapy initiation, stroke, or limb ischemia between the 2
strategies. However, the use of VA-ECMO with Impella was associated with
increased risk of major bleeding (57.2% vs 39.7%) (RR 1.66 [1.12 to 2.44],
I2 = 82%) and hemolysis (31% vs 7%) (RR 4.61 [1.24 to 17.17],
I2 = 66%) compared with VA-ECMO, along with IABP. In conclusion, in
patients requiring VA-ECMO for circulatory support, the concomitant use of
Impella or IABP had comparable short-term mortality. However, Impella use
was associated with increased risk of major bleeding and
hemolysis. Copyright © 2023 Elsevier Inc.

<55>
Accession Number
2027557725
Title
A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFICACY OF
EPIDURAL BUPIVACAINE (0.5%) WITH DEXMEDETOMIDINE (0.5 microG/KG) AND
MAGNESIUM SULPHATE (50 MG) AS AN ADJUVANT IN PATIENTS UNDERGOING MAJOR
LOWER LIMB ORTHOPEDIC SURGERIES.
Source
International Journal of Academic Medicine and Pharmacy. 5(3) (pp
2345-2350), 2023. Date of Publication: 2023.
Author
Srilekha R.; Ganessan R.; Iniya R.
Institution
(Srilekha) Department of Anesthesiology, Government Mohan Kumaramangalam
Medical College and Hospital, Tamilnadu, Salem, India
(Ganessan) Department of Anesthesiology, KAPV Govt Medical College & Mgm
Hospital, Tamilnadu, Tiruchirapalli, India
(Iniya) Department of Anesthesiology, Vinayaka Mission Medical College,
Puducherry, Karaikal, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Epidural anaesthesia is a recent evidence-based regimen for
peri-operative and post-operative pain relief after surgeries. The study
aimed to compare the efficacy of epidural bupivacaine (0.5%) with
dexmedetomidine (0.5 microg/kg) or Magnesium sulphate (50 mg) as an
adjuvant in American Society of Anaesthesiologists (ASA) I and II patients
undergoing major lower limb orthopaedic surgeries. Material(s) and
Method(s): This prospective randomised control trial was conducted on 50
patients who came for elective lower limb surgeries at the Government
Mohan Kumaramangalam Medical College and Hospital, Salem, Tamil Nadu, for
two years. Subjects were randomised into groups BD and BM. Group BD:
Bupivacaine 0.5% (12 ml) + Dexmedetomidine 0.5 microg/kg (1 ml), and Group
BM: Bupivacaine 0.5% (12 ml) + Magnesium sulphate 50 mg (1ml). A detailed
history of medical illness, prior surgeries, anaesthetic exposure, drug
intake, allergies, premedication, monitoring of NIBP, ECG, SpO2, heart
rate, and baseline cardio-respiratory parameters was recorded.
 Result(s): No significant difference in gender, ASA, age, weight, or
duration of surgery between groups. Heart rate, SPO2, and MAP decreased
gradually in both groups, with no significant difference. The
dexmedetomidine group had longer sensory and motor block duration but no
difference in time for sensory regression. Dexmedetomidine had a higher
sedation score than magnesium sulphate, with 19 (76%) of the
dexmedetomidine group having a sedation score >2. Bradycardia was only
present in the dexmedetomidine group. Conclusion(s): Dexmedetomidine
is a better adjuvant than magnesium sulphate with 0.5% bupivacaine,
providing exceptional post-operative analgesia and superior sedative
quality without side effects. Copyright © 2023 Authors. All
rights reserved.

<56>
Accession Number
2025955683
Title
Efficacy and safety of left atrial appendage closure compared with oral
anticoagulation in atrial fibrillation: a meta-analysis of randomized
controlled trials and propensity-matched studies.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1212161. Date of Publication: 2023.
Author
Franchin L.; Piroli F.; Demola P.; Mantovani F.; Iannaccone M.; Manfredi
R.; D'Ascenzo F.; Fortuni F.; Ugo F.; Meucci F.; Navazio A.; Boccuzzi G.
Institution
(Franchin, Iannaccone, Boccuzzi) Department of Cardiology, San Giovanni
Bosco Hospital, Turin, Italy
(Franchin) Department of Cardiology, Azienda Sanitaria Universitaria
Friuli Centrale, Udine, Italy
(Piroli, Demola, Mantovani, Navazio) Cardiology Unit, Azienda USL-IRCCS di
Reggio Emilia, Reggio Emilia, Italy
(Manfredi) Cardiology and Arrhythmology Clinic, University Hospital
"Ospedali Riuniti", Ancona, Italy
(D'Ascenzo) Division of Cardiology, Department of Medicine, A.O.U Citta
Della Salute e Della Scienza, Turin, Italy
(Fortuni) Department of Cardiology, San Giovanni Battista Hospital,
Foligno, Italy
(Fortuni) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Meucci) Structural Interventional Cardiology, Department of Clinical and
Experimental Medicine, Careggi University Hospital, Florence, Italy
(Ugo) Division of Cardiology, Sant'Andrea Hospital, Vercelli, Italy
Publisher
Frontiers Media SA
Abstract
Backgrounds: Two recent randomized controlled trials (RCTs), the
PROTECT-AF and the PREVAIL, showed that in atrial fibrillation (AF)
patients, left atrial appendage closure (LAAC) is comparable to oral
anticoagulants (OAC) in the prevention of stroke and could also possibly
reduce mortality. Nevertheless, this net clinical benefit was not
confirmed in the most recent RCT comparing LAAC vs. OAC, the PRAGUE-17
trial. Aim(s): aim of the present study was to evaluate the efficacy
and safety of LAAC compared with OAC among available high-quality studies.
 Method(s): A systematic search of electronic databases (Medline,
Scopus, Embase and the Cochrane Library) was performed to identify
eligible RCTs and observational studies with propensity score matching
(PSM) analysis. PRISMA guidelines were used for abstracting data and
assessing data quality and validity. Outcomes of interest were the
occurrence of cardiovascular death (CVD), all-cause death, all-type
stroke, and major bleedings. Result(s): A total of 3 RCTs and 7 PMS
studies involving 25,700 patients were identified. 12,961 patients
received LAAC while 12,739 received OAC therapy. After a median follow-up
of 2.6 years (IQR 2-4.4), patients who received LAAC had lower risk of CVD
(RR = 0.62; 95%CI, 0.51-0.74, I2= 0%), all-cause death (RR =
0.67; 95% CI, 0.57-0.78, I2 68%) and major bleedings (RR =
0.68; 95%CI, 0.48-0.95 I2= 87%) compared with patients on OAC.
No difference was found between the two groups regarding strokes incidence
(RR = 0.94; 95% CI, 0.77-1.15, I2= 0%). Conclusion(s):
According to this meta-analysis, LAAC has comparable efficacy in the
prevention of stroke compared with OAC and a reduced risk of major
bleedings, all-cause death and CVD that may be even larger with longer
follow-up. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269768,
identifier CRD42021269768. Copyright 2023 Franchin, Piroli, Demola,
Mantovani, Iannaccone, Manfredi, D'Ascenzo, Fortuni, Ugo, Meucci, Navazio
and Boccuzzi.

