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<1>
Accession Number
2022040704
Title
Microvascular resistance reserve in the presence of functionally
significant epicardial stenosis and changes after revascularization.
Source
Physiological Reports. 11(5) (no pagination), 2023. Article Number:
e15627. Date of Publication: March 2023.
Author
Hanyu Y.; Hoshino M.; Usui E.; Sugiyama T.; Kanaji Y.; Hada M.; Nagamine
T.; Nogami K.; Ueno H.; Sayama K.; Matsuda K.; Sakamoto T.; Yonetsu T.;
Sasano T.; Kakuta T.
Institution
(Hanyu, Hoshino, Usui, Kanaji, Hada, Nagamine, Nogami, Ueno, Sayama,
Matsuda, Sakamoto, Kakuta) Division of Cardiovascular Medicine, Tsuchiura
Kyodo General Hospital, Ibaraki, Japan
(Sugiyama, Yonetsu) Department of Interventional Cardiology, Tokyo Medical
and Dental University, Tokyo, Japan
(Sasano) Department of Cardiovascular Medicine, Tokyo Medical and Dental
University, Tokyo, Japan
Publisher
American Physiological Society
Abstract
In the presence of functionally significant epicardial lesions,
microvascular resistance reserve (MRR) calculation needs incorporation of
collateral flow. Coronary fractional flow reserve (FFR<inf>cor</inf>)
requiring coronary wedge pressure (P<inf>w</inf>), which is an essential
part of the true MRR calculation, is reportedly estimated by myocardial
FFR (FFR<inf>myo</inf>) not requiring P<inf>w</inf> measurement. We sought
to find an equation to calculate MRR without the need for P<inf>w</inf>.
Furthermore, we assessed changes in MRR after percutaneous coronary
intervention (PCI). An equation to estimate FFR<inf>cor</inf> was
developed from a cohort of 230 patients who underwent physiological
measurements and PCI. Corrected MRR was calculated using this equation and
compared with true MRR in 115 patients of the different set of the
validation cohort. True MRR was calculated using FFR<inf>cor</inf>.
FFR<inf>cor</inf> and FFR<inf>myo</inf> showed a strong linear
relationship (r² = 0.86) and an equation was FFR<inf>cor</inf>
= 1.36 x FFR<inf>myo</inf> - 0.34. This equation provided no significant
difference between corrected MRR and true MRR in the validation cohort.
Pre-PCI lower coronary flow reserve and higher index of microcirculatory
resistance were independent predictors of pre-PCI decreased true MRR. True
MRR significantly decreased after PCI. In conclusion, MRR can be
accurately corrected using an equation for FFR<inf>cor</inf> estimation
without P<inf>w</inf>.<br/>Copyright &#xa9; 2023 The Authors.
Physiological Reports published by Wiley Periodicals LLC on behalf of The
Physiological Society and the American Physiological Society.

<2>
Accession Number
2027547541
Title
Effect of noninvasive respiratory support after extubation on
postoperative pulmonary complications in obese patients: A systematic
review and network meta-analysis.
Source
Journal of Clinical Anesthesia. 91 (no pagination), 2023. Article Number:
111280. Date of Publication: December 2023.
Author
Li R.; Liu L.; Wei K.; Zheng X.; Zeng J.; Chen Q.
Institution
(Li, Liu, Wei) The First Affiliated Hospital of Chongqing Medical
University, Department of Anesthesiology, Youyi Road, Chongqing 400016,
China
(Zheng) The First Affiliated Hospital of Chongqing Medical University,
Department of Respiratory and Critical Care Medicine, Youyi Road,
Chongqing 400016, China
(Zeng) Stomatological Hospital of Chongqing Medical University, Department
of Anesthesiology, Songshibei Road, Chongqing 400016, China
(Chen) Chongqing University Cancer Hospital, Department of Anesthesiology,
Hanyu Road, Chongqing 400016, China
Publisher
Elsevier Inc.
Abstract
Study objective: Obesity is associated with an increased risk of
sleep-disordered breathing (SDB) and postoperative pulmonary complications
(PPCs). Postoperative noninvasive respiratory support (NRS) has been
recommended to obese patients despite the controversy about its benefit.
The network meta-analysis (NMA) was used in this study to compare the
effect of different methods of NRS on preventing PPCs in obese patients.
<br/>Design(s): This study is a network meta-analysis. <br/>Setting(s):
Post-anesthesia care unit and inpatient ward. <br/>Patient(s): 20
randomized controlled trials involving 1184 obese patients were included
in the final analysis. <br/>Intervention(s): One of the four NRS
techniques, which include continuous positive airway pressure (CPAP),
bi-level positive airway pressure (BiPAP), high-flow nasal cannula (HFNC),
or conventional oxygen therapy (COT), was performed after general
anesthesia. Measurements: The primary outcome was the incidence of PPCs,
e.g., atelectasis, pneumonia, hypoxemia, and respiratory failure. The
secondary outcomes included the incidence of oxygen treatment failure and
anastomotic leakage, oxygenation index, and length of hospital stay (LOS).
RevMan 5.3 and STATA 16.0 were used to analyze the results and any
potential bias. <br/>Main Result(s): Compared with COT, BiPAP and HFNC
were both effective in reducing the occurrence of postoperative
atelectasis. There were no significant differences in the occurrence of
other PPCs including pneumonia, hypoxemia and respiratory failure between
the four NRS techniques. CPAP and HFNC were superior to other techniques
in improving oxygenation and shortening LOS respectively. No differences
were found in oxygen treatment failure and anastomotic leakage between the
patients with different NRS. HFNC ranked the first in five of the eight
outcomes (hypoxemia, respiratory failure, treatment failure, anastomotic
leakage, LOS) in this review by the surface under the cumulative ranking
curve (SUCRA). <br/>Conclusion(s): Among the four postoperative NRS
techniques, HFNC seems to be the optimal choice for obese patients which
shows certain advantages in reducing the risk of PPCs and shortening
LOS.<br/>Copyright &#xa9; 2023

<3>
Accession Number
2027344637
Title
Nutritional markers accompanying acquired chylothorax in infants: a
systematic review.
Source
Nutrition Reviews. 81(10) (pp 1321-1328), 2023. Date of Publication: 01
Oct 2023.
Author
Marzotto K.N.; Choudhary T.; Wright L.A.; Howell M.P.; Kimball T.R.;
Pigula F.A.; Piggott K.D.
Institution
(Marzotto, Choudhary) Tulane University School of Medicine, New Orleans,
LA, United States
(Wright) Matas Library, Tulane University School of Medicine, New Orleans,
LA, United States
(Howell) Department of Pediatrics, Tulane University School of Medicine,
New Orleans, LA, United States
(Kimball, Piggott) Department of Pediatrics, Louisiana State University
Health, New Orleans, LA, United States
(Pigula) Department of Surgery, Louisiana State University Health, New
Orleans, LA, United States
Publisher
Oxford University Press
Abstract
Context: Chylothorax is a well-established acquired complication of
thoracic surgery in infants. Current data suggest acquired chylothorax may
affect infant growth and nutrition because of a loss of essential
nutrients via chylous effusion. <br/>Objective(s): The 3 objectives for
this study were: (1) identify nutritional markers affected by the
development of acquired chylothorax in infants; (2) highlight the
variability in methods used to assess nutritional status and growth in
this patient population; and (3) highlight nutritional deficits that can
serve as treatment targets during postoperative feeding protocols.
<br/>Data Sources: A systematic literature search was conducted between
May 31, 2021, and June 21, 2022, using the PubMed, Embase, CINAHL, and Web
of Science databases. Search terms included, but were not limited to,
"chylothorax,""infants,"and "nutrition."Data Extraction: Inclusion
criteria required studies that measured quantitative markers of nutrition
in >=10 participants aged <1 year with acquired chylothorax. A total of
575 studies were screened and all but 4 were eliminated. Nutritional
markers were categorized into 4 different groups: total serum protein
level, triglyceride levels, growth velocity, and weight for length. Data
Analysis: The variation in methods, time points, interventional groups,
and nutritional markers did not facilitate a meta-analysis. Risk of bias
was assessed using the Cochrane Risk of Bias in Nonrandomized Studies
assessment tool. <br/>Conclusion(s): This review highlights the need for
reliable quantitative markers of nutrition that will enable providers to
assess the nutritional needs of infants with chylothorax. Future studies
must focus on measuring markers of nutrition at regular intervals in
larger study populations.<br/>Copyright &#xa9; 2023 The Author(s).

<4>
Accession Number
2026661192
Title
A Systematic Review of the Design, Method of Implantation and Early
Clinical Outcomes of Transcatheter Tricuspid Prostheses.
Source
Reviews in Cardiovascular Medicine. 24(8) (no pagination), 2023. Article
Number: 231. Date of Publication: 2023.
Author
Sazzad F.; Zhu Y.; Leo H.L.; Nah J.H.; Ang H.Y.; Lee C.N.; Hon J.K.F.
Institution
(Sazzad, Nah, Lee, Hon) Department of Surgery, Yong Loo Lin School of
Medicine, National University of Singapore, Singapore 117597, Singapore
(Zhu, Leo, Ang, Lee) Department of Biomedical Engineering, College of
Design and Engineering, National University of Singapore, Singapore
117583, Singapore
(Lee, Hon) Department of Cardiac, Thoracic and Vascular Surgery, National
University Hospital, Singapore 119074, Singapore
Publisher
IMR Press Limited
Abstract
Background: Intervention for tricuspid regurgitation (TR) tends to happen
concurrently with and is addressed during mitral valve surgery. Isolated
TR interventions, however, are not unusual and are becoming more common.
The purpose of this study was to provide a general overview of the
transcatheter tricuspid valve implantation (TTVI) devices, taking into
account the several design variations, and to unify the implantation
technique, existing clinical results, and potential future directions for
TR replacement therapy. <br/>Method(s): The major databases, namely Pubmed
via Medline, Embase, and Cochrane library, were systematically searched
from the date of conception until 10 February 2023, in accordance with the
preferred reporting items for systematic reviews and meta-analyses
(PRISMA) standards. <br/>Result(s): Eleven studies were isolated from a
total cohort of 5842 publications. All the transcatheter tricuspid
prostheses were circular in design yet categorized into annular tricuspid
valve implantation (ATVI) and caval valve implantation (CAVI) groups.
Bleeding (25.2%), severe access site and vascular issues requiring
intervention (5.8%), device migration or embolization (3.6%), and
paravalvular leak (38%) are among the early TTVI-related complications
that have been observed. The CAVI group experienced 3 of 28 bleeding cases
and 2 of 4 device migration cases. <br/>Conclusion(s): Following the
intervention with a transcatheter tricuspid prosthesis, this review
discovered an early favorable outcome and a general improvement in heart
failure symptoms. However, there was a lot of variation in their design,
implantation technique, and early clinical outcomes. Understanding the
design variations, difficulty of implantation and learning from this
review's key findings could help with the future development of
catheter-based tricuspid valves. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022312142.<
br/>Copyright &#xa9; 2023 The Author(s).

<5>
Accession Number
2025959084
Title
Optimisation and Effect Analysis of the Blood Collection Method in
Pre-Deposit Autotransfusion Patients Undergoing Thoracotomy Surgery.
Source
Journal of Multidisciplinary Healthcare. 16 (pp 2793-2798), 2023. Date of
Publication: 2023.
Author
Jia L.; Wang Y.; Zhang W.; Lin Y.; Chen F.; Wan Y.; Fu X.
Institution
(Jia, Lin, Chen, Wan) Department of Cardiothoracic Surgery, Taizhou
Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,
Zhejiang, Taizhou 317000, China
(Wang) Department of Geriatrics, Taizhou Central Hospital (Taizhou
University Hospital) of Zhejiang, Zhejiang, Taizhou 318000, China
(Zhang) Department of ICU, Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Zhejiang, Taizhou 317000, China
(Fu) Department of Radiology, Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Zhejiang, Taizhou 317000, China
(Fu) Department of Radiology, Enze Hospital, Taizhou Enze Medical Center
(Group), Zhejiang, Taizhou 318000, China
Publisher
Dove Medical Press Ltd
Abstract
Background and Purpose: To explore the feasibility of the modified blood
collection method in pre-deposit autotransfusion in patients undergoing
thoracotomy surgery. <br/>Method(s): This double-blinded randomised
controlled trial enrolled 92 patients from the cardiothoracic surgery
department from February 2019 to October 2020. <br/>Result(s): Compared
with the conventional blood collection method, the modified blood
collection method avoided blood overflow from the oblique plane of the
needle (chi² = 61.986, P < 0.01) and reduced the diameter of
the bruising area after 24 hours (chi² = 24.611, P < 0.01).
Furthermore, due to optimising the blood collection method, diastolic
blood pressure reduced slightly before and after blood collection (t =
2.036, P < 0.05), and patients in the test group had less pain (based on
the numerical rating score) (t = 5.556, P < 0.01). Meanwhile, the time
required to collect 400 mL of blood was shortened (t = 17.744, p < 0.01).
<br/>Conclusion(s): An improved blood collection method can enhance the
blood donation experience, avoid blood spillage, lessen pain and reduce
adverse reactions. This may be of great significance in ensuring blood
quality and the safety of subsequent transfusions. Clinical Trials
Registration: ClinicalTrials.gov Identifier: NCT05539846.<br/>Copyright
&#xa9; 2023 Jia et al. This work is published and licensed by Dove Medical
Press Limited.

<6>
Accession Number
2025143269
Title
Effectiveness and quality of life in lung cancer, pre-, post- and
perioperative rehabilitation - A review.
Source
Physiology International. 110(2) (pp 89-107), 2023. Date of Publication:
June 2023.
Author
Abidi Y.; Fekete M.; Farkas A.; Horvath A.; Varga J.T.
Institution
(Abidi, Varga) Department of Pulmonology, Semmelweis University, Budapest
H-1083, Hungary
(Fekete) Department of Public Health, Faculty of Medicine, Semmelweis
University, Budapest, Hungary
(Farkas) Centre for Energy Research, Budapest H-1121, Hungary
(Horvath) Chiesi Hungary Kft., Budapest H-1138, Hungary
(Varga) Department of Pulmonary Rehabilitation, National Koranyi Institute
of Pulmonology, Budapest H-1122, Hungary
Publisher
Akademiai Kiado ZRt.
Abstract
Functional conditions like lung function and exercise capacity are
important limiting factors of chest surgery in lung cancer with
co-morbidities (chronic obstructive pulmonary disease (COPD) and other
chronic respiratory diseases). Pulmonary rehabilitation has a favourable
effect on the cardiovascular system, metabolism, respiratory and
peripheral muscles and lung mechanics. Our aim was to assess the role of
pre-, post- and peri-operative pulmonary rehabilitation in lung cancer in
this review. We sought to size up the importance of pulmonary
rehabilitation in patients undergoing surgery with or without
(neo)adjuvant treatment, radiotherapy, chemotherapy, chemoradiotherapy,
major physiological impairments and complications. Searches were performed
in PubMed and ClinicalTrials.gov databases using the terms "exercise",
"rehabilitation", "small cell lung cancer", "non-small cell lung cancer",
"exercise capacity", "chest surgery"and "quality of life"from inception to
February 7th, 2022. Pulmonary rehabilitation has been recognized as an
effective intervention to reduce lung cancer related symptoms and improve
the pulmonary function, lung mechanics, chest kinematics, respiratory- and
peripheral muscle function, physical activity and quality of life (QoL) of
the patients. In conclusion, this review shows positive, highly
encouraging and effective results of pulmonary rehabilitation in terms of
the patients' lung function, functional mobility and quality of life. The
tools for complex pulmonary rehabilitation have evolved considerably over
the past two decades, thus this research has been conducted on a variety
of studies about this subject and serves as a synthesis of the systematic
and meta-analytic reviews.<br/>Copyright &#xa9; 2023 The Author(s).

<7>
Accession Number
2025066157
Title
Femoral or Axillary Cannulation for Extracorporeal Circulation during
Minimally Invasive Heart Valve Surgery (FAMI): Protocol for a Multi-Center
Prospective Randomized Trial.
Source
Journal of Clinical Medicine. 12(16) (no pagination), 2023. Article
Number: 5344. Date of Publication: August 2023.
Author
Kruse J.; Silaschi M.; Velten M.; Wittmann M.; Alaj E.; Ahmad A.E.-S.;
Zimmer S.; Borger M.A.; Bakhtiary F.
Institution
(Kruse, Silaschi, Alaj, Ahmad, Bakhtiary) Department of Cardiac Surgery,
University Hospital Bonn, Bonn 53127, Germany
(Velten, Wittmann) Department of Anesthesiology and Intensive Care
Medicine, University Hospital Bonn, Bonn 53127, Germany
(Zimmer) Department of Cardiology, University Hospital Bonn, Bonn 53127,
Germany
(Borger) Department of Cardiac Surgery, Leipzig Heart Center, Leipzig
04289, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Minimally invasive heart valve surgery via anterolateral
mini-thoracotomy with full endoscopic 3D visualization (MIS) has become
the standard treatment of patients with valvular heart disease and low
operative risk over the past two decades. It requires extracorporeal
circulation and cardioplegic arrest. The most established form of arterial
cannulation for MIS is through the femoral artery and is used by most
surgeons, but it is suspected to increase the risk of stroke through
retrograde blood flow. An alternative route of cannulation is the axillary
artery, producing antegrade blood flow during extracorporeal circulation.
<br/>Method(s): Femoral or axillary cannulation for extracorporeal
circulation during minimally invasive heart valve surgery (FAMI) is a
multicenter randomized controlled trial designed to determine whether
axillary cannulation is superior to femoral cannulation for the outcome of
a manifest stroke within 7 days postoperatively. The target sample size
was 848 participants. Patients >= 18 years of age, with valvular
regurgitation or stenosis scheduled for minimally invasive surgery via
anterolateral mini-thoracotomy, were randomized to axillary cannulation
(treatment group) or to femoral cannulation (standard care). Patients were
followed up for seven days postoperatively. A CT scan was performed
pre-operatively to screen patients for vascular calcifications and to
assess the safety of femoral cannulation. The standard of care is femoral
artery cannulation, but is performed only in patients without significant
vascular calcifications or severe kinking of the iliac arteries and in
patients with sufficient vessel diameter. The cannulation is performed via
Seldinger's technique, and the vessel closed percutaneously using a
plug-based vascular closure device. Only patients without significant
vascular calcifications are considered for femoral cannulation, as an
increased risk of stroke is assumed. In patients with vascular
calcifications, axillary cannulation is the standard of care to avoid
these risks. Retrospective studies have hinted that, even in patients
without vascular calcifications, there may be a lower stroke risk with
axillary cannulation compared to femoral cannulation. We present a
protocol for a multi-center randomized trial to investigate this
hypothesis. <br/>Discussion(s): To date, evidence on the best access for
peripheral artery cannulation during minimally invasive heart valve
surgery has been scarce. Patients may benefit from axillary cannulation
for extracorporeal circulation in terms of stroke risk and other
neurological and vascular complications, though femoral cannulation is the
gold standard. The aim of this study is to determine the risks of
peri-operative stroke in a prospective randomized comparison of femoral
vs. axillary cannulation.<br/>Copyright &#xa9; 2023 by the authors.

<8>
Accession Number
2024564686
Title
Aortic Thrombosis in Patients on Mechanical Circulatory Support: A
Systematic Literature Review.
Source
Heart Lung and Circulation. 32(8) (pp 926-937), 2023. Date of Publication:
August 2023.
Author
Guglin M.; Rao R.A.
Institution
(Guglin, Rao) Indiana University School of Medicine, Division of
Cardiovascular Disease, Krannert Institute of Cardiology, Indianapolis,
IN, United States
Publisher
Elsevier Ltd
Abstract
Background: Aortic valve (AV) thrombosis is an uncommon but ominous
complication in patients managed with mechanical circulatory support (MCS)
devices. In this systematic review, we summarised the data on clinical
presentations and outcomes in such patients. <br/>Method(s): We searched
articles on PubMed and Google Scholar, reporting at least one adult
patient with aortic thrombosis on MCS support and where the individual
patient data could be extracted. We grouped the patients by the type of
MCS (temporary or durable), and the type of the AV (prosthetic, surgically
modified, or native) Results: We identified reports on six patients with
aortic thrombus on short-term MCS, and on 41 patients on durable left
ventricular assist devices (LVADs). On temporary MCS, AV thrombus
typically causes no symptoms and is found incidentally pre- or
intra-operatively. For those with durable MCS, the occurrence of aortic
thrombus forming on prosthetic or surgically modified valves appears to be
more related to the intervention on the valve, rather than from the
presence of LVAD. The mortality in this group was 18%. In patients with
native AV on durable LVAD support, 60% of patients presented with acute
myocardial infarction, acute stroke, or acute heart failure, and mortality
in this cohort was 45%. In terms of management, heart transplantation was
most successful. <br/>Conclusion(s): While the outcomes of aortic
thrombosis were good in patients where temporary MCS was used in the
setting of aortic valve surgery, patients with native AV who develop this
complication on durable LVAD have high morbidity and mortality. Cardiac
transplantation should be strongly considered in eligible candidates
because other therapies provide inconsistent results.<br/>Copyright &#xa9;
2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<9>
Accession Number
2026068005
Title
Outcomes of Chylothorax Nonoperative Management After Cardiothoracic
Surgery: A Systematic Review and Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 38(6) (no pagination), 2023.
Article Number: 20220326. Date of Publication: 2023.
Author
Dos Santos L.L.; Dos Santos C.L.; Hu N.K.T.; Datrino L.N.; Tavares G.;
Tristao L.S.; Orlandini M.F.; Serafim M.C.A.; Tustumi F.
Institution
(Dos Santos, Tustumi) Departament of Gastroenterology, Faculdade de
Medicina, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
(Dos Santos, Hu, Datrino, Tavares, Tristao, Orlandini, Serafim)
Departament of Evidence-Based Medicine, Faculdade de Medicina, Centro
Universitario Lusiada, Sao Paulo, Santos, Brazil
(Orlandini) Departament of Evidence-Based Medicine, Oya Care, Sao Paulo,
Sao Paulo, Brazil
(Tustumi) Departament of Health Sciences, Faculdade de Medicina, Hospital
Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Chylothorax after thoracic surgery is a severe complication
with high morbidity and mortality rate of 0.10 (95% confidence interval
[CI] 0.06 - 0.02). There is no agreement on whether nonoperative treatment
or early reoperation should be the initial intervention. This systematic
review and meta-analysis aimed to evaluate the outcomes of the
conservative approach to treat chyle leakage after cardiothoracic
surgeries. <br/>Method(s): A systematic review was conducted in PubMed,
Embase, Cochrane Library Central, and LILACS (Biblioteca Virtual em Saude)
databases; a manual search of references was also done. The inclusion
criteria were patients who underwent cardiothoracic surgery, patients who
received any nonoperative treatment (e.g., total parenteral nutrition,
low-fat diet, medium chain triglycerides), and studies that evaluated
chylothorax resolution, length of hospital stay, postoperative
complications, infection, morbidity, and mortality. <br/>Result(s):
Twenty-two articles were selected. Pulmonary complications, infections,
and arrhythmia were the most common complications after surgical
procedures. The incidence of chylothorax in cardiothoracic surgery was
1.8% (95% CI 1.7 - 2%). The mean time of maintenance of the chest tube was
16.08 days (95% CI 12.54 - 19.63), and the length of hospital stay was
23.74 days (95% CI 16.08 - 31.42) in patients with chylothorax receiving
nonoperative treatment. Among patients that received conservative
treatment, the morbidity event was 0.40 (95% CI 0.23 - 0.59), and
reoperation rate was 0.37 (95% CI 0.27 - 0.49). Mortality rate was 0.10
(95% CI 0.06 - 0.02). <br/>Conclusion(s): Nonoperative treatment for
chylothorax after cardiothoracic procedures has significant hospital stay,
morbidity, mortality, and reoperation rates.<br/>Copyright &#xa9; 2023,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<10>
Accession Number
358465629
Title
Cryoanalgesia of intercostal nerves following thoracotomy: Clinical trial
based on animal experiment.
Source
Neural Regeneration Research. 4(12) (pp 1083-1087), 2009. Date of
Publication: December 2009.
Author
Ma Y.; Liu Y.; Zuo J.
Institution
(Ma, Liu) Department of Thoracic Surgery, General Hospital of the People's
Liberation Army, Beijing 100853, China
(Zuo) Department of Thoracic Surgery, Military General Hospital of Beijing
PLA, Beijing 100700, China
Publisher
Editorial Board of Neural Regeneration Research
Abstract
BACKGROUND: Cryoanalgesia at -50 degreeC for 90 seconds yields effective
pain relief following thoracotomy. In China, -50 degreeC is a common
temperature for intercostal cryoanalgesia following thoracotomy. However,
experimental results vary. <br/>OBJECTIVE(S): To explore intercostal nerve
pathological changes at -70 degreeC for various freezing times by studying
canines, and to evaluate long-term clinical efficacy of intercostal nerve
cryoanalgesia for postoperative pain relief based on the animal
experiments. DESIGN, TIME AND SETTING: A comparative animal study was
performed at the Animal Experimental Center of the General Hospital of the
People's Liberation Army. Based on results from the animal study, a
randomized, controlled, clinical trial was performed at the Department of
Thoracic Surgery of the General Hospital of the People's Liberation Army
between October 2006 and October 2008. PARTICIPANTS: A total of 120
patients undergoing posterolateral single incision lobectomy at the
Department of Thoracic Surgery of PLA General Hospital between October
2006 and October 2008 were selected. Nervous system diseases were
excluded. <br/>METHOD(S): Animal experiment: 8 anaesthetized, mixed-breed
dogs were used. The intercostal nerves (costal bone 6-10) were frozen at
-70 degreeC for varying times (30, 60, 90, 120, and 180 seconds). Clinical
study: 120 patients were randomly assigned to 2 groups (n = 60). In the
cryoanalgesia group, the intercostal nerves were frozen prior to chest
closure, and 4 costal nerves (1 at incision level, 2 above and below
incision, and 1 at drainage tube level) were frozen for 90 seconds at -70
degreeC, respectively. Intercostal nerves were not frozen in the control
group patients. Dolantin was used to relieve postoperative pain in
patients from both groups. MAIN OUTCOME MEASURES: Pathological changes in
frozen intercostal nerves were examined at days 1, 10, 30, and 60
following freezing. Following surgery, the degree of postoperative pain in
all patients was evaluated by visual analogue scale at days 1, 3, 5, 9,
30, 60, 90, and 180. Dolantin doses at days 1, 3, 5, 9 post-surgery and
postoperative complications were noted. <br/>RESULT(S): Nerve damage
progressively increased with length of freezing time at -70 degreeC, and
recovery time from damage was gradually increased. After freezing for 90
seconds, the nerves exhibited obvious histopathological damage, and then
completely recovered. In addition, after freezing for 180 seconds, the
histopathological changes in nerves were reversible. In the clinical
study, visual analogue scale scores were significantly less in the
cryoanalgesia group compared with the control group (P < 0.01), which was
maintained over 30 days. In the cryoanalgesia group, the mean dolantin
dose administered and postoperative complications were significantly
reduced compared with the control group (P < 0.01). <br/>CONCLUSION(S):
Freezing of the intercostal nerve at -70 degreeC for 90 seconds is a safe
and long-term effective method for relieving post-thoracotomy pain.

<11>
Accession Number
2027597414
Title
The efficacy of inspiratory muscle training in patients with coronary
artery disease: Protocol for a systematic review and meta-analysis.
Source
PLoS ONE. 18(9 September) (no pagination), 2023. Article Number: e0289287.
Date of Publication: September 2023.
Author
Kadoya Y.; Balamane S.; Visintini S.; Chow B.
Institution
(Kadoya, Balamane, Visintini) Division of Cardiology, University of Ottawa
Heart Institute, Ottawa, ON, Canada
(Balamane) Faculty of Health Sciences, Queen's University, Kingston, ON,
Canada
(Chow) Berkman Library, University of Ottawa Heart Institute, Ottawa, ON,
Canada
Publisher
Public Library of Science
Abstract
Background Inspiratory muscle training (IMT) has been recognized as an
effective form of training in patients with cardiovascular disease and
heart failure. However, little is known about the efficacy of IMT in the
treatment of patients with coronary artery disease (CAD). The aim of this
systematic review will be to evaluate randomized controlled studies to
understand the effect of IMT on CAD patients. Method We will include
randomized controlled trials evaluating the efficacy of IMT in patients 18
years and older diagnosed with CAD. Crossover trials, cluster-randomized,
quasi-randomized, and non-randomized trials will be excluded. Study search
will be conducted in major databases (MEDLINE, the Cochrane Central
Register of Controlled Trials, Embase, and PEDro). The study intervention
will be IMT independent of the duration, frequency, or intensity of
training. The primary outcome will be quality of life, patient-reported
health status, and all adverse events related to IMT. Secondary outcomes
will include exercise capacity and respiratory muscle strength. The risk
of bias will be evaluated based on the Cochrane Risk of Bias tool.
Screening, data extraction, and quality assessment will be performed by
two independent reviewers. If two or more studies are considered to be
clinically homogeneous, a meta-analysis based on the random-effects model
will be performed. The quality of evidence will be evaluated based on the
GRADE approach. Conclusion This systematic review will improve our
understanding of the effects of IMT on CAD patients and potentially
establish IMT as an alternative form of exercise training for the
treatment of CAD.<br/>Copyright: &#xa9; 2023 Kadoya et al.

<12>
Accession Number
2027537872
Title
Flow-controlled versus pressure-controlled ventilation in cardiac surgery
with cardiopulmonary bypass - A single-center, prospective, randomized,
controlled trial.
Source
Journal of Clinical Anesthesia. 91 (no pagination), 2023. Article Number:
111279. Date of Publication: December 2023.
Author
Spraider P.; Abram J.; Martini J.; Putzer G.; Glodny B.; Hell T.; Barnes
T.; Enk D.
Institution
(Spraider, Abram, Martini, Putzer) Department of Anaesthesiology and
Intensive Care Medicine, Medical University of Innsbruck, Anichstrasse 35,
Innsbruck 6020, Austria
(Glodny) Department of Radiology, Medical University of Innsbruck,
Anichstrasse 35, Innsbruck 6020, Austria
(Hell) Department of Mathematics, Faculty of Mathematics, Computer Science
and Physics, University of Innsbruck, Technikerstrasse 15, Innsbruck 6020,
Austria
(Barnes) University of Greenwich, Old Royal Naval College, Park Row,
London SE109LS, United Kingdom
(Enk) Faculty of Medicine, University of Munster, Albert-Schweitzer-Campus
1, Munster 48149, Germany
Publisher
Elsevier Inc.
Abstract
Study objective: Multifactorial comparison of flow-controlled ventilation
(FCV) to standard of pressure-controlled ventilation (PCV) in terms of
oxygenation in cardiac surgery patients after chest closure.
<br/>Design(s): Prospective, non-blinded, randomized, controlled trial.
<br/>Setting(s): Operating theatre at an university hospital, Austria.
<br/>Patient(s): Patients scheduled for elective, open, on-pump, cardiac
surgery. <br/>Intervention(s): Participants were randomized to either
individualized FCV (compliance guided end-expiratory and peak pressure
setting) or control of PCV (compliance guided end-expiratory pressure
setting and tidal volume of 6-8 ml/kg) for the duration of surgery.
Measurements: The primary outcome measure was oxygenation
(PaO<inf>2</inf>/FiO<inf>2</inf>) 15 min after intraoperative chest
closure. Secondary endpoints included CO<inf>2</inf>-removal assessed as
required minute volume to achieve normocapnia and lung tissue aeration
assessed by Hounsfield unit distribution in postoperative computed
tomography scans. <br/>Main Result(s): Between April 2020 and April 2021
56 patients were enrolled and 50 included in the primary analysis (mean
age 70 years, 38 (76%) men). Oxygenation, assessed by
PaO<inf>2</inf>/FiO<inf>2</inf>, was significantly higher in the FCV group
(n = 24) compared to the control group (PCV, n = 26) (356 vs. 309, median
difference (MD) 46 (95% CI 3 to 90) mmHg; p = 0.038). Additionally, the
minute volume required to obtain normocapnia was significantly lower in
the FCV group (4.0 vs. 6.1, MD -2.0 (95% CI -2.5 to -1.5) l/min; p <
0.001) and correlated with a significantly lower exposure to mechanical
power (5.1 vs. 9.8, MD -5.1 (95% CI -6.2 to -4.0) J/min; p < 0.001).
Evaluation of lung tissue aeration revealed a significantly reduced amount
of non-aerated lung tissue in FCV compared to PCV (5 vs. 7, MD -3 (95% CI
-4 to -1) %; p < 0.001). <br/>Conclusion(s): In patients undergoing
on-pump, cardiac surgery individualized FCV significantly improved
oxygenation and lung tissue aeration compared to PCV. In addition, carbon
dioxide removal was accomplished at a lower minute volume leading to
reduced applied mechanical power.<br/>Copyright &#xa9; 2023 The Authors

<13>
Accession Number
2027159776
Title
Secondary analysis of REPRISE III trial: The Lotus valve's persistence
after withdrawal.
Source
Global Cardiology Science and Practice. 2023(4) (no pagination), 2023.
Date of Publication: 2023.
Author
Kotit S.
Institution
(Kotit) Aswan Heart Centre, Aswan, Egypt
Publisher
HBKU Press
Abstract
Introduction: Aortic stenosis (AS) is the leading heart valve disease in
developed countries, often caused by calcific degeneration. In
low-and-middle-income countries, it's primarily due to RHD. Prevalence of
AS increases with age and up to 22.8% of those affected over the age of
75. While surgical aortic valve replacement is standard treatment for AS,
many older individuals are not ideal candidates. Transcatheter aortic
valve replacement (TAVR) offers an alternative. The REPRISE III trial
showed the Lotus valve outperformed the CoreValve/EvolutR TAVR valves in
various metrics over 2 years. Despite its success and over 10,000
implantations, the Lotus valve was pulled from the market, highlighting
the need to understand its long-term outcomes. Study and results: In the
REPRISE III trial, the long-term outcomes of TAVR using the Lotus valve
were compared to the CoreValve/EvolutR over 5 years across 55 global
centers. Of the participants, 581 (95.7%) used the Lotus valve and 285
(93.4%) used CoreValve/EvolutR. Event rates for all-cause mortality were
similar between the groups, but the Lotus valve group had lower rates of
disabling stroke and pacemaker implantation. The Lotus valve showed a
higher aortic gradient but lower effective orifice area. Additionally, the
Lotus valve had reduced mild PVL, valve malpositioning, and the need for a
second valve. Both groups showed comparable long-term improvements in
heart and cardiomyopathy assessments. Lessons learned: The REPRISE III
analysis highlights the favourable long-term outcomes of the Lotus valve
and CoreValve/EvolutR for high-risk surgical patients. These findings
underscore the importance of ongoing management post-valve procedure and
the potential advantages of the Lotus valve design. Further studies
comparing these valves to surgery will inform aortic stenosis management
and potentially expand TAVR indications. The future goal is to develop a
tissue-engineered living heart valve to improve survival and quality of
life.<br/>Copyright &#xa9; 2023 Bloomsbury Qatar Foundation Journals. All
rights reserved.

