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<1>
Accession Number
2028317928
Title
Non-opioid versus Opioid Peri-operative Analgesia In Neurosurgery
(NOPAIN): Study protocol for a multi-centric randomised controlled trial.
Source
Indian Journal of Anaesthesia. 67(10) (pp 920-926), 2023. Date of
Publication: October 2023.
Author
Sriganesh K.; Singh G.; Bidkar P.U.; Sethuraman M.; Moningi S.
Institution
(Singh) Department of Neuroanaesthesiology, Christian Medical College,
Tamil Nadu, Vellore, India
(Bidkar) Division of Neuroanaesthesiology, Department of Anesthesiology
and Critical Care, Jawaharlal Institute of Postgraduate Medical Education
and Research, Puducherry, India
(Sethuraman) Division of Neuroanaesthesiology, Department of
Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and
Technology, Kerala, Trivandrum, India
(Moningi) Department of Anaesthesiology and Intensive Care, Nizam's
Institute of Medical Sciences, Telangana, Hyderabad, India
(Sriganesh) Department of Neuroanaesthesia and Neurocritical Care,
National Institute of Mental Health and Neurosciences, Karnataka,
Bengaluru, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Many patients suffer from post-operative pain after
neurosurgery despite using intra-operative opioids. Opioid side effects
are problematic in neurosurgical patients. Hence, non-opioid alternatives
for the management of nociception and pain are needed. Previous studies
comparing opioids with non-opioids in the neurosurgical population were
few, from single centres, of small sample sizes and were equivocal in
findings, which prevented change in clinical practice. To overcome these
limitations, we are conducting a multi-centre trial with objectives to
compare intra-operative rescue opioid requirements and post-operative pain
scores (primary objectives), adverse events, quality of recovery from
anaesthesia, quality of sleep and patient satisfaction during hospital
stay, and persistent post-surgical pain and quality of life at 3 and 6
months (secondary objectives) in patients receiving opioid and non-opioid
analgesia for brain tumour surgeries. Method(s): This study protocol
describes the methodology of a multi-centre randomised controlled trial.
Ethics committee approval has been obtained from all five centres, the
trial has been registered with the Clinical Trial Registry- India, and
insurance has been obtained for this investigator-initiated funded study.
In patients undergoing supra-tentorial brain tumour surgery (population),
we will compare fentanyl (intervention) 1 mug/kg/h with dexmedetomidine
(comparator) 0.5 mug/kg/h administered during surgery with regards to
intra-operative rescue opioid requirement and post-operative pain (primary
outcomes). Result(s): We describe the study protocol of the
multi-centre trial (protocol version 2, dated 29/01/2022). The first
patient was recruited on 19/10/2022, and we will complete recruitment
before March 2024. Conclusion(s): We expect our study to establish
dexmedetomidine as an effective non-opioid analgesic vis-a-vis opioids in
the neurosurgical population. Copyright © 2023 Indian Journal of
Anaesthesia.

<2>
Accession Number
2028312953
Title
Effect of Continuous Training versus Interval Training on Functional
Parameters of Stage-1 Hypertensive Patients: A Randomised Clinical Study.
Source
Journal of Clinical and Diagnostic Research. 17(10) (pp YK05-YK08), 2023.
Date of Publication: October 2023.
Author
Gajbhiye A.A.; Vardhan V.
Institution
(Gajbhiye) Department of Cardiorespiratory and Vascular Physiotherapy,
Datta Meghe Institute of Medical Sciences, Maharashtra, Wardha, India
(Vardhan) Department of Cardiovascular and Respiratory Physiotherapy,
Datta Meghe Institute of Medical Sciences, Maharashtra, Wardha, India
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Hypertension is one of the major risk factors for heart
attack and stroke, often referred to as the "silent killer." Non
pharmacological therapy can be used to manage hypertension in addition to
pharmacological therapy. Exercise such as continuous and interval training
are types of physical exercises. Findings indicate that Moderate-Intensity
Continuous Training (MICT) and High-Intensity Interval Training (HIIT),
lower average blood pressure in Stage-1 hypertensive patients. Need of the
study: To evaluate the effectiveness of interval training and continuous
training on patients with Stage-1 hypertension and to prevent the
progression to the next stage of hypertension. Aim(s): To compare the
effects of continuous training versus interval training on blood pressure,
heart rate, and Rate of Perceived Exertion (RPE) in Stage-1 hypertension.
 Material(s) and Method(s): This randomised clinical study will be
conducted at the Cardiovascular and Thoracic Surgery Unit, Acharya Vinobha
Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India, for a duration
of six months. In this study, 130 patients diagnosed with Stage-1
hypertension will be divided into two groups. The first 65 will be
randomly assigned to Group A as the interval training group, while the
remaining 65 will be assigned to Group B as the continuous training group.
Each patient's demographic information, including name, age, gender,
height, and weight, will be recorded. Before the intervention, patients'
blood pressure and heart rate will be measured, taking an average of three
readings. Training will then commence, and patients will be reassessed to
determine the effectiveness. Statistical analysis will be performed using
paired and unpaired t-tests. Copyright © 2023 Journal of Clinical
and Diagnostic Research. All rights reserved.

<3>
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Accession Number
2028184203
Title
Effect of manual hyperinflation with versus without positive
end-expiratory pressure on dynamic compliance in pediatric patients
following congenital heart surgery: A randomized controlled trial.
Source
Medicine (United States). 102(43) (pp E35715), 2023. Date of Publication:
27 Oct 2023.
Author
Guimaraes J.C.; Da Silva T.H.; Aragon D.C.; Johnston C.; Gastaldi A.C.;
Carlotti A.P.C.P.
Institution
(Guimaraes, Da Silva, Aragon, Carlotti) Department of Pediatrics, Division
of Pediatric Critical Care, Ribeirao Preto Medical School, University of
Sao Paulo, Ribeirao Preto, Brazil
(Johnston) Department of Pediatrics, Division of Pediatric Critical Care,
Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil
(Gastaldi) Department of Health Sciences, Ribeirao Preto Medical School,
University of Sao Paulo, Ribeirao Preto, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We aimed to compare the effect of manual hyperinflation with
versus without positive end-expiratory pressure (PEEP) on dynamic
compliance of the respiratory system in pediatric patients undergoing
congenital heart surgery; to assess the safety of the technique in this
population. Method(s): This was a randomized controlled trial
conducted at the pediatric intensive care unit (PICU) of a tertiary-care
hospital. Patients admitted to the PICU following cardiac surgery and
receiving postoperative mechanical ventilation were randomized to the
experimental or control group. Patients in the experimental group (n = 14)
underwent manual hyperinflation with a PEEP valve set at 5 cm H2O, once
daily, during the first 48 hours after surgery. Patients allocated to the
control group (n = 16) underwent manual hyperinflation without PEEP, at
the same time points. Lung mechanics was assessed before (T0) and 5
minutes (T5) after manual hyperinflation. The primary endpoint was dynamic
compliance. Secondary outcomes included oxygen saturation index, duration
of mechanical ventilation, length of stay, 28-day mortality and safety.
 Result(s): Demographic and clinical characteristics were comparable
in both groups. There was no significant difference in dynamic compliance
between times in each group (Day 1: (mean) 0.78 vs 0.81 and 0.70 vs 0.77;
Day 2: 0.85 vs 0.78 and 0.67 vs 0.68 mL/kg/cm H2O, in experimental and
control groups, respectively; P > .05). Mean deltas of dynamic compliance
were not significantly different between groups. The proportion of
patients extubated <72 hours after surgery was similar in experimental and
control groups (43% vs 50%, respectively; P = .73). Oxygen saturation
index, length of stay, and 28-day mortality were not significantly
different between groups. None of the patients had hemodynamic
instability. Conclusion(s): Manual hyperinflation was safe and well
tolerated in pediatric patients following surgery for congenital heart
disease. No significant change in dynamic compliance of the respiratory
system or in oxygenation was observed with the use of manual
hyperinflation with or without PEEP in this population. Copyright
© 2023 Lippincott Williams and Wilkins. All rights reserved.

<4>
Accession Number
2028352207
Title
Deep Parasternal Intercostal Plane Block for Postoperative Analgesia After
Sternotomy for Cardiac Surgery-A Retrospective Cohort Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Skojec A.J.; Christensen J.M.; Yalamuri S.M.; Smith M.M.; Arghami A.;
LeMahieu A.M.; Schroeder D.R.; Mauermann W.J.; Nuttall G.A.; Ritter M.J.
Institution
(Skojec, Christensen, Yalamuri, Smith, Mauermann, Nuttall, Ritter)
Department of Anesthesiology and Perioperative Medicine, Division of
Cardiothoracic Anesthesia, Mayo Clinic College of Medicine and Science,
Rochester, MN, United States
(Arghami) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(LeMahieu, Schroeder) Division of Biomedical Statistics and Informatics,
Mayo Clinic College of Medicine and Science, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Objective: To examine the analgesic efficacy of postoperative deep
parasternal intercostal plane (DPIP) blocks for patients having cardiac
surgery via median sternotomy. Design(s): This single-center
retrospective study compared patients receiving bilateral DPIP blocks with
a matched cohort of patients not receiving DPIP blocks. Setting(s):
Large quaternary referral center. Participant(s): Adult patients
admitted to the authors' institution from January 1, 2016, to August 14,
2020, for elective cardiac surgery via median sternotomy.
 Intervention(s): Patients received ultrasound-guided bilateral DPIP
blocks. Measurements and Main Results: A total of 113 patients
received a DPIP block; 3,461 patients did not. The estimated
multiplicative change in cumulative opioid consumption through 24 hours
was 0.42 (95% CI 0.32-0.56; p < 0.001), indicating that patients receiving
DPIP blocks required 60% fewer opioids than patients who did not.
Proportional odds ratios for the average pain score on postoperative day
(POD) 0 was 0.46 (95% CI 0.32-0.65; p < 0.001), and POD 1 was 0.67 (95% CI
0.47-0.94; p = 0.021), indicating lower pain scores for patients receiving
blocks. The exploratory analysis identified an inverse correlation between
DPIP blocks and atrial fibrillation incidence (2% v 15%; inverse
probability of treatment weighting odds ratio 0.088, 95% CI 0.02-0.41; p =
0.002). Conclusion(s): The use of DPIP blocks in patients undergoing
cardiac surgery via median sternotomy was associated with less opioid use
and improved pain scores in the early postoperative period compared with
patients not receiving blocks. Prospective randomized controlled studies
should further elucidate the efficacy and risks of DPIP blocks in cardiac
surgery. Copyright © 2023 Elsevier Inc.

<5>
Accession Number
2028352177
Title
Bioprosthetic leaflet thrombosis and reduced leaflet motion after
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Archives of Cardiovascular Diseases. (no pagination), 2023. Date of
Publication: 2023.
Author
Roule V.; Guedeney P.; Silvain J.; Beygui F.; Zeitouni M.; Sorrentino S.;
Kerneis M.; Barthelemy O.; Beaupre F.; Portal J.-J.; Vicaut E.;
Montalescot G.; Collet J.-P.
Institution
(Roule, Guedeney, Silvain, Zeitouni, Kerneis, Barthelemy, Beaupre,
Montalescot, Collet) ACTION Study Group, Sorbonne Universite, UMRS 1166,
Institut de Cardiologie, Pitie-Salpetriere Hospital (AP-HP), Paris 75013,
France
(Roule, Beygui) Service de Cardiologie, CHU de Caen Normandie, Normandie
Universite, Caen 14000, France
(Sorrentino) Division of Cardiology, Department of Medical and Surgical
Science, Magna Graecia University, Catanzaro 88100, Italy
(Portal, Vicaut) ACTION Study Group, Unite de Recherche Clinique,
Lariboisiere Hospital, AP-HP, Paris 75010, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Leaflet thrombosis and reduced leaflet motion have become a
concern with the expanding use of transcatheter aortic valve replacement
in lower-risk patients. Aim(s): To assess the proportions, predictors
and clinical impact of leaflet thrombosis and reduced leaflet motion after
transcatheter aortic valve replacement. Method(s): We performed a
meta-analysis of studies assessing the proportions of and/or clinical
outcomes according to the presence of leaflet thrombosis after
transcatheter aortic valve replacement identified with computed tomography
and/or echocardiography. Result(s): Fifty-three studies, representing
25,258 patients undergoing transcatheter aortic valve replacement, were
considered. The proportion of leaflet thrombosis was 5.2% overall, and was
higher in computed tomography versus echocardiography (16.4% vs. 1.1%,
respectively); reduced leaflet motion was identified in 11% of patients
with four-dimensional computed tomography. Intra-annular bioprostheses
were associated with a higher proportion of leaflet thrombosis, whereas
chronic oral anticoagulation was protective for leaflet thrombosis in both
computed tomography and echocardiographic studies (9.7% vs. 17.5%;
relative risk [RR]: 0.51, 95% confidence interval [95% CI]: 0.37-0.71 and
0.9% vs. 2.7%; RR: 0.22, 95% CI: 0.06-0.79, respectively) and for reduced
leaflet motion (2.5% vs. 12.4%; RR: 0.32, 95% CI: 0.13-0.76). Leaflet
thrombosis was not associated with an increased risk of death, but with a
higher risk of stroke in computed tomography studies (2.8% vs. 2.4%; RR:
1.63, 95% CI: 1.05-2.55), a difference more pronounced when considering
reduced leaflet motion (3.5% vs. 1.7%; RR: 2.39, 95% CI: 0.63-8.34).
 Conclusion(s): The proportion of leaflet thrombosis is highly
variable according to the screening approach, the type of valve and the
use of oral anticoagulation. The occurrence of cerebral events is
increased when leaflet thrombosis and/or reduced leaflet motion are
diagnosed, but leaflet thrombosis has no impact on survival. Copyright
© 2023 Elsevier Masson SAS

<6>
Accession Number
2026606028
Title
Absolute Quantification of Donor-Derived Cell-Free DNA in Pediatric and
Adult Patients After Heart Transplantation: A Prospective Study.
Source
Transplant International. 36 (no pagination), 2023. Article Number: 11260.
Date of Publication: 2023.
Author
Bohmer J.; Wasslavik C.; Andersson D.; Stahlberg A.; Jonsson M.; Wahlander
H.; Karason K.; Sunnegardh J.; Nilsson S.; Asp J.; Dellgren G.; Ricksten
A.
Institution
(Bohmer, Wasslavik, Stahlberg, Wahlander, Sunnegardh, Asp, Ricksten)
Sahlgrenska University Hospital, Gothenburg, Sweden
(Bohmer, Jonsson, Wahlander, Sunnegardh, Asp, Dellgren, Ricksten)
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Andersson, Stahlberg) Sahlgrenska Cancer Center, University of
Gothenburg, Gothenburg, Sweden
(Stahlberg) The Wallenberg Centre for Molecular and Translational
Medicine, University of Gothenburg, Gothenburg, Sweden
(Karason, Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Nilsson) Laboratory Medicine, University of Gothenburg, Gothenburg,
Sweden
Publisher
European Society for Organ Transplantation
Abstract
In this prospective study we investigated a cohort after heart
transplantation with a novel PCR-based approach with focus on treated
rejection. Blood samples were collected coincidentally to biopsies, and
both absolute levels of dd-cfDNA and donor fraction were reported using
digital PCR. 52 patients (11 children and 41 adults) were enrolled
(NCT03477383, clinicaltrials.gov), and 557 plasma samples were analyzed.
13 treated rejection episodes >14 days after transplantation were observed
in 7 patients. Donor fraction showed a median of 0.08% in the cohort and
was significantly elevated during rejection (median 0.19%, p < 0.0001),
using a cut-off of 0.1%, the sensitivity/specificity were 92%/56% (AUC
ROC-curve: 0.78). Absolute levels of dd-cfDNA showed a median of 8.8
copies/mL and were significantly elevated during rejection (median 23, p =
0.0001). Using a cut-off of 7.5 copies/mL, the sensitivity/specificity
were 92%/43% for donor fraction (AUC ROC-curve: 0.75). The results support
the feasibility of this approach in analyzing dd-cfDNA after heart
transplantation. The obtained values are well aligned with results from
other trials. The possibility to quantify absolute levels adds important
value to the differentiation between ongoing graft damage and quiescent
situations. Copyright © 2023 Bohmer, Wasslavik, Andersson,
Stahlberg, Jonsson, Wahlander, Karason, Sunnegardh, Nilsson, Asp, Dellgren
and Ricksten.

<7>
Accession Number
2026317442
Title
Intravascular lithotripsy compared to rotational atherectomy for the
treatment of calcified distal left main coronary artery disease: A single
center experience.
Source
Catheterization and Cardiovascular Interventions. 102(6) (pp 997-1003),
2023. Date of Publication: 15 Nov 2023.
Author
Sandesara P.B.; Elhage Hassan M.; Shekiladze N.; Turk A.A.; Montrivade S.;
Gold D.; Kindya B.; Rinfret S.; Nicholson W.J.; Jaber W.A.
Institution
(Sandesara, Elhage Hassan, Shekiladze, Turk, Montrivade, Gold, Kindya,
Rinfret, Nicholson, Jaber) Department of Medicine, Division of Cardiology,
Emory University School of Medicine, Emory Heart and Vascular Center,
Atlanta, GA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The safety and efficacy of intravascular lithotripsy (IVL) for
the treatment of calcified distal left main (LM) disease remains unclear,
especially compared to rotational atherectomy (RA). Method(s): We
retrospectively analyzed the baseline clinical, angiographic,
intravascular ultrasound (IVUS) characteristics and procedural outcomes of
107 patients who underwent distal LM percutaneous coronary intervention
(PCI) with IVL (with or without adjunct atherectomy) versus RA alone for
plaque modification before stenting at a single center between 2020 and
2022. Result(s): A total of 50 patients underwent calcium
modification with IVL with or without adjunct atherectomy and 57 with RA
only. The mean age was 73 years and with a high prevalence of diabetes
(58.9%), chronic kidney disease (42.1%), prior revascularization (coronary
artery bypass graft surgery [36.4%] or prior PCI [32.7%]). Acute coronary
syndrome was the primary indication for PCI in over 50% of the patients in
both groups. Medina 1-1-1 LM bifurcation disease was identified in 64% and
60% of the IVL and RA groups (p = 0.64) respectively. Final minimum stent
area in distal LM (>8.2 mm2), ostial LAD (>6.3 mm2)
and ostial LCX (>5.0 mm2) were achieved in 96%, 85% and 89% of
cases treated with IVL respectively and 93%, 93% and 100% of cases treated
with RA respectively (LM p = 1.00; LAD p = 0.62; LCX; p = 1.00 for
difference between the two groups). Procedural success (technical success
without in-hospital major adverse events) was achieved in 98% of the IVL
group and 86% of the RA-only group (p = 0.04). There were eight procedural
complications (flow-limiting dissection, perforation, or slow/no-reflow)
in the RA group compared to four in the IVL group (NS), and one patient in
the RA required salvaged mechanical support compared to none in the IVL
group. Conclusion(s): Plaque modification with coronary IVL appears
to be efficacious and safe for the treatment of severely calcified distal
LM lesions compared to RA only. Larger randomized studies are needed to
confirm these findings. Copyright © 2023 Wiley Periodicals LLC.