<57>
Accession Number
2025534083
Title
Vitamin C may reduce troponin and CKMB levels after PCI and CABG: a
meta-analysis.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
475. Date of Publication: December 2023.
Author
Rozemeijer S.; Hemila H.; van Baaren M.; de Man A.M.E.
Institution
(Rozemeijer, van Baaren, de Man) Department of Intensive Care Medicine,
Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science
(ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam
Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije
Universiteit Amsterdam, De Boelelaan 1117, Amsterdam 1081 HV, Netherlands
(Rozemeijer) Department of Anesthesiology, Amsterdam UMC, Location VUmc,
Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam 1081 HV,
Netherlands
(Hemila) Department of Public Health, University of Helsinki, Helsinki,
Finland
Publisher
BioMed Central Ltd
Abstract
Background: Ischemia/reperfusion injury contributes to periprocedural
myocardial injury (PMI) in patients undergoing percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG). PMI can be
estimated by the elevation of troponin (Tn) and creatine kinase-MB (CKMB)
plasma levels, and it is associated with increased risk of cardiovascular
events and mortality. Vitamin C might have a beneficial effect on PMI by
improving endothelial function, improving myocardial perfusion, and by
reducing oxidative stress generated during/after reperfusion. In several
small animal models of cardiac stress, vitamin C reduced the increase in
Tn and CKMB levels. The aim of this meta-analysis was to investigate
whether vitamin C administration may have an effect on Tn and CKMB levels
in patients undergoing PCI or CABG. Method(s): We searched PubMed,
Cochrane, Embase and Scopus databases for controlled clinical trials
reporting on Tn and CKMB levels in adult patients who underwent PCI or
CABG and received vitamin C. As secondary outcomes we collected data on
biomarkers of oxidative stress in the included trials. In our
meta-analysis, we used the relative scale and estimated the effect as the
ratio of means. Result(s): We found seven controlled trials which
included 872 patients. All included trials administered vitamin C
intravenously, with a range from 1 to 16 g/day, and all initiated vitamin
administration prior to the procedure. Vitamin C decreased peak Tn plasma
levels in four trials on average by 43% (95% CI: 13 to 63%, p = 0.01) and
peak CKMB plasma levels in five trials by 14% (95% CI: 8 to 21%, p <
0.001). Vitamin C also significantly decreased the biomarkers of oxidative
stress. Conclusion(s): Vitamin C may decrease cardiac enzyme levels
in patients undergoing elective PCI or CABG. This may be explained
partially by its antioxidant effects. Our findings encourage further
research on vitamin C administration during cardiac procedures and in
other clinical contexts that increase the level of cardiac enzymes. Future
studies should search for an optimal dosing regimen, taking baseline and
follow-up plasma vitamin C levels into account. Copyright © 2023,
BioMed Central Ltd., part of Springer Nature.

