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<1>
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.

<2>
Accession Number
2026676158
Title
Expert systematic review on the choice of conduits for coronary artery
bypass grafting: endorsed by the European Association for Cardio-Thoracic
Surgery (EACTS) and The Society of Thoracic Surgeons (STS).
Source
Journal of Thoracic and Cardiovascular Surgery. 166(4) (pp 1099-1114),
2023. Date of Publication: October 2023.
Author
Gaudino M.; Bakaeen F.G.; Sandner S.; Aldea G.S.; Arai H.; Chikwe J.;
Firestone S.; Fremes S.E.; Gomes W.J.; Bong-Kim K.; Kisson K.; Kurlansky
P.; Lawton J.; Navia D.; Puskas J.D.; Ruel M.; Sabik J.F.; Schwann T.A.;
Taggart D.P.; Tatoulis J.; Wyler von Ballmoos M.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York-Presbyterian Hospital, New York, NY, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Aldea) Division of Cardiothoracic Surgery, University of Washington
School of Medicine, Wash, Seattle, United States
(Arai) Department of Cardiovascular Surgery, Graduate School of Medical
and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo,
Japan
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, Calif, United States
(Firestone, Kisson) The Society of Thoracic Surgeons, Chicago, Ill, United
States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Gomes) Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo
Hospital, Universidade Federal de Sao Paulo (Unifesp), Escola Paulista de
Medicina, Sao Paulo, Brazil
(Bong-Kim) Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, South
Korea
(Kurlansky) Division of Cardiac Surgery, Department of Surgery, Columbia
University, New York, NY, United States
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University, Baltimore, Md, United States
(Navia) Department of Cardiac Surgery, ICBA Instituto Cardiovascular,
Buenos Aires, Argentina
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
New York, NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, Ohio, United States
(Schwann) Division of Cardiac Surgery, Baystate Health, Springfield, Mass,
United States
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital,
University of Oxford, Oxford, United Kingdom
(Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
University of Melbourne, Melbourne, Australia
(Wyler von Ballmoos) Division of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Houston, Tex, United States
Publisher
Elsevier Inc.

<3>
Accession Number
2026170784
Title
Clinical outcomes following tricuspid transcatheter edge-to-edge repair
with PASCAL: A meta-analysis.
Source
International Journal of Cardiology. 389 (no pagination), 2023. Article
Number: 131194. Date of Publication: 15 Oct 2023.
Author
Badwan O.; Mirzai S.; Skoza W.; Hawk F.; Braghieri L.; Persits I.;
Krishnaswamy A.; Puri R.; Kapadia S.R.
Institution
(Badwan, Mirzai, Skoza, Braghieri, Persits) Department of Internal
Medicine, Cleveland Clinic, Cleveland, OH, United States
(Hawk) Division of Cardiovascular Medicine, University of South Florida
College of Medicine, Tampa, FL, United States
(Krishnaswamy, Puri, Kapadia) Department of Cardiovascular Medicine,
Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Patients with severe tricuspid regurgitation (TR) exhibit high
morbidity and mortality. Tricuspid transcatheter edge-to-edge repair
(T-TEER) is a rapidly evolving strategy to address the unmet clinical need
of severe TR therapies. <br/>Objective(s): Organize the current body of
evidence on outcomes following use of the PASCAL (Edwards Lifesciences)
system for T-TEER. <br/>Method(s): For this meta-analysis, we searched the
MEDLINE/PubMed, Embase, and Cochrane databases for keywords ["tricuspid"]
and ["transcatheter" or "edge-to-edge"] and ["PASCAL" or "leaflet repair"
or "valve repair"] from the database inception until January 11, 2023.
Primary outcomes of interest were procedural success, mortality, New York
Heart Association (NYHA) functional class, 6-min walking distance (6MWD),
and TR severity. <br/>Result(s): A total of 549 patients undergoing PASCAL
or PASCAL Ace T-TEER were included. The mean age ranged from 71.0 to 80.3
years, with 25.0 to 63.6% females. The follow-up duration ranged from 30
days to 1 year. The success rate was 83.5% (409/490). There was
improvement in symptoms based on NYHA classification (at 1- to 6-months;
NYHA >=3 RR 0.27 [95% CI 0.19-0.39]; p < 0.001) and 6MWD (at 1-month;
50.96 [95% CI 32.34-69.59]; p < 0.001) post-procedure. On imaging, there
was improvement in TR severity post-procedure (at 1- to 12-months; >=
severe TR 0.21 [95% CI 0.14-0.31]; p < 0.001), which remained significant
with each study removed. <br/>Conclusion(s): PASCAL for T-TEER is
associated with high procedural success rates along with improvements in
NYHA functional class, TR severity, 6MWD, and patient-reported
outcomes.<br/>Copyright &#xa9; 2023

<4>
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)

<5>
Accession Number
2024927885
Title
Efficacy of 3D-multidetector computed tomography and fluoroscopy fusion
for percutaneous left atrial appendage occlusion procedures.
Source
Journal of Cardiovascular Electrophysiology. 34(10) (pp 2076-2083), 2023.
Date of Publication: October 2023.
Author
Carneiro H.A.; Dallan L.A.P.; Yoon S.-H.; Arora S.; Knezevich J.; Wass S.;
Lobo T.; Arruda M.; Rashid I.; Filby S.J.
Institution
(Carneiro, Dallan, Yoon, Arora, Knezevich, Wass, Arruda, Rashid, Filby)
Division of Cardiology, Harrington Heart & Vascular Institute, University
Hospitals Cleveland Medical Center, Cleveland, OH, United States
(Lobo) Department of Medicine, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: We studied the impact of the use of three-dimensional
multidetector computed tomography (3D-MDCT) and fluoroscopy fusion on
percutaneous left atrial appendage occlusion (LAAO) procedures in relation
to procedure time, contrast volume, fluoroscopy time, and total radiation.
<br/>Method(s): This was a single-center, prospective, single-blinded,
randomized control trial. Patients meeting criteria for LAAO were
randomized to undergo LAAO with the WATCHMAN FLX^TM device with
and without 3D-MDCT-fluoroscopy fusion guidance using a prespecified
protocol using computed tomography angiography for WATCHMAN
FLX^TM sizing, moderate sedation, and intracardiac
echocardiography for procedural guidance. <br/>Result(s): Overall, 59
participants were randomly assigned to the fusion (n = 33) or no fusion (n
= 26) groups. The median (interquartile range) age was 79 (75-83) years,
24 (41%) were female, and 55 (93%) were Caucasian. The median
CHA<inf>2</inf>DS<inf>2</inf> VASc and HASBLED scores were 5 (4-6) and 3
(3-4), respectively. At the time of the study, 51 (53%) patients were on a
direct acting oral anticoagulant. There were no significant differences
between the fusion and no fusion groups in procedure time (52.4 +/- 15.4
vs. 56.8 +/- 19.5 min, p =.36), mean contrast volume used (33.8 +/- 12.0
vs. 29.6 +/- 11.5 mls, p =.19), mean fluoroscopy time (31.3 +/- 9.9 vs.
28.9 +/- 8.7 min, p =.32), mean radiation dose (1177 +/- 969 vs. 1091 +/-
692 mGy, p =.70), and radiation dose product curve (23.9 +/- 20.5 vs. 35.0
+/- 49.1 Gy cm², p =.29). There was no periprosthetic leak in
the two groups in the immediate 1-month postprocedure follow-up periods.
<br/>Conclusion(s): There was no significant difference with and without
3D-MDCT-fluoroscopy fusion in procedure time, contrast volume use,
radiation dose, and radiation dose product.<br/>Copyright &#xa9; 2023
Wiley Periodicals LLC.

<6>
Accession Number
2024200483
Title
Turning the tides on the perioperative care of resectable lung cancer.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(5) (pp 1340-1346),
2023. Date of Publication: November 2023.
Author
Seitlinger J.; Spicer J.D.
Institution
(Seitlinger, Spicer) Division of Thoracic Surgery, McGill University
Health Center, Montreal, QC, Canada
Publisher
Elsevier Inc.

<7>
Accession Number
2022705825
Title
Comparison of intracardiac echocardiography with transesophageal
echocardiography for left atrial appendage occlusion: an updated
systematic review and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. 66(6) (pp 1337-1340),
2023. Date of Publication: September 2023.
Author
Krishan S.; Hashim L.; Javed L.; Gomez-Perez J.; Muhammad R.; Gondal J.;
Sacco J.; Clifton S.; Khattab M.; Munir M.B.; DeSimone C.V.; Deshmukh A.;
Stavrakis S.; Asad Z.U.A.
Institution
(Krishan, Hashim, Javed, Gomez-Perez, Gondal, Sacco, Khattab, Stavrakis,
Asad) Department of Medicine, University of Oklahoma Health Sciences
Center, 800 Stanton L. Young Blvd, AAT 5400, Oklahoma City, OK 73104,
United States
(Muhammad) Oklahoma State University College of Osteopathic Medicine,
Tulsa, OK, United States
(Clifton) Robert M. Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Munir) Department of Cardiovascular Medicine, Section of
Electrophysiology, University of California Davis, Davis, CA, United
States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
Springer

<8>
Accession Number
2027768225
Title
Gender-Based Outcome Discrepancies in Patients Who Underwent Alcohol
Septal Ablation or Septal Myectomy for Hypertrophic Obstructive
Cardiomyopathy: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 208 (pp 134-142), 2023. Date of
Publication: 01 Dec 2023.
Author
Saravanabavanandan R.; Jaimalani A.; Khan M.A.N.; Riaz S.; Mangas G.D.M.;
Ahsan S.M.; Posani S.; Patel T.; Fawad M.; Al-Tawil M.
Institution
(Saravanabavanandan) Department of Internal Medicine, Madha Medical
College and Research Institute, Chennai, India
(Jaimalani) Department of Medicine, Surat Municipal Institute of Medical
Education and Research, Surat, India
(Khan) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Riaz) Department of Medicine, Allama Iqbal Medical College, Lahore,
Pakistan
(Mangas) Fluminense Federal University, Rio de Janeiro, Brazil
(Ahsan) Dow Institute of Biological, Biochemical & Pharmaceutical
Sciences, Dow University of Health Sciences, Karachi, Pakistan
(Posani) Department of Medicine, Sri Devaraj URS Medical College, Kolar,
India
(Patel) American University of Antigua College of Medicine, Antigua and
Barbuda, Saint John, Antigua and Barbuda
(Fawad) Department of Neurosurgery, King Saud Hospital, Unayzah, Saudi
Arabia
(Al-Tawil) Faculty, Department of Medicine, Al-Quds University, Jerusalem,
Palestine
Publisher
Elsevier Inc.
Abstract
Clinical evidence and emerging studies suggest that the clinical
heterogeneity observed in hypertrophic cardiomyopathy could be because of
gender-based differences. We aimed to explore the gender-related
differences pertaining to the treatment outcomes after alcohol septal
ablation (ASA) and septal myectomy (SM). We searched PUBMED/MEDLINE,
EMBASE, and SCOPUS to identify studies that report gender-stratified
comparison of outcomes. The primary outcome of interest was short-term
(within 30 days) mortality. A total of 15 studies totaling 31,907 patients
(47% men and 53% women) were included. Women were found to be
significantly older at the time of intervention (ASA: mean difference [MD]
7.55 years; SM: MD 4.41). In the ASA and SM treatment arms, women had a
significantly higher risk of short-term all-cause mortality (ASA: risk
ratio 0.48, 95% confidence interval 0.32 to 0.71, p = 0.0003; SM: risk
ratio 0.63, 95% confidence interval 0.44 to 0.90, p = 0.01), more frequent
permanent pacemaker implantation (ASA; p = 0.002, SM: p = 0.05), and
longer in-hospital stay (ASA: MD 1.00 days, SM: MD 0.69). Among those who
underwent ASA, women had a significantly higher rate of atrioventricular
block. In conclusion, regardless of ASA or SM, women consistently
presented at an older age and exhibited a higher risk-increased mortality
rate, a greater incidence of atrioventricular block, and a higher
likelihood of permanent pacemaker requirement-and longer hospital stay
among women than men. This strongly emphasizes the need for a
gender-specific approach to optimize care and improve treatment outcomes
in hypertrophic cardiomyopathy.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<9>
Accession Number
2024482927
Title
Prognostic role of CA-125 in patients undergoing transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Clinical Cardiology. 46(10) (pp 1129-1136), 2023. Date of Publication:
October 2023.
Author
Diaz-Arocutipa C.; Saucedo-Chinchay J.; Mamas M.A.
Institution
(Diaz-Arocutipa) Vicerrectorado de Investigacion, Universidad San Ignacio
de Loyola, Lima, Peru
(Saucedo-Chinchay) Department of Cardiology, Hospital Nacional Edgardo
Rebagliati Martins, Lima, Peru
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Keele, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) has become a widely used
therapy for patients with severe aortic stenosis. Carbohydrate antigen 125
(CA-125) is a promising biomarker in some cardiovascular diseases. This
systematic review aims to assess the prognostic role of CA-125 in patients
undergoing TAVR. We searched electronic databases from inception to March
2023 to include cohort studies evaluating the association between
preprocedural CA-125 levels and mortality or heart failure (HF)
readmission at 12 months in patients undergoing TAVR. We pooled crude
(cHR) and adjusted hazard ratios (aHR) with their 95% confidence interval
(CI) using a random-effects model. The risk of bias was evaluated using
the QUIPS tool. The certainty of the evidence was assessed using the GRADE
approach. We included five cohort studies involving 1594 patients. Higher
levels of CA-125 were significantly associated with an increased risk of
mortality or HF readmission using crude (cHR 2.79, 95% CI 1.45-5.36,
I² = 72%) and adjusted (aHR 3.27, 95% CI 2.07-5.18,
I² = 0%, high certainty) effect estimates compared with lower
levels. Similarly, there was also associated with increased mortality
using crude (cHR 2.68, 95% CI 1.99-3.60, I² = 0%) and adjusted
(aHR 2.17, 95% CI 1.54-3.07, I² = 0%, high certainty) effect
estimates. The risk of bias varied between low to moderate across studies.
Our meta-analysis suggests that CA-125 has incremental prognostic value in
patients undergoing TAVR. Further studies are needed to determine the
clinical utility of CA-125 in guiding treatment decisions in this
population.<br/>Copyright &#xa9; 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<10>
Accession Number
2024189834
Title
External stenting for saphenous vein grafts in coronary artery bypass
grafting: A meta-analysis.
Source
European Journal of Clinical Investigation. 53(11) (no pagination), 2023.
Article Number: e14046. Date of Publication: November 2023.
Author
Chen H.; Si K.; Wu X.; Ni H.; Tang Y.; Liu W.; Wang Z.
Institution
(Chen, Wang, Wang) Department of Neurosurgery & Brain and Nerve Research
Laboratory, The First Affiliated Hospital of Soochow University, Jiangsu
Province, China
(Chen) Department of Neurology, The First Affiliated Hospital of Soochow
University, Suzhou, China
(Si) Department of Cardiovascular Surgery, The First Affiliated Hospital
of Soochow University, Suzhou, China
(Wu, Ni, Tang) Suzhou Medical College of Soochow University, Suzhou, China
(Liu) Department of Medicine, The Tianjin North China Hospital, Tianjin,
China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Autologous saphenous vein grafts (SVGs) are the most commonly
used bypass conduits in coronary artery bypass grafting (CABG) with
multivessel coronary artery disease. Although external support devices for
SVGs have shown promising outcomes, the overall efficacy and safety
remains controversial. We aimed to evaluate external stenting for SVGs in
CABG versus non-stented SVGs. <br/>Method(s): MEDLINE, EMBASE, Cochrane
Library and clinicaltrails.gov were searched for randomized controlled
trials (RCTs) to evaluate external-stented SVGs versus non-stented SVGs in
CABG up to 31 August 2022. The risk ratio and mean difference with 95%
confidence interval were analysed. The primary efficacy outcomes included
intimal hyperplasia area and thickness. The secondary efficacy outcomes
were graft failure (>=50% stenosis) and lumen diameter uniformity.
<br/>Result(s): We pooled 438 patients from three RCTs. The external
stented SVGs group showed significant reductions in intimal hyperplasia
area (MD: -0.78, p < 0.001, I² = 0%) and thickness (MD: -0.06,
p < 0.001, I² = 0%) compared to the non-stented SVGs group.
Meanwhile, external support devices improved lumen uniformity with
Fitzgibbon I classification (risk ratio (RR):1.1595, p = 0.05,
I² = 0%). SVG failure rates were not increased in the external
stented SVGs group during the short follow-up period (RR: 1.14, p = 0.38,
I² = 0%). Furthermore, the incidences of mortality and major
cardiac and cerebrovascular events were consistent with previous reports.
<br/>Conclusion(s): External support devices for SVGs significantly
reduced the intimal hyperplasia area and thickness, and improved the lumen
uniformity, assessed with the Fitzgibbon I classification. Meanwhile, they
did not increase the overall SVG failure rate.<br/>Copyright &#xa9; 2023
Stichting European Society for Clinical Investigation Journal Foundation.
Published by John Wiley & Sons Ltd.

<11>
Accession Number
2027807232
Title
Systematic review and meta-analysis of time-to-event long-term outcomes
following the Ross procedure.
Source
Journal of Thoracic Disease. 15(9) (pp 4693-4702), 2023. Date of
Publication: September 2023.
Author
Shimamura J.; Fukuhara S.; Yokoyama Y.; Takagi H.; Ouzounian M.; Kuno T.
Institution
(Shimamura) Division of Cardiothoracic Surgery, Department of Surgery,
Emory University School of Medicine, Atlanta, GA, United States
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Ouzounian) Department of Surgery University of Toronto, Toronto General
Hospital, Toronto, ON, Canada
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, New York, NY, United States
Publisher
AME Publishing Company
Abstract
Background: The optimal aortic valve substitute for non-elderly adults
remains controversial. Recently, considerable data on the Ross procedure
have accumulated. This study aimed to analyze long-term outcomes following
the Ross procedure from the current literature using a meta-analysis of
time-to-event outcomes. <br/>Method(s): A literature search was performed
with MEDLINE, EMBASE, Cochrane Library, Web of Science, and Google Scholar
through June 2022; studies reporting clinical outcomes of the Ross
procedure beyond 20 years were included for analysis. The outcomes of
interest were late survival and freedom from surgical or percutaneous
reintervention of the autograft or right ventricular outflow tract (RVOT).
<br/>Result(s): Six studies, including 4,910 patients (3,601 males), were
identified and analyzed. Survival rate at 5, 10, 15, and 20 years was
99.9%+/-0.1%, 97.6%+/-0.5%, 94.3%+/-0.9%, and 87.4%+/-1.9%. Freedom from
autograft reintervention at 5, 10, 15, and 20 years was 97.7%+/-0.5%,
95.3%+/-0.7%, 91.4%+/-1.2%, 84.8%+/-2.5%. Freedom from RVOT reintervention
was 99.0%+/-0.3%, 99.0%+/-0.3%, 97.5%+/-0.7%, 93.3%+/-1.8%. Freedom from
any valve reintervention (either autograft or RVOT) at 5, 10, 15, and 20
years was 95.8%+/-0.6%, 92.6%+/-0.9%, 88.5%+/-1.2%, 80.8%+/-2.5%.
<br/>Conclusion(s): This meta-analysis demonstrated that the Ross
procedure was confirmed to provide excellent survival despite the need for
reintervention of autograft or RVOT in approximately 20% of patients at 20
years.<br/>Copyright &#xa9; 2023 AME Publishing Company. All rights
reserved.

<12>
Accession Number
2027822764
Title
3D Printing for Cardiovascular Surgery and Intervention: A Review Article.
Source
Current Problems in Cardiology. Part B. 49(1) (no pagination), 2024.
Article Number: 102086. Date of Publication: January 2024.
Author
shabbak A.; Masoumkhani F.; Fallah A.; Amani-Beni R.; Mohammadpour H.;
Shahbazi T.; Bakhshi A.
Institution
(shabbak, Fallah, Mohammadpour) Research Committee, School of Medicine,
Guilan University of Medical Science, Rasht, Iran, Islamic Republic of
(Masoumkhani) Department of cardiology, Mousavi Hospital, Zanjan
University of Medical Sciences, Zanjan, Iran, Islamic Republic of
(Amani-Beni) School of Medicine, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Shahbazi) Neurosurgery Research Group (NRG), Student Research Committee,
Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Bakhshi) Remember of Research Committee, School of Medicine, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
3D printing technology can be applied to practically every aspect of
modern life, fulfilling the needs of people from various backgrounds. The
utilization of 3D printing in the context of adult heart disease can be
succinctly categorized into 3 primary domains: preoperative strategizing
or simulation, medical instruction, and clinical consultations. 3D-printed
model utilization improves surgical planning and intraoperative
decision-making and minimizes surgical risks, and it has demonstrated its
efficacy as an innovative educational tool for aspiring surgeons with
limited practical exposure. Despite all the applications of 3D printing,
it has not yet been shown to improve long-term outcomes, including safety.
There are no data on the outcomes of controlled trials available. To
appropriately diagnose heart disease, 3D-printed models of the heart can
provide a better understanding of the intracardiac anatomy and provide all
the information needed for operative planning. Experientially, 3D printing
provides a wide range of perceptions for understanding lower extremity
arteries' spatial geometry and anatomical features of pathology.
Practicing cardiac surgery processes using objects printed using 3D
imaging data can become the norm rather than the exception, leading to
improved accuracy and quality of treatment. This study aimed to review the
various applications of 3D printing technology in cardiac surgery and
intervention.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<13>
Accession Number
2026198701
Title
Impact of Adenosine Injection on the Clinical Outcome and Myocardial
Protection in Patients Undergoing Coronary Artery Bypass Graft Surgery.
Source
Iranian Heart Journal. 24(4) (pp 26-33), 2023. Date of Publication:
October 2023.
Author
Jalili Shahandashti F.; Memarjafari M.; Azarfarin R.; Toloueitabar Y.;
Asadian S.; Jalali A.; Kachoeian N.; Gorjipour F.
Institution
(Jalili Shahandashti, Memarjafari, Azarfarin, Toloueitabar, Asadian,
Jalali, Gorjipour) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Kachoeian) Department of cardiac surgery, Imam Hossein Educational
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Cellular damage is inevitable during cardiac surgery due to
cardioplegic solutions and subsequent ischemia-reperfusion injury. There
are controversies regarding the cardioprotective impact of adenosine
addition to cardioplegic solutions in patients undergoing coronary artery
bypass graft surgery (CABG). We aimed to assess the impact of adding
adenosine to antegrade cardioplegia and before aortic declamping to the
aortic root on the clinical outcomes of patients undergoing CABG.
<br/>Method(s): The present single-blinded randomized clinical trial was
performed on 99 patients of both sexes undergoing isolated CABG. The
patients were randomly allocated to 2 trial groups and 1 control group:
Group A, adenosine injection with antegrade cardioplegia (n=30); Group B,
adenosine injection before aortic declamping by the surgeon at the aortic
root (n=26); and Group C, control (n=30). In the course of the study, 13
participants lost their eligibility according to exclusion criteria. The
patients' plasma creatine kinase (CK-MB), troponin T, lactate, and
clinical outcomes were measured as trial outcomes. <br/>Result(s): The
frequency of patients with antiarrhythmic drug usage was significantly
lower in trial groups A and B than in the control group (P = 0.001). The
cardiac rhythm resumption time was significantly longer in the control
group (344.37 +/- 260.45) than in Group A (193.43 +/- 297.73) and Group B
(170.12 +/- 103.58) (P = 0.02). Adenosine injection before aortic
declamping (Group B) had the lowest time of cardiac rhythm resumption
between the trial groups. <br/>Conclusion(s): Our findings showed that
adenosine injection enhanced the efficacy of cardioplegic arrest and
myocardial protection during CABG.<br/>Copyright &#xa9; 2023, Iranian
Heart Association. All rights reserved.

<14>
Accession Number
2026013738
Title
Effect of postoperative delirium after cardiovascular surgery on 5-year
mortality.
Source
JA Clinical Reports. 9(1) (no pagination), 2023. Article Number: 66. Date
of Publication: December 2023.
Author
Yokoyama C.; Yoshitnai K.; Ogata S.; Fukushima S.; Matsuda H.
Institution
(Yokoyama, Yoshitnai) Department of Anesthesiology, National Cerebral and
Cardiovascular Center, 6-1, Osaka, Kishibeshinmachi, Suita, Japan
(Ogata) Department of, Preventive Medicine and Epidemiology, National
Cerebral and Cardiovascular Center, Osaka, Suita, Japan
(Fukushima, Matsuda) Department of Cardiovascular Surgery, National
Cerebral and Cardiovascular Center, Osaka, Suita, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Postoperative delirium is a common complication after
cardiovascular surgery. A meta-analysis revealed that postoperative
delirium was associated with cognitive decline and dementia, which may
affect long-term mortality. However, few studies have reported the
association between postoperative delirium after cardiovascular surgery
and long-term postoperative mortality. Therefore, we investigated the
effect of postoperative delirium on 5-year survival rates of patients who
underwent cardiovascular surgery. <br/>Method(s): We retrospectively
reviewed the records of patients who underwent cardiovascular surgery with
cardiopulmonary bypass from January 2016 to December 2019. Postoperative
delirium was defined as an Intensive Care Delirium Screening score >= 3,
which might include subclinical delirium. Cox proportional hazards
modeling was performed to assess the association between postoperative
delirium and mortality. Postoperative mortality in patients with and
without delirium was assessed using the Kaplan-Meier method and compared
using the log-rank test. <br/>Result(s): Postoperative delirium was
observed in 562 (31.9%) of 1731 patients. There were more elderly
patients, more emergent surgery procedures, longer operative time, and
larger transfusion volume in the postoperative delirium group. Cox
regression analyses showed that delirium (hazard ratio (HR), 1.501; 95%
confidence interval (CI), 1.053-2.140; p = 0.025) and emergent surgery
(HR, 3.380; 95% CI, 2.231-5.122; p < 0.001) are significantly associated
with 5-year mortality. Among patients who underwent elective surgery,
postoperative delirium (HR, 1.987; 95% CI, 1.135-3.481; p = 0.016) is
significantly associated with 5-year mortality. Kaplan-Meier survival
analysis revealed that patients with postoperative delirium had
significantly higher 5-year mortality. <br/>Conclusion(s): Patients with
postoperative delirium after cardiovascular surgery have significantly
higher 5-year mortality.<br/>Copyright &#xa9; 2023, The Japanese Society
of Anesthesiologists.

<15>
Accession Number
2027806499
Title
Postoperative Delirium and Dementia in Patients Undergoing Cardiac
Surgery: A Review of Randomized Controlled Trials.
Source
Galen Medical Journal. 12 (no pagination), 2023. Article Number: e3045.
Date of Publication: 2023.
Author
Raberi V.S.; Qazi M.S.K.; Gol A.Z.; Nia R.G.; Kahourian O.; Zadeh R.F.
Institution
(Raberi, Kahourian, Zadeh) Seyed-Al-Shohada cardiology Hospital, Urmia
University of Medical Sciences, Urmia, Iran, Islamic Republic of
(Qazi) School of Nursing and Midwifery, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Gol) Department of Pediatric Cardiology, Shahid Motahari Hospital, Urmia
University of Medical Sciences, Urmia, Iran, Islamic Republic of
(Nia) Noncommunicable Diseases Research Center, Bam University of Medical
Sciences, Bam, Iran, Islamic Republic of
Publisher
Salviapub
Abstract
Delirium and dementia are considered to be the most significant
postoperative neurocognitive complications in patients undergoing cardiac
surgery, particularly those aged 60 years and older, which reduces the
post-surgery quality of life, prolongs hospitalization, increases costs,
and elevated the rates of mortality. Nevertheless, the etiology, risk
factors, and predictive biomarkers, have not been well elucidated
particularly, in patients with unmanifested underline cognitive
impairments. The present study aimed to review the findings on the
etiology, factors increasing the risk of incidence, and predictive
biomarkers of postoperative delirium and dementia after cardiac surgery,
and to describe the suggested pharmacological and non-pharmacological
interventions. <br/>Copyright &#xa9; 2021, Galen Medical Journal.