<8>
Accession Number
642755525
Title
Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting
for Chronic Total Occlusion of Coronary Arteries: A Systematic Review and
Meta-Analysis.
Source
Journal of interventional cardiology. 2023 (pp 9928347), 2023. Date of
Publication: 2023.
Author
Wang C.; Liu S.; Kamronbek R.; Ni S.; Cheng Y.; Yan H.; Zhang M.
Institution
(Wang, Liu, Kamronbek, Ni, Zhang) Center for Coronary Heart Disease,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Cheng) Key Laboratory on Assisted Circulation, Ministry of Health,
Department of Cardiology, First Affiliated Hospital, Sun Yat-Sen
University, Guangzhou, China
(Yan) Department of Cardiology, Hangjinqi People's Hospital ,Hangjinqi,
Mongolia
Abstract
Introduction: Chronic total occlusion (CTO) of coronary arteries
constitutes a substantial clinical challenge and has historically been
managed through medical management and coronary artery bypass grafting
(CABG). However, with the advancement in interventional technology, the
success rate of percutaneous treatment has been significantly improved,
and percutaneous coronary intervention (PCI) has emerged as a primary mode
of treatment for CTOs, demonstrating remarkable clinical efficacy. The
objective of this systematic review and meta-analysis is to evaluate and
contrast the outcomes of PCI and CABG in patients with CTO. Methods
and Results: A systematic search was conducted in the databases of PubMed,
Embase, and Web of Science. The primary endpoints evaluated in this
meta-analysis were the occurrence of major adverse cardiac events (MACE)
and all-cause mortality. Secondary endpoints included myocardial
infarction (MI), cardiac death, and the need for repeat revascularization.
Nine studies, encompassing a total of 8,674 patients, were found to meet
the criteria for inclusion and had a mean follow-up duration of 4.3years.
The results of the meta-analysis revealed that compared to CABG, PCI was
associated with a lower incidence of all-cause mortality (RR: 0.78, 95%
CI: 0.66-0.92; P=0.003) and cardiac death (RR: 0.55; 95% CI: 0.31-0.96;
P<0.05), but an increased risk of myocardial infarction (MI) (RR: 1.96;
95%CI: 1.07-3.62; P<0.05) and repeat revascularization (RR: 7.13; 95% CI:
5.69-8.94; P<0.00001). There was no statistically significant difference
in MACE (RR: 1.11; 95% CI: 0.69-1.81; P=0.66) between the PCI and CABG
groups. Conclusion(s): In the present meta-analysis comparing PCI and
CABG in patients with chronic total occlusion of the coronary arteries,
the results indicated that PCI was superior to CABG in reducing all-cause
mortality and cardiac death but inferior in decreasing myocardial
infarction and repeat revascularization. There was no statistically
significant difference in MACE between the two groups. Copyright
© 2023 Chenyang Wang et al.

<9>
Accession Number
642460512
Title
Coronary calcification in patients presenting with acute coronary
syndromes: insights from the MATRIX trial.
Source
European heart journal. Acute cardiovascular care. 12(11) (pp 782-791),
2023. Date of Publication: 16 Nov 2023.
Author
Sanz-Sanchez J.; Garcia-Garcia H.M.; Branca M.; Frigoli E.; Leonardi S.;
Gagnor A.; Calabro P.; Garducci S.; Rubartelli P.; Briguori C.; Ando G.;
Repetto A.; Limbruno U.; Garbo R.; Sganzerla P.; Russo F.; Lupi A.;
Cortese B.; Ausiello A.; Ierna S.; Esposito G.; Santarelli A.; Sardella
G.; Varbella F.; Tresoldi S.; de Cesare N.; Rigattieri S.; Zingarelli A.;
Tosi P.; van 't Hof A.; Boccuzzi G.; Omerovic E.; Sabate M.; Heg D.;
Vranckx P.; Valgimigli M.
Institution
(Sanz-Sanchez) Cardiology Department, Hospital Universitari i Politecnic
La Fe, Valencia, Spain
(Sanz-Sanchez) Centro de Investigacion Biomedica en Red (CIBERCV), Madrid,
Spain
(Garcia-Garcia) Interventional Cardiology, MedStar Washington Hospital
Center, 10 Irving St NW, WA, United States
(Branca, Frigoli, Heg) CTU Bern, University of Bern, Bern, Switzerland
(Leonardi, Repetto) Coronary Care Unit, Department of Molecular Medicine,
University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia,
Italy
(Gagnor) Department of Invasive Cardiology, Maria Vittoria Hospital,
Turin, Italy
(Calabro) Division of Cardiology, 'Sant'Anna e San Sebastiano' Hospital,
Caserta, Italy
(Calabro) Department of Translational Medicine, University of Campania
'Luigi Vanvitelli', Caserta, Italy
(Garducci) Cardiology Department, A.O. Ospedale Civile di Vimercate,
Vimercate, Italy
(Rubartelli) Department of Cardiology, ASL3 Ospedale Villa Scassi, Genoa,
Italy
(Briguori) Cardiology Department, Clinica Mediterranea, Naples, Italy
(Ando) Azienda Ospedaliera Universitaria Policlinico 'Gaetano Martino',
University of Messina, Messina, Italy
(Limbruno) UO Cardiologia, ASL 9 Grosseto, Grosseto, Italy
(Garbo, Boccuzzi) GVM Care & Research, Turin, Italy
(Sganzerla) Cardiology Department, AO Ospedale Treviglio-Caravaggio,
Treviglio, Italy
(Russo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Lupi) Division of Cardiology, ASL VCO, Verbania, Italy
(Cortese) Cardiology Department, Ospedale FatebeneFratelli, Milano, Italy
(Ausiello) Cardiology Department, Casa di Cura Villa Verde, Taranto, Italy
(Ierna) Cardiology Department, Ospedale Sirai, Carbonia, Italy
(Esposito) Division of Cardiology, Department of Advanced Biomedical
Sciences, Federico II University of Naples, Naples, Italy
(Santarelli) Cardiovascular Department, Infermi Hospital, Rimini, Italy
(Sardella) 'Sapienza' University of Rome, Policlinico Umberto I, Rome,
Italy
(Varbella) Cardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3,
Turin, Italy
(Tresoldi) Cardiology Department, Azienda Ospedaliera Ospedale di Desio,
Desio, Italy
(de Cesare) Cardiology Department, Policlinico San Marco, Italy
(Rigattieri) Interventional Cardiology Unit, Sandro Pertini Hospital Rome,
Rome, Italy
(Zingarelli) Cardiology Department, IRCCS Azienda Ospedaliera
Universitaria San Martino, San Martino, Italy
(Tosi) Cardiology Department, Mater Salutis Hospital, Legnago, Italy
(van 't Hof) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Omerovic) Cardiology Department, Ahlgrenska University Hospital,
Goteborg, Sweden
(Sabate) Hospital Clinic, University of Barcelona, Thorax Institute,
Department of Cardiology, Barcelona, Spain
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Valgimigli) Division of Cardiology, Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale, Via Tesserete 48, Lugano 6900, Switzerland
Abstract
AIMS: The role of coronary calcification on clinical outcomes among
different revascularization strategies in patients presenting with acute
coronary syndromes (ACSs) has been rarely investigated. The aim of this
investigation is to evaluate the role of coronary calcification, detected
by coronary angiography, in the whole spectrum of patients presenting with
acute ACS. METHODS AND RESULTS: The present study was a post hoc analysis
of the MATRIX programme. The primary endpoint was major adverse
cardiovascular events (MACE), defined as the composite of all-cause
mortality, myocardial infarction (MI), or stroke up to 365 days. Among the
8404 patients randomized in the MATRIX trial, data about coronary
calcification were available in 7446 (88.6%) and therefore were included
in this post hoc analysis. Overall, 875 patients (11.7%) presented with
severe coronary calcification, while 6571 patients (88.3%) did not present
severe coronary calcification on coronary angiography. Fewer patients with
severe coronary calcification underwent percutaneous coronary intervention
whereas coronary artery bypass grafting or medical therapy-only was more
frequent compared with patients without severe calcification. At 1-year
follow-up, MACE occurred in 237 (27.1%) patients with severe calcified
coronary lesions and 985 (15%) patients without severe coronary calcified
lesions [hazard ratio (HR) 1.91; 95% confidence interval (CI) 1.66-2.20, P
< 0.001]. All-cause mortality was 8.6% in patients presenting with and
3.7% in those without severe coronary calcification (HR 2.38, 1.84-3.09, P
< 0.001). Patients with severe coronary calcification incurred higher rate
of MI (20.1% vs. 11.5%, HR 1.81; 95% CI 1.53-2.1, P < 0.001) and similar
rate of stroke (0.8% vs. 0.6%, HR 1.35; 95% CI 0.61-3.02, P = 0.46).
 CONCLUSION(S): Patients with ACS and severe coronary calcification,
as compared to those without, are associated with worse clinical outcomes
irrespective of the management strategy. Copyright © The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved. For permissions,
please e-mail: journals.permissions@oup.com.

<10>
[Use Link to view the full text]
Accession Number
2028397993
Title
Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation.
Source
New England Journal of Medicine. 389(15) (pp 1380-1389), 2023. Date of
Publication: 2023.
Author
Sohns C.; Fox H.; Marrouche N.F.; Crijns H.J.G.M.; Costard-Jaeckle A.;
Bergau L.; Hindricks G.; Dagres N.; Sossalla S.; Schramm R.; Fink T.; El
Hamriti M.; Moersdorf M.; Sciacca V.; Konietschke F.; Rudolph V.; Gummert
J.; Tijssen J.G.P.; Sommer P.
Institution
(Sohns, Bergau, Fink, El Hamriti, Moersdorf, Sciacca, Sommer) Clinics for
Electrophysiology, United States
(Fox, Costard-Jaeckle, Schramm, Gummert) Thoracic and Cardiovascular
Surgery, United States
(Fox, Costard-Jaeckle, Schramm, Gummert) Center for Interdisciplinary
Management of Advanced Heart Failure, Herz-und Diabeteszentrum
Nordrhein-Westfalen, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany
(Hindricks) Department of Cardiology, Angiology, and Intensive Care
Medicine, Charite Campus Mitte, German Heart Center of Charite-University
Medicine Berlin, Germany
(Konietschke) Institute of Biometry and Clinical Epidemiology,
Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat
Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Dagres) Department of Electrophysiology, Heart Center Leipzig, Leipzig,
Germany
(Sossalla) Department of Cardiology and Angiology, University of Giessen
and Kerckhoff Heart Center, Bad Nauheim, Germany
(Marrouche) Cardiology Department, Tulane University School of Medicine,
New Orleans, United States
(Crijns) Department of Cardiology and Cardiovascular Research Institute
Maastricht, Maastricht University, Maastricht, Netherlands
(Tijssen) Department of Cardiology, Amsterdam University Medical Centers,
University of Amsterdam, Amsterdam, Netherlands
(Rudolph) General and Interventional Cardiology-Angiology, United States
Publisher
Massachussetts Medical Society
Abstract
Background The role of catheter ablation in patients with symptomatic
atrial fibrillation and end-stage heart failure is unknown. Methods We
conducted a single-center, open-label trial in Germany that involved
patients with symptomatic atrial fibrillation and end-stage heart failure
who were referred for heart transplantation evaluation. Patients were
assigned to receive catheter ablation and guideline-directed medical
therapy or medical therapy alone. The primary end point was a composite of
death from any cause, implantation of a left ventricular assist device, or
urgent heart transplantation. Results A total of 97 patients were assigned
to the ablation group and 97 to the medical-therapy group. The trial was
stopped for efficacy by the data and safety monitoring board 1 year after
randomization was completed. Catheter ablation was performed in 81 of 97
patients (84%) in the ablation group and in 16 of 97 patients (16%) in the
medical-therapy group. After a median follow-up of 18.0 months
(interquartile range, 14.6 to 22.6), a primary end-point event had
occurred in 8 patients (8%) in the ablation group and in 29 patients (30%)
in the medical-therapy group (hazard ratio, 0.24; 95% confidence interval
[CI], 0.11 to 0.52; P<0.001). Death from any cause occurred in 6 patients
(6%) in the ablation group and in 19 patients (20%) in the medical-therapy
group (hazard ratio, 0.29; 95% CI, 0.12 to 0.72). Procedure-related
complications occurred in 3 patients in the ablation group and in 1
patient in the medical-therapy group. Conclusions Among patients with
atrial fibrillation and end-stage heart failure, the combination of
catheter ablation and guideline-directed medical therapy was associated
with a lower likelihood of a composite of death from any cause,
implantation of a left ventricular assist device, or urgent heart
transplantation than medical therapy alone. (Funded by Else
Kroner-Fresenius-Stiftung; CASTLE-HTx ClinicalTrials.gov number,
NCT04649801.) Copyright © 2023 Massachusetts Medical Society.

<11>
Accession Number
2026625617
Title
The effects of perioperative dexmedetomidine infusion on hemodynamic
stability during laparoscopic adrenalectomy for pheochromocytoma: a
randomized study.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1276535.
Date of Publication: 2023.
Author
Kim Y.; Yoo Y.C.; Kim N.Y.; Shin H.J.; Kweon K.H.; Moon J.; Kang S.-W.
Institution
(Kim, Yoo, Kim, Kweon, Moon) Department of Anesthesiology and Pain
Medicine, Anesthesia and Pain Research Institute, Yonsei University
College of Medicine, Seoul, South Korea
(Shin) Department of Research Affairs, Biostatistics Collaboration Unit,
Yonsei University College of Medicine, Seoul, South Korea
(Kang) Department of Surgery, Yonsei University College of Medicine,
Seoul, South Korea
Publisher
Frontiers Media SA
Abstract
Introduction: Pheochromocytoma is a rare catecholamine-producing
neuroendocrine tumor originating from the adrenal medulla chromaffin
cells. Hemodynamic instability can occur during the induction of
anesthesia and surgical manipulation of the tumor. This study investigated
the effects of intraoperative dexmedetomidine administration on
hemodynamic stability in patients undergoing laparoscopic adrenalectomy
for pheochromocytoma. Method(s): Forty patients who underwent
laparoscopic adrenalectomy for pheochromocytoma were randomly assigned to
the dexmedetomidine (n = 20) or control (n = 20) group. The primary
outcome of this study was intraoperative hemodynamic stability, and the
secondary endpoint was the plasma catecholamine concentrations,
specifically of epinephrine and norepinephrine. Result(s): The
intraoperative maximum blood pressures were significantly lower in the
dexmedetomidine group (control vs. dexmedetomidine group: 182 +/- 31 vs.
161 +/- 20, 102 +/- 17 vs. 90 +/- 10, and 128 +/- 22 vs. 116 +/- 12 [mean
+/- SD] mmHg and p = 0.020, 0.015, and 0.040 for systolic, diastolic, and
mean blood pressure, respectively). The maximum heart rate during surgery
was 108 +/- 15 bpm in the control group and 95 +/- 12 bpm in the
dexmedetomidine group (p = 0.010). Other parameters of hemodynamic
instability were comparable between both groups. Plasma catecholamine
concentrations did not differ between the groups. Conclusion(s):
Dexmedetomidine infusion following the induction of anesthesia at a rate
of 0.5 mug/kg/h significantly attenuated the maximum intraoperative SBP,
DBP, MBP, and HR, contributing to improved hemodynamic
stability. Copyright © 2023 Kim, Yoo, Kim, Shin, Kweon, Moon and
Kang.

<12>
Accession Number
2028411745
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in patients at low to intermediate surgical risk: rationale
and design of the randomised DEDICATE Trial.
Source
EuroIntervention. 19(8) (pp 652-658), 2023. Date of Publication: October
2023.
Author
Seiffert M.; Vonthein R.; Baumgartner H.; Borger M.A.; Choi Y.-H.; Falk
V.; Frey N.; Hagendorff A.; Hagl C.; Hamm C.; Konig I.R.; Landmesser U.;
Massberg S.; Reichenspurner H.; Thiele H.; Twerenbold R.; Vens M.; Walther
T.; Ziegler A.; Cremer J.; Blankenberg S.
Institution
(Seiffert) Department of Cardiology, University Heart and Vascular Center
Hamburg, Martinistrase 52, Hamburg 20246, Germany
(Seiffert, Twerenbold, Ziegler, Blankenberg) Department of Cardiology,
University Heart and Vascular Center Hamburg, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Seiffert, Twerenbold, Ziegler, Blankenberg) Centre for Population Health
Innovation (POINT), University Heart and Vascular Center Hamburg,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Seiffert, Konig, Reichenspurner, Twerenbold, Cremer, Blankenberg) DZHK
(German Centre for Cardiovascular Research) partner site
Hamburg/Kiel/Lubeck, Hamburg, Germany
(Vonthein, Konig, Vens) Institute of Medical Biometry and Statistics,
University of Lubeck, Lubeck, Germany
(Baumgartner) Department of Cardiology III - Adult Congenital and Valvular
Heart Disease, University Hospital Muenster, Muenster, Germany
(Borger) Department of Cardiac Surgery, Heart Center Leipzig, University
of Leipzig, Leipzig, Germany
(Choi) Department of Cardiac Surgery, Kerckhoff-Klinik, Bad Nauheim,
Germany
(Choi, Hamm, Walther) DZHK (German Centre for Cardiovascular Research)
partner site Rhine-Main, Rhine-Main, Germany
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC), Berlin, Germany
(Falk, Landmesser) DZHK (German Centre for Cardiovascular Research)
partner site Berlin, Berlin, Germany
(Falk) Department of Health Sciences & Technology, ETH Zurich,
Translational Cardiovascular Technology, Zurich, Switzerland
(Frey) Department of Cardiology, Angiology, and Pneumology, Heidelberg
University Hospital, Heidelberg, Germany
(Frey) DZHK (German Centre for Cardiovascular Research) partner site
Heidelberg/Mannheim, Heidelberg, Germany
(Hagendorff) Department of Cardiology, University of Leipzig, Leipzig,
Germany
(Hagl, Massberg) Department of Cardiac Surgery, University Hospital
Munich, Ludwig-Maximilians-University Munich, Munich, Germany
(Hagl) DZHK (German Centre for Cardiovascular Research) partner site
Munich Heart Alliance, Munich, Germany
(Hamm) Campus Kerckhoff and Medical Clinic I, University of Giessen,
Giessen, Germany
(Landmesser) Department of Cardiology, Angiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany and
Charite Universitatsmedizin Berlin, Berlin, Germany
(Massberg) Department of Cardiology, University Hospital Munich,
Ludwig-Maximilians-University Munich, Munich, Germany
(Reichenspurner) Department of Cardiovascular Surgery, University Heart,
Vascular Center Hamburg, Hamburg, Germany
(Thiele) Department of Cardiology, Heart Center Leipzig, University of
Leipzig, Leipzig, Germany
(Thiele) Leipzig Heart Science, Leipzig, Germany
(Walther) Department of Thoracic and Cardiovascular Surgery, University
Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main,
Germany
(Ziegler) Cardio-CARE, Medizincampus Davos, Davos, Switzerland
(Ziegler) School of Mathematics, Statistics and Computer Science,
University of KwaZulu-Natal, Pietermaritzburg, South Africa
(Cremer) Department of Cardiovascular Surgery, University Hospital of
Schleswig-Holstein, Kiel, Germany
Publisher
Europa Group
Abstract
Transcatheter aortic valve implantation (TAVI) has become the preferred
treatment option for patients with severe aortic stenosis at increased
risk for surgical aortic valve replacement (SAVR) and for older patients
irrespective of risk. However, in younger, low-risk patients for whom both
therapeutic options, TAVI and SAVR, are applicable, the optimal treatment
strategy remains controversial, as data on long-term outcomes remain
limited. The DEDICATE-DZHK6 Trial is an investigator-initiated,
industry-independent, prospective, multicentre, randomised controlled
trial investigating the efficacy and safety of TAVI compared to SAVR in
low- to intermediate-risk patients aged 65 years or older. To evaluate
both treatment strategies, approximately 1,404 patients determined
eligible for both TAVI and SAVR by the interdisciplinary Heart Team were
randomised to TAVI or SAVR. Broad inclusion and strict exclusion criteria
targeted an all-comers patient population. Procedures were performed
according to local best practice with contemporary routine medical
devices. The primary endpoints are a composite of mortality or stroke at 1
year and 5 years in order to incorporate midterm efficacy results and
complement early safety data. Primary outcomes will be tested sequentially
for non-inferiority and superiority. The DEDICATE-DZHK6 Trial has been
designed to mirror clinical reality for the treatment of severe aortic
stenosis and provide unique information on overall outcomes after TAVI and
SAVR that can be directly applied to clinical routines. Its results will
help further define optimal treatment strategies for low- to
intermediate-risk patients in whom both TAVI and SAVR are currently
advisable. Copyright © 2023 Authors. All rights reserved.