<14>
Accession Number
2026169733
Title
Evolut PRO/PRO+ versus Evolut R system for transcatheter aortic valve
replacement.
Source
International Journal of Cardiology. 389 (no pagination), 2023. Article
Number: 131196. Date of Publication: 15 Oct 2023.
Author
Bhogal S.; Rogers T.; Merdler I.; Reddy P.; Ali S.; Shea C.; Zhang C.;
Ben-Dor I.; Satler L.F.; Waksman R.
Institution
(Bhogal, Rogers, Merdler, Reddy, Ali, Shea, Zhang, Ben-Dor, Satler,
Waksman) Section of Interventional Cardiology, MedStar Washington Hospital
Center, Washington, DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: The self-expanding CoreValve Evolut PRO/PRO+ transcatheter
aortic valve was designed to overcome the limitations of its forerunner,
Evolut R. Evolut PRO/PRO+ offers the lowest delivery profile for 23-29 mm
valves, with an external tissue wrap on all valve sizes. We compared
safety and efficacy of Evolut PRO/PRO+ and Evolut R. <br/>Method(s): We
analyzed 300 patients enrolled in the EPROMPT Registry against a
historical control cohort of 242 patients who received Evolut R. The two
arms were matched (1:1) via propensity-score methodology by accounting for
differences in Society of Thoracic Surgeons Predicted Risk of Mortality
scores, yielding 440 patients. The endpoints included in-hospital safety
clinical outcomes, all-cause mortality, and echocardiographic parameters
at 30 days and 1 year. <br/>Result(s): After propensity-score matching,
cardiac death (0.5% vs. 0.5%, p = 0.995), stroke (1.6% vs. 2.8%, p =
0.410), life-threatening bleeding (1.1% vs. 3.3%, p = 0.139), major
vascular complications (0.5% vs. 0.9%, p = 0.653), and pacemaker
implantation (16.9% vs. 13.6%, p = 0.345) were comparable between the
Evolut PRO/PRO+ and Evolut R groups. Likewise, the rates of all-cause
mortality were similar both at 30 days (0.5% vs. 1.4%, p = 0.315) and 1
year (1.8% vs. 4.1%, p = 0.159). The rates of moderate paravalvular leak
(5.7% vs. 2.6%, p = 0.402), and mean gradient (7.27 +/- 3.25 mmHg vs. 8.84
+/- 4.36 mmHg, p = 0.105) were also comparable between groups at 1 year.
<br/>Conclusion(s): Our largest-to-date observational study suggests that
the Evolut PRO/PRO+ system is safe and effective in treating severe aortic
stenosis, with commensurate 30-day and 1-year mortality and similar 1-year
echocardiographic hemodynamic outcomes in comparison to Evolut
R.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<15>
Accession Number
2025928230
Title
Long-Term Outcomes of Patients Undergoing Aortic Root Replacement With
Mechanical Versus Bioprosthetic Valves: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. 12(18) (no pagination), 2023.
Article Number: e030629. Date of Publication: 19 Sep 2023.
Author
Sa M.P.; Tasoudis P.; Jacquemyn X.; Eynde J.V.D.; Caranasos T.G.;
Ikonomidis J.S.; Chu D.; Serna-Gallegos D.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Tasoudis, Caranasos, Ikonomidis) Division of Cardiothoracic Surgery,
Department of Surgery, University of North Carolina, Chapel Hill, NC,
United States
(Jacquemyn, Eynde) Department of Cardiovascular Sciences, KU Leuven,
Leuven, Belgium
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: An aspect not so clear in the scenario of aortic surgery is
how patients fare after composite aortic valve graft replacement (CAVGR)
depending on the type of valve (bioprosthetic versus mechanical). We
performed a study to evaluate the long-term outcomes of both strategies
comparatively. METHODS AND RESULTS: Pooled meta-analysis of Kaplan-Meier-
derived time-to-event data from studies with follow-up for overall
survival (all-cause death), event-free survival (composite end point of
cardiac death, valve-related complications, stroke, bleeding, embolic
events, and/or endocarditis), and freedom from reintervention.
Twenty-three studies met our eligibility criteria, including 11 428
patients (3786 patients with mechanical valves and 7642 patients with
bioprosthetic valve). The overall population was mostly composed of men
(mean age, 45.5-75.6 years). In comparison with patients who underwent
CAVGR with bioprosthetic valves, patients undergoing CAVGR with mechanical
valves presented no statistically significant difference in the risk of
all-cause death in the first 30 days after the procedure (hazard ratio
[HR], 1.24 [95% CI, 0.95-1.60]; P=0.109), but they had a significantly
lower risk of all-cause mortality after the 30-day time point (HR, 0.89
[95% CI, 0.81- 0.99]; P=0.039) and lower risk of reintervention (HR, 0.33
[95% CI, 0.24- 0.45]; P<0.001). Despite its increased risk for the
composite end point in the first 6 years of follow-up (HR, 1.41 [95% CI,
1.09-1.82]; P=0.009), CAVGR with mechanical valves is associated with a
lower risk for the composite end point after the 6-year time point (HR,
0.46 [95% CI, 0.31- 0.67]; P<0.001). <br/>CONCLUSION(S): CAVGR with
mechanical valves is associated with better long-term outcomes in
comparison with CAVGR with bioprosthetic valves.<br/>Copyright &#xa9; 2023
The Authors. Published on behalf of the American Heart Association, Inc.,
by Wiley.

<16>
Accession Number
2025581911
Title
The Academic Impact of Congenital Heart Surgeons' Society (CHSS) Studies.
Source
World Journal for Pediatric and Congenital Heart Surgery. 14(5) (pp
602-619), 2023. Date of Publication: September 2023.
Author
Jacobs J.P.; DeCampli W.M.; Karamlou T.; Najm H.K.; Marino B.S.;
Blackstone E.H.; McCrindle B.W.; Jegatheeswaran A.; St. Louis J.D.; Austin
E.H.; Caldarone C.A.; Mavroudis C.; Overman D.M.; Dearani J.A.; Jacobs
M.L.; Tchervenkov C.I.; Svensson L.G.; Barron D.; Kirklin J.K.; Williams
W.G.
Institution
(Jacobs) Congenital Heart Center, Division of Cardiovascular Surgery,
Departments of Surgery and Pediatrics, University of Florida, Gainesville,
FL, United States
(DeCampli) Division of Pediatric Cardiac Surgery, Arnold Palmer Hospital
for Children, Orlando, FL, United States
(Karamlou, Najm, Marino, Blackstone, Svensson) Pediatric and Adult
Congenital Heart Center, Cleveland Clinic, Cleveland, OH, United States
(McCrindle) Division of Pediatric Cardiology, Hospital for Sick Children,
Toronto, ON, Canada
(Jegatheeswaran) Cardiac Unit, Great Ormond Street Hospital for Children,
London, United Kingdom
(St. Louis) Department of Cardiac Surgery, Inova Fairfax Hospital and
Inova L.J Murphy Children's Hospital, Fairfax, VA, United States
(St. Louis) Departments of Surgery and Pediatrics, Children's Hospital of
Georgia, Augusta University, Augusta, GA, United States
(Austin) Department of Cardiovascular and Thoracic Surgery, University of
Louisville, Louisville, KY, United States
(Austin) Norton Children's Hospital, Louisville, KY, United States
(Caldarone) Pediatric Cardiac Surgery, Texas Children's Hospital, Houston,
TX, United States
(Mavroudis) Pediatric Cardiothoracic Surgery, Peyton Manning Children's
Hospital, Indianapolis, IN, United States
(Mavroudis) Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Overman, Dearani) Division of Cardiovascular Surgery, Mayo
Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, MN,
United States
(Jacobs) Department of Surgery, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Tchervenkov) Division of Cardiovascular Surgery, The Montreal Children's
Hospital, McGill University Health Centre, Montreal, QC, Canada
(Barron, Williams) Division of Cardiovascular Surgery, Hospital for Sick
Children, Toronto, ON, Canada
(Kirklin) Kirklin Institute for Research in Surgical Outcomes, Birmingham,
AL, United States
Publisher
SAGE Publications Inc.
Abstract
Purpose: We reviewed all 64 articles ever published by The Congenital
Heart Surgeons' Society (CHSS) Data Center to estimate the academic impact
of these peer-reviewed articles. <br/>Material(s) and Method(s): The
Congenital Heart Surgeons' Society has performed research based on 12
Diagnostic Inception Cohorts. The first cohort (Transposition) began
enrolling patients on January 1, 1985. We queried PubMed to determine the
number of publications that referenced each of the 64 journal articles
generated by the datasets of the 12 Diagnostic Inception Cohorts that
comprise the CHSS Database. Descriptive summaries of the data were
tabulated using mean with standard deviation and median with range.
<br/>Result(s): Sixty-four peer-reviewed papers have been published based
on the CHSS Database. Fifty-nine peer-reviewed articles have been
published based on the 12 Diagnostic Inception Cohorts, and five
additional articles have been published based on Data Science. Excluding
the recently established Diagnostic Inception Cohort for patients with
Ebstein malformation of tricuspid valve, the number of papers published
per cohort ranged from 1 for coarctation to 11 for transposition of the
great arteries. The 11 articles generated from the CHSS Transposition
Cohort were referenced by a total of 111 articles (median number of
references per journal article = 9 [range = 0-22, mean = 10.1]). Overall,
individual articles were cited by an average of 11 (mean), and a maximum
of 41 PubMed-listed publications. Overall, these 64 peer-reviewed articles
based on the CHSS Database were cited 692 times in PubMed-listed
publications. The first CHSS peer-reviewed article was published in 1987,
and during the 35 years from 1987 to 2022, inclusive, the annual number of
CHSS publications has ranged from 0 to 7, with a mean of 1.8 publications
per year (median = 1, mode = 1). <br/>Conclusion(s): Congenital Heart
Surgeons' Society studies are widely referenced in the pediatric cardiac
surgical literature, with over 10 citations per published article. These
cohorts provide unique information unavailable in other sources of data. A
tool to access this analysis is available at:
[https://data-center.chss.org/multimedia/files/2022/CAI.pdf].<br/>Copyrigh
t &#xa9; The Author(s) 2023.

<17>
Accession Number
2025326884
Title
Bariatric surgery and left ventricular assist device in patients with
heart failure: A systematic review and meta-analysis.
Source
American Journal of Surgery. 226(3) (pp 340-349), 2023. Date of
Publication: September 2023.
Author
Sharma I.; Nakanishi H.; Hage K.; Marrero K.; Diwan T.S.; daSilva-deAbreu
A.; Davis Jr S.S.; Clapp B.; Ghanem O.M.
Institution
(Sharma, Hage, Ghanem) Department of Surgery, Mayo Clinic, Rochester, MN,
United States
(Nakanishi) St George's University of London, London SW17 0RE, United
Kingdom
(Marrero) Carle Foundation Hospital General Surgery Residency, Champaign,
IL, United States
(Diwan) Division of Transplantation, Department of Surgery, Mayo Clinic,
Rochester, MN, United States
(daSilva-deAbreu) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Davis Jr) Department of Surgery, Emory University School of Medicine,
Atlanta, GA, United States
(Clapp) Department of Surgery, Texas Tech HSC Paul Foster School of
Medicine, El Paso, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of metabolic and bariatric surgery (MBS), in synergy
with left ventricular assist device (LVAD) implantation, in the scope of
end-stage heart failure management for patients with severe obesity is not
well elucidated. <br/>Method(s): We conducted a meta-analysis using
Cochrane, Embase, PubMed, and Scopus databases to include articles from
their inception to November 2022. <br/>Result(s): A total of 271 patients
who underwent MBS during or after the LVAD implantation were included from
eleven separate studies. After surgery, 67.4% of patients were listed on
the heart transplant waitlist with 32.5% undergoing a successful
transplant. We reported a mean listing time of 13.8 months. Finally, the
pooled postoperative complication rate, 30-day readmission rate, and
one-year mortality rate were 47.6%, 23.6% and 10.2% respectively.
<br/>Conclusion(s): MBS and LVAD is a safe and effective approach to
bridge patients with severe obesity and end-stage heart failure for
definitive heart transplantation.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<18>
Accession Number
2027552228
Title
GlideScope versus C-MAC D-blade videolaryngoscope for double-lumen tube
intubation in patients with anticipated difficult airways: A multi-center,
prospective, randomized, controlled trial.
Source
Journal of Clinical Anesthesia. 91 (no pagination), 2023. Article Number:
111274. Date of Publication: December 2023.
Author
Huang P.; Qiu Y.; Xu T.; Sun X.; Lu Z.; Zhang Y.; Yu J.; Wu J.; Su D.;
Huang Z.
Institution
(Huang, Sun, Lu, Su, Huang) Department of Anesthesiology, Renji Hospital,
Shanghai Jiaotong University School of Medicine, Shanghai, China
(Qiu, Zhang, Wu) Department of Anesthesiology, Shanghai Chest Hospital,
Shanghai Jiaotong University School of Medicine, Shanghai, China
(Xu, Yu) Department of Anesthesiology, Sichuan Academy of Medical Science
* Sichuan Provincial People's Hospital, University of Electronic Science
and Technology of China, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Study objective: Videolaryngoscopes are widely used to visualize difficult
airways. Our aim was to compare the GlideScope and C-MAC D-blade
videolaryngoscopes for double-lumen tube (DLT) intubation in patients with
difficult airways. <br/>Design(s): A multi-center, prospective, randomized
controlled trial. <br/>Setting(s): Three comprehensive tertiary,
high-volume hospitals from 5 December 2020 to 4 November 2021.
<br/>Patient(s): We included 348 adult patients with anticipated difficult
airways who underwent elective thoracic surgery. <br/>Intervention(s):
Patients were randomized into two groups: GlideScope and C-MAC D-blade.
Following anesthesia induction, DLT intubation was performed using
different videolaryngoscopes. Measurements: The primary outcome was the
first-pass success rate of DLT intubation. All other results were recorded
as secondary outcomes. <br/>Main Result(s): No significant differences
were observed in the first-pass success rate of DLT intubation between the
GlideScope and C-MAC D-blade (86.21% and 89.66%, respectively; P = 0.323).
However, compared with the GlideScope, the C-MAC D-blade provided a lower
Cormack-Lehane grade (P < 0.001), lower rates of external laryngeal
pressure (48 vs. 15, P < 0.001), and postprocedure sore throat (26 vs. 8,
P < 0.001). The numerical rating score for difficulty of videolaryngoscope
insertion into the oral cavity, delivery to the glottis, and intubation
into the main bronchus were significantly lower when using the C-MAC
D-blade (P < 0.001). Moreover, the duration of DLT intubation was shorter
in the C-MAC D-blade group (81 s [70-97 s] vs. 95 s [78-115 s], P <
0.001). In each group, two patients underwent fiberoptic intubation after
three attempts with a videolaryngoscope failed. <br/>Conclusion(s): In
patients with difficult airways, the GlideScope and C-MAC D-blade provided
a similar success rate on the first DLT intubation attempt; however, the
C-MAC D-blade offers a better glottic view, easier and faster intubation,
and lower incidence of sore throat.<br/>Copyright &#xa9; 2023

<19>
Accession Number
2025588590
Title
Invited commentary on Kowalewski M, Pasierski M, Makhoul M, et al. Topical
vancomycin for sternal wound infection prophylaxis. A systematic review
and updated meta-analysis of over 40,000 cardiac surgery patients.
Source
Surgery (United States). 174(5) (pp 1113), 2023. Date of Publication:
November 2023.
Author
Sellke F.W.
Institution
(Sellke) Division of Cardiothoracic Surgery, Alpert Medical School of
Brown University and Rhode Island Hospital, Providence, RI, United States
Publisher
Elsevier Inc.

<20>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<21>
Accession Number
2027674712
Title
On-Pump and Off-Pump Coronary Artery Bypass Grafting on 10-Year Mortality
Versus Percutaneous Coronary Intervention.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2023.
Washington, DC United States. 53(Supplement) (pp S43-S44), 2023. Date of
Publication: August 2023.
Author
Serruys P.W.; Kageyama S.; Ninomiya K.; O'Leary N.; Masuda S.; Kotoku N.;
Colombo A.; van Geuns R.-J.; Milojevic M.; Mack M.J.; Soo A.; Garg S.;
Onuma Y.
Institution
(Serruys, Kageyama, Ninomiya, O'Leary, Masuda, Kotoku, Soo, Onuma)
University of Galway, Galway, Ireland
(Colombo) Humanitas University, Rozzano-Milan, Italy
(van Geuns) Radboud University Medical Centre, Nijmegen, Netherlands
(Milojevic) Erasmus University Medical Centre, Rotterdam, Netherlands
(Mack) Baylor University Medical Center, Dallas, TX, United States
(Garg) Royal Blackburn Hospital, Blackburn, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objective: This study aims to investigate the impact of on-pump and
off-pump coronary artery bypass grafting (CABG) versus percutaneous
coronary intervention (PCI) on 10-year all-cause mortality.
<br/>Background(s): The very long-term mortality of off-pump and on-pump
CABG versus PCI in a randomized complex coronary artery disease (CAD)
population is unknown. <br/>Method(s): The SYNTAXES trial randomized 1800
patients with three-vessel and/or left main CAD to PCI or CABG and
assessed their survival at 10 years. In this sub-study, the hazard of
mortality over 10 years was compared according to the technique of
revascularization: on-pump CABG (n=725), off-pump CABG (n=128), and PCI
(n=903). <br/>Result(s): There was substantial inter-site variation in the
use of off-pump CABG despite baseline characteristics being largely
homogeneous amongst the three groups. The crude rate of mortality was
significantly lower following on-pump CABG versus PCI (25.6% vs 28.4%,
Hazard Ratio [HR] 0.79, 95% Confidence Interval [CI] 0.65-0.96), whilst it
was comparable between off-pump CABG and PCI (28.5% vs 28.4%, HR 0.98,
95%CI 0.69-1.40). After adjusting for the nine variables included in the
SYNTAX score II 2020, 10-year mortality remained significantly lower with
on-pump CABG than PCI (HR 0.75 against PCI, p=0.009). <br/>Conclusion(s):
In the SYNTAXES trial, 10-year mortality adjusted for major confounders
was significantly lower following on-pump CABG compared to PCI, whilst
off-pump CABG offered no prognostic survival benefit over PCI. Site
heterogeneity in the technique used in bypass surgery has had measurable
effects on treatment performance. Given its impact on outcomes, it should
be pre-stratified in future studies. [Formula presented]<br/>Copyright
&#xa9; 2023

<22>
Accession Number
2027674700
Title
Impact of Calcified Nodules on 2-Year Clinical Outcomes After IVL-Assisted
Coronary Stenting: Pooled Analysis From the DISRUPT CAD OCT Sub-Studies.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2023.
Washington, DC United States. 53(Supplement) (pp S10), 2023. Date of
Publication: August 2023.
Author
Shlofmitz R.A.; Saito S.; Honton B.; Riley R.F.; Hill J.; Ali Z.A.;
Maehara A.; Stone G.W.; Kereiakes D.J.
Institution
(Shlofmitz, Ali) St. Francis Hospital, Roslyn, NY, United States
(Saito) Shonankamakura General Hospital, Kamakura, Japan
(Honton) Clinique Pasteur, Toulouse, France
(Riley) Overlake Clinics, Bellevue, WA, United States
(Hill) Royal Brompton Hospital, London, United Kingdom
(Maehara) Cardiovascular Research Foundation, New York, NY, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Kereiakes) The Christ Hospital and the Lindner Research Center,
Cincinnati, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Calcified nodules (CN) have been associated with stent
under-expansion and worse long-term outcomes after percutaneous coronary
intervention (PCI). Consistent stent expansion and minimum stent area
(MSA) following intravascular lithotripsy (IVL) (Shockwave Medical, Santa
Clara, CA, USA) have been previously demonstrated in lesions with and
without calcified nodules. However, the long-term clinical impact of these
acute findings has not been reported. <br/>Method(s): Individual
patient-level follow-up data (N=155) were pooled from the Disrupt CAD III
and IV optical coherence tomography (OCT) sub-studies and were analysed
for the presence of CN by an independent OCT core laboratory.
CEC-adjudicated target lesion failure (TLF), major adverse cardiac events
(MACE), and stent thrombosis (ST) event rates at 2 years in lesions with
(N=29) and without (N=126) CN were assessed. <br/>Result(s): At 2 years,
TLF rates were 13.9% and 8.0% in the CN and non-CN group, respectively
(p=0.32), driven by target-vessel MI in both groups (TV-MI: 13.9% vs 7.2%
respectively, p=0.24) with low rates of ischemia-driven target lesion
revascularization (ID-TLR: 6.9% vs 2.4% respectively, p=0.21). The MACE
rates were 20.8% vs 11.2%, respectively (p=0.17). Stent thrombosis
(definite or probable) occurred in one patient in the CN group and in no
patients in the non-CN group. <br/>Conclusion(s): IVL treatment of CN
prior to stent implantation resulted in favorable clinical outcomes to 2
years. The rates of TLF and MACE in lesions with CN were acceptable given
the challenging lesion subset, with only one stent thrombosis event in the
CN cohort and low ID-TLR rates at 2 years. Larger studies and additional
analyses are needed to confirm these findings and to elucidate the factors
contributing to long-term clinical events in patients treated with
coronary IVL.<br/>Copyright &#xa9; 2023

<23>
Accession Number
2027674697
Title
TAVR in Intermediate-Risk Patients: 5-Year Outcomes From the SURTAVI
Continued Access Study.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2023.
Washington, DC United States. 53(Supplement) (pp S99-S100), 2023. Date of
Publication: August 2023.
Author
Mahoney P.; Newton J.; Gada H.; Mumtaz M.; Williams M.; Waksman R.; Bafi
A.; Fail P.; Netherland D.; Davis T.; Batra S.; Chhim R.; Verdoliva S.;
Reardon M.J.
Institution
(Mahoney, Newton) Sentara Norfolk General Hospital, Norfolk, VA, United
States
(Gada, Mumtaz) UPMC Pinnacle Health, Harrisburg, PA, United States
(Williams) NYU Langone Medical Center, New York, NY, United States
(Waksman, Bafi) MedStar Washington Hospital Center, Washington, DC
(Fail, Netherland) Terrebonne General Medical Center, Houma, LA, United
States
(Davis, Batra) Saint John Hospital and Medical Center, Detroit, MI, United
States
(Chhim) North American Science Associates, Chicago, IL, United States
(Verdoliva) Medtronic, Minneapolis, MN, United States
(Reardon) Houston Methodist Hospital, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The Surgical Replacement and Transcatheter Aortic Valve
Implantation Continued Access Study (SURTAVI CAS) evaluated the safety and
effectiveness of transcatheter aortic valve replacement (TAVR) in patients
with severe symptomatic aortic stenosis (AS) at intermediate surgical
risk. Long-term follow-up data after TAVR are limited, and the objective
of this analysis is to report 5-year outcomes for these patients.
<br/>Method(s): SURTAVI CAS was designed as a single-arm prospective,
multicenter, non-randomized phase of the primary SURTAVI randomized
controlled trial. Patients enrolled in CAS were selected based on detailed
inclusion and exclusion criteria and assigned to TAVR with either the
CoreValve or Evolut R device (Medtronic, Mpls, MN). The primary endpoint
was the composite of all-cause mortality or disabling stroke at 2 years.
Prespecified secondary endpoints were also defined, and echocardiographic
assessment of hemodynamics and measurements of health status and quality
of life were included. Echocardiograms were assessed by a central core
laboratory. Patients were followed through 5 years. <br/>Result(s): A
total of 275 patients underwent an attempted TAVR at 44 investigational
sites in the U.S. Mean age was 79.0+/-6.1 years, and 46.2% were male. At
baseline, most patients were in New York Heart Association class II
(54.5%) or III (42.9%), and the mean Society of Thoracic Surgeons
predicted risk of mortality score was 4.1+/-1.5%. Study compliance through
five years was 88.6% for follow-up visits. At 5-year follow-up, the rate
of all-cause mortality or disabling stroke was 29.9% (all-cause mortality,
29.2%; disabling stroke, 3.4%). The rate of reintervention was 1.1%, and
the new permanent pacemaker implantation rate was 27.6%. There were no
cases of clinical valve thrombosis, and 3 cases of valve endocarditis
(1.2%). The 5-year mean gradient was 9.16 mmHg and 5-year mean effective
orifice area was 2.06 cm². Most patients had no or trace aortic
regurgitation (87.9%) and no or trace paravalvular leak (89.4%). At 5-year
follow-up, the average increase in Kansas City Cardiomyopathy
Questionnaire overall summary score from baseline was 16.6 +/- 24.8,
p<0.001. <br/>Conclusion(s): For patients with severe symptomatic AS at
intermediate surgical risk treated with TAVR, 5-year data from SURTAVI CAS
shows favorable clinical outcomes, with excellent valve hemodynamics, low
reintervention rates, and no clinical valve thrombosis. These data
demonstrate the long-term safety and effectiveness of TAVR in this risk
population.<br/>Copyright &#xa9; 2023

<24>
Accession Number
2027674623
Title
Aspirin Versus Warfarin After Transcatheter Aortic Valve Replacement in
Low-Risk Patients: A 2-Year Follow-Up.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2023.
Washington, DC United States. 53(Supplement) (pp S100), 2023. Date of
Publication: August 2023.
Author
Merdler I.; Rogers T.; Bhogal S.; Reddy P.K.; Zhang C.; Satler L.;
Weissman G.; Ben-Dor I.; Waksman R.
Institution
(Merdler, Rogers, Bhogal, Reddy, Zhang, Satler, Weissman, Ben-Dor,
Waksman) MedStar Washington Hospital Center, Washington, DC
Publisher
Elsevier Inc.
Abstract
Background: Leaflet thrombosis may occur with transcatheter heart valves
and has been associated with early structural valve degeneration.
Anticoagulation with warfarin has shown to prevent valve dysfunction
without excess bleeding in the short term. Guidelines recommend the use of
antiplatelets post-transcatheter aortic valve replacement (TAVR) but not
the routine use of oral anticoagulation (OAC). <br/>Method(s): Patients
LRT (Low Risk TAVR) 2.0 trial were randomized 1:1 to receive low-dose
aspirin or warfarin plus low-dose aspirin, with 50 patients receiving
aspirin alone and 44 patients receiving aspirin plus warfarin with no OAC
indication. A non-randomized arm in our analysis included patients with a
preexisting indication for OAC or those who developed a new indication.
After 30 days of treatment, ongoing medication regimens were at the
operator's discretion and those not requiring warfarin were taken off the
medication. <br/>Result(s): Hypoattenuated leaflet thickening at 30 days
was 16.3% for aspirin and 4.7% for warfarin plus aspirin. At 24 months,
15.4% of the warfarin group patients were still on OAC, while 12.8% of the
aspirin patients were on OAC. In the aspirin group, 5.6% of patients had
symptoms that can be attributed to heart failure vs. 2.9% of the warfarin
group (p=0.57). Echocardiography follow-up showed no difference in
paravalvular leak (72.3% vs. 61%, p=0.26), aortic valve area (1.9+/-0.51
cm² vs.1.85+/-0.48 cm², p=0.64) and mean pressure
gradient (11.55+/-5.0 mmHg vs. 11.05+/-4.02 mmHg, p=0.6). A composite
clinical endpoint including both the randomized and the non-randomized
patients did not show any difference at long-term follow-up (p=0.155).
<br/>Conclusion(s): In low-risk TAVR patients, initial anticoagulation
with warfarin for one month is safe without excess of bleeding and may
prevent leaflet thrombosis; however, anticoagulation with warfarin for one
month did not impact long-term valve dysfunction. [Formula
presented]<br/>Copyright &#xa9; 2023

<25>
Accession Number
2027674520
Title
Transcatheter Aortic Valve Replacement With Self-Expanding Acurate Neo2
Valve Versus Acurate Neo Valve: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2023.
Washington, DC United States. 53(Supplement) (pp S105), 2023. Date of
Publication: August 2023.
Author
Aggarwal G.; Haddad T.M.; Bansal S.; Aggarwal S.; Umeh C.; Gokhroo R.;
Agarwal H.; Narmi A.E.; Reddy A.K.; DelCore M.G.
Institution
(Aggarwal, Haddad, Agarwal, Narmi, Reddy, DelCore) Creighton University
Medical Center, Omaha, NE, United States
(Bansal) Maharishi Markandeshwar Institute of Medical Sciences and
Research, Haryana, Mullana, India
(Aggarwal, Umeh, Gokhroo) Hemet Global Medical Center, Hemet, CA, United
States
Publisher
Elsevier Inc.
Abstract
Background: The ACURATE Neo2 valve was developed due to high rates of
para-valvular leak and other complications associated with first
generation ACURATE Neo valves in patients undergoing transcatheter aortic
valve replacement (TAVR). However, limited data have been published
comparing the two valves. We performed a meta-analysis of published
studies comparing the two valves in patients with aortic stenosis.
<br/>Method(s): We searched PubMed, EMBASE, Google Scholar and Ovid
databases for studies comparing outcomes of patients who underwent
transcatheter aortic valve replacement (TAVR) using ACURATE Neo2 versus
first generation ACURATE neo valves. Pooled risk ratios (RR) with 95%
confidence intervals (CI) were calculated using Openmeta software.
Heterogeneity and publication bias were also assessed. <br/>Result(s): A
total of six studies with 6028 patients were included. Compared with
patients who underwent TAVR with first generation ACURATE Neo, patients
with ACURATE Neo2 had significantly lower risk of moderate to severe PVL
(RR 0.41, 95% CI 0.27-0.6; p<0.001) and major bleeding (RR 0.63 95% CI
0.46-0.85 p=0.003). Rates of permanent pacemaker implantation (RR 0.90,
95% CI 0.74-1.1; p>0.05), all-cause mortality (RR 1.008, 95% CI 0.72-1.42;
p>0.05), major vascular complications (RR 0.65, 95% CI 0.36-1.17; p>0.05)
and device success (RR 1.02, 95% CI 0.98-1.07; p>0.05) were similar in
both groups. <br/>Conclusion(s): In patients undergoing TAVR, rates of
moderate to severe PVL and bleeding were significantly lower in ACURATE
Neo2 group compared to ACURATE Neo. [Formula presented]<br/>Copyright
&#xa9; 2023

<26>
Accession Number
2027674492
Title
Transcatheter Aortic Valve Replacement in Patients With and Without
Concomitant Aortic Aneurysm: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2023.
Washington, DC United States. 53(Supplement) (pp S114), 2023. Date of
Publication: August 2023.
Author
Aggarwal G.; Narmi A.E.; Bansal S.; Reddy A.K.; Aggarwal S.; Umeh C.;
Agarwal H.; Alla M.V.; Narayan M.A.; Pershad A.; Haddad T.M.; DelCore M.G.
Institution
(Aggarwal, Narmi, Reddy, Agarwal, Alla, Haddad, DelCore) Creighton
University Medical Center, Omaha, NE, United States
(Bansal) Maharishi Markandeshwar Institute of Medical sciences and
research, Haryana, Mullana, India
(Aggarwal, Umeh) Hemet Global Medical Center, Hemet, CA, United States
(Narayan) White River Medical Center, Batesville, AZ, United States
(Pershad) University of Arizona College of Medicine, Phoenix, AZ, United
States
Publisher
Elsevier Inc.
Abstract
Background: Patients with aortic stenosis and concomitant aortic aneurysm
(AA) are usually referred for surgical aortic valve replacement but may be
referred for transcatheter aortic valve replacement (TAVR) if deemed to be
high surgical risk. Data assessing TAVR outcomes in patients with and
without AA are limited. We performed a meta-analysis of published studies
to assess any differences in outcomes of TAVR in patients with and without
AA. <br/>Method(s): We searched PubMed, EMBASE, Google scholar and Ovid
databases for studies comparing outcomes for patients with and without AA
who underwent TAVR. Pooled risk ratios (RR) with 95% confidence intervals
(CI) were calculated and statistical analyses were performed using
Openmeta software. <br/>Result(s): A total of 3 studies with 200,760
patients were included in the analysis. There were no significant
differences in the risk of in-hospital mortality (RR 0.46, 95% CI
0.08-2.4; p>0.05), bleeding rates (RR 0.98 95% CI 0.85-1.13 p>0.05),
aortic dissection (RR 0.71, 95% CI 0.12-4.06; p>0.05) and stroke (RR 0.54,
95% CI 0.06-4.6; p>0.05) in patients with and without AA undergoing TAVR.
<br/>Conclusion(s): TAVR appears to be a safe procedure in patients who
have concomitant AA. Larger studies with long term follow up are needed to
assess the efficacy of TAVR is such patients. [Formula
presented]<br/>Copyright &#xa9; 2023

<27>
Accession Number
2027674397
Title
Impact of Left Ventricular Ejection Fraction on 10-Year Mortality After
Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting: Is
CABG Safer Than PCI in All Patients With Reduced Ejection Fraction?.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2023.
Washington, DC United States. 53(Supplement) (pp S30), 2023. Date of
Publication: August 2023.
Author
Serruys P.W.; Masuda S.; Ninomiya K.; Kageyama S.; Kotoku N.; Mack M.J.;
Morice M.-C.; Kappetein A.-P.; Onuma Y.
Institution
(Serruys, Masuda, Ninomiya, Kageyama, Kotoku, Onuma) National University
of Ireland Galway, Galway, Ireland
(Mack) Baylor University Medical Center, Dallas, TX, United States
(Morice) Hopital Prive Jacques Cartier, Massy, France
(Kappetein) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: The impact of reduced left ventricular ejection fraction
(LVEF) on long-term all-cause mortality after either PCI or CABG has been
established. <br/>Method(s): In the SYNTAX trial, 1,800 randomized pts
were categorized into 3 groups according to their LVEF; (1) reduced EF
(rEF: <=40%), (2) mildly reduced EF (mrEF: 41-49%), (3) preserved EF (pEF:
>=50%). The primary endpoint was 10-year all-cause mortality. The SYNTAX
score 2020 (SS-2020) was applied to the patients with EF<50% and >=50% and
their individual predicted and observed all-cause mortality assessed.
<br/>Result(s): Ten year mortality were 44.0% with rEF (n=168), 31.8% with
mrEF (n=179) and 22.6% with pEF (n=1453) (p<0.001). No significant
interaction was found between EF classification and treatment
(p<inf>interaction</inf>=0.183). In patients with rEF and mrEF, mortality
was numerically higher with PCI than with CABG (52.9% vs 39.6%, p=0.054
and 36.0% vs. 28.6%, p=0.273) whereas in pts with pEF mortality was
similar (23.9% vs. 22.2%, p=0.275). According to the SS-2020, PCI was an
equally safe modality of revascularization in 37.8% of the patients with
reduced EF <50%. In patients with preserved EF>=50%, the proportion of
patients eligible to either PCI or CABG with individual predicted
equipoise in mortality was 57.5%. <br/>Conclusion(s): EF is a determinant
factor in the choice of a revascularization strategy in patients
presenting with complex coronary artery disease and altered EF. Prediction
of individualized 10-year prognosis using the SS-2020 may add precision in
the decision-making process. [Formula presented]<br/>Copyright &#xa9; 2023

<28>
Accession Number
2027599587
Title
HOW DO AMERICAN REPRODUCTIVE ENDOCRINOLOGISTS' (REI) FINANCIAL
COMPENSATION COMPARE IN ACADEMICS AND PRIVATE PRACTICE WHEN TAKING INTO
CONSIDERATION OTHER FIELDS OF MEDICINE?.
Source
Fertility and Sterility. Conference: 79th Scientific Congress of the
American Society for Reproductive Medicine. New Orleans United States.
120(4 Supplement) (pp e125), 2023. Date of Publication: October 2023.
Author
Kolokythas A.; Dahan M.H.
Institution
(Kolokythas, Dahan) Division of Reproductive Endocrinology and
Infertility, McGill University Health Care Center, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
OBJECTIVE: The aim of this study is to investigate the magnitude of the
discrepancy in REI's financial compensation between the academic and
private sectors as compared to other medical specialties in the USA.
MATERIALS AND METHODS: Searches were conducted using Pubmed, Google
Scholar and Google to identify comparative data between academic and
private sector physicians' compensations in various medical specialties.
Data was acceptable if it included information on both academic and
private practice salaries in the USA. We retrieved 7 peer-reviewed
publications and one survey not published in a peer-reviewed journal but
conducted by NERVES (Neurosurgery Executives' Resource Value and Education
Society), a reputable source. We retrieved data on 14 specialties (REI,
Interventional Pulmonology, Neurosurgery, Cardiac Anesthesiology,
Interventional Radiology, Adolescent Gynecology, Cardiothoracic Surgery,
Pediatric Surgery, Plastic Surgery, Vascular Surgery, Trauma/Critical Care
Surgery, Transplant Surgery, Surgical Oncology and General Surgery), which
provided 37 datapoints for comparison of both academic (AC) and private
practice (PP) salaries at different time points and/or different
experience/academic levels. Data was presented as percentage, median, and
interquartile ranges. <br/>RESULT(S): The highest difference between AC
and PP was observed for the REIs, with specialists in PP earning 86% more
than the ACs ($373,250 vs $694,365), on average. For REIs with 10-14 years
of experience, this difference doubled to 161% ($447,632 vs $1,166,667).
The second highest difference was observed in assistant professor
transplant surgeons at 63% ($309,400 vs $505,404) and the third for
assistant professor cardiothoracic surgeons at 60% ($448,900 vs $717,987).
Among the specialties analyzed, the median difference in compensation was
18% and the interquartile range was 0%-32%. More than 85% of specialties
evaluated earned between 0% and 26% more in private practice.
<br/>CONCLUSION(S): The immense discrepancy in the private practice and
academic compensation of REIs needs to be further investigated and is
possibly the largest difference in all of American medicine. This
difference needs to be rectified otherwise it favors graduates leaving
academics. Although, this may be partially explained by academic REIs who
do not provide IVF care, it does not explain salaries in academic centers
with IVF practices. Salary gaps for academic REIs should be brought up to
par with other fields of medicine. IMPACT STATEMENT: Academic REI
specialists had the largest income gap when comparing academics and
private practice in all specialties evaluated. This discrepancy needs to
be rectified. REI salaries in academics should mirror the discrepancies
seen in other fields of American medicine. For example, private practice
REIs earn a similar income on average to private practice neurosurgeons
with academic REIs earning about 40% less than academic neurosurgeons.
Investigations should be undertaken to see if this is related to REIs
providing care for women or that most American REI's today are female,
both of which have been previously reported to be associated with lower
salaries for the physicians. SUPPORT: Nothing to declare.<br/>Copyright
&#xa9; 2023