<16>
Accession Number
2027802660
Title
Does addition of plane blocks to multimodal analgesic strategy really
improve postoperative pain control after endoscopic aortic valve
replacement?.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2023. Article
Number: e104990. Date of Publication: 2023.
Author
Xue F.-S.; He N.; Cheng Y.
Institution
(Xue, He, Cheng) Department of Anesthesiology, Beijing Friendship
Hospital, Capital Medical University, Beijing, China
Publisher
BMJ Publishing Group
Abstract
In a double-blind, randomized controlled, superiority trial of 75 patients
who underwent totally endoscopic aortic valve replacement, Vandenbrande et
al1 showed that addition of combined deep and superficial single-injection
serratus anterior plane block to a standard multimodal analgesic strategy
decreased opioid consumption and pain intensity within the first 24 hours
postoperatively. However, we have several questions about the methods and
results of Vandenbrande et al' study and would appreciate the responses
from them.<br/>Copyright &#xa9; American Society of Regional Anesthesia &
Pain Medicine 2023. No commercial re-use. See rights and permissions.
Published by BMJ.

<17>
Accession Number
2026121530
Title
Preoperative Sildenafil in Pediatric Patients Undergoing Congenital Heart
Surgeries: A Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2023. Date of Publication: 2023.
Author
Fikri Y.A.; Mulia E.P.B.; Nugroho F.W.
Institution
(Fikri) Dr. R. Soetrasno Regional General Hospital, Rembang, Indonesia
(Mulia, Nugroho) Department of Cardiology and Vascular Medicine, Dr. R.
Soetrasno Regional General Hospital, Rembang, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background. Pulmonary hypertension (PH) is a common complication of
congenital heart disease (CHD). With early surgical intervention, outcomes
have improved over the last two decades. Persistent PH, however, may still
occur following surgery. Sildenafil has been shown to be beneficial for
postoperative pulmonary hypertensive crises. The role of preoperative
sildenafil in controlling postoperative PH is poorly elucidated. This
study aimed to evaluate the effect of preoperative sildenafil on pediatric
patients undergoing congenital heart surgeries. Methods. A comprehensive
literature search was conducted in scientific databases. We included
randomized controlled trials which assessed the effect of preoperative
sildenafil in pediatric patients with CHD undergoing repair surgeries.
Primary outcomes were pre- and postoperative differences in mean pulmonary
arterial pressure (mPAP) and mean pulmonary artery/aortic pressure ratio
(PA/Ao ratio). Results. Four studies (n = 233) were retained for the final
analysis. Dose of sildenafil ranged from.3 to.5 mg/kg every 4-6 hours via
oral/nasogastric route, with timing of administration varied from 1 to 2
weeks before surgery. Compared to controls, preoperative sildenafil was
associated with greater reduction in postoperative mPAP (MD -5.02; 95% CI
[-8.91, -1.13]) and mean PA/Ao ratio (MD -.11; 95% CI [-.17, -.06]).
Shorter CPB time, ICU length of stay, and duration of mechanical
ventilation were also observed in the sildenafil group. Conclusion.
Preoperative sildenafil is beneficial in reducing PAP, thereby reducing
the risk of postoperative PH crisis. Further studies are warranted to
identify the optimal dosage and timing of administration of sildenafil in
CHD patients prior to surgery.<br/>Copyright &#xa9; The Author(s) 2023.

<18>
Accession Number
2026111308
Title
A systematic review of full economic evaluations of robotic-assisted
surgery in thoracic and abdominopelvic procedures.
Source
Journal of Robotic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Sadri H.; Fung-Kee-Fung M.; Shayegan B.; Garneau P.Y.; Pezeshki P.
Institution
(Sadri) Department of Health Economic and Outcomes Research, Medtronic
ULC, 99 Hereford St., Brampton, ON L6Y 0R3, Canada
(Fung-Kee-Fung) Champlain Regional Cancer Program Depts OB/GYN, Surgery,
The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada
(Shayegan) Division of Urology, Department of Surgery, McMaster
University, 50 Charlton Ave., Hamilton, ON L8N 4A6, Canada
(Garneau) Surgical Department, Hopital du Sacre-Coeur de Montreal, 5400
Boul Gouin O, Montreal, QC H4J 1C5, Canada
(Pezeshki) Department of Clinical Research, Medtronic ULC, 99 Hereford
St., Brampton, ON L6Y 0R3, Canada
Publisher
Springer Nature
Abstract
This study aims to conduct a systematic review of full economic analyses
of robotic-assisted surgery (RAS) in adults' thoracic and abdominopelvic
indications. Authors used Medline, EMBASE, and PubMed to conduct a
systematic review following the preferred reporting items for systematic
reviews and meta-analyses (PRISMA) 2020 guidelines. Fully published
economic articles in English were included. Methodology and reporting
quality were assessed using standardized tools. Majority of studies
(28/33) were on oncology procedures. Radical prostatectomy was the most
reported procedure (16/33). Twenty-eight studies used quality-adjusted
life years, and five used complication rates as outcomes. Nine used
primary and 24 studies used secondary data. All studies used modeling. In
81% of studies (27/33), RAS was cost-effective or potentially
cost-effective compared to comparator procedures, including radical
prostatectomy, nephrectomy, and cystectomy. Societal perspective,
longer-term time-horizon, and larger volumes favored RAS. Cost-drivers
were length of stay and equipment cost. From societal and payer
perspectives, robotic-assisted surgery is a cost-effective strategy for
thoracic and abdominopelvic procedures. Clinical trial registration This
study is a systematic review with no intervention, not a clinical
trial.<br/>Copyright &#xa9; 2023, The Author(s).

<19>
Accession Number
642511066
Title
Transcatheter Vacuum-Assisted Mass Extraction versus Surgical Debridement
for Vegetations in Tricuspid Valve Infective Endocarditis: A Meta-Analysis
of Observational Studies.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 13 Oct 2023.
Author
Kim A.G.; Salazar A.M.; Panama G.; Saeed M.; Sabanci R.; Al-Asad K.S.;
Yavari M.; Prasad R.M.; Rayamajhi S.; Abela G.S.
Institution
(Kim, Salazar, Panama, Saeed, Sabanci, Al-Asad, Yavari, Rayamajhi)
Division of Internal Medicine, Michigan State University
(Prasad, Abela) Division of Cardiology, Michigan State University
Abstract
Tricuspid valve infective endocarditis (TVIE), often associated with
vegetation in people who inject drugs, has introduced a less invasive
option for vegetation removal: transcatheter vacuum-assisted mass
extraction (TVME). This technique is emerging as an alternative to
standard surgical debridement (SD) and valve repair. However, the
comparative effectiveness of TVME versus SD in treating TVIE has yet to be
investigated. A comprehensive systematic literature search was performed
on PUBMED, EMBASE, and COCHRANE to identify all relevant studies comparing
TVME with SD in patients with TVIE. The search covered studies from
inception up to August 15, 2023. For data analysis, Review Manager
(RevMan) 5.4 software was employed, using a random-effects model to
calculate risk ratios (RR), mean differences, and 95% confidence intervals
(CI). Five studies included a total of 431 patients (244 in the TVME arm
and 187 in the SD arm). In-hospital mortality (p=0.72), procedural
mortality (p=0.77), 30-day mortality (p=0.25), and 1-year mortality
(p=0.44) insignificantly favored SD over TVME. Overall mortality across
the five studies insignificantly favored TVME over SD (RR=0.66, 95% CI
0.31-1.39, p=0.27, I2=57%). When addressing heterogeneity by excluding one
study, no statistical significance in the difference between the two arms
regarding overall mortality was observed (RR 0.99, 95% CI 0.60-1.63,
p=0.97, I2=0%). This meta-analysis of the five observational studies found
no significant difference in overall mortality between TVME and SD for the
treatment of TVIE. However, prospective randomized controlled trials are
necessary to further understand and compare the outcomes of these two
approaches.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<20>
Accession Number
2027822932
Title
The CINCH-FMR postmarket registry: Real-world long-term outcomes with
percutaneous mitral valve repair with the Carillon Mitral Contour System.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Yildiz M.; Haude M.; Sievert H.; Fichtlscherer S.; Lehmann R.; Klein N.;
Witte K.; Degen H.; Pfeiffer D.; Goldberg S.L.
Institution
(Yildiz) Hospital zum Heiligen Geist, Fritzlar, Germany
(Haude, Degen) Lukaskrankenhaus GmbH, Neuss, Germany
(Sievert) CVC Rhein- Main, Frankfurt, Germany
(Fichtlscherer, Lehmann) Universitatsklinik Frankfurt, Frankfurt, Germany
(Lehmann) UMM Universitatsklinik Mannheim, Mannheim, Germany
(Klein, Pfeiffer) Universitatsklinik Leipzig AoR, Leipzig, Germany
(Klein) Leipzig Klinikum St. Georg, Leipzig, Germany
(Witte) Universitatsklinik Aachen AoR, Aachen, Germany
(Goldberg) Private practice, Monterey, CA, United States
(Goldberg) Cardiac Dimensions, Kirkland, WA, United States
Publisher
Elsevier Inc.
Abstract
Background: The Carillon Mitral Contour System has been studied in 4
prospective controlled studies in the treatment of functional mitral
regurgitation (FMR) where it has been found to reduce mitral
regurgitation, reduce left ventricular and atrial volumes, and be
associated with improvements in clinical parameters. <br/>Aim(s): The
CINCH post-market registry is designed to evaluate immediate, mid-term and
long-term outcomes from a post-approval study of the Carillon device
evaluated in real-world practice. <br/>Method(s): The CINCH post-market
registry is a single-arm study of percutaneous mitral annuloplasty with
the Carillon device in patients with functional (secondary) mitral
regurgitation and symptomatic congestive heart failure when utilized in
real-world conditions. Patient selection, echocardiographic hemodynamic
measurements, and patient follow-up requirements were performed per
standard of care at each institution. <br/>Result(s): A total of 101
patients treated with the Carillon device at 13 sites in Germany were
enrolled in the CINCH registry. The mean age was 75 +/- 9 years, 57 % were
male, and patient presentation included primarily NYHA class III (69 %)
with MR grade 3 (68 %). Over 5 years of follow-up, all-cause mortality was
40.1 %, the incidence of HFH was 53.9 %, and the composite outcome of HFH
or death was 66.4 %. At each follow-up interval through 5 years,
statistically significant reductions in NYHA class (p < 0.05) and MR grade
(p < 0.01) were reported. <br/>Conclusion(s): In this "real world"
registry of the Carillon Mitral Contour System, procedural safety and
medium-term follow-up outcomes is similar to the outcomes seen in the
prospective, controlled clinical trials, despite being used in populations
of patients that extend outside of those studied in the trials. The use of
this therapy in patients with atrial functional mitral regurgitation, and
heart failure with preserved ejection fraction, was notable, since these
types of patients were excluded from the prospective, controlled trials.
This supports possible additional patient populations who might benefit
from this type of mechanical therapy. The safety profile of this therapy
in this registry and in the earlier trials may support a potential role in
earlier forms of secondary mitral regurgitation.<br/>Copyright &#xa9; 2023

<21>
Accession Number
2027822685
Title
Efficiency of optimal fluoroscopic projection angle defined by computed
tomography angiography for left atrial appendage closure.
Source
Hellenic Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Lu X.; Wang X.; Wang Q.; Song T.; Liu G.; Liu A.; Shi X.; Guo J.; Chen T.
Institution
(Lu, Wang, Wang, Song, Liu, Liu, Shi, Guo, Chen) Senior Department of
Cardiology, The Sixth Medical Center of PLA General Hospital, 6 Fucheng
Road, Haidian District, Beijing 100048, China
(Lu) Outpatient Department, The 44th Sanatorium of Retired Cadres in
Haidian District, No. 19 Dahuisi Road, Haidian District, Beijing 100081,
China
Publisher
Hellenic Cardiological Society
Abstract
Background: Left atrial appendage (LAA) closure (LAAC) procedures are
conventionally performed using empirical fluoroscopic viewing angles.
However, because the LAA is a highly variable anatomical structure, these
angles cannot depict the LAA in the optimal position. The present study
aimed to assess the efficiency of using a novel optimal fluoroscopic
projection angle (OPA) for LAAC and to validate its feasibility.
<br/>Method(s): The OPAs of the derivation cohort were acquired using
cardiac computed tomography angiography (CCTA) to assess its superiority
for depicting LAA depth versus traditional working angles (TAs) of RAO
30degree, CAU 20degree. The practicability of OPA-guided LAAC was
demonstrated by comparison between clinical data from the validation
cohort and those from a propensity-score matched (PSM) control group, as
well as randomized controlled studies investigating LAAC. <br/>Result(s):
Of 705 patients in the derivation cohort, the median OPA was RAO 46degree,
CAU 31degree. Compared with TA, the OPA depicted a longer mean (+/-SD) LAA
depth (5.1 +/- 4.4) mm and a larger orifice diameter (1.1 +/- 1.1 mm), (P
< 0.0001 for both). All 38 OPA-guided LAACs were successful, with a
shorter mean procedure duration (42.9 +/- 12.3 min versus [vs.] 107.2 +/-
41.5 min; P < 0.0001) and reduced device consumption (1.08 vs. 1.5 per
case), compared with the PSM control group. At the 3-month follow-up, the
incidence of peri-device leak was 52.6% (20/38) detected by CCTA, with a
mean leakage of 1.6 +/- 0.8 mm. <br/>Conclusion(s): By unfolding the LAA
depth and orifice diameter for a better view, OPA demonstrated the
potential to optimize LAAC procedural efficiency, although further
larger-scale studies are required to confirm this.<br/>Copyright &#xa9;
2023 Hellenic Society of Cardiology

<22>
Accession Number
2027819374
Title
Comparison of mid-term mortality after surgical, supported or unsupported
percutaneous revascularization in patients with severely reduced ejection
fraction: A direct and network meta-analysis of adjusted observational
studies and randomized-controlled.
Source
International Journal of Cardiology. (no pagination), 2023. Article
Number: 131428. Date of Publication: 2023.
Author
Iannaccone M.; Barbero U.; Franchin L.; Montabone A.; De Filippo O.;
D'ascenzo F.; Boccuzzi G.; Panoulas V.; Hill J.; Brilakis E.S.; Chieffo A.
Institution
(Iannaccone, Montabone, Boccuzzi) Division of Cardiology, San Giovanni
Bosco Hospital, ASL Citta di Torino, Turin, Italy
(Barbero) Division of Cardiology, SS. Annunziata Savigliano, ASL CN 1,
Savigliano, Italy
(Franchin) Cardiothoracic Department, Division of Cardiology, Azienda
Sanitaria Universitaria Friuli Centrale, Udine, Italy
(De Filippo, D'ascenzo) Cardiovascular and Thoracic Department, Division
of Cardiology, A. O. U. Citta della Salute e della Scienza, Turin, Italy
(Panoulas, Hill) Department of Cardiology, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital,
Harefield, London UB9 6BJ, United Kingdom
(Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute
Foundation, Minneapolis, MN, United States
(Chieffo) Vita-Salute San Raffaele University, Milan, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: The optimal revascularization strategy in patients with
heart failure with reduced ejection fraction (HFrEF) remains to be
elucidated. The aim of this paper is to compare the mid-term mortality
rate among patients with severely reduced ejection fraction (EF) and
complex coronary artery disease who underwent coronary artery bypass
grafting (CABG), percutaneous coronary intervention (PCI) with Impella
support, or without. <br/>Method(s): Randomized control trials and
propensity-adjusted observational studies including patients with ischemic
cardiomyopathy (ICM) and severe EF reduction undergoing revascularization
were selected. Different revascularization strategies (CABG, supported
PCI, and PCI without Impella) were compared in pairwise and network
meta-analysis. The primary endpoint was mid-term mortality (within the
first year after revascularization). <br/>Result(s): Fifteen studies,
mostly observational (17,841 patients; 6779 patients treated with CABG,
8478 treated with PCI without Impella, and 2584 treated with
Impella-supported PCI) were included in this analysis. The median age was
67.8 years (IQR 65-70.1), 21.2% (IQR 16.4-26%) of patients were female
sex, and a high prevalence of cardiovascular risk factors was noted across
the entire population. At pairwise analysis, CABG and PCI without Impella
showed similar one-year all-cause mortality (10.6% [IQR 7.5-12.6%] vs 12%
[IQR 8.4-11.5%]) RR 0.85 CI 0.67-1.09, while supported PCI reduced
one-year all-cause mortality compared to PCI without Impella (9.4% [IQR
5.7-12.5%] vs 10.6% [IQR 8.9-10.7%]) RR 0.77 CI 0.6-0.89. At network
meta-analysis, supported PCI showed better results (RR 0.75, 95% CI
0.59-0.94) compared to CABG. <br/>Conclusion(s): Our analysis found that
supported PCI may have a benefit over standard PCI in patients in direct
comparison, and over CABG from indirect comparison, and with HFrEF
undergoing revascularization. Further RCTs are needed to confirm this
result. (PROSPERO CRD42023425667).<br/>Copyright &#xa9; 2023 Elsevier B.V.

<23>
Accession Number
2027813148
Title
Intravenous iron administration before cardiac surgery reduces red blood
cell transfusion in patients without anaemia.
Source
British Journal of Anaesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Friedman T.; Dann E.J.; Bitton-Worms K.; Makhoul M.; Glam R.; Weis A.; Tam
D.Y.; Bolotin G.
Institution
(Friedman, Bitton-Worms, Makhoul, Glam, Weis, Bolotin) Department of
Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel
(Dann) Blood Bank and Apheresis Unit, Rambam Health Care Campus, Haifa,
Israel
(Dann) Department of Hematology and Bone Marrow Transplantation, Rambam
Health Care Campus, Haifa, Israel
(Friedman, Dann, Bolotin) Ruth and Bruce Rappaport Faculty of Medicine,
Technion, Haifa, Israel
(Tam) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Ltd
Abstract
Background: Reducing the need for blood transfusion among patients
undergoing cardiac surgery FLA reduce postoperative complications and
mortality. Our study aimed to assess the effects of administering
preoperative i.v. ferric carboxymaltose on postoperative red cell
transfusion requirements in patients without anaemia undergoing on-pump
cardiac surgery. <br/>Method(s): This double-blind, randomised,
placebo-controlled trial was conducted between October 2016 and November
2019, with a follow-up period of up to 6 weeks after surgery. Patients
without anaemia who underwent on-pump cardiac surgery were included as
participants and administered i.v. iron in the form of ferric
carboxymaltose or placebo once, 24-72 h before surgery. The primary
outcome was the number of red cell units transfused during the first four
postoperative days, and the secondary outcome measures were blood
haemoglobin concentrations at 4 days and 6 weeks after surgery.
<br/>Result(s): The 200 patients included were randomly assigned to the
ferric carboxymaltose (n=102) and placebo (n=98) groups. By postoperative
Day 4, a significantly lower mean number of red cell units were transfused
in the ferric carboxymaltose than in the placebo group, 0.3 (0.8) vs 1.6
(4.4), respectively; P=0.007. The mean haemoglobin concentrations on
postoperative Day 4 were 9.7 (1) g dl^-1 and 9.3 (1) g
dl^-1, respectively (P=0.03). Corresponding values at 6 weeks
after surgery were 12.6 (1.4) g dl^-1 and 11.8 (1.5) g
dl^-1, respectively (P=0.012). <br/>Conclusion(s): In patients
without anaemia undergoing on-pump cardiac surgery, treatment with a
single dose of 1000 mg ferric carboxymaltose i.v. 1-3 days before surgery
significantly reduced the need for red cell transfusions and increased the
postoperative haemoglobin concentration. Clinical trial registration:
NCT02939794.<br/>Copyright &#xa9; 2023 British Journal of Anaesthesia

<24>
Accession Number
2027811419
Title
Induction chemoimmunotherapy with surgery versus concurrent chemoradiation
followed by immunotherapy for stage III-N2 non-small cell lung cancer.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Kumar A.; Srinivasan D.; Potter A.L.; Mathey-Andrews C.; Lanuti M.; Martin
L.W.; Jeffrey Yang C.-F.
Institution
(Kumar) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Srinivasan, Potter, Mathey-Andrews, Lanuti, Jeffrey Yang) Division of
Thoracic Surgery, Department of Surgery, Massachusetts General Hospital,
Boston, Mass, United States
(Martin) Division of Thoracic and Cardiovascular Surgery, Department of
Surgery, University of Virginia, Charlottesville, VA, United States
Publisher
Elsevier Inc.
Abstract
Objective: Despite the growing relevance of immunotherapy for non-small
cell lung cancer (NSCLC), there is limited consensus on the optimal
treatment strategy for locally advanced NSCLC. This study evaluated the
overall survival of patients with stage III-N2 NSCLC undergoing induction
chemoimmunotherapy with surgery (CT/IO+Surgery) and definitive concurrent
chemoradiation followed by immunotherapy (cCRT+IO). <br/>Method(s):
Patients with cT1-3, N2, M0 NSCLC in the National Cancer Database (2013 to
2019) were included and stratified by treatment regimen: CT/IO+Surgery or
cCRT+IO. Overall survival was evaluated using Kaplan-Meier analysis, Cox
proportional hazards modeling, and propensity score matching on 10
prognostic variables. <br/>Result(s): Of the 3382 patients who met the
study eligibility criteria, 3289 (97.3%) received cCRT+IO and 93 (2.8%)
received CT/IO+Surgery. The 3-year overall survival of the entire cohort
was 58.2% (95% CI, 56.2% to 60.1%). Multivariable-adjusted Cox
proportional hazards modeling demonstrated better survival after
CT/IO+Surgery than after cCRT+IO (hazard ratio [HR], 0.52; 95% confidence
interval [CI], 0.32 to 0.84; P = .007). In a 3:1 variable ratio propensity
score-matched analysis of 223 patients who received cCRT+IO and 76
patients who received CT/IO+Surgery, 3-year overall survival was 63.2%
(95% CI, 55.9% to 70.2%) after cCRT+IO and 77.2% (95% CI, 64.6% to 85.7%)
after CT/IO+Surgery (P = .029). <br/>Conclusion(s): In this national
analysis, multimodal treatment including immunotherapy was associated with
a 3-year overall survival rate of 58.2% for all patients with stage III-N2
NSCLC and 77.2% for patients who underwent chemoimmunotherapy followed by
surgery. These results should be considered hypothesis-generating and
demonstrate the importance of developing a randomized trial to evaluate
the role of surgery versus chemoradiation for locally advanced NSCLC in
the modern immunotherapy era.<br/>Copyright &#xa9; 2023 The American
Association for Thoracic Surgery

<25>
Accession Number
2027810337
Title
Outcomes of untreated subclinical antibody-mediated rejection after heart
transplantation.
Source
Progress in Cardiovascular Diseases. (no pagination), 2023. Date of
Publication: 2023.
Author
Boulet J.; Kelleher J.; Wanderley M.R.B.; Nohria A.; Andersson C.; Kim M.;
Mehra M.R.
Institution
(Boulet) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Kelleher, Wanderley, Nohria, Andersson, Kim, Mehra) Center for Advanced
Heart Disease, Brigham and Women's Hospital and Harvard Medical School,
Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Subclinical antibody-mediated rejection (AMR) is represented by
histopathological and/or immunopathological manifestations in the absence
of significant cardiac allograft dysfunction. Treatment remains uncertain
as there is a lack of data on asymptomatic heart transplant (HT)
recipients (HTR) with a positive cardiac biopsy. We sought to determine
the impact of untreated subclinical biopsy-proven AMR, regardless of
circulating donor-specific antigen (DSA) expression, when diagnosed on
surveillance biopsies in the first year after HT. This retrospective case
control study evaluated 260 HTR between May 2004 and February 2021. These
comprised 231 controls and 29 patients with untreated subclinical AMR. The
mortality event rate was higher in controls (2.63 events per 100
person-years) compared to the scAMR Group (1.71 events per 100
person-years), a difference that did not reach statistical significance
(hazard ratio 0.66, CI: 0.18-2.36). The combined event rate of cardiac
allograft vasculopathy (CAV), graft dysfunction, or mortality was higher
in the subclinical AMR group (5.60 events per 100 person-years) than in
controls (3.89 events per 100 person-years) but did not reach statistical
significance (hazard ratio 1.63, CI: 0.07-40.09). Our results suggest that
subclinical AMR diagnosed in the first year after HT on surveillance
biopsy is not associated with decreased survival. This may sway the
management of subclinical AMR towards a more conservative approach in
transplant-capable institutions that currently prioritize treatment,
though prospective, randomized studies of such a management strategy are
required.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<26>
Accession Number
2027806767
Title
Temporary mechanical circulatory support with Impella in cardiac surgery:
A systematic review.
Source
International Journal of Cardiology. (no pagination), 2023. Article
Number: 131418. Date of Publication: 2023.
Author
Pieri M.; D'Andria Ursoleo J.; Nardelli P.; Ortalda A.; Ajello S.; Delrio
S.; Fominskiy E.; Scandroglio A.M.
Institution
(Pieri, D'Andria Ursoleo, Nardelli, Ortalda, Delrio, Fominskiy,
Scandroglio) Department of Anesthesia and Intensive Care, IRCCS San
Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
(Pieri) Vita-Salute San Raffaele University, Via Olgettina 58, Milan
20132, Italy
(Ajello) Department of Cardiology, IRCCS San Raffaele Scientific
Institute, Via Olgettina 60, Milan 20132, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Perioperative cardiogenic shock (CS) in cardiac surgery is
still burdened by a high mortality risk. The introduction of Impella pumps
in the therapeutic armory of temporary mechanical circulatory support
(tMCS) has potential implications to improve the management of complex
cases, although it has never been systematically addressed. We performed a
systematic review of the reported use of tMCS with Impella in cardiac
surgery. <br/>Method(s): We searched PubMed for all original studies on
the Impella use in adult patients in cardiac surgery. <br/>Result(s):
Nineteen studies (out of 151 identified by search string) were included.
All studies were observational and all but one (95%) were retrospective.
Seven studies focused on the implantation of Impella in the pre-operative
setting (coronary or valvular surgery), either as a prophylactic device in
high-risk cases (3 studies) or in patients with CS as stabilization tool
prior to cardiac surgery procedure (4 studies). Three studies reported the
use of Impella as periprocedural support for percutaneous valvular
procedure, three as bridge to heart replacement, and six for
postcardiotomy CS. Impella support had a low complication rate and was
successful in supporting hemodynamics pre-, intra- and postoperatively.
Most consistently reported data were left-ventricular ejection fraction at
implant, short-term survival and weaning rate. <br/>Conclusion(s): tMCS
with Impella in cardiac surgery patients is feasible and successful. It
can be applied in selected cardiac surgery patients and presents
advantages over other types of support. Systematic prospective studies are
needed to standardize indications for implant and management of surgical
issues, and to identify which patients may benefit.<br/>Copyright &#xa9;
2023 Elsevier B.V.