<13>
Accession Number
2028411741
Title
Clinical outcomes following different stenting techniques for coronary
bifurcation lesions: a systematic review and network meta-analysis of
randomised controlled trials.
Source
EuroIntervention. 19(8) (pp 664-675), 2023. Date of Publication: October
2023.
Author
Bujak K.; Verardi F.M.; Arevalos V.; Gabani R.; Spione F.; Rajwa P.;
Milasinovic D.; Stankovic G.; Gasior M.; Sabate M.; Brugaletta S.
Institution
(Bujak, Verardi, Arevalos, Gabani, Spione, Sabate, Brugaletta) Hospital
Clinic, Cardiovascular Clinic Institute, Institut d'Investigacions
Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona,
Barcelona, Spain
(Bujak, Gasior) 3rd Department of Cardiology, Faculty of Medical Sciences
in Zabrze, Medical University of Silesia, Katowice, Poland
(Verardi) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Cona, Italy
(Spione) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Rajwa) Department of Urology, Medical University of Vienna, Vienna,
Austria
(Milasinovic, Stankovic) Department of Cardiology, University Clinical
Center of Serbia, Belgrade, Serbia
(Milasinovic, Stankovic) Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
Publisher
Europa Group
Abstract
Background: Controversy still exists regarding the optimal treatment of
coronary bifurcation lesions. Aim(s): We aimed to analyse the
evidence from randomised controlled trials (RCTs) to compare outcomes
following different bifurcation stenting techniques. Method(s): We
systematically searched for RCTs comparing different techniques published
up to July 2022. We then conducted a pairwise meta-analysis to compare
outcomes between provisional stenting (PS) versus upfront 2-stent
techniques. Moreover, we performed a network meta-analysis (NMA) to
compare all strategies with each other. The primary endpoint was major
adverse cardiac events (MACE). Result(s): Twenty-four RCTs (6,890
patients) analysed PS, T-stenting, double-kissing (DK)-crush, crush, or
culotte stenting. The pairwise meta-analysis did not reveal a significant
difference between the PS and 2-stent techniques. However, the
prespecified sensitivity analysis, which included RCTs exclusively
enrolling patients with true bifurcation lesions, showed a lower rate of
MACE following 2-stent techniques, and meta-regression indicated that a
longer side branch lesion was associated with a greater benefit from the
2-stent strategy, which was the most apparent in RCTs with a mean lesion
length >11 mm. NMA revealed that DK-crush was associated with the lowest
MACE rate (odds ratio 0.47, 95% confidence interval: 0.36-0.62; p<0.01; PS
as a reference). Conclusion(s): Overall, 2-stent techniques were not
significantly better than PS in terms of clinical outcomes. However, the
results of the sensitivity analysis suggested that there might be a
benefit of a 2-stent approach in selected patients with true bifurcation
lesions, especially in the case of long side branch lesions. An NMA
revealed that DK-crush was associated with the lowest event rates when
compared with other techniques. Copyright © 2023 University of
Punjab (new Campus). All rights reserved.

<14>
Accession Number
2028460005
Title
A systematic review and meta-analysis of internal thoracic artery
harvesting techniques: Skeletonized vs pedicled.
Source
International Journal of Cardiology. (no pagination), 2023. Article
Number: 131577. Date of Publication: 2023.
Author
Dimagli A.; Gemelli M.; Kumar N.; Mitra M.; Sinha S.; Fudulu D.; Harik L.;
Cancelli G.; Soletti G.; Olaria R.P.; Bonaros N.; Gaudino M.; Angelini
G.D.
Institution
(Dimagli, Harik, Cancelli, Soletti, Olaria, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Dimagli, Gemelli, Kumar, Mitra, Sinha, Fudulu, Angelini) Bristol Heart
Institute, University of Bristol, Bristol, United Kingdom
(Gemelli) Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular,
and Public Health Sciences, University of Padua, Padova, Italy
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Anichstr. 35, Innsbruck 6020, Austria
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: The aim of this meta-analysis was to compare clinical and
angiographic outcomes of skeletonized versus pedicled internal thoracic
artery for coronary artery bypass grafting. Method(s): A
comprehensive search on Ovid MEDLINE, Ovid EMBASE and Scopus was performed
from inception to December 2022. The primary outcome was follow-up
mortality and graft failure. Secondary outcomes were repeat
revascularization, cardiovascular death and operative mortality,
myocardial infarction, stroke, and sternal wound complications (SWCs).
Pooled estimate for follow-up outcomes was summarized as incidence rate
ratio (IRR) and 95% confidence interval (CI) while short-term outcomes
were pooled as odds ratio (OR) and 95% CI. For all outcomes, inverse
variance weighting was used for pooling. Result(s): Twenty-eight
studies, including 7 randomized trials and 21 observational studies, for a
total of 5664 patients in the skeletonized group and 7434 in the pedicled
group, were included in the analysis. At a mean weighted follow-up of 4.8
years, there was no difference in mortality between the two groups (IRR
1.14; 95% CI 0.59-2.20). However, the skeletonized group had a higher
incidence of graft failure compared to the pedicled group (IRR 1.87, 95%
CI 1.33-2.63) but a lower risk of SWCs (OR 0.42; 95% CI 0.30-0.60). There
was no difference in short-term outcomes. Conclusion(s): Compared to
the pedicled harvesting technique, skeletonization of the internal
thoracic artery is associated with higher rate of graft failure and lower
risk of SWCs without mortality difference. Copyright © 2023

<15>
Accession Number
642755034
Title
Long term outcomes of bioprosthetic valves in the mitral position. A
systematic review of studies published over the last 20 years.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 14 Nov 2023.
Author
Koulouroudias M.; Di Mauro M.; Lorusso R.
Institution
(Koulouroudias, Di Mauro, Lorusso) Cardiovascular Research Institute,
CARIM, University of Maastricht, Netherlands
(Koulouroudias) Trent Cardiac Centre, Nottingham University Hospitals,
United Kingdom
(Lorusso) Heart & Vascular Centre, Maastricht University Medical Centre
Abstract
OBJECTIVES: Although the use of bioprostheses for mitral valve
replacement(bMVR) is on the rise, their long- term durability is not well
described. Defining bMVR durability will be instrumental in setting the
standard against which the performance of transcatheter mitral replacement
is to be judged against.The authors of this systematic review aimed to
identify, assess the quality, and review the outcomes in studies reporting
on long term outcomes after bMVR published over the last 20years.
 METHOD(S): Medline, Embase and Cochrane CENTRAL were searched for
studies that have reported outcomes beyond a minimum of five years of
follow- up after bMVR. Cohort characteristics, definitions of structural
valve deterioration(SVD), and outcomes were summarized. The risk of bias
in included studies was assessed using the Cochrane QUIPS tool.
 RESULT(S): Twenty- one studies, including 15 833 patients were
identified. 64% of all implants were porcine and the remaining bovine
pericardial.Freedom from SVD at 10years ranged from 58.9% to 100% and at
15years from 58.3% to 93%. Freedom from reoperation ranged from 65% to
98.7% at 10years and 78.5% to 91% at 15years.Information on native valve
pathology or dominant haemodynamic lesion was missing in 25% and 66% of
studies, respectively. Reports of post- operative echocardiography were
lacking, despite the heavy reliance on echocardiography for SVD diagnosis.
 CONCLUSION(S): There is considerable variability in reporting bMVR
long- term outcomes. As such, it is difficult to generate an unbiased,
generalisable understanding of long- term outcomes after bMVR across the
spectrum of mitral disease phenotypes. Copyright © The Author(s)
2023. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<16>
Accession Number
2017404087
Title
Prognostic Value of Creatine Phosphate and Inflammatory Markers for Mitral
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Applied Bionics and Biomechanics. 2022 (no pagination), 2022. Article
Number: 1132452. Date of Publication: 2022.
Author
Zhu Y.; Zou C.; Zhang J.; Chen L.; Jia Y.
Institution
(Zhu, Jia) Department of Cardiac Surgery, Shandong Provincial Hospital,
Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021,
China
(Zhu, Zou, Zhang, Chen, Jia) Department of Cardiac Surgery, Shandong
Provincial Hospital Affiliated to Shandong First Medical University,
Jinan, Shandong 250021, China
Publisher
Hindawi Limited
Abstract
Purpose. The prognosis of mitral valve replacement is an important
clinical issue and may produce unexpected mortality rates if not properly
addressed. The postoperative examination results have important prognostic
implications. This study was designed to determine the prognostic value of
phosphocreatine and inflammatory markers after mitral valve replacement.
Method. Comparison and analysis of the data obtained using SPSS software.
The computer retrieved PubMed, Science Citation Index (SCI), Embase, VIP,
CNKI, CBM, and Wanfang database and manually retrieved randomized
controlled trials (RCTs) published at home and abroad on the central
muscle protection role of creatine phosphate in heart valve replacement,
and the search period was established until February 2018. Two random
literature reviewers independently screened the literature and extracted
data, using Review Manager (RevMan) (Computer program), version 5.3 (The
Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, 2014).
RevMan software version 5.0 assesses the risk of bias for inclusion in
studies. The software performs a meta-analysis of the obtained data.
Results. Ten RCTs with a total of 464 participants were enrolled. The
meta-analysis results showed that (1) elevated creatine kinase levels
often predict a better prognosis after mitral valve replacement (RR=1.36,
95% CI: 1.22 to 1.52, P<0.00001), (2) the creatine kinase isoenzyme level
in the venous blood of the phosphocreatine group after 24 h of aortic
blocking was significantly lower than that in the control group
(SMD=-2.90, 95% CI: -5.19 to -0.60, P=0.01), and (3) Troponin I levels
were significantly lower in the intravenous creatine group than in the
control group 24 h after opening of the aortic block (SMD=-1.49, 95% CI:
-2.02 to -0.97,P<0.00001). Conclusions. Creatine phosphate and
inflammatory factor have good predictive value for the prognosis of mitral
valve replacement. Copyright © 2022 Yanhui Zhu et al.

<17>
Accession Number
2028318418
Title
The Impact of Elevated Troponin Levels on Clinical Outcomes in Patients
with Acute Ischemic Stroke: A Systematic Review.
Source
Annals of Indian Academy of Neurology. 26(5) (pp 641-654), 2023. Date of
Publication: 2023.
Author
Pitliya A.; Aledani E.M.; Bhangu J.K.; Javed K.; Manshahia P.K.; Nahar S.;
Kanda S.; Chatha U.; Odoma V.; Mohammed L.
Institution
(Pitliya, Aledani, Bhangu, Javed, Manshahia, Nahar, Kanda, Chatha, Odoma,
Mohammed) Department of Research, California Institute of Behavioral
Neurosciences and Psychology, Fairfield, CA, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
The association between high cardiac troponin (cTn) levels and stroke
characteristics and outcomes remains unclear. This systematic review aimed
to determine the prevalence and clinical implications of elevated cTn
levels in patients with acute ischemic stroke (AIS). We conducted a
systematic review using the Preferred Reporting Items for Systematic
Reviews and Meta-analysis (PRISMA) 2020 guidelines. A comprehensive search
of PubMed, Google Scholar, Science Direct, and Research Gate databases was
conducted to identify relevant studies published in English up to May
2023. This study included all reports on serum cTn levels and AIS. Two
independent reviewers assessed study quality and bias using study-specific
tools before inclusion. The systematic review included a total of 14
articles with 16906 participants, including one systematic review, one
randomized controlled trial (RCT), and 12 observational studies. The
results of this systematic review indicate that the prevalence of high cTn
levels is averaged at 17.9%, or 1 in 5 individuals, who have an AIS. The
review emphasizes the detrimental effects of increased cTn levels on
outcomes for in-hospital and all-cause mortality as well as cardiovascular
outcomes in patients with AIS. These results demonstrate that serum cTn
has the potential to be a useful tool for risk classification and
prognostic assessment in individuals with AIS. AIS patients with elevated
serum cTn at baseline have an increased risk of mortality. Early and
routine evaluation of serum cTn may contribute to the timely detection of
co-morbid cardiovascular injury and prevent unfavorable outcomes in
patients with AIS. Copyright © 2023 Annals of Indian Academy of
Neurology.

<18>
Accession Number
2028272435
Title
Plasmalyte and Ringer Lactate as Priming Solutions in Pediatric
Cardiopulmonary Bypass: A Comparative Study.
Source
Cardiometry. (28) (pp 34-42), 2023. Date of Publication: August 2023.
Author
Abdellatif A.E.; Alassal M.A.; Raihan-Ul-Haq; Abdelsabour M.M.
Institution
(Abdellatif, Alassal) Cardiothoracic Surgery Department, Faculty of
Medicine, Benha University, Benha 13511, Egypt
(Raihan-Ul-Haq) AIIMS, New Delhi, India
(Raihan-Ul-Haq) PAAMCC, Arar, Saudi Arabia
(Abdelsabour) Cardiothoracic Surgery Department, Faculty of Medicine,
Menoufia University, Menoufia, Egypt
Publisher
Novyi Russkii Universitet
Abstract
Background: Pediatric heart surgery, particularly for cyanotic congenital
heart conditions, commonly requires the utilization of cardiopulmonary
bypass (CPB) to assist with surgical interventions. The choice of priming
solution for the CPB circuit can influence postoperative outcomes. This
study aimed to assess the impact of two different priming solutions,
Plasmalyte and Ringer's Lactate, on postoperative outcomes, blood
biochemistry, pulmonary and renal function, bleeding, and hemostasis in
children undergoing open cardiac surgery with CPB. Method(s): This
randomized prospective study was conducted on 80 pediatric patients aged 1
to 10 years, undergoing elective cardiac surgery with CPB. Patients were
randomly assigned to receive either Plasmalyte (Group A) or Ringer's
Lactate (Group B) as their CPB circuit priming solution. Standardized
protocols for anesthesia, CPB circuit components, and surgical techniques
were maintained. Postoperative parameters including blood chemistry,
perfusion indicators, and physiological measurements were recorded and
analyzed. Result(s): After CPB initiation, lactate levels were
significantly higher in Group B (Ringer's Lactate) compared to Group A
(Plasmalyte) (P-value <0.001). Calcium levels also showed a significant
difference between the two groups (P-value <0.001). Postoperative lactate
levels remained higher in Group B (P-value <0.001), while bicarbonate,
calcium, urine output, urea, and creatinine levels at 6th hour
postoperatively were statistically significant (p<0.05).
 Conclusion(s): Priming the CPB circuit with Plasmalyte may be
associated with favorable outcomes in terms of lactate and calcium levels
compared to Ringer Lactate in pediatric patients undergoing cardiac
surgery. Copyright © 2023 Novyi Russkii Universitet. All rights
reserved.

<19>
Accession Number
2028126305
Title
Bilateral external oblique intercostal plane block (EOIPB) in patients
undergoing laparoscopic cholecystectomy.
Source
Saudi Medical Journal. 44(10) (pp 1037-1046), 2023. Date of Publication:
October 2023.
Author
Korkusuz M.; Basaran B.; Et T.; Bilge A.; Yarimoglu R.; Yildirim H.
Institution
(Korkusuz, Basaran, Et, Bilge) The Department of Anesthesiology and
Reanimation, Kamil Ozdag Faculty of Science, Karaman, Turkey
(Korkusuz, Basaran, Et, Bilge) Karamanoglu Mehmetbey University School of
Medicine, the Department of Anesthesiology and Reanimation, Kamil Ozdag
Faculty of Science, Karaman, Turkey
(Yarimoglu) Karaman Training and Research Hospital, the Department of
Mathematics, Kamil Ozdag Faculty of Science, Karaman, Turkey
(Yildirim) Karamanoglu Mehmetbey University, Kamil Ozdag Faculty of
Science, Karaman, Turkey
Publisher
Saudi Arabian Armed Forces Hospital
Abstract
Objectives: To measure tramadol intake in the first 24 hours post-surgery.
In addition, pain scores and quality of recovery were evaluated as
secondary outcomes. Method(s): A total of 80 adult patients scheduled
for laparoscopic cholecystectomy were randomized into 2 groups (with and
without external oblique intercostal plane block [EOIPB]). Control group
of patients received standard multimodal analgesia, EOIPB was applied on
each side to patients in EOIPB group in addition to multimodal analgesia.
The primary outcome was to evaluate tramadol consumption at postoperative
24 hours. Secondary outcomes were evaluating the Numeric Rating Scale
(NRS) scores, postoperative Quality of Recovery score (QoR-15), sedation
score, the incidence of nausea and vomiting, and antiemetic consumption.
 Result(s): In EOIPB group, median (Q1, Q3) tramadol consumption
values for 24 hours (0 [0,50] mg) were found to be significantly lower
than the control group (50 [50,100] mg) (median difference -50) (p<0.001).
NRS values during rest and motion were lower in EOIPB group compared to
the control group at all measurement points within 24 hours (p<0.05). The
total QoR-15 scores were significantly higher in EOIPB group compared to
the control group (p<0.001). No differences were detected in other
secondary outcome parameters. Conclusion(s): External oblique
intercostal plane block resulted in less postoperative tramadol
consumption. However, there were no minimal clinically important
differences about postoperative opioid consumption. On the other hand,
compared to multimodal analgesia addition of EOIPB improved overall QoR-15
scores at postoperative 24 hours. Copyright © 2023 Saudi Arabian
Armed Forces Hospital. All rights reserved.

<20>
Accession Number
2026601522
Title
The effect of hospital-to-home transitional care using a digital messaging
application on the health outcomes of patients undergoing CABG and their
family caregivers: a randomized controlled trial study protocol.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1224302. Date of Publication: 2023.
Author
Maleki M.; Mardani A.; Iloonkashkooli R.; Khachian A.; Glarcher M.;
Vaismoradi M.
Institution
(Maleki) Pediatric and Neonatal Intensive Care Nursing Education
Department, School of Nursing and Midwifery, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mardani, Khachian) Nursing and Midwifery Care Research Center, School of
Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Iloonkashkooli) Student Research Committee, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Glarcher) Institute of Nursing Science and Practice, Paracelsus Medical
University, Salzburg, Austria
(Vaismoradi) Faculty of Nursing and Health Sciences, Nord University,
Bodo, Norway
(Vaismoradi) Faculty of Science and Health, Charles Sturt University,
Orange, NSW, Australia
Publisher
Frontiers Media SA
Abstract
Objectives: Given the increasing trend of care transition from healthcare
settings to patients' own home, patients and their family caregivers
should take more responsibilities for care at own home. This study is
going to investigate the effect of a transitional care program from
hospital to own home using a digital messaging application on patients'
undergoing coronary artery bypass graft (CABG) surgery and their family
caregivers' health outcomes. Method(s): A parallel randomized
controlled trial study will be conducted in a hospital in a metropolis
located in southwestern Iran. Sampling will be performed sequentially and
the eligible dyad of patients and family caregivers will be randomly
assigned to intervention and control groups. The intervention group will
receive a transitional care program for 8 weeks using the WhatsApp on the
mobile phone based on the person-centered care approach, but the control
group will receive routine care for patient's transition. Data collection
will be conducted at baseline, immediately after the intervention, and two
months after the intervention using demographic questionnaire, Cardiac
Self-Efficacy Scale (CSES), MacNew Heart Disease Health-Related Quality of
Life questionnaire (MNHD-Q), Cardiac Symptom Scale (CSS), Morisky
Medication Adherence Scale, and Caregiver Burden Scale (CBS). Descriptive
and inferential statistics will be used for data analysis.
 Conclusion(s): The results of this study will allow evaluating the
effectiveness of an innovative transitional care program to patients' own
home using a digital messaging application. If the transitional program is
shown feasible and effective it can be incorporated into existing care
programs and stimulate further studies on the use of digital solutions for
improving the continuity of care in own home. Copyright 2023 Maleki,
Mardani, Iloonkashkooli, Khachian, Glarcher and Vaismoradi.