<29>
Accession Number
2027547537
Title
A RANDOMIZED, MULTI-CENTER, PHASE 2 TRIAL OF RBT-1 VERSUS PLACEBO
EVALUATING CYTOPROTECTIVE BIOMARKERS AND POSTOPERATIVE OUTCOMES IN
PATIENTS UNDERGOING CARDIAC SURGERY ON CARDIOPULMONARY BYPASS.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S171-S172), 2023. Date of Publication:
October 2023.
Author
Lamy A.; Jessen M.; Marzouk M.; Ruiz S.; Singh B.
Institution
(Lamy, Jessen, Marzouk, Ruiz, Singh) Burlington, Ontario
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Among patients undergoing cardiac surgery with cardiopulmonary
bypass (CPB), postoperative complications are common and significantly
impact long-term outcomes. We conducted a Phase 2 clinical trial of RBT-1,
a pharmacologic preconditioning drug, to assess cytoprotective biomarkers
and clinical outcomes. We are reporting our final results. METHODS AND
RESULTS: This randomized, blinded, placebo-controlled trial enrolled 152
patients in US, Canada, and Australia who were scheduled to undergo CABG
and/or valve surgery on CPB. Eligible patients were randomized to receive
one intravenous dose of RBT-1 (low or high dose) or placebo 24 to 48 hours
before surgery. The primary endpoint was a cytoprotective preconditioning
response, measured by a composite of biomarkers representing antioxidant,
anti-inflammatory, and iron scavenging pathways (i.e., heme oxygenase-1,
interleukin-10, and ferritin). Key secondary/exploratory endpoints
included ventilator, ICU, and hospital days; readmission rates, and
incidence of AKI and major adverse kidney events (MAKE). <br/>Result(s):
Baseline characteristics were: mean age 65 years, heart failure rate of
15%, Stage 3 or 4 CKD at 25%, and 23% of patients underwent combined
CABG/valve surgery. Both low and high doses of RBT-1 significantly
increased the biomarker response by >160% (p < 0.0001), meeting our
primary endpoint. RBT-1 yielded a significant reduction in ICU days
(p=0.0101) and 30-day cardiopulmonary readmission rates (p=0.0391). RBT-1
yielded a meaningful reduction in hospital days, atrial fibrillation, and
MAKE at Day 30 (MAKE30). RBT-1 was well tolerated with only transient
photosensitivity (19.8% incidence) as the primary adverse event and more
commonly seen in the high dose group. A post-hoc hierarchical composite
(win ratio) of clinical outcomes (in rank-order of death, AKI requiring
dialysis, ICU days, cardiopulmonary readmission, atrial fibrillation, and
hospital days) achieved a statistically significant win ratio of 1.63
(p=0.0161), suggesting RBT-1 improved clinical outcomes post-cardiac
surgery. <br/>CONCLUSION(S): RBT-1 is a novel preconditioning drug used
safely in the setting of CABG/valve surgery requiring CPB. Treatment with
RBT-1 resulted in favorable changes in cytoprotective biomarkers and
suggested benefits on multiple clinical outcomes of relevance. Based on
these findings, FDA has granted Fast Track designation to advance clinical
development of RBT-1 to reduce the risk of postoperative complications in
patients undergoing cardiac surgery. [Formula presented]<br/>Copyright
&#xa9; 2023

<30>
Accession Number
2027547376
Title
OPTIMAL ANTITHROMBOTIC THERAPY AFTER TRANSCATHETER AORTIC VALVE
IMPLANTATION: A NETWORK META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S41), 2023. Date of Publication: October
2023.
Author
Barry A.; Turgeon R.; Ellis U.
Institution
(Barry, Turgeon, Ellis) VancouverBCUnited States
Publisher
Elsevier Inc.
Abstract
BACKGROUND: The optimal regimen of antithrombotic therapy in patients who
undergo transcatheter aortic valve implantation (TAVI) is unknown due to
the risk of both thrombotic and bleeding complications. We performed a
systematic review and network meta-analysis of randomized controlled
trials (RCTs) to compare different oral anticoagulant (OAC) and
antiplatelet regimens. METHODS AND RESULTS: We searched MEDLINE, Embase,
CENTRAL, and from inception to April 2023. The co-primary outcomes were
all-cause death and major bleeding. Secondary outcomes included
cardiovascular death, major adverse cardiovascular events, and minor
bleeding based on Valve Academic Research Consortium criteria. Included
were RCTs that compared any regimen of OAC and/or antiplatelet therapy and
reported 1 or more outcomes of interest. No language restrictions were
applied. Two reviewers independently screened articles, extracted data,
and performed quality assessments using the Cochrane risk-of-bias tool 2.
We performed Bayesian network meta-analyses to compare all interventions
simultaneously using the Markov-chain Monte Carlo method. We generated
odds ratios with 95% credible intervals from the medians and 2.5th and
97.5th percentiles of the posterior distributions using a hierarchical
Bayesian framework and random-effects model with informative priors. To
rank interventions for each outcome, we calculated the mean surface under
the cumulative ranking (SUCRA) curve. From 262 citations, 11 RCTs (N=6415)
were included. One RCT was unpublished. Overall risk of bias was low or
with some concerns. Ten RCTs were open-label and 1 was double-blind. Three
trials exclusively enrolled patients with an indication for OAC therapy.
Median age was 81 years. Median follow-up was 6 months. Compared to dual
antiplatelet therapy (DAPT), a direct-acting OAC plus single antiplatelet
therapy (DOAC+SAPT) had a higher risk of death, whereas there was no
difference between DAPT and SAPT. DOAC+SAPT increased the risk of major
bleeding compared to DAPT, while SAPT lowered the risk. DAPT and SAPT
ranked best for all-cause death (SUCRA 0.85 and 0.81, respectively). DAPT
ranked best for cardiovascular death (SUCRA 0.70) and major adverse
cardiovascular events (SUCRA 0.80). SAPT ranked best for major and minor
bleeding (SUCRA 0.98 and 0.88, respectively). DOAC+SAPT ranked worst for
all-cause death (SUCRA 0.19) and major bleeding (SUCRA 0.05). Results were
nearly identical in the subgroup of trials that included patients without
an indication for an OAC. <br/>CONCLUSION(S): In post-TAVI patients, DAPT
and SAPT ranked best for reducing death, whereas SAPT ranked best for
bleeding. SAPT may provide the optimal balance of reducing thrombotic
events while minimizing the risk of bleeding. [Formula presented] [Formula
presented]<br/>Copyright &#xa9; 2023

<31>
Accession Number
2027547282
Title
INDUCTION THERAPY IN HEART TRANSPLANTATION: A SYSTEMATIC REVIEW AND
NETWORK META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S64), 2023. Date of Publication: October
2023.
Author
Kugathasan L.; Rayner D.; Wang S.; Rodenas-Alesina E.; Orchanian-Cheff A.;
Stehlik J.; Gustafsson F.; Greig D.; McDonald M.; Bertolotti A.;
Demas-Clarke P.; Kozuszko S.; Foroutan F.; Alba A.
Institution
(Kugathasan, Rayner, Wang, Rodenas-Alesina, Orchanian-Cheff, Stehlik,
Gustafsson, Greig, McDonald, Bertolotti, Demas-Clarke, Kozuszko, Foroutan,
Alba) Toronto, Ontario
Publisher
Elsevier Inc.
Abstract
BACKGROUND: The utility of induction therapy (IT) in heart transplantation
remains contested. Commissioned by a clinical-practice guidelines panel to
evaluate the effectiveness and safety of IT in adult heart transplantation
patients, we conducted this systematic review and network meta-analysis
(NMA) to assess the short and long-term outcomes. METHODS AND RESULTS: We
searched bibliographic databases for studies published from January 2000
to October 2022 that enrolled adult (at least 95% of the population >=18
years) de novo, single-organ heart transplantation recipients, and
reporting on the use of any IT agent and the impact on any
post-transplantation outcome. Based on patient-important outcomes informed
by our patient partners and clinicians, we performed frequentist NMAs
separately for RCTs, and observational studies with adjusted analyses. We
determined absolute effect estimates using MAGICapp, by determining
baseline risks reported in the studies and used the GRADE framework to
assess the certainty of evidence and summarize the findings. From 5,156
publications identified, we included 7 RCTs, and 12 observational studies
evaluating outcomes using multivariable analysis (Cox proportional hazards
models or logistic regression models), and report on the use of two
contemporarily-used IT agents - basiliximab and rATG. The RCTs provide
only very low certainty evidence, and thus proved uninformative of the
effect of the two agents versus no IT or one another. With low certainty
in the evidence from observational studies, basiliximab may increase
30-day (OR 1.13; 95%CI 1.06-1.20) and 1-year (OR 1.11; 95%CI 1.02-1.22)
mortality compared to no IT. With low certainty from observational
studies, rATG may decrease 5-year cardiac allograft vasculopathy (OR 0.82;
95%CI 0.74-0.90) compared to no IT, as well as 30-day (OR 0.85; 95%CI
0.80-0.92), 1-year (OR 0.87; 95%CI 0.79-0.96), and overall (HR 0.84; 95%CI
0.76-0.93) mortality compared to basiliximab. Tables 1a, 1b, and 1c
summarize the network estimates, absolute effect estimates, and certainty
of evidence. <br/>CONCLUSION(S): With low and very low certainty in the
synthetized evidence, these NMAs provide no compelling evidence for or
against the routine use of IT, and highlight the need for future studies.
Low certainty evidence suggests possible superiority of rATG versus
basiliximab. [Formula presented]<br/>Copyright &#xa9; 2023

<32>
Accession Number
2027547259
Title
SAFETY AND EFFICACY OF POSTERIOR PERICARDIOTOMY AFTER CARDIAC SURGERY: A
SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S99), 2023. Date of Publication: October
2023.
Author
Tang X.; McEwen C.; Ibrahim O.; Kremic L.; Ginson B.; Lazzam D.; Karbassi
A.; Whitlock R.; McIntyre W.; Belley-Cote E.
Institution
(Tang, McEwen, Ibrahim, Kremic, Ginson, Lazzam, Karbassi, Whitlock,
McIntyre, Belley-Cote) Hamilton, Ontario
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Postoperative atrial fibrillation (AF) is a frequent
complication of cardiac surgery. Several randomized controlled trials
(RCTs) have assessed whether posterior pericardiotomy reduces AF. We
performed a systematic review and meta-analysis to summarize data on the
safety and efficacy of posterior pericardiotomy. METHODS AND RESULTS: We
searched MEDLINE, EMBASE, Web of Science, and the Cochrane Central
Register of Controlled Trials (CENTRAL) for RCTs from inception to March
11, 2023. We also searched the grey literature. In duplicate, reviewers
screened references and potentially eligible full-texts, collected data,
and assessed risk of bias. We pooled data using a random effects model.
After reviewing 2452 citations, we included 18 RCTs with a total of 3558
participants (1771 in the pericardiotomy group and 1787 in the control
group). Of participants, 13.3% (235/1771) and 25.2% (452/1787) developed
AF in the pericardiotomy and control groups, respectively. The incidence
of AF (RR = 0.53, 95% CI 0.40-0.70, I2 = 67%), pericardial effusion (RR =
0.36, 95% CI 0.17-0.73, I2 = 100%), and surgical re-exploration (RR =
0.61, 95% CI 0.41-0.91, I2 = 0%) were significantly lower in the
pericardiotomy group. In contrast, pleural effusion requiring intervention
(RR = 1.70, 95% CI 1.12-2.57, I2 = 15%) was significantly higher in the
pericardiotomy group. We found no significant difference in all-cause
mortality, hospital or ICU length of stay, time on bypass, and cross-clamp
time (Table 1). <br/>CONCLUSION(S): Posterior pericardiotomy is safe and
effective in preventing AF after cardiac surgery. [Formula
presented]<br/>Copyright &#xa9; 2023

<33>
Accession Number
2027547231
Title
FIVE-YEAR BIOPROSTHETIC VALVE DYSFUNCTION AFTER SURGERY OR SELF-EXPANDING
TRANSCATHETER AORTIC VALVE IMPLANTATION.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S40), 2023. Date of Publication: October
2023.
Author
Radhakrishnan S.; Yakubov S.; Van Mieghem N.; Oh J.; Dedrick A.; Reardon
M.
Institution
(Radhakrishnan, Yakubov, Van Mieghem, Oh, Dedrick, Reardon)
TorontoOntarioCanada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Bioprosthetic valve dysfunction (BVD) after aortic valve
replacement includes structural valve deterioration (SVD), non-structural
valve dysfunction (NSVD) (prosthesis-patient mismatch [PPM], paravalvular
regurgitation [PVR]), clinical valve thrombosis, and infectious
endocarditis. Our prior work from the CoreValve US High Risk and SURTAVI
randomized clinical trials (RCTs) demonstrated a significantly lower
5-year incidence of SVD in TAVI vs surgery.1 Here, we evaluate 5-year
valve performance and durability by incidence of overall BVD. METHODS AND
RESULTS: Five-year BVD data from the CoreValve Pivotal and SURTAVI trials
were recently presented at CRT 2023 as a late breaker. A total of 1128
TAVI and 971 surgery patients from the CoreValve US High Risk and SURTAVI
RCTs were retrospectively analyzed. BVD was defined as: 1) SVD; mean
gradient increase >=10 mmHg from discharge/30-day to last echo AND >=20
mmHg at last echo, OR new onset/increase of >= moderate intraprosthetic
aortic regurgitation, 2) NSVD; severe PPM (VARC-3) at 30-day/discharge, OR
severe PVR through 5 years, 3) clinical valve thrombosis, OR 4) infectious
endocarditis. The cumulative incidence rates of BVD, SVD, NSVD and severe
PVR were estimated using interval censoring analysis and treating death as
a competing risk. The cumulative incidence rates of thrombosis and
endocarditis were estimated using proportional sub-distribution hazard
regression for right-censored data. Severe PPM rate was estimated as a
proportion. BVD was found in 80 TAVI and 130 surgery randomized patients
through 5 years. The cumulative incidence rate of BVD was significantly
lower following TAVI than surgery (7.8% vs 14.2%; hazard ratio [HR], 0.50;
95% confidence interval [CI], 0.38-0.66; p< 0.001). SVD and NSVD were
significantly lower after TAVI vs surgery, whereas no significant
differences were found in the incidence of valve thrombosis or
endocarditis (Table). <br/>CONCLUSION(S): Five-year valve performance
assessed by BVD was significantly better after self-expanding,
supra-annular TAVI vs surgery, with three times lower severe PPM. These
findings may have implications for shared decision-making in lower risk
patients with severe aortic stenosis, where durability should be a key
consideration for initial valve selection. REFERENCES 1. O'Hair D, Yakubov
SJ, Grubb KJ, et al. (2022). Structural Valve Deterioration After
Self-Expanding Transcatheter or Surgical Aortic Valve Implantation in
Patients at Intermediate or High Risk. JAMA Cardiol,. 2. Yakubov SJ, Van
Mieghem NM, Oh JK, et al (2023). Five-Year Incidence of Bioprosthetic
Valve Dysfunction in Patients Randomized to Surgery or TAVR: Insights From
the CoreValve US Pivotal and SURTAVI Trials. Late breaker presentation,
CRT 2023, February 25-28, 2023. Washington, USA. [Formula
presented]<br/>Copyright &#xa9; 2023

<34>
Accession Number
2027547229
Title
TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT IN AORTIC STENOSIS
PATIENTS AT LOW SURGICAL RISK: 3-YEAR OUTCOMES FROM THE EVOLUT LOW RISK
TRIAL.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S242-S243), 2023. Date of Publication:
October 2023.
Author
Bagur R.; Forrest J.; Deeb G.; Yakubov S.; Chu M.; Huang J.; Reardon M.;
Chow S.
Institution
(Bagur, Forrest, Deeb, Yakubov, Chu, Huang, Reardon, Chow) London, Ontario
Publisher
Elsevier Inc.
Abstract
BACKGROUND: With an increasing number of younger, low risk patients
undergoing transcatheter aortic valve replacement (TAVR), understanding
mid-term (>2 year) outcomes with TAVR vs surgical AVR (SAVR) is of
critical importance for informed decision making by patients and
physicians. All patients in the randomized Evolut Low Risk trial of TAVR
vs SAVR have now completed 3-year follow-up and herein we report the first
randomized data for low risk patients at 3 years. This is an encore
submission of data that have been previously presented [1] and published
[2]. METHODS AND RESULTS: Low risk patients were randomized to TAVR with a
self-expanding, supra-annular CoreValve, Evolut R, or PRO bioprosthesis
(Medtronic, Minneapolis, MN) or SAVR. Clinical outcomes reported as
Kaplan-Meier estimates and echocardiographic outcomes were assessed at 3
years. Patient-prosthesis mismatch (PPM) was defined per VARC-3. There
were 1414 attempted implants (730 TAVR; 684 SAVR). Patients had a baseline
mean age of 74 years and STS score of 2.0% and 1.9% in the TAVR and SAVR
groups, respectively. At 3 years, the primary endpoint of all-cause
mortality or disabling stroke was 7.4% with TAVR vs 10.4% with SAVR
(p=0.051). The differences in Kaplan-Meier rates for the primary endpoint
for the TAVR vs SAVR groups were broadly consistent over time: Year 1 =
-1.8%; Year 2 = -2.0%; Year 3 = -2.9% (Figure). The composite of all-cause
mortality, disabling stroke, or aortic valve rehospitalization was 13.2%
with TAVR vs 16.8% with SAVR (p=0.050). The rate of new permanent
pacemaker was 23.2% with TAVR vs 9.1% with SAVR (p < 0.001). Clinical
(0.3% vs 0.2%, p=0.61) and subclinical (0.4% vs 0.5%, p=0.91) valve
thrombosis rates were low in both groups. Mean gradient (9.1 vs 12.1 mmHg,
p< 0.001) and effective orifice area (2.2 vs 2.0 cm2, p< 0.001) were
significantly better in the TAVR group. TAVR patients had significantly
less >=moderate PPM (10.6% vs 25.1%, p< 0.001). Moderate or greater
paravalvular leakage (PVL) occurred in 0.9% of TAVR and 0.2% of SAVR
patients (p=0.16). <br/>CONCLUSION(S): Low risk patients who underwent
TAVR with a self-expanding valve continue to have favorable clinical
outcomes through 3 years. TAVR continued to show better valve hemodynamics
at 3 years with a high proportion of none/trace PVL and low incidence of
valve thrombosis. REFERENCES 1. Forrest JK, et al. Presented at ACC
Scientific Sessions 2023; March 5, 2023, New Orleans, LA, USA. 2. Forrest
JK, et al. J Am Coll Cardiol.
2023;81(17):1663-1674.10.1016/j.jacc.2023.02.017. [Formula
presented]<br/>Copyright &#xa9; 2023

<35>
Accession Number
2027547156
Title
LONG-TERM RECURRENCE OF NEW-ONSET POST-OPERATIVE AF IN CARDIAC SURGERY
PATIENTS AS DETECTED BY AN IMPLANTABLE LOOP RECORDER: A SYSTEMATIC REVIEW
AND INDIVIDUAL PARTICIPANT DATA META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S50-S51), 2023. Date of Publication: October
2023.
Author
Kaur H.; Tao B.; Silverman M.; Healey J.; Belley-Cote E.; Whitlock R.;
Devereaux P.; Conen D.; Bidar E.; Kawczynski M.; Ayala-Paredes F.;
Ayala-Valani L.; Sandgren E.; El-Chami M.; Jorgensen T.; Thyregod H.;
Sabbag A.; McIntyre W.
Institution
(Kaur, Tao, Silverman, Healey, Belley-Cote, Whitlock, Devereaux, Conen,
Bidar, Kawczynski, Ayala-Paredes, Ayala-Valani, Sandgren, El-Chami,
Jorgensen, Thyregod, Sabbag, McIntyre) Markham, Ontario
Publisher
Elsevier Inc.
Abstract
BACKGROUND: New-onset post-operative atrial fibrillation (POAF) occurs in
25-50% of patients after cardiac surgery. In some patients, POAF is a
transient entity, while in others it represents a first presentation of
paroxysmal or persistent AF. The long-term AF recurrence rate in patients
with POAF is unknown. This study estimates the AF recurrence rate in
patients with new-onset POAF following cardiac surgery as evaluated with
an implantable loop recorder (ILR). METHODS AND RESULTS: We searched
MEDLINE, Embase and Cochrane CENTRAL to April 2, 2023 for studies of adult
patients without a history of AF, who had POAF detected following cardiac
surgery and received an ILR. We defined POAF as AF occurring in the first
30 days postoperatively and AF recurrence as occurring after 30 days. We
contacted authors of eligible studies to request individual participant
time-to-event data on AF recurrence. When individual data were not
available, we estimated events from study figures. We constructed a
Kaplan-Meier curve illustrating the time to first recurrence. From 8111
screened citations, we identified 8 eligible studies (Table 1). All
studies were single-centre prospective cohorts from 7 countries including
the United States of America (2), Canada, Denmark, Israel, The
Netherlands, Russia and Sweden. Two studies defined AF recurrence as
lasting >= 30 seconds, four defined AF recurrence as lasting >= 2 minutes,
one defined AF recurrence as lasting >= 5 minutes and one defined AF
recurrence as lasting >= 6 minutes. We received data from 6 studies and
estimated events for one study; data were not available from one study. We
pooled data from a total of 186 participants, with a median follow-up of
1.7 (interquartile range (IQR): 1.3 - 2.8) years. Overall, 19.7% of
participants were female, 79.8% of participants had isolated CABG, and the
median (IQR) CHA2DS2-VASc was 3 (1 - 6). Rates of AF recurrence beginning
after the 30-day post-operative period were: 15.1% (95% CI 10.5% - 21.2%)
at 3 months, 23.9% (95% CI 18.1% - 31.0%) at 6 months, 30.7% (95% CI 24.1%
- 38.1%) at 12 months and 39.2% (95% CI 32.0% - 47.0%) at 18 months
(Figure 1, wherein the shaded area indicates the 95% CI).
<br/>CONCLUSION(S): For patients with new-onset POAF following cardiac
surgery, AF recurrence, as detected by an ILR, is common, with
approximately 1 in 3 experiencing recurrence in the first year after
surgery. The optimal strategy for monitoring for recurrence, its clinical
sequelae, and appropriate management in this population remains uncertain.
[Formula presented] [Formula presented]<br/>Copyright &#xa9; 2023

<36>
Accession Number
2027547100
Title
OUTCOMES IN DONATION AFTER CIRCULATORY DEATH CARDIAC TRANSPLANTATION: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Canadian Journal of Cardiology. Conference: Vascular 2023. Montreal
Canada. 39(10 Supplement) (pp S97-S98), 2023. Date of Publication: October
2023.
Author
Basha A.; Singh R.; Paneitz D.; Osho A.
Institution
(Basha, Singh, Paneitz, Osho) Calgary, Alberta
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Donation After Circulatory Death (DCD) donors represent a
valued source of donor organs in the current setting of organ shortage.
Historically, DCD donors were less preferred than Donation After Brain
Death (DBD) donors for cardiac transplantation due to a warm ischemic
period in the procurement process. However, recent evidence suggests that
with increasing surgeon experience, improved perfusion techniques, and
novel organ-care systems, DCD cardiac transplantation may be associated
with similar outcomes when compared to DBD donors. METHODS AND RESULTS: A
systematic literature search for relevant articles was performed of the
MEDLINE, EMBASE, Cochrane CENTRAL, and CINAHL databases from inception to
January 1, 2023. Furthermore, searching of the Web of Science and Scopus
registries was completed. Gray literature searches of major conference
abstracts between 2021 and 2023 and of the citations of included articles
were completed. Identified articles underwent independent two-stage
screening for inclusion (Covidence, Veritas Health Innovation, Melbourne,
Australia). Articles reporting the same patient cohorts were grouped and
the most informative publication was used in this meta-analysis. Following
extraction, Stata 17 (College Station, TX, USA) was applied to conduct
pairwise and proportional random-effects meta-analyses. For pairwise
comparisons, weighted pooled estimates from the random-effects models were
calculated with the DerSimonian-Laird method. Pooled estimates of
continuous outcomes were reported as standardized mean differences
(Hedge's G). Proportional meta-analyses involved logit transformation of
continuous outcomes, inverse variance weighting, and DerSimonian-Laird
estimation of the between-study variance (tau2) and subsequently the
pooled effect size. Estimates of hetereogeneity were based on
Mantel-Haenszel weights and these included inspection of funnel plots, the
I2 statistics, and Cochran's Q tests where applicable. The search
identified 9 studies comprising 443 DCD and 691 DBD isolated orthotopic
cardiac transplant recipients (n=1134); 2 studies with pairwise
comparisons were included. An additional 15 studies, though relevant, were
excluded due to reporting of the same patient cohorts. Compared to DBD
donors, DCD cardiac transplantation was associated with similar 30-day
mortality (Risk Ratio [RR] 0.752, 95% Confidence Interval [CI]:
0.304-1.863, p=0.539), mortality at last available follow-up (RR 1.153,
95%CI: 0.655-2.030, p=0.622), and postoperative organ rejection (RR 1.225,
95%CI: 0.664-2.260, p=0.516). No significant difference in hospital length
of stay was found (Hedge's G: -0.167, 95%CI: -1.305-0.971, p=0.774).
<br/>CONCLUSION(S): DCD cardiac transplantation is associated with similar
acute outcomes as cardiac transplantation from DBD donors. Additional
evidence is needed to understand the role of donor type in cardiac
transplantation and further randomized comparisons of donor types are
required. [Formula presented] [Formula presented]<br/>Copyright &#xa9;
2023

<37>
Accession Number
2027647529
Title
Echocardiographic and Clinical Outcomes in Symptomatic Patients With Less
Than Severe Aortic Stenosis After Supra-Annular Self-Expanding
Transcatheter Aortic Valve Replacement.
Source
American Journal of Cardiology. 208 (pp 37-43), 2023. Date of Publication:
01 Dec 2023.
Author
Sharma R.K.; Laham R.J.; Sorajja P.; Shah B.; Garcia S.; Jain R.; Fender
E.A.; Philip F.; Eisenberg R.; Popma J.J.; Chetcuti S.
Institution
(Sharma) Division of Cardiovascular Medicine, University of Louisville
School of Medicine, Louisville, Kentucky, United States
(Laham) Beth Israel Deaconess Medical Center and Harvard School of
Medicine, Boston, Massachusetts, United States
(Sorajja) Minneapolis Heart Institute, Minneapolis, MN, United States
(Shah) VA NY Harbor Healthcare System and NYU School of Medicine, New
York, New York, United States
(Garcia) The Christ Hospital Heart and Vascular Institute and the Lindner
Research Center, Cincinnati, Ohio, United States
(Jain) Aurora St. Luke'S Medical Center, Milwaukee, WI, United States
(Fender) Christiana Care Health System, Newark, Delaware, United States
(Philip) Kaiser Permanente Medical Center, Sacramento, California, United
States
(Eisenberg, Popma) Medtronic, Mounds View, MN, United States
(Chetcuti) University of Michigan Hospitals, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Optimal timing for aortic valve replacement in symptomatic patients with
less than severe aortic stenosis (AS) is not well defined. There is
limited information on the benefit of valve replacement in these patients.
Symptomatic patients with less than severe AS, defined as a mean aortic
gradient >=20 and <40 mm Hg, peak aortic velocity >3 and <4 m/s, and
aortic valve area >1.0 and <1.5 cm², enrolled in the Society
for Thoracic Surgery/American College of Cardiology Transcatheter Valve
Therapy Registry and who underwent attempted supra-annular, self-expanding
transcatheter aortic valve replacement (TAVR) were reviewed. Site-reported
valve hemodynamics, clinical events, and quality of life metrics were
analyzed at 30 days and 1 year after the procedure. A total of 1,067
patients with attempted TAVR (mean age 78.4 +/- 8.4 years; Society for
Thoracic Surgery score 4.7 +/- 3.4%) were found to have symptoms but less
than severe AS. From baseline to postprocedure, mean gradient decreased
(29.9 +/- 4.9 vs 8.4 +/- 4.8 mm Hg, p <0.001), and aortic valve area
increased (1.2 +/- 0.1 vs 2.2 +/- 0.7 cm², p <0.001). Clinical
events included 30-day and 1-year all-cause mortality (1.5% and 9.6%),
stroke (2.2% and 3.3%), and new pacemaker implantation (18.1% and 20.9%).
There were statistically significant improvements in the New York Heart
Association functional class and Kansas City Cardiomyopathy Questionnaire
at 30 days and 1 year. In conclusion, patients with symptomatic but less
than severe AS who underwent supra-annular, self-expanding TAVR
experienced improved valve hemodynamics and quality of life measures 1
year after the procedure. Randomized studies of TAVR versus a control arm
in symptomatic patients with less than severe AS are
ongoing.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<38>
Accession Number
2027339640
Title
Aromatherapy in patients undergoing coronary artery bypass surgery: A
systematic review of clinical trials.
Source
Global Journal of Medical Pharmaceutical and Biomedical Update. 16(1) (no
pagination), 2021. Article Number: 6. Date of Publication: 2021.
Author
Moradifar N.; Shahijan M.K.; Bakhtiari N.; Tavakoli M.; Amin A.
Institution
(Moradifar, Amin) Department of Cardiology, Lorestan University of Medical
Sciences, Lorestan, Khorramabad, Iran, Islamic Republic of
(Shahijan, Tavakoli) Student Research Committee, Lorestan University of
Medical Sciences, Lorestan, Khorramabad, Iran, Islamic Republic of
(Bakhtiari) Department of Pharmacy, Ayatollah Amoli Branch, Islamic Azad
University, Ayatollah Amoli Branch, Islamic Azad University, Mazandaran,
Amol, Iran, Islamic Republic of
Publisher
Scientific Scholar
Abstract
In recent years, various investigations have been conducted on the
aromatherapy with some essential oils as a non-invasive nursing
intervention in various conditions, such as the improvement of anxiety in
patients with cardiovascular diseases. The current study aims to
systematically review and determine the effects of aromatherapy with
various herbs in patients undergoing coronary artery bypass surgery. Five
English databases, including Web of Science, Scopus, PubMed, EMBASE, and
Google Scholar, were used to find all published clinical papers related to
the effects of aromatherapy on the patients with coronary artery bypass
surgery without time limitation. All searches were based on the 06- PRISMA
guideline and registered in the CAMARADES-NC3Rs Preclinical Systematic
Review and Meta-Analysis Facility (SyRF) database. Out of 1835 papers, 13
papers up to 2021, met the inclusion criteria for discussion in this
systematic review with the data extracted. The most studies were carried
out on effect of aromatherapy on anxiety of patients with coronary artery
bypass graft (CABG) surgery (8 papers, 61.5%). The most common used
essential oil was belonged to lavender essential oil (11 papers, 84.6%).
The findings of the present investigation demonstrated that aromatherapy
particularly with lavender is able to significantly decrease anxiety,
pain, nausea and vomiting, Sleep quality, Hemodynamic Indices, blood
pressure, and extubation time in patients with CABG surgery. However, more
studies are required to confirm the accurate mechanisms and side effects
of the alternative treatment.<br/>Copyright &#xa9;2021 Published by
Scientific Scholar on behalf of Global Journal of Medical, Pharmaceutical,
and Biomedical Update.

<39>
Accession Number
2027698912
Title
Associations of Inflammatory Biomarkers With the Risk of Morbidity and
Mortality After Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Canadian Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Heo R.H.; Wang M.K.; Meyre P.B.; Birchenough L.; Park L.; Vuong K.;
Devereaux P.J.; Blum S.; Lindahl B.; Stone G.; Conen D.
Institution
(Heo) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Heo, Wang, Devereaux, Blum, Conen) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Wang, Devereaux, Conen) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Wang, Devereaux, Conen) Department of Health Research Methods, Evidence,
and Impact, McMaster University, Hamilton, ON, Canada
(Meyre, Blum) Division of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, Basel, Switzerland
(Birchenough, Park) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Vuong) Faculty of Health Sciences, Western University, London, ON, Canada
(Lindahl) Department of Medical Sciences, Uppsala University and Uppsala
Clinical Research Center, Uppsala, Sweden
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Stone) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Although inflammatory biomarkers have been associated with
cardiovascular events in nonsurgical settings, these associations have not
been systematically addressed in patients undergoing cardiac surgery. This
review aimed to evaluate the relationships of inflammatory markers with
mortality and adverse cardiovascular events in patients undergoing cardiac
surgery. <br/>Method(s): Medline, Embase, and Central databases were
systematically searched for studies reporting pre- or postoperative levels
of inflammatory biomarkers in patients undergoing cardiac surgery.
Outcomes of interest were postoperative mortality, nonfatal myocardial
infarction, stroke, congestive heart failure, and major adverse
cardiovascular events (MACE). Studies reporting multivariable adjusted
risk estimates were included. Risk estimates were pooled with the use of
random-effects models and reported as summary odds ratios (ORs).
<br/>Result(s): Among 14,465 citations identified, 29 studies including
29,401 participants met the eligibility criteria. The average follow-up
time after surgery was 31 months. Preoperative C-reactive protein (CRP)
levels were associated with an increased risk of all-cause mortality (OR
1.88, 95% CI 1.60-2.20; I² = 19%; 11 studies) and MACE (OR
1.73, 95% CI 1.34-2.24; I² = 0%; 3 studies). CRP levels
measured on postoperative day 6 (OR 7.4, 95% CI 2.90-18.88, 1 study) and
day 10 (OR 11.8, 95% CI 3.50-39.78, 1 study) were associated with a higher
risk of all-cause mortality. Less, but overall similar, information was
available for other inflammatory biomarkers. <br/>Conclusion(s): In this
large meta-analysis, inflammatory biomarkers measured before or after
cardiac surgery were associated with mortality and adverse cardiovascular
outcomes in patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2023
Canadian Cardiovascular Society

<40>
Accession Number
642443814
Title
The efficacy of earplugs and eye masks for delirium severity and sleep
quality in patients undergoing coronary artery bypass grafting in cardiac
intensive care units: A single-blind, randomised controlled trial.
Source
Australian critical care : official journal of the Confederation of
Australian Critical Care Nurses. (no pagination), 2023. Date of
Publication: 04 Oct 2023.
Author
Shorofi S.A.; Dadashian P.; Arbon P.; Moosazadeh M.
Institution
(Shorofi) Traditional and Complementary Medicine Research Center,
Addiction Institute, Mazandaran University of Medical Sciences, Sari,
Iran; Adjunct Research Fellow, Flinders University, Adelaide, Australia
(Dadashian) Student Research Committee, School of Nursing and Midwifery,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Arbon) Torrens Resilience Institute, Flinders University, Adelaide,
Australia
(Moosazadeh) Health Sciences Research Center, Addiction Institute,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
Abstract
BACKGROUND AND PURPOSE: Delirium is a neuropsychiatric syndrome with a
wide range of possible causes and multiple complications in patients
admitted to intensive care units. It is, therefore, necessary to seek
appropriate and safe strategies to prevent and manage delirium. This study
is intended to examine the efficacy of eye masks and earplugs for delirium
severity and sleep quality in patients with coronary artery bypass
grafting in a cardiac intensive care unit. MATERIALS AND METHODS: This
single-blind, randomised controlled trial was conducted on 114 patients
who were consecutively enrolled and randomly assigned to either the
experimental group or the control group. The experimental group received
routine care plus eye masks and earplugs, and the control group received
only routine care. The delirium severity and sleep quality were measured
with the Neelon and Champagne confusion scale and the Verran and
Snyder-Halpern sleep scale. <br/>RESULT(S): The mean delirium severity
score differed significantly between the two groups on the second, third,
and fourth postoperative days (p < 0.001). Although the trend of changes
in the mean delirium severity score from the first postoperative day
(before the intervention) to the second, third, and fourth postoperative
days was downward in the two groups (trending towards higher delirium
severity), the control group experienced greater changes than the
experimental group. An intragroup analysis of delirium severity detected a
statistically significant difference in both the experimental and control
groups (p < 0.001). The sleep quality domains (sleep disturbance, sleep
effectiveness, sleep supplementation) showed a statistically significant
difference between the two groups across the three intervention days (p <
0.001). <br/>CONCLUSION(S): The overnight use of eye masks and earplugs
were found to have positive effects on sleep quality domains (sleep
disturbance, sleep effectiveness, sleep supplementation) and delirium
severity in coronary artery bypass grafting patients admitted to the
cardiac intensive care unit for several days. It was also found that a
significant interaction effect between the sleep disturbance subscale and
delirium severity exists. CLINICAL TRIAL REGISTRATION NUMBER:
(https://en.irct.ir): IRCT20210523051370N2.<br/>Copyright &#xa9; 2023
Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd.
All rights reserved.

<41>
Accession Number
638001941
Title
Clinical Outcomes of Different Warfarin Self-Care Strategies: A Systematic
Review and Network Meta-Analysis.
Source
Thrombosis and Haemostasis. 122(4) (pp 492-505), 2022. Date of
Publication: January 20, 2022.
Author
Dhippayom T.; Boonpattharatthiti K.; Thammathuros T.; Dilokthornsakul P.;
Sakunrag I.; Devine B.
Institution
(Dhippayom, Boonpattharatthiti, Thammathuros, Sakunrag) Department of
Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan
University, Phitsanulok, Thailand
(Boonpattharatthiti) Division of Clinical Pharmacy, Faculty of
Pharmaceutical Sciences, Burapha University, Chon Buri, Thailand
(Dilokthornsakul) Department of Pharmacy Practice, Center of
Pharmaceutical Outcomes Research, Faculty of Pharmaceutical Sciences,
Naresuan University, Phitsanulok, Thailand
(Devine) The Comparative Health Outcomes, Policy, and Economics Institute,
School of Pharmacy, University of Washington, Seattle, WA, United States
Publisher
Georg Thieme Verlag
Abstract
Aim To compare the effects of different strategies for warfarin self-care.
Methods PubMed, EMBASE, CENTRAL, CINAHL, ProQuest Dissertations & Theses,
and OpenGrey were searched from inception to August 2021. Randomized
controlled trials (RCTs) of warfarin self-care, either patient
self-testing (PST) or patient self-management (PSM), were included.
Self-care approaches were classified based on the TIP framework (theme,
intensity, provider): (1) PST >=1/week via e-Health (PST/High/e-Health);
(2) PST >=1/week by health care practitioner (PST/High/HCP); (3) PST
<1/week via e-Health (PST/Low/e-Health); (4) PSM >=1/week by e-Health
(PSM/High/e-Health); (5) PSM >=1/week by patient (PSM/High/Pt); (6) PSM
<1/week by patient (PSM/Low/Pt); and (7) PSM with flexible frequency by
patient (PSM/Flex/Pt). Mean differences (MDs) and risk ratios (RRs) with
95% confidence interval (CI) were estimated using frequentist network
meta-analyses with a random-effects model. The certainty of evidence was
evaluated using CINeMA (Confidence in Network Meta-Analysis). Results
Sixteen RCTs involving 5,895 participants were included. When compared
with usual care, time in therapeutic range was higher in PSM/High/Pt and
PST/High/e-Health with MD [95% CI] of 7.67% [0.26-15.08] and 5.65%
[0.04-11.26], respectively. The certainty of evidence was rated as
moderate for these findings. The risk of thromboembolic events was lower
in the PSM/Flex/Pt group when compared with PST/High/e-Health (RR: 0.39
[0.20-0.77]) and usual care (RR: 0.38 [0.17-0.88]) with low and very low
level of evidence, respectively. There was no significant difference in
the proportion of international normalized ratio (INR) values in range,
major bleeding, and all-cause mortality among different self-care
features. Conclusion Patient self-care (either PST or PSM) by measuring
INR values at least once weekly is more effective in controlling the INR
level.<br/>Copyright &#xa9; 2022 Georg Thieme Verlag. All rights reserved.