<27>
Accession Number
2027744694
Title
Frequency of Stroke in Intermediate-Risk Patients in the Long-Term
Undergoing TAVR vs SAVR: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. Part B. 49(1) (no pagination), 2024.
Article Number: 102099. Date of Publication: January 2024.
Author
Llerena-Velastegui J.; Navarrete-Cadena C.; Delgado-Quijano F.;
Trujillo-Delgado M.; Aguayo-Zambrano J.; Villacis-Lopez C.; Marcalla-Rocha
M.; Benitez-Acosta K.; Vega-Zapata J.
Institution
(Llerena-Velastegui, Navarrete-Cadena) Pontifical Catholic University of
Ecuador, Medical School, Quito, Ecuador
(Delgado-Quijano) Vantage Healthcare, Rehabilitation Center, MA, United
States
(Trujillo-Delgado, Aguayo-Zambrano) Catholic University of Santiago de
Guayaquil, Medical School, Guayaquil, Ecuador
(Villacis-Lopez) Central University of Ecuador, Medical School, Quito,
Ecuador
(Marcalla-Rocha) National University of Chimborazo, Medical School,
Riobamba, Ecuador
(Benitez-Acosta) La Sabana University, Medical School, Bogota, Colombia
(Vega-Zapata) Regional Autonomous University of Los Andes, Medical School,
Ambato, Ecuador
Publisher
Elsevier Inc.
Abstract
The aim of this research is to compare the long-term incidence of stroke
in intermediate-risk patients who have undergone either transcatheter
aortic valve replacement (TAVR) or surgical aortic valve replacement
(SAVR) procedures. The objective is to identify which method exhibits a
higher propensity for stroke occurrence, potentially contributing to
disability or stroke-related mortality. We conducted a systematic review
and meta-analysis to evaluate the frequency of stroke post-TAVR and SAVR
procedures. Data were compiled from a diverse array of research articles,
retrieved from the Embase, Cochrane Library, and PubMed databases.
Conclusions were derived from the comprehensive analysis of forest plots.
The analysis indicates no significant reduction in stroke incidence among
patients undergoing TAVR compared to those receiving SAVR. This
conclusion, underscored by a P-value of 0.76 and a 95% confidence interval
(CI) ranging from 0.80 to 1.17, arises from a careful review of multiple
pertinent studies. The meta-analysis of pooled data does not reveal a
significant decrease in stroke frequency associated with TAVR. For
intermediate-risk patients, both TAVR and SAVR present similar stroke
risks, indicating no procedure is inherently safer. Healthcare providers
must take this into account when counseling patients, considering each
procedure's benefits and drawbacks. This study focuses specifically on
intermediate-risk individuals, so results may not apply universally.
Further research across different risk categories is needed. This study
emphasizes the need for individualized patient care and informed
decision-making in aortic stenosis management.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<28>
Accession Number
2026010252
Title
P-TS-24 , Design of ReCePI, a Randomized, Double-Blinded, Phase III Study
to Evaluate the Efficacy and Safety of Pathogen Reduced RBCs in Complex
Cardiac Surgery.
Source
Transfusion. 63(S5) (pp 271A), 2023. Date of Publication: October 2023.
Author
Benjamin R.; Pitman J.; Corash L.; Varrone J.; Mufti N.
Institution
(Benjamin, Pitman, Corash, Varrone, Mufti) Cerus Corporation, Concord, CA,
United States
Publisher
John Wiley and Sons Inc

<29>
Accession Number
2025995653
Title
OCOSO2: study protocol for a single-blinded, multicentre, randomised
controlled trial assessing a central venous oxygen saturation-based
goal-directed therapy to reduce postoperative complications in high-risk
patients after elective major surgery.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 659. Date of
Publication: December 2023.
Author
Pastene B.; Bernat M.; Baumstark K.; Bezulier K.; Gricourt Y.; De Guibert
J.-M.; Charvet A.; Colin M.; Leone M.; Zieleskiewicz L.
Institution
(Pastene, Bernat, Bezulier, Charvet, Colin, Leone, Zieleskiewicz)
Department of Anaesthesiology and Intensive Care Unit, Hopital Nord,
Hopitaux Universitaires de Marseille, Marseille, France
(Pastene, Leone, Zieleskiewicz) Centre for Cardiovascular and Nutrition
Research (C2VN), INRA, Aix Marseille University, INSERM, Marseille, France
(Baumstark) Department of Epidemiology and Health Economy, Hopitaux
Universitaires de Marseille, Marseille, France
(Gricourt) Department of Anaesthesiology and Pain Management, Centre
Hospitalo-Universitaire Caremeau, Nimes and Montpellier University 1,
Nimes, France
(De Guibert) Department of Anaesthesiology and Intensive Care Unit,
Institut Paoli Calmettes, Marseille, France
Publisher
BioMed Central Ltd
Abstract
Background: Fluid loading-based goal-directed therapy is a cornerstone of
anaesthesia management in major surgery. Its widespread application has
contributed to a significant improvement in perioperative morbidity and
mortality. In theory, only hypovolemic patients should receive fluid
therapy. However, to achieve such a diagnosis, a surrogate marker of
cardiac output adequacy must be used. Current methods of fluid
loading-based goal-directed therapy do not assess cardiac output adequacy.
Nowadays, new devices make it possible to continuously monitor central
venous oxygen saturation (ScvO<inf>2</inf>) and therefore, to assess the
adequacy of perioperative cardiac output during surgery. In major surgery,
ScvO<inf>2</inf>-based goal-directed therapy can be used to enhance fluid
therapy and improve patient outcomes. <br/>Method(s): We designed a
prospective, randomised, single-blinded, multicentre controlled
superiority study with a 1:1 allocation ratio. Patients to be included
will be high-risk major surgery patients (> 50 years old, ASA score > 2,
major intra-abdominal or intra-thoracic surgery > 90 min). Patients in the
control group will undergo standard fluid loading-based goal-directed
therapy, as recommended by the guidelines. Patients in the intervention
group will have ScvO<inf>2</inf>-based goal-directed therapy and receive
fluid loading only if fluid responsiveness and cardiac output inadequacy
are present. The primary outcome will be the Comprehensive Complication
Index on day five postoperatively. <br/>Discussion(s): This study is the
first to address the issue of cardiac output adequacy in goal-directed
therapy. Our hypothesis is that cardiac output optimisation during major
surgery achieved by continuous monitoring of the ScvO<inf>2</inf> to guide
fluid therapy will result in a reduction of postoperative complications as
compared with current goal-directed fluid therapy practices. Trial
registration: ClinicalTrials.gov. NCT03828565. Registered on February 4,
2019.<br/>Copyright &#xa9; 2023, BioMed Central Ltd., part of Springer
Nature.

<30>
Accession Number
2025955683
Title
Efficacy and safety of left atrial appendage closure compared with oral
anticoagulation in atrial fibrillation: a meta-analysis of randomized
controlled trials and propensity-matched studies.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1212161. Date of Publication: 2023.
Author
Franchin L.; Piroli F.; Demola P.; Mantovani F.; Iannaccone M.; Manfredi
R.; D'Ascenzo F.; Fortuni F.; Ugo F.; Meucci F.; Navazio A.; Boccuzzi G.
Institution
(Franchin, Iannaccone, Boccuzzi) Department of Cardiology, San Giovanni
Bosco Hospital, Turin, Italy
(Franchin) Department of Cardiology, Azienda Sanitaria Universitaria
Friuli Centrale, Udine, Italy
(Piroli, Demola, Mantovani, Navazio) Cardiology Unit, Azienda USL-IRCCS di
Reggio Emilia, Reggio Emilia, Italy
(Manfredi) Cardiology and Arrhythmology Clinic, University Hospital
"Ospedali Riuniti", Ancona, Italy
(D'Ascenzo) Division of Cardiology, Department of Medicine, A.O.U Citta
Della Salute e Della Scienza, Turin, Italy
(Fortuni) Department of Cardiology, San Giovanni Battista Hospital,
Foligno, Italy
(Fortuni) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Meucci) Structural Interventional Cardiology, Department of Clinical and
Experimental Medicine, Careggi University Hospital, Florence, Italy
(Ugo) Division of Cardiology, Sant'Andrea Hospital, Vercelli, Italy
Publisher
Frontiers Media SA
Abstract
Backgrounds: Two recent randomized controlled trials (RCTs), the
PROTECT-AF and the PREVAIL, showed that in atrial fibrillation (AF)
patients, left atrial appendage closure (LAAC) is comparable to oral
anticoagulants (OAC) in the prevention of stroke and could also possibly
reduce mortality. Nevertheless, this net clinical benefit was not
confirmed in the most recent RCT comparing LAAC vs. OAC, the PRAGUE-17
trial. <br/>Aim(s): aim of the present study was to evaluate the efficacy
and safety of LAAC compared with OAC among available high-quality studies.
<br/>Method(s): A systematic search of electronic databases (Medline,
Scopus, Embase and the Cochrane Library) was performed to identify
eligible RCTs and observational studies with propensity score matching
(PSM) analysis. PRISMA guidelines were used for abstracting data and
assessing data quality and validity. Outcomes of interest were the
occurrence of cardiovascular death (CVD), all-cause death, all-type
stroke, and major bleedings. <br/>Result(s): A total of 3 RCTs and 7 PMS
studies involving 25,700 patients were identified. 12,961 patients
received LAAC while 12,739 received OAC therapy. After a median follow-up
of 2.6 years (IQR 2-4.4), patients who received LAAC had lower risk of CVD
(RR = 0.62; 95%CI, 0.51-0.74, I²= 0%), all-cause death (RR =
0.67; 95% CI, 0.57-0.78, I² 68%) and major bleedings (RR =
0.68; 95%CI, 0.48-0.95 I²= 87%) compared with patients on OAC.
No difference was found between the two groups regarding strokes incidence
(RR = 0.94; 95% CI, 0.77-1.15, I²= 0%). <br/>Conclusion(s):
According to this meta-analysis, LAAC has comparable efficacy in the
prevention of stroke compared with OAC and a reduced risk of major
bleedings, all-cause death and CVD that may be even larger with longer
follow-up. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269768,
identifier CRD42021269768.<br/>Copyright 2023 Franchin, Piroli, Demola,
Mantovani, Iannaccone, Manfredi, D'Ascenzo, Fortuni, Ugo, Meucci, Navazio
and Boccuzzi.

<31>
Accession Number
2027754694
Title
DEL NIDO CARDIOPLEGIA: A 'MAGIC BULLET' FOR CARDIAC SURGEON- A
MULTIVARIATE PROSPECTIVE COMPARATIVE STUDY.
Source
Journal of Cardiovascular Disease Research. 14(2) (pp 567-578), 2023. Date
of Publication: 2023.
Author
Sahoo S.P.; Sahoo A.K.; Thatei C.R.; Pattnaik M.K.
Institution
(Sahoo) Dept. of CTVS, S.C.B.Medical College, Mangalabagh, Odisha, Cuttack
753007, India
(Sahoo, Thatei) Dept. of Anaesthesiology S.C.B.Medical College,
Mangalabagh, Odisha, Cuttack 753007, India
(Pattnaik) Dept of CTVS, S.C.B.Medical College, Mangalabagh, Odisha,
Cuttack 753007, India
Publisher
EManuscript Technologies
Abstract
Introduction-Cardioplegia remains an essential component of myocardial
protection during cardiac surgeries. Main purpose-This is a single centre
prospective study that compares the better cardioprotective effect between
del Nido(DN) and modified St. Thomas(mST) cardioplegia solution during
intraoperative and immediate post-operative period. MethodThis is a
prospective randomised double blind study conducted over a period of one
year from among the patients admitted for different cardiac surgeries. The
selected patients were divided into two groups. Surgical procedures
included in this study: coronary artery bypass graft(CABG)(multiple
graft), mitral valve repair / replacement+ tricuspid ring annuloplasty
(MVR+TVR), mitral + aortic valve replacement (DVR), ventricular septal
defect(VSD) repair, intra-cardiac repair for Tetralogy of Fallot (TOF).
Surgical procedures excluded in this study were: isolated mitral valve
replacement, aortic valve replacement (AVR), atrial septal defect (ASD),
CABG (single graft). Primary end point was to compare the cardioprotective
factors in DN and mST group. ResultIn comparison to modified St Thomas
group, del Nido group had lesser cardiopulmonarybypass time(76.50 min vs
67.16 min), aortic cross clamp time(60.60 min vs 53.52 min) and
comparatively lesser rise in post-operative Troponin T level (1.027 ng/dl
vs 0.719 ng/dl) and earlier appearance of first cardiac rhythm after
removal of aortic cross clamp(39.88 sec vs 29.52 sec) and lesser
incidence(n=8) of re-dosing of cardioplegia administration, lower rate of
post-operative defibrillation(six vs twenty) and lower post-operative
complication rate (three vs ten). ConclusionOur study demonstrated that by
using del Nido cardioplegia, there is in better myocardial protection and
improved cardiac output in comparison to other standard cardioplegic
solutions along with improved haemo-concentration. Hence, the del Nido
cardioplegia can be a 'magic bullet' for cardiac surgeons.<br/>Copyright
&#xa9; 2023 EManuscript Technologies. All rights reserved.

<32>
Accession Number
2027750816
Title
Septal Myectomy and Subvalvular Repair in Hypertrophic Cardiomyopathy, a
Systematic Review and Pooled Analysis.
Source
Reviews in Cardiovascular Medicine. 24(9) (no pagination), 2023. Article
Number: rcm2409268. Date of Publication: September 2023.
Author
Song M.-Y.; Wei X.; Li C.-H.; Li R.
Institution
(Song, Wei, Li, Li) Division of Cardiothoracic and Vascular Surgery,
Tongji Hospital, Tongji Medical College, Huazhong University of Science
and Technology, Hubei, Wuhan 430030, China
(Wei, Li) Key Laboratory of Organ Transplantation, Ministry of Education,
Hubei, Wuhan 430010, China
(Wei, Li) NHC Key Laboratory of Organ Transplantation, Hubei, Wuhan
430073, China
(Wei, Li) Key Laboratory of Organ Transplantation, Chinese Academy of
Medical Sciences, Hubei, Wuhan 430010, China
Publisher
IMR Press Limited
Abstract
Background: Some patients with hypertrophic obstructive cardiomyopathy
(HOCM) still exhibit systolic anterior motion (SAM) and mitral
regurgitation (MR) even after undergoing an isolated ventricular
septectomy. Currently, there are disputes regarding whether to perform a
mitral valve intervention and which type of operation is more effective.
<br/>Method(s): By searching PubMed, Cochrane, Embase, Web of Science,
FDA.gov, and ClinicalTrials.gov, as well as other resource databases, we
obtained all articles published before December 2022 on ventricular septal
myectomy combined with mitral valve intervention for hypertrophic
cardiomyopathy. Demographic information and outcome variable data were
extracted from 10 screened studies on ventricular septal resection
combined with mitral valve repair. The risk of bias was assessed using
methodological index for non-randomized studies (MINORS). Student's t-test
was used for comparisons of continuous variables, and the chi-square or
Fisher's exact test was used for dichotomous variables. A total of 692
patients across 10 studies were analyzed. <br/>Result(s): There were 5
(0.7%) deaths in the perioperative period. The average cardiopulmonary
bypass time was 64.7+/-22.2 minutes, and the average follow-up time was
39.6+/-36.3 months. Compared with baseline levels, the left ventricular
outflow tract gradient (83.6 +/- 32.2 mmHg vs. 11.0 +/- 7.8 mmHg, p <
0.01), maximum interventricular septal thickness (22.5 +/- 5.1 mm vs. 14.7
+/- 5.5 mm, p < 0.01), III/IV mitral regurgitation (351/692 vs. 17/675, p
< 0.01), anterior mitral leaflet (AML)-annulus ratio (0.49 +/- 0.14 vs.
0.60 +/- 0.12, p < 0.01), tenting area (2.72 +/- 0.60 cm2 vs. 1.95 +/-
0.60 cm2, p < 0.01), and SAM (181/194 vs. 11/215, p < 0.01) were
significantly improved. 14 (2.1%) patients were in New York Heart
Association functional class III/IV, which was significantly improved
compared with the preoperative state (541/692 vs. 14/682, p < 0.01).
<br/>Conclusion(s): Ventricular septectomy combined with mitral valve
repair can be a safe and effective treatment option for patients suffering
from HOCM with SAM and severe MR. <br/>Copyright &#xa9; 2023 The
Author(s).

<33>
Accession Number
2027746394
Title
Index hospital cost of adverse events following thoracic surgery: A
systematic review of economic literature.
Source
BMJ Open. 13(9) (no pagination), 2023. Article Number: e069382. Date of
Publication: 28 Sep 2023.
Author
Jones D.; Kumar S.; Anstee C.; Gingrich M.; Simone A.; Ahmadzai Z.;
Thavorn K.; Seely A.
Institution
(Jones) Department of Surgery, University of Ottawa, Ottawa, ON, Canada
(Jones, Kumar, Anstee, Gingrich, Simone) Methods Centre, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Ahmadzai) Department of Surgery, OHRI, Ottawa, ON, Canada
(Thavorn) Clinical Epidemiology Program, Ottawa Hospital Research
Institute, Ottawa, ON, Canada
(Seely) Department of Epidemiology, Ottawa Hospital Research Institute,
Ottawa, ON, Canada
(Seely) Department of Surgery, Ottawa Hospital, Ottawa, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objectives Adverse events (AEs) following thoracic surgery place
considerable strain on healthcare systems. A rigorous evaluation of the
economic impact of thoracic surgical AEs remains lacking and is required
to understand the value of money of formal quality improvement
initiatives. Our objective was to conduct a systematic review of all
available literature focused on specific cost of postoperative AEs
following thoracic surgery. Design Systematic review of the economic
literature was performed, following recommendations from the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses statement. Data
sources An economic search filter developed by the Canadian Agency for
Drugs and Technologies in Health was applied, and MEDLINE, Embase and The
Cochrane Library were searched from inception to January 2022. Eligibility
criteria We included English articles involving adult patients who
underwent a thoracic surgical procedure with estimated costs of
postoperative complications. Eligible study designs included comparative
observational studies, randomised control trials, decision analytic or
cost-prediction models, cost analyses, cost or burden of illness studies,
economic evaluation studies and systematic reviews and/or meta-analyses of
cost analyses and cost of illness studies. Data extraction and synthesis
Two reviewers independently screened titles and abstracts in the first
stage and full-text articles of included studies in the second stage.
Disagreements during abstract and full-text screening stages were resolved
via discussion until a consensus was reached. Studies were appraised for
methodological quality using the Critical Appraisal Skills Program
checklist. Results 3349 studies were identified: 20 met inclusion
criteria. Most were conducted in the USA (12/20), evaluating AE impact on
hospital expenditures (18/20). 68 procedure-specific AE mean costs were
characterised (USD$). The most commonly described were anastomotic leak
(mean:range) (USD$49 278:$6 176-$133 002) and pneumonia ($12 258:$2608-$34
591) following esophagectomy, and prolonged air leak ($2556:$571-$3573),
respiratory failure ($19 062:$11 841-$37 812), empyema ($30 189:$23
784-$36 595), pneumonia ($15 362:$2542-$28 183), recurrent laryngeal nerve
injury ($16 420:$4224-$28 616) and arrhythmia ($6835:$5833-$8659)
following lobectomy. Conclusions Hospital costs associated with AEs
following thoracic surgery are substantial and varied. Quantifying costs
of AEs enable future economic evaluation studies, which could help
prioritising value-directed quality improvement to optimally improve
outcomes and reduce costs. <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.

<34>
Accession Number
2027275404
Title
Treatment of hypoplastic left heart syndrome: A systematic review and
meta-Analysis of randomised controlled trials.
Source
Cardiology in the Young. (no pagination), 2023. Date of Publication:
2023.
Author
Kim A.Y.; Woo W.; Saxena A.; Tanidir I.C.; Yao A.; Kurniawati Y.; Thakur
V.; Shin Y.R.; Shin J.I.; Jung J.W.; Barron D.J.
Institution
(Kim, Jung) Division of Pediatric Cardiology, Department of Pediatrics,
Severance Cardiovascular Hospital, Yonsei University College of Medicine,
Seoul, South Korea
(Kim, Jung) Department of Pediatrics, Yonsei University College of
Medicine, Seoul, South Korea
(Woo) Department of Thoracic and Cardiovascular Surgery, Gangnam Severance
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Saxena) Department of Cardiology, All India Institute of Medical
Sciences, New Delhi, India
(Tanidir) Department of Pediatric Cardiology, Basaksehir Cam and Sakura
City Hospital, Istanbul, Turkey
(Yao) Department of Health Service Promotion, University of Tokyo, Japan
(Kurniawati) Department of Pediatric Cardiology, National Cardiovascular
Center Harapan Kita, Jakarta, Indonesia
(Thakur, Shin) Department of Pediatrics, Labatt Family Heart Center, The
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
(Shin) Department of Cardiovascular Surgery, Yonsei University College of
Medicine, Seoul, South Korea
(Shin) Severance Underwood Meta-research Center, Institute of Convergence
Science, Yonsei University, Seoul, South Korea
(Barron) Division of Cardiovascular Surgery, Department of Surgery, The
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Publisher
Cambridge University Press
Abstract
Background: This meta-Analysis aimed to consolidate existing data from
randomised controlled trials on hypoplastic left heart syndrome.
<br/>Method(s): Hypoplastic left heart syndrome specific randomised
controlled trials published between January 2005 and September 2021 in
MEDLINE, EMBASE, and Cochrane databases were included. Regardless of
clinical outcomes, we included all randomised controlled trials about
hypoplastic left heart syndrome and categorised them according to their
results. Two reviewers independently assessed for eligibility, relevance,
and data extraction. The primary outcome was mortality after Norwood
surgery. Study quality and heterogeneity were assessed. A random-effects
model was used for analysis. <br/>Result(s): Of the 33 included randomised
controlled trials, 21 compared right ventricle-To-pulmonary artery shunt
and modified Blalock-Taussig-Thomas shunt during the Norwood procedure,
and 12 regarded medication, surgical strategy, cardiopulmonary bypass
tactics, and ICU management. Survival rates up to 1 year were superior in
the right ventricle-To-pulmonary artery shunt group; this difference began
to disappear at 3 years and remained unchanged until 6 years. The right
ventricle-To-pulmonary artery shunt group had a significantly higher
reintervention rate from the interstage to the 6-year follow-up period.
Right ventricular function was better in the modified
Blalock-Taussig-Thomas shunt group 1-3 years after the Norwood procedure,
but its superiority diminished in the 6-year follow-up. Randomised
controlled trials regarding medical treatment, surgical strategy during
cardiopulmonary bypass, and ICU management yielded insignificant results.
<br/>Conclusion(s): Although right ventricle-To-pulmonary artery shunt
appeared to be superior in the early period, the two shunts applied during
the Norwood procedure demonstrated comparable long-Term prognosis despite
high reintervention rates in right ventricle-To-pulmonary artery shunt due
to pulmonary artery stenosis. For medical/perioperative management of
hypoplastic left heart syndrome, further randomised controlled trials are
needed to deliver specific evidence-based recommendations. <br/>Copyright
&#xa9; The Author(s), 2023. Published by Cambridge University Press.

<35>
Accession Number
2026076146
Title
Cold-stored platelets for acute bleeding in cardiac surgical patients: a
narrative review.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Lu J.; Karkouti K.; Peer M.; Englesakis M.; Spinella P.C.; Apelseth T.O.;
Scorer T.G.; Kahr W.H.A.; McVey M.; Rao V.; Abrahamyan L.; Lieberman L.;
Mewhort H.; Devine D.V.; Callum J.; Bartoszko J.
Institution
(Lu) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Karkouti, Peer) Department of Anesthesia and Pain Management, Sinai
Health System, Women's College Hospital, University Health Network,
Toronto General Hospital, Toronto, ON, Canada
(Karkouti, McVey, Bartoszko) Department of Anesthesiology and Pain
Medicine, University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(Karkouti) Interdepartmental Division of Critical Care Medicine,
University of Toronto, Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(Spinella) Department of Critical Care Medicine, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
(Spinella) Department of Surgery, University of Pittsburgh, Pittsburgh,
PA, United States
(Apelseth) Department of Immunology and Transfusion Medicine, Haukeland
University Hospital, University of Bergen, Bergen, Norway
(Apelseth) Norwegian Armed Forces Joint Medical Services, Norwegian Armed
Forces, Oslo, Norway
(Scorer) Centre of Defence Pathology, Royal Centre for Defence Medicine,
Birmingham, United Kingdom
(Scorer) School of Cellular and Molecular Medicine, University of Bristol,
Bristol, United Kingdom
(Kahr) Division of Haematology/Oncology, The Hospital for Sick Children
(SickKids), Toronto, ON, Canada
(Kahr) Cell Biology Program, SickKids Research Institute, Toronto, ON,
Canada
(Kahr) Departments of Paediatrics and Biochemistry, University of Toronto,
Toronto, ON, Canada
(McVey) Department of Anesthesia and Pain Medicine, The Hospital for Sick
Children (SickKids), Toronto, ON, Canada
(McVey) Department of Physics, Toronto Metropolitan University, Toronto,
ON, Canada
(Rao) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University of Toronto, Toronto, ON, Canada
(Abrahamyan) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Abrahamyan) Toronto Health Economics and Technology Assessment (THETA)
Collaborative, Toronto General Research Institute, Toronto, ON, Canada
(Lieberman) Department of Laboratory Medicine and Pathobiology, University
of Toronto, Toronto, ON, Canada
(Mewhort) Department of Surgery, School of Medicine, Queen's University,
Kingston, ON, Canada
(Devine) Canadian Blood Services, Vancouver, BC, Canada
(Devine) Department of Pathology and Laboratory Medicine, The University
of British Columbia, Vancouver, BC, Canada
(Callum) Quality in Utilization, Education and Safety in Transfusion
Research Program, University of Toronto, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, School of
Medicine, Queen's University, Kingston, ON, Canada
(Callum) Kingston Health Sciences Centre, Kingston General Hospital,
Kingston, ON, Canada
(Bartoszko) Department of Anesthesia and Pain Management, Sinai Health
System, Women's College Hospital, University Health Network, Toronto
General Hospital, 200 Elizabeth Street, 3EN-464, Toronto, ON M5G 2C4,
Canada
Publisher
Springer
Abstract
Purpose: Cold-stored platelets (CSP) are an increasingly active topic of
international research. They are maintained at 1-6 degreeC, in contrast to
standard room-temperature platelets (RTP) kept at 20-24 degreeC. Recent
evidence suggests that CSP have superior hemostatic properties compared
with RTP. This narrative review explores the application of CSP in adult
cardiac surgery, summarizes the preclinical and clinical evidence for
their use, and highlights recent research. Source: A targeted search of
MEDLINE and other databases up to 24 February 2022 was conducted. Search
terms combined concepts such as cardiac surgery, blood, platelet, and
cold-stored. Searches of trial registries ClinicalTrials.gov and WHO
International Clinical Trials Registry Platform were included. Articles
were included if they described adult surgical patients as their
population of interest and an association between CSP and clinical
outcomes. References of included articles were hand searched. Principal
findings: When platelets are stored at 1-6 degreeC, their metabolic rate
is slowed, preserving hemostatic function for increased storage duration.
Cold-stored platelets have superior adhesion characteristics under
physiologic shear conditions, and similar or superior aggregation
responses to physiologic agonists. Cold-stored platelets undergo
structural, metabolic, and molecular changes which appear to "prime" them
for hemostatic activity. While preliminary, clinical evidence supports the
conduct of trials comparing CSP with RTP for patients with
platelet-related bleeding, such as those undergoing cardiac surgery.
<br/>Conclusion(s): Cold-stored platelets may have several advantages over
RTP, including increased hemostatic capacity, extended shelf-life, and
reduced risk of bacterial contamination. Large clinical trials are needed
to establish their potential role in the treatment of acutely bleeding
patients.<br/>Copyright &#xa9; 2023, Canadian Anesthesiologists' Society.