<21>
Accession Number
2026586432
Title
Comparison of robot-assisted thoracic surgery versus video-assisted
thoracic surgery in the treatment of lung cancer: a systematic review and
meta-analysis of prospective studies.
Source
Frontiers in Oncology. 13 (no pagination), 2023. Article Number: 1271709.
Date of Publication: 2023.
Author
Huang S.; Huang X.; Huang Z.; Luo R.; Liang W.
Institution
(Huang, Huang, Huang, Luo, Liang) The First Affiliated Hospital of Guangxi
University of Science and Technology, Guangxi University of Science and
Technology, Guangxi, Liuzhou, China
Publisher
Frontiers Media SA
Abstract
Introduction: Previous studies have compared robot-assisted thoracic
surgery(RATS) with video-assisted thoracic surgery (VATS) in the treatment
of patients with lung cancer, but results were conflicting. The present
meta-analysis aimed to compare the clinical outcomes of RATS with VATS in
the treatment of patients with lung cancer. Material(s) and
Method(s): Web of Science, PubMed, Cochrane Library and Embase were
comprehensively searched for randomized controlled trials or prospective
cohort studies comparing the clinical outcomes of RATS and VATS from
inception to 22 July 2023. The Cochrane Risk of Bias tool was used to
assess risk of bias. Meta-analyses of length of hospital stay,
postoperative duration of drainage, postoperative complications, operative
time, conversion, estimated blood loss, the number of dissected lymph
nodes and stations, 30-day readmission and 30-day mortality were
performed. Result(s): In total 5 studies were included in the
meta-analysis. A total of 614 patients were included, of which 299
patients were treated by RATS and 315 patients treated by VATS. Blood loss
was significantly less in RATS group than that in VATS (MD = -17.14, 95%
CI -29.96 ~ -4.33, P = 0.009). More nodes stations were dissected in RATS
group compared with VATS group(MD= 1.07, 95% CI 0.79 ~ 1.36, P < 0.001).
No significant difference occurred between RATS and VATS in length of
hospital stay(MD= -0.19, 95% CI -0.98~0.61), readmission(OR=0.74, 95%CI
0.36~1.51, P=0.41), operative time(MD=11.43 95% CI -8.41~31.26, P=0.26),
conversion(OR=0.58, 95% CI 0.29~1.17, P=0.13), number of dissected lymph
nodes(MD=0.98, 95% CI -0.02~1.97, P=0.05), upstaging rate(OR =0.67, 95% CI
0.38 ~ 1.18, P =0.16, I2 = 0%), time of chest tube drainage
(MD= -0.34, 95%CI -0.84~0.15, P=0.17), post-operative
complications(OR=0.76, 95% CI 0.52~ 1.11, P=0.16) and total cost(MD =
3103.48, 95% CI -575.78 ~ 6782.74, P=0.1, I2 = 99%).
 Conclusion(s): RATS is a feasible and safe treatment that can achieve
better surgical outcomes compared with VATS in terms of short-term
outcomes. Except of higher total cost, RATS has obvious advantage in
lymphadenectomy and control of intraoperative bleeding. However, large
sample and long follow-up randomized clinical trials comparing RATS with
VATS are still necessary to better demonstrate the advantages of RATS for
lung cancer. Systematic review registration:
https://www.crd.york.ac.uk/prospero/, Identifier
CRD42023446653. Copyright © 2023 Huang, Huang, Huang, Luo and
Liang.

<22>
Accession Number
2025193934
Title
Sex differences in permanent pacemaker implantation after transcatheter
aortic valve replacement: a systematic review and meta-analysis.
Source
Expert Review of Cardiovascular Therapy. 21(9) (pp 631-641), 2023. Date of
Publication: 2023.
Author
Rivera F.B.; Cha S.W.; Aparece J.P.; Gonzales J.S.T.; Salva W.F.C.;
Bantayan N.R.B.; Carado G.P.; Sharma V.; Al-Abcha A.; Co M.L.; Collado
F.M.S.; Volgman A.S.
Institution
(Rivera) Department of Medicine, Lincoln Medical Center, New York, NY,
United States
(Cha, Aparece, Gonzales, Salva) Cebu Institute of Medicine, Cebu,
Philippines
(Bantayan) University of the Philippines College of Medicine, Manila,
Philippines
(Carado) University of the East Ramon Magsaysay Memorial Medical Center,
Quezon, Philippines
(Sharma) Department of Cardiology, University of Iowa Hospitals and
Clinics, Lowa City, IA, United States
(Al-Abcha) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Co) Section of Clinical Cardiac Electrophysiology, Thomas Jefferson
University, Philadelphia, PA, United States
(Collado, Volgman) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: There is limited evidence on the effect of sex on permanent
pacemaker implantation (PPMI) after transcatheter aortic valve replacement
(TAVR). The primary objective of this meta-analysis was to determine the
role of sex among patients requiring PPMI post-TAVR. Method(s): A
literature search was conducted using the SCOPUS, MEDLINE, and CINAHL
databases for studies published until October 2022. Eligible studies
included published randomized controlled trials (RCTs) and Observational
Cohort Studies (OCS) articles that reported PPMI as an outcome of
pacemaker status following TAVR. This study was performed per the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) Guidelines. Publication bias was estimated using a Funnel plot
and Egger's test. Data were pooled using a random-effects model. The
primary endpoint was the sex difference in PPMI after TAVR, with odds
ratios and 95% confidence intervals (CIs) extracted. Result(s): Data
was obtained from 63 studies, and a total of 79,655 patients were
included. The cumulative PPMI rate was 15.5% (95% CI, 13.6%-17.7%). The
pooled analysis revealed that while there were more females than males
undergoing TAVR (51.6%, 95% CI 50.4%-52.8%), males have a 14.5% higher
risk for post-TAVR PPMI than females (OR 1.145, 95% CI 1.047-1.253, P <
0.01). Conclusion(s): Males are more likely to experience PPMI after
TAVR than females. Further research needs to be done to better explain
these observed differences in outcomes. Copyright © 2023 Informa
UK Limited, trading as Taylor & Francis Group.

<23>
Accession Number
2026602374
Title
The effects of tranexamic acid on platelets in patients undergoing cardiac
surgery: a systematic review and meta-analysis.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2023. Date of
Publication: 2023.
Author
Zou Z.-Y.; He L.-X.; Yao Y.-T.
Institution
(Zou, He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular
Hospital, Yunnan Province, Kunming 650000, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing 100037, China
Publisher
Springer
Abstract
Abstract: This meta-analysis was designed to evaluate the effects of
tranexamic acid (TXA) on platelets in patients undergoing cardiac surgery
(CS). Relevant trials were identified by computerized searches of PUBMED,
Cochrane Library, EMBASE, OVID, China National Knowledge Infrastructure
(CNKI), Wanfang Data and VIP Data till Jun 4th, 2022, were searched using
search terms "platelet", "Tranexamic acid", "cardiac surgery", "randomized
controlled trial" database search was updated on Jan 1st 2023. Primary
outcomes included platelet counts, function and platelet membrane
proteins. Secondary outcome included postoperative bleeding. Search
yielded 49 eligible trials, which were finally included in the current
study. As compared to Control, TXA did not influence post-operative
platelet counts in adult patients undergoing on- or off-pump CS, but
significantly increased post-operative platelet counts in pediatric
patients undergoing on-pump CS [(WMD = 16.72; 95% CI 6.33 to 27.10; P =
0.002)], significantly increased post-operative platelet counts in adults
valvular surgery [(WMD = 14.24; 95% CI 1.36 to 27.12; P = 0.03).
Additionally, TXA improved ADP-stimulated platelet aggression [(WMD =
1.88; 95% CI 0.93 to 2.83; P = 0.0001)] and improved CD63 expression on
platelets [(WMD = 0.72; 95% CI 0.29 to 1.15; P = 0.001)]. The current
study demonstrated that TXA administration did not affect post-operative
platelet counts in adult patients undergoing either on- or off-pump CABG,
but significantly increased post-operative platelet counts in pediatric
patients undergoing on-pump CS and adults valvular surgery. Furthermore,
TXA improved ADP-stimulated platelet aggression and improved CD63
expression on platelets. To further confirm this, more well designed and
adequately powered randomized trials are needed. Graphical abstract:
[Figure not available: see fulltext.]. Copyright © 2023, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<24>
Accession Number
2026424044
Title
Landiolol for the prevention of postoperative atrial fibrillation after
cardiac surgery: a systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. 70(11) (pp 1828-1838), 2023. Date of
Publication: November 2023.
Author
Cafaro T.; Allwood M.; McIntyre W.F.; Park L.J.; Daza J.; Ofori S.N.; Ke
Wang M.; Borges F.K.; Conen D.; Marcucci M.; Healey J.S.; Whitlock R.P.;
Lamy A.; Belley-Cote E.P.; Spence J.D.; McGillion M.; Devereaux P.J.
Institution
(Cafaro, McIntyre, Ofori, Ke Wang, Borges, Conen, Marcucci, Healey,
Whitlock, Lamy, Belley-Cote, Spence, McGillion, Devereaux) Population
Health Research Institute, McMaster University, Hamilton, ON, Canada
(Cafaro) Division of Internal Medicine, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Cafaro) Department of Medicine, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Cafaro) Lady Davis Institute, Jewish General Hospital, Montreal, QC,
Canada
(Allwood) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(McIntyre, Ofori, Ke Wang, Borges, Conen, Marcucci, Healey, Whitlock,
Lamy, Belley-Cote, Spence, McGillion, Devereaux) Health Research Methods,
Evidence, and Impact (HEI), Faculty of Health Sciences, McMaster
University, Hamilton, ON, Canada
(Park) Division of General Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Daza) Division of General Surgery, Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Cafaro) David Braley Research Institute, C1-109, 237 Barton Street East,
Hamilton, ON L8L 2X2, Canada
Publisher
Springer
Abstract
Purpose: Postoperative atrial fibrillation (POAF) is a common complication
following cardiac surgery. Although the evidence suggests that beta
blockers prevent POAF, they often cause hypotension. Landiolol, an
ultra-short-acting beta<inf>1</inf> blocker, may prevent POAF, without
adverse hemodynamic consequences. Source: We searched MEDLINE, CENTRAL,
Embase, and trial registries between January 1970 and March 2022. We
included randomized controlled trials (RCTs) that evaluated the effect of
landiolol for the prevention of POAF after cardiac surgery. Two reviewers
independently assessed eligibility, extracted data, and assessed risk of
bias using the Risk of Bias 2.0 tool. We pooled data using random-effects
models. We used the Grading of Recommendations, Assessment, Development
and Evaluations framework to assess certainty of evidence. Principal
findings: Nine RCTs including 868 participants met the eligibility
criteria. Patients randomized to landiolol (56/460) had less POAF compared
with controls (133/408) with a relative risk (RR) of 0.40 (95% confidence
interval [CI], 0.30 to 0.54; I2 = 0%;) and an absolute risk of
12.2% vs 32.6% (absolute risk difference, 20.4%; 95% CI, 15.0 to 25.0).
Landiolol resulted in a shorter hospital length-of-stay (LOS) (268
patients; mean difference, -2.32 days; 95% CI, -4.02 to -0.57;
I2 = 0%). We found no significant difference in bradycardia
(RR, 1.11; 95% CI, 0.48 to 2.56; I2 = 0%). No hypotension was
reported with landiolol. We judged the certainty of evidence as moderate
for POAF (because of indirectness as outcomes were not clearly defined)
and low for LOS (because of imprecision and concern of reporting bias).
 Conclusion(s): In patients undergoing cardiac surgery, landiolol
likely reduces POAF and may reduce LOS. A definitive large RCT is needed
to confirm these findings. Study registration: PROSPERO (CRD42021262703);
registered 25 July 2021. Copyright © 2023, The Author(s).

<25>
Accession Number
2023804300
Title
Ultrasonic scalpel versus electrocautery for internal mammary artery
harvesting: a meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. 71(12) (pp 723-729), 2023.
Date of Publication: December 2023.
Author
Kaneyuki D.; Patil S.; Jackson J.; Ahmad D.; Plestis K.A.; Guy T.S.;
Massey H.T.; Entwistle J.W.; Morris R.J.; Tchantchaleishvili V.
Institution
(Kaneyuki, Patil, Jackson, Ahmad, Plestis, Guy, Massey, Entwistle, Morris,
Tchantchaleishvili) Division of Cardiac Surgery, Department of Surgery,
Thomas Jefferson University, 1025 Walnut St, Suite 607, Philadelphia, PA
19107, United States
Publisher
Springer
Abstract
Objective: Although an ultrasonic harmonic scalpel (HS) has been used to
harvest the internal mammary artery (IMA) for coronary artery bypass
grafting, the benefits and risks compared to conventional electrocautery
(EC) are not clear. We aimed to compare the outcomes of HS versus EC for
IMA harvesting. Method(s): An electronic search was performed to
identify all relevant studies. Baseline characteristics, perioperative
variables, and clinical outcomes were extracted and pooled for
meta-analysis. Result(s): This meta-analysis included 12 studies.
Pooled analyses demonstrated that both groups had comparable preoperative
baseline characteristics including age, gender, and left ventricular
ejection fraction. HS included more diabetic patients [33% (95% CI 30, 35)
vs. 27% (23, 31), p = 0.01]. Harvest time for unilateral IMA was
significantly longer with HS than EC [39 (31, 47) minutes vs. 25 (17, 33)
minutes, p < 0.01]. However, the rate of pedicled unilateral IMA was
significantly higher for EC compared with HS [20% (17, 24) vs. 8% (7, 9),
p < 0.01]. The rate of intact endothelium was significantly higher with HS
than EC [95% (88, 98) vs. 81% (68, 89), p < 0.01). There was no
significant difference in postoperative outcomes including bleeding [3%
(2, 4)], sternal infection [3% (2, 4)], and operative/30-day mortality [3%
(2, 4)]. Conclusion(s): HS required longer IMA harvest times which
could be partially attributed to a higher skeletonization rate in this
category. HS may cause less endothelial injury than EC; however, no
significant differences in postoperative outcomes were seen between the
groups. Copyright © 2023, The Author(s), under exclusive licence
to The Japanese Association for Thoracic Surgery.

<26>
Accession Number
2028391714
Title
Retraction: Prognostic Value of Creatine Phosphate and Inflammatory
Markers for Mitral Valve Replacement: A Systematic Review and
Meta-Analysis (Applied Bionics and Biomechanics (2022) 2022 (1132452) DOI:
10.1155/2022/1132452).
Source
Applied Bionics and Biomechanics. 2023 (no pagination), 2023. Article
Number: 9859846. Date of Publication: 2023.
Author
Anonymous
Publisher
Hindawi Limited
Abstract
This article has been retracted by Hindawi following an investigation
undertaken by the publisher [1]. This investigation has uncovered evidence
of one or more of the following indicators of systematic manipulation of
the publication process: (1) Discrepancies in scope (2) Discrepancies in
the description of the research reported (3) Discrepancies between the
availability of data and the research described (4) Inappropriate
citations (5) Incoherent, meaningless and/or irrelevant content included
in the article (6) Peer-review manipulation. The presence of these
indicators undermines our confidence in the integrity of the article s
content and we cannot, therefore, vouch for its reliability. Please note
that this notice is intended solely to alert readers that the content of
this article is unreliable. We have not investigated whether authors were
aware of or involved in the systematic manipulation of the publication
process. Wiley and Hindawi regrets that the usual quality checks did not
identify these issues before publication and have since put additional
measures in place to safeguard research integrity. We wish to credit our
own Research Integrity and Research Publishing teams and anonymous and
named external researchers and research integrity experts for contributing
to this investigation. The corresponding author, as the representative of
all authors, has been given the opportunity to register their agreement or
disagreement to this retraction. We have kept a record of any response
received. Copyright © 2023 Applied Bionics and Biomechanics.

<27>
Accession Number
2026647071
Title
Comparing acute normovolumic hemodilution with autologous platelet-rich
plasma for blood preservation during aortic surgery : study protocol for a
randomized controlled clinical trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 741. Date of
Publication: December 2023.
Author
Zhu D.; Li Y.; Tian A.-Y.; Wang H.-N.
Institution
(Zhu, Li, Tian, Wang) Department of Anesthesiology, The First Hospital of
China Medical University, 155 Nanjing North Street, Heping District,
Liaoning Province, Shenyang, China
Publisher
BioMed Central Ltd
Abstract
Background: Both acute normovolumic hemodilution (ANH) and autologous
platelet-rich plasma (aPRP) have been demonstrated blood-protective
effects in cardiac aortic surgery; however, the efficacies of the two
methods have not been compared. This study aims to compare the effects of
aPRP and ANH prior to aortic surgery on postoperative bleed and other
outcomes. Methods and analysis: This is a prospective, single-center,
double-blind controlled clinical trial including 160 patients randomized
1:1 to receive aPRP (test group) or autologous whole blood (ANH, control
group). The primary objective is to compare the drainage volumes in the
two groups at 24, 48, and 72 h postoperatively. Secondary outcomes include
input of allogeneic blood and blood products and durations of aortic
block, extracorporeal circulation, deep hypothermic arrest of circulation,
tracheal extubation, hospital stay, requirement for secondary surgical
hemostasis, and application of intra-aortic balloon pump or extracorporeal
membrane oxygenation in the two groups. In addition, heart rate, systolic
blood pressure, diastolic blood pressure, central venous pressure, and
thromboelastography recorded before blood reservation (T1), after blood
reservation (T2), before blood transfusion (T3), and after the blood is
returned (T4) to the transfusion will be compared between the two groups
of patients. Discussion(s): This study will demonstrate if the use of
aPRP could reduce the risk of bleeding after aortic surgery compared with
ANH. The results are expected to have practical clinical applications in
terms of more effective blood protection and shorter hospital stay. Trial
registration: This study was registered with the Chinese Clinical Trial
Registry (http://www.chictr.org.cn/) with the ID ChiCTR
1900023351.Registered on May 23, 2019. Trial status: Recruiting start
date: July 1, 2019; expected recruiting end date: July 1, 2024 Version
number and date: Version 2 of 05-04-2019 Copyright © 2023, The
Author(s).

<28>
Accession Number
2026646473
Title
The efficacy of phase I cardiac rehabilitation training based on augmented
reality on the self-efficacy of patients undergoing coronary artery bypass
graft surgery: A randomized clinical trial.
Source
BMC Sports Science, Medicine and Rehabilitation. 15(1) (no pagination),
2023. Article Number: 156. Date of Publication: December 2023.
Author
Ghlichi Moghaddam N.; Namazinia M.; Hajiabadi F.; Mazlum S.R.
Institution
(Ghlichi Moghaddam) Department of Medical - Surgical Nursing, School of
Nursing and Midwifery (MSC Student), Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Namazinia) Department of Nursing, School of Nursing and Midwifery, Torbat
Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,
Islamic Republic of
(Hajiabadi, Mazlum) Department of Medical - Surgical Nursing, School of
Nursing and Midwifery, Mashhad University Medical of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Ghlichi Moghaddam, Hajiabadi, Mazlum) Nursing and Midwifery Care Research
Center, Mashhad University Medical of Medical Sciences, Mashhad, Iran,
Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Open-heart surgery is considered one of the primary treatments
for severe coronary artery stenosis, but it comes with its own set of
complications. However, these complications can be reduced through the
implementation of proper cardiac rehabilitation during phase I. This study
aimed to examine the impact of phase I cardiac rehabilitation training,
using augmented reality, on the self-efficacy of cardiac management in
patients undergoing coronary artery bypass grafting. Methodology: This
randomized clinical trial study involved 60 patients who were admitted to
the Cardiac Surgery Intensive Care Unit at Ghaem Hospital in Mashhad. The
software used in this study consisted of various videos and educational
images demonstrating physical exercises for cardiac rehabilitation. The
software was developed to train the patients in the intervention group on
the rehabilitation program, starting from their admission to the Intensive
Care Unit until their discharge from the hospital. The collected data were
analyzed using statistical tests such as independent t-test, Mann-Whitney
test, paired t-test, chi-square test, as well as descriptive indicators.
Cohen's d was also used to evaluate the magnitude of the effect size.
 Result(s): The findings of this study revealed that the total mean
score for cardiovascular management self-efficacy significantly increased
during the transfer to the Intensive Care Unit and at the time of
discharge. Notably, the increase observed in the intervention group was
significantly greater than that of the control group (P < 0.001).
 Conclusion(s): The results of this study indicated that implementing
early rehabilitation programs, using innovative educational technology
like augmented reality, enhanced the self-efficacy of patients undergoing
coronary artery bypass grafting. These findings suggest that such programs
can be effectively employed as educational tools throughout different
stages of cardiac rehabilitation. Trial Registration: This study was
registered in the Iranian Registry of Clinical Trials (no.
IRCT20200203046361N1) on 16/02/2020. Copyright © 2023, The
Author(s).