<58>
Accession Number
2024043072
Title
Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with
type 2 diabetes: randomised controlled trial (Dapa-Hospital trial).
Source
Acta Diabetologica. 60(11) (pp 1481-1490), 2023. Date of Publication:
November 2023.
Author
Kuchay M.S.; Khatana P.; Mishra M.; Surendran P.; Kaur P.; Wasir J.S.;
Gill H.K.; Singh A.; Jain R.; Kohli C.; Bakshi G.; Radhika V.; Saheer S.;
Singh M.K.; Mishra S.K.
Institution
(Kuchay, Khatana, Mishra, Kaur, Wasir, Gill, Singh, Jain, Kohli, Bakshi,
Radhika, Saheer, Mishra) Division of Endocrinology and Diabetes,
Medanta-The Medicity Hospital, Haryana, Gurugram 122001, India
(Surendran) ICMR - National Institute of Epidemiology, Tamil Nadu,
Ayapakkam, Ambattur, Chennai 600077, India
(Singh) Department of Clinical Research and Studies, Medanta-The Medicity
Hospital, Haryana, Gurugram 122001, India
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Aims: To examine the efficacy and safety of dapagliflozin in the treatment
of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D).
 Method(s): Cardiac surgery patients with T2D (n = 250) were randomly
assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA
group) or basal-bolus insulin alone (INSULIN group) in the early
postoperative period. The primary outcome was mean difference in daily
blood glucose (BG) concentrations between groups. The major safety
outcomes were the occurrence of severe ketonemia/diabetic ketoacidosis
(DKA) and hypoglycemia. All analyses were performed according to the
intention-to-treat principle. Result(s): The median age of the
patients was 61 years (range, 55-61), and 219 (87.6%) were men. Overall,
the randomization blood glucose was 165 mg/dL (SD, 37) and glycated
hemoglobin was 7.7% (SD, 1.4). There were no differences in mean daily BG
concentrations (149 vs. 150 mg/dL), mean percentage of readings within
target BG of 70-180 mg/dL (82.7% vs. 82.5%), total daily insulin dose
(mean, 39 vs. 40 units/day), number of daily insulin injections (median,
3.9 vs. 4), length of hospital stay (median, 10 vs. 10 days), or hospital
complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. The
mean plasma ketone levels were significantly higher in the DAPA group than
in the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs.
0.19 mmol/L) of randomization. Six patients in the DAPA group developed
severe ketonemia, but no patient developed DKA. There were no differences
in the proportion of patients with BG < 70 mg/dL (9.6% vs. 7.2%) between
the two groups. Conclusion(s): Dapagliflozin complementary to
basal-bolus insulin does not improve glycemia further over and above the
basal-bolus insulin alone in hospitalized cardiac surgery patients.
Dapagliflozin significantly increases plasma ketones levels. Safety of
dapagliflozin in hospitalized patients needs further investigation. Trial
registration ClinicalTrials.gov NCT05457933. Copyright © 2023,
Springer-Verlag Italia S.r.l., part of Springer Nature.

<59>
Accession Number
2020808126
Title
Novel hardening bone putty enhances sternal closure and accelerates
postoperative recovery.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(5) (pp e430-e443),
2023. Date of Publication: November 2023.
Author
Vasanthan V.; Hassanabad A.F.; Kang S.; Dundas J.; Ramadan D.; Holloway
D.; Adams C.; Ahsan M.; Fedak P.W.M.
Institution
(Vasanthan, Hassanabad, Kang, Dundas, Ramadan, Holloway, Adams, Ahsan,
Fedak) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin
Cardiovascular Institute, Cumming School of Medicine, University of
Calgary, Calgary, AB, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: Regaining and maintaining sternal stability are key to
recovery after cardiac surgery and resuming baseline quality of life.
Montage (ABYRX) is a moldable, calcium phosphate-based putty that adheres
to bleeding bone, hardens after application, and is resorbed and replaced
with bone during the remodeling process. We evaluate the feasibility,
safety, and efficacy of enhanced sternal closure with this novel putty to
accelerate recovery in patients after sternotomy. Method(s): A
single-center, single-blinded, randomized controlled trial was performed
(NCT03365843). Patients undergoing elective cardiac surgery via sternotomy
received sternal closure with either Montage bone putty and wire cerclage
(enhanced sternal closure; n = 33) or wire cerclage alone (control; n =
27). Standardized patient-reported outcomes assessed health-related
quality of life (EQ-5D Index) and physical disability (Health Assessment
Questionnaire). A Likert-type 11-point scale quantified pain. Spirometry
assessed respiratory function. Patients reached 6-week follow-up, with
1-year follow-up for safety end points. Result(s): There were no
device-related adverse events. Enhanced sternal closure improved physical
functional recovery (reduced Healthcare Index and Quality) and quality of
life (increased EQ-5D Index) at day 5/discharge, week 2, and week 4.
Enhanced sternal closure reduced incisional pain while resting, breathing,
sleeping, and walking at day 5/discharge. Enhanced sternal closure reduced
chest wall and back pain at day 3 and day 5 discharge. A higher proportion
of patients with enhanced sternal closure recovered to 60% of their
baseline forced vital capacity by day 5/discharge. Enhanced sternal
closure shortened hospital stay. Conclusion(s): Enhanced sternal
closure improves and accelerates postoperative recovery compared with
conventional wire closure. Earlier discharge may provide substantial cost
benefits for the healthcare system. Copyright © 2022 The American
Association for Thoracic Surgery