<36>
Accession Number
2025995268
Title
Left ventricular assist device implantation and concomitant mitral valve
surgery: A systematic review and meta-analysis.
Source
Artificial Organs. (no pagination), 2023. Date of Publication: 2023.
Author
ArjomandiRad A.; Fleet B.; Zubarevich A.; Nanchahal S.; Naruka V.;
SubbiahPonniah H.; Vardanyan R.; SardariNia P.; Loubani M.; Moorjani N.;
Schmack B.; Punjabi P.P.; Schmitto J.; Ruhparwar A.; Weymann A.
Institution
(Arjomandi Rad) Medical Sciences Division, University of Oxford, Oxford,
United Kingdom
(Arjomandi Rad, Nanchahal, Naruka, Subbiah Ponniah, Vardanyan) Department
of Surgery and Cancer, Imperial College London, London, United Kingdom
(Arjomandi Rad, Sardari Nia) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre, Maastricht, Netherlands
(Fleet) School of Medicine, Lancaster University, Lancaster, United
Kingdom
(Zubarevich, Schmack, Schmitto, Ruhparwar, Weymann) Department of
Cardiothoracic Transplant and Vascular Surgery, Hannover Medical School,
Hannover, Germany
(Loubani) Department of Cardiothoracic Surgery, Hull University Teaching
Hospitals NHS Trust, Hull, United Kingdom
(Moorjani) Department of Cardiothoracic Surgery, Royal Papworth NHS Trust,
Cambridge, United Kingdom
(Punjabi) Department of Cardiothoracic Surgery, National Heart and Lung
Institute, Imperial College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: The management of concomitant valvular lesions in patients
undergoing left ventricular assist device (LVAD) implantation remains a
topic of debate. This systematic review and meta-analysis aimed to
evaluate the existing evidence on postoperative outcomes following LVAD
implantation, with and without concomitant MV surgery. <br/>Method(s): A
systematic database search was conducted as per PRISMA guidelines, of
original articles comparing LVAD alone to LVAD plus concomitant MV surgery
up to February 2023. The primary outcomes assessed were overall mortality
and early mortality, while secondary outcomes included stroke, need for
right ventricular assist device (RVAD) implantation, postoperative mitral
valve regurgitation, major bleeding, and renal dysfunction.
<br/>Result(s): The meta-analysis included 10 studies comprising 32 184
patients. It revealed that concomitant MV surgery during LVAD implantation
did not significantly affect overall mortality (OR:0.83; 95% CI: 0.53 to
1.29; p = 0.40), early mortality (OR:1.17; 95% CI: 0.63 to 2.17; p =
0.63), stroke, need for RVAD implantation, postoperative mitral valve
regurgitation, major bleeding, or renal dysfunction. These findings
suggest that concomitant MV surgery appears not to confer additional
benefits in terms of these clinical outcomes. <br/>Conclusion(s): Based on
the available evidence, concomitant MV surgery during LVAD implantation
does not appear to have a significant impact on postoperative outcomes.
However, decision-making regarding MV surgery should be individualized,
considering patient-specific factors and characteristics. Further research
with prospective studies focusing on specific patient populations and
newer LVAD devices is warranted to provide more robust evidence and guide
clinical practice in the management of valvular lesions in LVAD
recipients.<br/>Copyright &#xa9; 2023 The Authors. Artificial Organs
published by International Center for Artificial Organ and Transplantation
(ICAOT) and Wiley Periodicals LLC.

<37>
Accession Number
2025978909
Title
Effect of skeletonisation and pedicled bilateral internal mammary artery
grafting in coronary artery bypass surgery on post-operative wound
infection: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Nie C.; Deng Y.; Lu Y.
Institution
(Nie, Lu) Traditional Chinese Medicine University of Guangzhou, Guangzhou,
China
(Deng) Zhongnan University of Economics and Law, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
The results showed that different internal thoracic artery (ITA) was
associated with the rate of postoperative wound infection and the severity
of pain following coronary artery bypass grafting (CABG). In order to
ascertain if there was any genuine difference in the rate of postoperative
infection and severity of the pain, we conducted a meta-analysis to
evaluate if there was any actual difference in the wound complication that
had been identified with the ITA method. Through EMBASE, Cochrane Library
and Pubmed, and so forth, we systematically reviewed the results by August
2023, which compared the impact of skeletonised versus pedicled internal
mammary artery (IMA) on wound complications following CABG. The trial data
have been pooled and analysed in order to determine if a randomisation or
fixed-effect model should be applied. The meta-analysis of data was
performed with Revman 5.3 software. The results of this meta-study
included 252 related articles from four main databases, and nine articles
were chosen to be extracted and analysed. A total of 3320 patients were
treated with coronary artery transplantation. Based on current data
analysis, we have shown that the rate of postoperative wound infections is
reduced by the use of the skeletonised internal mammary artery (SIMA) (OR,
1.84; 95% CI, 1.13, 3.01; p = 0.01). But the results showed that there
were no statistically significant differences in the post-operation pain
score of the patients (MD, 0.09; 95% CI, -0.58, 0.76; p = 0.79).
Furthermore, the duration of the operation was not significantly different
between the SIMA and pedicled internal mammary artery (PIMA) (MD, 3.30;
95% CI, -3.13, 9.73; p = 0.31). Overall, the SIMA decreased the rate of
postoperative wound infection in CABG patients than the
PIMA.<br/>Copyright &#xa9; 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<38>
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.

<39>
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.

<40>
Accession Number
2026748415
Title
Impact of Complete Revascularization in the ISCHEMIA Trial.
Source
Journal of the American College of Cardiology. 82(12) (pp 1175-1188),
2023. Date of Publication: 19 Sep 2023.
Author
Stone G.W.; Ali Z.A.; O'Brien S.M.; Rhodes G.; Genereux P.; Bangalore S.;
Mavromatis K.; Horst J.; Dressler O.; Poh K.K.; Nath R.K.; Moorthy N.;
Witkowski A.; Dwivedi S.K.; Bockeria O.; Chen J.; Smanio P.E.P.; Picard
M.H.; Chaitman B.R.; Berman D.S.; Shaw L.J.; Boden W.E.; White H.D.;
Fremes S.E.; Rosenberg Y.; Reynolds H.R.; Spertus J.A.; Hochman J.S.;
Maron D.J.; Boden W.; Harrington R.; Williams D.; Alexander K.P.; Berger
J.; Mark D.; Ballantyne C.; Beyar R.; Bhargava B.; Buller C.; Carvalho
A.T.; Diaz R.; Doerr R.; Dzavik V.; Goodman S.; Gosselin G.; Hachamovitch
R.; Hamm C.; Held C.; Helm M.; Huber K.; Jiang L.; Keltai M.; Kohsaka S.;
Lang I.; Lopes R.; Maggioni A.; Mancini J.; Bairey Merz C.N.; Min J.;
Peterson E.; Ruzyllo W.; Selvanayagam J.; Senior R.; Sharir T.; Steg G.;
Szwed H.; Van de Werf F.; Weintraub W.; White H.; Calfas K.; Champagne
M.A.; Davidson M.; Fleg J.; McCullough P.A.; Newman J.; Stone P.; Menasche
P.; Fremes S.; Guyton R.; Mack M.; Mohr F.; Rao A.; Sabik J.; Shapira O.;
Taggart D.; Tatoulis J.; Blankenship J.; Brener S.; Colombo A.; de Bruyne
B.; Kereiakes D.; Lefevre T.; Moses J.; Mahaffey K.; Cruz-Flores S.;
Danchin N.; Feen E.; Garcia M.J.; Hauptman P.; Laddu A.A.; Passamani E.;
Pina I.L.; Simoons M.; Skali H.; Thygesen K.; Waters D.; Endsley P.;
Esposito G.; Kanters J.; Pownall J.; Stournaras D.; Friedrich M.; Kwong
R.; Oliver D.; Harrell F.; Blume J.; Lee K.; Kullo I.; McManus B.; Newby
K.; Cohen D.; Bugiardini R.; Celutkiene J.; Escobedo J.; Hoye A.;
Lyubarova R.; Mattina D.; Peteiro J.; Smanio P.; Berman D.; Leipsic J.;
Mathew R.; Sidhu M.; Friedman L.; Anderson J.; Berg J.; DeMets D.; Gibson
C.M.; Lamas G.; Deming N.; Himmelfarb J.; Ouyang P.; Woodard P.; Nwosu S.;
Kirby R.; Jeffries N.; Denaro J.E.; Mavromichalis S.; Chan K.; Cobb G.;
Contreras A.; Cukali D.; Ferket S.; Gabriel A.; Hansen A.; Roberts A.;
Naumova A.; Chang M.; Islam S.; Wayser G.; Yakubov S.; Yee M.; Callison
C.; Hogan I.; Qelaj A.; Pirro C.; Van Loo K.; Wisniewski B.; Gilsenan M.;
Lang B.; Mohamed S.; Esquenazi-Karonika S.; Mathews P.; Setang V.; Xavier
M.; Bagai A.; Broderick S.; Crowder M.; Cyr D.; Garg J.; Gu X.; Hatch L.;
Heath A.; Huang Z.; Leimberger J.; Marcus J.; Page C.; Parker W.; Pennachi
W.; Rockhold F.; Stevens S.; Stone A.; Thompson O.; Ussery S.; White J.;
Williams M.K.; Xing W.; Zhu S.; Anstrom K.; Baloch K.; Blount J.; Cowper
P.; Davidson-Ray L.; Drew L.; Harding T.; Knight J.D.; Minshall Liu D.;
O'Neal B.; Redick T.; Jones P.; Nugent K.; Jingyan Wang G.; Phillips L.;
Goyal A.; Hetrick H.; Hayes S.W.; Friedman J.D.; Gerlach R.J.; Hyun M.;
Miranda-Peats R.; Slomka P.; Thomson L.; Kwong R.Y.; Mongeon F.P.; Michael
S.; Hung J.; Scherrer-Crosbie M.; Zeng X.; Eckstein J.; Guruge B.; Streif
M.; Alfonso M.A.; Corral M.P.; Garcia J.J.; Jankovic I.; Konigstein M.;
Lustre M.B.; Peralta Y.; Sanchez R.; Arsanjani R.; Budoff M.; Elmore K.;
Gomez M.; Hague C.; Hindoyan N.; Mancini G.J.; Nakanishi R.;
Srichai-Parsia M.B.; Yeoh E.; Youn T.; Maggioni A.P.; Bianchini F.; Ceseri
M.; Lorimer A.; Magnoni M.; Orso F.; Sarti L.; Tricoli M.; Carvalho A.;
Barbosa L.M.; Bello Duarte T.; Colaiacovo Soares T.; de Aveiro Morata J.;
Carvalho P.; de Carvalho Maffei N.; Egydio F.; Kawakami A.; Oliveira J.;
Restelli Piloto E.; Pozzibon J.; Camara D.; Mowafy N.; Spindler C.; Dai
H.; Feng F.; Li J.; Li L.; Liu J.; Xie Q.; Zhang H.; Zhang J.; Zhang L.;
Zhang N.; Zhong H.; Escobar C.; Martin M.E.; Pascual A.; Lopez-Sendon J.;
Moraga P.; Hernandez V.; Castro A.; Posada M.; Fernandez S.; Narro
Villanueva J.L.; Selgas R.; Abergel H.; Juliard J.M.; Alsweiler C.; Claes
K.; Goetschalckx K.; Luyten A.; Robesyn V.; Selvanayagam J.B.; Murphy D.;
Garcevic N.; Stojkovic J.; Ahmed A.; Bhatt R.; Chadha N.; Kumar V.; Lubna
S.; Naik P.; Pandey S.; Ramasamy K.; Saleem M.; Sharma P.; Siddaram H.
Institution
(Stone, Shaw) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Ali) St Francis Hospital, Roslyn, NY, United States
(Ali, Horst, Dressler) Cardiovascular Research Foundation, New York, NY,
United States
(O'Brien, Rhodes) Duke Clinical Research Institute, Durham, NC, United
States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Bangalore, Reynolds, Hochman) NYU Grossman School of Medicine, New York,
NY, United States
(Mavromatis) Emory University School of Medicine, Atlanta, GA, United
States
(Poh) National University Heart Center Singapore and the Yong Loo Lin
School of Medicine, National University of Singapore, Singapore
(Nath) Dr Ram Manohar Lohia Hospital, New Delhi, India
(Moorthy) Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka, Bangalore-Karnataka, India
(Witkowski) National Institute of Cardiology, Warsaw, Poland
(Dwivedi) King George Medical University, Lucknow Up, India
(Bockeria) National Research Center for Cardiovascular Surgery, Moscow,
Russian Federation
(Chen) Guangdong Provincial People's Hospital, Guangdong, China
(Smanio) Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e
Saude, Sao Paulo, Brazil
(Picard) Massachusetts General Hospital and Harvard Medical School,
Boston, MA, United States
(Chaitman) St Louis University School of Medicine Center for Comprehensive
Cardiovascular Care, St Louis, MO, United States
(Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Boden) Boston University School of Medicine, Boston, MA, United States
(White) Auckland City Hospital Green Lane Cardiovascular Services and
University of Auckland, Auckland, New Zealand
(Fremes) University of Toronto, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Rosenberg) National Heart, Lung, and Blood Institute, Washington, DC,
United States
(Spertus) Saint Luke's Mid America Heart Institute and the University of
Missouri, Kansas City, Kansas City, MO, United States
(Maron) Department of Medicine, Stanford School of Medicine, Stanford, CA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Anatomic complete revascularization (ACR) and functional
complete revascularization (FCR) have been associated with reduced death
and myocardial infarction (MI) in some prior studies. The impact of
complete revascularization (CR) in patients undergoing an invasive (INV)
compared with a conservative (CON) management strategy has not been
reported. <br/>Objective(s): Among patients with chronic coronary disease
without prior coronary artery bypass grafting randomized to INV vs CON
management in the ISCHEMIA (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) trial, we examined the
following: 1) the outcomes of ACR and FCR compared with incomplete
revascularization; and 2) the potential impact of achieving CR in all INV
patients compared with CON management. <br/>Method(s): ACR and FCR in the
INV group were assessed at an independent core laboratory.
Multivariable-adjusted outcomes of CR were examined in INV patients.
Inverse probability weighted modeling was then performed to estimate the
treatment effect had CR been achieved in all INV patients compared with
CON management. <br/>Result(s): ACR and FCR were achieved in 43.4% and
58.4% of 1,824 INV patients. ACR was associated with reduced 4-year rates
of cardiovascular death or MI compared with incomplete revascularization.
By inverse probability weighted modeling, ACR in all 2,296 INV patients
compared with 2,498 CON patients was associated with a lower 4-year rate
of cardiovascular death or MI (difference -3.5; 95% CI: -7.2% to 0.0%). In
comparison, the event rate difference of cardiovascular death or MI for
INV minus CON in the overall ISCHEMIA trial was -2.4%. Results were
similar but less pronounced with FCR. <br/>Conclusion(s): The outcomes of
an INV strategy may be improved if CR (especially ACR) is achieved.
(International Study of Comparative Health Effectiveness With Medical and
Invasive Approaches [ISCHEMIA]; NCT01471522)<br/>Copyright &#xa9; 2023
American College of Cardiology Foundation

<41>
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.

<42>
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.

<43>
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.

<44>
Accession Number
2024649501
Title
Renal safety of critical care sedation with sevoflurane: a systematic
review and meta-analysis.
Source
Journal of Anesthesia. 37(5) (pp 794-805), 2023. Date of Publication:
October 2023.
Author
Taylor B.; Scott T.E.; Shaw J.; Chockalingam N.
Institution
(Taylor, Scott) Department of Anaesthesia and Critical Care, University
Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
(Taylor, Scott, Shaw) Academic Department of Military Anaesthesia and
Critical Care, Birmingham, United Kingdom
(Shaw) Emergency Medical Retrieval and Transport Service Cymru, Llanelli,
United Kingdom
(Taylor, Scott, Chockalingam) Centre for Biomechanics and Rehabilitation
Technologies, Staffordshire University, Stoke-on-Trent, United Kingdom
Publisher
Springer
Abstract
Volatile anesthetic agents are increasingly widely used for critical care
sedation. There are concerns that sevoflurane presents a risk of renal
injury when used in this role. RCTs comparing the use of critical care
sevoflurane sedation with any control in humans were systematically
identified using MEDLINE, Cochrane CENTRAL, web of Science, and CINAHL
(until May 2022), if they presented comparative data on renal function or
serum inorganic fluoride levels. Pooled SMDs (95% CI) were calculated
where possible after assessment of quality with GRADE and risk of bias
with ROB-2. Eight studies analyzing 793 patients were included. The median
duration of use of critical care sevoflurane sedation was 4.8 [IQR
3.5-9.2] hours; however, most trials also included a period of prior
intraoperative use. No significant difference was found in serum
creatinine at 1 day (SMD 0.05, 95% CI - 0.12 to 0.21), 48 h (SMD = - 0.04;
95% Cl - 0.25 to 0.17), 72 h (SMD = - 0.15; 95% CI - 0.45 to 0.15), and at
discharge (SMD = - 0.1; 95% CI - 0.3 to 0.13) between the sevoflurane
group and the control groups. Creatinine clearance was measured in two
studies at 48 h with no significant difference (SMD = - 0.13; 95% Cl -
0.38 to 0.11). Levels of serum inorganic fluoride were significantly
elevated in patients where sevoflurane was used. Sevoflurane was not
associated with renal failure when used for critical care sedation of
fewer than 72-h duration, despite the elevation of serum fluoride.
Longer-term studies are currently inadequate, including in patients with
compromised renal function, to further evaluate the role of sevoflurane in
this setting. Trial registration PROSPERO (CRD42022333099).<br/>Copyright
&#xa9; 2023, Crown.

<45>
Accession Number
2018037595
Title
Late outcomes of transcatheter aortic valve implantation in bicuspid
versus tricuspid valves: Meta-analysis of reconstructed time-to-event
data.
Source
Trends in Cardiovascular Medicine. 33(7) (pp 458-467), 2023. Date of
Publication: October 2023.
Author
Sa M.P.; Van den Eynde J.; Jacquemyn X.; Tasoudis P.; Erten O.; Dokollari
A.; Torregrossa G.; Sicouri S.; Ramlawi B.
Institution
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Tasoudis, Erten, Dokollari, Torregrossa, Sicouri, Ramlawi) Department
of Cardiothoracic Surgery Research, Lankenau Institute for Medical
Research, Wynnewood, PA, United States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
Publisher
Elsevier Inc.
Abstract
Based on previous meta-analyses including immediate/1-year results,
individuals with bicuspid aortic valve (BAV) stenosis can undergo TAVI
with similar outcomes as those with tricuspid aortic valve (TAV), but with
higher rates of periprocedural complications. The widespread belief is
that BAV patients would have poor results in comparison with TAV patients
after TAVI over time. Therefore, we performed a systematic review with
meta-analysis with reconstructed time-to-event data of studies published
by January 2022 to compare late outcomes of patients with BAV versus TAV
who underwent TAVI. This approach reconstructs individual patient data
(IPD) based on the published Kaplan-Meier graphs. Ten studies met our
eligibility criteria, including 9,071 patients with BAV and 171,070
patients with TAV. Patients with BAV had a significantly lower risk of
mortality (HR 0.70, 95%CI 0.65-0.77, P<0.001), however, this result was
driven by populations in which the risk score was statistically
significantly lower in the BAV group (HR 0.69, 95%CI 0.63-0.76, P<0.001)
and by populations in which the BAV group was statistically significantly
younger (HR 0.72, 95%CI 0.64-0.81, P<0.001). In patients with selected BAV
anatomy deemed favorable for TAVI, we did not find worse survival over
time in comparison with patients with TAV; however, the follow-up beyond 1
year remains limited in the studies and we need more investigation for
specific bicuspid anatomies with longer follow-up. Most importantly,
randomized controlled trials including exclusively BAV patients treated
with TAVI versus SAVR are warranted.<br/>Copyright &#xa9; 2022

<46>
Accession Number
2027354959
Title
Immediate versus staged complete revascularization in acute coronary
syndrome: A meta-analysis of randomized controlled trials.
Source
International Journal of Cardiology. 393 (no pagination), 2023. Article
Number: 131397. Date of Publication: 15 Dec 2023.
Author
Bujak K.; Rinaldi R.; Vidal-Cales P.; Montone R.A.; Diletti R.; Gasior M.;
Crea F.; Sabate M.; Brugaletta S.
Institution
(Bujak, Rinaldi, Vidal-Cales, Sabate, Brugaletta) Hospital Clinic,
Cardiovascular Clinic Institute, Institut d'Investigacions Biomediques
August Pi i Sunyer (IDIBAPS), Barcelona, Spain
(Bujak, Gasior) 3rd Department of Cardiology, Faculty of Medical Sciences
in Zabrze, Medical University of Silesia, Katowice, Poland
(Rinaldi, Montone, Crea) Department of Cardiovascular and Pulmonary
Sciences, Catholic University of the Sacred Heart, Rome, Italy
(Diletti) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: Clinical guidelines recommend a complete revascularization
(CR) in patients with acute coronary syndromes (ACS) and multivessel
disease (MVD). However, its optimal timing is unclear. The aim of this
meta-analysis was to compare the clinical outcomes following immediate
versus staged CR in ACS. <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

<47>
Accession Number
2024833246
Title
Current Status of Simulation in Thoracic Surgical Training.
Source
Annals of Thoracic Surgery. 116(5) (pp 1107-1115), 2023. Date of
Publication: November 2023.
Author
Whittaker G.; Ghita I.-A.; Taylor M.; Salmasi M.Y.; Granato F.; Athanasiou
T.
Institution
(Whittaker, Salmasi, Athanasiou) Department of Surgery and Cancer,
Imperial College London, London, United Kingdom
(Whittaker, Taylor, Granato) Department of Cardiothoracic Surgery,
Manchester University NHS Foundation Trust, Manchester, United Kingdom
(Ghita) Faculty of Medicine, University of Medicine and Pharmacy of
Craiova, Craiova, Romania
Publisher
Elsevier Inc.
Abstract
Background: Simulation is playing an increasingly important role in
surgical training but is not yet a mandatory part of most surgical
curricula. A simulator must undergo rigorous validation to verify it as a
reliable tool. The aim of this study was to review the literature to
identify simulators that are currently available to augment thoracic
surgical training and to analyze any evidence supporting or validating
them. <br/>Method(s): A literature search of the MEDLINE (1946 to November
2022) and Embase (1947 to November 2022) databases was performed to
identify simulators for basic skills and procedures in thoracic surgery. A
selection of keywords were used to perform the literature search. After
identification of appropriate articles, data were extracted and analyzed.
<br/>Result(s): Thirty-three simulators were found in 31 articles.
Simulators for basic skills (n = 13) and thoracic lobectomy (n = 13) were
most commonly described, followed by miscellaneous (n = 7). Most models
were of a hybrid modality (n = 18). Evidence of validity was established
in 48.5% (n = 16) of simulators. In total, 15.2% (n = 5) of simulators had
3 or more elements of validity demonstrated, and only 3.0% (n = 1)
accomplished full validation. <br/>Conclusion(s): Numerous simulators of
varying modality and fidelity exist for a variety of thoracic surgical
skills and procedures, although validation evidence is frequently
inadequate. Simulation models may be able to provide training in basic
surgical and procedural skills; however, further assessment of validity
needs to be undertaken before consideration of their integration into
training programs.<br/>Copyright &#xa9; 2023 The Society of Thoracic
Surgeons

<48>
Accession Number
2024009250
Title
Glutamate infusion associated with reduced rises of p-Copeptin after
coronary surgery: Substudy of GLUTAMICS II.
Source
Acta Anaesthesiologica Scandinavica. 67(10) (pp 1373-1382), 2023. Date of
Publication: November 2023.
Author
Svedjeholm R.; Ferrari G.; Vanky F.; Friberg O.; Holm J.
Institution
(Svedjeholm, Vanky, Holm) Department of Thoracic and Vascular Surgery,
Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular
Medicine, Linkoping University, Linkoping, Sweden
(Ferrari, Friberg) Department of Cardiothoracic and Vascular Surgery,
Faculty of Medicine and Health, Health Care Research Centre, Orebro
University, Orebro, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Glutamate plays a key role for post-ischaemic recovery of
myocardial metabolism. According to post hoc analyses of the two GLUTAMICS
trials, patients without diabetes benefit from glutamate with less
myocardial dysfunction after coronary artery bypass surgery (CABG).
Copeptin reflects activation of the Arginine Vasopressin system and is a
reliable marker of heart failure but available studies in cardiac surgery
are limited. We investigated whether glutamate infusion is associated with
reduced postoperative rises of plasma Copeptin (p-Copeptin) after CABG.
<br/>Method(s): A prespecified randomised double-blind substudy of
GLUTAMICS II. Patients had left ventricular ejection fraction <=0.30 or
EuroSCORE II >=3.0 and underwent CABG +/- valve procedure. Intravenous
infusion of 0.125 M L-glutamic acid or saline at 1.65 mL/kg/h was
commenced 10-20 min before the release of the aortic cross-clamp and then
continued for another 150 min P-Copeptin was measured preoperatively and
postoperatively on day one (POD1) and day three. The primary endpoint was
an increase in p-Copeptin from the preoperative level to POD1.
Postoperative stroke <=24 h and mortality <=30 days were safety outcomes.
<br/>Result(s): We included 181 patients of whom 48% had diabetes. The
incidence of postoperative mortality <=30 days (0% vs. 2.1%; p =.50) and
stroke <=24 h (0% vs. 3.2%; p =.25) did not differ between the glutamate
group and controls. P-Copeptin increased postoperatively with the highest
values recorded on POD1 without significant inter-group differences. Among
patients without diabetes, p-Copeptin did not differ preoperatively but
postoperative rise from preoperative level to POD1 was significantly
reduced in the glutamate group (73 +/- 66 vs. 115 +/- 102 pmol/L; p =.02).
P-Copeptin was significantly lower in the Glutamate group on POD1 (p =.02)
and POD 3 (p =.02). <br/>Conclusion(s): Glutamate did not reduce rises of
p-Copeptin significantly after moderate to high-risk CABG. However,
glutamate was associated with reduced rises of p-Copeptin among patients
without diabetes. These results agree with previous observations
suggesting that glutamate mitigates myocardial dysfunction after CABG in
patients without diabetes. Given the exploratory nature of these findings,
they need to be confirmed in future studies.<br/>Copyright &#xa9; 2023 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<49>
Accession Number
2027762686
Title
TCT-720 Patient-Reported Outcomes in Tricuspid Valve Intervention: Patient
Preference Results From the TRISCEND II Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B289-B290),
2023. Date of Publication: 24 Oct 2023.
Author
Brener M.; Barker C.; Davidson C.; Narang A.; Sharma R.; Haeffele C.;
Yadav P.; Thourani V.; Kodali S.; Hahn R.; Makkar R.; Makar M.; Hausleiter
J.; Nabauer M.; O'Neill W.; Wang D.D.; Lindman B.; Zahr F.; Chadderdon S.;
Eleid M.; Pislaru S.; Mancilla M.; Kemp L.; Mollenkopf S.; Ryan M.; Cohen
D.
Institution
(Brener, Kodali, Hahn) NewYork-Presbyterian Columbia University Irving
Medical Center, New York, NY, United States
(Barker, Lindman) Vanderbilt University Medical Center, Nashville, TN,
United States
(Davidson) Northwestern Memorial Hospital, Chicago, IL, United States
(Narang) Northwestern University, Chicago, IL, United States
(Sharma) Stanford University School of Medicine, Stanford, CA, United
States
(Haeffele) Stanford University, Pacifica, CA, United States
(Yadav, Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Makkar, Makar) Cedars-Sinai Medical Center, Los Angeles, CA, United
States
(Hausleiter) Klinikum Der Universitat Munchen, Munich, Germany
(Nabauer) LMU, Munich, Germany
(O'Neill) Henry Ford Health System, Orchard Lake, MI, United States
(Wang) Henry Ford Health, Detroit, MI, United States
(Zahr, Chadderdon) Oregon Health and Science University, Portland, OR,
United States
(Eleid, Pislaru) Mayo Clinic, Rochester, MN, United States
(Mancilla, Kemp, Mollenkopf) Edwards Lifesciences, Irvine, CA, United
States
(Ryan) MPR Consulting, Cincinnati, OH, United States
(Cohen) St. Francis Hospital, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Validated patient reported outcome measures for tricuspid
regurgitation (TR) are lacking. To address this knowledge gap, we assessed
patient priorities for improvement during evaluation for treatment of TR.
<br/>Method(s): Participants in the prospective, multicenter TRISCEND II
pivotal randomized trial, comparing outcomes of the EVOQUE transcatheter
tricuspid valve replacement (TTVR) system (Edwards Lifesciences) plus
optimal medical therapy (OMT) vs OMT alone for at least severe TR were
administered a patient preference survey at baseline. Survey questions
assessed patients' priorities for improvement in 6 symptoms (swelling in
legs, ankles, and feet; fatigue; poor sleep; depression or anxiety;
shortness of breath) and 6 activities (self-care; walking 1 block on level
ground; climbing stairs; performing work, chores, or hobbies; recreational
activities; and visiting family and friends). <br/>Result(s): 131 trial
participants completed the survey correctly. For symptoms, participants
most frequently prioritized improvement in shortness of breath (37.4%) and
fatigue (23.7%) (see Table 1). For activities, patients prioritized
self-care (54.2%) and ability to visit family/friends outside of the home
(10.7%). Ongoing analyses will examine the relationship between patient
preferences, changes in health status, and treatment assignment. [Formula
presented] <br/>Conclusion(s): Among patients undergoing treatment for
severe TR in the TRISCEND II RCT, improvements in dyspnea and independence
were identified as key goals of therapy. The relationship between these
goals and health status outcomes with TTVR vs medical therapy will be
presented and will provide novel insights into the value of TTVR from the
patient's perspective. Categories: STRUCTURAL: Valvular Disease:
Tricuspid<br/>Copyright &#xa9; 2023