<29>
Accession Number
2026644577
Title
EFFECTS OF TAI CHI EXERCISES ON PHYSICAL ACTIVITY AND PULMONARY FUNCTION
IN PATIENTS WITH CORONARY ARTERY BYPASS GRAFTING.
Source
Journal of Medical Sciences (Peshawar). 31(4) (pp 261-265), 2023. Date of
Publication: 14 Nov 2023.
Author
Razzaq M.; Obaid S.; Tariq I.; Iqbal M.A.; Kiani S.K.; Ramzan T.
Institution
(Razzaq, Obaid, Tariq, Kiani) Riphah College of Rehabilitation & Allied
Health Sciences, Riphah International University, Islamabad, Pakistan
(Iqbal) Armed Forces Institute of Cardiology, National Institute of Heart
Diseases, Rawalpindi, Pakistan
(Ramzan) Shifa Tameer E Millat University, Islamabad, Pakistan
Publisher
Khyber Medical College
Abstract
Objective: To determine the effects of Tai Chi exercises on physical
activity, pulmonary function, and rate of perceived exertion in
post-coronary artery bypass grafting patients. Material(s) and
Method(s): A Randomized control trial was conducted in the Armed Forces
Institute of Cardiology/National Institute of Heart Diseases Rawalpindi
Pakistan from January 2018-July 2018. 50 post-coronary artery bypass
grafting patients were calculated by the open epi tool and randomly
allocated into two groups in equal halves through non-probability
purposive sampling with the toss the coin method. 40-60 years males and
females with >40% ejection fraction were included while vitally unstable
patients were excluded. The experimental group was given Tai Chi exercises
while the control group was given a bicycle. Levels of physical activity
and pulmonary functions were assessed at baseline, 4thand 6th week of
training. Result(s): Out of the total sample size only 39 were
analyzed 11 were dropped off due to not following proper follow-up, and
there was no statistical difference in heart rate P=0.095. Oxygen
saturation shows a significant difference with P<0.001, Physical activity
was low at baseline but after exercise training, the Tai Chi group showed
great improvement P< 0.01. Pulmonary functions showed statistically
insignificant results P=0.865. The rate of perceived exertion was high in
2nd week and gradually decreased with the mean of 3.20 and 3.37 while the
time of exercise was improved with P<0.01. Conclusion(s): Tai Chi
exercises have better improvement in pulmonary function, rate of perceived
exertion, time of exercise, and physical activity in post-coronary artery
bypass grafting patients. Copyright © 2023, Khyber Medical
College. All rights reserved.

<30>
Accession Number
2028481549
Title
Clinical impact of coronary revascularization over medical treatment in
chronic coronary syndromes: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Panuccio G.; Carabetta N.; Torella D.; De Rosa S.
Institution
(Panuccio, Carabetta, De Rosa) Department of Medical and Surgical
Sciences, Italy
(Torella) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
Publisher
Hellenic Cardiological Society
Abstract
Objective: To provide a quantitative comparison between myocardial
revascularization (REVASC) and optimal medical treatment (OMT) alone in
patients with chronic coronary syndrome (CCS). Method(s): Pertinent
studies were searched for in PubMed/Medline until 12/03/2023. Randomized
controlled trials that compare REVASC to OMT reporting clinical outcomes
were selected according to PRISMA guidelines. The primary outcome was
cardiovascular death. Two investigators independently assessed the study
quality and extracted data. Result(s): Twenty-eight randomized
controlled studies (RCTs) including 20692 patients were included in this
meta-analysis. The rate of cardiovascular mortality was significantly
lower among patients treated with myocardial revascularization [risk ratio
(RR) 0.79, 95% CI 0.69-0.90]. Age (p = 0.03), multivessel disease (p <
0.001), and follow-up duration (p = 0.001) were significant moderators of
CV mortality. Subgroup analyses showed a larger benefit in patients
treated with drug-eluting stents and those without chronic total
occlusion. Among secondary outcomes, myocardial infarction was less
frequent in the REVASC group (RR = 0.74; p < 0.001), while no significant
difference was found for all-cause mortality (p = 0.09) nor stroke (p =
0.26). Conclusion(s): The present analysis showed lower rates of CV
mortality and myocardial infarction in CCS patients treated with
myocardial revascularization compared to OMT. This benefit was larger with
increasing follow-up duration. Personalized treatment based on patient
characteristics and lesion complexity may optimize clinical outcomes in
patients with CCS. Copyright © 2023 Hellenic Society of
Cardiology

<31>
Accession Number
642751170
Title
Epidural analgesia versus oral morphine for postoperative pain management
following video-assisted thoracic surgery: A randomised, controlled,
double-blind trial.
Source
European journal of anaesthesiology. (no pagination), 2023. Date of
Publication: 14 Nov 2023.
Author
Holm J.H.; Andersen C.; Toft P.
Institution
(Holm) From the Department of Anaesthesiology and Intensive Care, Odense
University Hospital, Odense, CA, United States
Abstract
BACKGROUND: The use of thoracic epidural analgesia for postoperative pain
management in video-assisted thoracic surgery (VATS) is controversial.
Still, the evidence on omitting it in favour of systemic opioids is
inconclusive, and studies are small and non-blinded. OBJECTIVE(S): We
aimed to compare pain after VATS using epidural analgesia or enteral
opioids for postoperative pain management.
DESIGN/SETTING/PATIENTS/INTERVENTION: A randomised, double-blind,
controlled trial at a Danish tertiary hospital. Adult patients scheduled
for VATS were assigned to multimodal non-opioid baseline analgesia
supplemented with either thoracic epidural analgesia (TE Group) or oral
morphine (OM Group) for postoperative pain management. We recorded pain
five times a day, both at rest and during activity, using the Numeric
Rating Scale (NRS) and categorised it into "acceptable pain" or
"unacceptable pain". Unacceptable pain was defined as NRS (at rest) >=3 or
NRS (with activity) >=5 when supplementary analgesics were given. MAIN
OUTCOME MEASURES: The primary outcomes were the proportions of patients
experiencing "unacceptable pain" during the postoperative period and the
use of intravenous "rescue" opioids. RESULT(S): Of the 161 included
patients, 146 received the allocated treatment and their data were
analysed. At rest, 34% of patients in the TE Group and 64% of patients in
the OM Group experienced unacceptable pain during the study period, a
significant between-group difference of 30% (P < 0.0005). During activity
these percentages were 32% of patients in the TE Group and 59% in the OM
group, a difference of 27% (P < 0.005). The median intravenous rescue
morphine consumption during the study period was 4.5 [interquartile range
(IQR), 0-10.0] mg in the TE Group and 7.5 [0-19.0] mg in the OM Group (P <
0.005). CONCLUSION(S): Epidural analgesia provided better pain relief
after VATS than oral morphine. The between-group difference in rescue
intravenous morphine consumption was statistically significant but
clinically irrelevant. TRIAL REGISTRATION: ClinicalTrials.gov
(NCT02359175). Copyright © 2023 The Author(s). Published by
Wolters Kluwer Health, Inc. on behalf of the European Society of
Anaesthesiology and Intensive Care.

<32>
Accession Number
642750687
Title
One-Year Outcomes From the CLASP IID Randomized Trial for Degenerative
Mitral Regurgitation.
Source
JACC. Cardiovascular interventions. (no pagination), 2023. Date of
Publication: 26 Oct 2023.
Author
Zahr F.; Smith R.L.; Gillam L.D.; Chadderdon S.; Makkar R.; von Bardeleben
R.S.; Ruf T.F.; Kipperman R.M.; Rassi A.N.; Szerlip M.; Goldman S.;
Inglessis-Azuaje I.; Yadav P.; Lurz P.; Davidson C.J.; Mumtaz M.; Gada H.;
Kar S.; Kodali S.K.; Laham R.; Hiesinger W.; Fam N.P.; Kessler M.; O'Neill
W.W.; Whisenant B.; Kliger C.; Kapadia S.; Rudolph V.; Choo J.; Hermiller
J.; Morse M.A.; Schofer N.; Gafoor S.; Latib A.; Mahoney P.; Kaneko T.;
Shah P.B.; Riddick J.A.; Muhammad K.I.; Boekstegers P.; Price M.J.; Praz
F.; Koulogiannis K.; Marcoff L.; Hausleiter J.; Lim D.S.
Institution
(Zahr, Chadderdon) Oregon Health and Science University, Portland, Oregon,
USA
(Smith, Szerlip) Baylor Scott and White the Heart Hospital Plano, Plano,
TX, United States
(Gillam, Kipperman, Koulogiannis, Marcoff) Atlantic Health System
Morristown Medical Center, Morristown, NJ, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(von Bardeleben, Ruf) University Medical Centre Mainz, Mainz, Germany
(Rassi) Kaiser Permanente San Francisco Medical Center, San Francisco, CA,
United States
(Goldman) Lankenau Medical Center, Wynnewood, PA, United States
(Inglessis-Azuaje) Massachusetts General Hospital, Boston, MA, United
States
(Yadav) Piedmont Heart Institute, Atlanta, GA, United States
(Lurz) University of Leipzig, Leipzig, Germany
(Davidson) Northwestern University, Chicago, IL, United States
(Mumtaz, Gada) UPMC Pinnacle, Harrisburg, PA, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kodali) Columbia University Medical Center, NY, United States
(Laham) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Hiesinger) Stanford University Medical Center, Palo Alto, CA, United
States
(Fam) St. Michael's Hospital, Toronto, ON, Canada
(Kesler) University of Ulm, Ulm, Germany
(O'Neill) Henry Ford Hospital, Detroit, MI, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Kliger) Northwell-Lenox Hill, NY, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Rudolph) Ruhr-Universitat Bochum, Bochum, Bad Oeynhausen, Germany
(Choo) Christ Hospital, Cincinnati, OH, United States
(Hermiller) St. Vincent Heart Center of Indiana, Indianapolis, IN, United
States
(Morse) Ascension Saint Thomas Hospital, Nashville, TN, United States
(Schofer) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Gafoor) Swedish Medical Center, Seattle, WA, United States
(Latib) Montefiore Medical Center, Bronx, NY, United States
(Mahoney) Sentara Norfolk General Hospital, Norfolk, VA, United States
(Kaneko, Shah) Brigham and Women's Hospital, Boston, MA, United States
(Riddick) Tristar Centennial Medical Center, Nashville, TN, United States
(Muhammad) Oklahoma Heart Institute, Tulsa, OK, United States
(Boekstegers) Helios Clinic, Siegburg, Germany
(Price) Scripps Clinic, La Jolla, CA, United States
(Praz) University Hospital Bern, Bern, Switzerland
(Hausleiter) Klinikum der Universitat Munchen, Munich, Germany
(Lim) University of Virginia Health System Hospital, Charlottesville, VA,
United States
Abstract
BACKGROUND: The CLASP IID (Edwards PASCAL TrAnScatheter Valve RePair
System Pivotal Clinical) trial is the first randomized controlled trial
comparing the PASCAL system and the MitraClip system in prohibitive risk
patients with significant symptomatic degenerative mitral regurgitation
(DMR). OBJECTIVE(S): The study sought to report primary and secondary
endpoints and 1-year outcomes for the full cohort of the CLASP IID trial.
 METHOD(S): Prohibitive-risk patients with 3+/4+ DMR were randomized
2:1 (PASCAL:MitraClip). One-year assessments included secondary
effectiveness endpoints (mitral regurgitation [MR] <=2+ and MR <=1+), and
clinical, echocardiographic, functional, and quality-of-life outcomes.
Primary safety (30-day composite major adverse events [MAE]) and
effectiveness (6-month MR <=2+) endpoints were assessed for the full
cohort. RESULT(S): Three hundred patients were randomized (PASCAL: n
= 204; MitraClip: n = 96). At 1 year, differences in survival, freedom
from heart failure hospitalization, and MAE were nonsignificant (P > 0.05
for all). Noninferiority of the PASCAL system compared with the MitraClip
system persisted for the primary endpoints in the full cohort (For PASCAL
vs MitraClip, the 30-day MAE rates were 4.6% vs 5.4% with a rate
difference of -0.8% and 95% upper confidence bound of 4.6%. The 6-month
MR<=2+ rates were 97.9% vs 95.7% with a rate difference of 2.2% and 95%
lower confidence bound (LCB) of -2.5%, for, respectively). Noninferiority
was met for the secondary effectiveness endpoints at 1 year (MR<=2+ rates
for PASCAL vs MitraClip were 95.8% vs 93.8% with a rate difference of 2.1%
and 95% LCB of -4.1%. The MR<=1+ rates were 77.1% vs 71.3% with a rate
difference of 5.8% and 95% LCB of -5.3%, respectively). Significant
improvements in functional classification and quality of life were
sustained in both groups (P <0.05 for all vs baseline).
 CONCLUSION(S): The CLASP IID trial full cohort met primary and
secondary noninferiority endpoints, and at 1 year, the PASCAL system
demonstrated high survival, significant MR reduction, and sustained
improvements in functional and quality-of-life outcomes. Results affirm
the PASCAL system as a beneficial therapy for prohibitive-surgical-risk
patients with significant symptomatic DMR. Copyright © 2023
American College of Cardiology Foundation. Published by Elsevier Inc. All
rights reserved.

<33>
Accession Number
2028361055
Title
Mediastinal lymph node dissection versus spared mediastinal lymph node
dissection in stage IA non-small cell lung cancer presented as ground
glass nodules: Study protocol of a phase III, randomised, multicentre
trial (MELDSIG) in China.
Source
BMJ Open. 13(10) (no pagination), 2023. Article Number: e075242. Date of
Publication: 28 Oct 2023.
Author
Li C.; Ni Y.; Liu C.; Liu R.; Zhang C.; Song Z.; Liu H.; Jiang T.; Zhang
Z.
Institution
(Li, Zhang) Department of Lung Cancer, Tianjin Medical University Cancer
Institute and Hospital, National Clinical Research Center for Cancer, Key
Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research
Center for Cancer, Tianjin, China
(Ni, Jiang) Department of Thoracic Surgery, Air Force Medical University,
Tangdu Hospital, Shanxi, Xi'an, China
(Liu, Zhang, Liu) Department of Thoracic Surgery, Liaoning Cancer
Institute and Hospital, Liaoning, Shenyang, China
(Liu, Song) Department of Lung Cancer Surgery, Tianjin Medical University
General Hospital, Tianjin, China
Publisher
BMJ Publishing Group
Abstract
Introduction Radical surgery including mediastinal lymph node dissection
is the standard treatment for early-stage non-small cell lung cancer
(NSCLC). About 50% lung nodules are pure ground glass or part-solid
nodules, which are predominantly clinical stage IA NSCLC. Non-solid
nodules rarely develop mediastinal lymph node metastasis. Method and
analysis A phase III study was started in China to evaluate the
non-inferiority in overall survival of spared mediastinal lymph node
dissection compared with mediastinal lymph node dissection in stage IA
NSCLC. A total of 1362 patients will be enrolled from 4 institutions in
2-3 years. The second endpoints are relapse-free survival and
perioperative data, including duration of hospitalisation, duration of
chest tube placement, operation time, blood loss. Ethics and dissemination
This protocol has been reviewed and approved by the Clinical Research
Review Board of Tianjin Medical University Cancer Institute and Hospital.
The findings will be disseminated in peer-reviewed publications. Trial
registration number NCT04631770. Copyright © Author(s) (or their
employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<34>
Accession Number
2028360957
Title
Association between perioperative statin treatment and short-term clinical
outcomes following transcatheter aortic valve implantation: a
retrospective cohort study.
Source
Open Heart. 10(2) (no pagination), 2023. Article Number: e002348. Date of
Publication: 27 Oct 2023.
Author
Lefeber G.; Dautzenberg L.; Knol W.; Huijbers C.; Voskuil M.; Kraaijeveld
A.O.; Bouvy M.; De Boer A.; Emmelot-Vonk M.; Koek H.L.
Institution
(Lefeber, Dautzenberg, Knol, Emmelot-Vonk, Koek) Department of Geriatric
Medicine, Utrecht University, Utrecht, Netherlands
(Huijbers, Bouvy, De Boer) Pharmacoepidemiology and Clinical Pharmacology,
Utrecht University, Utrecht, Netherlands
(Voskuil, Kraaijeveld) Department of Cardiology, Umc, Utrecht, Netherlands
Publisher
BMJ Publishing Group
Abstract
Background Studies have found statin treatment to be associated with
improved 1-year survival after transcatheter aortic valve implantation
(TAVI), suggesting pleiotropic effects of statins on preventing
perioperative complications. Statin treatment is not associated with
postoperative cardiovascular complications or mortality; however, other
postoperative complications have not been investigated. Aim To explore
whether preoperative statin treatment is associated with a lower
short-term risk of mortality, readmission and major postoperative
complications in older patients undergoing TAVI. Methods A retrospective
cohort study including patients aged 65 years and older who had undergone
a comprehensive geriatric assessment prior to TAVI between January 2014
and January 2021. The primary outcomes were 90-day mortality, 90-day
readmissions and major postoperative complications according to the
Clavien-Dindo classification. Multivariable logistic regression was
performed with adjustment for potential confounders, namely age, gender,
comorbidity, body mass index, smoking, diminished renal function, alcohol
use and falls. Results This study included 584 patients, of whom 324
(55.5%) were treated with a statin. In the statin treated group, 15 (4.6%)
patients died within 90 days of TAVI compared with 10 (3.8%) patients in
the non statin group (adjusted OR 1.17; 95% CI 0.51 to 2.70). The number
of 90-day readmissions was 39 (12.0%) and 34 (13.1%) (adjusted OR 0.91;
95% CI 0.54 to 1.52), respectively. In the statin treated group, 115
(35.5%) patients experienced a major complication compared with 98 (37.7%)
in the non-statin group (adjusted OR 0.95; 95% CI 0.67 to 1.37).
Conclusion Preoperative statin treatment is not associated with improved
short-term outcomes after TAVI. A randomised controlled trial with
different statin doses may be warranted to investigate whether initiating
statin treatment before TAVI improves both postoperative outcomes and
long-term survival. Copyright © 2023 BMJ Publishing Group. All
rights reserved.