<42>
Accession Number
636912019
Title
Efficacy and Safety of Aspirin for Primary Cardiovascular Risk Prevention
in Younger and Older Age: An Updated Systematic Review and Meta-analysis
of 173,810 Subjects from 21 Randomized Studies.
Source
Thrombosis and Haemostasis. 122(3) (pp 445-455), 2022. Date of
Publication: December 31, 2021.
Author
Calderone D.; Greco A.; Ingala S.; Agnello F.; Franchina G.; Scalia L.;
Buccheri S.; Capodanno D.
Institution
(Calderone, Greco, Ingala, Agnello, Franchina, Scalia, Capodanno) Division
of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico -
San Marco, University of Catania, Catania, Italy
(Buccheri) Department of Medical Sciences, Uppsala University, Uppsala,
Sweden
(Buccheri) Uppsala Clinical Research Center, Uppsala University, Uppsala,
Sweden
Publisher
Georg Thieme Verlag
Abstract
Aims The efficacy and safety of aspirin for primary cardiovascular disease
(CVD) prevention is controversial. The aim of this study was to
investigate the efficacy and safety of aspirin in subjects with no overt
CVD, with a focus on age as a treatment modifier. Methods and Results
Randomized trials comparing aspirin use versus no aspirin use or placebo
were included. The primary efficacy outcome was all-cause death. The
primary safety outcome was major bleeding. Secondary ischemic and bleeding
outcomes were explored. Subgroup analyses were conducted to investigate
the consistency of the effect sizes in studies including younger and older
individuals, using a cut-off of 65 years. A total of 21 randomized trials
including 173,810 individuals at a mean follow-up of 5.3 years were
included. Compared with control, aspirin did not reduce significantly the
risk of all-cause death (risk ratio: 0.96; 95% confidence interval:
0.92-1.00, p = 0.057). Major adverse cardiovascular events were
significantly reduced by 11%, paralleled by significant reductions in
myocardial infarction and transient ischemic attack. Major bleeding,
intracranial hemorrhage, and gastrointestinal bleeding were significantly
increased by aspirin. There was a significant age interaction for death (p
for interaction = 0.007), with aspirin showing a statistically significant
7% relative benefit on all-cause death in studies including younger
patients. Conclusion The use of aspirin in subjects with no overt CVD was
associated with a neutral effect on all-cause death and a modest lower
risk of major cardiovascular events at the price of an increased risk in
major bleeding. The benefit of aspirin might be more pronounced in younger
individuals.<br/>Copyright &#xa9; 2022 Georg Thieme Verlag. All rights
reserved.

<43>
Accession Number
635319371
Title
Safety and Efficacy of Different Antithrombotic Strategies after
Transcatheter Aortic Valve Implantation: A Network Meta-Analysis.
Source
Thrombosis and Haemostasis. 122(2) (pp 216-225), 2022. Article Number:
210095. Date of Publication: June 15, 2021.
Author
Navarese E.P.; Grisafi L.; Spinoni E.G.; Mennuni M.G.; Rognoni A.;
Ratajczak J.; Podhajski P.; Koni E.; Kubica J.; Patti G.
Institution
(Navarese, Kubica) Department of Cardiology and Internal Medicine,
Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Grisafi, Spinoni, Patti) Department of Translational Medicine, University
of Eastern Piedmont, Via Solaroli 17, Novara, Italy
(Grisafi, Spinoni, Mennuni, Rognoni, Patti) Department of Thoracic, Heart
and Vascular Diseases, Maggiore della Carita Hospital, Novara, Italy
(Ratajczak) Department of Health Promotion, Nicolaus Copernicus
University, Bydgoszcz, Poland
(Ratajczak, Podhajski) Department of Cardiology and Internal Medicine,
Nicolaus Copernicus University, Bydgoszcz, Poland
(Koni) Department of Interventional Cardiology, Santa Corona Hospital,
Pietra Ligure, Italy
Publisher
Georg Thieme Verlag
Abstract
Background The optimal pharmacological therapy after transcatheter aortic
valve implantation (TAVI) remains uncertain. We compared efficacy and
safety of various antiplatelet and anticoagulant approaches after TAVI by
a network meta-analysis. Methods A total of 14 studies (both observational
and randomized) were considered, with 24,119 patients included. Primary
safety endpoint was the incidence of any bleeding complications during
follow-up. Secondary safety endpoint was major bleeding. Efficacy
endpoints were stroke, myocardial infarction, and cardiovascular
mortality. A frequentist network meta-analysis was conducted with a
random-effects model. The following strategies were compared: dual
antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT), oral
anticoagulation (OAC), and OAC + SAPT. The mean follow-up was 15 months.
Results In comparison to DAPT, SAPT was associated with a 44% risk
reduction of any bleeding (odds ratio [OR]: 0.56 [95% confidence interval,
CI: 0.39-0.80]). SAPT was ranked as the safest strategy for the prevention
of any bleeding (p -score: 0.704), followed by OAC alone (p -score: 0.476)
and DAPT (p -score: 0.437). Consistent results were observed for major
bleeding. The incidence of cardiovascular death and secondary ischemic
endpoints did not differ among the tested antithrombotic approaches. In
patients with indication for long-term anticoagulation, OAC alone showed
similar rates of stroke (OR: 0.92 [95% CI: 0.41-2.05], p = 0.83) and
reduced occurrence of any bleeding (OR: 0.49 [95% CI: 0.37-0.66], p <
0.01) versus OAC + SAPT. Conclusion The present network meta-analysis
supports after TAVI the use of SAPT in patients without indication for OAC
and OAC alone in those needing long-term anticoagulation.<br/>Copyright
&#xa9; 2022 American Institute of Physics Inc.. All rights reserved.

<44>
Accession Number
2027304207
Title
Predicting Death or Disability after Surgery in the Older Adult.
Source
Anesthesiology. 139(4) (pp 420-431), 2023. Date of Publication: 01 Oct
2023.
Author
Shulman M.A.; Wallace S.; Gilbert A.; Reilly J.R.; Kasza J.; Myles P.S.
Institution
(Shulman, Wallace, Reilly, Myles) Department of Anaesthesiology and
Perioperative Medicine, Alfred Hospital, Monash University, Melbourne,
Australia
(Gilbert) Data Governance and Security, Alfred Hospital, Melbourne,
Australia
(Kasza) School of Public Health and Preventive Medicine, Monash
University, Melbourne, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Older patients are vulnerable to developing new or worsening
disability after surgery. Despite this, patient or surgical
characteristics predisposing to postoperative disability are poorly
defined. The aim of the study was to develop and validate a model,
subsequently transformed to point-score form, to predict 6-month death or
disability in older patients after surgery. <br/>Method(s): The authors
built a prospective, single-center registry to develop and validate the
prediction model. The registry included patients 70 yr of age or older
undergoing elective and nonelective, cardiac and noncardiac surgery
between May 25, 2017, and February 11, 2021, and combined clinical data
from the electronic medical record, hospital administrative data
(International Classification of Diseases, Tenth Revision, Australian
Modification codes) and World Health Organization (Geneva, Switzerland)
Disability Assessment Schedule data collected directly from the patients.
Death or disability was defined as being dead or having a World Health
Organization Disability Assessment Schedule score 16% or greater. Included
patients were randomly divided into model development (70%) and internal
validation (30%) cohorts. Once constructed, the logistic regression and
point-score models were assessed using the internal validation cohort and
an external validation cohort comprising data from a separate randomized
trial. <br/>Result(s): Of 2,176 patients who completed the World Health
Organization Disability Assessment Schedule immediately before surgery,
927 (43%) patients were disabled, and 413 (19%) had significant
disability. By 6 months after surgery, 1,640 patients (75%) had data
available for the primary outcome analysis. Of these patients, 195 (12%)
patients had died, and 691 (42%) were dead or disabled. The developed
point-score model included the preoperative World Health Organization
Disability Assessment Schedule score, patient age, dementia, and chronic
kidney disease. The point score model retained good discrimination in the
internal (area under the curve, 0.74; 95% CI, 0.69 to 0.79) and external
(area under the curve, 0.77; 95% CI, 0.74 to 0.80) validation data sets.
<br/>Conclusion(s): The authors developed and validated a point score
model to predict death or disability in older patients after
surgery.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All
rights reserved.

<45>
Accession Number
2027304157
Title
Complete Revascularization Versus Culprit-Lesion-Only PCI in STEMI
Patients with Diabetes and Multivessel Coronary Artery Disease: Results
from the COMPLETE Trial.
Source
Circulation: Cardiovascular Interventions. 16(9) (pp 574-583), 2023. Date
of Publication: 01 Sep 2023.
Author
Oqab Z.; Kunadian V.; Wood D.A.; Storey R.F.; Rao S.V.; Mehran R.;
Pinilla-Echeverri N.; Mani T.; Boone R.H.; Kassam S.; Bossard M.; Mansour
S.; Ball W.; Sibbald M.; Valettas N.; Moreno R.; Steg P.G.; Cairns J.A.;
Mehta S.R.
Institution
(Oqab, Pinilla-Echeverri, Mani, Sibbald, Valettas, Mehta) Population
Health Research Institute, Hamilton, ON, Canada
(Oqab, Pinilla-Echeverri, Mani, Sibbald, Valettas, Mehta) McMaster
University, Hamilton, ON, Canada
(Oqab, Pinilla-Echeverri, Mani, Sibbald, Valettas, Mehta) Hamilton Health
Sciences, ON, Canada
(Oqab) Dalhousie University, Halifax, NS, Canada
(Kunadian) Translational and Clinical Research Institute, Faculty of
Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman
Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United
Kingdom
(Wood, Boone, Cairns) Centre for Cardiovascular Innovation, UBC Division
of Cardiology, St Paul's and Vancouver General Hospital, Canada
(Storey) Department of Infection, Immunity and Cardiovascular Disease,
University of Sheffield, United Kingdom
(Rao) NYU Langone Health System, New York, United States
(Mehran) Zena A. Wiener Cardiovascular Institute, Icahn School of Medicine
at Mount Sinai, New York, United States
(Kassam) Scarborough Health Network Centenary, Toronto, ON, Canada
(Bossard) Kantonsspital Lucerne, Switzerland
(Mansour) Centre Hospitalier de l'Universite de Montreal, Montreal, QC,
Canada
(Ball) Peterborough Regional Health Centre, Toronto, ON, Canada
(Mehran, Moreno) University Hospital la Paz, Madrid, Spain
(Steg) Hopital Bichat, Assistance Publique-Hopitaux de Paris, France
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the COMPLETE trial (Complete Versus Culprit-Only
Revascularization to Treat Multivessel Disease After Early PCI for STEMI),
a strategy of complete revascularization reduced the risk of major
cardiovascular events compared with culprit-lesion-only percutaneous
coronary intervention in patients presenting with ST-segment-elevation
myocardial infarction (STEMI) and multivessel coronary artery disease.
Patients with diabetes have a worse prognosis following STEMI. We
evaluated the consistency of the effects of complete revascularization in
patients with and without diabetes. <br/>METHOD(S): The COMPLETE trial
randomized a strategy of complete revascularization, consisting of
angiography-guided percutaneous coronary intervention of all suitable
nonculprit lesions, versus a strategy of culprit-lesion-only percutaneous
coronary intervention (guideline-directed medical therapy alone). In
prespecified analyses, treatment effects were determined in patients with
and without diabetes on the first coprimary outcome of cardiovascular
death or new myocardial infarction and the second coprimary outcome of
cardiovascular death, new myocardial infarction, or ischemia-driven
revascularization. Interaction P values were calculated to evaluate
whether there was a differential treatment effect in patients with and
without diabetes. <br/>RESULT(S): Of the 4041 patients enrolled in the
COMPLETE trial, 787 patients (19.5%) had diabetes. The median HbA1c
(glycated hemoglobin) was 7.7% in the diabetes group and 5.7% in the
nondiabetes group. Complete revascularization consistently reduced the
first coprimary outcome in patients with diabetes (hazard ratio, 0.87 [95%
CI, 0.59-1.29]) and without diabetes (hazard ratio, 0.70 [95% CI,
0.55-0.90]), with no evidence of a differential treatment effect
(interaction P=0.36). Similarly, for the second coprimary outcome, no
differential treatment effect (interaction P=0.27) of complete
revascularization was found in patients with diabetes (hazard ratio, 0.61
[95% CI, 0.43-0.87]) and without diabetes (hazard ratio, 0.48 [95% CI,
0.39-0.60]). <br/>CONCLUSION(S): Among patients presenting with STEMI and
multivessel disease, the benefit of complete revascularization over a
culprit-lesion-only percutaneous coronary intervention strategy was
consistent regardless of the presence or absence of
diabetes.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins. All
rights reserved.

<46>
Accession Number
2027291293
Title
Everolimus-Eluting Stents or Bypass Surgery for Multivessel Disease in
Diabetics: The BEST Extended Follow-Up Study.
Source
JACC: Cardiovascular Interventions. 16(19) (pp 2412-2422), 2023. Date of
Publication: 09 Oct 2023.
Author
Kim H.; Kang D.-Y.; Ahn J.-M.; Lee J.; Choi Y.; Hur S.H.; Park H.-J.;
Tresukosol D.; Kang W.C.; Kwon H.M.; Rha S.-W.; Lim D.-S.; Jeong M.-H.;
Lee B.-K.; Huang H.; Lim Y.-H.; Bae J.H.; Kim B.O.; Ong T.K.; Ahn S.G.;
Chung C.-H.; Park D.-W.; Park S.-J.
Institution
(Kim, Kang, Ahn, Lee, Choi, Chung, Park, Park) Heart Institute, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Hur) Keimyung University Dongsan Medical Center, Daegu, South Korea
(Park) Catholic University of Korea, Seoul St. Mary's Hospital, Seoul,
South Korea
(Tresukosol) Siriraj Hospital, Bangkok, Thailand
(Kang) Gachon University Gil Hospital, Incheon, South Korea
(Kwon) Gangnam Severance Hospital, Seoul, South Korea
(Rha) Korea University Guro, Seoul, South Korea
(Lim) Anam Hospital, Seoul, South Korea
(Jeong) Chonnam National University Hospital, Gwangju, South Korea
(Lee) Kangwon National University Hospital, Chuncheon, South Korea
(Huang) Sir Run Run Shaw Hospital, Zhejiang, Hangzhou, China
(Lim) Hanyang University Hospital, Seoul, South Korea
(Bae) Konyang University Hospital, Daejeon, South Korea
(Kim) Inje University Sanggye Paik Hospital, Seoul, South Korea
(Ong) Sarawak General Hospital, Sarawak, Kuching, Malaysia
(Ahn) Yonsei University Wonju Severance Christian Hospital, Wonju, South
Korea
Publisher
Elsevier Inc.
Abstract
Background: Diabetes mellitus is associated with more complex coronary
artery diseases. Coronary artery bypass grafting (CABG) is a preferred
revascularization strategy over percutaneous coronary intervention (PCI)
in diabetics with multivessel coronary artery disease (MVD).
<br/>Objective(s): This study sought to examine the different prognostic
effects of revascularization strategies according to the diabetes status
from the randomized BEST (Randomized Comparison of Coronary Artery Bypass
Surgery and Everolimus-Eluting Stent Implantation in the Treatment of
Patients With Multivessel Coronary Artery Disease) trial. <br/>Method(s):
Patients (n = 880) with MVD were randomly assigned to undergo PCI with an
everolimus-eluting stent vs CABG stratified by diabetics (n = 363) and
nondiabetics (n = 517). The primary endpoint was the composite of death,
myocardial infarction, or target vessel revascularization during a median
follow-up of 11.8 years (IQR: 10.6-12.5 years). <br/>Result(s): In
diabetics, the primary endpoint rate was significantly higher in the PCI
group than in the CABG group (43% and 32%; HR: 1.53; 95% CI: 1.12-2.08; P
= 0.008). However, in nondiabetics, no significant difference was found
between the groups (PCI group, 29%; CABG group, 29%; HR: 0.97; 95% CI:
0.67-1.39; P = 0.86; P<inf>interaction</inf> = 0.009). Irrespective of the
presence of diabetes, no significant between-group differences were found
in the rate of a safety composite of death, myocardial infarction, or
stroke and mortality rate. However, the rate of any repeat
revascularization was significantly higher in the PCI group than in the
CABG group. <br/>Conclusion(s): In diabetics with MVD, CABG was associated
with better clinical outcomes than PCI. However, the mortality rate was
similar between PCI and CABG irrespective of diabetes status during an
extended follow-up. (Ten-Year Outcomes of Randomized Comparison of
Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation
in the Treatment of Patients With Multivessel Coronary Artery Disease
[BEST Extended], NCT05125367; Randomized Comparison of Coronary Artery
Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment
of Patients With Multivessel Coronary Artery Disease [BEST],
NCT00997828)<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<47>
Accession Number
2027273339
Title
Frequency of postoperative cognitive dysfunction after non-cardiac surgery
and its impact on functional outcomes: protocol for a systematic review.
Source
BMJ Open. 13(9) (no pagination), 2023. Article Number: 071732. Date of
Publication: 18 Sep 2023.
Author
Roldan Y.; Khattak S.; Samari S.; Chan O.; Pancucci M.; Sritharan P.;
Jamil Y.; Marcucci M.
Institution
(Roldan) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Khattak, Samari, Sritharan) Michael G DeGroote School of Medicine,
McMaster University, Hamilton, ON, Canada
(Chan, Pancucci) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Jamil) Department of Internal Medicine, Yale University, New Haven, CT,
United States
(Marcucci) Departments of Health Research Methods, Evidence, and Impact,
and Medicine, Division of Perioperative Care and Department of Medicine,
Division of General Internal Medicine, McMaster University, Hamilton, ON,
Canada
(Marcucci) Perioperative Medicine and Surgical Research Unit, Population
Health Research Institute, Hamilton, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Older surgical candidates are at increased risk of a
phenomenon known as postoperative cognitive dysfunction (POCD). Several
studies have looked at the incidence of POCD at different time points
following surgery, using different study methods. Fewer have assessed
whether changes in cognition after surgery are attributable to surgery and
how they impact patient function and quality of life. The aim of this
systematic review is to summarise and appraise studies addressing any of
the following research questions (RQs): (RQ1) what is the frequency of
POCD after non-cardiac surgery?; (RQ2) is non-cardiac surgery associated
with an increased risk of cognitive decline?; (RQ3) is POCD after
non-cardiac surgery associated with patient-important outcomes? Methods
and analysis This protocol adhered to the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses Protocols guidelines. Three
electronic databases (MEDLINE, PsycINFO and EMBASE) will be systematically
searched from their inception date. Identified studies will be screened by
two reviewers for eligibility using Covidence, and data will be extracted
into a standardised electronic form. We will evaluate methodological
quality of included studies using the Quality In Prognosis Studies and its
adaptation to the overall prognosis question, and the CLARITY risk of bias
for cohort and case-control studies. For RQ1, we will estimate an average
POCD frequency at different time points by performing a meta-analysis of
included studies when appropriate. For RQ2 and RQ3, we will extract and
meta-analyse the effect measures for the association of surgery with
cognitive decline when compared with the non-surgical comparator, and
association of cognitive changes with functional changes, quality of life
and other patient-important outcomes based on available evidence. We will
narratively summarise and discuss the different methods implemented in the
existing studies to answer the three RQs, and when meta-analysis is deemed
infeasible, we will qualitatively report the results of the included
studies. Ethics and dissemination This project involves the collection and
analysis of data from previously published studies and therefore does not
require ethics approval. We plan to present the findings of this research
project at peer-reviewed conferences and publish the results in
peer-reviewed journals. PROSPERO registration number
CRD42022370674.<br/>Copyright &#xa9; 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.

<48>
Accession Number
2027262401
Title
A STUDY OF PRE-OPERATIVE AND INTRAOPERATIVE EVALUATION OF AUTONOMIC
FUNCTIONS IN DIABETIC PATIENTS UNDERGOING NEUROSURGERY UNDER GENERAL
ANAESTHESIA.
Source
Journal of Cardiovascular Disease Research. 14(9) (pp 45-56), 2023. Date
of Publication: 2023.
Author
Mohapatra A.K.; Mohapatra R.; Ray H.; Das R.K.; Swain D.; Behera D.
Institution
(Mohapatra) Department of Neurosurgery, SCB Medical College, Odisha,
Cuttack, India
(Mohapatra) Department of Anaesthesiology, Fakir Mohan Medical College,
Odisha, Balasore, India
(Ray) Department of Anaesthesiology, Bhima Bhoi Medical College, Odisha,
Balangir, India
(Das) Department of Anaesthesiology, Pain and Palliative care, Acharya
Harihar Postgraduate Institute of Cancer, Odisha, Cuttack, India
(Swain, Behera) Department of Anaesthesiology and critical care, S.C.B.
Medical College, Odisha, Cuttack, India
Publisher
EManuscript Technologies
Abstract
The Autonomic nervous system (ANS) controls involuntary activities of the
body outside the normal realm of consciousness. Cardiovascular autonomic
neuropathy is frequently observed in patients with diabetes mellitus. As
anaesthesia has a marked effect on peri-operative autonomic function, the
interplay between diabetic neuropathy and anaesthesia may result in
unexpected haemodynamic instability during surgery. The objective of this
literature review was to examine the association of cardiovascular
autonomic neuropathy with peri-operative cardiovascular complications.
Depending on the type of anaesthesia, the presence of cardiovascular
autonomic neuropathy in surgical patients can markedly affect
peri-operative haemodynamics and postoperative recovery. Pre-operative
testing of the extent of autonomic dysfunction in particular populations,
like diabetics, may contribute to a reduction in haemodynamic instability
and cardiovascular complications.<br/>Copyright &#xa9; 2023 EManuscript
Technologies. All rights reserved.

<49>
Accession Number
2027242862
Title
Paediatric aortic valve replacement: a meta-analysis and microsimulation
study.
Source
European Heart Journal. 44(34) (pp 3231-3246), 2023. Date of Publication:
07 Sep 2023.
Author
Notenboom M.L.; Schuermans A.; Etnel J.R.G.; Veen K.M.; Van De Woestijne
P.C.; Rega F.R.; Helbing W.A.; Bogers A.J.J.C.; Takkenberg J.J.M.
Institution
(Notenboom, Etnel, Veen, Van De Woestijne, Bogers, Takkenberg) Department
of Cardiothoracic Surgery, Erasmus University Medical Centre, Erasmus MC,
Doctor Molewaterplein 40, , Zuid-Holland, Rotterdam 3015 GD, Netherlands
(Schuermans, Rega) Department of Cardiac Surgery, University Hospitals
Leuven, UZ Leuven Gasthuisberg, Herestraat 49, , Flanders, Leuven 3000,
Belgium
(Schuermans) Cardiovascular Research Center, Massachusetts General
Hospital, 149 13th Street, 4th floor, Boston, MA 02129, United States
(Schuermans) Program in Medical and Population Genetics, Cardiovascular
Disease Initiative, Broad Institute of Harvard and MIT, Merkin Building,
415 Main St., Cambridge, MA 02142, United States
(Helbing) Department of Paediatrics, Division of Paediatric Cardiology,
Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, , Zuid-Holland,
Rotterdam 3015 CN, Netherlands
Publisher
Oxford University Press
Abstract
Aims: To support decision-making in children undergoing aortic valve
replacement (AVR), by providing a comprehensive overview of published
outcomes after paediatric AVR, and microsimulation-based age-specific
estimates of outcome with different valve substitutes. <br/>Methods and
Results: A systematic review of published literature reporting clinical
outcome after paediatric AVR (mean age <18 years) published between
1/1/1990 and 11/08/2021 was conducted. Publications reporting outcome
after paediatric Ross procedure, mechanical AVR (mAVR), homograft AVR
(hAVR), and/or bioprosthetic AVR were considered for inclusion. Early
risks (<30d), late event rates (>30d) and time-to-event data were pooled
and entered into a microsimulation model. Sixty-eight studies, of which
one prospective and 67 retrospective cohort studies, were included,
encompassing a total of 5259 patients (37 435 patient-years; median
follow-up: 5.9 years; range 1-21 years). Pooled mean age for the Ross
procedure, mAVR, and hAVR was 9.2 +/- 5.6, 13.0 +/- 3.4, and 8.4 +/- 5.4
years, respectively. Pooled early mortality for the Ross procedure, mAVR,
and hAVR was 3.7% (95% CI, 3.0%-4.7%), 7.0% (5.1%-9.6%), and 10.6%
(6.6%-17.0%), respectively, and late mortality rate was 0.5%/year
(0.4%-0.7%/year), 1.0%/year (0.6%-1.5%/year), and 1.4%/year
(0.8%-2.5%/year), respectively. Microsimulation-based mean life-expectancy
in the first 20 years was 18.9 years (18.6-19.1 years) after Ross
(relative life-expectancy: 94.8%) and 17.0 years (16.5-17.6 years) after
mAVR (relative life-expectancy: 86.3%). Microsimulation-based 20-year risk
of aortic valve reintervention was 42.0% (95% CI: 39.6%-44.6%) after Ross
and 17.8% (95% CI: 17.0%-19.4%) after mAVR. <br/>Conclusion(s): Results of
paediatric AVR are currently suboptimal with substantial mortality
especially in the very young with considerable reintervention hazards for
all valve substitutes, but the Ross procedure provides a survival benefit
over mAVR. Pros and cons of substitutes should be carefully weighed during
paediatric valve selection.<br/>Copyright &#xa9; 2023 The Author(s).
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<50>
Accession Number
2027236426
Title
Quality Review Committee Audit Improves Thoracic Enhanced Recovery After
Surgery Protocol Compliance.
Source
Journal of Surgical Research. 293 (pp 144-151), 2024. Date of Publication:
January 2024.
Author
Dyas A.R.; Kelleher A.D.; Cumbler E.U.; Barker A.R.; McCabe K.O.; Bata
K.E.; Abrams B.A.; Randhawa S.K.; Mitchell J.D.; Meguid R.A.
Institution
(Dyas, Meguid) Surgical Outcomes and Applied Research Program, Department
of Surgery, University of Colorado, Aurora, Colorado, United States
(Dyas, Kelleher, Cumbler, Barker, McCabe, Bata, Randhawa, Mitchell,
Meguid) Department of Surgery, University of Colorado Hospital, Aurora,
Colorado, United States
(Cumbler) Department of Medicine, University of Colorado Hospital, Aurora,
Colorado, United States
(Abrams) Department of Anesthesiology, University of Colorado Hospital,
Aurora, Colorado, United States
Publisher
Academic Press Inc.
Abstract
Introduction: Compliance with thoracic Enhanced Recovery After Surgery
(ERAS) protocols is critical to achieving their maximum benefits. We
sought to examine utilization of quality review meetings as a method to
improve protocol compliance through identification and resolution of
barriers with compliance. <br/>Method(s): A multidisciplinary committee
implemented a thoracic ERAS protocol for anatomic lung resections across
five hospitals within our health system. Compliance data at one
institution were tracked for 4 mo after initiation of the ERAS protocol; a
quality review meeting was held at one hospital, and two additional months
of compliance data were recorded. Outcomes of interest were compliance
changes to five protocol elements. Pathway elements deferred due to
"mindful deviation" were excluded. Chi-square and Fisher's exact tests
were used to compare compliance differences. <br/>Result(s): We included
81 patients: 53 patients before the quality review meeting and 28 after.
There were 405 compliance opportunities; 68 (17%) were excluded for
mindful deviation, leaving 337 (83%) for inclusion. Overall compliance
improved from 53% before to 84% after the quality review meeting.
Compliance to avoiding intraoperative urinary catheters, placing chest
tubes to water seal in postanesthesia care unit, liberal chest tube
removal, and postoperative multimodal pain regimen use improved after the
quality review meeting (P values <0.05). Use of preoperative pain bundles
was not significantly different (87% versus 96%, P = 0.25).
<br/>Conclusion(s): Conducting a quality review meeting significantly
improved ERAS protocol element use at our intervention healthcare region.
This methodology should be considered at other institutions implementing
surgical protocols.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<51>
Accession Number
2027222785
Title
Comparing the Effectiveness and Safety of MedAn with the Nishikawa Blade
and UE Videolaryngoscopes for Left-Sided Double-Lumen Endobronchial Tube
Intubation: A Randomized Controlled Trial.
Source
Medical Science Monitor. 29 (no pagination), 2023. Article Number:
e940916. Date of Publication: 2023.
Author
Zhang Y.; Zhang W.; Wang S.; Yin H.; Xu Y.; Fang Z.; Bao H.; Zhang C.;
Wang X.; Liu W.
Institution
(Zhang, Zhang, Wang, Yin, Xu, Fang, Bao, Zhang, Wang) Department of
Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital,
Nanjing Medical University, Jiangsu, Nanjing, China
(Liu) Department of Pharmacology, School of Basic Medical Sciences,
Nanjing Medical University, Jiangsu, Nanjing, China
Publisher
International Scientific Information, Inc.
Abstract
Background: The purpose of this study was to compare the effectiveness and
safety of the MedAn videolaryngoscope with the Nishikawa blade (MedAn) vs
the UE videolaryngoscope (UE) for intubation with a left-sided
double-lumen endobronchial tube (LDLT) in patients with normal airways.
Material/Methods: We randomly categorized 106 patients scheduled to
undergo elective thoracic surgery with LDLT for one-lung ventilation into
2 groups: the UE group (Group UE) and the MedAn group (Group MedAn), using
the MedAn or UE for LDLT intubation. The primary outcome was time to
successful intubation. The Cormack-Lehane classification of laryngeal view
was the key secondary outcome. Other secondary outcomes included
first-attempt and overall intubation success rates, laryngoscopy time,
LDLT placement time, operators' subjective evaluation of
videolaryngoscopes, hemodynamic changes during videolaryngoscopic
intubation, and adverse outcomes. <br/>Result(s): The time to successful
intubation and LDLT placement time of Group MedAn were 42.0 (32.35, 47.0)
s and 23.0 (18.0, 26.0) s, and it was shorter than in Group UE (median, 42
s vs 49 s, 23 s vs 30 s, P<0.001). Group MedAn had a better laryngeal view
(P=0.03) and less subglottic/tracheal mucosal injury (P<0.001) than Group
UE. Moreover, the operators' subjective grading of ease of laryngoscopy,
quality of view, and ease of LDLT placement were higher in Group MedAn
than in Group UE (P<0.05). <br/>Conclusion(s): Compared with the UE, the
MedAn could reduce the intubation time and provide a better laryngeal view
and sufficient intubation space for safer LDLT intubation in patients with
normal airways.<br/>Copyright &#xa9; Med Sci Monit, 2023.

<52>
Accession Number
2027175820
Title
Transcatheter Edge-to-Edge Repair for Tricuspid Regurgitation-A Systematic
Review and Meta-Analysis.
Source
Current Problems in Cardiology. Part B. 49(1) (no pagination), 2024.
Article Number: 102055. Date of Publication: January 2024.
Author
Rehan S.T.; Eqbal F.; ul Hussain H.; Ali E.; Ali A.; Ullah I.; Ullah W.;
Ahmed J.; Brailovsky Y.; Rajapreyar I.N.; Asghar M.S.
Institution
(Rehan, Eqbal, ul Hussain, Ali, Ali, Ahmed) Dow University of Health
Sciences, Karachi, Pakistan
(Ullah) Kabir Medical College, Gandhara University, Peshawar, Pakistan
(Ullah, Brailovsky, Rajapreyar) Thomas Jefferson University Hospitals,
Philadelphia, PA, United States
(Asghar) Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Transcatheter edge-to-edge repair (TEER) has emerged as a widely accepted
procedure for tricuspid regurgitation (TR) as gauged by echocardiographic
parameters and clinical outcomes. Our study aims to assess TR severity and
other echocardiographic outcomes in patients undergoing TEER with TriClip,
MitraClip, and PASCAL devices. A literature search of 5 databases was
performed until 1st June 2023. Randomized controlled trials (RCTs) or
observational studies with moderate to severe (grade III-V) TR patients
undergoing isolated TEER were considered eligible. Echocardiographic, and
quality of life determining outcomes such as improvement in TR severity
grade >=3, New York Heart Association (NYHA) class >=3, procedural
success, 6-minute walking distance (6MWD), and adverse outcomes were
analyzed. Grade assessment was performed and studies were assessed for
risk of bias and publication bias. We included 15 studies (14
observational and 1 RCT) in our paper. Analysis revealed a substantial
reduction in TR volume (P < 0.00001), TR grading (P < 0.00001), tricuspid
annular diameter (P < 0.00001), proximal isovelocity surface area radius
(P < 0.00001), effective regurgitant orifice area (P < 0.00001), and
improvement in NYHA class (P < 0.00001) at 30 days from baseline,
postprocedurally. A significant increase in 6MWD at 1 year (P = 0.001) was
also recorded. No significant differences in left ventricular ejection
fraction (P = 0.87), fractional area change (P = 0.37), or tricuspid
annular plane systolic excursion (P = 0.76) were observed. TEER procedural
success was 97%. TEER produced a significant reduction in TR grade and
volume, NYHA class, 6MWD, and showed prominent procedural success. Large
scale RCTs comparing the TEER devices are needed to strengthen the present
findings.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<53>
Accession Number
2027124525
Title
Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A
Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 207 (pp 159-169), 2023. Date of
Publication: 15 Nov 2023.
Author
Kaddoura R.; Bhattarai S.; Abushanab D.; Al-Hijji M.
Institution
(Kaddoura) Pharmacy Department, Heart Hospital, Hamad Medical Corporation,
Doha, Qatar
(Bhattarai) Department of hematology and oncology, Bhaktapur Cancer
Hospital, Bhaktapur, Dudhpati, Nepal
(Abushanab) Drug Information Center, Hamad Medical Corporation, Qatar,
Doha, Qatar
(Al-Hijji) Interventional Cardiology Department, Heart Hospital, Hamad
Medical Corporation, Qatar, Doha, Qatar
Publisher
Elsevier Inc.
Abstract
This systematic review and meta-analysis aimed to investigate whether
percutaneous mitral valve repair (PMVr) using MitraClip was more effective
than surgery or medical therapy for long-term morbidity and mortality. We
searched MEDLINE, EMBASE, and CENTRAL (Cochrane Library) databases to
identify relevant studies that recruited adult patients with functional or
secondary mitral valve regurgitation who underwent PMVr with MitraClip
implantation using appropriate search terms and Boolean operators. The
odds ratios (ORs) were pooled using the random-effects model. A total of
14 studies recruiting 2,593 patients were included. Within 12 months of
follow-up, patients who underwent PMVr did not maintain mitral valve
regurgitation grade 2+ (OR 0.22, 95% confidence interval [CI] 0.12 to
0.41, p <0.0001, I² = 0.0%, p = 0.52) or symptom-free heart
failure (OR 0.47, 95% CI 0.29 to 0.77, p = 0.0028, I² = 0.0%, p
= 0.66) compared with their surgical counterparts. Patients were more
likely to be rehospitalized for heart failure (OR 2.79, 95% CI 1.54 to
5.05, p = 0.0007, I² = 0.0%, p = 0.51). However, there was no
difference between the groups in terms of all-cause or cardiovascular
mortality. Whereas, in comparison with medical therapy, PMVr significantly
reduced all-cause mortality at 12 and >=24 months of follow-up (OR 0.41,
95% CI 0.24, 0.69, p = 0.0009, I² = 32%, p = 0.23 and OR 0.55,
95% CI 0.40, 0.75, p = 0.0002, I² = 0.0%, p = 0.45,
respectively). In conclusion, there was no difference in all-cause death
at 12 or 24 months of follow-up between PMVr and the surgical approach,
but the durability of valvular repair was inferior to PMVr. In comparison
with medical therapy, there was a significant reduction in mortality with
PMVr.<br/>Copyright &#xa9; 2023 The Author(s)

<54>
Accession Number
2027119359
Title
PROSPECTIVE STUDY TO COMPARE EFFECTIVENESS OF UFH AND LMWH IN PATIENTS
RECEIVING IABP UNDERGOING ELECTIVE CABG SURGERY.
Source
Journal of Cardiovascular Disease Research. 13(8) (pp 2088-2094), 2022.
Date of Publication: 2022.
Author
Minda S.; Mohire V.; Khatnani L.; Rai N.; Sulya D.; Jain A.
Institution
(Minda, Khatnani, Rai, Sulya, Jain) Department of Cardiothoracic and
Vascular Surgery, NSCB Medical College, Jabalpur, India
(Mohire) Department of Anesthesia, NSCB Medical College, Jabalpur, India
Publisher
EManuscript Technologies
Abstract
Objective- Our study aimed to compare effectiveness and safety of low
molecular weight heparin (LMWH) and unfractionated heparin (UFH) in
patients undergoing elective coronary artery bypass grafting with
prophylactically inserted intra-aortic balloon counterpulsation(IABP).
Material and methods - We included patients scheduled for CABG with
ejection fraction less than 40% and prophylactically inserted IABP.
Patients were randomized with computer generated sequence to receive LMWH
or UFH . 30 patients received UFH (a bolus of injection 70 u/kg
immediately after IABP, followed by infusion at a rate of 15 u/Kg/hr) and
targeted APT T of 50-70 seconds. Another set of 30 patients received
LMWH(subcutaneous injection of 1 mg/kg every 12 hrs). Total of 60 patients
were included in study .Major end-points included were thrombotic events
and bleeding events. Thrombotic events included arterial thromboembolism
and leg-ischemia. Bleeding events included major access and nonaccess site
bleeding. Major bleeding was defined by as a hemoglobin decrease by
>50mg/l or bleeding that caused hemodynamic shock or life threatening or
requiring blood transfusion. Results- Subjects receiving UFH and LMWH were
similar in baseline characteristics. Arterial thromboemolism occured in
(2/30) patients in UFH group and (1/30) patients in LMWH. Major bleeding
occured in 3 and 2 patients in UFH and LMWH groups respectively. Linear
Regression analysis indicated no association between ischemia or bleeding
with heparin type. Conclusion- LMWH can reduce complications like ischemia
and bleeding, but for statistical significancea larger sample size is
needed.<br/>Copyright &#xa9; 2022 EManuscript Technologies. All rights
reserved.