<50>
Accession Number
2027762676
Title
TCT-702 Clinical In-Hospital Outcomes Comparing Effectiveness of
Percutaneous Left Atrial Appendage Closure to Medical Therapy Among
Patients With Nonvalvular Atrial Fibrillation: An Updated Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B282-B283),
2023. Date of Publication: 24 Oct 2023.
Author
Moras E.; Gandhi K.; Choi J.; Moras A.; Aronow W.
Institution
(Moras, Choi) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Gandhi) Mount Sinai Health System, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Moras) Fr Muller Medical College, Karnataka, Mangalore, India
(Aronow) Westchester Medical Center, Valhalla, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage closure (LAAC) has emerged as an
alternative to long-term oral anticoagulation for stroke prophylaxis in
patients with nonvalvular atrial fibrillation. The safety and efficacy of
percutaneous LAAC have been a topic of debate, and current data remains
controversial raising questions about safety of LAAC in light of the novel
medical therapy. We; therefore, sought to perform an updated meta-analysis
of available studies comparing LAAC to medical therapy, focusing on
important clinical outcomes. <br/>Method(s): We performed a systematic
search of the MEDLINE, EMBASE, and Cochrane Central Register. All studies
comparing LAAC to medical therapy up to December 2022 were included. A
random-effects model using Revman 5.4 statistical software was used to
calculate risk ratios (RRs) and 95% CI. <br/>Result(s): 8 studies (3
randomized controlled trials, 5 observational studies) were finally
included with a pooled population of 3,235 LAAC and 3,067 medical therapy
patients. LAAC was associated with a reduced risk of all-cause mortality
(RR: 0.64; 95% CI: 0.51-0.81; P < 0.005) and major bleeding (RR: 0.69; 95%
CI: 0.57-0.84; P < 0.001). There were no significant differences in terms
of stroke from all causes (RR: 0.98; 95% CI: 0.79-1.21; P < 0.83) or
cardiovascular death (RR: 0.72; 95% CI: 0.51-1.02; P < 0.07). [Formula
presented] <br/>Conclusion(s): Our meta-analysis indicates that the use of
left atrial appendage closure (LAAC) therapy, compared with medical
therapy, shows evidence of reduced long-term risk of death, possibly
attributed to lower rates of major bleeding. Categories: STRUCTURAL: Left
Atrial Appendage Exclusion<br/>Copyright &#xa9; 2023

<51>
Accession Number
2027762623
Title
TCT-701 Transcatheter Mitral Valve Repair in Heart Failure Patients With
Secondary Mitral Regurgitation: An Updated Meta-analysis of Impact on
Mortality and Rehospitalizations.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B282), 2023.
Date of Publication: 24 Oct 2023.
Author
Akbar U.; Umer A.M.; Shafique N.; Saad M.; Qazi S.; Qadeer A.; Anwar R.U.;
Zain S.; Haider A.; Muhibullah F.; Basit J.; Mughal A.K.; Dani S.
Institution
(Akbar) West Virginia University Camden Clark Medical Center, Parkersburg,
WV, United States
(Umer) WVU Camden Clark Medical Center, Vienna, WV, United States
(Shafique, Anwar) University of Louisville, Louisville, KY, United States
(Saad) Marshall University School of Medicine, Huntington, WV, United
States
(Qazi) Sheikh Zayed Hospital, Rahim Yar Khan, Pakistan
(Qadeer) Nishtar Medical University, Rajanpur, Pakistan
(Zain) Shan Medical Center, Prairie Village, KS, United States
(Haider, Muhibullah) Nishtar Medical University, Multan, Pakistan
(Basit) Rawalpindi Medical University, Rawalpindi, Pakistan
(Mughal) Ch Pervaiz Elahi Institute of Cardiology, Multan, Pakistan
(Dani) Lahey Hospital and Medical Center, Burlington, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Secondary mitral regurgitation (MR) increases morbidity and
mortality in heart failure patients. While guideline-directed medical
therapy (GDMT) is the conventional management approach, recent studies
highlight the potential of transcatheter mitral valve repair (TMVR). We
conducted a systematic review and meta-analysis to evaluate TMVR plus GDMT
versus GDMT alone in secondary MR. <br/>Method(s): We conducted a
systematic literature search following PRISMA guidelines using terms like
"transcatheter mitral valve repair," "MitraClip," "heart failure," and
"secondary mitral regurgitation." Studies involving adult heart failure
patients treated with TMVR or GDMT alone until June 2023 were included.
Using Review Manager (RevMan) 5.4, a variance-weighted random-effects
model estimated event rates and ORs. <br/>Result(s): Our results showed
that heart failure patients undergoing TMVR in addition to medical therapy
experienced significantly lower mortality (OR: 0.63; 95% CI [0.43-0.92]; P
= 0.02; I2 = 55%) and reduced rates of rehospitalization (OR: 0.40; 95% CI
[0.33-0.49]; P < 0.00001; I2 = 93%) as compared with those receiving
medical therapy alone. Although beneficial outcomes were observed,
considerable heterogeneity was noted across studies for both mortality and
rehospitalization rates (Figure 1). [Formula presented]
<br/>Conclusion(s): TMVR with medical therapy notably reduces mortality
and rehospitalization in heart failure patients with secondary MR compared
with medical therapy alone. More randomized trials are needed to tailor
TMVR-based strategies. Categories: STRUCTURAL: Valvular Disease:
Mitral<br/>Copyright &#xa9; 2023

<52>
Accession Number
2027762468
Title
TCT-309 Transcatheter Aortic Valve Replacement in Patients With Severe
Rheumatic Aortic Stenosis: A Proportional Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B123-B124),
2023. Date of Publication: 24 Oct 2023.
Author
Ahsan M.J.; Ahmad S.; Ghumman G.M.; Yousaf A.; Dvalishvili M.; Ahsan M.Z.;
Latif A.; Waqas H.; Goldsweig A.
Institution
(Ahsan) Iowa Heart Center, MercyOne, West Des Moines, IA, United States
(Ahmad) University of Nebraska Medical Center (UNMC/UNO), Omaha, NE,
United States
(Ghumman) Mercy Health Saint Vincent Medical Center, Toledo, OH, United
States
(Yousaf) McLaren Flint/Michigan State University, Flint, MI, United States
(Dvalishvili) East Carolina University, Greenville, NC, United States
(Ahsan) Fatima Memorial Hospital, Lahore, Pakistan
(Latif) Creighton University, Omaha, NE, United States
(Waqas) Icahn School of Medicine at Mount Sinai, New York, New York,
United States
(Goldsweig) Baystate Medical Center, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Limited data exist regarding the use of transcatheter aortic
valve replacement (TAVR) in patients with rheumatic heart disease (RHD).
We conducted this systematic review and meta-analysis to evaluate the
outcomes of TAVR for severe aortic stenosis (AS) in the setting of RHD.
<br/>Method(s): PubMed, Scopus, Embase, Cochrane Central Register of
Controlled Trials (CENTRAL), and Clinicaltrials.gov were searched through
June 15, 2023, for studies reporting clinical outcomes of TAVR in patients
with severe AS and RHD. We used the Freeman-Tukey transformation ("ftt
cimethod") method to transform the incidence rate estimates from
individual studies to calculate weighted summary proportions using STATA
version 17.0. <br/>Result(s): A total of 5 studies met inclusion criteria
(n = 2,850). TAVR in severe rheumatic AS was associated with 1% (95% CI:
1%-2%) mortality during short-term follow-up. Peri-procedural stroke
occurred in 1% (95% CI: 0%-1%) of patients during the first 30 days'
post-TAVR. Permanent pacemaker implantation was required in 13% (95% CI:
8%-20%) of patients after TAVR for severe rheumatic AS. The mean length of
stay (LOS) was 7 +/- 4 days. [Formula presented] <br/>Conclusion(s): TAVR
appears to be feasible and safe in patients with severe AS due to RHD.
Outcomes in RHD are similar to all-comers TAVR outcomes, although a
substantial number of RHD patients required pacemaker implantation.
Further research is needed to assess long-term outcomes and to refine
patient selection criteria for TAVR in the context of RHD. Categories:
STRUCTURAL: Valvular Disease: Aortic<br/>Copyright &#xa9; 2023

<53>
Accession Number
2027762466
Title
TCT-131 The Influence of Transcatheter Aortic Valve Implantation on Left
Atrial Strain Mechanics: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B51-B52), 2023.
Date of Publication: 24 Oct 2023.
Author
Meredith T.; Brown L.; Roy D.; Feneley M.P.; Muller D.; Namasivayam M.
Institution
(Meredith, Roy, Feneley, Namasivayam) St Vincent's Hospital, Sydney, NSW,
Australia
(Brown) University of Sydney, Sydney, NSW, Australia
(Muller) St Vincent's Hospital, Darlinghurst, NSW, Australia
Publisher
Elsevier Inc.
Abstract
Background: The morphology and function of the left atrium (LA) is
intimately tied to left ventricular loading conditions. LA function,
measured with speckle-tracking echocardiography (STE), has been
demonstrated to provide independent prognostic information for a range of
cardiomyopathic states and valvular diseases. Data pertaining to the
effect of transcatheter aortic valve implantation (TAVI) on LA function
and geometry are scarce. As such, we sought to quantify these associations
by pooling available data from published observational studies.
<br/>Method(s): A systematic review and meta-analysis were performed.
Included studies needed to report serial LA strain data, quantified by
STE, before and after TAVI. Other outcome data of interest were LA area
and indexed volume (LAVi), as well as standard chamber measurements.
Outcomes were stratified by timing of follow-up echocardiography: early
(<6 mo) or late (>=6 mo). Where data were sufficiently homogeneous to
permit pooling and meta-analysis, differences were expressed as the mean
difference (MD) with 95% CI for continuous outcomes. The Hedges
random-effects model was used, which has utility in correcting for bias in
small sample sizes. <br/>Result(s): Eleven studies were included. The
pooled cohort was 934 patients. The median LVEF and AVA were 53.7% (IQR:
53.2%-59.5%) and 0.7 cm² (IQR: 0.68-0.73 cm²),
respectively. LA booster function predominantly recovered early (MD: 2.26;
P < 0.01) rather than late (MD: 1.41; P = 0.05). Pooled improvement in LA
booster function was 1.96% (95% CI: 1.11-2.8; P < 0.01). LA reservoir
function improved overall by a mean difference of 3.45% (95% CI:
1.27-5.62; P < 0.01), as well as when stratified by early (MD: 3.93%; P =
0.04) and late (MD: 2.88%; P = 0.02) follow-up. The mean overall reduction
in LAVi was 2.37 mL/kg following TAVI (95% CI: 0.97-3.78; P < 0.01),
although a significant change was seen only in the late, rather than
early, echo cohort. <br/>Conclusion(s): The afterload reduction afforded
by TAVI is associated with significant hemodynamic and morphologic
up-stream LA changes. The prognostic relevance of these findings requires
further investigation. Categories: STRUCTURAL: Valvular Disease:
Aortic<br/>Copyright &#xa9; 2023

<54>
Accession Number
2027762119
Title
TCT-258 Personalized, CT-Guided Antithrombotic Therapy Versus Lifelong
Single Antiplatelet Therapy to Reduce Thromboembolic and Bleeding Events
in Nonatrial Patients After Transcatheter Aortic Valve Replacement.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B101), 2023.
Date of Publication: 24 Oct 2023.
Author
Overduin D.; Jan van Ginkel D.; Delewi R.; Budde R.; Deneer V.; Motwani
M.; Berg J.T.
Institution
(Overduin) St. Antonius Hospital, Nieuwegein, Netherlands
(Jan van Ginkel) St. Antonius Hospital, Nieuwegein, Netherlands
(Delewi) Amsterdam University Medical Center, Amsterdam, Netherlands
(Budde) Erasmus Medical Center, Rotterdam, Netherlands
(Deneer) University Medical Center Utrecht, Utrecht, Netherlands
(Motwani) Manchester Heart Institute, Manchester, United Kingdom
(Berg) St. Antonius Hospital, Bilthoven, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Thromboembolic and bleeding events remain frequent after
transcatheter aortic valve replacement (TAVR). Although guidelines advise
lifelong single antiplatelet therapy (SAPT) after TAVR, it is unknown
whether this is beneficial for these elderly patients at high risk for
bleeding. Further, subclinical leaflet thrombosis (SCLT) is frequent under
antiplatelet therapy. <br/>Method(s): The POPular ATLANTIS (PersOnalized,
CT-guided antithrombotic theraPy versus lifelong single Antiplatelet
Therapy to reduce thromboemboLic And bleediNg evenTs In non-atrial
fibrillation patientS after transcatheter aortic valve implantation) is an
international, event-driven, randomized, clinical trial with open-label
treatment and blinded endpoint assessment. All patients are initially
treated according to standard care and will be randomized (1:1) 3 months
after TAVR to computed tomography (CT)-guided antithrombotic therapy
(intervention group) vs standard care (control group). In the intervention
group, patients undergo cardiac CT imaging at 3 months after TAVR for the
detection of SCLT. Patients with SCLT are switched from SAPT to apixaban,
and patients without SCLT discontinue SAPT (unless another indication for
antiplatelet therapy exists). In the control group, patients continue SAPT
without cardiac CT imaging. The co-primary endpoints consist of: 1)
thromboembolic events (cardiovascular death, stroke, transient ischemic
attack, myocardial infarction, systemic embolism, and clinically
significant valve thrombosis); and 2) bleeding (type 1-4 bleeding),
according to the VARC-3 criteria. Secondary endpoints include separate
components of the co-primary endpoints, bioprosthetic valve dysfunction,
quality of life, cognitive functioning, and medication adherence.
Recruitment is planned to start in autumn 2023. We expect to enroll
approximately 2,403 patients across Europe, who will be followed for a
median of 2 to 3 years for the primary analysis; enrollment will stop when
the predefined number of endpoints has been reached. <br/>Result(s): -
<br/>Conclusion(s): POPular ATLANTIS is the first randomized clinical
trial which evaluates whether a personalized, CT-guided strategy improves
efficacy and safety of antithrombotic therapy after TAVR. Categories:
ENDOVASCULAR: Aortic Disease and Aortic Intervention<br/>Copyright &#xa9;
2023

<55>
Accession Number
2027762108
Title
TCT-577 The Optimal Timing of Complete Revascularization in Heterogeneous
Cohorts With Multivessel Coronary Artery Disease: An Updated Meta-Analysis
of 116,730 Patients.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B231-B232),
2023. Date of Publication: 24 Oct 2023.
Author
AbdelAziz A.; Atta K.; Elsayed H.; Hamdaalah A.; Kadhim H.; Mechi A.;
Hafez A.; Elaraby A.; Ellabban M.; Bakr A.; Fadel A.; Ibrahim A.; Ezzat
M.; AbdelAziz M.; Nouh A.; Gaith H.; Suppah M.
Institution
(AbdelAziz) Faculty of Medicine, Al-Azhar University, El-Bagour, Egypt
(Atta) National Research Mordovia State University, Saransk, Russian
Federation
(Elsayed) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Hamdaalah) Damietta Faculty of Medicine, Al-Azhar University, Damietta,
Egypt
(Kadhim) College of Medicine, Al Muthanna University, Samawah, Iraq
(Mechi) Medicine College, University of Kufa, Internal Medicine
Department, Najaf, Iraq
(Hafez, Elaraby, Ellabban, AbdelAziz, Gaith) Al-Azhar University Faculty
of Medicine, Cairo, Egypt
(Bakr) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Fadel) Faculty of Medicine, Sohag University, Sohag, Egypt
(Ibrahim, Ezzat) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Nouh) Faculty of Medicine, Sohag University, Sohag, Egypt
(Suppah) Mayo Clinic, Phoenix, AZ, United States
Publisher
Elsevier Inc.
Abstract
Background: Complete revascularization (CR) in patients with multivessel
coronary disease (MVD) is associated with improved clinical outcomes;
however, the optimal timing of CR whether early or delayed remains
challenging. Therefore, this systematic review and meta-analysis aimed to
provide a comprehensive appraisal of the optimal timing of complete
revascularization in cohorts with MVD. <br/>Method(s): PubMed, Scopus, Web
of Science, and Cochrane library were retrieved from inception till April
2023. RCTs and observational studies that reported clinical outcomes of
participant scheduled for early or delayed CR were included. Dichotomous
data were pooled as odds ratio (OR) with its 95% confidence interval (CI)
using Der-Simonian Laired random-effect model. <br/>Result(s): A total of
48 trials comprising 116,730 patients were included in the analysis. Early
CR was favored to reduce the incidence of MACE (OR: 0.78; 95% CI:
0.69-0.88), all-cause death (OR: 0.81; 95% CI: 0.69-0.95), cardiac death
(OR: 0.7; 95% CI: 0.5-0.97), MI (OR: 0.75; 95% CI: 0.62-0.91), and repeat
revascularization (OR: 0.68; 95% CI: 0.59-0.79). However, no significant
difference was reported regarding the incidence of stroke, CIN, or major
bleeding. <br/>Conclusion(s): Early CR approach was superior to delayed
approach to reduce the incidence of MACE, all-cause and cardiac death, MI,
and repeat revascularization in heterogeneous patients with MVD; moreover,
these results should be validated in contemporary clinical practice.
Categories: CORONARY: Cardiac and Coronary Artery Surgery and Hybrid
Revascularization<br/>Copyright &#xa9; 2023

<56>
Accession Number
2027762070
Title
TCT-390 AI-Guided Assessment of Calcium Burden for Enhanced Risk
Stratification and Outcome Prediction in Severe Aortic Stenosis Patients
Undergoing Transcatheter Aortic Valve Replacement.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B155), 2023.
Date of Publication: 24 Oct 2023.
Author
Rouhollahi A.; Haltmeier S.; Javadikasgari H.; Farhat E.B.; Cruz K.D.L.;
Aikawa E.; Nezami F.
Institution
(Rouhollahi) Brigham and Women's Hospital, Belmont, Massachusetts, USA,
United States
(Haltmeier, Farhat, Cruz, Aikawa, Nezami) Brigham and Women's Hospital,
Boston, Massachusetts, USA, United States
(Javadikasgari) Brigham and Women's Hospital, Boston, Massachusetts, USA,
Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Aortic stenosis (AS) is a growing global health burden,
particularly among the elderly. Limited understanding exists regarding the
temporal and spatial progression of calcification in relation to disease
severity and intervention outcomes, highlighting the need for artificial
intelligence-guided approaches that intricately quantify calcium topology.
<br/>Method(s): Retrospective collection of CT images from 1,700
transcatheter aortic valve replacement patients between 2013 and 2022 was
conducted following our IRB protocol. Our deep learning tool generated
digital representations of the aortic root and calcified valve,
quantifying calcium distribution parameters (in axial, radial, and angular
directions) and leaflet-specific metrics. We evaluated the predictive
potential of these patient-specific metrics for post-transcatheter aortic
valve replacement permanent pacemaker placement using principal component
analysis and a support vector machine model. <br/>Result(s): We created
patient-specific geometries for 45 randomly selected severe AS patients
and successfully quantified spatial calcium distribution as
proof-of-concept (Figure 1). Significant correlations (P < 0.05) were
found between various spatial calcification metrics, such as calcium load
in the lower root, mean size of calcium across leaflets, and calcium
volume in the right leaflet, among others, with the outcome of permanent
pacemaker placement. [Formula presented] <br/>Conclusion(s): Spatial
calcification distribution, practically quantifiable with machine
learning, accurately correlates with post-intervention complications.
Personalized, data-driven approaches inform intervention planning and
procedural optimization, reducing adverse consequences and improving the
prosthetic valves design. Categories: STRUCTURAL: Valvular Disease:
Aortic<br/>Copyright &#xa9; 2023

<57>
Accession Number
2027762033
Title
TCT-180 Dual ProGlide Versus ProGlide and AngioSeal for Hemostasis at the
Femoral Access After Transcatheter Aortic Valve Replacement: A Randomized
Comparative Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B69-B70), 2023.
Date of Publication: 24 Oct 2023.
Author
Yeh C.-F.; Ko T.; Chen Y.-H.; Huang C.-C.; Hsien-Li Kao P.; Lin M.-S.
Institution
(Yeh, Ko, Chen, Huang, Hsien-Li Kao, Lin) National Taiwan University
Hospital, Taipei, Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Background: Vascular complications in transcatheter aortic valve
replacement (TAVR) are often relevant to the failure of vascular closure
device (VCD). We sought to compare dual Perclose ProGlide (PP) strategy vs
hybrid combination of PP and Angio-Seal (AS) for hemostasis at the femoral
access after TAVR. <br/>Method(s): A single-center randomized comparative
trial comparing dual PP vs 1 PP and 1 AS (AS+PP) for vascular closure
after TAVR was conducted. The primary endpoints consisted of access
site-related vascular complications and life-threatening, major, or minor
bleeding. Secondary endpoints included in-hospital serious vascular
complications, additional VCD use, and significant peripheral ischemia
related to arteriotomy closure within 1 year. Modified VCD failure,
defined as failure to achieve hemostasis within 5 minutes or requiring
additional endovascular maneuvers, also was determined. <br/>Result(s): A
total of 257 TAVR patients were included from March 2018 to April 2023.
There were higher rates of vascular complication (29.8% vs 18.2% in PP vs
AS+PP; P = 0.0381), additional VCD usage (19.0% vs 0.8%; P < 0.0001), and
modified VCD failure (33.1% vs 9.9%; P < 0.0001) in the dual PP group. In
addition, there was a trend of higher rate of vascular complications
requiring unplanned intervention in the dual PP group (25.6% vs 18.2%; P =
0.1712). Bleeding complication rates were similar in both groups. [Formula
presented] <br/>Conclusion(s): Hybrid combination of PP and AS for
hemostasis at the femoral access following TAVR had lower rates of
vascular complications, additional VCD usage, and modified VCD failure
than dual PP. Categories: VASCULAR ACCESS: Valvular Access:
Structural<br/>Copyright &#xa9; 2023

<58>
Accession Number
2027762012
Title
TCT-331 Cardiac Damage Staging Predicts Outcomes in Symptomatic and
Asymptomatic Aortic Valve Stenosis After Aortic Valve Replacement:
Meta-Analysis of Reconstructed Time-to-Event Data.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B132-B133),
2023. Date of Publication: 24 Oct 2023.
Author
Abdelfattah O.; Jacquemyn X.; Sa M.P.; Jneid H.; Sultan I.; Cohen D.;
Gillam L.; Clavel M.-A.; Pibarot P.; Kapadia S.; Leon M.; Genereux P.
Institution
(Abdelfattah) University of Texas Medical Branch, Friendswood, TX, United
States
(Jacquemyn) KU Leuven, Leuven, Belgium
(Sa) UPMC Heart and Vascular Institute, Pittsburgh, PA, United States
(Jneid) University of Texas Medical Branch, Galveston, TX, United States
(Sultan) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Cohen) St. Francis Hospital, New York, New York, United States
(Gillam) Morristown Medical Center, Morristown, NJ, United States
(Clavel) Institut Universitaire De Cardiologie Et De Pneumologie De
Quebec, Quebec, QC, Canada
(Pibarot) Quebec Heart and Lung Institute, Longueuil, QC, Canada
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Leon) NewYork-Presbyterian/Columbia University Irving Medical Center, New
York, New York, United States
(Genereux) Columbia University Medical Center/Hopital du Sacre-Coeur de
Montreal, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: The prognostic value of a new cardiac damage staging
classification based on the extent of extra-valvular damage has been
proposed in moderate/severe aortic stenosis (AS). <br/>Method(s): This is
a pooled meta-analysis of Kaplan-Meier-derived reconstructed time-to-event
data of studies published by February 2023. <br/>Result(s): In total, 16
studies (N = 14,499) met our eligibility criteria (12,282 patients with
symptomatic severe AS and 2,217 patients with asymptomatic moderate/severe
AS). For patients with symptomatic severe AS, all-cause mortality was
24.0%, 27.7%, 38.0%, 56.3%, and 57.3% at 5 years in patients with cardiac
damage stage 0, 1, 2, 3, and 4, respectively (Stage 0 as reference; HR in
Stage 1: 1.30 [95% CI: 1.03-1.64; P = 0.029]; Stage 2: 1.74 [95% CI:
1.41-2.16; P < 0.001]; Stage 3: 2.92 [95% CI: 2.35-3.64; P < 0.001]; and
Stage 4: 3.51 [95% CI: 2.79-4.41; P < 0.001]). For patients with
asymptomatic moderate/severe AS, all-cause mortality was 19.3%, 36.9%,
51.7%, and 67.8% at 8 years in patients with cardiac damage stage 0, 1, 2,
and 3 to 4, respectively (HR in Stage 1: 1.70 [95% CI: 1.21-2.38; P =
0.002]; Stage 2: 2.20 [95% CI: 1.60-3.02; P < 0.001]; and Stage 3-4: 3.90
[95% CI: 2.79-5.47; P < 0.001). [Formula presented] <br/>Conclusion(s):
This pooled meta-analysis in patients undergoing AVR suggests that staging
of baseline cardiac damage should be included in all patients with
moderate or severe AS to determine the need for earlier AVR or adjunctive
pharmacotherapy to prevent irreversible cardiac damage and improve
long-term prognosis. Categories: STRUCTURAL: Valvular Disease:
Aortic<br/>Copyright &#xa9; 2023