<60>
Accession Number
2017201361
Title
Clinical impact of del Nido cardioplegia in adult cardiac surgery: A
prospective randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(5) (pp 1458-1467),
2023. Date of Publication: November 2023.
Author
Garcia-Suarez J.; Garcia-Fernandez J.; Martinez Lopez D.; Reques L.; Sanz
S.; Carballo D.; Martin C.E.; Ospina V.M.; Villar S.; Martin A.; Casado
M.; Villafranca A.; Gonzalez A.I.; Serrano S.; Forteza A.
Institution
(Garcia-Suarez, Garcia-Fernandez, Sanz, Carballo, Casado, Villafranca,
Gonzalez) Department of Anesthesiology and Critical Care, Puerta de Hierro
University Hospital, Madrid, Spain
(Martinez Lopez, Martin, Ospina, Villar, Serrano, Forteza) Department of
Cardiac Surgery, Puerta de Hierro University Hospital, Madrid, Spain
(Reques, Martin) Cardiac Surgery Perfusion Department, Puerta de Hierro
University Hospital, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objective: The study objective was to assess the benefits of del Nido
cardioplegia compared with cold blood cardioplegia solution in terms of
myocardial protection during adult cardiac surgery. Method(s): A
total of 474 adult patients undergoing coronary artery bypass grafting,
heart valve surgery, thoracic aortic surgery, or combined procedures were
randomized to the del Nido cardioplegia group (n = 234) or the cold blood
cardioplegia solution group (n = 240) after provided informed consent. The
primary end points assessed inotropic support requirements, severe
cardiovascular events, and troponin trend within the first 48 hours of
intensive care unit stay. Reperfusion arrhythmias, aortic crossclamp and
cardiopulmonary bypass times, and other clinical perioperative variables
were considered as secondary end points. Result(s): No statistically
significant differences were found regarding postoperative inotropic
support requirements or the incidence of severe cardiovascular events. The
del Nido cardioplegia group showed a higher return to spontaneous sinus
rhythm (P < .001), a lower number of defibrillation attempts (P < .001),
and an earlier peak troponin value in the postoperative period. Peak blood
glucose levels and intravenous insulin requirements were significantly
lower in the del Nido cardioplegia group. We found no significant
differences regarding aortic crossclamp or cardiopulmonary bypass time. We
did observe a lower incidence of postoperative stroke in the del Nido
cardioplegia group (2.6% vs 6.7%; P = .035). Conclusion(s): del Nido
cardioplegia can be used safely and with comparable outcomes compared with
traditional cardioplegia solutions. Additional advantages over glycemic
control, reperfusion arrhythmias, and its comfortable redosing interval
make del Nido an interesting alternative for myocardial protection in
adult cardiac surgery. A significant decrease in postoperative stroke will
require further research to shed light on the results of this study. Video
Abstract: [Figure presented] Copyright © 2022 The American
Association for Thoracic Surgery

<61>
Accession Number
2026121530
Title
Preoperative Sildenafil in Pediatric Patients Undergoing Congenital Heart
Surgeries: A Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2023. Date of Publication: 2023.
Author
Fikri Y.A.; Mulia E.P.B.; Nugroho F.W.
Institution
(Fikri) Dr. R. Soetrasno Regional General Hospital, Rembang, Indonesia
(Mulia, Nugroho) Department of Cardiology and Vascular Medicine, Dr. R.
Soetrasno Regional General Hospital, Rembang, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background. Pulmonary hypertension (PH) is a common complication of
congenital heart disease (CHD). With early surgical intervention, outcomes
have improved over the last two decades. Persistent PH, however, may still
occur following surgery. Sildenafil has been shown to be beneficial for
postoperative pulmonary hypertensive crises. The role of preoperative
sildenafil in controlling postoperative PH is poorly elucidated. This
study aimed to evaluate the effect of preoperative sildenafil on pediatric
patients undergoing congenital heart surgeries. Methods. A comprehensive
literature search was conducted in scientific databases. We included
randomized controlled trials which assessed the effect of preoperative
sildenafil in pediatric patients with CHD undergoing repair surgeries.
Primary outcomes were pre- and postoperative differences in mean pulmonary
arterial pressure (mPAP) and mean pulmonary artery/aortic pressure ratio
(PA/Ao ratio). Results. Four studies (n = 233) were retained for the final
analysis. Dose of sildenafil ranged from.3 to.5 mg/kg every 4-6 hours via
oral/nasogastric route, with timing of administration varied from 1 to 2
weeks before surgery. Compared to controls, preoperative sildenafil was
associated with greater reduction in postoperative mPAP (MD -5.02; 95% CI
[-8.91, -1.13]) and mean PA/Ao ratio (MD -.11; 95% CI [-.17, -.06]).
Shorter CPB time, ICU length of stay, and duration of mechanical
ventilation were also observed in the sildenafil group. Conclusion.
Preoperative sildenafil is beneficial in reducing PAP, thereby reducing
the risk of postoperative PH crisis. Further studies are warranted to
identify the optimal dosage and timing of administration of sildenafil in
CHD patients prior to surgery. Copyright © The Author(s) 2023.