<35>
Accession Number
2007084995
Title
Synthetic mRNA Encoding VEGF-A in Patients Undergoing Coronary Artery
Bypass Grafting: Design of a Phase 2a Clinical Trial.
Source
Molecular Therapy Methods and Clinical Development. 18 (pp 464-472), 2020.
Date of Publication: 11 September 2020.
Author
Anttila V.; Saraste A.; Knuuti J.; Jaakkola P.; Hedman M.; Svedlund S.;
Lagerstrom-Fermer M.; Kjaer M.; Jeppsson A.; Gan L.-M.
Institution
(Anttila, Saraste) Heart Center, Turku University Hospital and University
of Turku, Turku, Finland
(Saraste, Knuuti) Turku PET Center, Turku University Hospital and
University of Turku, Turku, Finland
(Jaakkola, Hedman) Heart Center, Kuopio University Hospital, Kuopio,
Finland
(Svedlund) Department of Clinical Physiology, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Svedlund, Jeppsson, Gan) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Lagerstrom-Fermer, Gan) Research and Early Development, Cardiovascular,
Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg,
Sweden
(Kjaer) Early Biometrics and Statistical Innovation, Data Science & AI,
BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
(Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Gan) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Cell Press
Abstract
Therapeutic angiogenesis may improve outcomes in patients with coronary
artery disease undergoing surgical revascularization. Angiogenic factors
may promote blood vessel growth and regenerate regions of ischemic but
viable myocardium. Previous clinical trials of vascular endothelial growth
factor A (VEGF-A) gene therapy with DNA or viral vectors demonstrated
safety but not efficacy. AZD8601 is VEGF-A<inf>165</inf> mRNA formulated
in biocompatible citrate-buffered saline and optimized for high-efficiency
VEGF-A expression with minimal innate immune response. EPICCURE is an
ongoing randomized, double-blind, placebo-controlled study of the safety
of AZD8601 in patients with moderately decreased left ventricular function
(ejection fraction 30%-50%) undergoing elective coronary artery bypass
surgery. AZD8601 3 mg, 30 mg, or placebo is administered as 30 epicardial
injections in a 10-min extension of cardioplegia. Injections are targeted
to ischemic but viable myocardial regions in each patient using
quantitative 15O-water positron emission tomography (PET)
imaging (stress myocardial blood flow < 2.3 mL/g/min; resting myocardial
blood flow > 0.6 mL/g/min). Improvement in regional and global myocardial
blood flow quantified with 15O-water PET is an exploratory
efficacy outcome, together with echocardiographic, clinical, functional,
and biomarker measures. EPICCURE combines high-efficiency delivery with
quantitative targeting and follow-up for robust assessment of the safety
and exploratory efficacy of VEGF-A mRNA angiogenesis (ClinicalTrials.gov:
NCT03370887).
In the EPICCURE study, patients undergoing coronary artery bypass grafting
receive epicardial injections of synthetic mRNA encoding vascular
endothelial growth factor A or placebo. Imaging of myocardial blood flow
with 15O-water PET is used to target injections to ischemic but
viable regions in each participant and to monitor potential
improvement. Copyright © 2020 The Authors

<36>
Accession Number
2028331463
Title
Protocol and Methods: Role of Levothyroxine on the Progression of Chronic
Kidney Disease in Subclinical Hypothyroid Populations (LP-CKD) - A
Multicenter Randomized Controlled Trial.
Source
Indian Journal of Nephrology. 33(6) (pp 449-455), 2023. Date of
Publication: 2023.
Author
Prasad N.; Singh S.; Kumar V.; Sahay M.; Chaudhury A.R.; Behera M.R.;
Kushwaha R.S.; Yadav D.; Gautam S.; Jaiswal A.
Institution
(Behera, Kushwaha, Yadav, Gautam, Jaiswal) Department of Nephrology,
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
(Singh) Institute of Medical Science, Banaras Hindu University, Uttar
Pradesh, Varanasi, India
(Kumar) Institute of Medical Education and Research, Chandigarh, India
(Sahay) Osmania Medical College, Osmania General Hospital, Telangana,
Hyderabad, India
(Chaudhury) Post Graduate Medical Education and Research, West Bengal,
Kolkata, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Subclinical hypothyroidism (SCH) is highly prevalent and
associated with chronic kidney disease (CKD). However, it is still
unanswered whether the restoration of euthyroid status in these patients
will be beneficial in retarding a decline in glomerular filtration rate in
early CKD patients. We aim to evaluate the efficacy of levothyroxine
therapy versus placebo in slowing estimated glomerular filtration rate
(eGFR) decline among CKD patients (stage 2-4) with SCH. Method(s):
This study will be a multicentric, double-blind, randomized,
parallel-group, placebo-controlled study. A total of 500 CKD patients, 250
patients in the treatment group and 250 patients in the placebo group,
will be randomized. The randomization between the treatment arm and
placebo arm will be performed as per the computer-generated random number
table in a 1:1 ratio. The sample size was calculated based on the assumed
reduction in eGFR after 1-year follow-up in the treatment and placebo
groups of 10% and 25%, respectively, at a minimum two-sided 99% confidence
interval and 90% power of the study and considering 20% loss on follow-up.
Each patient will be followed every 3 months for at least 1 year after
randomization. Individuals completing 1-year follow-up visits will be
considered for analysis. The baseline and follow-up data will be compared
between the treatment and placebo groups. The study will evaluate the
efficacy and safety of levothyroxine therapy versus placebo in slowing
eGFR decline among CKD patients (stage 2-4) with SCH. The primary endpoint
will be the end of follow-up of the patients, reduction of eGFR by >=50%
from a baseline of that patient, or development of ESKD or death of the
patients. The secondary endpoint will be any cardiovascular event or
arrhythmia after the institution of the drug. Copyright © 2023
Wolters Kluwer Medknow Publications. All rights reserved.

<37>
Accession Number
2028330903
Title
The advantages of inhalational sedation using an anesthetic-conserving
device versus intravenous sedatives in an intensive care unit setting: A
systematic review.
Source
Annals of Thoracic Medicine. 18(4) (pp 182-189), 2023. Date of
Publication: 01 Oct 2023.
Author
Al Aseri Z.; Ali Alansari M.; Al-Shami S.A.; Alaskar B.; Aljumaiah D.;
Elhazmi A.
Institution
(Al Aseri) Department Emergency Medicine and Critical Care, College of
Medicine, King Saud University, Saudi Arabia
(Al Aseri, Al-Shami, Alaskar, Aljumaiah) Department of Clinical Sciences,
College of Medicine, Riyadh Hospital, Dar Al Uloom University, Saudi
Arabia
(Al Aseri) Emergency and Critical Care Development Program, Therapeutic
Deputyship, Ministry of Health, Riyadh, Saudi Arabia
(Ali Alansari) Department of Adult Critical Care, King Fahad Hospital,
Al-Ahsa Health Cluster, Al Hofuf, Saudi Arabia
(Elhazmi) Department of Internal Medicine, College of Medicine, Alfaisal
University, Riyadh, Saudi Arabia
Publisher
Wolters Kluwer Medknow Publications
Abstract
BACKGROUND: Sedation is fundamental to the management of patients in the
intensive care unit (ICU). Its indications in the ICU are vast, including
the facilitating of mechanical ventilation, permitting invasive
procedures, and managing anxiety and agitation. Inhaled sedation with
halogenated agents, such as isoflurane or sevoflurane, is now feasible in
ICU patients using dedicated devices/ systems. Its use may reduce adverse
events and improve ICU outcomes compared to conventional intravenous (IV)
sedation in the ICU. This review examined the effectiveness of
inhalational sedation using the anesthetic conserving device (ACD)
compared to standard IV sedation for adult patients in ICU and highlights
the technical aspects of its functioning. METHOD(S): We searched the
PubMed, Cochrane Central Register of Controlled Trials, The Cochrane
Library, MEDLINE, Web of Science, and Sage Journals databases using the
terms "anesthetic conserving device," "Anaconda," "sedation" and
"intensive care unit" in randomized clinical studies that were performed
between 2012 and 2022 and compared volatile sedation using an ACD with IV
sedation in terms of time to extubation, duration of mechanical
ventilation, and lengths of ICU and hospital stay. RESULT(S): Nine
trials were included. Volatile sedation (sevoflurane or isoflurane)
administered through an ACD shortened the awakening time compared to IV
sedation (midazolam or propofol). CONCLUSION(S): Compared to IV
sedation, volatile sedation administered through an ACD in the ICU
shortened the awakening and extubation times, ICU length of stay, and
duration of mechanical ventilation. More clinical trials that assess
additional clinical outcomes on a large scale are needed. Copyright
© 2023 Annals of Thoracic Medicine.

<38>
Accession Number
2028313090
Title
Malnutrition Predicts Adverse Outcomes After Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
Anatolian Journal of Cardiology. 27(5) (pp 240-248), 2023. Date of
Publication: May 2023.
Author
Dong M.; Cheng J.; Gong L.; Xiao Y.; Shao S.; Song J.
Institution
(Dong, Song) Department of Nursing, The Second Affiliated Hospital of
Zhejiang University School of Medicine, Hangzhou City, China
(Cheng) Cardiac Intervention Center, The Second Affiliated Hospital of
Zhejiang University School of Medicine, Hangzhou City, China
(Gong) Department of Cardiology, Yuechi County People's Hospital, Sichuan
Province, China
(Xiao) School of Nursing, School of Medicine, Huzhou University, Huzhou
City, China
(Shao) School of Medicine, Huzhou University, Huzhou City, China
Publisher
Turkish Society of Cardiology
Abstract
Background: Several studies have shown that malnutrition helps to predict
the occurrence of adverse outcomes after transcatheter aortic valve
replacement. However, there is still controversy and uncertainty regarding
the prevalence and consequences of malnutrition. We performed a systematic
review and meta-analysis to assess the relationship between malnutrition
and poor postoperative outcomes in transcatheter aortic valve replacement.
 Method(s): Observational studies were searched in PubMed, EMBASE,
Cochrane Library, Web of Science, and MEDLINE regarding the relationship
between malnutrition and adverse outcomes after transcatheter aortic valve
replacement, with the primary endpoint being all-cause mortality and
secondary outcomes such as cardiovascular complications and readmission
rates. This meta-analysis was registered in PROSPERO (number
CRD42022310139). Result(s): A total of 10 studies involving 5936
subjects were included in the systematic review and meta-analysis. The
results showed that malnourished patients had an increased risk of
all-cause mortality after transcatheter aortic valve replacement compared
with non-malnourished patients (hazard ratios [HR] = 1.32, 95% CI [1.13,
1.53], P <.01). Subgroup analysis showed that in Asia, postoperative
all-cause mortality was significantly higher in malnourished transcatheter
aortic valve replacement patients than in non-malnourished transcatheter
aortic valve replacement patients (P <.01), and in addition, sample size
and follow-up time may have contributed to the large heterogeneity.
 Conclusion(s): Malnutrition increases the risk of all-cause mortality
in such patients and may predict the occurrence of adverse postoperative
outcomes. Copyright@Author(s)

<39>
Accession Number
2028286215
Title
Critical Reading of cardiovascular trials with neutral or negative
results.
Source
European Heart Journal. 44(40) (pp 4230-4232), 2023. Date of Publication:
21 Oct 2023.
Author
Rapezzi C.; Aimo A.; Fabiani I.; Castiglione V.; Ferrari R.; Maggioni
A.P.; Tavazzi L.
Institution
(Rapezzi, Ferrari) Cardiology Centre, Universita degli studi di Ferrara,
via Ludovico Ariosto, Ferrara 35 - 44121, Italy
(Tavazzi) GVM Care & Research, Maria Cecilia Hospital, Via Corriera, 1,
Cotignola 48033, Italy
(Aimo, Castiglione) Scuola Superiore Sant'Anna, Piazza Martiri della
Liberta 33, Pisa 56127, Italy
(Aimo, Fabiani, Castiglione) Cardiology Division, Fondazione Toscana
Gabriele Monasterio, Piazza Martiri della Liberta 33, Pisa 56127, Italy
(Maggioni) Centro studi ANMCO, Via La Marmora 36, Firenze 50121, Italy
Publisher
Oxford University Press
Abstract
Proposed framework for the interpretation of superiority trials with
neutral or negative results. See text for details. CABANA, catheter
ablation vs. antiarrhythmic drug therapy for atrial fibrillation;
CASTLE-AF, catheter ablation for atrial fibrillation with heart failure;
COVID-19, coronavirus disease-19; DOREMI, dobutamine compared with
milrinone; FLOWER-MI, flow evaluation to guide revascularization in
multivessel ST-elevation myocardial infarction; FU, follow-up; GUIDE-HF,
haemodynamic-GUIDEd management of heart failure; LIFE, LCZ696 in advanced
heart failure; OVERTURE, Omapatrilat Versus Enalapril Randomized Trial of
Utility in Reducing Events; PARAGON-HF, prospective comparison of ARNI
with ARB global outcomes in HF with preserved ejection fraction;
PROACTIVE, PROspective pioglitAzone Clinical Trial In macroVascular
Events; RED-HF, reduction of events by darbepoetin alfa in heart failure;
STICH, surgical treatment for ischaemic heart failure; STICHES, STICH
Extension Study; TOPCAT, treatment of preserved cardiac function heart
failure with an aldosterone antagonist. Copyright © The Author(s)
2023. Published by Oxford University Press on behalf of the European
Society of Cardiology. All rights reserved.

<40>
Accession Number
2028248709
Title
Unfractionated heparin and the activated clotting time in non-cardiac
arterial procedures.
Source
Journal of Cardiovascular Surgery. 64(5) (pp 488-494), 2023. Date of
Publication: October 2023.
Author
Roosendaal L.C.; van Den Ancker W.; Wiersema A.M.; Blankensteijn J.D.;
Jongkind V.
Institution
(Roosendaal, Wiersema) Department of Vascular Surgery, Dijklander
Ziekenhuis, Hoorn, Netherlands
(Roosendaal, Wiersema, Blankensteijn, Jongkind) Department of Vascular
Surgery, Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
(Roosendaal, Wiersema, Blankensteijn, Jongkind) Amsterdam Cardiovascular
Sciences, Microcirculation, Amsterdam, Netherlands
(van Den Ancker) Department of Clinical Hematology, Amsterdam UMC,
Amsterdam, Netherlands
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Unfractionated heparin is administered during non-cardiac
arterial procedures (NCAP) to prevent thromboembolic complications. In
order to achieve a safe level of anticoagulation, the effect of heparin
can be measured. The aim of this review was to provide an overview on what
is known about heparin, suggested tests to monitor the effect of heparin,
including the activated clotting time (ACT), and the factors that could
influence that ACT. EVIDENCE ACQUISITION: A literature search in PubMed
was performed. Articles reporting on heparin, clotting time tests
(including thrombin time, activated partial thromboplastin time,
anti-activated factor X and ACT), and ACT measurement devices were
selected. EVIDENCE SYNTHESIS: Heparin has a non-predictable effect in the
individual patient, which could be measured using the ACT. However, ACT
values can be influenced by many factors, such as hemodilution,
hypothermia and thrombocytopenia. In addition, a high variation in ACT
outcomes is found between measurement devices of different brands. In the
sparse literature on the role of ACT during NCAP, no consensus has been
reached on optimal target ACT values. An ACT >250 seconds leads to more
bleeding complications. Females have a longer ACT after heparin
administration, with a higher risk of bleeding complications.
 CONCLUSION(S): The effect of heparin is unpredictable. ACT can be
used to monitor the effect of heparin and achieve individualized
anticoagulation, tailored to the patient and the specifics of the
operative procedure. However, the ACT itself can be affected by several
factors and caution must be present, as measured ACT values differ between
measurement devices. Copyright © 2023 EDIZIONI MINERVA MEDICA.

<41>
Accession Number
2028171281
Title
Transcatheter Vacuum-Assisted Mass Extraction Versus Surgical Debridement
for Vegetations in Tricuspid Valve Infective Endocarditis: A Meta-Analysis
of Observational Studies.
Source
American Journal of Cardiology. 210 (pp 69-75), 2024. Date of Publication:
01 Jan 2024.
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)
Divisions of Internal Medicine
(Prasad, Abela) Cardiology, Michigan State University, East Lansing, MI,
United States
Publisher
Elsevier Inc.
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 (RRs), mean differences, and 95% confidence
intervals (CIs). 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 5 studies insignificantly favored TVME over SD (RR =
0.66, 95% CI 0.31 to 1.39, p = 0.27, I2 = 57%). When addressing
heterogeneity by excluding 1 study, no statistical significance in the
difference between the 2 arms regarding overall mortality was observed (RR
0.99, 95% CI 0.60 to 1.63, p = 0.97, I2 = 0%). This
meta-analysis of the 5 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 2
approaches. Copyright © 2023 Elsevier Inc.

<42>
[Use Link to view the full text]
Accession Number
2028161798
Title
Hemodynamic Tolerance of New Resistance Training Methods in Patients With
Heart Failure and Coronary Artery Disease: A RANDOMIZED CROSSOVER STUDY.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 43(6) (pp
453-459), 2023. Date of Publication: 01 Nov 2023.
Author
Gillet A.; Lamotte M.; Forton K.; Roussoulieres A.; Dewachter C.;
Bouziotis J.; Deboeck G.; Van De Borne P.
Institution
(Gillet, Lamotte, Forton, Roussoulieres, Dewachter, Van De Borne)
Department of Cardiology, Hopital Universitaire de Bruxelles (H.U.B.), Cub
Hopital Erasme, Universite Libre de Bruxelles, Brussels, Belgium
(Gillet, Lamotte, Forton) Department of Physiotherapy, Hopital
Universitaire de Bruxelles (H.U.B.), Cub Hopital Erasme, Universite Libre
de Bruxelles, Brussels, Belgium
(Bouziotis) Department of Biomedical Research, Hopital Universitaire de
Bruxelles (H.U.B.), Cub Hopital Erasme, Universite Libre de Bruxelles,
Brussels, Belgium
(Gillet, Deboeck) Research Unit in Rehabilitation, Faculty of Motor Skills
Science, Universite Libre de Bruxelles, Brussels, Belgium
(Dewachter) Laboratory of Physiology and Pharmacology, Faculty of
Medicine, Universite Libre de Bruxelles, Brussels, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: The purpose of this study was to determine and compare the
effectiveness of three different resistance training (RT) methods for
cardiac rehabilitation. Method(s): Individuals with heart failure
with reduced ejection fraction (HFrEF, n = 23) or coronary artery disease
(CAD, n = 22) and healthy controls (CTRL, n = 29) participated in this
randomized crossover trial of RT exercises at 70% of the one-maximal
repetition on a leg extension machine. Peak heart rate (HR) and blood
pressure (BP) were measured noninvasively. The three RT methods were five
sets of increasing repetitions from three to seven (RISE), of decreasing
repetitions from seven to three (DROP), and three sets of nine repetitions
(USUAL). Interset rest intervals were 15 sec for RISE and DROP and 60 sec
for USUAL. Result(s): Peak HR differed on average by <4 bpm between
methods in the HFrEF and CAD groups (P <.02). Rises in systolic BP (SBP)
in the HFrEF group were comparable across methods. In the CAD group, mean
SBP at peak exercise increased more in RISE and DROP than in USUAL (P
<.001), but the increase was <=10 mm Hg. In the CTRL group, SBP was higher
for DROP than for USUAL (152 +/- 22 vs 144 +/- 24 mm Hg, respectively; P
<.01). Peak cardiac output and perceived exertion did not differ between
methods. Conclusion(s): The RISE, DROP, and USUAL RT methods induced
a similar perception of effort and similar increases in peak HR and BP.
The RISE and DROP methods appear more efficient as they allow a comparable
training volume in a shorter time than the USUAL method. Copyright
© 2023 Wolters Kluwer Health, Inc.