<59>
Accession Number
2027761250
Title
TCT-569 Balloon- vs Self-Expanding Valve Systems for Failed Small Surgical
Aortic Valve Bioprostheses: 1-Year Results of the LYTEN Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B228-B229),
2023. Date of Publication: 24 Oct 2023.
Author
Nuche J.; Abbas A.; Vilalta V.; Nombela-Franco L.; Regueiro A.; Al-Azizi
K.; Iskander A.; Conradi L.; Forcillo J.; Lilly S.; Goena A.C.; Mohammadi
S.; Giuliani C.; Pelletier-Beaumont E.; Pibarot P.; Rodes-Cabau J.
Institution
(Nuche) Institute Universitaire De Cardiologie Et De Pneumologie De
Quebec, Quebec, QC, Canada
(Abbas) William Beaumont Hospital, Birmingham, MI, United States
(Vilalta) Hospital Germans Trias I Pujol, Barcelona, Spain
(Nombela-Franco) Hospital Clinico San Carlos, Madrid, Spain
(Regueiro) Hospital Clinic Barcelona, Barcelona, Spain
(Al-Azizi) Baylor Scott & White The Heart Hospital - Plano, Plano, TX,
United States
(Iskander) SJH Cardiology Assos, Liverpool, New York, United States
(Conradi) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Forcillo) Centre Hospitalier L'universite De Mtl, Montreal, QC, Canada
(Lilly) Univ Penn, Philadelphia, PA, United States
(Goena) Vall d' Hebron Hospital, Barcelona, Spain
(Mohammadi) Quebec Heart & Lung Institute, Quebec, QC, Canada
(Giuliani) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec (IUCPQ), Quebec, QC, Canada
(Pelletier-Beaumont) Institut Universitaire de Cardiologie et de
Pneumologie de Quebec, Quebec, QC, Canada
(Pibarot) Quebec Heart and Lung Institute, Longueuil, QC, Canada
(Rodes-Cabau) University of Laval, Quebec, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: The LYTEN trial is the first randomized trial comparing
balloon-expandable valve (BEV) vs self-expandable valve (SEV) in
valve-in-valve transcatheter aortic valve replacement (ViV-TAVR). This
study aimed to determine the 1-year hemodynamic performance and clinical
outcomes of ViV-TAVR recipients included in the LYTEN trial.
<br/>Method(s): Patients with a failed small (<=23 mm) surgical valve
undergoing transarterial ViV-TAVR were randomized to receive a SEV (Evolut
R/PRO/PRO+, Medtronic) or a BEV (SAPIEN3/3 ULTRA, Edwards Lifesciences).
Patients were evaluated at 30-day and 1-year follow-up, including a
clinical status and Doppler echocardiography assessment. Study outcomes
were defined according to VARC-2 consensus. <br/>Result(s): A total of 98
patients (47% women, 80 +/- 7 years, STS 5.0% [3.7-7.2]) were included in
the study (46-BEV, 52-SEV). Baseline and procedural characteristics were
well balanced between groups. All TAVR procedures were successful with no
intra- or periprocedural deaths. At 1-year follow-up, there were no
differences between groups in mortality (BEV: 7%, SEV: 4%, P = 0.663),
heart failure hospitalization (BEV: 7%, SEV: 2%, P = 0.339), permanent
pacemaker implantation (BEV: 2%, SEV: 2%, P = 1.000), or
major/life-threatening bleeding (BEV: 15%, SEV: 6%, P = 0.182). None of
the patients had a disabling stroke during the study period. A similar
functional status was observed in both groups (NYHA functional class >II:
BEV: 5%, SEV: 4%, P = 1.000). Patients receiving a SEV presented lower
peak and mean transaortic gradients (peak: 41 +/- 15 mm Hg-BEV vs 27 +/-
14 mm Hg-SEV, P < 0.001; mean: 23 +/- 9 mm Hg-BEV vs 14 +/- 7 mm Hg-SEV, P
< 0.001) and a lower rate of severe patient-prosthesis mismatch (BEV: 67%,
SEV: 36%, P = 0.011). The rate of moderate-severe aortic regurgitation was
similar between groups (BEV: 3%, SEV: 0%; P = 0.471). The echo-based
parameters will be confirmed by core-lab analysis before their definitive
presentation and publication. <br/>Conclusion(s): In patients with small
failed aortic bioprostheses, ViV-TAVR with a SEV was associated with
better valve hemodynamics as evaluated by echocardiography at 1-year
follow-up. However, no differences were found between SEV and BEV groups
in terms of functional status or clinical outcomes. Categories:
STRUCTURAL: Valvular Disease: Aortic<br/>Copyright &#xa9; 2023

<60>
Accession Number
2027761191
Title
TCT-283 Does a Systematic Screening Approach Contribute to Unravel Novel
Risk Factors in Revascularization of Complex Coronary Artery Disease?.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B111-B112),
2023. Date of Publication: 24 Oct 2023.
Author
Kageyama S.; Ninomiya K.; Jonik S.; Masuda S.; Kotoku N.; Revaiah P.C.;
O'Leary N.; Onuma Y.; Serruys P.; Mazurek T.
Institution
(Kageyama, Onuma) National University of Ireland Galway, Galway, Ireland
(Ninomiya) National University of Ireland Galway, Galway, Ireland
(Jonik) Medical University of Warsaw, Warsaw, Poland
(Masuda, Kotoku) University of Galway, Galway, Ireland
(Revaiah) National University of Galway, Galway, Ireland
(O'Leary) National University of Ireland Galway, Galway, Ireland
(Serruys) University of Galway, Galway, Ireland
(Mazurek) Medical University of Warsaw, Warsaw, Poland
Publisher
Elsevier Inc.
Abstract
Background: In randomized control trials, established baseline risk
factors for patients with 3-vessel coronary artery disease and/or left
main disease play a key role in the selection of the revascularization
strategy, either percutaneous (percutaneous coronary intervention [PCI])
or surgical (coronary artery bypass grafting [CABG]), that may diverge
from the real clinical practice. This study aimed to assess whether the
systematic screening of baseline characteristics unravels novel and
registry-specific risk factors for long-term mortality. <br/>Method(s): In
1,035 consecutive 3-vessel coronary artery disease patients treated with
either PCI or CABG and followed up to 5 years (Polish registry), a LASSO
regression was used to screen all the 41 common baseline characteristics
documented in the SYNTAX trial and used prediction of 5-year death after
either PCI or CABG. After the screening, classical Cox regression analysis
was done to examine the suitability of the linear model for 5-year
mortality prediction. The same approach is taken in the SYNTAX trial for
comparison. The risk factors eventually remaining for risk prediction were
compared between the Polish registry and the SYNTAX trial. <br/>Result(s):
Five-year mortality in the Polish registry and in the SYNTAX trial was
comparable (12.3% vs 12.8%). However, in the Polish registry, pulmonary
hypertension, chronic obstructive pulmonary disease, and insulin-dependent
diabetes are outstanding risk factors in the prediction of 5-year
all-cause death while other risk factors are implicated in the SYNTAX
trial. For example, in the Polish registry, the anatomical SYNTAX score
was not an effective modifier of the mortality risk for PCI.
<br/>Conclusion(s): Deep learning approach potentially enables the
detection of specific risk registry of all-comer patients amenable to
surgical or percutaneous revascularization. Pulmonary hypertension with
chronic obstructive pulmonary disease is a novel and registry-specific
factor detected by LASSO regression in screening the baseline
characteristics of a Polish registry. The risk factors obtained from
randomized control trials are not necessarily the same as those detected
in real clinical practice when a systematic practice is applied.
Categories: CORONARY: Cardiac and Coronary Artery Surgery and Hybrid
Revascularization<br/>Copyright &#xa9; 2023

<61>
Accession Number
2027761152
Title
TCT-508 A Meta-Analysis on the Obesity Paradox in Patients Undergoing
Transcatheter Aortic Valve Replacement.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B204-B205),
2023. Date of Publication: 24 Oct 2023.
Author
Matzko N.; Chen S.; Berman E.; Ahmad Y.; Reisman M.; Madhavan M.
Institution
(Matzko) Weill Cornell, New York, NY, United States
(Chen) Weill Cornell New York-Presbyterian Hospital, New York, NY, United
States
(Berman) Weill Cornell, Yakima, WA, United States
(Ahmad) Yale School of Medicine, New Haven, CT, United States
(Reisman) NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY,
United States
(Madhavan) NYP/CUIMC, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Previous studies have reported an association between high
body mass index (BMI) and lower mortality risk in the settings of heart
failure and myocardial infarction. This observation, termed the obesity
paradox, has also been described in patients undergoing transcatheter
aortic valve replacement (TAVR) for the treatment of aortic stenosis. The
purpose of this meta-analysis was to examine the effect of high BMI on
mortality and other clinical outcomes related to TAVR. <br/>Method(s): We
searched PubMed and EMBASE databases for studies examining the
relationship between BMI and TAVR outcomes. Meta-analyses were performed
for studies reporting hazard (HR) and odds ratios (OR) with corresponding
confidence intervals (CI) in short- (30 days) and long-term outcomes.
<br/>Result(s): Seventeen studies (59,533 patients) were included in the
current study. Significant differences in 30-day mortality (OR: 0.76; 95%
CI: 0.65-0.90; Figure 1) and stroke (OR: 0.76; 95% CI: 0.65-0.89) were
observed between obese patients (BMI >30 kg/m²) and non-obese
patients. No differences were found in major vascular complications (OR:
0.98; 95% CI: 0.82-1.17), 30-day myocardial infarction (OR: 0.81; 95% CI:
0.62-1.06), major bleeding (OR: 1.06; 95% CI: 0.86-1.30), stage 2 or 3
acute kidney injury (OR: 1.18; 95% CI: 0.91-1.52), and new pacemaker
implantation (OR: 1.12; 95% CI: 0.95-1.32). [Formula presented]
<br/>Conclusion(s): Among patients undergoing TAVR, obesity was associated
with lower risk of short-term mortality and stroke. Categories:
STRUCTURAL: Valvular Disease: Aortic<br/>Copyright &#xa9; 2023

<62>
Accession Number
2027761122
Title
TCT-306 Impact of Cardiac Amyloidosis in Patients With Severe Aortic
Stenosis Undergoing Transcatheter and Surgical Aortic Valve Replacement: A
Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B122), 2023.
Date of Publication: 24 Oct 2023.
Author
Ahsan M.J.; Ahmad S.; Ghumman G.M.; Yousaf A.; Dvalishvili M.; Ahsan M.Z.;
Waqas H.; Srikanth S.; Goldsweig A.
Institution
(Ahsan) Iowa Heart Center, MercyOne, West Des Moines, IA, United States
(Ahmad) University of Nebraska Medical Center (UNMC/UNO), Omaha, NE,
United States
(Ghumman) Mercy Health Saint Vincent Medical Center, Toledo, OH, United
States
(Yousaf) McLaren Flint/Michigan State University, Flint, MI, United States
(Dvalishvili) East Carolina University, Greenville, NC, United States
(Ahsan) Fatima Memorial Hospital, Lahore, Pakistan
(Waqas) Icahn School of Medicine at Mount Sinai, New York, New York,
United States
(Srikanth) ECU Health, Greenville, NC, United States
(Goldsweig) Baystate Medical Center, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Data are limited regarding the prognostic implications of
cardiac amyloidosis (CA) in patients with severe aortic stenosis (AS) and
their outcomes with transcatheter and surgical aortic valve replacement
(TAVR and SAVR, respectively). <br/>Method(s): We conducted a systematic
database search for relevant studies using MEDLINE (PubMed), Embase,
Scopus, Cochrane CENTRAL, Conference Abstracts, and ClinicalTrials.com
through June 20, 2023. The primary outcome was long-term mortality.
Meta-analysis was performed using the random-effects Mantel-Haenszel
method, and pooled risk ratios (RRs) along with 95% CIs were calculated.
<br/>Result(s): Eleven studies with 2,209 patients were included. The mean
age was 80 years, and 38% were female. Patients with AS in the setting of
CA (AS-CA) had higher mortality compared with patients with AS alone (RR:
2.31; 95% CI: 1.35-3.94; P = 0.002; I² = 60%). TAVR was
associated with improved survival compared with conservative management
for AS-CA (RR: 0.45; 95% CI: 0.25-0.81; P = 0.008; I² = 0%),
and had a similar mortality risk as TAVR in patients with AS alone (RR:
1.41; 95% CI: 0.83-2.38; P = 0.20; I² = 34%). There was no
difference in survival between TAVR and SAVR for patients with AS-CA (RR:
0.37; 95% CI: 0.06-2.33; P = 0.29; I² = 0%). [Formula
presented] <br/>Conclusion(s): CA is associated with increased mortality
risk in patients with AS. TAVR in AS-CA resulted in improved survival
compared with conservative management. The survival benefit of TAVR in
AS-CA was similar to that of SAVR in AS-CA and of TAVR in AS alone. These
findings suggest that TAVR is a safe and effective treatment option for
patients with AS-CA. Categories: STRUCTURAL: Valvular Disease:
Aortic<br/>Copyright &#xa9; 2023

<63>
Accession Number
2027760874
Title
TCT-665 A Real-World Comparative Analysis of Surgical and Transcatheter
Approaches to Tricuspid Regurgitation.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B268), 2023.
Date of Publication: 24 Oct 2023.
Author
Gaspardone C.; Gramegna F.; Morosato M.; Vetrugno L.; Paci G.; Mula C.;
Fuga A.; Morciano D.A.; Rizza V.; Ancona F.; Denti P.; Buzzatti N.;
Agricola E.; Maisano F.; Godino C.
Institution
(Gaspardone, Gramegna, Morosato, Vetrugno, Mula, Fuga, Rizza, Ancona,
Agricola, Maisano, Godino) San Raffaele Hospital, Milan, Italy
(Paci) San Raffaele Hospital, Prato, Italy
(Morciano) IRCCS San Raffaele Scientific Institute, Milan, Italy
(Denti, Buzzatti) San Raffaele University Hospital, Milan, Italy
Publisher
Elsevier Inc.
Abstract
Background: The management of severe tricuspid regurgitation (TR) is
challenging. We aimed to compare the demographic traits, echocardiographic
features, and clinical outcomes of patients undergoing transcatheter
tricuspid valve repair (TTVR) versus those undergoing isolated surgical
tricuspid valve repair or replacement (STVR). <br/>Method(s): We conducted
a retrospective analysis of consecutive adult patients treated for severe
TR using TTVR or STVR at San Raffaele Hospital between 2017 and 2023.
Baseline and follow-up data were obtained from electronic health records
and through telephone interviews. <br/>Result(s): Among the 79 TTVR
patients and 80 STVR patients, the TTVR group was significantly older (76
years vs 65 years; P < 0.001), had higher prevalence of coronary artery
disease (31% vs 14%; P = 0.02) and atrial fibrillation (79% vs 57%; P =
0.007), and were more symptomatic (NYHA functional class III/IV, 59% vs
37%; P = 0.01). A higher TRI-SCORE was observed in the TTVR group (5.03 vs
3.04; P < 0.007). There was no significant difference in baseline TR
severity, however functional TR etiology was more common in the TTVR group
(86% vs 63%; P = 0.003). This cohort also exhibited worsened right
ventricle (RV) function and RV ventriculo-arterial coupling (TAPSE/PASP
<0.36, 35% vs 15%; P = 0.01). At a median follow-up of 1.14 years (IQR:
0.41-1.50 years), the primary endpoint incidence (including death, TV
surgery, or heart failure hospitalization) and mortality rates were
similar in both groups (HR for primary endpoint: 0.91; 95% CI: 0.50-1.65;
P = 0.75) (HR for death: 0.77; 95% CI: 0.33-1.84; P = 0.56). When we
employed a landmark analysis at the discharge time, STVR patients
experienced a 3-fold increase of in-hospital mortality rates (HR: 3.01;
95% CI: 0.62-14.46; P = 0.15), but a 3-fold decrease of postdischarge
mortality rates (HR: 0.29; 95% CI: 0.09-0.97; P = 0.04) when compared with
TTVR patients. <br/>Conclusion(s): This real-world retrospective study
underscores the different characteristics of patients between TTVR and
STVR. Despite a higher surgical risk and comorbidity burden among TTVR
patients, midterm clinical outcomes were similar to STVR. However,
large-scale randomized trials are required to validate these findings.
Categories: STRUCTURAL: Valvular Disease: Tricuspid<br/>Copyright &#xa9;
2023

<64>
Accession Number
2025973503
Title
Cardiac metastasis in uterine cervical cancer: Systematic review and case
report.
Source
Radiotherapy and Oncology. Conference: ESTRO 2023. Vienna Austria.
182(Supplement 1) (pp S1148), 2023. Date of Publication: May 2023.
Author
Simek I.; Kranz A.; Alina S.; Knoth J.; Vogele-Kadletz M.; Spannbauer A.;
Bergler-Klein J.; Widder J.; Schmid M.
Institution
(Simek, Kranz, Alina, Knoth, Widder, Schmid) Medical University of Vienna,
Radiooncology, Vienna, Austria
(Vogele-Kadletz) Medical University of Vienna, Cardiac Surgery, Vienna,
Austria
(Spannbauer) Medical University of Vienna, Cardiology, Vienna, Austria
(Bergler-Klein) Medical University of Vienna, Cadiology, Vienna, Austria
Publisher
Elsevier Ireland Ltd
Abstract
Purpose or Objective To present a systematic review - based on a case
report - on patients with cardiac metastasis from cervical cancer.
Materials and Methods A systematic literature search employing PRISMA
guidelines focused on case reports about cardiac metastases from cervical
cancer. PubMed was queried using the following search terms: (((*card* OR
heart) AND metast*) AND ((cervic* OR uter*) AND cancer)); Scopus, using
("cardiac metastasis" AND "cervical cancer"), Web of Science with
((TS=(uter* AND cervi*)) AND (TS=(card* AND metast*))), CENTRAL with
(Disease: cervical cancer/cervix cancer/cervix dysplasia/cervical
dysplasia/; Additional terms: card* metast*) and ClinicalTrials.gov via
"Disease: cervical cancer/cervix cancer/cervix dysplasia/cervical
dysplasia; Additional terms: card* metast*". Searches were conducted in
December 2019, an e-mail-alert was created for PubMed and Web of Science
that was followed until May 2022. Based on the search results, a title
search was conducted, followed by an abstract search and a full text
search. The search was supplemented by cross-referencing the cited
references of relevant papers. Results Eighty-one papers were identified
describing 86 cases in total. Cardiac metastasis occurred at all stages of
cervical cancer and in all age groups. Median time from initial diagnosis
to diagnosis of cardiac metastasis was 12 months, ranging from no time to
more than ten years. Dyspnea (69%), chest pain (31%), deteriorating
general condition and arrhythmias (both 11%) were the main reported
symptoms due to cardiac metastasis, whilst 9% of patients had no symptoms.
ECG findings were reported in 51 cases and were pathologic in 31 patients.
The cardiac mass was most frequently detected by transthoracic echography.
The most common tumor histology was squamous cell carcinoma. Chemotherapy
and surgical interventions were the main treatment modalities. Median time
of survival after diagnosis of cardiac metastasis was 3 months, with 14%
of patients surviving for more than 1 year and 21% of patients surviving
for less than a month. Of the cases with known survival time (n=63),
median survival was 5 months in patients who had cardiac surgery (n=25)
versus 2.5 months in those who had no cardiac surgery (n=38). [Figure
presented] Conclusion This largest review on cardiac metastases from
cervical cancer confirmed the heart as a very infrequent site of
metastasis. There are <100 cases described in the literature with very
poor prognosis and undefined clinical management.<br/>Copyright &#xa9;
2023 Elsevier B.V.

<65>
Accession Number
642479228
Title
Red Blood Cell Transfusion: 2023 AABB International Guidelines.
Source
JAMA. (no pagination), 2023. Date of Publication: 12 Oct 2023.
Author
Carson J.L.; Stanworth S.J.; Guyatt G.; Valentine S.; Dennis J.; Bakhtary
S.; Cohn C.S.; Dubon A.; Grossman B.J.; Gupta G.K.; Hess A.S.; Jacobson
J.L.; Kaplan L.J.; Lin Y.; Metcalf R.A.; Murphy C.H.; Pavenski K.;
Prochaska M.T.; Raval J.S.; Salazar E.; Saifee N.H.; Tobian A.A.R.;
So-Osman C.; Waters J.; Wood E.M.; Zantek N.D.; Pagano M.B.
Institution
(Carson) Department of Medicine, Rutgers Robert Wood Johnson Medical
School, New Brunswick, New Jersey
(Stanworth) Department of Haematology, Oxford University Hospitals NHS
Trust, Oxford, United Kingdom
(Stanworth) NHSBT, Oxford, United Kingdom
(Stanworth) Radcliffe Department of Medicine, University of Oxford,
Oxford, United Kingdom
(Stanworth) Department of Transfusion Medicine, NHS Blood and Transplant,
Oxford, United Kingdom
(Guyatt) Departments of Clinical Epidemiology and Biostatistics and
Medicine, McMaster University, Hamilton, Ontario, Canada
(Valentine) Department of Pediatrics, University of Massachusetts Chan
Medical School, Worcester, United Kingdom
(Dennis) Cochrane Injuries Group, London School of Hygiene and Tropical
Medicine, London, United Kingdom
(Bakhtary) Department of Laboratory Medicine, University of California,
San Francisco, Mexico
(Cohn, Zantek) Department of Laboratory Medicine and Pathology, University
of Minnesota, Minneapolis, United States
(Dubon) Patient partner
(Grossman) Department of Pathology and Immunology, Washington University
School of Medicine in St Louis, St Louis, MO, United States
(Gupta) Department of Pathology and Laboratory Medicine, Memorial Sloan
Kettering Cancer Center, NY, United States
(Hess) Departments of Anesthesiology and Pathology and Laboratory
Medicine, University of Wisconsin-Madison, Madison, United States
(Jacobson) Department of Pathology, New York University Grossman School of
Medicine, NY, United States
(Jacobson) NYC Health + Hospitals/Bellevue, NY, United States
(Kaplan) Department of Surgery, Division of Trauma, Surgical Critical Care
and Surgical Emergencies, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, United States
(Lin) Precision Diagnostics and Therapeutics Program, Sunnybrook Health
Sciences Centre, Department of Laboratory Medicine and Pathobiology,
University of Toronto, Toronto, ON, Canada
(Metcalf) Department of Pathology, University of Utah, Salt Lake City,
United States
(Murphy) Pathology Associates of Albuquerque, Albuquerque, NM, United
States
(Pavenski) Department of Laboratory Medicine and Pathobiology, University
of Toronto and St Michael's Hospital-Unity Health Toronto, Toronto, ON,
Canada
(Prochaska) Department of Medicine, University of Chicago, Chicago, IL,
United States
(Raval) Department of Pathology, University of New Mexico, Albuquerque,
United States
(Salazar) Department of Pathology and Laboratory Medicine, UT Health San
Antonio, San Antonio, TX, United States
(Saifee) Department of Laboratory Medicine and Pathology, Seattle
Children's Hospital, Seattle, WA, United States
(Tobian) Department of Pathology, Johns Hopkins University, Baltimore, MD,
Liberia
(So-Osman) Department of Unit Transfusion Medicine (UTG), Sanquin Blood
Bank, Amsterdam, Netherlands
(So-Osman) Department Hematology, Erasmus Medical Center, Rotterdam,
Netherlands
(Waters) Department of Anesthesiology and Perioperative Medicine,
University of Pittsburgh, Pittsburgh, PA, United States
(Wood) Department of Haematology, Monash University School of Public
Health and Preventive Medicine, Monash Health, Melbourne, VIC, Australia
(Pagano) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, United States
Abstract
Importance: Red blood cell transfusion is a common medical intervention
with benefits and harms. <br/>Objective(s): To provide recommendations for
use of red blood cell transfusion in adults and children. Evidence Review:
Standards for trustworthy guidelines were followed, including using
Grading of Recommendations Assessment, Development and Evaluation methods,
managing conflicts of interest, and making values and preferences
explicit. Evidence from systematic reviews of randomized controlled trials
was reviewed. <br/>Finding(s): For adults, 45 randomized controlled trials
with 20599 participants compared restrictive hemoglobin-based transfusion
thresholds, typically 7 to 8 g/dL, with liberal transfusion thresholds of
9 to 10 g/dL. For pediatric patients, 7 randomized controlled trials with
2730 participants compared a variety of restrictive and liberal
transfusion thresholds. For most patient populations, results provided
moderate quality evidence that restrictive transfusion thresholds did not
adversely affect patient-important outcomes. Recommendation 1: for
hospitalized adult patients who are hemodynamically stable, the
international panel recommends a restrictive transfusion strategy
considering transfusion when the hemoglobin concentration is less than 7
g/dL (strong recommendation, moderate certainty evidence). In accordance
with the restrictive strategy threshold used in most trials, clinicians
may choose a threshold of 7.5 g/dL for patients undergoing cardiac surgery
and 8 g/dL for those undergoing orthopedic surgery or those with
preexisting cardiovascular disease. Recommendation 2: for hospitalized
adult patients with hematologic and oncologic disorders, the panel
suggests a restrictive transfusion strategy considering transfusion when
the hemoglobin concentration is less than 7 g/dL (conditional
recommendations, low certainty evidence). Recommendation 3: for critically
ill children and those at risk of critical illness who are hemodynamically
stable and without a hemoglobinopathy, cyanotic cardiac condition, or
severe hypoxemia, the international panel recommends a restrictive
transfusion strategy considering transfusion when the hemoglobin
concentration is less than 7 g/dL (strong recommendation, moderate
certainty evidence). Recommendation 4: for hemodynamically stable children
with congenital heart disease, the international panel suggests a
transfusion threshold that is based on the cardiac abnormality and stage
of surgical repair: 7 g/dL (biventricular repair), 9 g/dL
(single-ventricle palliation), or 7 to 9 g/dL (uncorrected congenital
heart disease) (conditional recommendation, low certainty evidence).
<br/>Conclusions and Relevance: It is good practice to consider overall
clinical context and alternative therapies to transfusion when making
transfusion decisions about an individual patient.

<66>
Accession Number
642479175
Title
Exploring the effect of music therapy as intervention to reduce anxiety
pre- and post-operatively in CABG surgery: A quantitative systematic
review.
Source
Nursing open. (no pagination), 2023. Date of Publication: 12 Oct 2023.
Author
Wu L.; Yao Y.
Institution
(Wu) Cardiac Care Unit, First Affiliated Hospital of Shantou University
Medical College, Shantou, Guangdong, China
(Yao) Oncology Department, Guangdong Clifford Hospital, Guangzhou,
Guangdong, China
Abstract
AIM: Patients undergoing coronary artery bypass graft (CABG) surgery may
experience psychological complications, which can increase mortality. This
review aims to explore the efficacy of music therapy as an intervention to
reduce anxiety pre- and post-operatively in CABG surgery. DESIGN: This was
a quantitative systematic review registered in PROSPERO (REDACTED).
<br/>METHOD(S): This review used the PECOD framework to identify
quantitative questions. We systematically searched seven electronic
databases (Cochrane Central Register of Controlled Trials, CINAHL,
MEDLINE, PubMed, Embase, PsycArticles, and PsycInfo) for articles
published between 1 January 1992 and 13 July 2022. Studies were critically
appraised, and the results of this systematic review yielded a narrative
summary of the findings. <br/>RESULT(S): Four randomized control trials
and one quasi-experimental study published in English were included in the
review. Narrative analysis indicated that patients undergoing CABG who
were assigned to the group receiving music therapy reported significantly
reduced anxiety levels compared with controls who did not listen to music.
In addition, music therapy can effectively be used as a
non-pharmacological intervention to manage anxiety pre- and
post-operatively in CABG surgery. No members of the public or patients
were involved in the design or conduct of the study.<br/>Copyright &#xa9;
2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.

<67>
Accession Number
642476674
Title
Systemic Therapy for Small-Cell Lung Cancer: ASCO-Ontario Health (Cancer
Care Ontario) Guideline.
Source
Journal of clinical oncology : official journal of the American Society of
Clinical Oncology. (pp JCO2301435), 2023. Date of Publication: 11 Oct
2023.
Author
Khurshid H.; Ismaila N.; Bian J.; Dabney R.; Das M.; Ellis P.; Feldman J.;
Hann C.; Kulkarni S.; Laskin J.; Manochakian R.; Mishra D.R.; Preeshagul
I.; Reddy P.; Saxena A.; Weinberg F.; Kalemkerian G.P.
Institution
(Khurshid) Brown University, Providence, RI, United States
(Ismaila) American Society of Clinical Oncology (ASCO), Alexandria, VA
(Bian) Maine Health, South Portland, ME, United States
(Dabney) Texas Oncology, Grapevine, TX, United States
(Das) Stanford University, Stanford, CA, United States
(Ellis) Juravinski Cancer Center, Hamilton Health Sciences, Hamilton,
Ontario, Canada
(Feldman) EGFR Resisters Patient Advocacy Group, Deerfield, IL, United
States
(Hann) Johns Hopkins University, Baltimore, MD, Liberia
(Kulkarni) Western University, Windsor Regional Cancer Program, Windsor,
ON, Canada
(Laskin) University of British Columbia, Vancouver, BC, Canada
(Manochakian) Mayo Clinic, Jacksonville, FL, Puerto Rico
(Mishra) KathmanduNepal
(Preeshagul) Memorial Sloan Kettering Cancer Center, Montvale, NJ, United
States
(Reddy) Cancer Center of Kansas, Wichita, KS, United States
(Saxena) Weill Cornell Medicine, New York, NY
(Weinberg) University of Illinois, Chicago, IL, United States
(Kalemkerian) University of Michigan, Ann Arbor, MI, United States
Abstract
PURPOSE: To provide evidence-based recommendations to practicing
clinicians on the management of patients with small-cell lung cancer.
<br/>METHOD(S): An Expert Panel of medical oncology, thoracic surgery,
radiation oncology, pulmonary, community oncology, research methodology,
and advocacy experts were convened to conduct a literature search, which
included systematic reviews, meta-analyses, and randomized controlled
trials published from 1990 through 2022. Outcomes of interest included
response rates, overall survival, disease-free survival or recurrence-free
survival, and quality of life. Expert Panel members used available
evidence and informal consensus to develop evidence-based guideline
recommendations. <br/>RESULT(S): The literature search identified 95
relevant studies to inform the evidence base for this guideline.
RECOMMENDATIONS: Evidence-based recommendations were developed to address
systemic therapy options, timing of therapy, treatment in patients who are
older or with poor performance status, role of biomarkers, and use of
myeloid-supporting agents in patients with small-cell lung
cancer.Additional information is available at
www.asco.org/thoracic-cancer-guidelines.