<62>
Accession Number
2026114026
Title
Effects of parasternal intercostal block on surgical site wound infection
and pain in patients undergoing cardiac surgery: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Li J.-Q.; Li Z.-H.; Dong P.; Liu P.; Xu Y.-Z.; Fan Z.-J.
Institution
(Li) Department of Cardiac Surgery, Yantai Yuhuangding Hospital, Yantai,
China
(Li, Xu) Department of Anesthesiology, Qingdao Fuwai Hospital, Qingdao,
China
(Dong) Department of Hematology, Yantai Yuhuangding Hospital, Yantai,
China
(Liu) Department of Cardiac Surgery ICU, Yantai Yuhuangding Hospital,
Yantai, China
(Fan) Department of Cardiac Surgery, Qingdao Fuwai Hospital, Qingdao,
China
Publisher
John Wiley and Sons Inc
Abstract
This study aimed to assess the effect of parasternal intercostal block on
postoperative wound infection, pain, and length of hospital stay in
patients undergoing cardiac surgery. PubMed, Embase, Cochrane Library,
China National Knowledge Infrastructure, VIP, and Wanfang databases were
extensively queried using a computer, and randomised controlled studies
(RCTs) from the inception of each database to July 2023 were sought using
keywords in English and Chinese language. Literature quality was assessed
using Cochrane-recommended tools, and the included data were collated and
analysed using Stata 17.0 software for meta-analysis. Ultimately, eight
RCTs were included. Meta-analysis revealed that utilising parasternal
intercostal block during cardiac surgery significantly reduced
postoperative wound pain (standardised mean difference [SMD] = -1.01, 95%
confidence intervals [CI]: -1.70 to -0.31, p = 0.005) and significantly
shortened hospital stay (SMD = -0.40, 95% CI: -0.77 to -0.04, p = 0.029),
though it may increase the risk of wound infection (OR = 5.03, 95%
CI:0.58-44.02, p = 0.144); however, the difference was not statistically
significant. The application of parasternal intercostal block during
cardiac surgery can significantly reduce postoperative pain and shorten
hospital stay. This approach is worth considering for clinical
implementation. Decisions regarding its adoption should be made in
conjunction with the relevant clinical indices and surgeon's
experience. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<63>
Accession Number
2027874101
Title
Systematic review and meta-analysis of deep venous reflux correction in
chronic venous insufficiency.
Source
Journal of Vascular Surgery: Venous and Lymphatic Disorders. 11(6) (pp
1265-1275.e5), 2023. Date of Publication: November 2023.
Author
Maleti O.; Orso M.; Lugli M.; Perrin M.
Institution
(Maleti, Lugli) National reference Training Center in Phlebology, UEMS,
Vascular Surgery, Cardiovascular Department Hesperia Hospital, Modena,
Italy
(Orso) Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche
'Togo Rosati', Perugia, Italy
(Perrin) Jean Kunlin, Vascular Unit, Chassieu, France
Publisher
Elsevier Inc.
Abstract
Objective: The aim of this study was to investigate the technical
feasibility, operative techniques, safety, and efficacy outcomes of
procedures aimed at correcting deep venous reflux, in patients with
chronic venous insufficiency. Method(s): We performed systematic
literature searches in PubMed, Embase, and Web of Science from databases'
inception to February 2022. We included systematic reviews, randomized
controlled trials, and observational studies describing surgical
procedures to treat patients with deep reflux due to primary and secondary
incompetence, post-thrombotic syndrome (PTS). Proportion meta-analyses
were performed for all the efficacy and safety outcomes. Result(s):
We included 57 studies in the quantitative synthesis: three randomized
controlled trials including 252 patients and 54 case series including 4004
patients. Studies included a median of 38 patients, with a mean age of 51
years; 52% of them were males. Forty percent of studies included 2291
patients with primary incompetence, 29% of studies included 595 patients
with PTS, and 31% of studies included 1118 patients with both diseases. As
for primary incompetence, pooled estimates for all procedures showed an
89% (95% confidence interval [CI], 82%-94%) of ulcer healing, 10% (95% CI,
4%-18%) ulcer recurrence, 98% (95% CI, 93%-100%) valve patency, 84% (95%
CI, 78%-90%) valve competence, 0.05% (1/1904 patients) pulmonary embolism,
1% (95% CI, 0%-3%) wound infections, 5% (95% CI, 1%-9%) hematoma, 2% (95%
CI, 0%-6%) lymphocele, 2% (95% CI, 1%-4%) thrombosis, 85% (95% CI,
74%-94%) pain improvement, 89% (95% CI, 65%-100%) edema improvement, and
85% (95% CI, 73%-93%) lipodermatosclerosis improvement. Patients with PTS
showed less favorable outcomes: 82% (95% CI, 71%-91%) of ulcer healing,
18% (95% CI, 5%-36%) ulcer recurrence, 88% (95% CI, 78%-96%) valve
patency, 78% (95% CI, 66%-88%) valve competence, no pulmonary embolism, 6%
(95% CI, 0%-22%) wound infections, 6% (95% CI, 3%-10%) hematoma, 5% (95%
CI, 1%-12%) lymphocele, 7% (95% CI, 1%-16%) thrombosis, 79% (95% CI,
59%-94%) pain improvement, 75% (95% CI, 61%-88%) edema improvement, and
64% (95% CI, 9%-100%) lipodermatosclerosis improvement.
 Conclusion(s): The number of studies included in each meta-analysis
are limited, and knowing how this element can affect the statistical
power, as well as the absence of comparative control groups, it is not
possible to draw definitive conclusions. Nevertheless, deep venous
reconstructive surgery for reflux may increase the probability of clinical
improvement in patients affected by chronic venous insufficiency. Outcomes
appear to be satisfactory even if possible adjunctive procedures may be
required over the course of the patient's lifetime. Consequently, a strict
follow-up protocol is required to maintain outcomes. Further studies are
required to evaluate deep venous reconstructive surgery for reflux
particularly as to how it compares with the more recently introduced
endovenous approaches. Copyright © 2023