<55>
Accession Number
2027114486
Title
Predictors of All-Cause Mortality After Successful Transcatheter Aortic
Valve Implantation in Patients With Atrial Fibrillation.
Source
American Journal of Cardiology. 207 (pp 150-158), 2023. Date of
Publication: 15 Nov 2023.
Author
Yamamoto M.; Hayashida K.; Hengstenberg C.; Watanabe Y.; Van Mieghem N.M.;
Jin J.; Saito S.; Valgimigli M.; Nicolas J.; Mehran R.; Moreno R.; Kimura
T.; Chen C.; Unverdorben M.; Dangas G.D.
Institution
(Yamamoto) Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
(Hayashida) Department of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Hengstenberg) Division of Cardiology, Department of Internal Medicine II,
Vienna General Hospital, Medical University, Vienna, Austria
(Watanabe) Division of Cardiology, Teikyo University Hospital, Tokyo,
Japan
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Thoraxcenter, Rotterdam, Netherlands
(Jin, Chen, Unverdorben) Global Specialty Medical Affairs, Daiichi Sankyo,
Inc., Basking Ridge, NJ, United States
(Saito) Division of Cardiology & Catheterization Laboratories, Shonan
Kamakura General Hospital, Kamakura, Japan
(Valgimigli) Division of Cardiocentro Ticino Institute, Ente Ospedaliero
Cantonale, Universita della Svizzera Italiana (USI), Lugano, Switzerland
(Valgimigli) Department of Cardiology, University of Bern, Bern,
Switzerland
(Nicolas) Icahn School of Medicine, New York, NY, United States
(Mehran, Dangas) Zena and Michael A. Wiener Cardiovascular Institute,
Mount Sinai Hospital, New York, New York, United States
(Moreno) Department of Cardiology, University Hospital La Paz, Madrid,
Spain
(Kimura) Primary Medical Science Department, Daiichi Sankyo Co., Ltd.,
Tokyo, Japan
Publisher
Elsevier Inc.
Abstract
Prevalent and incident atrial fibrillation are common in patients who
undergo transcatheter aortic valve implantation and are associated with
impaired postprocedural outcomes, including mortality. We determined
predictors of long-term mortality in patients with atrial fibrillation
after successful transcatheter aortic valve implantation. The EdoxabaN
Versus standard of care and theIr effectS on clinical outcomes in pAtients
havinG undergonE Transcatheter Aortic Valve Implantation-Atrial
Fibrillation (ENVISAGE-TAVI AF) trial (NCT02943785) was a multicenter,
prospective, randomized controlled trial in patients with prevalent or
incident atrial fibrillation after successful transcatheter aortic valve
implantation who received edoxaban or vitamin K antagonists. A Cox
proportional hazard model was performed to identify predictors of
all-cause mortality using a stepwise approach for multiple regression
analysis. In addition, we assessed the performance of different risk
scores and prediction models using ENVISAGE-TAVI AF data. Of 1,426
patients in ENVISAGE-TAVI AF, 178 (12.5%) died during the follow-up period
(median 548 days). Our stepwise approach identified greater risk of
mortality with older age, impaired renal function, nonparoxysmal atrial
fibrillation, excessive alcohol use, New York Heart Association heart
failure class III/IV, peripheral artery disease, and history of major
bleeding or predisposition to bleeding. The present model (concordance
statistic [c-statistic] 0.67) was a better discriminator than were other
frequently used risk scores, such as the Society of Thoracic Surgeons
score (c-statistic 0.56); Congestive heart failure, Hypertension, Age
>=75, Diabetes, Stroke, Vascular disease, Age 65 to 74 years, and Sex
category (CHA<inf>2</inf>DS<inf>2</inf>-VASc) score (c-statistic 0.54); or
Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or
predisposition, Labile international normalized ratio, Elderly, and
Drugs/alcohol concomitantly (HAS-BLED) score (c-statistic 0.58). In
ENVISAGE-TAVI AF, several modifiable and nonmodifiable clinical
characteristics were significantly associated with greater long-term
all-cause mortality. Improved risk stratification to estimate the
probability of mortality after successful transcatheter aortic valve
implantation in patients with atrial fibrillation may improve long-term
patient prognosis.<br/>Copyright &#xa9; 2023 The Author(s)

<56>
Accession Number
2026725669
Title
Pulmonary Vasodilator and Inodilator Drugs in Cardiac Surgery: A
Systematic Review With Bayesian Network Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2261-2271),
2023. Date of Publication: November 2023.
Author
Sardo S.; Tripodi V.F.; Guerzoni F.; Musu M.; Cortegiani A.; Finco G.
Institution
(Sardo, Guerzoni, Musu, Finco) Department of Medical Sciences and Public
Health, University of Cagliari, Monserrato, Italy
(Tripodi) Department of Human Pathology, Unit of Anesthesia and Intensive
Care, University Hospital of Messina, Messina, Italy
(Cortegiani) Department of Surgical Oncological and Oral Science,
University of Palermo, Palermo, Italy
(Cortegiani) Department of Anesthesia Intensive Care and Emergency,
University Hospital "Policlinico Paolo Giaccone", Palermo, Italy
Publisher
W.B. Saunders
Abstract
Objective: The authors performed a systematic review to evaluate the
effect of pharmacologic therapy on pulmonary hypertension in the
perioperative setting of elective cardiac surgery (PROSPERO
CRD42023321041). <br/>Design(s): Systematic review of randomized
controlled trials with a Bayesian network meta-analysis. <br/>Setting(s):
The authors searched biomedical databases for randomized controlled trials
on the perioperative use of inodilators and pulmonary vasodilators in
adult cardiac surgery, with in-hospital mortality as the primary outcome
and duration of ventilation, length of stay in the intensive care unit,
stage 3 acute kidney injury, cardiogenic shock requiring mechanical
support, and change in mean pulmonary artery pressure as secondary
outcomes. <br/>Participant(s): Twenty-eight studies randomizing 1,879
patients were included. <br/>Intervention(s): Catecholamines and
noncatecholamine inodilators, arterial pulmonary vasodilators,
vasodilators, or their combination were considered eligible interventions
compared with placebo or standard care. <br/>Measurements and Main
Results: Ten studies reported in-hospital mortality and assigned 855
patients to 12 interventions. Only inhaled prostacyclin use was supported
by a statistically discernible improvement in mortality, with a
number-needed-to-treat estimate of at least 3.3, but a wide credible
interval (relative risk 1.26 x 10^-17 - 0.7). Inhaled
prostacyclin and nitric oxide were associated with a reduction in
intensive care unit stay, and none of the included interventions reached a
statistically evident difference compared to usual care or placebo in the
other secondary clinical outcomes. <br/>Conclusion(s): Inhaled
prostacyclin was the only pharmacologic intervention whose use is
supported by a statistically discernible improvement in mortality in the
perioperative cardiac surgery setting as treatment of pulmonary
hypertension. However, available evidence has significant limitations,
mainly the low number of events and imprecision.<br/>Copyright &#xa9; 2023
The Author(s)

<57>
Accession Number
2026725324
Title
Red Blood Cell Transfusion Guided by Hemoglobin Only or Integrating
Perfusion Markers in Patients Undergoing Cardiac Surgery: A Systematic
Review and Meta-Analysis With Trial Sequential Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2252-2260),
2023. Date of Publication: November 2023.
Author
Putaggio A.; Tigano S.; Caruso A.; La Via L.; Sanfilippo F.
Institution
(Putaggio) School of Anesthesia and Intensive Care, University Magna
Graecia, Catanzaro, Italy
(Tigano, Caruso) School of Anesthesia and Intensive Care, University of
Catania, Catania, Italy
(La Via, Sanfilippo) University Hospital Policlinico, G. Rodolico - San
Marco, Catania, Italy
(Sanfilippo) Department of Surgery and Medical-Surgical Specialties,
University of Catania, Catania, Italy
Publisher
W.B. Saunders
Abstract
Objective: Strategies for red blood cell (RBC) transfusion in patients
undergoing cardiac surgery have been traditionally anchored to hemoglobin
(Hb) targets. A more physiologic approach would consider markers of organ
hypoperfusion. <br/>Design(s): The authors conducted a systematic review
and meta-analysis with trial sequential analysis of randomized controlled
trials (RCTs). <br/>Setting(s): Cardiac surgery. <br/>Participant(s):
Adult patients. <br/>Intervention(s): RBC transfusion targeting only Hb
levels compared with strategies combining Hb values with markers of organ
hypoperfusion. <br/>Measurements and Main Results: Primary outcomes were
the number of RBC units transfused, the number of patients transfused at
least once, and the average number of transfusions. Secondary outcomes
were postoperative complications, intensive care (ICU) and hospital
lengths of stay, and mortality. Only 2 RCTs were included (n = 257
patients), and both used central venous oxygen saturation
(ScvO<inf>2</inf>) as a marker of organ hypoperfusion (cut-off: <70% or
<=65%). A transfusion protocol combining Hb and ScvO<inf>2</inf> reduced
the overall number of RBC units transfused (risk ratio [RR]: 1.57
[1.33-1.85]; p < 0.0001, I² = 0%), and the number of patients
transfused at least once (RR: 1.33 [1.16-1.53]; p < 0.0001, I²
= 41%), but not the average number of transfusions (mean difference [MD]:
0.18 [-0.11 to 0.47]; p = 0.24, I² = 66%), with moderate
certainty of evidence. Mortality (RR: 1.29, [0.29-5.77]; p = 0.73,
I² = 0%), ICU length-of-stay (MD: -0.06 [-0.58 to 0.46]; p =
0.81, I² = 0%), hospital length-of-stay (MD: -0.05 [-1.49 to
1.39];p = 0.95, I² = 0%), and all postoperative complications
were not affected. <br/>Conclusion(s): In adult patients undergoing
cardiac surgery, a restrictive protocol integrating Hb values with a
marker of organ hypoperfusion (ScvO<inf>2</inf>) reduces the number of RBC
units transfused and the number of patients transfused at least once
without apparent signals of harm. These findings were preliminary and
warrant further multicentric research.<br/>Copyright &#xa9; 2023 The
Author(s)

<58>
Accession Number
2026433177
Title
Appraisal of Postoperative Outcomes of Volatile and Intravenous
Anesthetics: A Network Meta-Analysis of Patients Undergoing Cardiac
Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2215-2222),
2023. Date of Publication: November 2023.
Author
Heybati K.; Zhou F.; Baltazar M.; Poudel K.; Ochal D.; Ellythy L.; Deng
J.; Chelf C.J.; Welker C.; Ramakrishna H.
Institution
(Heybati, Poudel, Ochal, Ellythy) Mayo Clinic Alix School of Medicine,
Mayo Clinic - Rochester, Rochester, MN, United States
(Zhou) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Baltazar) Philadelphia College of Osteopathic Medicine, Philadelphia, PA,
United States
(Deng) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Chelf) Mayo Clinic Libraries, Rochester, MN, United States
(Welker, Ramakrishna) Department of Anesthesiology and Perioperative
Medicine, Mayo Clinic - Rochester, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Objectives: To determine the relative efficacy of specific regimens used
as primary anesthetics, as well as the potential combination of volatile
and intravenous anesthetics among patients undergoing cardiac, thoracic,
and vascular surgery. <br/>Design(s): This frequentist, random-effects
network meta-analysis was registered prospectively (CRD42022316328) and
conducted according to the PRISMA-NMA framework. Literature searches were
conducted up to April 1, 2022 across relevant databases. Risk of bias
(RoB) and confidence of evidence were assessed by RoB-2 and CINeMA,
respectively. Pooled treatment effects were compared with propofol
monotherapy. <br/>Setting(s): Fifty-three randomized controlled trials (N
= 8,085) were included, of which 46 trials (N = 6,604) enrolled patients
undergoing cardiac surgery. <br/>Participant(s): Trials enrolling adults
(>=18) undergoing cardiac, thoracic, and vascular surgery, using the same
induction regimens, and comparing volatile and/or total intravenous
anesthesia for the maintenance of anesthesia. Given that the majority of
trials focused on those undergoing cardiac surgery and the heterogeneity,
analyses were restricted to this population. Measurement and Main Results:
Outcomes of interest included intensive care unit (ICU) length of stay
(LOS), myocardial infarction, in-hospital and 30-day mortality, stroke,
and delirium. Across 19 trials (N = 1,821; 9 arms; I² = 64.5%),
sevoflurane combined with propofol decreased ICU LOS (mean difference [MD]
-18.26 hours; 95% CI -34.78 to -1.73 hours), whereas midazolam with
propofol (MD 17.51 hours; 95% CI 2.78-32.25 hours) was associated with a
significant increase in ICU LOS, when compared with propofol monotherapy.
Among 27 trials (N = 4,080; 10 arms; I² = 0%), midazolam was
associated with significantly greater risk of myocardial infarction versus
propofol (risk ratio 1.94; 95% CI 1.01-3.71). There were no significant
differences across other outcomes. <br/>Conclusion(s): In patients
undergoing cardiac surgery, sevoflurane with propofol was associated with
decreased ICU LOS compared with propofol monotherapy. Midazolam with
propofol increased ICU LOS compared with propofol alone. The combined use
of intravenous and volatile anesthetics should be explored further. Future
trials in thoracic and vascular surgery are warranted.<br/>Copyright
&#xa9; 2023 Elsevier Inc.

<59>
Accession Number
2026211591
Title
Efficacy of Perioperative Infusion of N(2)-L-alanyl-L-glutamine in
Glycemic Control for Patients With Uncontrolled Diabetes Mellitus
Presented for Urgent Coronary Artery Bypass Surgery: A Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2289-2298),
2023. Date of Publication: November 2023.
Author
Ahmad A.H.M.; Kamal Eldin F.; Rashed M.M.
Institution
(Ahmad, Kamal Eldin, Rashed) Faculty of Medicine, Ain Shams University,
Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the efficacy of preoperative glutamine infusion in
reducing insulin requirements in patients with uncontrolled type 2
diabetes, defined as glycated hemoglobin (HbA1c) >7%, undergoing urgent
coronary artery bypass graft (CABG) surgery. <br/>Design(s): A randomized
controlled trial. <br/>Setting(s): At Ain Shams University Hospital,
Cardiothoracic Academy. <br/>Participant(s): Ninety-three patients (of
both sexes) with uncontrolled diabetes presenting for urgent CABG were
categorized into 2 groups. <br/>Intervention(s): The dipeptiven group (n =
46) was given an infusion of dipeptiven 1.5 mL/kg body weight dissolved in
normal saline (200 mL) over 3 hours before surgery. The control group (n =
47) received a normal saline infusion (200 mL). <br/>Measurements and Main
Results: The dipeptiven group demonstrated statistically significant lower
intraoperative (173.74 +/- 19.97 mg/dL v 198.22 +/-14.64 mg/dL) and
postoperative (162.36 +/-13.11 mg/dL v 176.13 +/-14.86 mg/dL) mean blood
glucose levels. In addition, dipeptiven infusion was found to reduce mean
total insulin requirements intraoperatively by 3.64 +/- 0.56 units/h and
postoperatively by 37.109 +/- 4.30 units/24 h in comparison to placebo
(50.98 +/- 16.55 units/24 h and 5.10 +/- 2.28 units/h, respectively).
<br/>Conclusion(s): A preoperative infusion of dipeptiven can contribute
to ameliorating stress hyperglycemia in uncontrolled diabetic patients
undergoing urgent CABG.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<60>
Accession Number
2026084796
Title
Usefulness of C-curved stylet for intubation with the C-MAC Miller
videolaryngoscope in neonates and infants: a prospective randomized
controlled trial.
Source
Korean Journal of Anesthesiology. 76(5) (pp 433-441), 2023. Date of
Publication: 01 Oct 2023.
Author
Park J.-B.; Kang P.-Y.; Kim T.; Ji S.-H.; Jang Y.-E.; Kim E.-H.; Kim
J.-T.; Kim H.-S.; Lee J.H.
Institution
(Park, Kang, Kim, Ji, Jang, Kim, Kim, Kim, Lee) Department of
Anesthesiology and Pain Medicine, Seoul National University Hospital,
Seoul National University College of Medicine, Seoul, South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Optimizing endotracheal tube (ETT) shape is important for
successful vide-olaryngoscope-aided intubation. This prospective
randomized controlled study aimed to compare the tube-handling time
between a C-curved and hockey stick-shaped stylet in infants and neonates
using the C-MAC videolaryngoscope Miller blade. <br/>Method(s): A total of
110 infants (age < 1 year) were randomly assigned to either the hockey
stick-curved stylet group (group H, n = 53) or the C-curved stylet group
(group C, n = 57). The primary outcome was tube handling time after
glottis visualization and the secondary outcomes were the total intubation
time, incidence of successful intubation, initial tube tip location at the
laryngeal inlet, and numerical rating scale for ease of intubation.
<br/>Result(s): Tube insertion time and total intubation duration (both in
seconds) were signifi-cantly shorter in group C than in group H (13.3 +/-
8.9 vs. 25.1 +/- 27.0, P = 0.002; 19.9 +/- 9.4 vs. 32.8 +/- 27.1, P =
0.001, respectively). Group C displayed a higher rate of intubation
success within 30 s than group H (87.7% vs. 69.8%, P = 0.029). The initial
tube tip was located at the center in 34 children in group C (59.6%) and
12 children in group H (26.1%, P < 0.001). Laryngoscope operators rated
intubation as easier when provided with a C-curved stylet.
<br/>Conclusion(s): In neonates and infants, modification of the ETT shape
into a C-curve may reduce tube handling time compared to the conventional
hockey stick-shaped tube during intubation using a C-MAC video
laryngoscope Miller blade.<br/>Copyright &#xa9; The Korean Society of
Anesthesiologists, 2023.

<61>
Accession Number
2025897078
Title
Effect of Dexmedetomidine on Postoperative Plasma Neurofilament Light
Chain in Elderly Patients Undergoing Thoracoscopic Surgery: A Prospective,
Randomized Controlled Trial.
Source
Clinical Interventions in Aging. 18 (pp 1565-1576), 2023. Date of
Publication: 2023.
Author
Hou Y.-R.; Xu C.-Y.; An M.-Z.; Li Z.-P.; Ni H.-D.; Chen T.; Zhou Q.-H.
Institution
(Hou, Xu, An) Anesthesia Medicine, Zhejiang Chinese Medical University,
Zhejiang, Hangzhou, China
(Hou, Xu, An, Li, Ni, Zhou) Department of Anesthesiology and Pain
Medicine, the Affiliated Hospital of Jiaxing University, Jiaxing,
Zhejiang, China
(Chen) Department of Anesthesiology, Tongxiang First People's Hospital,
Tongxiang, Zhejiang, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Dexmedetomidine exerts a neuroprotective effect, however, the
mechanism underlying this effect remains unclear. This study aimed to
explore whether dexmedetomidine can reduce the increase in neurofilament
light chain (NfL) protein concentration to play a neuroprotective role
during thoracoscopic surgery. <br/>Patients and Methods: Patients aged
>=60 years undergoing general anesthesia for thoracoscopic surgery were
randomly assigned to receive dexmedetomidine (group D) or not receive
dexmedetomidine (group C). Patients in group D received a loading dose of
dexmedetomidine 0.5 microg/kg before anesthesia induction and a continuous
infusion at 0.5 mug.kg^{-1.h -1} until the end of the surgery.
Dexmedetomidine was not administered in group C. The primary outcome was
the NfL concentration on postoperative day 1. The concentrations of
procalcitonin (PCT), serum amyloid A (SAA), and high-sensitivity
C-reactive protein (hs-CRP) were detected preoperatively and on
postoperative day 1. In addition, the numerical rating scale (NRS) and
quality of recovery-40 (QoR-40) scores were evaluated. <br/>Result(s): A
total of 38 patients in group D and 37 in group C were included in the
analysis. No differences were observed between the groups in terms of the
plasma concentration of NfL preoperatively and on postoperative day 1
(11.17 [8.86, 13.93] vs 13.15 [10.76, 15.56] pg/mL, P > 0.05; 16.70
[12.23, 21.15] vs 19.48 [15.25, 22.85] pg/mL, P > 0.05, respectively).
However, the postoperative plasma NfL concentration was significantly
higher than the preoperative value in both groups (both P < 0.001). The
groups exhibited no differences in PCT, SAA, hs-CRP, NRS, and QoR-40 (all
P > 0.05). <br/>Conclusion(s): Intraoperative administration of
dexmedetomidine at a conventional dose does not appear to significantly
reduce the increase in postoperative plasma NfL concentration in elderly
patients undergoing thoracoscopic surgery. This finding suggests that the
neuroprotective effect of dexmedetomidine at a conventional dose was not
obvious during general anesthesia.<br/>Copyright &#xa9; 2023 Hou et al.

<62>
Accession Number
2025206316
Title
Efficacy of intraoperative thoracoscopic intercostal nerve blocks in
nonintubated and intubated video-assisted thoracic surgery: A randomized
study.
Source
Journal of the Formosan Medical Association. 122(10) (pp 986-993), 2023.
Date of Publication: October 2023.
Author
Chan K.-C.; Wu L.-L.; Han S.-C.; Chen J.-S.; Cheng Y.-J.
Institution
(Chan) Department of Anesthesiology, National Taiwan University Hospital,
Taipei, Taiwan (Republic of China)
(Wu, Han, Cheng) Department of Anesthesiology, National Taiwan University
Cancer Center, National Taiwan University College of Medicine, Taipei,
Taiwan (Republic of China)
(Chen) Department of Surgery, National Taiwan University Cancer Center,
National Taiwan University College of Medicine, Taipei, Taiwan (Republic
of China)
Publisher
Elsevier B.V.
Abstract
Background: The efficacy of thoracoscopic intercostal nerve blocks (TINBs)
for noxious stimulation from video-assisted thoracic surgery (VATS)
remains unclear. The efficacy of TINBs may also be different between
nonintubated VATS (NIVATS) and intubated VATS (IVATS). We aim to compare
the efficacy of TINBs on analgesia and sedation for NIVATS and IVATs
intraoperatively. <br/>Method(s): Sixty patients randomized to the NIVATS
or IVATS group (30 each) received target-controlled propofol and
remifentanil infusions, with bispectral index (BIS) maintained at 40-60,
and multilevel (T3-T8) TINBs before surgical manipulations. Intraoperative
monitoring data, including pulse oximetry, mean arterial pressure (MAP),
heart rate, BIS, density spectral arrays (DSAs), and propofol and
remifentanil effect-site concentration (Ce) at different time points. A
two way ANOVA with post hoc analysis was applied to analyze the
differences and interactions of groups and time points. <br/>Result(s): In
both groups, DSA monitoring revealed burst suppression and alpha dropout
immediately after the TINBs. The Ce of the propofol infusion had to be
reduced within 5 min post-TINBs in both NIVATS (p < 0.001) and IVATS (p =
0.252) groups. The Ce of remifentanil infusion was significantly reduced
after TINBs in both groups (p < 0.001), and was significantly lower in
NIVATS (p < 0.001) without group interactions. <br/>Conclusion(s): The
surgeon-performed intraoperative multilevel TINBs allow reduced anesthetic
and analgesic requirement for VATS. With lower requirement of remifentanil
infusion, NIVATS presents a significantly higher risk of hypotension after
TINBs. DSA is beneficial for providing real-time data that facilitate the
preemptive management, especially for NIVATS.<br/>Copyright &#xa9; 2023

<63>
Accession Number
2025075625
Title
Effects of exercise prehabilitation and/or rehabilitation on
health-related quality of life and fatigue in patients with non-small cell
lung cancer undergoing surgery: A systematic review.
Source
European Journal of Surgical Oncology. 49(10) (no pagination), 2023.
Article Number: 106909. Date of Publication: October 2023.
Author
Voorn M.J.J.; Driessen E.J.M.; Reinders R.J.E.F.; van Kampen-van den
Boogaart V.E.M.; Bongers B.C.; Janssen-Heijnen M.L.G.
Institution
(Voorn, Janssen-Heijnen) Department of Clinical Epidemiology, VieCuri
Medical Centre, Venlo, Netherlands
(Voorn, Janssen-Heijnen) Department of Epidemiology, Maastricht University
Medical Centre, GROW School for Oncology and Reproduction, Maastricht,
Netherlands
(Driessen) Department of Urology, Maastricht University Medical Center,
Netherlands
(Reinders) Practice for physical therapy, Zorgboog in Balans, Helmond,
Netherlands
(van Kampen-van den Boogaart) Department of Pulmonology, VieCuri Medical
Centre, Venlo, Netherlands
(Bongers) Department of Nutrition and Movement Sciences, Nutrition and
Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine
and Life Sciences, Maastricht University, Maastricht, Netherlands
(Bongers) Department of Surgery, Nutrition and Translational Research in
Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences,
Maastricht University, Maastricht, Netherlands
Publisher
W.B. Saunders Ltd
Abstract
Background: This systematic review aimed to appraise the current available
evidence regarding the effects of exercise prehabilitation and
rehabilitation on perceived health-related quality of life (HRQoL) and
fatigue in patients undergoing surgery for non-small cell lung cancer
(NSCLC). <br/>Method(s): Studies were selected according to Cochrane
guidelines and assessed for methodological quality and therapeutic quality
(the international CONsensus on Therapeutic Exercise aNd Training
(i-CONTENT)). Eligible studies included patients with NSCLC performing
exercise prehabilitation and/or rehabilitation and postoperative HRQoL and
fatigue up to 90-days postoperatively. <br/>Result(s): Thirteen studies
were included. Exercise prehabilitation and rehabilitation significantly
improved postoperative HRQoL in almost half of the studies (47%), although
none of the studies demonstrated a decrease in fatigue. Methodological
quality and therapeutic quality were poor in respectively 62% and 69% of
the studies. <br/>Conclusion(s): There was an inconsistent effect of
exercise prehabilitation and exercise rehabilitation on improving HRQoL in
patients with NSCLC undergoing surgery, with no effect on fatigue. Due to
the low methodological and therapeutic quality of included studies, it was
not possible to identify the most effective training program content to
improve HRQoL and reduce fatigue. It is recommended to investigate the
impact of a high therapeutic qualified exercise prehabilitation and
exercise rehabilitation on HRQoL and fatigue in larger
studies.<br/>Copyright &#xa9; 2023 The Authors

<64>
Accession Number
2024115591
Title
Prognostic value of coronary computed tomography angiographic derived
fractional flow reserve: a systematic review and meta-analysis.
Source
Heart. 108(3) (pp 194-202), 2022. Date of Publication: 2022.
Author
Norgaard B.L.; Gaur S.; Fairbairn T.A.; Douglas P.S.; Jensen J.M.; Patel
M.R.; Ihdayhid A.R.; Ko B.S.H.; Sellers S.L.; Weir-McCall J.; Matsuo H.;
Niels Peter R.S.; Ovrehus K.A.; Rogers C.; Mullen S.; Nieman K.; Parner
E.; Leipsic J.; Abdulla J.
Institution
(Norgaard, Gaur, Jensen) Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(Fairbairn) Liverpool Heart and Chest Hospital, NHS Trust, Liverpool,
United Kingdom
(Douglas, Patel) DCRI, Duke University, Durham, NC, United States
(Ihdayhid, Ko) Cardiology, MonashHeart, Melbourne, VIC, Australia
(Sellers, Leipsic) Radiology, St Pauls Hospital, Vancouver, BC, Canada
(Weir-McCall) Radiology, University of Cambridge, School of Clinical
Medicine, Cambridge, United Kingdom
(Matsuo) Cardiology, Gify Heart Center, Gifu, Japan
(Niels Peter) Institute of Regional Health Services Research, University
of Southern Denmark, Esbjerg, Denmark
(Ovrehus) Cardiology, University of Southern Denmark, Odense, Denmark
(Rogers, Mullen) HeartFlow Inc, Redwood City, CA, United States
(Nieman) Cardiology, Stanford University Hospital, Palo Alto, CA, United
States
(Parner) Department of Public Health, Aarhus Universitet Health, Aarhus,
Denmark
(Abdulla) Cardiology, Glostrup University Hospital, Glostrup, Denmark
Publisher
BMJ Publishing Group
Abstract
Objectives To obtain more powerful assessment of the prognostic value of
fractional flow reserve<inf>CT</inf> testing we performed a systematic
literature review and collaborative meta-analysis of studies that assessed
clinical outcomes of CT-derived calculation of FFR (FFR<inf>CT</inf>)
(HeartFlow) analysis in patients with stable coronary artery disease
(CAD). Methods We searched PubMed and Web of Science electronic databases
for published studies that evaluated clinical outcomes following
fractional flow reserve<inf>CT</inf> testing between 1 January 2010 and 31
December 2020. The primary endpoint was defined as'all-cause mortality
(ACM) or myocardial infarction (MI)' at 12-month follow-up. Exploratory
analyses were performed using major adverse cardiovascular events (MACEs,
ACM+MI+unplanned revascularisation), ACM, MI, spontaneous MI or unplanned
(>3 months) revascularisation as the endpoint. Results Five studies were
identified including a total of 5460 patients eligible for meta-analyses.
The primary endpoint occurred in 60 (1.1%) patients, 0.6% (13/2126) with
FFR<inf>CT</inf>>0.80% and 1.4% (47/3334) with FFR<inf>CT</inf> <=0.80
(relative risk (RR) 2.31 (95% CI 1.29 to 4.13), p=0.005). Likewise, MACE,
MI, spontaneous MI or unplanned revascularisation occurred more frequently
in patients with FFR<inf>CT</inf> <=0.80 versus patients with
FFR<inf>CT</inf> >0.80. Each 0.10-unit FFR<inf>CT</inf> reduction was
associated with a greater risk of the primary endpoint (RR 1.67 (95% CI
1.47 to 1.87), p<0.001). Conclusions The 12-month outcomes in patients
with stable CAD show low rates of events in those with a negative
FFR<inf>CT</inf> result, and lower risk of an unfavourable outcome in
patients with a negative test result compared with patients with a
positive test result. Moreover, the FFR<inf>CT</inf> numerical value was
inversely associated with outcomes.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<65>
Accession Number
2024071345
Title
Infective endocarditis involving MitraClip^&#xa9; devices: a
systematic literature review.
Source
Infection. 51(5) (pp 1241-1248), 2023. Date of Publication: October 2023.
Author
Bertolino L.; Ramadan M.S.; Zampino R.; Durante-Mangoni E.
Institution
(Bertolino, Zampino) Department of Advanced Medical & Surgical Sciences,
University of Campania 'L. Vanvitelli', Naples, Italy
(Ramadan, Zampino, Durante-Mangoni) Unit of Infectious and Transplant
Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore
Ruggieri, Naples 80131, Italy
(Ramadan, Durante-Mangoni) Department of Precision Medicine, University of
Campania 'L. Vanvitelli', Naples, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Progress of interventional cardiology has boosted the use of
newer cardiac devices. These devices are perceived to be less prone to
infections compared to traditional surgical prostheses, but little data
are currently available. In this systematic review (SR), we summarize
current literature regarding the clinical characteristics, management, and
outcomes of patients with MitraClip-related infective endocarditis (IE).
<br/>Method(s): We conducted a SR of PubMed, Google Scholar, Embase, and
Scopus between January 2003 and March 2022. MitraClip-related IE was
defined according to 2015 ESC criteria whereas MitraClip involvement as
vegetation on the device or on the mitral valve. Risk of bias was assessed
through standardized checklist and potential bias of underestimation
cannot be excluded. Data regarding clinical presentation,
echocardiography, management, and outcome were collected. <br/>Result(s):
Twenty-six cases of MitraClip-related IE were retrieved. The median age of
patients was 76 [61-83] years with a median EuroScore of 41%. Fever was
present in 65.8% of patients followed by signs and symptoms of heart
failure (42.3%). IE occurred early in 20 (76.9%) cases with a median time
between MitraClip implantation and IE symptom onset of 5 [2-16] months.
Staphylococcus aureus was the major causative microorganism (46%).
Surgical mitral valve replacement was needed in 50% of patients. A
conservative medical approach was considered in the remainder. The overall
in-hospital mortality rate was 50% (surgical group: 38.4%; medical group:
58.3%; p = 0.433). <br/>Conclusion(s): Our results suggest that
MitraClip-related IE affects elderly, comorbid patients, is mostly due to
Staphylococcus aureus, and has a poor prognosis irrespective of the
therapeutic approach. Clinicians must be aware of the features of this new
entity among cardiovascular infections.<br/>Copyright &#xa9; 2023, The
Author(s).

<66>
Accession Number
2023928974
Title
Extrapleural infusion of levobupivacaine versus
levobupivacaine-sufentanil-adrenaline after video-assisted thoracoscopic
surgery (VATS): A randomised controlled trial.
Source
Acta Anaesthesiologica Scandinavica. 67(9) (pp 1256-1265), 2023. Date of
Publication: October 2023.
Author
Larsson M.; Sartipy U.; Franco-Cereceda A.; Spigset O.; Loevenich M.;
Owall A.; Jakobsson J.
Institution
(Larsson, Sartipy, Franco-Cereceda, Owall) Department of Molecular
Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
(Larsson, Owall) Function Perioperative Medicine and Intensive Care,
Section for Cardiothoracic Anaesthesia and Intensive Care, Karolinska
University Hospital, Stockholm, Sweden
(Sartipy, Franco-Cereceda) Department of Cardiothoracic Surgery,
Karolinska University Hospital, Stockholm, Sweden
(Spigset, Loevenich) Department of Clinical Pharmacology, St. Olav
University Hospital, Trondheim, Norway
(Spigset) Department of Clinical and Molecular Medicine, Norwegian
University of Science and Technology, Trondheim, Norway
(Jakobsson) Institution for Clinical Sciences, Karolinska Institutet at
Danderyd Hospital, Stockholm, Sweden
(Jakobsson) Department of Anaesthesia and Intensive Care, Danderyd
Hospital, Stockholm, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Peripheral blocks are increasingly used for analgesia after
video-assisted thoracic surgery (VATS). We hypothesised that addition of
sufentanil and adrenaline to levobupivacaine would improve the analgesic
effect of a continuous extrapleural block. <br/>Method(s): We randomised
60 patients undergoing VATS to a 5-mL h^-1 extrapleural infusion
of levobupivacaine at 2.7 mg mL^-1 (LB group) or levobupivacaine
at 1.25 mg mL^-1, sufentanil at 0.5 mug mL^-1, and
adrenaline at 2 mug mL^-1 (LBSA group). The primary outcome was
the cumulative morphine dose administered as patient-controlled analgesia
(PCA-morphine) at 48 and 72 h. The secondary outcomes were pain according
to numerical rating scale (NRS) at rest and after two deep breaths twice
daily, peak expiratory flow (PEF) daily, quality of recovery (QoR)-15
score at 1 day and 3 weeks postoperatively, serum levobupivacaine
concentrations at 1 h after the start and at the end of the intervention,
and adverse events. <br/>Result(s): At 48 h, the median cumulative
PCA-morphine dose for the LB group was 6 mg (IQR, 2-10 mg) and for the
LBSA group 7 mg (IQR, 3-13.5 mg; p =.378). At 72 h, morphine doses were 10
mg (IQR, 3-22 mg) and 12.5 mg (IQR, 4-21 mg; p =.738), respectively.
Median NRS score at rest and after two deep breaths was 3 or lower at all
time points for both treatment groups. PEF did not differ between groups.
Three weeks postoperatively, only the LB group returned to baseline QoR-15
score. The LB group had higher, but well below toxic, levobupivacaine
concentrations at 48 and 72 h. The incidence of nausea, dizziness,
pruritus and headache was equally low overall. <br/>Conclusion(s): For a
continuous extrapleural block, and compared to plain levobupivacaine at
13.5 mg h^-1, levobupivacaine at 6.25 mg h^-1 with
addition of sufentanil and adrenaline did not decrease postoperative
morphine consumption. The levobupivacaine serum concentrations after 48
and 72 h of infusion were well below toxic levels, therefore our findings
support the use of the maximally recommended dose of levobupivacaine for a
2- to 3-day continuous extrapleural block.<br/>Copyright &#xa9; 2023 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<67>
[Use Link to view the full text]
Accession Number
2018016667
Title
Combined Programmed Intermittent Bolus Infusion With Continuous Infusion
for the Thoracic Paravertebral Block in Patients Undergoing Thoracoscopic
Surgery A Prospective, Randomized, and Double-blinded Study.
Source
Clinical Journal of Pain. 38(6) (pp 410-417), 2022. Date of Publication:
2022.
Author
Yang L.; Huang X.; Cui Y.; Xiao Y.; Zhao X.; Xu J.
Institution
(Yang, Huang, Cui, Xiao, Zhao, Xu) Department of Anesthesiology, The
Second Xiangya Hospital, Central South University, Hunan Province,
Changsha, China
(Yang, Huang, Cui, Xiao, Xu) Hunan Province Center for Clinical Anesthesia
and Anesthesiology, Research Institute of Central South University, Hunan
Province, Changsha, China
(Zhao) Department of Anesthesiology, The First Affiliated Hospital, Sun
Yat-sen University, Guangdong Province, Guangzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Continuous thoracic paravertebral block (TPVB) connected with
patient-controlled analgesia (PCA) pump is an effective modality to reduce
postoperative pain following thoracic surgery. For the PCA settings, the
programmed intermittent bolus infusion (PIBI) and continuous infusion (CI)
are commonly practiced. However, the comparative effectiveness between the
2 approaches has been inconsistent. Thus, the aim of this study was to
explore the optimal PCA settings to treat postthoracotomy pain by combing
PIBI and CI together. <br/>Method(s): All enrolled patients undergoing
thoracoscopic surgery accepted ultrasound-guided TPVB catheterization
before the surgery and then were randomly allocated in to 3 groups
depending on different settings of the PCA pump connecting to the TPVB
catheter: the PIBI+CI, PIBI, and CI groups. Numerical Rating Scales were
evaluated for each patient at T1 (1 h after extubation), T2 (12 h after
the surgery), T3 (24 h after the surgery), T4 (36 h after the surgery),
and T5 (48 h after the surgery). Besides, the consumptions of PCA
ropivacaine, the number of blocked dermatomes at T3, and the requirement
for extra dezocine for pain relief among the 3 groups were also compared.
<br/>Result(s): First, the Numerical Rating Scale scores in the PIBI+CI
group were lower than the CI group at T2 and T3 (P < 0.05) when patients
were at rest and were also lower than the CI group at T2, T3, and T4 (P <
0.01) and the PIBI group at T3 when patients were coughing (P < 0.01).
Second, the 2-day cumulative dosage of PCA in the PIBI+CI group was lower
than both the CI and PIBI groups (P < 0.01). Third, the number of blocked
dermatomes in the PIBI and PIBI+CI groups were comparable and were both
wider than the CI group at T3 (P < 0.01). Finally, a smaller proportion
(not statistically significant) of patients in the PIBI+CI group (5.26%,
2/38) had required dezocine for pain relief when compared with the PIBI
group (19.44%, 7/36) and the CI group (15.79%, 6/38). <br/>Conclusion(s):
The combination of PIBI and CI provides superior analgesic modality to
either PIBI or CI alone in patients undergoing thoracoscopic surgery.
Therefore, it should be advocated to improve the management of
postoperative pain, clinical outcomes, and ultimately patient
satisfaction.<br/>Copyright &#xa9; 2022 The Author(s). Published by
Wolters Kluwer Health, Inc.