<68>
Accession Number
642479971
Title
Chronic systemic glucocorticoid therapy is associated with increased risk
of major vascular complications and cardiac tamponade after transcatheter
aortic valve implantation: a systematic review and meta-analysis.
Source
Minerva cardiology and angiology. (no pagination), 2023. Date of
Publication: 12 Oct 2023.
Author
Chiabrando J.G.; Lombardi M.; Seropian I.M.; Valle Raleigh J.M.; Vergallo
R.; Larribau M.; Agatiello C.R.; Trani C.; Burzotta F.
Institution
(Chiabrando) Unit of Interventional Cardiology, Italian Hospital of Buenos
Aires, Buenos Aires, Argentina
(Chiabrando) Unit of Interventional Cardiology, Spanish Hospital of
Mendoza, Mendoza, Argentina
(Lombardi, Trani, Burzotta) Department of Cardiovascular Sciences, IRCCS
A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic
University, Rome, Italy
(Lombardi, Vergallo) Department of Internal Medicine and Medical
Specialties (DIMI), University of Genoa, Genoa, Italy
(Seropian, Valle Raleigh, Agatiello) Unit of Interventional Cardiology,
Italian Hospital of Buenos Aires, Buenos Aires, Argentina
(Vergallo) Cardiothoracic and Vascular Department (DICATOV), IRCCS San
Martino Polyclinic Hospital, Genoa, Italy
(Larribau) Unit of Interventional Cardiology, Spanish Hospital of Mendoza,
Mendoza, Argentina
Abstract
INTRODUCTION: TAVI-related complications, such as conduction disturbances,
vascular complications or death may be related to increased inflammatory
response. The aim of this study was to elucidate the efficacy and safety
of the systemic glucocorticoid therapy regarding the adverse events after
TAVI deployment. EVIDENCE ACQUISITION: We conducted a systemic search of
PubMed, a reference list of relevant articles, and Medline. The main
efficacy outcomes of interest were all-cause death, cardiac and
non-cardiac death, permanent pacemaker implantation (PPM), new left bundle
branch block (LBBB), stroke, and myocardial infarction (MI). Safety
endpoints were major vascular complications, major bleeding events, and
cardiac tamponade. EVIDENCE SYNTHESIS: A total of 7 studies including data
from 3439 patients with a median follow-up was 30 days. Systemic
glucocorticoid compared to the control group were associated with an
increased risk of non-cardiac death (Relative Risk [RR] 5.90 95%CI [2.95;
11.80], P<0.001) major vascular complications (RR 1.78, 95%CI [1.22 -
2.61], P=0.003) and cardiac tamponade (RR 3.42, 95%CI [1.69 - 6.92],
P<0.001). However, there were no differences in all-cause death, cardiac
death, new LBBB, stroke, MI, or major bleeding events (all P values
>0.05). <br/>CONCLUSION(S): Glucocorticoid therapy before the TAVI
procedure was associated with an increase in non-cardiac death, major
vascular events and cardiac tamponade. There were no differences in the
risk of all-cause death, cardiac death, PPM or LBBB, stroke, or MI.

<69>
Accession Number
642505325
Title
Oral Anticoagulation versus Antiplatelet Treatment after Mitral Valve
Repair: a Systematic Review and Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 12 Oct 2023.
Author
Tomsic A.; Zhao C.; Schoones J.W.; Klautz R.J.M.; Palmen M.
Institution
(Tomsic) Department of Cardiothoracic Surgery, Leiden University Medical
Centre, Leiden, Netherlands
(Zhao, Klautz, Palmen) Department of Cardiothoracic Surgery, Leiden
University Medical Centre, Leiden, Netherlands
(Schoones) Directorate of Research Policy, Leiden University Medical
Centre, Leiden, Netherlands
Abstract
BACKGROUND: Oral anticoagulation with vitamin K antagonists (VKA) is
currently advised for a period of three months following surgical mitral
valve repair, regardless of the rhythm status. The evidence supporting
this recommendation is weak and recent studies have challenged the safety
and efficacy of this recommendation. A systematic review of literature was
conducted by searching PubMed, Embase, Web of Science, Emcare and Cochrane
Library databases for original publications comparing the efficacy and
safety of oral anticoagulation with vitamin K antagonists to antiplatelet
treatment early after mitral valve surgery in patients with no atrial
fibrillation. Study endpoints included thromboembolic complications,
bleeding complications and survival. A total of five studies, including
5093 patients, met the inclusion criteria; 2824 patients were included in
the oral anticoagulation and 2269 in the on antiplatelet treatment group.
Pooled analyses demonstrated no beneficial effect of oral anticoagulation
on the incidence of thromboembolic complications (risk ratio 1.14, 95%
confidence interval 0.76-1.70, P=0.53, I2=8%). Moreover, oral
anticoagulation did not result in a significantly increased risk of
bleeding complications (risk ratio 0.89, 95% confidence interval 0.32 -
2.44, P=0.81, I2=87%). When combining the efficacy and safety endpoints,
no difference was observed between groups (risk ratio 1.01, 95% confidence
interval 0.51-1.97, P=0.99 I2=85%). Likewise, mortality did not differ
between groups (risk ratio 0.89, 95% confidence interval 0.15-5.23, P=0.90
I2=71%). Our results confirmed the safety but failed to confirm the
efficacy of oral anticoagulation in patients undergoing mitral valve
surgery. A randomized controlled trial would provide the evidence needed
to support treatment recommendations.<br/>Copyright &#xa9; 2023 The
Author(s). Published by Elsevier Inc. All rights reserved.

<70>
Accession Number
642504817
Title
Dual antiplatelet management in the perioperative period: updated and
expanded systematic review.
Source
Systematic reviews. 12(1) (pp 197), 2023. Date of Publication: 14 Oct
2023.
Author
Premji A.M.; Blegen M.B.; Corley A.M.; Ulloa J.; Booth M.S.; Begashaw M.;
Larkin J.; Shekelle P.; Girgis M.D.; Maggard-Gibbons M.
Institution
(Premji, Blegen, Ulloa, Begashaw, Shekelle, Girgis, Maggard-Gibbons)
Veterans Health Administration, Greater Los Angeles Healthcare System,
11301 Wilshire Blvd., Los Angeles, CA 90073, United States
(Blegen) National Clinician Scholars Program, University of California,
1100 Glendon Ave. ,Suite 900, Los Angeles, CA 90024, United States
(Corley) Duke University School of Medicine, DUMC Box 104002, Durham, NC
27710, United States
(Ulloa, Girgis, Maggard-Gibbons) David Geffen School of Medicine at
University of California, 885 Tiverton Dr., Los Angeles, CA 90095, United
States
(Booth, Larkin) Southern California Evidence-Based Practice Center, RAND
Corporation, 1776 Main Street, Santa Monica, CA 90401, United States
Abstract
BACKGROUND: Antiplatelet agents are central in the management of vascular
disease. The use of dual antiplatelet therapy (DAPT) for the management of
thromboembolic complications must be weighed against bleeding risk in the
perioperative setting. This balance is critical in patients undergoing
cardiac or non-cardiac surgery. The management of patients on DAPT for any
indication (including stents) is not clear and there is limited evidence
to guide decision-making. This review summarizes current evidence since
2015 regarding the occurrence of major adverse events associated with
continuing, suspending, or varying DAPT in the perioperative period.
<br/>METHOD(S): A research librarian searched PubMed and Cochrane from
November 30, 2015 to May 17, 2022, for relevant terms regarding adult
patients on DAPT for any reason undergoing surgery, with a perioperative
variation in DAPT strategy. Outcomes of interest included the occurrence
of major adverse cardiac events, major adverse limb events, all-cause
death, major bleeding, and reoperation. We considered withdrawal or
discontinuation of DAPT as stopping either aspirin or a P2Y12 inhibitor or
both agents; continuation of DAPT indicates that both drugs were given in
the specified timeframe. <br/>RESULT(S): Eighteen observational studies
met the inclusion criteria. No RCTs were identified, and no studies were
judged to be at low risk of bias. Twelve studies reported on CABG.
Withholding DAPT therapy for more than 2 days was associated with less
blood loss and a slight trend favoring less transfusion and surgical
re-exploration. Among five observational CABG studies, there were no
statistically significant differences in patient death across DAPT
management strategies. Few studies reported cardiac outcomes. The
remaining studies, which were about procedures other than exclusively
CABG, demonstrated mixed findings with respect to DAPT strategy, bleeding,
and ischemic outcomes. <br/>CONCLUSION(S): The evidence base on the
benefits and risks of different perioperative DAPT strategies for patients
with stents is extremely limited. The strongest signal, which was still
judged as low certainty evidence, is that suspension of DAPT for greater
than 2 days prior to CABG surgery is associated with less bleeding,
transfusions, and re-explorations. Different DAPT strategies' association
with other outcomes of interest, such as MACE, remains uncertain.
SYSTEMATIC REVIEW REGISTRATION: A preregistered protocol for this review
can be found on the PROSPERO International Prospective Register of
systematic reviews ( http://www.crd.york.ac.uk/PROSPERO/ ; registration
number: CRD42022371032).<br/>Copyright &#xa9; 2023. BioMed Central Ltd.,
part of Springer Nature.

<71>
[Use Link to view the full text]
Accession Number
642501067
Title
Comparing the effectiveness of single-lumen high-frequency positive
pressure ventilation with double-lumen endobronchial tube for the
anesthesia management of endoscopic thoracic sympathetic blockade surgery.
Source
Medicine. 102(41) (pp e35315), 2023. Date of Publication: 13 Oct 2023.
Author
Akaslan I.; Koc S.
Institution
(Akaslan) Department of Thoracic Surgery, Biruni University, Istanbul,
Turkey
(Koc) Department of Anesthesiology and Reanimation, Biruni University,
Istanbul, Turkey
Abstract
OBJECTIVES: In this trial, we aimed to compare anesthetic effectiveness of
single lumen tube (SLT) for tracheal intubation with high-frequency
positive pressure ventilation (HFPPV) versus classic double lumen tube
(DLT) for tracheal intubation in endoscopic thoracic sympathetic blockade
surgery. DESIGN: This was a prospective randomized controlled clinical
study. SETTING: The study was single-centered and conducted in a
university hospital. PARTICIPANTS: There were 135 endoscopic thoracic
sympathetic blockade patients in this study. INTERVENTIONS: The patients
were randomly allocated either to DLT (n = 67) or SLT (n = 68) groups. In
SLT group, the ventilator setting was kept with frequencies that range
from 1 to 1.8 Hz (60-110/min). Data regarding anesthesia duration, surgery
duration, difficult intraoperative lung deflation, postoperative
atelectasis, postoperative pain, postoperative pneumothorax were recorded
and compared. All patients were operated by a single experienced surgeon
under general anesthesia provided by the same anesthesia team.
MEASUREMENTS AND MAIN RESULTS: Both groups were age and gender matched.
Among all recorded variables, only anesthesia time was found to be close
to statistical significance (P = .059, favoring single lumen). All other
parameters were found to be similar between groups. (P < .05).
<br/>CONCLUSION(S): We reported that DLT and single lumen tracheal
intubation were equally effective for lung deflation during surgery, and
SLT with HFPPV ventilation mode during endoscopic thoracic sympathetic
blockade surgery provided the surgeon with an adequate and clean workspace
with shorter onset of anesthesia. We may suggest the HFPPV technique for
uncomplicated surgery groups or where sufficient conditions for DLT cannot
be provided in the operating room.<br/>Copyright &#xa9; 2023 the
Author(s). Published by Wolters Kluwer Health, Inc.

<72>
Accession Number
642500711
Title
Hemolysis and cardiopulmonary bypass: meta-analysis and systematic review
of contributing factors.
Source
Journal of cardiothoracic surgery. 18(1) (pp 291), 2023. Date of
Publication: 13 Oct 2023.
Author
Bhirowo Y.P.; Raksawardana Y.K.; Setianto B.Y.; Sudadi S.; Tandean T.N.;
Zaharo A.F.; Ramsi I.F.; Kusumawardani H.T.; Triyono T.
Institution
(Bhirowo, Sudadi) Department of Anesthesiology and Intensive Care, Faculty
of Medicine, Public Health and Nursing, Dr. Sardjito General Hospital,
Universitas Gadjah MadaJl. Kesehatan No. 1 ,Sekip Utara, Yogyakarta 55281,
Indonesia
(Raksawardana, Tandean, Ramsi, Kusumawardani) Faculty of Medicine, Public
Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(Setianto) Department of Cardiology, Faculty of Medicine, Public Health
and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada,
Yogyakarta, Indonesia
(Zaharo) Department of Ophthalmology, Faculty of Medicine, Public Health
and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada,
Yogyakarta, Indonesia
(Triyono) Department of Clinical Pathology and Laboratory Medicine,
Faculty of Medicine, Public Health and Nursing, Dr. Sardjito General
Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
Abstract
BACKGROUND: The use of cardiopulmonary bypass (CPB) is almost inevitable
in cardiac surgery. However, it can cause complications, including
hemolysis. Until now, there have not been any standards for reducing
hemolysis from CPB. Therefore, this systematic review was conducted to
determine the factors that increase or reduce hemolysis in the use of CPB.
<br/>METHOD(S): Keywords Earches (cardiac surgery AND cardiopulmonary
bypass AND hemolysis) were done on PubMed databases and Cochrane CENTRAL
from 1990-2021 for published randomized controlled trials (RCTs) that
studied interventions on CPB, in cardiac surgery patients, and measured
hemolysis as one of the outcomes. Studies involving patients with
preoperative hematological disorders, prosthetic valves, preoperative use
of intra-aortic balloon pumps and extracorporeal circulation, emergency
and minimally invasive surgery are excluded RESULTS: The search yielded 64
studies that met the inclusion criteria, which involved a total of 3,434
patients. The most common surgery was coronary revascularization (75%).
Out of 64 studies, 33 divided into 7 analyses. Remaining 31 studies were
synthesized qualitatively. Significant decreases were found in centrifugal
vs roller pumps for PFHb (p=0.0006) and Hp (p<0.0001) outcomes, separated
vs combined suctioned blood (p=0.003), CPB alternatives vs conventional
CPB (p<0.0001), and mini extracorporeal circulation (MiniECC) vs
conventional CPB for LDH (p=0.0008). Significant increases were found in
pulsatility (p=0.03) and vacuum-assisted venous drainage (VAVD) vs
gravity-assisted venous drainage (GAVD) (p=0.002). <br/>CONCLUSION(S): The
review shows that hemolysis could be caused by several factors and efforts
have been made to reduce it, combining significant efforts could be
beneficial. However, this review has limitations, such as heterogeneity
due to no standards available for conducting CPB. Therefore, further
research with standardized guidelines for CPB is needed to yield more
comparable studies. Meta-analyses with more specific parameters should be
done to minimize heterogeneity.<br/>Copyright &#xa9; 2023. BioMed Central
Ltd., part of Springer Nature.

<73>
Accession Number
642495400
Title
Valve-Sparing Aortic Root Replacement With Reimplantation vs Remodeling: A
Meta-analysis.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 19 Sep 2023.
Author
Sa M.P.; Jacquemyn X.; Awad A.K.; Brown J.A.; Chu D.; Serna-Gallegos D.;
Kari F.A.; Sultan I.
Institution
(Sa) Department of Cardiothoracic Surgery, University of Pittsburgh,
Pittsburgh, Pennsylvania; UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address:
michel_pompeu@yahoo.com.br
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Brown, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, Pennsylvania; UPMC Heart and
Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh,
Pennsylvania
(Kari) Section of Pediatric and Congenital Cardiac Surgery, European
Pediatric Heart Center, Ludwig Maximilian University (LMU) University
Hospital and German Heart Center, Munich, Germany
Abstract
BACKGROUND: Long-term outcomes of valve-sparing aortic root replacement
(VSARR) with reimplantation vs remodeling in patients undergoing aortic
root surgery remains a controversial subject. <br/>METHOD(S): This study
was a pooled meta-analysis of Kaplan-Meier-derived data from comparative
studies published by December 31, 2022. <br/>RESULT(S): Fifteen studies
met our eligibility criteria, comprising 3044 patients (1991 in the
reimplantation group and 2018 in the remodeling group). Patients who
underwent VSARR with remodeling had a higher risk of all-cause death
(hazard ratio [HR], 1.54; 95% CI, 1.16-2.03; P = .002, log-rank test P <
.001). Landmark analysis (with 4 years as the landmark time point)
demonstrated that survival was lower in patients who underwent VSARR with
remodeling (HR, 2.15; 95% CI, 1.43-3.24; P < .001) in the first 4 years.
Beyond the 4-year time point, no difference in survival was observed (HR,
1.04; 95% CI, 0.72-1.50; P = .822). The risk for need of aortic valve
and/or root reintervention was higher in patients undergoing VSARR with
remodeling (HR, 1.49; 95% CI, 1.07-2.07; P = .019, log-rank test P <
.001). We did not find statistically significant coefficients for the
covariates of age, female sex, connective tissue disorders, bicuspid
aortic valve, aortic dissection, coronary bypass surgery, total arch
replacement, or annular stabilization, which means that these covariates
did not modulate the effects observed in our pooled analyses.
<br/>CONCLUSION(S): VSARR with reimplantation is associated with better
overall survival and lower risk of need for reintervention over time
compared with VSARR with remodeling. Regarding overall survival, we
observed a time-varying effect that favored the reimplantation technique
up to 4 years of follow-up, but not beyond this time point.<br/>Copyright
&#xa9; 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc.
All rights reserved.

<74>
Accession Number
642489787
Title
Systematic review of physiological and psychological outcomes of surgery
for pectus excavatum supporting commissioning of service in the UK.
Source
BMJ open respiratory research. 10(1) (no pagination), 2023. Date of
Publication: 01 Oct 2023.
Author
Walsh J.; Walsh R.; Redmond K.
Institution
(Walsh, Walsh) Department of Cardiothoracic Surgery, Fiona Stanley
Hospital, Murdoch, WA, Australia
(Redmond) Cardiothoracic Surgery, Mater Misericordiae University Hospital,
Dublin, Ireland
Abstract
BACKGROUND: Pectus excavatum (PEx) is the most common congenital chest
wall abnormality affecting 1 in 400 births in the UK. PEx is associated
with significant physiological and psychological impairment. While readily
surgically correctable, the benefits that surgery can bring have been
debated and proven difficult to objectively measure. In the UK, this has
led to the decommissioning of PEx surgery. The aim of this review is to
conduct a systematic search of the literature on PEx surgery to assess
physiological and psychological outcomes. <br/>METHOD(S): A systematic
review of the MEDLINE (PubMed), Embase and Cochrane databases was
performed. Articles were sought which included patients undergoing surgery
for PEx and reported on changes in cardiopulmonary measures, symptoms,
quality of life and psychological assessments before and after surgical
repair. Last search was performed in July 2022 and relevant findings were
synthesised by narrative review. <br/>RESULT(S): Fifty-one articles were
included in qualitative synthesis, with 34 studies relating to
physiological outcomes and 17 studies relating to psychological and
quality of life measures. Twenty-one studies investigated pulmonary
function at rest. There was no change in forced vital capacity or forced
expiratory volume in 1 second following open repair and transient
reductions followed closed repair. In the 11 studies investigating
echocardiography, transthoracic rarely demonstrated cardiac compression;
however, transoesophageal demonstrated intraoperative relief in cardiac
compression in severe cases. Sixteen studies investigated exercise testing
(cardiopulmonary exercise testing, CPET), 12 of which demonstrated
significant improvement following surgery, both in maximal oxygen
consumption and oxygen pulse. Seventeen studies investigated quality of
life, all but one of which showed improvement following repair of PEx. All
papers that reported on patient satisfaction following surgery found high
rates, between 80% and 97%. DISCUSSION: While the majority of studies to
date have been small and data heterogeneous, the literature shows that for
many patients with PEx, there exists a cardiopulmonary limitation that
while difficult to objectify, is likely to improve with surgical repair.
Resting parameters offer little yield in aiding this except in the most
severe cases. CPET therefore offers a better option for dynamic assessment
of this limitation and improvements following repair. Surgery
significantly improves psychological well-being and quality of life for
patients with PEx.<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.

<75>
Accession Number
2023775539
Title
Opioid-free anesthesia versus opioid-based anesthesia in patients
undergoing cardiovascular and thoracic surgery: a meta-analysis and
systematic review.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 27(3) (pp 162-170),
2023. Date of Publication: September 2023.
Author
Mathew D.M.; Fusco P.J.; Varghese K.S.; Awad A.K.; Vega E.; Mathew S.M.;
Polizzi M.; George J.; Mathew C.S.; Thomas J.J.; Calixte R.; Ahmed A.
Institution
(Fusco, Varghese, Vega, Mathew, Polizzi, Mathew, Thomas, Ahmed) CUNY
School of Medicine, New York, NY, United States
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
(Calixte) Epidemiology and Biostatistics, SUNY Downstate Health Sciences
University, Brooklyn, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Despite their extensive clinical use, opioids are
characterized by several side effects. These complications, coupled with
the ongoing opioid epidemic, have favored the rise of
opioid-free-anesthesia (OFA). Herein, we perform the first pairwise
meta-analysis of clinical outcomes for OFA vs opioid-based anesthesia
(OBA) in patients undergoing cardiovascular and thoracic surgery.
<br/>Method(s): We comprehensively searched medical databases to identify
studies comparing OFA and OBA in patients undergoing cardiovascular or
thoracic surgery. Pairwise meta-analysis was performed using the
Mantel-Haenszel method. Outcomes were pooled as risk ratios (RR) or
standard mean differences (SMD) and their 95% confidence intervals (95%
CI). <br/>Result(s): Our pooled analysis included 919 patients (8
studies), of whom 488 underwent surgery with OBA and 431 with OFA. Among
cardiovascular surgery patients, compared to OBA, OFA was associated with
significantly reduced post-operative nausea and vomiting (RR, 0.57; P
=.042), inotrope need (RR.84, P =.045), and non-invasive ventilation
(RR,.54; P =.028). However, no differences were observed for 24hr pain
score (SMD, -.35; P =.510) or 48hr morphine equivalent consumption (SMD,
-1.09; P =.139). Among thoracic surgery patients, there was no difference
between OFA and OBA for any of the explored outcomes, including
post-operative nausea and vomiting (RR, 0.41; P =.025).
<br/>Conclusion(s): Through the first pooled analysis of OBA vs OFA in a
cardiothoracic-exclusive cohort, we found no significant difference in any
of the pooled outcomes for thoracic surgery patients. Although limited to
2 cardiovascular surgery studies, OFA was associated with significantly
reduced postoperative nausea and vomiting, inotrope need, and non-invasive
ventilation in these patients. With growing use of OFA in invasive
operations, further studies are needed to assess their efficacy and safety
in cardiothoracic patients.<br/>Copyright &#xa9; The Author(s) 2023.

<76>
Accession Number
2013604779
Title
Use of the helical SUPERATM stent and Passeo-18 LuxTM drug-coated balloon
to treat recurrent cephalic arch stenosis for dysfunctional
brachiocephalic fistulas: 1 year results of the Arch V SUPERA-LUX study.
Source
Journal of Vascular Access. 24(4) (pp 591-598), 2023. Date of Publication:
July 2023.
Author
Tang T.Y.; Soon S.X.Y.; Yap C.J.Q.; Chan S.L.; Tan R.Y.; Pang S.C.; Choke
E.T.C.; Tan C.S.; Chong T.T.
Institution
(Tang, Soon, Yap, Chong) Department of Vascular Surgery, Singapore General
Hospital, Singapore, Singapore
(Tang) Duke NUS Graduate Medical School, Singapore, Singapore
(Chan) Health Services Research Center, SingHealth, Singapore, Singapore
(Tan, Pang, Tan) Department of Renal Medicine, Singapore General Hospital,
Singapore, Singapore
(Choke) Department of General Surgery, Sengkang General Hospital,
Singapore, Singapore
Publisher
SAGE Publications Ltd
Abstract
Background: Aim of Arch V SUPERA-LUX was to evaluate the safety and
efficacy of the combination therapy of SUPERATM (Abbott Vascular, Santa
Clara, CA, USA) helical stent implantation and Passeo-18 LuxTM (Biotronik
Asia Pacific Pte Ltd, Singapore) drug coated balloon (DCB) elution to
treat recurrent cephalic arch stenosis (CAS) in the setting of AV access
dysfunction. <br/>Method(s): Investigator-initiated, single-center,
single-arm prospective pilot study of 20 end-stage renal failure Asian
patients with a dysfunctional brachiocephalic fistula. All had symptomatic
recurrent CAS within 6 months of prior intervention. The lesion was
pre-dilated with a standard high-pressure balloon (Biotronik Passeo-35 HP
balloon). The DCB (Passeo-18 LuxTM) is subsequently inflated and the
SUPERATM stent deployed to sit 2 mm distal to the cephalic arch and
covering the CAS but within the DCB zone. All patients were prescribed
dual antiplatelet therapy for 3 months and followed up with Duplex
ultrasound at 6- and 12-months. <br/>Result(s): There were 9 (45%) males
and mean age was 67 +/- 11.0 years. Mean time from prior procedure was 113
+/- 68 days and main indication for reintervention was high venous
pressure (9/20, 45%). Technical success was 100% and there were no
peri-procedural complications related to either stent or DCB deployment.
Target lesion primary patency at 6- and 12-months was 10/18 (55%) and 5/16
(31%), respectively. Mean time to target lesion re-intervention was 170
+/- 82 days. Circuit access patency was 8/18 (44%) and 2/16 (13%) at 6-
and 12-months respectively and mortality was 3/20 (15%) attributed to the
patients' underlying co-morbidities. <br/>Conclusion(s): Dual prong
strategy of using SUPERATM stenting and Passeo-18 LuxTM drug elution for
recurrent CAS, although safe, was no more efficacious than conventional
balloon angioplasty or stenting alone. Development of an intense
inflammatory reaction within the stent led to reinterventions of a number
of cases with suboptimal results.<br/>Copyright &#xa9; The Author(s) 2021.

<77>
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

<78>
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.

<79>
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.