<43>
[Use Link to view the full text]
Accession Number
2028159420
Title
Enhanced CT-guided adrenal venous sampling versus traditional X-ray-guided
adrenal venous sampling in patients with primary aldosteronism.
Source
Medicine (United States). 102(42) (pp E35611), 2023. Date of Publication:
20 Oct 2023.
Author
Chen C.; Li F.; Han J.; Chen X.
Institution
(Chen) Department of Clinical Nutrition, The First Affiliated Hospital,
Fujian Medical University, Fuzhou, China
(Chen) Department of Clinical Nutrition, National Regional Medical Center,
Binhai Campus of the First Affiliated Hospital, Fujian Medical University,
Fuzhou, China
(Li) Department of Endocrinology, Xiangyang Central Hospital, Affiliated
Hospital of Hubei University of Arts and Science, Xiangyang, China
(Han) Department of Interventional Radiology, Xiangyang Central Hospital,
Affiliated Hospital of Hubei University of Arts and Science, Xiangyang,
China
(Chen) Department of Endocrinology, The First Affiliated Hospital, Fujian
Medical University, Fuzhou, China
(Chen) Department of Endocrinology, National Regional Medical Center,
Binhai Campus of the First Affiliated Hospital, Fujian Medical University,
Fuzhou, China
(Chen) Diabetes Research Institute of Fujian Province, The First
Affiliated Hospital, Fujian Medical University, Fuzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
To compare the accuracy, safety, operation time, and radiation dose of
enhanced computed tomography (CT)-guided adrenal vein sampling (AVS)
versus traditional X-ray-guided AVS in patients with primary
aldosteronism. A total of 97 patients with primary aldosteronism were
randomly assigned to either the enhanced CT-guided group (n = 48) or the
traditional X-ray-guided group (n = 49). Baseline characteristics were
compared between the 2 groups. The primary outcome was the accuracy of
AVS, assessed by aldosterone-to-cortisol ratio. Secondary outcomes
included safety measures (intraoperative and postoperative complication
rates, procedure termination rates, blood pressure, and heart rate
changes), operation time, and radiation dose. The CT-guided group
demonstrated significantly higher aldosterone-to-cortisol ratios,
indicating improved accuracy in AVS (P <.001). The CT-guided group also
showed significantly lower intraoperative blood pressure change and
intraoperative heart rate change compared to the X-ray-guided group (P
<.05). In addition, the CT-guided group had significantly shorter
operation times (P <.001) and lower radiation exposure (P <.001). The
enhanced CT-guided AVS demonstrated significantly better accuracy, safety,
and efficiency compared to traditional X-ray-guided AVS in patients with
primary aldosteronism. The enhanced CT-guided approach also resulted in
lower radiation exposure for patients, making it a favorable option in the
diagnosis and treatment of primary aldosteronism. Copyright ©
2023 Lippincott Williams and Wilkins. All rights reserved.

<44>
Accession Number
2028151123
Title
Comparison of tirzepatide and dulaglutide on major adverse cardiovascular
events in participants with type 2 diabetes and atherosclerotic
cardiovascular disease: SURPASS-CVOT design and baseline characteristics.
Source
American Heart Journal. 267 (pp 1-11), 2024. Date of Publication: January
2024.
Author
Nicholls S.J.; Bhatt D.L.; Buse J.B.; Prato S.D.; Kahn S.E.; Lincoff A.M.;
McGuire D.K.; Nauck M.A.; Nissen S.E.; Sattar N.; Zinman B.; Zoungas S.;
Basile J.; Bartee A.; Miller D.; Nishiyama H.; Pavo I.; Weerakkody G.;
Wiese R.J.; D'Alessio D.
Institution
(Nicholls, Zoungas) Victorian Heart Institute, Monash University,
Melbourne, VIC, Australia
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Buse) University of North Carolina, Chapel Hill, NC, United States
(Prato) Department of Clinical and Experimental Medicine, Section of
Metabolic Diseases and Diabetes, University of Pisa, Pisa, Sant'Anna
School of Advanced Studies, Pisa, Italy
(Kahn) Division of Metabolism, Endocrinology and Nutrition, Department of
Medicine, VA Puget Sound Health Care System and University of Washington,
Seattle, WA, United States
(Lincoff, Nissen) Cleveland Clinic Coordinating Center for Clinical
Research (C5Research) and Department of Cardiovascular Medicine,
Cleveland, OH, United States
(McGuire) University of Texas Southwestern Medical Center and Parkland
Health and Hospital System, Dallas, TX, United States
(Nauck) Diabetes, Endocrinology and Metabolism Section, Department of
Medicine I, St. Josef-Hospital, Katholisches Klinikum Bochum gGmbH, Ruhr
University of Bochum, Bochum, Germany
(Sattar) School of Cardiovascular and Metabolic Health, University of
Glasgow, United Kingdom
(Zinman) University of Toronto, Lunenfeld-Tanenbaum Research Institute and
Mount Sinai Hospital, Toronto, ON, Canada
(Zoungas) School of Public Health and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(Basile) Medical University of South Carolina, Ralph H. Johnson VA Medical
Center, Charleston, SC, United States
(Bartee, Miller, Nishiyama, Pavo, Weerakkody, Wiese) Eli Lilly and
Company, Indianapolis, IN, United States
(D'Alessio) Duke University Medical Center, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Tirzepatide, a once-weekly GIP/GLP-1 receptor agonist, reduces
blood glucose and body weight in people with type 2 diabetes. The
cardiovascular (CV) safety and efficacy of tirzepatide have not been
definitively assessed in a cardiovascular outcomes trial. Method(s):
Tirzepatide is being studied in a randomized, double-blind,
active-controlled CV outcomes trial. People with type 2 diabetes aged >=40
years, with established atherosclerotic CV disease, HbA1c >=7% to <=10.5%,
and body mass index >=25 kg/m2 were randomized 1:1 to once
weekly subcutaneous injection of either tirzepatide up to 15 mg or
dulaglutide 1.5 mg. The primary outcome is time to first occurrence of any
major adverse cardiovascular event (MACE), defined as CV death, myocardial
infarction, or stroke. The trial is event-driven and planned to continue
until >=1,615 participants experience an adjudication-confirmed component
of MACE. The primary analysis is noninferiority for time to first MACE of
tirzepatide vs dulaglutide by demonstrating an upper confidence limit
<1.05, which will also confirm superiority vs a putative placebo, and also
to determine whether tirzepatide produces a greater CV benefit than
dulaglutide (superiority analysis). Result(s): Over 2 years, 13,299
people at 640 sites in 30 countries across all world regions were
randomized. The mean age of randomized participants at baseline was 64.1
years, diabetes duration 14.7 years, HbA1c 8.4%, and BMI 32.6
kg/m2. Overall, 65.0% had coronary disease, of whom 47.3%
reported prior myocardial infarction and 57.4% had prior coronary
revascularization. 19.1% of participants had a prior stroke and 25.3% had
peripheral artery disease. The trial is fully recruited and ongoing.
 Conclusion(s): SURPASS-CVOT will provide definitive evidence as to
the CV safety and efficacy of tirzepatide as compared with dulaglutide, a
GLP-1 receptor agonist with established CV benefit. Copyright ©
2023 The Authors

<45>
Accession Number
2027742209
Title
Impact of surgical technique on outcome measures in chest masculinization:
A systemic review and meta-analysis.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 87 (pp 109-116),
2023. Date of Publication: December 2023.
Author
Zhu J.; Wang E.; Liu S.; Koos J.; Shroyer L.; Krajewski A.
Institution
(Zhu, Wang, Liu) Renaissance School of Medicine at Stony Brook University,
Stony Brook, NY, United States
(Koos) Stony Brook University, Stony Brook, NY, United States
(Shroyer, Krajewski) Department of Surgery, Stony Brook Renaissance School
of Medicine, Stony Brook, NY, United States
Publisher
Churchill Livingstone
Abstract
Background: Among plastic surgeons, there are several conventional
techniques for performing chest surgery. Research on surgical approaches
has focused cis-gender patients with medical conditions, such as breast
cancer or gynecomastia, but has never studied transgender populations. The
aim of this study is to perform the first systematic review of
gender-affirming surgery (GAS) in transgender populations and determine
postoperative outcomes differences in relation to surgical technique.
 Method(s): Two reviewers independently searched Medline, Embase,
CINAHL, Web of Science, and Cochrane databases for studies published prior
to 2021. Studies selected for inclusion were retrospective or prospective
studies of adult transgender men undergoing GAS that utilized appropriate
operative techniques and reported complications and/or patient-reported
outcomes. Result(s): A total of 26 randomized controlled trials,
including 40 distinct populations and 3055 patients, were identified.
Surgical techniques compared double incision free nipple graft (DIFNG)
(2053 patients [67.20%]), pedicled nipple techniques (PNT) (297 [9.72%]),
and periareolar techniques (PAT) (705 [23.08%]). Pairwise analysis found
the lowest complication rates associated with procedures utilizing DIFNG,
followed by PNT, then PAT. Patients with PAT had significantly higher
satisfaction scores than DIFNG. Conclusion(s): This is the first
systematic review to evaluate outcomes of chest surgery techniques among
the transgender population. Results indicate significantly more
complications for PAT compared to DIFNG or PNT. Analysis of
patient-reported outcomes was limited due to heterogeneity in
reporting. Copyright © 2023

<46>
Accession Number
2027698912
Title
Associations of Inflammatory Biomarkers With the Risk of Morbidity and
Mortality After Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Canadian Journal of Cardiology. 39(11) (pp 1686-1694), 2023. Date of
Publication: November 2023.
Author
Heo R.H.; Wang M.K.; Meyre P.B.; Birchenough L.; Park L.; Vuong K.;
Devereaux P.J.; Blum S.; Lindahl B.; Stone G.; Conen D.
Institution
(Heo) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Heo, Wang, Devereaux, Blum, Conen) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Wang, Devereaux, Conen) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Wang, Devereaux, Conen) Department of Health Research Methods, Evidence,
and Impact, McMaster University, Hamilton, ON, Canada
(Meyre, Blum) Division of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, Basel, Switzerland
(Birchenough, Park) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Vuong) Faculty of Health Sciences, Western University, London, ON, Canada
(Lindahl) Department of Medical Sciences, Uppsala University and Uppsala
Clinical Research Center, Uppsala, Sweden
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Stone) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Although inflammatory biomarkers have been associated with
cardiovascular events in nonsurgical settings, these associations have not
been systematically addressed in patients undergoing cardiac surgery. This
review aimed to evaluate the relationships of inflammatory markers with
mortality and adverse cardiovascular events in patients undergoing cardiac
surgery. Method(s): Medline, Embase, and Central databases were
systematically searched for studies reporting pre- or postoperative levels
of inflammatory biomarkers in patients undergoing cardiac surgery.
Outcomes of interest were postoperative mortality, nonfatal myocardial
infarction, stroke, congestive heart failure, and major adverse
cardiovascular events (MACE). Studies reporting multivariable adjusted
risk estimates were included. Risk estimates were pooled with the use of
random-effects models and reported as summary odds ratios (ORs).
 Result(s): Among 14,465 citations identified, 29 studies including
29,401 participants met the eligibility criteria. The average follow-up
time after surgery was 31 months. Preoperative C-reactive protein (CRP)
levels were associated with an increased risk of all-cause mortality (OR
1.88, 95% CI 1.60-2.20; I2 = 19%; 11 studies) and MACE (OR
1.73, 95% CI 1.34-2.24; I2 = 0%; 3 studies). CRP levels
measured on postoperative day 6 (OR 7.4, 95% CI 2.90-18.88, 1 study) and
day 10 (OR 11.8, 95% CI 3.50-39.78, 1 study) were associated with a higher
risk of all-cause mortality. Less, but overall similar, information was
available for other inflammatory biomarkers. Conclusion(s): In this
large meta-analysis, inflammatory biomarkers measured before or after
cardiac surgery were associated with mortality and adverse cardiovascular
outcomes in patients undergoing cardiac surgery. Copyright © 2023
Canadian Cardiovascular Society

<47>
Accession Number
2027355779
Title
The Paradox of Choice in Transcatheter Edge-to-Edge Mitral Valve Repair
for Functional Mitral Regurgitation: What Meta-Analyses Can and Can Not
Tell Us.
Source
American Journal of Cardiology. 207 (pp 515-517), 2023. Date of
Publication: 15 Nov 2023.
Author
Barbieri A.; Mantovani F.
Institution
(Barbieri) Division of Cardiology, Department of Diagnostics, Clinical and
Public Health Medicine, Policlinico University Hospital of Modena, Modena,
Italy
(Mantovani) Cardiology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio
Emilia, Italy
Publisher
Elsevier Inc.

<48>
Accession Number
2026584981
Title
Perioperative myocardial injury is associated with increased postoperative
non-cardiac complications in patients undergoing vascular surgery: a post
hoc analysis of a randomised clinical pilot trial.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 58.
Date of Publication: December 2023.
Author
Valadkhani A.; Gupta A.; Bell M.
Institution
(Valadkhani, Gupta, Bell) Perioperative Medicine and Intensive Care (PMI),
Karolinska University Hospital, Stockholm, Sweden
(Valadkhani, Gupta, Bell) Department of Pharmacology and Physiology,
Karolinska Institutet, Stockholm, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Elevated cardiac biomarkers, such as high-sensitivity cardiac
Troponin T and N-terminal pro-B-type natriuretic peptide improve the
prediction of major adverse cardiac events. However, very few trials have
investigated the association between perioperative cardiac injury and
non-cardiac complications. The primary aim of this study was to determine
the association between peri-operative myocardial injury and non-cardiac
complications in patients undergoing vascular surgery. Additionally, the
association between elevated pre-operative high-sensitivity cardiac
Troponin T or N-terminal pro-B-type natriuretic peptide and non-cardiac
complications was explored. Method(s): This study is a post hoc
analysis of a multicentre randomised controlled trial. Patients were
recruited from three centres in Sweden between 2016 and 2019. Cardiac
troponin level was measured pre-operatively and at 4, 24, and 48 h after
the start of surgery in patients undergoing vascular surgery. N-terminal
pro-B-type natriuretic peptide was measured pre-operatively. The primary
outcome was a composite of major postoperative non-cardiac complications
assessed at 30 days. Result(s): A total of 184 patients undergoing
peripheral or aortic vascular surgery were included in this study. The
primary endpoint occurred in 67 (36%) patients. Perioperative myocardial
injury was significantly associated with non-cardiac complications, with
an adjusted odds ratio (OR) of 2.71 (95% confidence interval 1.33-5.55, P
= 0.01). Sensitivity and specificity were 0.40 and 0.81, respectively. No
association was found between pre-operative hs-cTnT or NT-proBNP and
non-cardiac complications. Conclusion(s): In this pilot study, we
found that new peri-operative myocardial injury is associated with an
increased risk of non-cardiac complications within 30 days after index
surgery in patients undergoing vascular surgery. Pre-operative
high-sensitivity cardiac Troponin T or N-terminal pro-B-type natriuretic
peptide did not appear to predict non-cardiac complications. Larger
studies are needed to confirm our findings. Trial registration: EudraCT
database: 2016-001584-36 Copyright © 2023, The Author(s).

<49>
Accession Number
2026565902
Title
Intraoperative intravenous infusion of lidocaine increases total and small
vessel densities of sublingual microcirculation: a randomized prospective
pilot study.
Source
Journal of International Medical Research. 51(11) (no pagination), 2023.
Date of Publication: November 2023.
Author
Grotowska M.; Gozdzik W.
Institution
(Grotowska, Gozdzik) Clinical Department of Anesthesiology and Intensive
Therapy, University Hospital in Wroclaw, Wroclaw Medical University,
Wroclaw, Poland
Publisher
SAGE Publications Ltd
Abstract
Objective: Multiple organ failure can occur as a result of postoperative
complications. Research has indicated that the underlying mechanism of
organ dysfunction is a microcirculation disorder. Because of its
antioxidant and anti-inflammatory properties, lidocaine has the potential
to improve microvascular blood flow. This study was performed to assess
the effect of intraoperative intravenous lidocaine infusion on the
microcirculation and determine the incidence of postoperative
complications. Method(s): In this prospective randomized double-blind
pilot study, 12 patients scheduled for abdominal surgery were randomly
allocated to receive an intraoperative infusion of either 1% lidocaine or
the same volume of 0.9% sodium chloride solution. The microcirculation was
monitored using sidestream dark-field imaging and the vascular occlusion
test combined with near-infrared spectroscopy. Result(s): Lidocaine
significantly increased the total vascular density and small vessel
density after 2 hours of infusion, with preservation of 99% to 100% of the
capillary perfusion in both groups. No patients developed organ failure.
 Conclusion(s): An increase in vessel density may be beneficial in
major abdominal surgeries because it is associated with better tissue
perfusion and oxygen delivery. However, this finding requires further
investigation in patients with increased surgical risk. Overall, this
study indicates that lidocaine has potential to improve microvascular
perfusion. Research Registry number: 9549
(https://www.researchregistry.com/browse-the-registry#home/registrationdet
ails/650ffd27b3f547002bd7635f/). Copyright © The Author(s) 2023.

<50>
Accession Number
2026160155
Title
The Effect of Goal-directed Fluid Management based on Stroke Volume
Variation on ICU Length of Stay in Elderly Patients Undergoing Elective
Craniotomy: A Randomized Controlled Trial.
Source
Indian Journal of Critical Care Medicine. 27(10) (pp 709-716), 2023. Date
of Publication: October 2023.
Author
Sae-Phua V.; Tanasittiboon S.; Sangtongjaraskul S.
Institution
(Sae-Phua, Tanasittiboon, Sangtongjaraskul) Department of Anesthesiology,
Faculty of Medicine, Chulalongkorn University and King Chulalongkorn
Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
Publisher
Jaypee Brothers Medical Publishers (P) Ltd
Abstract
Background: Inappropriate fluid management during neurosurgery can
increase postoperative complications. In this study, we aimed to
investigate the effect of goal-directed fluid therapy using stroke volume
variation (SVV) in elderly patients undergoing elective craniotomy.
 Material(s) and Method(s): We randomized 100 elderly patients
scheduled for elective craniotomy into two groups: goal-directed therapy
(GDT, n = 50) group and conventional group (n = 50). Fluid management
protocol using SVV was applied in the GDT group. Decisions about fluid and
hemodynamic management in the conventional group were made by the
anesthesiologist. Perioperative variables including fluid balance, lactate
level, and intensive care unit (ICU) length of stay were assessed.
 Result(s): There was no significant difference in ICU length of stay
between the two groups: 14 (12, 16.75) hours in GDT group vs 15 (13, 18)
hours in control group (p = 0.116). Patients in the GDT group received a
significantly less amount of crystalloid compared with the control group:
1311.5 (823, 2018) mL vs 2080 (1420, 2690) mL (p < 0.001). Our study
demonstrated a better fluid balance in the GDT group as 342.5 (23, 607) mL
compared with the conventional group 771 (462, 1269) mL (p < 0.001).
 Conclusion(s): Intraoperative goal-directed fluid management based on
SVV in elderly patients undergoing elective craniotomy did not reduce the
ICU length of stay or postoperative complications. It did result in an
improved fluid balance with no evidence of inadequate organ perfusion.
Clinical trial registration number: TCTR20190812003. Copyright ©
The Author(s).