<68>
Accession Number
2027587197
Title
A Perioperative Mental Health Intervention for Depressed and Anxious Older
Surgical Patients: Results From a Feasibility Study.
Source
American Journal of Geriatric Psychiatry. (no pagination), 2023. Date of
Publication: 2023.
Author
Abraham J.; Holzer K.J.; Lenard E.M.; Meng A.; Pennington B.R.T.; Wolfe
R.C.; Haroutounian S.; Calfee R.; Hammil C.W.; Kozower B.D.; Cordner T.A.;
Schweiger J.; McKinnon S.; Yingling M.; Baumann A.A.; Politi M.C.;
Kannampallil T.; Miller J.P.; Avidan M.S.; Lenze E.J.
Institution
(Abraham, Holzer, Meng, Pennington, Haroutounian, Cordner, McKinnon,
Kannampallil, Avidan) Department of Anesthesiology (JA, KJH, AM, BRTP, SH,
TAC, SM, TK, MSA), Washington University School of Medicine, St. Louis,
MO, United States
(Abraham, Kannampallil, Miller) Institute for Informatics (JA, TK, JPM),
Data Science and Biostatistics, Washington University School of Medicine,
St. Louis, MO, United States
(Lenard, Schweiger, Yingling, Lenze) Department of Psychiatry (EML, JS,
MY, EJ), Washington University School of Medicine, St. Louis, MO, United
States
(Wolfe) Department of Pharmacy (RCW), Barnes-Jewish Hospital, St. Louis,
MO, United States
(Calfee) Department of Orthopaedic Surgery (RC), Washington University
School of Medicine, St. Louis, MO, United States
(Hammil, Kozower, Baumann, Politi) Department of Surgery (CWH, BDK, AAB,
MCP), Washington University School of Medicine, St. Louis, MO, United
States
Publisher
Elsevier B.V.
Abstract
Objectives: The perioperative period is challenging and stressful for
older adults. Those with depression and/or anxiety have an increased risk
of adverse surgical outcomes. We assessed the feasibility of a
perioperative mental health intervention composed of medication
optimization and a wellness program following principles of behavioral
activation and care coordination for older surgical patients.
<br/>Method(s): We included orthopedic, oncologic, and cardiac surgical
patients aged 60 and older. Feasibility outcomes included study reach, the
number of patients who agreed to participate out of the total eligible;
and intervention reach, the number of patients who completed the
intervention out of patients who agreed to participate. Intervention
efficacy was assessed using the Patient Health Questionnaire for Anxiety
and Depression (PHQ-ADS). Implementation potential and experiences were
collected using patient surveys and qualitative interviews. Complementary
caregiver feedback was also collected. <br/>Result(s): Twenty-three out of
28 eligible older adults participated in this study (mean age 68.0 years,
65% women), achieving study reach of 82% and intervention reach of 83%. In
qualitative interviews, patients (n = 15) and caregivers (complementary
data, n = 5) described overwhelmingly positive experiences with both the
intervention components and the interventionist, and reported improvement
in managing depression and/or anxiety. Preliminary efficacy analysis
indicated improvement in PHQ-ADS scores (F = 12.13, p <0.001).
<br/>Conclusion(s): The study procedures were reported by participants as
feasible and the perioperative mental health intervention to reduce
anxiety and depression in older surgical patients showed strong
implementation potential. Preliminary data suggest its efficacy for
improving depression and/or anxiety symptoms. A randomized controlled
trial assessing the intervention and implementation effectiveness is
currently ongoing.<br/>Copyright &#xa9; 2023 American Association for
Geriatric Psychiatry

<69>
Accession Number
2027201146
Title
Atrial Fibrillation and Bioprosthetic Valves: An Evidence-Based Approach
to Anticoagulation Therapy With Direct Oral Anticoagulants and Vitamin K
Antagonists: A Systematic Review, Meta-Analysis, and Network
Meta-Analysis.
Source
American Journal of Cardiology. 206 (pp 339-340), 2023. Date of
Publication: 01 Nov 2023.
Author
Orban M.
Institution
(Orban) Nemocnicna a.s., Cardiology Clinic, Slovakia, Malacky, Slovakia
Publisher
Elsevier Inc.

<70>
Accession Number
2024992316
Title
Clinical outcomes and the impact of valve morphology for transcatheter
aortic valve replacement in bicuspid aortic valves: A systematic review
and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 102(4) (pp 721-730),
2023. Date of Publication: 01 Oct 2023.
Author
Gupta R.; Mahmoudi E.; Behnoush A.H.; Malik A.H.; Mahajan P.; Lin M.;
Bandyopadhyay D.; Goel A.; Chakraborty S.; Aedma S.K.; Gupta H.B.; Vyas
A.V.; Combs W.G.; Mathur M.; Yakubov S.J.; Patel N.C.
Institution
(Gupta, Vyas, Combs, Patel) Lehigh Valley Heart Institute, Lehigh Valley
Health Network, Allentown, PA, United States
(Mahmoudi) Universal Scientific Education and Research Network, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Behnoush) School of Medicine, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Malik, Bandyopadhyay, Goel, Chakraborty) Department of Cardiology,
Westchester Medical Center and New York Medical College, Valhalla, NY,
United States
(Mahajan, Aedma) Department of Medicine, Carle Foundation Hospital,
Urbana, IL, United States
(Lin) Morsani College of Medicine, University of South Florida, Tampa, FL,
United States
(Gupta) Guru Nanak Dev Hospital, Department of medicine, Government
Medical College, Punjab, Amritsar, India
(Mathur) Heart & Vascular Institute, Penn State Health, Milton S. Hershey
Medical Center, Hershey, PA, United States
(Yakubov) Department of Interventional Cardiology, Riverside
Methodist-Ohio Health, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Bicuspid aortic valve (BAV) is present in approximately
0.5%-2% of the general population, causing significant aortic stenosis
(AS) in 12%-37% of affected individuals. Transcatheter aortic valve
replacement (TAVR) is being considered the treatment of choice in patients
with symptomatic AS across all risk spectra. <br/>Aim(s): Aim Our study
aims to compare TAVR outcomes in patients with BAV versus tricuspid aortic
valves (TAV). <br/>Method(s): A comprehensive literature search was
performed in PubMed, Web of Science, and Cochrane trials. Studies were
included if they included BAV and TAV patients undergoing TAVR with
quantitative data available for at least one of our predefined outcomes.
Meta-analysis was performed by the random-effects model using Stata
software. <br/>Result(s): Fifty studies of 203,288 patients were included.
BAV patients had increased 30-day all-cause mortality (odds ratio [OR] =
1.23 [1.00-1.50], p = 0.05), in-hospital stroke (OR = 1.39 [1.01-1.93], p
= 0.05), in-hospital and 30-day PPI (OR = 1.13 [1.00-1.27], p = 0.04; OR =
1.16 [1.04-1.13], p = 0.01) and in-hospital, 30-day and 1-year aortic
regurgitation (AR) (OR = 1.48 [1.19-1.83], p < 0.01; OR = 1.79
[1.26-2.52], p < 0.01; OR = 1.64 [1.03-2.60], p = 0.04). Subgroup analysis
on new-generation valves showed a reduced 1-year all-cause mortality (OR =
0.86 [CI = 0.75-0.98], p = 0.03), despite higher in-hospital and 30-day
PPI (OR = 0.1.21 [1.04-1.41], p = 0.01; OR = 1.17 [1.05-1.31], p = 0.01)
and in-hospital AR (OR = 1.62 [1.14-2.31], p = 0.01) in the BAV group. The
quality of included studies was moderate-to-high, and only three analyses
presented high heterogeneity. <br/>Conclusion(s): TAVR is associated with
comparable outcomes in patients with BAV and TAV. Careful selection of BAV
cases by preprocedural assessment of valve anatomy and burden of
calcification, pre- and post-procedural dilation, and implementing newer
generations of valves may improve the safety and efficacy of TAVR in BAV
patients.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<71>
Accession Number
2024892152
Title
Outcomes of transcatheter edge-to-edge repair for atrial functional mitral
regurgitation: A meta-analysis of observational studies.
Source
Catheterization and Cardiovascular Interventions. 102(4) (pp 751-760),
2023. Date of Publication: 01 Oct 2023.
Author
Hamada S.; Ueyama H.; Aikawa T.; Kampaktsis P.N.; Misumida N.; Takagi H.;
Kuno T.; Latib A.
Institution
(Hamada) Imperial College London, School of Public Health, London, United
Kingdom
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Aikawa) Department of Cardiology, Juntendo University Urayasu Hospital,
Urayasu, Japan
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, NY, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno, Latib) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York City, NY, United States
(Kuno) Department of Cardiology, Jacobi Medical Center, Albert Einstein
College of Medicine, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter edge-to-edge repair (TEER) may have potential
benefits in the treatment of atrial functional mitral regurgitation
(AFMR), but robust evidence is currently lacking. We conducted a
systematic review and meta-analysis to investigate the clinical outcomes
of TEER for AFMR, including comparisons to ventricular functional MR
(VFMR). <br/>Method(s): MEDLINE and EMBASE were searched through January
2023 to identify studies eligible for analysis. The primary outcome was
postprocedural MR severity. Postprocedural New York Heart Association
(NYHA) functional class classification and all-cause mortality were also
evaluated. Outcomes were stratified into short term (postprocedure to 6
months) and long term (6 months to 2 years). <br/>Result(s): A total of
eight observational studies met the inclusion criteria, enrolling 539 AFMR
and 3486 VFMR patients. Postprocedural MR grade <=2 in the AFMR group was
observed in 93.7% (454/491 patients; 95% confidence interval (CI),
91.1%-96.2%, I² = 24.3%) and 97.1% (89/93 patients; 95% CI,
92.9%-100%, I² = 26.4%) in short- and long-term follow-up,
respectively. There was no difference in the rates of postprocedural MR
grade <=2 between AFMR and VFMR either in short-term (risk ratio [RR],
1.00 [95% CI, 0.95-1.06]; p = 0.90; I² = 53%) or long-term
follow-up (RR, 1.08 [95% CI, 0.89-1.32]; p = 0.44; I² = 22%).
Similarly, no difference was observed between AFMR and VFMR in the rates
of postprocedural NYHA class <=2 or all-cause mortality.
<br/>Conclusion(s): TEER provides similar clinical outcomes for AFMR and
VFMR. A high rate of MR grade <=2 was observed in patients at both short-
and long-term follow-ups. Further prospective studies with TEER versus
medical therapy and/or rhythm control for AFMR are
warranted.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<72>
Accession Number
2024026023
Title
Effect of cryothermic and radiofrequency Cox-Maze IV ablation on atrial
size and function assessed by 2D and 3D echocardiography, a randomized
trial. To freeze or to burn.
Source
Clinical Physiology and Functional Imaging. 43(6) (pp 431-440), 2023. Date
of Publication: November 2023.
Author
Boano G.; Vanky F.; Astrom Aneq M.
Institution
(Boano, Vanky) Department of Thoracic and Vascular Surgery in
Ostergotland, and Department of Health, Medicine and Caring Sciences,
Linkoping University, Linkoping, Sweden
(Astrom Aneq) Department of Clinical Physiology in Linkoping, Department
of Health, Medicine and Caring Sciences Linkoping University, Linkoping,
Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrial linear scars in Cox-Maze IV procedures are achieved
using Cryothermy (Cryo) or radiofrequency (RF) techniques. The subsequent
postoperative left atrial (LA) reverse remodelling is unclear. We used 2-
and 3-dimensional echocardiography (2-3DE) to compare the impact of Cryo
and RF procedures on LA size and function 1 year after Cox-maze IV
ablation concomitant with Mitral valve (MV) surgery. <br/>Method(s):
Seventy-two patients with MV disease and AF were randomized to Cryo (n =
35) or RF (n = 37) ablation. Another 33 patients were enroled without
ablation (NoMaze). All patients underwent an echocardiogram the day before
and 1 year after surgery. The LA function was assessed on 2D strain by
speckle tracking and 3DE. <br/>Result(s): Forty-two ablated patients
recovered sinus rhythm (SR) 1 year after surgery. They had comparable left
and right systolic ventricular function, LA volume index (LAVI), and 2D
reservoir strain before surgery. At follow-up, the 3DE extracted reservoir
and booster function were higher after RF (37 +/- 10% vs. 26 +/- 6%; p <
0.001) than Cryo ablation (18 +/- 9 vs. 7 +/- 4%; p < 0.001), while
passive conduit function was comparable between groups (24 +/- 11 vs. 20
+/- 8%; p = 0.17). The extent of LAVI reduction depended on the duration
of AF preoperatively. <br/>Conclusion(s): SR restoration after MV surgery
and maze results in LA size reduction irrespective of the energy source
used. Compared to RF, the extension of ablation area produced by Cryo
implies a structural LA remodelling affecting LA systolic
function.<br/>Copyright &#xa9; 2023 The Authors. Clinical Physiology and
Functional Imaging published by John Wiley & Sons Ltd on behalf of
Scandinavian Society of Clinical Physiology and Nuclear Medicine.

<73>
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. <br/>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.
<br/>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. <br/>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.<br/>Copyright &#xa9; 2023 Authors. All
rights reserved.

<74>
Accession Number
2027557189
Title
ASSESSMENT OF EFFECT OF TXA IN OFF-PUMP CARDIAC SURGERY PATIENTS.
Source
International Journal of Academic Medicine and Pharmacy. 5(2) (pp
1604-1607), 2023. Date of Publication: 2023.
Author
Vijay D.; Gajarajan S.; Sindhu S.
Institution
(Vijay, Gajarajan) Department of Anaesthesia, Velammal Medical College &
Research Institute, Tamil Nadu, Madurai, India
(Sindhu) Department of Pharmacology, Velammal Medical College & Research
Institute, Tamil Nadu, Madurai, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: To investigate the effect of TXA in off-pump cardiac surgery
(OPCAB) patients. <br/>Material(s) and Method(s): Sixty patients scheduled
to undergo OPCAB of both genders were randomly assigned to 2 groups. Group
I received TXA and group II received placebo. TXA was administered
intravenously at a dose of 15 mg/kg before the start of surgery and a
second dose of 15 mg/kg at the end of surgery. Placebo was also
administered in the same manner. Parameters such as the amount of blood
loss during surgery, the need for blood transfusions, length of hospital
stay, the incidence of perioperative complications and mortality was
recorded. <br/>Result(s): Group I comprised of 20 males and 10 females and
group II 18 males and 12 females. The mean blood loss in group I was 625.0
ml and in group II was 694.4 ml. The difference was significant (P< 0.05).
Fresh frozen plasma (FFP) was required in 2 patients in group I and 5 in
group II. Packed cell (PC) was required in 2 patients on group I and 6 in
group II. A significant difference was found (P< 0.05). The mean stay in
hospital was 8.11 days in group I and 9.14 days in group II. The mean stay
in ICU was 3.38 days in group I and 4.61 days in group II. A significant
difference was found (P< 0.05). Complications observed were infection in 1
patient in group I and 3 patients in group II. Intraoperative bleeding was
seen in 2 in group I and 5 in group II. Pericardial effusion was observed
in 2 patients in group II. A significant difference was found (P< 0.05). 1
patient in group I died due to cardiac arrest on 8th postoperative day. 3
patients in group II died due to cardiac arrest on 6th postoperative day.
A significant difference was found (P< 0.05). <br/>Conclusion(s): TXA
found to be effective in reducing bleeding and the need for blood
transfusions in OPCAB. It reduced complications as compared to
placebo.<br/>Copyright &#xa9; 2023 Society for Healthcare and Research
Development. All Rights Reserved.

<75>
Accession Number
2027556768
Title
A COMPARISON OF EFFICACY OF TRANSVERSUS ABDOMINIS PLANE BLOCK VERSUS
RECTUS SHEATH BLOCK OF BUPIVACAINE FOR POSTOPERATIVE ANALGESIA FOLLOWING
TOTAL ABDOMINAL HYSTERECTOMY: A RANDOMIZED CLINICAL STUDY.
Source
International Journal of Academic Medicine and Pharmacy. 5(1) (pp
561-566), 2023. Date of Publication: 2023.
Author
Sivabalan R.G.; Maheswari U.P.; Kumar A.D.; Prabakaran W.
Institution
(Sivabalan, Maheswari, Kumar, Prabakaran) Institute of Anaesthesiology and
Critical Care, Madras Medical College, Tamil Nadu, Chennai, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Total abdominal hysterectomy is a major surgical procedure
associated with significant post-operative pain, which arises from several
traumatized structures during surgery. This study compares the analgesic
efficacy of transversus abdominis plane block (TAPB) versus rectus sheath
block (RSB) with 0.5% Bupivacaine in providing post-operative analgesia
following Total Abdominal Hysterectomy. <br/>Material(s) and Method(s):
This randomized clinical study was designed to determine the
post-operative analgesic efficacy of TAPB versus RSB following total
abdominal hysterectomy. A total of 60 patients posted for elective total
abdominal hysterectomy assessed under ASA physical status 1 and 2 were
randomly assigned to two groups. At the end of the surgery, 30 patients
received TAPB, and the remaining 30 patients received RSB with 0.5%
bupivacaine. All surgeries were done under spinal anesthesia. Visual
analogue pain scores, heart rate, blood pressure and rescue analgesia were
monitored at 0, 4, 8, 12, 16, 20, and 24 hours. <br/>Result(s): In the
present study, it was observed that Visual analogue pain scores were less
in the TAPB group when compared to the RSB group. Also, rescue analgesic
requirement was less in the TAPB group compared to the RSB group. It was
also observed that post-operative heart rate was less in the TAPB group
compared to the RSB group. <br/>Conclusion(s): The present study concludes
that TAPB provides better post-operative analgesia compared to RSB in
terms of lower visual analogue pain scores, haemodynamic stability and
lesser need for rescue analgesia.<br/>Copyright &#xa9; International
Journal of Academic Medicine and Pharmacy 2023. All rights reserved.

<76>
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.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<77>
Accession Number
2027278057
Title
Complete Percutaneous Coronary Revascularization in Acute Coronary
Syndromes With Multivessel Coronary Disease: A Systematic Review.
Source
JACC: Cardiovascular Interventions. 16(19) (pp 2347-2364), 2023. Date of
Publication: 09 Oct 2023.
Author
Faro D.C.; Laudani C.; Agnello F.G.; Ammirabile N.; Finocchiaro S.;
Legnazzi M.; Mauro M.S.; Mazzone P.M.; Occhipinti G.; Rochira C.; Scalia
L.; Spagnolo M.; Greco A.; Capodanno D.
Institution
(Faro, Laudani, Agnello, Ammirabile, Finocchiaro, Legnazzi, Mauro,
Mazzone, Occhipinti, Rochira, Scalia, Spagnolo, Greco, Capodanno) Division
of Cardiology, Azienda Ospedaliero-Universitaria Policlinico G.
Rodolico-San Marco, University of Catania, Catania, Italy
Publisher
Elsevier Inc.
Abstract
Multivessel disease (MVD) affects approximately 50% of patients with acute
coronary syndromes (ACS) and is significantly burdened by poor outcomes
and high mortality. It represents a clinical challenge in patient
management and decision making and subtends an evolving research area
related to the pathophysiology of unstable plaques and local or systemic
inflammation. The benefits of complete revascularization are established
in hemodynamically stable ACS patients with MVD, and guidelines provide
some reference points to inform clinical practice, based on an evidence
level that is solid for ST-segment elevation myocardial infarction and
less robust for non-ST-segment elevation myocardial infarction and
cardiogenic shock. However, several areas of uncertainty remain, such as
the optimal timing for complete revascularization or the best guiding
strategy for intermediate stenoses. We performed a systematic review of
current evidence in the field of percutaneous revascularization in ACS and
MVD, also including future perspectives from ongoing trials that will
directly compare different timing strategies and investigate the role of
invasive and noninvasive guidance techniques. (Complete percutaneous
coronary revascularization in patients with acute myocardial infarction
and multivessel disease; CRD42022383123)<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<78>
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. (no pagination), 2023. Article
Number: 131397. Date of Publication: 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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023

<79>
Accession Number
642431925
Title
Custodiol versus blood cardioplegia in pediatric cardiac surgery: a
randomized controlled trial.
Source
European journal of medical research. 28(1) (pp 404), 2023. Date of
Publication: 05 Oct 2023.
Author
Elmahrouk A.F.; Shihata M.S.; Al-Radi O.O.; Arafat A.A.; Altowaity M.;
Alshaikh B.A.; Galal M.N.; Bogis A.A.; Al Omar H.Y.; Assiri W.J.; Jamjoom
A.A.
Institution
(Elmahrouk) Cardiothoracic Surgery Department, King Faisal Specialist
Hospital and Research Centre, P.O. Box: 40047, Jeddah 21499, Saudi Arabia
(Elmahrouk) Cardiothoracic Surgery Department, Tanta University, Egypt
(Shihata, Al-Radi, Altowaity, Bogis, Jamjoom) Cardiothoracic Surgery
Department, King Faisal Specialist Hospital and Research Centre, P.O. Box:
40047, Jeddah 21499, Saudi Arabia
(Al-Radi) Department of Surgery, Cardiac Surgery Section, King Abdulaziz
University, Jeddah, Saudi Arabia
(Arafat) Cardiothoracic Surgery Department, Tanta University, Egypt
(Alshaikh) Cardiac Surgery Department, King Fahad Armed Forces Hospital,
Jeddah, Saudi Arabia
(Galal) Pediatric Cardiac Surgery Department, King Fahad Armed Forces
Hospital, Jeddah, Saudi Arabia
(Al Omar) Research Centre, King Faisal Specialist Hospital and Research
Centre, Jeddah, Saudi Arabia
(Assiri) Department of Nursing, King Faisal Specialist Hospital and
Research Centre, Jeddah, Saudi Arabia
Abstract
BACKGROUND: Blood-based cardioplegia is the standard myocardial protection
strategy in pediatric cardiac surgery. Custadiol
(histidine-tryptophan-ketoglutarate), an alternative, may have some
advantages but is potentially less effective at myocardial protection.
This study aimed to test whether custadiol is not inferior to blood-based
cardioplegia in pediatric cardiac surgery. <br/>METHOD(S): The study was
designed as a randomized controlled trial with a blinded outcome
assessment. All pediatric patients undergoing cardiac surgery with
cardiopulmonary bypass and cardioplegia, including neonates, were
eligible. Emergency surgery was excluded. The primary outcome was a
composite of death within 30 days, an ICU stay longer than 5 days, or
arrhythmia requiring intervention. Secondary endpoints included total
hospital stay, inotropic score, cardiac troponin levels, ventricular
function, and extended survival postdischarge. The sample size was
determined a priori for a noninferiority design with an expected primary
outcome of 40% and a clinical significance difference of 20%.
<br/>RESULT(S): Between January 2018 and January 2021, 226 patients,
divided into the Custodiol cardioplegia (CC) group (n=107) and the blood
cardioplegia (BC) group (n=119), completed the study protocol. There was
no difference in the composite endpoint between the CC and BC groups, 65
(60.75%) vs. 71 (59.66%), respectively (P=0.87). The total length of stay
in the hospital was 14 (Q2-Q3: 10-19) days in the CC group vs. 13 (10-21)
days in the BC group (P=0.85). The inotropic score was not significantly
different between the CC and BC groups, 5 (2.6-7.45) vs. 5 (2.6-7.5),
respectively (P=0.82). The cardiac troponin level and ventricular function
did not differ significantly between the two groups (P=0.34 and P=0.85,
respectively). The median duration of follow-up was 32.75 (Q2-Q3:
18.73-41.53) months, and there was no difference in survival between the
two groups (log-rank P=0.55). <br/>CONCLUSION(S): Custodial cardioplegia
is not inferior to blood cardioplegia for myocardial protection in
pediatric patients. Trial registration The trial was registered in
Clinicaltrials.gov, and the ClinicalTrials.gov Identifier number is
NCT03082716 Date: 17/03/2017.<br/>Copyright &#xa9; 2023. BioMed Central
Ltd., part of Springer Nature.

<80>
Accession Number
642431349
Title
Effectiveness of acupuncture for postoperative gastrointestinal recovery
in patients undergoing thoracoscopic surgery: a prospective randomized
controlled study.
Source
Acupuncture in medicine : journal of the British Medical Acupuncture
Society. (pp 9645284231202807), 2023. Date of Publication: 06 Oct 2023.
Author
Zhang Y.; Ou C.; Luo X.; Kang Y.; Jiang L.; Wu S.; Ouyang H.
Institution
(Zhang, Ou, Luo, Kang, Wu, Ouyang) Department of Anesthesiology, State Key
Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer
Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou,
China
(Jiang) Department of Integrative Medicine, State Key Laboratory of
Oncology in Southern China, Sun Yat-sen University Cancer Center,
Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
Abstract
BACKGROUND: Postoperative gastrointestinal dysfunction (PGD) is one of the
most common complications among patients who have undergone thoracic
surgery. Acupuncture has long been used in traditional Chinese medicine to
treat gastrointestinal diseases and has shown benefit as an alternative
therapy for the management of digestive ailments. This study aimed to
explore the therapeutic effectiveness of acupuncture as a means to aid
postoperative recovery of gastrointestinal function in patients undergoing
thoracoscopic surgery. <br/>METHOD(S): In total, 112 patients aged
18-70years undergoing thoracoscopic surgery between 15 June 2022 and 30
August 2022 were randomized into two groups. Patients in the acupuncture
group (AG) first received acupuncture treatment 4h after surgery, and
treatment was repeated at 24 and 48h. Patients in the control group (CG)
did not receive any acupuncture treatment. Both groups received the same
anesthetic protocol. Ultrasound-guided thoracic paravertebral block (TPVB)
was performed in the paravertebral spaces between T4 and T5 with
administration of 20mL of 0.33% ropivacaine. All patients received
patient-controlled intravenous analgesia (PCIA) after surgery.
<br/>RESULT(S): Median time to first flatus [interquartile range] in the
AG was significantly less than in the CG (23.25 [18.13, 29.75] vs 30.75
[24.13, 45.38]h, p<0.001). Time to first fluid intake after surgery was
significantly less in the AG, as compared with the CG (4 [3, 7] vs 6.5
[4.13, 10.75]h, p=0.003). Static pain, measured by visual analog scale
(VAS) score, was significantly different on the third day after surgery
(p=0.018). Dynamic pain VAS scores were lower in the AG versus CG on the
first three postoperative days (p=0.014, 0.003 and 0.041, respectively).
<br/>CONCLUSION(S): Addition of acupuncture appeared to improve recovery
of postoperative gastrointestinal function and alleviate posteoperative
pain in patients undergoing thoracoscopic surgery. Acupuncture may
represent a feasible strategy for the prevention of PGD occurrence. TRIAL
REGISTRATION NUMBER: ChiCTR2200060888 (Chinese Clinical Trial Registry).

<81>
Accession Number
642429981
Title
Mollicutes-related infections in thoracic surgery including lung and heart
transplantation: a systematic review.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2023. Date of Publication: 03 Oct 2023.
Author
Farfour E.; Vasse M.; Vallee A.
Institution
(Farfour) Service de Biologie Clinique, hopital Foch, Suresnes, France
(Vasse) Service de Biologie Clinique, hopital Foch, Suresnes, France;
Universite Paris-Saclay, INSERM Hemostase inflammation thrombose HITH
U1176, 94276 Le Kremlin-Bicetre, France
(Vallee) Departement d'Epidemiologie et de Sante Publique, Hopital Foch,
Suresnes, France
Abstract
BACKGROUND: Urogenital Mollicutes, i.e., Mycoplasma hominis and Ureaplasma
spp., can colonize the urogenital tract. While urogenital colonization is
frequent, infections are rare but should not be missed. Furthermore,
extragenital infections are even rarer. Over the past years, they have
been increasingly documented as a cause of hyperammonemia syndrome (HS)
and post-surgical infections. We review the literature on studies focused
on post-surgical infections and HS involving urogenital Mollicutes after
thoracic surgery including lung (LTR) and heart (HTR) transplantation.
<br/>METHOD(S): A systematic review was performed by searching
PubMed/Medline case reports, case series, cohort studies, and clinical
trials. Cases of infections and HS by urogenital Mollicutes after HTR and
LTR transplantations were reported. <br/>RESULT(S): Overall, urogenital
Mollicutes were associated with 15 HS, 31 infections in HTR and LTR, and
18 post-thoracic surgical infections in another context. Post-surgical
infections were reported in all contexts. They were mainly due to
Mycoplasma hominis, the only species that could cultivate on standard
enriched agar forming pinpoint colonies after 3 to 5 days of incubation.
Microbiologists should be prompted to pinpoint colonies even if the
examination of Gram-staining is negative. The patients' management
required surgical treatment and antimicrobials, almost always
tetracyclines and/or fluoroquinolones. Conversely, HS occurred almost
exclusively in bilateral LTR and is more likely due to Ureaplasma spp. As
Ureaplasma spp. do not cultivate on standard media, the microbiological
diagnosis was performed using molecular methods. <br/>CONCLUSION(S):
Infections involving urogenital Mollicute should be considered in LTR with
HS. The overall rate of mortality is high and might be due in part to
delay in etiologic diagnosis. Post-surgical infections were reported in
all contexts. The route of contamination with Mollicutes remains unknown
in HTR and non-transplant surgery, but evidence of transmission from
donors has been documented for LTR.<br/>Copyright &#xa9; 2023. Published
by Elsevier Inc.

<82>
Accession Number
2023639721
Title
Direct assessment of microcirculation in shock: a randomized-controlled
multicenter study.
Source
Intensive Care Medicine. 49(6) (pp 645-655), 2023. Date of Publication:
June 2023.
Author
Bruno R.R.; Wollborn J.; Fengler K.; Flick M.; Wunder C.; Allgauer S.;
Thiele H.; Schemmelmann M.; Hornemann J.; Moecke H.M.E.; Demirtas F.;
Palici L.; Franz M.; Saugel B.; Kattan E.; De Backer D.; Bakker J.;
Hernandez G.; Kelm M.; Jung C.
Institution
(Bruno, Schemmelmann, Hornemann, Moecke, Demirtas, Palici, Kelm, Jung)
Medical Faculty, Department of Cardiology, Pulmonology and Vascular
Medicine, Heinrich-Heine-University Duesseldorf, Moorenstrase 5,
Duesseldorf 40225, Germany
(Wollborn) Department of Anesthesiology, Perioperative and Pain Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, United
States
(Fengler, Thiele) Department of Cardiology, Heart Center Leipzig at
University of Leipzig, Leipzig, Germany
(Flick, Saugel) Department of Anesthesiology, Center of Anesthesiology and
Intensive Care Medicine, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Wunder) Department of Anesthesiology and Intensive Care Medicine,
Robert-Bosch-Krankenhaus, Stuttgart, Germany
(Allgauer) Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart,
Germany
(Kattan, Hernandez) Departamento de Medicina Intensiva, Facultad de
Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
(De Backer) Department of Intensive Care, CHIREC Hospitals, Universite
Libre de Bruxelles, Brussels, Belgium
(Bakker) NYU Langone Health and Columbia University Irving Medical Center,
New York, United States
(Franz, Bakker) Erasmus MC University Medical Center, Rotterdam,
Netherlands
(Kelm) CARID (Cardiovascular Research Institute Dusseldorf), Dusseldorf,
Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Shock is a life-threatening condition characterized by
substantial alterations in the microcirculation. This study tests the
hypothesis that considering sublingual microcirculatory perfusion
variables in the therapeutic management reduces 30-day mortality in
patients admitted to the intensive care unit (ICU) with shock.
<br/>Method(s): This randomized, prospective clinical multicenter
trial-recruited patients with an arterial lactate value above two mmol/L,
requiring vasopressors despite adequate fluid resuscitation, regardless of
the cause of shock. All patients received sequential sublingual
measurements using a sidestream-dark field (SDF) video microscope at
admission to the intensive care unit (+/- 4 h) and 24 (+/- 4) hours later
that was performed blindly to the treatment team. Patients were randomized
to usual routine or to integrating sublingual microcirculatory perfusion
variables in the therapy plan. The primary endpoint was 30-day mortality,
secondary endpoints were length of stay on the ICU and the hospital, and
6-months mortality. <br/>Result(s): Overall, we included 141 patients with
cardiogenic (n = 77), post cardiac surgery (n = 27), or septic shock (n =
22). 69 patients were randomized to the intervention and 72 to routine
care. No serious adverse events (SAEs) occurred. In the interventional
group, significantly more patients received an adjustment (increase or
decrease) in vasoactive drugs or fluids (66.7% vs. 41.8%, p = 0.009)
within the next hour. Microcirculatory values 24 h after admission and
30-day mortality did not differ [crude: 32 (47.1%) patients versus 25
(34.7%), relative risk (RR) 1.39 (0.91-1.97); Cox-regression: hazard ratio
(HR) 1.54 (95% confidence interval (CI) 0.90-2.66, p = 0.118)].
<br/>Conclusion(s): Integrating sublingual microcirculatory perfusion
variables in the therapy plan resulted in treatment changes that do not
improve survival at all. Graphical Abstract: [Figure not available: see
fulltext.].<br/>Copyright &#xa9; 2023, The Author(s).