<80>
Accession Number
2025591172
Title
Clopidogrel as a Distinctive Cause of Insulin Autoimmune Syndrome: A
Systematic Case Review.
Source
Diabetes, Metabolic Syndrome and Obesity. 16 (pp 2583-2592), 2023. Date of
Publication: 2023.
Author
Chen S.; Qiang J.; Zhao B.; Tian R.; Yuan T.; Li M.; Gu Z.; Yang L.; Zhu
H.; Pan H.; Tang Y.; Li Y.
Institution
(Chen, Qiang, Yuan, Li, Li, Zhu, Pan, Li) Key Laboratory of Endocrinology
of National Health Commission, Department of Endocrinology, Peking Union
Medical College Hospital, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing 100730, China
(Qiang) Eight-Year Program of Clinical Medicine, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing 100730, China
(Zhao, Tang) Department of Pharmacy, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing 100730, China
(Tian) Department of Cardiology, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing 100730, China
(Gu) Department of Radiotherapy, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing 100730, China
(Yang) Department of Pharmacy, Handan First Hospital, Hebei Province,
Handan, China
(Pan) State Key Laboratory of Complex Severe and Rare Diseases, Peking
Union Medical College Hospital, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing 100730, China
Publisher
Dove Medical Press Ltd
Abstract
The sulfhydryl group of clopidogrel metabolite could induce insulin
autoimmune syndrome (IAS) with hypoglycemia as the major symptom. For
patients with cardiovascular disease taking clopidogrel for vascular
protection, this adverse event hypoglycemia increases the risk of
cardiovascular events. However, discontinuing clopidogrel leaves patients
without appropriate antiplatelet therapy. Treating IAS with
glucocorticoids is also risky for these patients' primary cardiovascular
diseases. Early recognition and appropriate treatment of
clopidogrel-induced IAS (CIAS) would be beneficial for patients. This
research aimed to discover the clinical features and investigate optimal
therapeutic management of CIAS. We systematically searched for cases of
CIAS in PubMed and Embase and performed data mining in Food and Drug
Administration Adverse Event Reporting System (FAERS). In the CIAS series,
clinical features were summarized and compared to 287 IAS cases, including
demographic information, HLA alleles, onset, and symptoms. The therapeutic
effect of glucocorticoids was compared between the receiving group and the
not-receiving group. The possibilities of common antiplatelet drugs to
induce hypoglycemia/IAS were investigated with chemical structure and
FAERS reports. A CIAS series of 51 patients was established. CIAS had an
onset age of 74.8+/-8.6 years old, 92.2% male, and a balanced proportion
of East Asians and non-East Asians. Confusion occurred more frequently in
CIAS than in IAS from various causes, while the other symptoms and
hypoglycemia types were similar. The recovery time was approximately the
same whether using glucocorticoids/immunotherapy in CIAS or not. Among
common antiplatelet drugs, ticagrelor and rivaroxaban were unlikely to
induce hypoglycemia/IAS. Clopidogrel is a distinctive cause of IAS
featuring an elderly male presenting confusion as the symptom of
hypoglycemia. Glucocorticoids/immunotherapy might not be necessary for the
long-term recovery of CIAS. To balance the risks of hypoglycemia and
cardiovascular events, substituting clopidogrel with ticagrelor and
rivaroxaban might be considered.<br/>Copyright &#xa9; 2023 Chen et al.

<81>
Accession Number
2025457808
Title
Micronutrient Deficiency and Its Potential Role in Delirium Onset in Older
Adults: A Systematic Review.
Source
Journal of Nutrition, Health and Aging. 27(9) (pp 785-790), 2023. Date of
Publication: September 2023.
Author
Ceolin C.; Papa M.V.; De Rui M.; Devita M.; Sergi G.; Coin A.
Institution
(Ceolin, Papa, De Rui, Devita, Sergi, Coin) Department of Medicine
(DIMED), Geriatrics Division, University of Padua, via Giustiniani 2,
Padua 35128, Italy
(Devita) Department of General Psychology (DPG), University of Padua, via
Giustiniani 2, Padua 35128, Italy
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Background and Objectives: One of the pathogenetic hypotheses of delirium
is the "neuroinflammatory theory" with consequent neurotoxicity of brain
connectivity networks. Micronutrients may play a significant role in the
prevention of neuroinflammation. This systematic review addresses the role
of micronutrients in the development of delirium in older populations.
<br/>Method(s): The EBSCO, Cochrane, PubMed, and Web of Science databases
were searched for articles on delirium and micronutrients. The
methodological quality of the studies included in the review was evaluated
with the Newcastle-Ottawa Scales for observational studies and for
case-control studies. <br/>Result(s): 1326 papers were identified from the
searches, 7 of which met the inclusion criteria (see section 2.3). All the
papers included were written in English. Delirium was predominantly
secondary to post-operative dysfunction or acute medical conditions. By
altering the production of neurotransmitters resulting in an imbalance,
and by reducing their immunomodulatory role with a consequent increase in
inflammatory oxidative stress, micronutrient deficiency seems to be
associated with an increased incidence of delirium. <br/>Conclusion(s):
This review supports the existence of an association between micronutrient
deficiency (i.e. cobalamin, thiamine, and vitamin D) and an increased
incidence of delirium, with a greater prevalence in hospitalized
patients.<br/>Copyright &#xa9; 2023, The Author(s).

<82>
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.

<83>
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.

<84>
Accession Number
2023677357
Title
Influence of preoperative frailty on quality of life after cardiac
surgery: A systematic review and meta-analysis.
Source
Journal of the American Geriatrics Society. 71(10) (pp 3278-3286), 2023.
Date of Publication: October 2023.
Author
Fehlmann C.A.; Bezzina K.; Mazzola R.; Visintini S.M.; Guo M.H.; Rubens
F.D.; Wells G.A.; McGuinty C.; Huang A.; Khoury L.; Boczar K.E.
Institution
(Fehlmann, Rubens, Wells, Boczar) School of Epidemiology and Public
Health, University of Ottawa, Ottawa, ON, Canada
(Fehlmann) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Fehlmann) Division of Emergency Medicine, Geneva University Hospitals,
Geneva, Switzerland
(Bezzina) Care of the Elderly Program, Elisabeth Bruyere Hospital, Ottawa,
ON, Canada
(Mazzola, McGuinty, Boczar) University of Ottawa Heart Institute, Ottawa,
ON, Canada
(Visintini) Berkman Library, University of Ottawa Heart Institute, Ottawa,
ON, Canada
(Guo, Rubens) Department of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Wells) Research Methods Centre, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Huang, Khoury) Division of Geriatric Medicine, The Ottawa Hospital,
Ottawa, ON, Canada
(Boczar) Division of Cardiology, Department of Medicine, University of
Pennsylvania, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Frailty has emerged as an important prognostic marker of
increased mortality after cardiac surgery, but its association with
quality of life (QoL) and patient-centered outcomes is not fully
understood. We sought to evaluate the association between frailty and such
outcomes in older patients undergoing cardiac surgery. <br/>Method(s):
This systematic review included studies evaluating the effect of
preoperative frailty on QoL outcomes after cardiac surgery amongst
patients 65 years and older. The primary outcome was patient's perceived
change in QoL following cardiac surgery. Secondary outcomes included
residing in a long-term care facility for 1 year, readmission in the year
following the intervention, and discharge destination. Screening,
inclusion, data extraction, and quality assessment were performed
independently by two reviewers. Meta-analyses based on the random-effects
model were conducted. The evidential quality of findings was assessed with
the GRADE profiler. <br/>Result(s): After the identification of 3105
studies, 10 observational studies were included (1580 patients) in the
analysis. Two studies reported on the change in QoL following cardiac
surgery, which was higher for patients with frailty than for patients
without. Preoperative frailty was associated with both hospital
readmission (pooled odds ratio [OR] 1.48 [0.80-2.74], low GRADE level) as
well as non-home discharge (pooled OR 3.02 [1.57-5.82], moderate GRADE
level). <br/>Conclusion(s): While evidence in this field is limited by
heterogeneity of frailty assessment and non-randomized data, we
demonstrated that baseline frailty may possibly be associated with
improved QoL, but with increased readmission as well as discharge to a
non-home destination following cardiac surgery. These patient-centered
outcomes are important factors when considering interventional options for
older patients. Study Registration: OSF registries
(https://osf.io/vm2p8).<br/>Copyright &#xa9; 2023 The Authors. Journal of
the American Geriatrics Society published by Wiley Periodicals LLC on
behalf of The American Geriatrics Society.

<85>
Accession Number
2017201361
Title
Clinical impact of del Nido cardioplegia in adult cardiac surgery: A
prospective randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(5) (pp 1458-1467),
2023. Date of Publication: November 2023.
Author
Garcia-Suarez J.; Garcia-Fernandez J.; Martinez Lopez D.; Reques L.; Sanz
S.; Carballo D.; Martin C.E.; Ospina V.M.; Villar S.; Martin A.; Casado
M.; Villafranca A.; Gonzalez A.I.; Serrano S.; Forteza A.
Institution
(Garcia-Suarez, Garcia-Fernandez, Sanz, Carballo, Casado, Villafranca,
Gonzalez) Department of Anesthesiology and Critical Care, Puerta de Hierro
University Hospital, Madrid, Spain
(Martinez Lopez, Martin, Ospina, Villar, Serrano, Forteza) Department of
Cardiac Surgery, Puerta de Hierro University Hospital, Madrid, Spain
(Reques, Martin) Cardiac Surgery Perfusion Department, Puerta de Hierro
University Hospital, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objective: The study objective was to assess the benefits of del Nido
cardioplegia compared with cold blood cardioplegia solution in terms of
myocardial protection during adult cardiac surgery. <br/>Method(s): A
total of 474 adult patients undergoing coronary artery bypass grafting,
heart valve surgery, thoracic aortic surgery, or combined procedures were
randomized to the del Nido cardioplegia group (n = 234) or the cold blood
cardioplegia solution group (n = 240) after provided informed consent. The
primary end points assessed inotropic support requirements, severe
cardiovascular events, and troponin trend within the first 48 hours of
intensive care unit stay. Reperfusion arrhythmias, aortic crossclamp and
cardiopulmonary bypass times, and other clinical perioperative variables
were considered as secondary end points. <br/>Result(s): No statistically
significant differences were found regarding postoperative inotropic
support requirements or the incidence of severe cardiovascular events. The
del Nido cardioplegia group showed a higher return to spontaneous sinus
rhythm (P < .001), a lower number of defibrillation attempts (P < .001),
and an earlier peak troponin value in the postoperative period. Peak blood
glucose levels and intravenous insulin requirements were significantly
lower in the del Nido cardioplegia group. We found no significant
differences regarding aortic crossclamp or cardiopulmonary bypass time. We
did observe a lower incidence of postoperative stroke in the del Nido
cardioplegia group (2.6% vs 6.7%; P = .035). <br/>Conclusion(s): del Nido
cardioplegia can be used safely and with comparable outcomes compared with
traditional cardioplegia solutions. Additional advantages over glycemic
control, reperfusion arrhythmias, and its comfortable redosing interval
make del Nido an interesting alternative for myocardial protection in
adult cardiac surgery. A significant decrease in postoperative stroke will
require further research to shed light on the results of this study. Video
Abstract: [Figure presented]<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<86>
Accession Number
641825670
Title
Pharmacologic interventions for the therapy of postanesthetic shivering in
adults: a systematic review and network meta-analysis.
Source
Minerva anestesiologica. 89(10) (pp 923-935), 2023. Date of Publication:
01 Oct 2023.
Author
Dinges H.-C.; Al-Dahna T.; Rucker G.; Wulf H.; Eberhart L.; Wiesmann T.;
Schubert A.-K.
Institution
(Dinges) Department of Anesthesia and Intensive Care, University Hospital
Marburg, Marburg, Germany
(Al-Dahna, Wulf, Eberhart, Wiesmann, Schubert) Department of Anesthesia
and Intensive Care, University Hospital Marburg, Marburg, Germany
(Rucker) Faculty of Medicine and Medical Center, Institute of Medical
Biometry and Statistics, University of Freiburg, Freiburg, Germany
(Wiesmann) Department of Anesthesiology and Intensive Care Medicine,
Schwabisch-Hall, Germany
Abstract
INTRODUCTION: Shivering is a common side effect after general anesthesia.
Risk factors are hypothermia, young age and postoperative pain. Severe
complications of shivering are rare but can occur due to increased oxygen
consumption. Previous systematic reviews are outdated and have summarized
the evidence on the topic using only pairwise comparisons. The objective
of this manuscript was a quantitative synthesis of evidence on
pharmacological interventions to treat postanesthetic shivering. EVIDENCE
ACQUSITION: Systematic review and frequentist network meta-analysis using
the R package netmeta. Endpoints were the risk ratio (RR) of persistent
shivering at one, five and 10 minutes after treatment with saline/placebo
as the comparator. Data were retrieved from Medline, Embase, Central and
Web of Science up to January 2022. Eligibility criteria were: randomized,
controlled, and blinded trials comparing pharmacological interventions to
treat shivering after general anesthesia. Studies on shivering during or
after any type of regional anesthesia were excluded as well as sedated
patients after cardiac surgery. EVIDENCE SYNTHESIS: Thirty-two trials were
eligible for data synthesis, including 28 pharmacological interventions.
The largest network included 1431 patients. The network geometry was
two-centered with most comparisons linked to saline/placebo or pethidine.
The best interventions were after one minute: doxapram 2 mg/kg, tramadol 2
mg/kg and nefopam 10 mg, after 5 minutes: tramadol 2 mg/kg, nefopam 10 mg
and clonidine 150 microg and after 10 minutes: nefopam 10 mg,
methylphenidate 20 mg and tramadol 1 mg/kg, all reaching statistical
significance. Pethidine 25 mg and clonidine 75 microg also performed well
and with statistical significance in all networks. <br/>CONCLUSION(S):
Nefopam, tramadol, pethidine and clonidine are the most effective
treatments to stop postanesthetic shivering. The efficacy of doxapram is
uncertain since different doses showed contradictory effects and the
evidence for methylphenidate is based on a single comparison in only one
network. Furthermore, both lack data on side effects. Further studies are
needed to clarify the efficacy of dexmedetomidine to treat postanesthetic
shivering.

<87>
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

<88>
Accession Number
2025299710
Title
Video-assisted thoracoscopic epicardial pacing: A contemporary overview.
Source
PACE - Pacing and Clinical Electrophysiology. 46(10) (pp 1215-1221), 2023.
Date of Publication: October 2023.
Author
Marini M.; Pannone L.; Branzoli S.; Quintarelli S.; Coser A.; Guarracini
F.; Bonmassari R.; La Meir M.; de Asmundis C.
Institution
(Marini, Quintarelli, Coser, Guarracini, Bonmassari) Department of
Cardiology, S. Chiara Hospital, Trento, Italy
(Marini, Pannone, de Asmundis) Heart Rhythm Management Centre,
Postgraduate program in Cardiac Electrophysiology and Pacing, Vrije
Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
(Branzoli) Department of Cardiac Surgery, S. Chiara Hospital, Trento,
Italy
(Branzoli, La Meir) Cardiac Surgery Department, Vrije Universiteit
Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Video-assisted thoracoscopic surgery (VATS) has revolutionized the
approach and management of pulmonary and cardiac diseases, and its
applications have significantly expanded in the last two decades. Beyond
its established role in thoracic procedures, VATS has also emerged as a
valuable technique for various electrophysiological procedures, including
pacemaker implantations, ablation procedures, and left atrial appendage
exclusion. This paper presents a thorough review of the existing
literature on pacing procedures performed using a VATS approach. By
analyzing and synthesizing the available studies, we aim to provide an
in-depth understanding of the current knowledge and advancements in
VATS-based pacing procedures. A key focus of this review is the detailed
description of implantation techniques via a VATS approach.<br/>Copyright
&#xa9; 2023 Wiley Periodicals LLC.

<89>
Accession Number
2023142702
Title
Gender trends in cardiothoracic surgery authorship.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(5) (pp 1375-1384),
2023. Date of Publication: November 2023.
Author
Bryan D.S.; Debarros M.; Wang S.X.; Xie Y.; Mazzola E.; Bueno R.; Marshall
M.B.
Institution
(Bryan) Section of Thoracic Surgery, University of Chicago, Chicago, Ill,
United States
(Debarros) Department of Thoracic Surgery, Madigan Army Medical Center,
Tacoma, Wash, United States
(Wang, Bueno, Marshall) Division of Thoracic and Cardiac Surgery, Brigham
and Women's Hospital, Boston, Mass, United States
(Xie, Mazzola) Department of Biostatistics and Computational Biology,
Dana-Farber Cancer Institute, Boston, Mass, United States
(Bueno, Marshall) Harvard Medical School, Boston, Mass, United States
Publisher
Elsevier Inc.
Abstract
Objective: In recent years, the historically low proportion of women
cardiothoracic surgeons and trainees has been a subject of intense focus.
Publications remain a key metric of academic success and career
advancement. We sought to identify trends in the gender of first and last
author publications in cardiothoracic surgery. <br/>Method(s): We searched
for publications between 2011 and 2020 in 2 US cardiothoracic surgery
journals, identifying those with Medical Subject Heading publication types
of clinical trials, observational studies, meta-analyses, commentary,
reviews, and case reports. A commercially available, validated software
(Gender-API) was used to associate gender with author names. Association
of American Medical Colleges Physician Specialty Data Reports were used to
identify concurrent changes in the proportion of active women in
cardiothoracic surgery. <br/>Result(s): We identified 6934 (57.1%) pieces
of commentary; 3694 (30.4%) case reports; 1030 (8.5%) reviews, systematic
analyses, meta-analyses, or observational studies; and 484 (4%) clinical
trials. In total, 15,189 total names were included in analysis. Over the
10-year study period, first authorship by women rose from 8.5% to 16%
(0.42% per year, on average), whereas the percentage of active US women
cardiothoracic physicians rose from 4.6% to 8% (0.42% per year). Last
authorship was generally flat over the decade, going from 8.9% in 2011% to
7.8% in 2020 and on average, increased at just 0.06% per year (P = .79).
<br/>Conclusion(s): Over the past decade, authorship by women has steadily
increased, more so at the first author position. Author-volunteered gender
identification at the time of manuscript acceptance may be useful to more
accurately follow trends in publication.<br/>Copyright &#xa9; 2023 The
American Association for Thoracic Surgery

<90>
Accession Number
2025300252
Title
Five-year outcomes of off and on-pump CABG: Insights from PROMOTE Patency
Trial.
Source
Asian Cardiovascular and Thoracic Annals. 31(8) (pp 659-666), 2023. Date
of Publication: October 2023.
Author
Sajja L.R.; Sarkar K.; Mannam G.; Padmanabhan C.; Narayan P.; Kamtam
D.N.H.; Balakrishna N.; Kodali V.K.K.; Mulay A.; Peter S.; Beri P.
Institution
(Sajja, Mannam) Division of Cardiothoracic Surgery, Star Hospitals,
Hyderabad, India
(Sajja, Kamtam, Beri) Division of Clinical Research in Cardiovascular
Medicine/Surgery, Sajja Heart Foundation, Hyderabad, India
(Sarkar) Division of Cardiothoracic Surgery, Medica Superspeciality
Hospital, Kolkata, India
(Padmanabhan) Division of Cardiothoracic Surgery, G Kuppuswamy Naidu
Memorial Hospital, Coimbatore, India
(Narayan) Division of Cardiothoracic Surgery, Rabindranath Tagore
International Institute of Cardiac Sciences, Kolkata, India
(Balakrishna) Department of Biostatistics, Sajja Heart Foundation,
Hyderabad, India
(Kodali) Division of Cardiothoracic Surgery, Krishna Institute of Medical
Sciences, Secunderabad, India
(Mulay) Division of Cardiothoracic Surgery, Sir H. N. Reliance Foundation
Hospital and Research Centre, Mumbai, India
(Peter) Division of Cardiothoracic Surgery, DDMM Heart Institute, Nadiad,
India
Publisher
SAGE Publications Inc.
Abstract
Background: There are limited studies reporting follow-up outcome data
comparing of off-pump coronary artery bypass (OPCAB) with on-pump (ONCAB)
technique. The aim of the study was to report the 5-year clinical outcomes
of OPCAB and ONCAB in a post hoc analysis of the PROMOTE patency trial.
<br/>Method(s): From March 2016 through March 2017, a total of 321
patients undergoing coronary artery bypass grafting (CABG) were randomised
to either the off-pump or the on-pump technique. Data on all-cause
mortality, myocardial infarction (MI), cerebrovascular accident (CVA),
repeat revascularisation and need for renal replacement therapy (RRT) were
recorded. The composite and each of these individual outcomes are reported
at 5-year interval. <br/>Result(s): The mean follow-up period was 65.9
months (+/-3.39). A total of 275 (85.93%) patients followed up at the
5-year interval who underwent CABG by the off-pump (n = 158) and the
on-pump (n = 162) technique. The all-cause mortality was 8.9% and 5.7% in
ONCAB and OPCAB, respectively (hazard ratio [HR] = 0.62; 95% confidence
interval [CI] 0.25-1.57, p = 0.31). The composite of all-cause mortality,
non-fatal MI, non-fatal CVA, RRT and need for repeat revascularisation was
comparable in both groups (7.1% vs. 11.9%, HR = 0.57; 95% CI 0.25-1.31, p
= 0.18 in OPCAB and ONCAB, respectively). The rates of 5-year non-fatal MI
(p = 0.2), non-fatal CVA (p = 0.36) and need for repeat revascularisation
(p = 1) were similar in both groups. A sub-group analysis did not show any
significant interaction or effect modification with either of the
techniques. <br/>Conclusion(s): The 5-year clinical outcomes of OPCAB are
comparable to ONCAB in low-risk patients undergoing CABG. Off-pump
coronary artery bypass had no additional benefit in any
subgroup.<br/>Copyright &#xa9; The Author(s) 2023.

<91>
Accession Number
2023961575
Title
Left-Sided Double-Lumen Tube vs EZ-Blocker for One-Lung Ventilation in
Thoracic Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 27(3) (pp 171-180),
2023. Date of Publication: September 2023.
Author
Kumar N.; Mitchell J.; Siemens A.; Deiparine S.; Saddawi-Konefka D.;
Hussain N.; Iyer M.H.; Essandoh M.; Sawyer T.R.; Hao D.
Institution
(Kumar, Siemens, Saddawi-Konefka, Hao) Harvard Medical School, Department
of Anesthesiology, Pain Medicine, and Critical Care Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Mitchell, Deiparine) The Ohio State University College of Medicine,
Columbus, OH, United States
(Hussain, Iyer, Essandoh) Department of Anesthesiology, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
(Sawyer) Central Michigan University College of Medicine, Mt. Pleasant,
MI, United States
Publisher
SAGE Publications Inc.
Abstract
Background. The EZ-Blocker is the newest generation of bronchial blocker
and offers a potential alternative to left-sided double lumen tubes for
lung isolation and one-lung ventilation during thoracic surgery. Methods.
Databases were searched for randomized controlled trials comparing
left-sided double lumen tube to the EZ-Blocker for one-lung ventilation
during thoracic surgery. The time for placement, incidence of
intraoperative displacement, and surgeons' rating of lung collapse quality
were designated as coprimary outcomes. The safety profiles of the two
devices, including the incidence of airway trauma and post-extubation
discomfort were also examined. Results. Six randomized controlled trials
(495 patients) were analyzed. Compared to the EZ-Blocker, the left-sided
double lumen tube was faster to place by a weighted mean difference of
[95% CI] of -61.24 seconds [-102.48, -20.00] (P =.004) and was much less
likely to become displaced during lung isolation with an odds ratio [95%
CI] of.56 [.34,.91] (P =.02). The left-sided double lumen tube and the
EZ-Blocker provided similar surgeon-rated quality of lung isolation.
Although the left-sided double lumen tube caused a greater degree of
post-extubation sore throat, there was a similar incidence of carinal
trauma and post-extubation hoarseness compared to the EZ-Blocker.
Conclusion. Our analysis suggests that the left-sided double lumen tube
can be placed more quickly and is less prone to intraoperative
displacement compared to the EZ-Blocker; the quality of lung collapse is
similar. Thus, evidence appears to support the continued utilization of
the left-sided double lumen tube for routine thoracic surgery requiring
one-lung ventilation.<br/>Copyright &#xa9; The Author(s) 2023.

<92>
Accession Number
2020625528
Title
Racial and Ethnic Disparities in U.S Children Undergoing Surgery for
Congenital Heart Disease: A Narrative Literature Review.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 27(3) (pp 224-234),
2023. Date of Publication: September 2023.
Author
Ross F.J.; Latham G.; Tjoeng L.; Everhart K.; Jimenez N.
Institution
(Ross, Latham, Everhart, Jimenez) Department of Anesthesiology and Pain
Medicine, Seattle Children's Hospital/University of Washington, Seattle,
WA, United States
(Tjoeng) Department of Critical Care Medicine/Department of Cardiology,
Seattle Children's Hospital/University of Washington, Seattle, WA, United
States
Publisher
SAGE Publications Inc.
Abstract
Congenital Heart Disease (CHD) is a significant source of pediatric
morbidity and mortality. As in other fields of medicine, studies have
demonstrated racial and ethnic disparities in congenital heart disease
outcomes. The cause of these outcome disparities is multifactorial,
involving biological, behavioral, environmental, sociocultural, and
systemic medical factors. Potential contributors include differences in
preoperative illness severity secondary to coexisting medical conditions,
differences in the rate of prenatal and early postnatal detection of CHD,
and delayed access to care, as well as discrepancies in socioeconomic and
insurance status, and systemic disparities in hospital care. Understanding
the factors that contribute to these disparities is an essential step
towards developing strategies to address them. As stewards of the
perioperative surgical home, anesthesiologists have an important role in
developing institutional policies that mitigate racial disparities. Here,
we provide a thorough narrative review of recent research concerning
perioperative factors contributing to surgical outcomes disparities for
children of all ages with CHD, examine potentially modifiable contributing
factors, discuss avenues for future research, and suggest strategies to
address disparities both locally and nationally.<br/>Copyright &#xa9; The
Author(s) 2022.

<93>
Accession Number
2024058204
Title
Diuresis-matched versus standard hydration in patients undergoing
percutaneous cardiovascular procedures: meta-analysis of randomized
clinical trials.
Source
Revista Espanola de Cardiologia. 76(10) (pp 759-766), 2023. Date of
Publication: October 2023.
Author
Occhipinti G.; Laudani C.; Spagnolo M.; Greco A.; Capodanno D.
Institution
(Occhipinti, Laudani, Spagnolo, Greco, Capodanno) Division of Cardiology,
Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco,
University of Catania, Catania, Italy
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Contrast-associated acute kidney injury
(CA-AKI) is a potential complication of procedures requiring
administration of iodinated contrast medium. RenalGuard, which provides
real-time matching of intravenous hydration with furosemide-induced
diuresis, is an alternative to standard periprocedural hydration
strategies. The evidence on RenalGuard in patients undergoing percutaneous
cardiovascular procedures is sparse. We used a Bayesian framework to
perform a meta-analysis of RenalGuard as a CA-AKI preventive strategy.
<br/>Method(s): We searched Medline, Cochrane Library and Web of Science
for randomized trials of RenalGuard vs standard periprocedural hydration
strategies. The primary outcome was CA-AKI. Secondary outcomes were
all-cause death, cardiogenic shock, acute pulmonary edema, and renal
failure requiring renal replacement therapy. A Bayesian random-effect risk
ratio (RR) with corresponding 95% credibility interval (95%CrI) was
calculated for each outcome. PROSPERO database number CRD42022378489.
<br/>Result(s): Six studies were included. RenalGuard was associated with
a significant relative reduction in CA-AKI (median RR, 0.54; 95%CrI,
0.31-0.86) and acute pulmonary edema (median RR, 0.35; 95%CrI, 0.12-0.87).
No significant differences were observed for the other secondary endpoints
[all-cause death (RR, 0.49; 95%CrI, 0.13-1.08), cardiogenic shock (RR,
0.06; 95%CrI, 0.00-1.91), and renal replacement therapy (RR, 0.52; 95%CrI,
0.18-1.18)]. The Bayesian analysis also showed that RenalGuard had a high
probability of ranking first for all the secondary outcomes. These results
were consistent in multiple sensitivity analyses. <br/>Conclusion(s): In
patients undergoing percutaneous cardiovascular procedures, RenalGuard was
associated with a reduced risk of CA-AKI and acute pulmonary edema
compared with standard periprocedural hydration strategies.<br/>Copyright
&#xa9; 2023

<94>
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.