<64>
Accession Number
2026191362
Title
Correlation Between Pain Intensity and Quality of Recovery After
Video-Assisted Thoracic Surgery for Lung Cancer Resection.
Source
Journal of Pain Research. 16 (pp 3343-3352), 2023. Date of Publication:
2023.
Author
Yoon S.-H.; Bae J.; Yoon S.; Na K.J.; Lee H.-J.
Institution
(Yoon, Yoon, Lee) Department of Anesthesiology and Pain Medicine, Seoul
National University Hospital, Seoul, South Korea
(Bae) Department of Anesthesiology and Pain Medicine, Ajou University
School of Medicine, Suwon, South Korea
(Yoon, Lee) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul, South Korea
(Na) Department of Thoracic and Cardiovascular Surgery, Seoul National
University Hospital, Seoul, South Korea
(Na) Department of Thoracic and Cardiovascular Surgery, Seoul National
University College of Medicine, Seoul, South Korea
Publisher
Dove Medical Press Ltd
Abstract
Purpose: The Quality of Recovery-15 (QoR-15) questionnaire provides a
multifaceted assessment of postoperative recovery, and the resulting score
is recommended as an endpoint in clinical studies focused on postoperative
pain. We aimed to investigate the correlation between the QoR-15 score and
postoperative pain intensity in surgical patients. Patients and
Methods: Adult patients who underwent video-assisted thoracoscopic surgery
(VATS) for lung cancer resection and were enrolled in a prospective
registry or in a previous prospective study were included in this study.
Baseline and perioperative data, including the results of assessment using
the Korean version of the QoR-15 (QoR-15K) questionnaire at 48 hours
postoperatively, were collected from the database. Correlations between
the QoR-15K total score, questionnaire dimensions, and postoperative pain
intensity at 48 hours postoperatively were determined using the Spearman
correlation coefficient (rho). Result(s): We analyzed a total of 137
eligible patients. Significant negative correlations were noted between
the QoR-15K total score and pain intensity at rest (rho = -0.45, 95%
confidence interval [CI]: -0.57 - -0.31, P < 0.001) and during coughing
(rho = -0.55, 95% CI: -0.65 - -0.42, P < 0.001) at 48 hours
postoperatively. The pain dimension and pain intensity at 48 hours
postoperatively showed significant correlations with physical comfort,
emotional state, and physical independence dimensions. Multivariable
logistic regression revealed a significant negative association between
the pain score at 24 hours postoperatively and good or excellent
postoperative recovery. Conclusion(s): The results support the impact
of postoperative pain on the overall postoperative quality of recovery in
patients who underwent VATS for lung cancer resection. Moreover, the
QoR-15K score may be considered as a primary endpoint in clinical studies
on postoperative pain control. Copyright © 2023 Yoon et al. This
work is published and licensed by Dove Medical Press Limited.

<65>
Accession Number
642520229
Title
Outcomes Following Transcatheter Aortic Valve Replacement for Aortic
Stenosis in Patients With Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid
Aortic Valves.
Source
Circulation. Cardiovascular interventions. (pp e013083), 2023. Date of
Publication: 17 Oct 2023.
Author
He J.; Xiong T.-Y.; Yao Y.-J.; Peng Y.; Wei J.-F.; Zhao Z.-G.; Chen G.; Ou
Y.-W.; Liu Q.; Wang X.; Zhu Z.; Yang H.-R.; Jia K.; Mylotte D.; Piazza N.;
Prendergast B.; Feng Y.; Chen M.
Institution
(He, Xiong, Yao, Peng, Wei, Zhao, Ou, Liu, Wang, Zhu, Yang, Jia, Feng,
Chen) Department of Cardiology (J.H., Y.P.
(He) West China Hospital, Sichuan University. Cardiology Department, First
Affiliated Hospital of Sun Yat-sen University, China (J.H.), Guangzhou,
China
(Xiong, Zhao, Yang, Chen) Laboratory of Heart Valve Disease (T.-Y.X.
(Chen) Department of Anesthesiology (G.C.)
(Mylotte) Department of Cardiology, University Hospital Galway, National
University of Ireland (D.M.), Ireland
(Piazza) Division of Cardiology, Department of Medicine, McGill University
Health Center, Montreal, QC, Canada
(Prendergast) Department of Cardiology, United Kingdom (B.P.), St. Thomas'
Hospital, London, United Kingdom
(Prendergast) United Kingdom (B.P.), United Kingdom
Abstract
BACKGROUND: Data concerning the outcomes of transcatheter aortic valve
replacement in type 0 bicuspid aortic stenosis (AS) are scarce. The study
aims to compare the outcomes of transcatheter aortic valve replacement for
AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic
valve anatomy. METHOD(S): We enrolled consecutive patients undergoing
transcatheter aortic valve replacement for severe AS between 2012 and 2022
in this single-center retrospective cohort study. The primary outcome was
mortality, while secondary outcomes included in-hospital complications
such as stroke and pacemaker implantation and transcatheter heart valve
hemodynamic performance. RESULT(S): The number of patients with AS
with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy
was 328, 302, and 642, respectively. Self-expanding transcatheter heart
valves were used in the majority of patients (n=1160; 91.4%). In the
matched population, differences in mortality (30 days: 4.2% versus 1.7%
versus 1.7%, Poverall=0.522; 1 year: 10% versus 2.3% versus 6.2%,
Poverall=0.099) and all stroke (30 days: 1.0% versus 0.9% versus 0.0%,
Poverall=0.765; 1 year: 1.4% versus 1.6% versus 1.3%, Poverall=NS) were
nonsignificant, and the incidence of overall in-hospital complications was
comparable among groups. Ascending aortic diameter was the single
predictor of 1-year mortality in type 0 bicuspid patients (hazard ratio,
1.59 [95% CI, 1.03-2.44]; P=0.035). The proportion of patients with a mean
residual gradient >=20 mmHg was the highest in those with type 0 bicuspid
anatomy, although the need for permanent pacemaker implantation was the
lowest in this group. CONCLUSION(S): Major clinical outcomes of
transcatheter aortic valve replacement for AS in patients with type 0
bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy are
equivalent at short- and mid-term follow-up. These observations merit
further exploration in prospective international registries and randomized
controlled trials.