<83>
Accession Number
2007404360
Title
Efficacy of Transcutaneous Electrical Nerve Stimulation for Postoperative
Pain, Pulmonary Function, and Opioid Consumption Following Cardiothoracic
Procedures: A Systematic Review.
Source
Neuromodulation. 24(8) (pp 1439-1450), 2021. Date of Publication: December
2021.
Author
Cardinali A.; Celini D.; Chaplik M.; Grasso E.; Nemec E.C.
Institution
(Cardinali, Celini, Chaplik, Grasso, Nemec) Sacred Heart University,
Fairfield, CT, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Transcutaneous electrical nerve stimulation (TENS) is a
minimally invasive method for treating pain. In the most recent review
published in 2012, TENS was associated with increased pain relief
following cardiothoracic surgery when compared to standard multimodal
analgesia. The purpose of this systematic review and meta-analysis is to
determine if adding TENS to current pain management practices decreases
pain and analgesic use and improves pulmonary function for
postcardiothoracic surgery patients. <br/>Material(s) and Method(s):
CINAHL, MEDLINE, Cochrane Database of Systematic Reviews, PubMed, and
ClinicalTrials.gov were searched using specific keywords. Covidence was
used to screen, select studies, and extract data by two independent
reviewers. The Cochrane Risk of Bias tool assessed risk of bias. Visual
analog scale (VAS) and pulmonary function data were exported for
meta-analysis using a random effects model. <br/>Result(s): The search
yielded 38 articles. Eight randomized controlled trials met inclusion
criteria for the literature review. Five studies were included in the
meta-analysis of pain at 24, 48, and 72 hours postoperatively. Data were
analyzed using the standard mean difference (SMD). TENS had a significant
impact on VAS at rest (-0.76 SMD [95% confidence interval, CI = -1.06 to
-0.49], p < 0.00001) and with coughing (-1.11 SMD [95% CI = -1.64 to
-0.56], p < 0.0001). FEV1 improved after 72 hours (1.00 SMD [95% CI =
0.66-1.35], p < 0.00001), as did forced vital capacity (1.16 SMD [95% CI =
0.23-2.10], p = 0.01). <br/>Conclusion(s): The addition of TENS therapy to
multimodal analgesia significantly decreases pain following cardiothoracic
surgery, increases the recovery of pulmonary function, and decreases the
use of analgesics.<br/>Copyright &#xa9; 2020 International Neuromodulation
Society

<84>
Accession Number
2025326975
Title
Metabolic Sequelae of Everolimus Treatment After Cardiac Transplant: A
Hypothesis-Generating Study.
Source
Heart Lung and Circulation. 32(9) (pp 1076-1079), 2023. Date of
Publication: September 2023.
Author
Raven L.M.; Muir C.A.; Pouliopoulos J.; Hayward C.S.; Macdonald P.S.;
Greenfield J.R.; Jabbour A.
Institution
(Raven, Muir, Greenfield) Department of Diabetes and Endocrinology, St
Vincent's Hospital, Sydney, NSW, Australia
(Raven, Greenfield) Clinical Diabetes, Appetite and Metabolism Laboratory,
Garvan Institute of Medical Research, Sydney, NSW, Australia
(Raven, Muir, Pouliopoulos, Hayward, Macdonald, Greenfield, Jabbour)
School of Clinical Medicine, St Vincent's Campus, Faculty of Medicine and
Health, University of New South Wales, Sydney, NSW, Australia
(Pouliopoulos, Hayward, Macdonald, Jabbour) Victor Chang Cardiac Research
Institute, Sydney, NSW, Australia
(Pouliopoulos, Hayward, Macdonald, Jabbour) Department of Heart and Lung
Transplantation, St Vincent's Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Although modern immunosuppressants improve survival
post-transplant, they are associated with long-term metabolic
complications, such as post-transplant diabetes mellitus (PTDM).
Calcineurin inhibitor-sparing regimens using everolimus attenuate some
complications such as left ventricular hypertrophy. However, the metabolic
effects of everolimus following transplant are less clear. <br/>Method(s):
Post-hoc analysis to compare PTDM and other metabolic outcomes in
participants of a randomised open-label clinical trial of low-dose
everolimus and tacrolimus versus standard-dose tacrolimus in heart
transplant recipients (RADTAC¹ study). <br/>Result(s): There
were 39 participants in the trial; mean follow-up was 6.4+/-1.5 years.
There was a high rate of pre-existing diabetes (26%) and newly diagnosed
PTDM (36%) during follow-up. Half the patients who developed PTDM in the
everolimus-tacrolimus group (n=4/8) ceased diabetes medications during
follow-up, which was not observed in patients on standard tacrolimus
(n=0/6). In the first 12 months there was a higher use of non-insulin
treatment for diabetes in the everolimus-tacrolimus group compared to the
standard tacrolimus group. <br/>Conclusion(s): This study suggests that
treatment with everolimus may be associated with improved glycaemic
control of PTDM relative to treatment with standard doses of calcineurin
inhibitor. These findings should be further studied in prospective
randomised trials.<br/>Copyright &#xa9; 2023 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<85>
Accession Number
633831896
Title
Association of Sickle Cell Trait with Incidence of Coronary Heart Disease
among African American Individuals.
Source
JAMA Network Open. 4(1) (no pagination), 2021. Article Number: e2030435.
Date of Publication: 05 Jan 2021.
Author
Hyacinth H.I.; Franceschini N.; Seals S.R.; Irvin M.R.; Chaudhary N.; Naik
R.P.; Alonso A.; Carty C.L.; Burke G.L.; Zakai N.A.; Winkler C.A.; David
V.A.; Kopp J.B.; Judd S.E.; Adams R.J.; Gee B.E.; Longstreth W.T.; Egede
L.; Lackland D.T.; Greenberg C.S.; Taylor H.; Manson J.E.; Key N.S.;
Derebail V.K.; Kshirsagar A.V.; Folsom A.R.; Konety S.H.; Howard V.;
Allison M.; Wilson J.G.; Correa A.; Zhi D.; Arnett D.K.; Howard G.; Reiner
A.P.; Cushman M.; Safford M.M.
Institution
(Hyacinth, Gee) Aflac Cancer and Blood Disorder Center, Department of
Pediatrics, Emory University, School of Medicine, Atlanta, GA, United
States
(Franceschini) Department of Epidemiology, University of North Carolina,
Chapel Hill, United States
(Seals) Department of Mathematics and Statistics, University of West
Florida, Pensacola, United States
(Irvin, Chaudhary, Judd) School of Public Health, University of Alabama at
Birmingham, Birmingham, United States
(Naik) Division of Hematology, Department of Medicine, The Johns Hopkins
University, Baltimore, MD, United States
(Alonso) Department of Epidemiology, Rollins School of Public Health,
Emory University, Atlanta, GA, United States
(Carty) Fred Hutchinson Cancer Research Center, Seattle, WA, United States
(Burke) Department of Public Health Sciences, Wake Forest University,
Winston-Salem, NC, United States
(Zakai, Cushman) Department of Medicine and Pathology and Laboratory
Medicine, University of Vermont, Burlington, United States
(Winkler, David) Basic Science Laboratory, National Cancer Institute and
Frederick National Laboratory, Leidos Biomedical Research, Frederick, MD,
United States
(Kopp) National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda, MD, United States
(Adams, Lackland) Stroke Center, Department of Neurology, Medical
University of South Carolina, Charleston, United States
(Longstreth) Department of Neurology, University of Washington, Seattle,
United States
(Longstreth) Department of Epidemiology, University of Washington,
Seattle, United States
(Egede) Division of General Internal Medicine, Medical College of
Wisconsin, Milwaukee, United States
(Greenberg) Division of Hematology-Oncology, Medical University of South
Carolina, Charleston, United States
(Taylor) Cardiovascular Research Institute, Morehouse School of Medicine,
Atlanta, GA, United States
(Manson) Department of Medicine, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Key) Division of Hematology/Oncology, University of North Carolina at
Chapel Hill, Chapel Hill, United States
(Derebail, Kshirsagar) University of North Carolina Kidney Center,
University of North Carolina at Chapel Hill, Chapel Hill, United States
(Folsom) Division of Epidemiology and Community Health, University of
Minnesota, School of Public Health, Minneapolis, United States
(Konety) Division of Cardiology, University of Minnesota Medical Center,
Minneapolis, United States
(Howard) Department of Epidemiology, School of Public Health, University
of Alabama at Birmingham, Birmingham, United States
(Allison) Department of Family Medicine and Public Health, University of
California San Diego, San Diego, United States
(Wilson) Department of Physiology and Biophysics, University of
Mississippi Medical Center, Jackson, United States
(Correa) Jackson Heart Study, University of Mississippi Medical Center,
Jackson, United States
(Zhi, Howard) Department of Biostatistics, School of Public Health,
University of Alabama at Birmingham, Birmingham, United States
(Arnett) College of Public Health, University of Kentucky, Lexington,
United States
(Reiner) University of Washington, Fred Hutchinson Cancer Research Center,
Seattle, United States
(Safford) Division of General Internal Medicine, Weill Cornell Medicine,
New York, NY, United States
Publisher
American Medical Association
Abstract
Importance: The incidence of and mortality from coronary heart disease
(CHD) are substantially higher among African American individuals compared
with non-Hispanic White individuals, even after adjusting for traditional
factors associated with CHD. The unexplained excess risk might be due to
genetic factors related to African ancestry that are associated with a
higher risk of CHD, such as the heterozygous state for the sickle cell
variant or sickle cell trait (SCT). <br/>Objective(s): To evaluate whether
there is an association between SCT and the incidence of myocardial
infarction (MI) or composite CHD outcomes in African American individuals.
<br/>Design, Setting, and Participant(s): This cohort study included 5
large, prospective, population-based cohorts of African American
individuals in the Women's Health Initiative (WHI) study, the Reasons for
Geographic and Racial Differences in Stroke (REGARDS) study, the
Multi-Ethnic Study of Atherosclerosis (MESA), the Jackson Heart Study
(JHS), and the Atherosclerosis Risk in Communities (ARIC) study. The
follow-up periods included in this study were 1993 and 1998 to 2014 for
the WHI study, 2003 to 2014 for the REGARDS study, 2002 to 2016 for the
MESA, 2002 to 2015 for the JHS, and 1987 to 2016 for the ARIC study. Data
analysis began in October 2013 and was completed in October 2020.
Exposures: Sickle cell trait status was evaluated by either direct
genotyping or high-quality imputation of rs334 (the sickle cell variant).
Participants with sickle cell disease and those with a history of CHD were
excluded from the analyses. <br/>Main Outcomes and Measures: Incident MI,
defined as adjudicated nonfatal or fatal MI, and incident CHD, defined as
adjudicated nonfatal MI, fatal MI, coronary revascularization procedures,
or death due to CHD. Cox proportional hazards regression models were used
to estimate the hazard ratio for incident MI or CHD comparing SCT carriers
with noncarriers. Models were adjusted for age, sex (except for the WHI
study), study site or region of residence, hypertension status or systolic
blood pressure, type 1 or 2 diabetes, serum high-density lipoprotein
level, total cholesterol level, and global ancestry (estimated from
principal components analysis). <br/>Result(s): A total of 23197 African
American men (29.8%) and women (70.2%) were included in the combined
sample, of whom 1781 had SCT (7.7% prevalence). Mean (SD) ages at baseline
were 61.2 (6.9) years in the WHI study (n = 5904), 64.0 (9.3) years in the
REGARDS study (n = 10714), 62.0 (10.0) years in the MESA (n = 1556), 50.3
(12.0) years in the JHS (n = 2175), and 53.2 (5.8) years in the ARIC study
(n = 2848). There were no significant differences in the distribution of
traditional factors associated with cardiovascular disease by SCT status
within cohorts. A combined total of 1034 participants (76 with SCT) had
incident MI, and 1714 (137 with SCT) had the composite CHD outcome. The
meta-analyzed crude incidence rate of MI did not differ by SCT status and
was 3.8 per 1000 person-years (95% CI, 3.3-4.5 per 1000 person-years)
among those with SCT and 3.6 per 1000 person-years (95% CI, 2.7-5.1 per
1000 person-years) among those without SCT. For the composite CHD outcome,
these rates were 7.3 per 1000 person-years (95% CI, 5.5-9.7 per 1000
person-years) among those with SCT and 6.0 per 1000 person-years (95% CI,
4.9-7.4 per 1000 person-years) among those without SCT. Meta-analysis of
the 5 study results showed that SCT status was not significantly
associated with MI (hazard ratio, 1.03; 95% CI, 0.81-1.32) or the
composite CHD outcome (hazard ratio, 1.16; 95% CI, 0.92-1.47).
<br/>Conclusions and Relevance: In this cohort study, there was not an
association between SCT and increased risk of MI or CHD in African
American individuals. These disorders may not be associated with sickle
cell trait-related sudden death in this population..<br/>Copyright &#xa9;
2021 American Medical Association. All rights reserved.

<86>
Accession Number
633195584
Title
Comparison of Heart Team vs Interventional Cardiologist Recommendations
for the Treatment of Patients with Multivessel Coronary Artery Disease.
Source
JAMA Network Open. 3(8) (pp E2012749), 2020. Date of Publication: 10 Aug
2020.
Author
Tsang M.B.; Schwalm J.D.; Gandhi S.; Sibbald M.G.; Gafni A.; Mercuri M.;
Salehian O.; Lamy A.; Pericak D.; Jolly S.; Sheth T.; Ainsworth C.;
Velianou J.; Valettas N.; Mehta S.; Pinilla N.; Yanagawa B.; Zhang L.; Chu
V.; Parry D.; Whitlock R.; Dyub A.; Cybulsky I.; Semelhago L.; Ioannou K.;
Hameed A.; Wright D.; Mulji A.; Darvish-Kazem S.; Gupta N.; Alshatti A.;
Natarajan M.K.
Institution
(Tsang, Schwalm, Sibbald, Salehian, Lamy, Jolly, Sheth, Ainsworth,
Velianou, Valettas, Mehta, Pinilla, Ioannou, Hameed, Wright, Mulji,
Darvish-Kazem, Alshatti, Natarajan) Division of Cardiology, Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Gandhi, Gupta) Division of Cardiology, Department of Medicine, University
of Toronto, Toronto, ON, Canada
(Gandhi) Trillium Health Partners, Mississauga, ON, Canada
(Gafni) Center for Health Economics and Policy Analysis, Department of
Health Research Methods, Evidence and Impact, McMaster University,
Hamilton, ON, Canada
(Mercuri, Pericak, Zhang, Chu, Parry, Whitlock, Dyub, Cybulsky, Semelhago)
Division of Cardiovascular Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Yanagawa) Division of Cardiovascular Surgery, St Michael's Hospital,
Toronto, ON, Canada
(Yanagawa) Division of Cardiac Surgery, Department of Surgery, University
of Toronto, Toronto, ON, Canada
(Parry) Dunedin Hospital, Otago, New Zealand
(Ioannou) Oakville Trafalgar Memorial Hospital, Oakville, ON, Canada
(Darvish-Kazem) Brampton Civic Hospital, William Osler Health System,
Brampton, ON, Canada
Publisher
American Medical Association
Abstract
Importance: Although the heart team approach is recommended in
revascularization guidelines, the frequency with which heart team
decisions differ from those of the original treating interventional
cardiologist is unknown. <br/>Objective(s): To examine the difference in
decisions between the heart team and the original treating interventional
cardiologist for the treatment of patients with multivessel coronary
artery disease. <br/>Design, Setting, and Participant(s): In this
cross-sectional study, 245 consecutive patients with multivessel coronary
artery disease were recruited from 1 high-volume tertiary care referral
center (185 patients were enrolled through a screening process, and 60
patients were retrospectively enrolled from the center's database). A
total of 237 patients were included in the final virtual heart team
analysis. Treatment decisions (which comprised coronary artery bypass
grafting, percutaneous coronary intervention, and medication therapy) were
made by the original treating interventional cardiologists between March
15, 2012, and October 20, 2014. These decisions were then compared with
pooled-majority treatment decisions made by 8 blinded heart teams using
structured online case presentations between October 1, 2017, and October
15, 2018. The randomized members of the heart teams comprised experts from
3 domains, with each team containing 1 noninvasive cardiologist, 1
interventional cardiologist, and 1 cardiovascular surgeon. Cases in which
all 3 of the heart team members disagreed and cases in which procedural
discordance occurred (eg, 2 members chose coronary artery bypass grafting
and 1 member chose percutaneous coronary intervention) were discussed in a
face-to-face heart team review in October 2018 to obtain pooled-majority
decisions. Data were analyzed from May 6, 2019, to April 22, 2020.
<br/>Main Outcomes and Measures: The Cohen kappa coefficient between the
treatment recommendation from the heart team and the treatment
recommendation from the original treating interventional cardiologist.
<br/>Result(s): Among 234 of 237 patients (98.7%) in the analysis for whom
complete data were available, the mean (SD) age was 67.8 (10.9) years; 176
patients (75.2%) were male, and 191 patients (81.4%) had stenosis in 3
epicardial coronary vessels. A total of 71 differences (30.3%; 95% CI,
24.5%-36.7%) in treatment decisions between the heart team and the
original treating interventional cardiologist occurred, with a Cohen kappa
of 0.478 (95% CI, 0.336-0.540; P =.006). The heart team decision was more
frequently unanimous when it was concordant with the decision of the
original treating interventional cardiologist (109 of 163 cases [66.9%])
compared with when it was discordant (28 of 71 cases [39.4%]; P <.001).
When the heart team agreed with the original treatment decision, there was
more agreement between the heart team interventional cardiologist and the
original treating interventional cardiologist (138 of 163 cases [84.7%])
compared with when the heart team disagreed with the original treatment
decision (14 of 71 cases [19.7%]); P <.001). Those with an original
treatment of coronary artery bypass grafting, percutaneous coronary
intervention, and medication therapy, 32 of 148 patients [22.3%], 32 of 71
patients [45.1%], and 6 of 15 patients [40.0%], respectively, received a
different treatment recommendation from the heart team than the original
treating interventional cardiologist; the difference across the 3 groups
was statistically significant (P =.002). <br/>Conclusions and Relevance:
The heart team's recommended treatment for patients with multivessel
coronary artery disease differed from that of the original treating
interventional cardiologist in up to 30% of cases. This subset of cases
was associated with a lower frequency of unanimous decisions within the
heart team and less concordance between the interventional cardiologists;
discordance was more frequent when percutaneous coronary intervention or
medication therapy were considered. Further research is needed to evaluate
whether heart team decisions are associated with improvements in outcomes
and, if so, how to identify patients for whom the heart team approach
would be beneficial..<br/>Copyright &#xa9; 2020 American Medical
Association. All rights reserved.

<87>
Accession Number
632489500
Title
Association of Gender and Race with Allocation of Advanced Heart Failure
Therapies.
Source
JAMA Network Open. 3(7) (no pagination), 2020. Date of Publication: 21 Jul
2020.
Author
Breathett K.; Yee E.; Pool N.; Hebdon M.; Crist J.D.; Yee R.H.; Knapp
S.M.; Solola S.; Luy L.; Herrera-Theut K.; Zabala L.; Stone J.; McEwen
M.M.; Calhoun E.; Sweitzer N.K.
Institution
(Breathett, Sweitzer) Sarver Heart Center, Division of Cardiology,
Department of Medicine, University of Arizona, Tucson, United States
(Yee, Yee) Sarver Heart Center, Clinical Research Office, University of
Arizona, Tucson, United States
(Pool, Crist, McEwen) College of Nursing, University of Arizona, Tucson,
United States
(Hebdon) College of Nursing, University of Utah, Salt Lake City, United
States
(Knapp) Statistics Consulting Lab, Bio5 Institute, University of Arizona,
Tucson, United States
(Solola) Department of Medicine, University of Arizona, Tucson, United
States
(Luy) University of Rochester, New York, United States
(Herrera-Theut) University of Arizona, Medical School, Tucson, United
States
(Zabala) Department of Medicine, University of California, Los Angeles,
United States
(Stone) Department of Psychology, University of Arizona, Tucson, United
States
(Calhoun) Center for Population Health Sciences, University of Arizona,
Tucson, United States
Publisher
American Medical Association
Abstract
Importance: Racial bias is associated with the allocation of advanced
heart failure therapies, heart transplants, and ventricular assist
devices. It is unknown whether gender and racial biases are associated
with the allocation of advanced therapies among women. <br/>Objective(s):
To determine whether the intersection of patient gender and race is
associated with the decision-making of clinicians during the allocation of
advanced heart failure therapies. <br/>Design, Setting, and
Participant(s): In this qualitative study, 46 US clinicians attending a
conference for an international heart transplant organization in April
2019 were interviewed on the allocation of advanced heart failure
therapies. Participants were randomized to examine clinical vignettes that
varied 1:1 by patient race (African American to white) and 20:3 by gender
(women to men) to purposefully target vignettes of women patients to
compare with a prior study of vignettes of men patients. Participants were
interviewed about their decision-making process using the think-aloud
technique and provided supplemental surveys. Interviews were analyzed
using grounded theory methodology, and surveys were analyzed with Wilcoxon
tests. Exposure: Randomization to clinical vignettes. <br/>Main Outcomes
and Measures: Thematic differences in allocation of advanced therapies by
patient race and gender. <br/>Result(s): Among 46 participants (24 [52%]
women, 20 [43%] racial minority), participants were randomized to the
vignette of a white woman (20 participants [43%]), an African American
woman (20 participants [43%]), a white man (3 participants [7%]), and an
African American man (3 participants [7%]). Allocation differences
centered on 5 themes. First, clinicians critiqued the appearance of the
women more harshly than the men as part of their overall impressions.
Second, the African American man was perceived as experiencing more severe
illness than individuals from other racial and gender groups. Third, there
was more concern regarding appropriateness of prior care of the African
American woman compared with the white woman. Fourth, there were greater
concerns about adequacy of social support for the women than for the men.
Children were perceived as liabilities for women, particularly the African
American woman. Family dynamics and finances were perceived to be greater
concerns for the African American woman than for individuals in the other
vignettes; spouses were deemed inadequate support for women. Last,
participants recommended ventricular assist devices over transplantation
for all racial and gender groups. Surveys revealed no statistically
significant differences in allocation recommendations for African American
and white women patients. <br/>Conclusions and Relevance: This national
study of health care professionals randomized to clinical vignettes that
varied only by gender and race found evidence of gender and race bias in
the decision-making process for offering advanced therapies for heart
failure, particularly for African American women patients, who were judged
more harshly by appearance and adequacy of social support. There was no
associated between patient gender and race and final recommendations for
allocation of advanced therapies. However, it is possible that bias may
contribute to delayed allocation and ultimately inequity in the allocation
of advanced therapies in a clinical setting..<br/>Copyright &#xa9; 2020
American Medical Association. All rights reserved.

<88>
Accession Number
2027650703
Title
Utility of Fractional Flow Reserve Computed Tomography Angiography in
Patients With Stable Coronary Artery Disease.
Source
American Journal of Cardiology. 208 (pp 31-36), 2023. Date of Publication:
01 Dec 2023.
Author
Tao M.; Gier C.; Al-Sadawi M.; Dhaliwal S.; Masson R.; Rahman T.; Gavalas
M.; Tam E.; Mann N.
Institution
(Tao, Gier, Al-Sadawi, Dhaliwal, Masson, Rahman, Gavalas, Tam, Mann)
Division of Cardiology, Department of Medicine, Stony Brook University
Hospital, Stony Brook, NY, United States
Publisher
Elsevier Inc.
Abstract
Coronary computed tomography angiography is a modality with high negative
predictive value for evaluation of coronary artery disease (CAD). However,
its diagnostic accuracy for obstructive CAD is limited by multiple
factors. Fractional flow reserve (FFR) computed tomography
(FFR<inf>CT</inf>) is an emerging analysis tool for identifying
flow-limiting disease; nonetheless, the prognostic value of
FFR<inf>CT</inf> is not well established. This meta-analysis aims to
evaluate the association of FFR<inf>CT</inf> with clinical outcomes in
patients with stable CAD. A literature search was conducted for studies
reporting the association between FFR<inf>CT</inf> measurements and
all-cause mortality, major adverse cardiovascular events (MACEs), acute
myocardial infarction (AMI), and any need for coronary revascularization.
Obstructive disease was defined as a FFR value <=0.80; nonobstructive
disease was defined as an FFR value >0.80. Ten studies were identified to
meet the inclusion criteria; mean follow-up was 17 months (range, 3 to 56
months). There was no difference in risk of all-cause mortality between
patients with obstructive and those with nonobstructive CAD on
FFR<inf>CT</inf>. However, obstructive lesions were associated with
increased risk of MACE, AMI, and any need for revascularization.
FFR<inf>CT</inf> is a useful adjunctive modality for further risk
stratification of patients with stable CAD. Obstructive lesions identified
by FFR<inf>CT</inf> are associated with increased risk of MACE, AMI, and
any need for revascularization.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<89>
Accession Number
2026084840
Title
Remimazolam vs Etomidate: Haemodynamic Effects in Hypertensive Elderly
Patients Undergoing Non-Cardiac Surgery.
Source
Drug Design, Development and Therapy. 17 (pp 2943-2953), 2023. Date of
Publication: 2023.
Author
Chen J.; Zou X.; Hu B.; Yang Y.; Wang F.; Zhou Q.; Shen M.
Institution
(Chen) School of Anesthesiology, Guizhou Medical University, Guizhou
Province, Guiyang City, China
(Zou, Hu, Yang, Wang, Zhou, Shen) Department of Anesthesiology, Affiliated
Hospital of Guizhou Medical University, Guizhou Province, Guiyang City,
China
Publisher
Dove Medical Press Ltd
Abstract
Background: Remimazolam tosilate (RT) is a novel ultrashort-acting
gamma-aminobutyric acid subtype A (GABA<inf>A</inf>) agonist, with several
advantages including rapid induction and recovery, stable haemodynamics,
and mild respiratory inhibition. However, studies have not been conducted
to explore the haemodynamic effects of RT in elderly hypertensive subjects
undergoing non-cardiac surgery. Therefore, we sought to compare the
effects of anaesthesia induction using different doses of RT and etomidate
on the haemodynamics of this group of patients. <br/>Method(s): Patients
were recruited into this single-center, prospective, randomized,
double-blind trial from October 2022 to June 2023. A total of 150
hypertensive elderly undergoing non-cardiac surgery were randomly assigned
into 0.2 mg/kg RT group (Group RL), 0.3 mg/kg RT group (Group RH) and 0.3
mg/kg etomidate group (Group E). The primary outcome of the study was
haemodynamic changes (mean arterial pressure fluctuation value-MAP and
heart rate fluctuation value-HR) observed during anaesthesia induction.
Secondary outcomes included incidence of adverse cardiovascular events and
adverse drug reactions (injection pain and myoclonus), cumulative doses of
vasoactive drugs and vital signs at different time points. <br/>Result(s):
Patients in Group E and Group RL had significantly lower haemodynamic
fluctuations (MAP), lower incidence of hypotension and cumulative dose of
ephedrine than subjects in Group RH. Patients in groups RL and RH had
significantly lower incidence of injection pain and myoclonus compared
with patients in group E. The results showed no statistically significant
differences in HR, hypertension, bradycardia, tachycardia, and time to
loss of eye-opening reflex and start of intubation, and vital signs at
different time points among the three groups. <br/>Conclusion(s): Use of
low-dose RT (0.2 mg/kg) for induction of non-cardiac surgical anaesthesia
in elderly hypertensive patients is more effective in maintaining
haemodynamic stability and has fewer adverse effects compared with
etomidate.<br/>Copyright &#xa9; 2023 Chen et al. This work is published
and licensed by Dove Me.

<90>
Accession Number
2025666340
Title
Allopurinol for Secondary Prevention in Patients with Cardiovascular
Disease: A Systematic Review and Meta-Analysis of Randomized Controlled
Trials.
Source
Journal of Cardiovascular Development and Disease. 10(9) (no pagination),
2023. Article Number: 379. Date of Publication: September 2023.
Author
Ye Y.; Liao G.; Liu T.; Hu X.; Chen X.; Bai L.; Peng Y.
Institution
(Ye, Liao, Liu, Chen, Bai, Peng) Department of Cardiology, West China
Hospital, Sichuan University, 37 Guoxue Street, Chengdu 610041, China
(Hu) School of Medicine, Zhengzhou University, Zhengzhou 450052, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The effects of allopurinol in patients with cardiovascular
disease are not well defined; therefore, the latest evidence is summarized
in this study. <br/>Method(s): PubMed, Embase, Cochrane Library, and
ClinicalTrials.gov databases were searched for randomized controlled
trials (RCTs) of allopurinol in patients with cardiovascular disease
published up to 11 February 2023. The primary outcome was cardiovascular
death. <br/>Result(s): We combined the results of 21 RCTs that included
22,806 patients. Compared to placebo/usual care, allopurinol treatment was
not associated with a significant reduction in cardiovascular death (RR
0.60; 95% CI 0.33-1.11) or all-cause death (RR 0.90; 95% CI 0.72-1.12).
However, evidence from earlier trials and studies with small sample sizes
indicated that allopurinol might confer a protective effect in decreasing
cardiovascular death (RR 0.34; 95% CI 0.15-0.76) across patients
undergoing coronary artery bypass grafting (CABG) or having acute coronary
syndrome (ACS). In comparisons between allopurinol and febuxostat, we
observed no difference in cardiovascular death (RR 0.92; 95% CI 0.69-1.24)
or all-cause death (RR 1.02; 95% CI 0.75-1.38). <br/>Conclusion(s):
Allopurinol could not reduce cardiovascular (CV) death or major adverse CV
outcomes significantly in patients with existing cardiovascular diseases.
Given the limitations of the original studies, the potential advantages of
allopurinol observed in patients undergoing CABG or presenting with ACS
necessitate further confirmation through subsequent RCTs. In the
comparisons between allopurinol and febuxostat, our analysis failed to
uncover any marked superiority of allopurinol in reducing the risk of
adverse cardiovascular incidents.<br/>Copyright &#xa9; 2023 by the
authors.

<91>
Accession Number
2027325020
Title
Effect of Crystalloids on Intraoperative Plasma Glucose Levels in Elective
Non-Diabetic Patients under General Anaesthesia.
Source
Journal of Cardiovascular Disease Research. 14(8) (pp 1398-1408), 2023.
Date of Publication: 2023.
Author
Das S.K.; Marthy B.K.; Swain A.; Dansana S.K.
Institution
(Das, Marthy, Swain, Dansana) Department of Anaesthesiology, SCB Medical
College and Hospital, Odisha, Cuttack, India
Publisher
EManuscript Technologies
Abstract
Background: In this study, non-diabetic patients undergoing elective major
non-cardiac surgery under general anaesthesia were monitored to examine
the different crystalloids frequently used in daily practice and to
evaluate as to how maintenance fluid regimens affected intraoperative
blood glucose levels. <br/>Method(s): This was a hospital-based randomized
prospective study conducted among 90 nondiabetic patients of ASA physical
status I or II of age group 18-50 years of either sex undergoing major
non-cardiac surgery under general anaesthesia in the Department of
Anaesthesiology and Critical Care, SCB Medical College and Hospital,
Cuttack, Odisha, from March 2021 to February 2023, after obtaining
clearance from the institutional ethics committee and written informed
consent from the study participants. <br/>Result(s): The CBG just after
intubation was significantly higher than baseline in group D but was lower
than baseline and comparable between groups R and N. The CBG in the
1^st and 2^nd intra-operative hours was significantly
higher in group D than in groups R and N, but the CBG in the
3^rd intra-operative hour was comparable among all the groups.
27% of patients in group R and 20% of patients in group N, in contrast to
100% of patients in group D, had at least one episode of hyperglycaemia
and required rescue insulin. The incidence of hyperglycaemic episodes (CBG
>= 150 mg/dL) was highest in group D, i.e., 82%, whereas in group R it was
9% and in group N it was only 7%. In comparison to groups R and N, group D
had a considerably greater mean insulin consumption. The incidence of
hyperglycaemia despite rescue insulin was much higher (59%) in groups D in
comparison to groups R and N. <br/>Conclusion(s): As far as
intra-operative hyperglycaemia due to stress is concerned, RL and NS are
preferable maintenance fluids over DNS for elective major
surgeries.<br/>Copyright &#xa9; 2023 EManuscript Technologies. All rights
reserved.

<92>
Accession Number
2027557463
Title
THE EFFECT OF SINGLE DOSE ETOMIDATE AND PROPOFOL ON SERUM CORTISOL LEVEL
IN CARDIAC PATIENTS UNDERGOING CARDIAC SURGERY ON CARDIOPULMONARY BYPASS:
A PROSPECTIVE COMPARATIVE STUDY.
Source
International Journal of Academic Medicine and Pharmacy. 5(3) (pp
967-971), 2023. Date of Publication: 2023.
Author
Srivastava V.K.; Goel M.; Kushwaha B.B.; Naithani B.; Hemlata; Prabha R.
Institution
(Srivastava, Kushwaha, Hemlata, Prabha) Department Anaesthesiology and
Critical Care, KGMU, Uttar Pradesh, Lucknow, India
(Goel) Pvt Hospital, Haryana, Kaithal, India
(Naithani) Critical Care Unit, Department of Plastic and Reconstructive
Surgery, KGMU, Uttar Pradesh, Lucknow, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Cardiovascular patients are highly prone for hemodynamic
perturbation and exaggerated stress response during induction and cardio
pulmonary bypass. Induction agents used for same should have minimum
hemodynamic variation and maintains myocardial oxygen supply demands
during procedure. Propofol and etomidate are well known anesthestic agents
used for induction including all cardiovascular surgery. <br/>Material(s)
and Method(s): After getting approval from institutional ethical
committee, the study was conducted in department of anaesthesiology and
critical care with the collaboration of cardiovascular surgery department.
For these sixty patients of either sex, aged between 20-80 years of age,
ASA grade II to IV were enrolled for this prospective, randomized,
clinical trial. After preanesthetic check-up all enrolled patients were
randomly allocated into two group of 30 each. Group I received 0.4 mg/kg
etomidate and group II received 2 mg/kg as induction along with 2
microgram/kg fentanyl. Serum cortisol level were measured at baseline, 6
hour and 24 hours postoperatively after induction. <br/>Result(s): Serum
cortisol level were increased in both group from baseline and mean
increment at 6 hours was more marked in etomidate group (105.85+/-182.83
nmol/L) than propofol (153.22+/-150.54 nmol/L that was statistically
significant. At 24 hours although serum cortisol was increased in
etomidate group but was statistically insignificant. It shows
adrenocortical suppression was more in etomidate group means less stress
response. <br/>Conclusion(s): Etomidate can be safely used as induction
agent in patients of cardiac surgeries with compromised LV function for
cardiac surgeries under cardio-pulmonary bypass without serious cortisol
suppression.<br/>Copyright &#xa9; 2023 Society for Healthcare and Research
Development.

<93>
Accession Number
2027557390
Title
EFFECT OF INTRAVENOUS LIGNOCAINE INFUSION ON POSTOPERATIVE ANALGESIA IN
PERCUTANEOUS NEPHROLITHOTOMY.
Source
International Journal of Academic Medicine and Pharmacy. 5(3) (pp
605-608), 2023. Date of Publication: 2023.
Author
Cheeran S.T.; Joseph E.; Santhi K.S.; Anuraj V.T.
Institution
(Cheeran, Santhi, Anuraj) Department of Anesthesiology, Government medical
college, Kerala, Kottayam, India
(Joseph) Government medical college, Kerala, Kottayam, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Percutaneous nephrolithotomy (PCNL) is usually performed under
general anaesthesia. Optimal pain management has been attempted with
various modalities like regional anaesthesia and opioids. Many recent
studies have shown that intravenous lignocaine infusion can reduce
anaesthetic and opioid requirements in perioperative period.
<br/>Objective(s): To determine the effects of intravenous lignocaine
infusion to provide post-operative analgesia and intraoperative
haemodynamic stability in patients undergoing PCNL with General
Anesthesia. <br/>Material(s) and Method(s): Sixty patients of American
Society of Anesthesiologists Grade 1 and 2 in the age group of 25 to 65
years undergoing PCNL were allocated randomly into 2 groups of thirty
patients each. Group A was administered preservative free 2% lignocaine
1.5mg/kg iv [volume of 6ml with normal saline] over ten minutes which was
followed by an infusion of the same drug at the rate of 1.5mg per kg/hour
[6ml/hour] till end of the surgery or when the maximum dose of lignocaine
is reached. Group B was given 6ml of normal saline as bolus over ten
minutes and 6ml normal saline/hour infusion till the end of surgery. The
heart rate (HR) and the mean arterial blood pressure (MAP) values before
inducing anesthesia were recorded as baseline. Then HR and the MAP were
also recorded 1 minute after intubation and 1 minute after extubation.
Duration of analgesia [VAS<4] was taken from time of extubation to first
requirement of rescue analgesia. <br/>Result(s): The time to first rescue
analgesia was 174 +/- 51.30 minutes in Group A as compared to 114 +/-
39.01 minutes in Group B. Mean difference was 60 minutes which is
statistically significant. In Group B, increase in the HR and the MAP
after intubation and extubation are statistically significant. In Group A,
increase in the HR and the MAP after intubation and extubation was not
statistically significant. <br/>Conclusion(s): Intravenous lignocaine
infusion administered intraoperatively provides postoperative analgesia
and perioperative haemodynamic stability.<br/>Copyright &#xa9; 2023
Society for Healthcare and Research Development. All rights reserved.

<94>
Accession Number
2027556892
Title
EFFECT OF YOGA BASED CARDIAC REHABILITATION AFTER CORONARY ARTERY BYPASS
SURGERY IN PATIENTS OF CORONARY ARTERY DISEASE WITH MODERATE-SEVERE LEFT
VENTRICULAR DYSFUNCTION.
Source
International Journal of Academic Medicine and Pharmacy. 5(2) (pp
187-192), 2023. Date of Publication: 2023.
Author
Kumar R.; Saxena A.
Institution
(Kumar) Department of Cardiothoracic & Vascular Surgery, Institute of
Medical Sciences, Banaras Hindu University, Uttar Pradesh, Varanasi, India
(Saxena) Department of Biochemistry, Peoples College of Medical Sciences
and Research Centre, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: To evaluate the effect of yoga based cardiac rehabilitation
(YBCR) on exercise capacity, quality of life and modifiable risk factors
in patients of coronary artery disease with moderate to severe left
ventricular dysfunction undergoing coronary artery bypass graft surgery
(CABG). <br/>Material(s) and Method(s): In this prospective randomized
controlled trial, 110 subjects were recruited (10 dropped out of the
study, 5 from each arm) and randomized into Intervention arm who underwent
YBCR in addition to the physiotherapy based cardiac rehabilitation (PBCR).
The control group received only the standard physiotherapy care under
PBCR. There were two assessment point i.e. Baseline (3rd month post CABG)
and at 6th month (9th month post CABG) of recruitment. Both the groups
were compared using the STATA statistics package (version 14.2).
<br/>Result(s): After 6 months, body weight, Fasting Blood Sugar (FBS),
High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL),
Triglyceride (TG), LDL/HDL ratio, high sensitivity C Reactive Protein
(hs-CRP), Perceived Stress Scale (PSS), Negative Affect Scale of Positive
and negative Affect Score (PANAS) significantly decreased (p<.05) in
patients undergoing YBCR+PBCR. There was also a significant(p<.05)
increase in World Health Organization Brief Quality of life (WHO-QOL BREF
SCORE), Positive Affect Scale of Positive and Negative Affect (PANAS)
Score, Six Minute Walk test, and left ventricular ejection fraction
(LVEF). <br/>Conclusion(s): A significant reduction in weight, LDL,
triglyceride, hsCRP, PANAS negative social scale score with significant
improvement in biochemical, stress scale scores, echocardiographic, and
functional outcomes with yoga based cardiac rehabilitation as an add on
therapy to standard physiotherapy.<br/>Copyright &#xa9; 2023 International
Journal of Academic Medicine and Pharmacy. All rights reserved.

<95>
Accession Number
2027355779
Title
The Paradox of Choice in Transcatheter Edge-to-Edge Mitral Valve Repair
for Functional Mitral Regurgitation: What Meta-Analyses Can and Can Not
Tell Us.
Source
American Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Barbieri A.; Mantovani F.
Institution
(Barbieri) Division of Cardiology, Department of Diagnostics, Clinical and
Public Health Medicine, Policlinico University Hospital of Modena, Modena,
Italy
(Mantovani) Cardiology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio
Emilia, Italy
Publisher
Elsevier Inc.

<96>
Accession Number
2027355764
Title
Cognitive Deficits in Executive and Language Functions Predict
Postoperative Delirium.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Olotu C.; Lebherz L.; Ascone L.; Scherwath A.; Kuhn S.; Harter M.;
Kiefmann R.
Institution
(Olotu, Kiefmann) Department of Anaesthesiology, University Medical Center
Hamburg, Hamburg, Germany
(Lebherz, Scherwath, Harter) Institute of Medical Psychology, University
Medical Center Hamburg, Hamburg, Germany
(Ascone, Kuhn) Department of Psychiatry and Psychotherapy, University
Medical Center Hamburg, Hamburg, Germany
(Scherwath) Department of Stem Cell Transplantation, University Medical
Center Hamburg, Hamburg, Germany
(Kiefmann) Anesthesia Department, Rotkreuzklinikum Munich, Munich, Germany
Publisher
W.B. Saunders
Abstract
Objectives: Postoperative delirium (POD) remains the most common
complication in older adults, with cognitive impairment being the main
risk factor. Patients with mild cognitive impairment, in particular, have
much to lose from delirium; despite this, their cognitive impairment might
be clinically overlooked. Understanding which cognitive domains are
particularly predictive in this regard may improve the sensitivity of
preoperative testing and allow for a more targeted application of
resource-intensive measures to prevent delirium in the perioperative
period. The authors conducted this study with the aim of identifying the
most indicative cognitive domains. <br/>Design(s): A secondary analysis of
a randomized controlled trial. <br/>Setting(s): At a single center, the
University Medical Centre Hamburg in Hamburg, Germany.
<br/>Participant(s): Patients >=60 years without major neurocognitive
disorders (dementia, Mini-Mental State Examination score <=23) scheduled
for cardiovascular surgery. <br/>Measurements and Main Results:
Preoperative neuropsychologic testing and delirium screening were
performed twice daily until postoperative day 5. A multiple logistic
regression model was applied to determine the predictive ability of test
performances for the development of delirium. <br/>Result(s): A total of
541 patients were included in the analysis; the delirium rate was 15.6%.
After controlling for confounders, only low performance within the Trail
Making Test B/A (odds ratio [OR] = 1.32; 95% CI: 1.05-1.66) and letter
fluency (OR = 0.66; 95% CI: 0.45-0.96) predicted a particularly high risk
for delirium development. The discriminative ability of the final multiple
logistic regression model to predict POD had an area under the curve of
0.786. <br/>Conclusion(s): Impairment in the cognitive domains of
executive function and language skills associated with memory, inhibition,
and access speed seem to be particularly associated with the development
of delirium after surgery in adults >=65 years of age without apparent
preoperative neurocognitive impairment.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<97>
Accession Number
2027355572
Title
The effect of back massage with frankincense and myrrh oil before the
cardiac electrophysiological procedure on back pain intensity and comfort:
A single-blind randomized controlled trial.
Source
Explore. (no pagination), 2023. Date of Publication: 2023.
Author
Ozdemir U.; Tasci S.; Doner A.; Ozdemir Alkanat H.; Inanc M.T.
Institution
(Ozdemir, Tasci, Doner) Department of Internal Medicine Nursing, Erciyes
University Faculty of Health Sciences, Kayseri, Turkey
(Ozdemir Alkanat) Department of Internal Medicine Nursing, Giresun
University Faculty of Health Sciences, Giresun, Turkey
(Inanc) Internal Medicine Scientist, Department of Cardiology, Erciyes
University Faculty of Medicine, Kayseri, Turkey
Publisher
Elsevier Inc.
Abstract
Context: Back pain is one of the most common problems experienced by
patients after the cardiac electrophysiological study procedure. In
addition, limitation of movement after the procedure negatively affects
the comfort and satisfaction of patients. <br/>Objective(s): The aim of
this study was to determine the effect of back massage with frankincense
and myrrh oil on back pain severity and comfort in patients who were to
undergo cardiac electrophysiological study. <br/>Method(s): This is a
randomized controlled study with a pretest-posttest design. This study was
conducted from October 2020 to March 2021, at the angio unit of a heart
hospital at a university in Turkey. The study was completed with 30
patients in each group, a total of 90 people. Data were collected using a
patient information form, a Visual Analogue Scale (VAS) and the General
Comfort Questionnaire (GCQ). The intervention group and the placebo group
received back massage with frankincense and myrrh essential oil and with
jojoba fixed oil respectively. No intervention was applied to the control
group. <br/>Result(s): There was no statistically significant difference
between the post-procedure VAS values according to the groups. Except for
sociocultural comfort, there were significant differences between the
groups in terms of GCQ total scores and subscales at the first and last
follow-up. <br/>Conclusion(s): Back massage with frankincense and myrrh
oil increased overall comfort, physical comfort, the psychospiritual
comfort. Additional research with a rigorous design is needed to determine
its effect on pain.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<98>
Accession Number
642425664
Title
CPAP Effect on Progression of Retinal Disease in Patients with Sleep Apnea
and Non-proliferative Diabetic Retinopathy: A Randomized Clinical Trial.
Source
Annals of the American Thoracic Society. (no pagination), 2023. Date of
Publication: 04 Oct 2023.
Author
Garcia-Sanchez A.; Villalain I.; Jaureguizar A.; Zamarron E.;
Martinez-Ceron E.; Casitas R.; Galera R.; Cubillos-Zapata C.; Garcia J.;
Asencio M.; Garcia-Rio F.
Institution
(Garcia-Sanchez, Jaureguizar) Hospital Universitario Ramon y Cajal,
Madrid, Spain
(Villalain, Asencio) Hospital Universitario La Paz, Servicio de
Oftalmologia, Madrid, Spain
(Zamarron, Martinez-Ceron, Casitas, Galera) Hospital Universitario La Paz,
Servicio de Neumologia, Madrid, Spain
(Cubillos-Zapata) Hospital Universitario La Paz-IdiPAZ, Grupo de
Enfermedades Respiratorias, Madrid, Spain
(Cubillos-Zapata) Centro de Investigacion Biomedica en Red en Enfermedades
Respiratorias (CIBERES), Madrid, Spain
(Garcia) Hospital Universitario La Paz-IdiPAZ, Servicio de Oftalmologia,
Madrid, Spain
(Garcia-Rio) Hospital Universitario La Paz, Servicio de Neumologia,
Madrid, Spain; fgr01m@gmail.com
Publisher
NLM (Medline)
Abstract
RATIONALE: Obstructive sleep apnea (OSA) is associated with impaired
glycemic control, and a higher risk of vascular complications, such as
diabetic retinopathy. However, the effect of apnea-hypopneas suppression
on retinal disease progression is unclear. <br/>OBJECTIVE(S): To evaluate
the efficacy and safety of continuous positive airway pressure (CPAP) for
the reduction of retinal lesions in patients with non-proliferative
diabetic retinopathy (NPDR) and OSA. <br/>METHOD(S): This open-label,
parallel-group, randomized controlled trial was conducted between October
2016 and February 2020 at a University Hospital in Spain. The date of
final follow-up was March 2, 2021. 83 patients with OSA and mild-moderate
NPDR receiving stable treatment were randomized to receive CPAP and usual
care (43 patients, with 79 available eyes) or usual care alone (40
patients with 67 available eyes) for 52 weeks. The primary outcomes were
the change in the percentage of eyes with retinal exudates and the number
of retinal microhaemorrhages from baseline to week 52. We also assessed
the effect of both interventions on retinal thickness by means of optical
coherence tomography (OCT), serum levels of glycated haemoglobin, blood
pressure, lipid levels, sleepiness, and quality of life. <br/>RESULT(S):
52-weeks of CPAP treatment were associated with a reduction from baseline
in the percentage of eyes with hard exudates (overall difference -21.7%,
P=0.035) as well as in OCT indices of retinal oedema, including central
subfield thickness and cube volume. However, in patients who met
prespecified criteria for CPAP adherence, treatment was also associated
with a higher number of retinal microhaemorrhages at 52 weeks (intergroup
adjusted difference, 6.0 [95% confidence interval 0.6 to 11.5]; P=0.029),
which was directly related to prescribed pressure levels. CPAP treatment
also improved glycaemic control, sleepiness, and general health-related
quality of life. <br/>CONCLUSION(S): In patients with OSA and NPDR,
long-term CPAP treatment in addition to usual care may result in slower
progression of retinal disease, although it could also induce an increase
in retinal microhaemorrhages. CLINICAL TRIAL REGISTRATION: The trial is
registered with ClinicalTrials.gov (NCT02874313). Primary Source of
Funding: Sociedad Espanola de Neumologia y Cirugia Toracica/Spanish
Society of Pneumology and Thoracic Surgery.

<99>
Accession Number
642425178
Title
Removal of Wires for Sternal Internal Fixation After Cardiac Surgery in
Adolescents.
Source
Alternative therapies in health and medicine. (no pagination), 2023. Date
of Publication: 06 Oct 2023.
Author
Dong Y.; Tian L.; Li X.; Cui Y.
Publisher
NLM (Medline)
Abstract
Objective: The objective of this study was to assess the safety and
patient satisfaction of sternal wire removal surgery, rendering reference
for clinical practice in the future. <br/>Method(s): A total of 70
adolescent patients with completely healed sternum and no other diseases
or able to receive surgery were randomly selected and subjected to sternal
wire removal surgery. Besides, relevant data including patient age,
gender, wire rupture, reason for wire removal, postoperative wire
residuals, patient satisfaction, age at cardiac surgery, waiting time
after cardiac surgery, and removal duration were recorded. <br/>Result(s):
Raptured wire group exhibited higher proportions of males and chest pain
cases and longer operative time than unruptured wire group. The demand for
wire removal had no relation to gender, but patients receiving surgery due
to chest pain were mainly aged 12-15 years old, those undergoing surgery
due to employment and further education were mainly aged 9-12 years old,
and those subjected to surgery sue to ruptures found in physical
examinations were mainly aged 6-9 years old. According to statistics of
wire rupture position, the rupture of the 4th wire accounted for the
largest proportion, and rupture of multiple wires was found in some
patients. No statistically significant differences were found in gender,
age, age at cardiac surgery, and waiting time after cardiac surgery
between patients with only one wire ruptured and those with multiple wires
ruptured. Patients were grouped based on the absence and presence of chest
pain, and it was found that chest pain group had a longer removal
duration, but comparable age at cardiac surgery and waiting time after
cardiac surgery, and the waiting time after cardiac surgery was a risk
factor for chest pain. The waiting time after cardiac surgery was
positively correlated with operative time, so we recommend that if there
were symptoms of chest discomfort, it should be removed as soon as
possible. However, due to the needs of the patients, no control group was
set up, which is the limitation of this study. In the next step, we will
conduct more long-term observation of the patients to confirm whether the
chest pain can be relieved by itself without removing the wire.
<br/>Conclusion(s): This study found that for adolescent patients with
chest pain or other life troubles after cardiac surgery, removing the
sternal internal fixation wire can quickly and effectively relieve the
troubles, and is a safe and reliable treatment means. Therefore, if it is
necessary to remove the wire, it should be removed as soon as possible to
avoid wire breakage and increase the difficulty of surgery.

<100>
Accession Number
642424901
Title
No randomized trial has confirmed significantly better long-term survival
for either radial artery or saphenous vein graft recipients in coronary
artery bypass grafting surgery.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 04 Oct 2023.
Author
Nezic D.
Institution
(Nezic) "Dedinje" Cardiovascular Institute, Belgrade, Serbia
Publisher
NLM (Medline)

<101>
Accession Number
2027203694
Title
Recurrent Cardiac Sarcoidosis and Giant Cell Myocarditis After Heart
Transplant: A Case Report and Systematic Literature Review.
Source
American Journal of Cardiology. 207 (pp 271-279), 2023. Date of
Publication: 15 Nov 2023.
Author
Stein A.P.; Stewart B.D.; Patel D.C.; Al-Ani M.; Vilaro J.; Aranda J.M.;
Ahmed M.M.; Parker A.M.
Institution
(Stein) Department of Medicine
(Stewart) Department of Pathology
(Patel) Division of Pulmonary, Critical Care and Sleep Medicine
(Al-Ani, Vilaro, Aranda, Ahmed, Parker) Division of Cardiology, Department
of Medicine, University of Florida Gainesville, Florida, United States
Publisher
Elsevier Inc.
Abstract
Recurrence of cardiac sarcoidosis (CS) and giant cell myocarditis (GCM)
after heart transplant is rare, with rates of 5% in CS and 8% in GCM. We
aim to identify all reported cases of recurrence in the literature and to
assess clinical course, treatments, and outcomes to improve understanding
of the conditions. A systematic review, utilizing Preferred Reporting
Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, was
conducted by searching MEDLINE/PubMed and Embase of all available
literature describing post-transplant recurrent granulomatous myocarditis,
CS, or GCM. Data on demographics, transplant, recurrence, management, and
outcomes data were collected from each publication. Comparison between the
2 groups were made using standard statistical approaches. Post-transplant
GM recurrence was identified in 39 patients in 33 total publications.
Reported cases included 24 GCM, 12 CS, and 3 suspected cases. Case reports
were the most frequent form of publication. Mean age of patients
experiencing recurrence was 42 years for GCM and 48 years for CS and
favored males (62%). Time to recurrence ranged from 2 weeks to 9 years
post-transplant, occurring earlier in GCM (mean 1.8 vs 3.0 years).
Endomyocardial biopsies (89%) were the most utilized diagnostic method
over cardiac magnetic resonance and positron emission tomography.
Recurrence treatment regimens involved only steroids in 40% of CS, whereas
other immunomodulatory regimens were utilized in 70% of GCM. In
conclusion, GCM and CS recurrence after cardiac transplantation holds
associated risks including concurrent acute cellular rejection, a higher
therapeutic demand for GCM recurrence compared with CS, and mortality. New
noninvasive screening techniques may help modify post-transplant
monitoring regimens to increase both early detection and treatment of
recurrence.<br/>Copyright &#xa9; 2023

<102>
Accession Number
2027119833
Title
The effect of continuous glucose monitoring-guided glycemic control on
progression of coronary atherosclerosis in type 2 diabetic patients with
coronary artery disease: The OPTIMAL randomized clinical trial.
Source
Journal of Diabetes and its Complications. 37(10) (no pagination), 2023.
Article Number: 108592. Date of Publication: October 2023.
Author
Kataoka Y.; Kitahara S.; Funabashi S.; Makino H.; Matsubara M.; Matsuo M.;
Omura-Ohata Y.; Koezuka R.; Tochiya M.; Tamanaha T.; Tomita T.;
Honda-Kohmo K.; Noguchi M.; Maruki M.; Kanai E.; Murai K.; Iwai T.; Sawada
K.; Matama H.; Honda S.; Fujino M.; Yoneda S.; Takagi K.; Otsuka F.;
Asaumi Y.; Hosoda K.; Nicholls S.J.; Yasuda S.; Noguchi T.
Institution
(Kataoka, Kitahara, Funabashi, Kanai, Murai, Iwai, Sawada, Matama, Honda,
Fujino, Yoneda, Takagi, Otsuka, Asaumi, Noguchi) Department of
Cardiovascular Medicine, National Cerebral & Cardiovascular Centre, Osaka,
Suita, Japan
(Kitahara) Department of Cardiovascular Medicine, Kashiwa Kousei General
Hospital, Kashiwa, Japan
(Funabashi) Department of Cardiovascular Medicine, Kyorin University,
Tokyo, Mitaka, Japan
(Makino, Matsubara, Matsuo, Omura-Ohata, Koezuka, Tochiya, Tamanaha,
Tomita, Honda-Kohmo, Noguchi, Maruki, Hosoda) Division of Diabetes and
Lipid Metabolism, National Cerebral & Cardiovascular Center, Osaka, Suita,
Japan
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Yasuda) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
Publisher
Elsevier Inc.
Abstract
Background: Continuous glucose monitoring (CGM) improves glycemic
fluctuation and reduces hypoglycemic risk. Whether CGM-guided glycemic
control favorably modulates coronary atherosclerosis in patients with type
2 diabetes (T2DM) remains unknown. <br/>Method(s): The OPTIMAL trial was a
prospective, randomized, single-center trial in which 94 T2DM patients
with CAD were randomized to CGM- or HbA1c-guided glycemic control for 48
weeks (jRCT1052180152). The primary endpoint was the nominal change in
total atheroma volume (TAV) measured by serial IVUS. The secondary
efficacy measure was the nominal change in maxLCBI<inf>4mm</inf> on
near-infrared spectroscopy imaging. <br/>Result(s): Among the 94
randomized patients, 82 had evaluable images at 48 weeks. Compared to
HbA1c-guided glycemic control, CGM-guided control achieved a greater
reduction in %coefficient of variation [-0.1 % (-1.8 to 1.6) vs. -3.3 %
(-5.1 to -1.5), p = 0.01] and a greater increase in the duration with
glucose between 70 and 180 mg/dL [-1.5 % (-6.0 to 2.9) vs. 6.7 % (1.9 to
11.5), p = 0.02]. TAV increased by 0.11 +/- 1.9 mm³ in the
HbA1c-guided group and decreased by -3.29 +/- 2.00 mm³ in the
CGM-guided group [difference = -3.4 mm³ (95%CI: -8.9 to 2.0
mm³), p = 0.22]. MaxLCBI<inf>4mm</inf>, increased by 90.1 +/-
25.6 in the HbA1c-guided group and by 50.6 +/- 25.6 in the CGM-guided
group (difference = -45.6 (95%CI: -118.1 to 26.7) p = 0.21]. A post-hoc
exploratory analysis showed a greater regression of maxLCBI<inf>4mm</inf>
in the CGM-guided group [difference = 20.4 % (95%CI:1.3 to 39.5 %), p =
0.03]. <br/>Conclusion(s): CGM-guided control for 48 weeks did not slow
disease progression in T2DM patients with CAD. A greater regression of
lipidic plaque under CGM-guided glycemic control in the post-hoc analysis
requires further investigation.<br/>Copyright &#xa9; 2023 The Author(s)

<103>
Accession Number
2026539536
Title
Stepwise Provisional versus Planned Double Stenting Strategies in Treating
Unprotected Left Main Distal Bifurcation Lesions: A Systematic Review and
Meta-Analysis Comprising 11,672 Patients.
Source
Reviews in Cardiovascular Medicine. 24(8) (no pagination), 2023. Article
Number: 216. Date of Publication: 2023.
Author
Li D.; Liu H.; Gao C.; Liu J.; Liu P.; Cheng M.; Zheng Q.; Deng J.; Zhang
M.; Luo Z.; Guo W.
Institution
(Li, Liu, Gao, Liu, Liu, Cheng, Zhang, Guo) Department of Cardiology,
Tangdu Hospital, Air Force Medical University, Shaanxi, Xi'an 710038,
China
(Zheng, Deng) Department of Cardiology, The Second Affiliated Hospital of
Xi'an Jiaotong University, Shaanxi, Xi'an 710004, China
(Luo) Department of Intervention Radiology, Tangdu Hospital, Air Force
Medical University, Shaanxi, Xi'an 710038, China
Publisher
IMR Press Limited
Abstract
Background: Provisional stenting is the preferred strategy for non-left
main bifurcation lesions. However, its superiority over planned double
stenting for unprotected left main distal bifurcation (UPLMB) lesions
remains unclear. Previous studies have reported conflicting results.
<br/>Method(s): Randomised controlled trials (RCTs) and observational
studies comparing the outcomes of provisional stenting to planned double
stenting for UPLMB lesions were identified. The primary endpoint was major
adverse cardiac events (MACE). The secondary endpoints were myocardial
infarction (MI), target vessel revascularisation (TVR), target lesion
revascularisation (TLR), all-cause death, cardiac death and stent
thrombosis (ST). Aggregated odds ratios (OR) and 95% confidence intervals
were calculated. A sensitivity analysis was conducted if I² was
>50% or p < 0.01. Publication bias analysis was considered if more than 10
studies were enrolled. <br/>Result(s): Two RCTs and 19 observational
studies comprising 11,672 patients were enrolled. Provisional stenting had
a significantly lower incidence of MACE, mainly driven by TLR and TVR.
Double stenting had a significantly lower incidence of cardiac death. In
addition, patients undergoing provisional stenting had a lower tendency
towards the occurrence of MI, while patients undergoing double stenting
had a lower tendency towards all-cause death and ST. <br/>Conclusion(s): A
provisional stenting strategy was associated with lower MACE, TVR and TLR
but higher cardiac death. Further investigation is needed through RCTs to
assess which strategy performs better.<br/>Copyright: &#xa9; 2023 The
Author(s). Published by IMR Press.

<104>
Accession Number
2026325983
Title
Efficacy of Incisional Ropivacaine Infiltration by Presternal
Multi-Orifice Catheter for Post-sternotomy Pain Relief in Pediatric
Patients Undergoing Cardiac Surgery: A Prospective, Randomized, Controlled
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2282-2288),
2023. Date of Publication: November 2023.
Author
Das D.; Chauhan S.; Gayatri S.; Chaudhury M.; Makhija N.; Bisoi A.K.
Institution
(Das, Chauhan, Chaudhury, Makhija) Department of Cardiac Anesthesia and
Critical Care, Cardiothoracic Centre, AIIMS, New Delhi, India
(Gayatri, Bisoi) Department of Cardiothoracic and Vascular Surgery,
Cardiothoracic Centre, AIIMS, New Delhi, India
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the efficacy of incisional ropivacaine infiltration
by presternal multi-orifice catheter to manage poststernotomy pain in
pediatric cardiac surgery. <br/>Design(s): A prospective, randomized, and
double-blind comparative study. <br/>Setting(s): At a single-institution
tertiary referral cardiac center. <br/>Participant(s): The study comprised
200 children undergoing cardiac surgeries through a midline sternotomy.
<br/>Intervention(s): Children were allocated randomly to 1 of 3 groups.
Group A (n = 65) and group B (n = 64) received 0.375% ropivacaine infusion
and intermittent bolus, respectively, by presternal multi-orifice
catheter, whereas Group C (n = 64) did not receive any local anesthetic
(LA) drug. Postoperatively, intravenous paracetamol was used for
multimodal analgesia, and fentanyl was given as rescue analgesia,
respectively. <br/>Measurements and Main Results: Pain was assessed by a
Modified Objective Pain Score (MOPS) for 48 hours postextubation. Group B
had significantly lower early MOPS at the first hour, but in the later
period, the mean MOPS was lower in group A. The requirement of the first
rescue analgesia was 3 +/- 1.51, 6.1 +/- 2.26, and 2.6 +/- 0.87 hours for
groups A (n = 60), B (n = 60), and C (n = 60), respectively. The 48-hour
fentanyl consumption was significantly lower (p < 0.001) in group A (0.5
+/- 0.68 microg/kg) and group B (0.7 +/- 0.86 microg/kg) than the control
group (3.4 +/- 0.68 microg/kg). The length of intensive care unit stay was
lower (p < 0.001) in groups A and B than in group C; however, the length
of hospital stay was comparable (p = 0.07). <br/>Conclusion(s): LA bolus
and infusion through presternal multi-orifice catheter provided effective
analgesia postoperatively. However, the bolus was more efficacious in the
early phase but equivalent in later periods. Therefore, bolus and LA
infusion can be used for steady poststernotomy pain relief in children
undergoing cardiac surgeries.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<105>
Accession Number
2026110300
Title
Comparison of Crystalloid Preloading and Coloading for Prevention of
Spinal-induced Hypotension in Cesarean Delivery: A Randomized Controlled
Trial at a Tertiary Facility in Ghana.
Source
Open Access Macedonian Journal of Medical Sciences. 11(B) (pp 627-633),
2023. Date of Publication: 2023.
Author
Quarshie A.; Anno A.; Djagbletey R.; Sarpong P.; Sottie D.; Phillips B.J.;
Lassey P.D.; Aryee G.; Essuman R.; Darkwa E.O.
Institution
(Quarshie, Anno, Sarpong, Sottie) Department of Anesthesia, Korle-Bu
Teaching Hospital, Accra, Ghana
(Djagbletey, Phillips, Lassey, Aryee, Essuman, Darkwa) Department of
Anaesthesia, University of Ghana Medical School, Accra, Ghana
Publisher
Scientific Foundation SPIROSKI
Abstract
BACKGROUND: Spinal anesthesia is the recommended technique for cesarean
section. It is easy to perform and provides a reliable, safe, effective,
and fast sensory and motor block of high quality. Hypotension, which can
be deleterious to both mother and baby, is however a common side effect.
Preloading has not been shown to consistently prevent spinal-induced
hypotension. AIM: The aim of this study was to compare coloading with
preloading using crystalloids for preventing spinal anesthesia-induced
hypotension in parturients undergoing scheduled cesarean delivery.
MATERIALS AND METHODS: A single-blinded, randomized, and controlled study
was conducted on 88 patients at term scheduled for elective cesarean
delivery under spinal anesthesia at the Korle-Bu Teaching Hospital.
Parturients were randomly assigned to receive a preload of 12.5 mL/kg of
Ringer's Lactate (Group P) before the spinal anesthetic or a coload of
12.5 mL/kg of Ringers Lactate (Group C) at the time of the spinal
procedure. Blood pressure, heart rate, incidence and timing of nausea and
vomiting, and amount and frequency of vasopressor used were recorded for
the first 10 minutes post-spinal anesthesia. Neonatal Apgar scores were
determined at 1 and 5 minutes after birth. <br/>RESULT(S): The two groups
were comparable with respect to age, weight, height, gestational age, ASA
classification, baseline hemodynamic measurements, time to onset of
hypotension, and time to delivery of baby post-spinal anesthesia.
Post-spinal anesthesia changes in the heart rate, systolic blood pressure
and mean arterial blood pressure were also comparable between the two
groups. None of the patients in both groups experienced nausea or vomiting
without hypotension. Although the cumulative dose of ephedrine to treat
hypotension in the preload group was higher compared to the coload group,
the difference was not statistically significant (16.3 vs. 12.4; p-value =
0.110). <br/>CONCLUSION(S): Preloading and coloading with 12.5 mL/kg of
Ringer's Lactate are comparable but neither is effective alone for
preventing spinal-induced hypotension in the obstetric population. A
vasopressor regimen is required to improve efficacy of the fluid load for
preventing spinal-induced hypotension.<br/>Copyright &#xa9; 2023 Amanda
Quarshie, Audrey Anno, Robert Djagbletey, Pokua Sarpong, Daniel Sottie,.

<106>
Accession Number
2024838689
Title
Intraoperative hemodynamics and risk of cardiac surgery-associated acute
kidney injury: An observation study and a feasibility clinical trial.
Source
Clinical and Experimental Pharmacology and Physiology. 50(11) (pp
878-892), 2023. Date of Publication: November 2023.
Author
Noe K.M.; Don A.; Cochrane A.D.; Zhu M.Z.L.; Ngo J.P.; Smith J.A.; Thrift
A.G.; Vogiatjis J.; Martin A.; Bellomo R.; McMillan J.; Evans R.G.
Institution
(Noe, Don, Zhu, Ngo, Vogiatjis, Martin, Evans) Cardiovascular Disease
Program, Department of Physiology, Biomedicine Discovery Institute, Monash
University, Melbourne, VIC, Australia
(Noe, Cochrane, Zhu, Smith, Martin, Evans) Department of Surgery, School
of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC,
Australia
(Cochrane, Zhu, Smith, Martin) Department of Cardiothoracic Surgery,
Monash Health, Monash University, Melbourne, VIC, Australia
(Ngo) Department of Cardiac Physiology, National Cerebral and
Cardiovascular Center Research Institute, Osaka, Japan
(Thrift) Department of Medicine, School of Clinical Sciences at Monash
Health, Monash University, Melbourne, VIC, Australia
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
(Bellomo) Department of Intensive Care, Austin Health, Heidelberg, VIC,
Australia
(Bellomo, Evans) Pre-clinical Critical Care Unit, Florey Institute of
Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
(McMillan) Perfusion Services Pty Ltd, Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Targeting greater pump flow and mean arterial pressure (MAP) during
cardiopulmonary bypass (CPB) could potentially alleviate renal hypoxia and
reduce the risk of postoperative acute kidney injury (AKI). Therefore, in
an observational study of 93 patients undergoing on-pump cardiac surgery,
we tested whether intraoperative hemodynamic management differed between
patients who did and did not develop AKI. Then, in 20 patients, we
assessed the feasibility of a larger-scale trial in which patients would
be randomized to greater than normal target pump flow and MAP, or usual
care, during CPB. In the observational cohort, MAP during hypothermic CPB
averaged 68.8 +/- 8.0 mmHg (mean +/- SD) in the 36 patients who developed
AKI and 68.9 +/- 6.3 mmHg in the 57 patients who did not (p = 0.98). Pump
flow averaged 2.4 +/- 0.2 L/min/m² in both groups. In the
feasibility clinical trial, compared with usual care, those randomized to
increased target pump flow and MAP had greater mean pump flow (2.70 +/-
0.23 vs. 2.42 +/- 0.09 L/min/m² during the period before
rewarming) and systemic oxygen delivery (363 +/- 60 vs. 281 +/- 45
mL/min/m²). Target MAP >=80 mmHg was achieved in 66.6% of
patients in the intervention group but in only 27.3% of patients in the
usual care group. Nevertheless, MAP during CPB did not differ
significantly between the two groups. We conclude that little insight was
gained from our observational study regarding the impact of variations in
pump flow and MAP on the risk of AKI. However, a clinical trial to assess
the effects of greater target pump flow and MAP on the risk of AKI appears
feasible.<br/>Copyright &#xa9; 2023 The Authors. Clinical and Experimental
Pharmacology and Physiology published by John Wiley & Sons Australia, Ltd.

<107>
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).
<br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023,
Springer-Verlag Italia S.r.l., part of Springer Nature.

<108>
[Use Link to view the full text]
Accession Number
641544698
Title
Meta-analysis of post-transcatheter aortic valve replacement outcomes in
patients with cardiac amyloidosis and aortic stenosis.
Source
International journal of surgery (London, England). 109(9) (pp 2872-2874),
2023. Date of Publication: 01 Sep 2023.
Author
Jaiswal V.; Joshi A.; Ishak A.; Nataraj M.; Ang S.P.; Khan N.; Daneshvar
F.; Aguilera-Alvarez V.H.; Verma D.; Shrestha A.B.; Sharma P.
Institution
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Joshi) Vydehi Institute of Medical Sciences and Research Centre,
Bangalore, India
(Ishak) European University Cyprus, School of Medicine, Nicosia, Cyprus
(Nataraj) Cardio-Pulmonary Physiotherapist and Research, Manipal,
Karnataka, India
(Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Khan) Jinnah Sindh Medical University, Karachi, Pakistan
(Daneshvar) Department of Cardiology, FL, United States
(Aguilera-Alvarez) Universidad Autonoma de Baja, CA, United States
(Verma) Janaki Medical College, Nepal
(Shrestha) Department of Internal Medicine, Abdur Rahim Medical College,
Dinajpur, Bangladesh
(Sharma) Division of Cardiology, Department of Internal Medicine, King
George's Medical University, India
Publisher
NLM (Medline)

<109>
Accession Number
2027181523
Title
Perioperative Arrhythmias.
Source
Deutsches Arzteblatt International. 120(33-34) (pp 564-574), 2023. Date of
Publication: 21 Aug 2023.
Author
Pecha S.; Kirchhof P.; Reissmann B.
Institution
(Pecha, Kirchhof, Reissmann) University Heart & Vascular Center Hamburg,
Department of Cardiology, Germany
(Kirchhof) Institute of Cardiovascular Sciences, University of Birmingham,
United Kingdom
Publisher
Deutscher Arzte-Verlag GmbH
Abstract
Background: Perioperative arrhythmias are common depending on the type of
the operation and can increase morbidity and mortality. <br/>Method(s):
This review is based on pertinent publications retrieved by a selective
search in PubMed, as well as the relevant European guidelines.
<br/>Result(s): Arrhythmias are seen in more than 90% of cardiac
operations; they are usually transient and often asymptomatic. The risk
factors for arrhythmia include ion channel diseases, old age, structural
heart disease, cardiac surgery, noncardiac surgery with major fluid
shifts, and pulmonary resection. The full spectrum of supraventricular and
ventricular arrhythmias can arise perioperatively. Correct ECG
interpretation, consideration of the arrhythmia in the overall clinical
context, and an understanding of its causes, pathophysiology, and options
for effective treatment are critically important. According to a
meta-analysis, beta-blockers lower the risk of perioperative atrial
fibrillation (OR = 0.56; 95% confidence interval: [0.35; 0.91]). If
anticoagulant treatment is not interrupted for surgery, there is less
bleeding with direct oral anticoagulants than with vitamin K antagonists
(relative risk: 0.62 [0.47; 0.82]). Moreover, clinical follow-up is
important, especially for patients with new-onset atrial fibrillation or
heart failure. <br/>Conclusion(s): The identification of high-risk
patients and the provision of individualized perioperative monitoring are
essential aspects of patient safety. Outpatient cardiological follow-up
can improve outcomes.<br/>Copyright &#xa9; 2023 Deutscher Arzte-Verlag
GmbH. All rights reserved.

<110>
Accession Number
2027168718
Title
Plasma type i collagen alpha1 chain in relation to coronary artery
disease: Findings from a prospective population-based cohort and an acute
myocardial infarction prospective cohort in Sweden.
Source
BMJ Open. 13(9) (no pagination), 2023. Article Number: e073561. Date of
Publication: 15 Sep 2023.
Author
Hammareus F.; Nilsson L.; Ong K.-L.; Kristenson M.; Festin K.; Lundberg
A.K.; Chung R.W.S.; Swahn E.; Alfredsson J.; Holm Nielsen S.; Jonasson L.
Institution
(Hammareus, Nilsson, Kristenson, Festin, Lundberg, Chung, Swahn,
Alfredsson, Jonasson) Department of Health Medicine and Caring Sciences,
Linkoping University, Linkoping, Sweden
(Ong) Faculty of Medicine and Health, NHMRC Clinical Trials Centre, The
University of Sydney, Sydney, NSW, Australia
(Holm Nielsen) Department of Biotechnology and Biomedicine, Technical
University of Denmark, Lyngby, Denmark
(Holm Nielsen) Nordic Bioscience, Herlev, Denmark
Publisher
BMJ Publishing Group
Abstract
Objectives To investigate the association between type I collagen alpha1
chain (COL1alpha1) levels and coronary artery disease (CAD) by using
absolute quantification in plasma. Also, to investigate the correlates of
COL1alpha1 to clinical characteristics and circulating markers of collagen
metabolism. Design Life conditions, Stress and Health (LSH) study:
prospective cohort study, here with a nested case-control design.
Assessing Platelet Activity in Coronary Heart Disease (APACHE) study:
prospective cohort study. Setting LSH: primary care setting, southeast
Sweden. APACHE: cardiology department, university hospital, southeast
Sweden. Participants LSH: 1007 randomly recruited individuals aged 45-69
(50% women). Exclusion criteria was serious disease. After 13 years of
follow-up, 86 cases with primary endpoint were identified and
sex-matched/age-matched to 184 controls. APACHE: 125 patients with
myocardial infarction (MI), 73 with ST-elevation MI and 52 with
non-ST-elevation MI. Exclusion criteria: Intervention study participation,
warfarin treatment and short life expectancy. Primary and secondary
outcome measures Primary outcome was the association between baseline
COL1alpha1 and first-time major event of CAD, defined as fatal/non-fatal
MI or coronary revascularisation after 13 years. Secondary outcomes were
the association between the collagen biomarkers PRO-C1 (N-terminal
pro-peptide of type I collagen)/C1M (matrix metalloproteinase-mediated
degradation of type I collagen) and CAD; temporal change of COL1alpha1
after acute MI up to 6 months and lastly, correlates between COL1alpha1
and patient characteristics along with circulating markers of collagen
metabolism. Results COL1alpha1 levels were associated with CAD, both
unadjusted (HR=0.69, 95% CI=0.56 to 0.87) and adjusted (HR=0.55, 95%
CI=0.41 to 0.75). PRO-C1 was associated with CAD, unadjusted (HR=0.62, 95%
CI=0.47 to 0.82) and adjusted (HR=0.61, 95% CI=0.43 to 0.86), while C1M
was not. In patients with MI, COL1alpha1 remained unchanged up to 6
months. COL1alpha1 was correlated to PRO-C1, but not to C1M. Conclusions
Plasma COL1alpha1 was independently and inversely associated with CAD.
Furthermore, COL1alpha1 appeared to reflect collagen synthesis but not
degradation. Future studies are needed to confirm whether COL1alpha1 is a
clinically useful biomarker of CAD. <br/>Copyright &#xa9; 2023 BMJ
Publishing Group. All rights reserved.