<66>
Accession Number
642523751
Title
The postoperative analgesia of retrolaminar block in patients undergoing
surgery with general anesthesia: a systematic review.
Source
Minerva anestesiologica. (no pagination), 2023. Date of Publication: 18
Oct 2023.
Author
Hu X.; Jiao B.; Zhou R.; Zhu T.
Institution
(Hu, Jiao, Zhou) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, Sichuan, China
(Zhu) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, Sichuan, China
Abstract
INTRODUCTION: Postoperative pain has always been a difficult problem in
anesthesia management. The neurological block technique has been used for
postoperative analgesia management, but compared with the traditional
block method, the effect of postoperative analgesia after layer block is
still controversial, and a clear literature review is needed. This
systematic review's goal was to investigate RLB's impact on postoperative
analgesia. EVIDENCE ACQUISITION: The literature search was performed using
the PubMed, Web of Science, Embase, and Cochrane Central Register of
Controlled Trials (CENTRAL) databases. Patients aged 18 years who
underwent retrolaminar block were considered eligible. The article must
report the results of the original study related to postoperative
analgesia. The characteristics of the study sample and evaluating the RLB
for postoperative analgesia were extracted from each included article and
concluded. EVIDENCE SYNTHESIS: Eleven randomized controlled trials (726
patients) were included. After summarizing the analysis of the results of
RLB on changing postoperative analgesia indexes in different surgeries, we
concluded that PVB is better used for postoperative analgesia compared
with RLB. The analgesic effect of RLB provides advantages compared with
EPSB, SCPB, etc.. CONCLUSION(S): Based on the results of this review,
RLB can be applied to thoracic surgery, abdominal surgery and parotid
surgery, but its analgesic effect is not significant enough, and further
research is needed in the future to provide stronger evidence for
postoperative analgesia in surgical patients.

<67>
Accession Number
642523433
Title
Treatment Satisfaction and Convenience for Patients With Atrial
Fibrillation on Edoxaban or Vitamin K Antagonists After Transcatheter
Aortic Valve Replacement: A Post Hoc Analysis from the ENVISAGE-TAVI AF
Trial.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 14 Oct 2023.
Author
Hengstenberg C.; Van Mieghem N.M.; Wang R.; Shi L.; Guo S.; Chen C.; Jin
J.; Ye X.; Dangas G.; Unverdorben M.
Institution
(Hengstenberg) Division of Cardiology, Department of Internal Medicine II,
Vienna General Hospital, Medical University, Vienna, Austria
(Van Mieghem) Department of Cardiology, Erasmus University Medical Centre,
Thoraxcenter, Rotterdam, Netherlands
(Wang, Chen, Jin, Ye, Unverdorben) Daiichi Sankyo, Inc., Basking Ridge,
NJ, United States
(Ye, Shi, Guo) LLC, Bethesda, MD, Liberia
(Dangas) Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai
Hospital, New York, New York; School of Medicine, National and
Kapodistrian University of Athens, Athens, Greece
Abstract
ENVISAGE-TAVI AF (Edoxaban vs Standard of Care and Their Effects on
Clinical Outcomes in Patients Having Undergone Transcatheter Aortic Valve
Implantation-Atrial Fibrillation; NCT02943785) was a prospective,
randomized, open-label trial comparing non-vitamin K oral anticoagulant
(NOAC) edoxaban with vitamin K antagonists (VKAs) in patients with atrial
fibrillation after successful transcatheter aortic valve replacement
(TAVR). The effect of edoxaban- or VKA-based therapy on patient-reported
outcomes remains unknown, as most studies focus on efficacy and safety.
Pre-TAVR patient-reported expectations and post-TAVR Treatment
Satisfaction and Convenience with edoxaban or VKA treatment (at months 3
and 12) were analyzed using the Perception of Anticoagulation Treatment
Questionnaire (PACT-Q). This analysis included randomized and dosed
patients with an evaluable PACT-Q1 assessment at baseline and >=1
postbaseline assessment (PACT-Q2). Subanalyses included patients
stratified by pre-TAVR anticoagulant (NOAC, VKA, no NOAC/VKA). Edoxaban-
(n=585) and VKA-treated (n=522) patients had similar baseline
characteristics and treatment expectations. Pre-TAVR anticoagulant use did
not affect treatment expectations. After TAVR, edoxaban-treated patients
had significantly higher Treatment Satisfaction and Convenience scores
compared with VKA-treated patients at all time points (p <0.001 for all).
Among edoxaban-treated patients, those who received VKAs pre-TAVR were
significantly more satisfied with treatment than those who received NOACs
(p <0.001) or no NOACs/VKAs (p=0.003); however, there was no significant
difference in the perception of convenience (p=0.927 and p=0.092,
respectively). Conversely, among VKA-treated patients, the type of
anticoagulant used pre-TAVR did not affect Treatment Satisfaction or
Convenience scores post-TAVR. In conclusion, patients with atrial
fibrillation who received edoxaban post-TAVR reported significantly higher
Treatment Satisfaction and Convenience scores compared with those who
received VKAs, resulting in a clinically meaningful difference between
treatment groups. Copyright © 2023 The Authors. Published by
Elsevier Inc. All rights reserved.

<68>
Accession Number
642523222
Title
What Does Minimally Invasive Mitral Valve Surgery Really Mean? Defining
Totally Endoscopic Mitral Valve Surgery Through Meta Analysis.
Source
Surgical technology international. 43 (no pagination), 2023. Date of
Publication: 18 Oct 2023.
Author
Katsiroubas J.; Manin E.; Rosen J.L.; Choe Y.; Ding I.; Jonnalagadda K.;
Guy T.S.
Institution
(Katsiroubas) Department of Surgery, New York Presbyterian Brooklyn
Methodist Hospital, Brooklyn, NY, United States
(Manin) Weill Cornell Medical College, Cornell University, Manhattan, NY,
United States
(Rosen) Sidney Kimmel Medical College, Thomas Jefferson University,
Philadelphia, PA, United States
(Choe, Jonnalagadda) Rowan-Virtua School of Osteopathic Medicine, Rowan
University, Stratford, NJ, United States
(Ding) Lewis Katz School of Medicine, Temple University, Philadelphia, PA,
United States
(Guy) Department of Cardiac Surgery, Georgia Heart Institute, Gainesville,
Georgia
Abstract
INTRODUCTION: Minimally invasive approaches to mitral valve surgery are
being performed with increasing frequency; however, many of these
procedures still involve rib spreading and large incisions. The
heterogeneity of self-reported "minimally invasive" approaches limits
analysis of outcomes. This review aims to formally define totally
endoscopic mitral valve surgery (TEMVS) and assess outcomes. MATERIALS AND
METHODS: A comprehensive literature search in Pub-Med, Cochrane Library,
and EMBASE was used to find studies reporting outcomes on totally
endoscopic mitral valve surgery. "Totally endoscopic" was defined as
incisions less than 3cm and the avoidance of rib spreading. The primary
outcome was 30-day mortality and secondary endpoints included
postoperative myocardial infarction (MI), stroke, early reoperation, wound
infection, renal failure, and prolonged ventilation. Perioperative patient
characteristics were also recorded and analyzed. RESULT(S):
Thirty-three studies (6031 patients) were included in our meta-analysis.
The 30-day mortality rate was 0.33%, p=0.88. The most frequent
complications were early reoperation (2.12%, p=0.44) and prolonged
ventilation (1.46% p=<0.01). Rates of MI, stroke, and renal failure were
each less than 1%. Patient characteristics including age, body mass index
(BMI), and ejection fractions were also analyzed. CONCLUSION(S): We
propose a formal definition of TEMVS, which is performed through incisions
less than 3cm and without rib spreading. Thirty-day mortality and other
adverse sequelae of TEMVS are uncommon.

<69>
Accession Number
642522309
Title
Surgical Ablation for Atrial Fibrillation During Mitral Valve Surgery: A
Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 14 Oct 2023.
Author
Gemelli M.; Gallo M.; Addonizio M.; Van den Eynde J.; Pradegan N.; Danesi
T.H.; Pahwa S.; Dixon L.K.; Slaughter M.S.; Gerosa G.
Institution
(Gemelli, Addonizio, Pradegan, Gerosa) Department of Cardiac, Thoracic,
Vascular Sciences and Public Health, Cardiac Surgery Unit, University of
Padua, Padua, Italy
(Gallo, Pahwa, Slaughter) Department of Cardiothoracic Surgery, University
of Louisville, Louisville, KY, United States
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Danesi) Cardiac Surgery Unit, San Bortolo Hospital, Vicenza, Italy;
Division of Cardiac Surgery, University of Cincinnati College of Medicine,
Cincinnati, Ohio
(Dixon) Clinical Effectiveness Unit, Royal College of Surgeons of England,
London, United Kingdom
Abstract
Although surgical ablation has been shown to produce excellent outcomes at
follow-up for patients with atrial fibrillation who underwent mitral valve
replacement/repair (MVR), this procedure is not commonly performed. Our
objective was to conduct a systematic review and meta-analysis to evaluate
the outcomes of concomitant surgical ablation during MVR. Three databases
were systematically reviewed for randomized clinical trials published by
August 2022. The primary outcome was sinus rhythm (SR) at 12 months.
Secondary outcomes included SR at discharge and 6 months, all-cause
mortality, permanent pacemaker implantation, and stroke and thromboembolic
events. A random-effects meta-analysis was performed, calculating odds
ratios (ORs) for each outcome. Thirteen studies were included, involving
1,089 patients comparing patients who underwent either isolated MVR
("MVR-only") or concomitant surgical ablation during MVR ("MVR+Ablation").
The odds of SR were significantly higher in the MVR+Ablation group at
discharge (OR 9.62, 95% confidence interval [CI] 4.87 to 19.02, I2=55%),
at 6-month follow-up (OR 7.21, 95% CI 4.30 to 12.11, I2=34%), and at
1-year follow-up (OR 8.41, 95% CI 5.14 to 13.77, I2=48%). All-cause
mortality was not different in the groups, as were stroke and
thromboembolic events, whereas the odds of permanent pacemaker
implantation were slightly higher in the MVR+Ablation group (OR 1.87, 95%
CI 1.11 to 3.17, I2=0%). Concomitant surgical ablation during MVR showed
excellent outcomes at short-term follow-up, despite a slightly higher rate
of permanent pacemaker implantation. Further studies with longer
follow-ups are needed to assess if the SR is maintained over the
years. Copyright © 2023 Elsevier Inc. All rights reserved.

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