<51>
Accession Number
2025629625
Title
Evidence of Bariatric Surgery Benefits Cardiac Function in Non-HFpEF
Patients with Obesity: a Meta-Analysis.
Source
Obesity Surgery. 33(11) (pp 3353-3361), 2023. Date of Publication:
November 2023.
Author
Lu S.-J.; Zhang T.-T.; Zhang X.-W.; Wang L.; Zhao Y.-W.; Wang R.; Miao
X.-Q.; Zhao G.-H.
Institution
(Lu, Zhang, Zhang, Zhao, Wang, Miao, Zhao) Department of Gastroenterology
Surgery, The Dalian Municipal Central Hospital Affiliated of Dalian
Medical University, No. 826 Southwest Road Shahekou District, Dalian
116033, China
(Lu, Zhao, Wang) Dalian Medical University, No. 9 West Section Lvshun
South Road, Dalian 116044, China
(Wang) Department of Cardiology, The Dalian Municipal Central Hospital
Affiliated of Dalian Medical University, No. 826 Southwest Road Shahekou
District, Dalian 116033, China
Publisher
Springer
Abstract
Background/Objective: Nowadays, increasing clinical evidence on metabolic
and weight-loss effects of bariatric surgery on improving cardiac
structure in obese patients, but its application in improving the cardiac
function of HF (heart failure) patients remains controversial. The
objective of this meta-analysis was to assess the effects of BS on cardiac
function by quantifying the changes of LVEF (left ventricular ejection
fraction) and NYHA (New York Heart Association classification) after
operations in non-HFpEF (heart failure and preserved ejection fraction)
patients. Method(s): Articles were searched using PubMed and Embase
from inception to December 9, 2022, and the Minors scale was used for
quality assessments. The included patients should be non-HFpEF and
clinically severely obese, and their pre-operative and post-operative
values of LVEF or NYHA should be reported. Result(s): Nine studies
involving 146 patients were eventually included with a final result
showing that the cardiac functional parameters were improved in non-HFpEF
patients. After a weighted mean follow-up time of 15.8 months, the mean
NYHA decreased by 0.59 (I 2 = 0; 95% CI 0.27 ~ 0.92; p =
0.003), and the mean LVEF increased by 7.49% (I 2 = 0; 95% CI -
9.99 ~ - 4.99; p < 0.00001). Conclusion(s): Bariatric surgery offers
beneficial cardiac effects on non-HFpEF patients with obesity but failed
to show a significant improvement in the pooled analysis for the changes
of cardiac parameters. The improving degree may be related to the baseline
BMI, the extent of BMI loss, and the baseline age. Future studies should
focus on finding out the influencing factors of effectivenesses and
defining the suitable crowd. Graphical Abstract: [Figure not available:
see fulltext.]. Copyright © 2023, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<52>
Accession Number
2028210465
Title
The Effect of Esmolol Cardioplegia on Reducing Perioperative Myocardial
Ischemia in Patients with Coronary Artery Disease.
Source
Anestezi Dergisi. 31 (pp 277-285), 2023. Date of Publication: 2023.
Author
Jordanoska B.K.; Nikolic A.; Stefanovski I.; Bedzeti F.; Bislimovski D.
Institution
(Jordanoska, Nikolic, Stefanovski, Bedzeti, Bislimovski) Acibadem Sistina
Hospital, Department of Cardiac Surgery, Skopje, North Macedonia
Publisher
Anestezi Dergisi
Abstract
Introduction: Patients with coronary artery disease undergoing coronary
artery bypass surgery (CABG) are susceptible to perioperative ischemia and
numerous complications due to inadequate myocardial protection.
Administration of esmolol, a cardioselective beta-1 blocker with
ultra-short action, is a pharmacological cardioprotective method for
protecting the myocardium. Determination of serum troponin T and lactate
concentrations are frequently used markers of myocardial injury.
 Objective(s): The aim of this study was to determine whether the
administration of a fast-acting beta-1 selective adrenergic blocker -
esmolol immediately before CABG and as an adjunct to cardioplegia itself
would provide additional myocardial protection and reduce serum troponin T
and lactate levels, in the postoperative period. Method(s): 100
patients aged 40-80 years with coronary artery disease were included in
this prospective, randomized, controlled study. Patients were grouped into
two randomized groups according to whether they received esmolol
betal-selective adrenergic blocker according to a well-defined protocol or
placebo. A computer-generated list of random numbers was used to randomize
patients. In all patients, the serum troponin T level was measured
according to the protocol, the highest troponin T value and the highest
serum lactate level were determined in the first three hours
postoperatively. Result(s): All troponin T measurements according to
the well-defined protocol, including the peak value, showed lower values
in patients in the esmolol group compared to others. The serum troponin T
value measured at time zero was statistically significantly lower
(p=0.042) in patients receiving esmolol compared to others. We also
obtained statistical significance in the serum troponin T value at 4 hours
(p=0.040) as well as its peak serum value (p=0.020) in patients given
esmolol. Lactate levels in the first three hours were statistically
significantly lower (p=0.020) in patients in the esmolol group compared to
others. Conclusion(s): A pharmacological cardioprotective method for
the protection of the myocardium with a beta-1 selective adrenergic
blocker - esmolol given as an adjunct before and during cardioplegia in
patients with coronary artery disease has a positive effect on reducing
the level of troponin T and lactates in the postoperative
period. Copyright © 2023 Anestezi Dergisi. All rights reserved.

<53>
Accession Number
2026567233
Title
Outcomes of left-sided heart valve surgery after heart transplantation: a
systematic review.
Source
Heart Failure Reviews. (no pagination), 2023. Date of Publication: 2023.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Modine T.; Labrousse L.; Pernot M.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Modine, Labrousse, Pernot)
Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Av. Magellan,
Pessac 33604, France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Baudo) Department of Cardiac Surgery, University Hospitals Leuven,
Louvain, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
Springer
Abstract
As the survival after heart transplantation (HTx) is steadily improving,
an increasing number of patients with late cardiac pathologies such as
valvular disease is expected to rise. Nevertheless, no guidelines for
indication of redo cardiac surgery after HTx exists. The aim of the
present systematic review is to describe the results reported in the
literature of surgical management of severe aortic and/or mitral valve
disease. A systematic review was conducted including studies reporting on
adult patients with severe mitral or aortic valve pathology needing
surgery after their previous HTx. Exclusion criteria consisted in surgery
with no left heart valve surgery, concomitant valve surgery during heart
transplant, transcatheter interventions, and heterotopic HTx. A total of
35 papers met our inclusion criteria out of 2755 potentially eligible
studies with 44 mitral valve surgery patients and 20 aortic valve surgery
patients. In the entire population, the mean time from HTx to
reintervention was 6.19 +/- 5.22 years. After a mean follow-up of 2.78 +/-
3.54 years and 1.53 +/- 2.26 years from reintervention, 65.6% mitral and
86.7% aortic patients were reported as alive, respectively. As guidelines
on cardiac surgery after HTx are currently lacking, left-sided valvular
cardiac reinterventions can be considered a possible therapeutic approach
in carefully selected patients. These interventions may not only improve
the patient's functional status and survival, but may ultimately reduce
the need for re-transplantation due to the chronic shortage of donor
hearts. However, the support of more robust data is
warranted. Copyright © 2023, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<54>
Accession Number
2026080694
Title
Intercostal Nerve Cryoablation for Postoperative Pain Control in Pediatric
Thoracic Surgery: A Scoping Review.
Source
Journal of Laparoendoscopic and Advanced Surgical Techniques. 33(10) (pp
994-1004), 2023. Date of Publication: 01 Oct 2023.
Author
Lai K.; Eldredge R.S.; Zobel M.; Hargis-Villanueva A.; Ostlie A.; Padilla
B.E.
Institution
(Lai, Eldredge, Hargis-Villanueva, Padilla) Division of Pediatric Surgery,
Phoenix Children's Hospital, Phoenix, AZ, United States
(Zobel) Division of Pediatric Surgery, University of California San
Francisco, San Francisco, United States
(Ostlie, Padilla) Department of Child Health, University of Arizona School
of Medicine, Tucson, AZ, United States
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Cryoanalgesia uses the application of cold temperatures to
temporarily disrupt peripheral sensory nerve function for pain control.
This review outlines the principles of cryoablation, clinical
applications, and clinical data for its use in pediatric thoracic surgery.
 Method(s): A comprehensive PubMed search was performed using the
principal terms and combinations of cryoablation, cryoanalgesia, Nuss,
Nuss repair, pectus, pectus excavatum, thoracic surgery, thoracotomy, and
chest wall. Pediatric articles were reviewed and included if relevant.
Adult articles were reviewed for supporting information as needed.
Reference lists of included articles were reviewed for possible additional
sources. Discussion(s): The scientific and clinical principles of
cryoablation are outlined, followed by a focused review of current
clinical application and outcome data. Conclusion(s): Postoperative
pain is a major challenge following thoracic surgery. Cryoanalgesia is
emerging as an adjunct in pediatric thoracic surgery, particularly for the
Nuss procedure or minimally invasive repair of pectus excavatum. It
effectively controls pain, decreasing postoperative opioid use and
hospital length of stay with few short-term complications. Although more
long-term studies are needed, early evidence suggests there is reliable
return of sensation to the chest wall and long-term neuropathic pain is
rare. Copyright © Mary Ann Liebert, Inc.

<55>
Accession Number
2025458330
Title
An analysis of quality of life and functional outcomes as reported in
randomized trials for red cell transfusions.
Source
Transfusion. 63(11) (pp 2032-2039), 2023. Date of Publication: November
2023.
Author
Pagano M.B.; Dennis J.A.; Idemudia O.M.; Stanworth S.J.; Carson J.L.
Institution
(Pagano) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, WA, United States
(Dennis) Cochrane Injuries Group, London School of Hygiene & Tropical
Medicine, London, United Kingdom
(Idemudia, Carson) Department of Medicine, Rutgers Robert Wood Johnson
Medical School, Piscataway, NJ, United States
(Stanworth) NHS Blood and Transplant, Oxford, United Kingdom
(Stanworth) Oxford University Hospitals NHS Foundation Trust, John
Radcliffe Hospital, Oxford, United Kingdom
(Stanworth) Radcliffe Department of Medicine, University of Oxford,
Oxford, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Meta-analyses of randomized controlled trials (RCTs)
evaluating thresholds for red blood cell (RBC) transfusion typically focus
on mortality; however, other outcomes are highly relevant. The aim of this
study is to summarize the effects of different transfusion thresholds on
the outcomes of quality of life (QoL) and function. Study Design: We
extracted data from RCTs identified in a recently published Cochrane
systematic review. Primary analysis was descriptive. Result(s): A
total of 23 RCTs with 13,743 adult participants were included. Fifteen
RCTs included patients in the postoperative period, of which 9 RCTs were
conducted in hip (n = 3024) and 6 (n = 8672) in cardiac surgeries; 5 RCTs
(n = 489) were in patients with hematological malignancies; 2 in the
setting of bleeding (gastrointestinal bleed [n = 936] and postpartum [n =
521]); and one RCT (n = 936) included critically ill patients. QoL and
function were reported using a variety of questionnaires and tools. The
timing of assessments varied between trials. No clear clinical differences
in QoL outcomes were identified in comparisons between restrictive and
liberal transfusion thresholds. Discussion(s): There is no evidence
that a liberal transfusion strategy improves QoL and functional outcomes.
However, the substantial limitations of many included studies indicate the
need for further well-designed and adequately powered
trials. Copyright © 2023 AABB.

<56>
Accession Number
2028115094
Title
Effect of ageing on oxidative stress and inflammatory response by on-pump
cardiac surgery in patients treated with antioxidants: a randomized
controlled trial.
Source
Free Radical Biology and Medicine. Conference: SfRBM - SFRRI 2023
Conference. Punta del Este Uruguay. 208(Supplement 1) (pp S88-S89), 2023.
Date of Publication: 01 Nov 2023.
Author
Lillo-Moya J.; Jacob Gajardo Cortez A.I.; Prieto J.C.; Aguayo R.; Puentes
Rico A.A.; Silva S.; Ramos C.; Ramos K.; Rodrigo R.
Institution
(Lillo-Moya, Rodrigo) Molecular and Clinical Pharmacology Program,
Institute of Biomedical Sciences, Faculty of Medicine, University of
Chile, University of Chile, Santiago, Chile
(Jacob Gajardo Cortez) Program of Pathophysiology, Faculty of Medicine,
University of Chile, Chile
(Prieto) Molecular and Clinical Pharmacology Program, Institute of
Biomedical Sciences, Faculty of Medicine, University of Chile &
Cardiovascular Department, University of Chile Clinical Hospital,
University of Chile, Chile
(Aguayo, Puentes Rico) Cardiology Unit, Department of Medicine, Occident
Division, San Juan de Dios Hospital, Hospital San Juan de Dios, Chile
(Silva, Ramos) Department of Radiology, University of Chile Clinical
Hospital, University of Chile, Chile
(Ramos) Intensive Medicine Unit, Faculty of Medicine, Pontifical Catholic
University of Chile, Pontifical Catholic University of Chile, Chile
Publisher
Elsevier Inc.
Abstract
Introduction: Cardiac surgery with extracorporeal circulation (CSEC)
induces oxidative stress (OS) and inflammatory damage by ischemia
reperfusion (IR). OS has been postulated as an important factor in this
process and also in human ageing but there are lack evidence about the
effect of ageing on IR. Aim(s): To evaluate whether there is an
age-related response on OS and inflammation in patients undergoing CSEC
treated with antioxidants. Method(s): Randomized controlled trial
with 203 patients scheduled for CSEC who were allocated to placebo or
antioxidants before CSEC. Patients were divided by age in young patients
(44-59 years) and older patients (>60 years). Blood samples were withdrawn
before and after CSEC to measure malondialdehyde (MDA), ferric reducing
ability of plasma (FRAP), leukocytes and hsCRP. For each parameter a ratio
(before/after CSEC) was calculated to assess the OS and inflammatory
response induced by CSEC. Linear regression analyses was performed to test
the effect of ageing and antioxidants on IR response. Result(s):
Antioxidant supplementation reduced the OS and inflammatory response
induced by CSEC in both young and older patients. In placebo group,
elderly patients shown a higher MDA and leukocytes ratio but lower FRAP
ratio than youngers. On the other hand, antioxidant therapy annulled MDA,
FRAP and leukocytes differences between older and young patients, and also
induced a lower hsCRP ratio in elderlies. Conclusion(s): Antioxidant
supplementation reduces OS and inflammation by ischemia-reperfusion in
CSEC. Although there is an age-related response on OS and inflammation by
CSEC, the antioxidant supplementation annuls this effect. doi:
xxxxx Copyright © 2023

<57>
Accession Number
642726840
Title
A SYSTEMATIC REVIEW OF THE EVIDENCE SUPPORTING THE USE OF SURGICAL AORTIC
AND MITRAL VALVES: AN UPDATE FROM THE CORE MD CONSORTIUM.
Source
Heart. Conference: 74th Annual Scientific Meeting Irish Cardiac Society
and AGM. Kildare Ireland. 109(Supplement 6) (pp A30-A31), 2023. Date of
Publication: October 2023.
Author
McGovern L.; Siontis G.; Coughlan J.J.; Melvin T.; Geertsma R.; Frenk A.;
Schnell-Inderst P.; McGauran G.; Fraser A.G.; Windecker S.; Byrne R.A.
Institution
(McGovern, Coughlan, Byrne) Cardiovascular Research Institute (CVRI)/Mater
Private Network/RCSI, Dublin, Ireland
(Siontis, Frenk, Windecker) Bern University Hospital (BUH), Bern,
Switzerland
(Melvin, McGauran) Health Products Regulatory Authority (HPRA), Dublin,
Ireland
(Geertsma) RIVM: National Institute for Public Health and the Environment,
Utrecht, Netherlands
(Schnell-Inderst) UMIT TIROL, Tirol, Austria
(Fraser) University Hospital of Wales, Cardiff, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction The European Union (EU) Medical Device Regulation (MDR)
2017/745 challenges the medical community to engage with regulators,
notified bodies and industry to develop transparent, rigorous, and
proportionate methods to evaluate the clinical safety and efficacy of
medical devices and to monitor their performance. As part of the EU
Horizon 2020 funded CORE-MD project, we performed a systematic review of
the published scientific evidence available for surgical heart valve
replacements for native aortic and mitral valve pathologies. Purpose The
aim of this analysis is to review the scientific evidence available which
supports the use of currently available surgical aortic and mitral valves.
Methods A systematic literature review was conducted using Ovid, MEDLINE,
Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL).
We included only surgical aortic and mitral valves that received CE Mark
approval from the year 2000 onwards. The date of CE-Mark approval was
defined based on press releases, information provided by regulatory
sources, and communications with the corresponding manufacturers. We
included any study of prospective design (randomised or non-randomised
clinical trials of any design) in humans, published between January 2000
and August 2021. We excluded retrospective studies, case reports, reviews,
systematic reviews, meta-analyses, and expert opinion documents. Title and
abstract screening, full-text review, risk of bias evaluation and data
collection were performed by two authors independently, with disagreements
resolved by discussion with a third author. Results A total of 17 surgical
aortic valves and 4 surgical mitral valves were identified based on the CE
mark criterion (figure 1). The initial literature search identified 4901
and 3696 potentially eligible papers in the aortic and mitral valve
categories, respectively. Following title and abstract screening, 269
aortic and 59 mitral valve manuscripts underwent full text review.
Finally, 39 aortic valve studies (37 unique studies) and 1 mitral valve
study were included after full text review (figure 2). The majority of
included studies (90%) had a nonrandomised, prospective, observational
design with 68% receiving industry funding. The studies predominantly
originated from Europe and the USA (78%). The median number of patients
included was 295 [interquartile range (IQR): 153, 689] with a median
maximum follow-up of 24 months [IQR: 12, 60]. Only 50% of the identified
studies had a pre-specified registered study protocol and only 5% included
a power calculation to estimate the required study size. No study reported
patient involvement in the study design and only 15% of studies had a
comparator group. Using the ROBINS I AND II assessment tools, 90% of the
included studies were classified as having a high or serious risk of bias.
Conclusion The evidence available for currently used surgical aortic and
mitral replacement heart valves is largely from small, industry funded,
non-randomised controlled trials. The median duration of maximum follow up
was only 24 months, the majority of studies were classed as having a
high/serious risk of bias and only half had a pre-registered study
protocol. These results highlight the limitations of the available
scientific evidence supporting the surgical aortic and mitral valves used
in current clinical practice.

<58>
Accession Number
642726743
Title
Irish Cardiac Society 74th Annual Scientific Meeting and AGM.
Source
Heart. Conference: 74th Annual Scientific Meeting Irish Cardiac Society
and AGM. Kildare Ireland. 109(Supplement 6) (no pagination), 2023. Date of
Publication: October 2023.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 63 papers. The topics discussed include: does the
use of resource efficient checklists improve guideline directed medical
therapy prescription rates and outcomes for patients admitted with
decompensated heart failure - a systematic review; effect of intravascular
lithotripsy on varying calcium morphologies: a multicenter prospective
study; impact of preprocedural computer tomography versus transoesophageal
echocardiography for left atrial appendage occlusion procedure planning;
the impact of a conservative management strategy for stable coronary
artery disease prior to TAVI; titration of heart failure guideline
directed therapy: a comparison between the performance of Irish heart
failure nurses and observational registries; indications and outcomes of
non-invasive coronary artery calcium score and coronary angiography; and
clinical characteristics, procedural and short term outcomes for patients
undergoing calcium modification using intravascular lithotripsy in a
tertiary referral center: a single center retrospective analysis.

<59>
Accession Number
642726652
Title
THE IMPACT OF A CONSERVATIVE MANAGEMENT STRATEGY FOR STABLE CORONARY
ARTERY DISEASE PRIOR TO TAVI.
Source
Heart. Conference: 74th Annual Scientific Meeting Irish Cardiac Society
and AGM. Kildare Ireland. 109(Supplement 6) (pp A1-A2), 2023. Date of
Publication: October 2023.
Author
Pollock A.; Twomey D.; Waters M.; O'Connor C.; Ullah I.; Hennessy T.;
Farhat Abbas S.; Kiernan T.; Arnous S.
Institution
(Pollock, Twomey, Waters, O'Connor, Ullah, Hennessy, Farhat Abbas,
Kiernan, Arnous) University Hospital Limerick, Ireland
(Kiernan) Department of Medicine, University of Limerick, Ireland
Publisher
BMJ Publishing Group
Abstract
Background The optimum strategy for managing coronary artery disease (CAD)
prior to transcatheter aortic valve implantation (TAVI) remains unclear. A
recent consensus statement from the European Association of Percutaneous
Cardiovascular Interventions (EAPCI) on the management of CAD in patients
undergoing TAVI, recommended PCI before TAVI in patients with severe CAD
(i.e. >70% stenosis in proximal segments of a major epicardial vessel or
>50% stenosis in the left main coronary artery). We sought to assess the
outcomes of a predominantly conservative management strategy for CAD in an
Irish TAVI population 1 year after implantation. Aims The aim of this
study was to assess the 1 year outcomes of a conservative management
strategy for significant stable CAD prior to TAVI. Methods Single centre
retrospective review of patients who underwent TAVI between 2014 and 2022
with a minimum of 1 year follow-up. The images and reports of coronary
angiography performed prior to TAVI were analysed to identify patients who
would be defined as severe CAD requiring intervention as per the EAPCI
consensus statement recommendations. Local electronic medical records,
discharge summaries, radiology and cardiology systems, and national death
notification database were analysed for one year follow up data. The
primary outcome for the study was major adverse cardiac events (MACE) at
one year. The secondary outcomes for the study were mortality, myocardial
infarction (MI), stroke, repeat angiography and revascularisation at one
year. Results In total, 145 patients were included in the study (mean age
79.6 years, 35.9% female). The cohort had a high level of co-morbidities:
24.8% IHD, 40% HTN, 55.2% dyslipidaemia, 25.5% diabetes mellitus, 15.2%
CKD, 35.9% atrial fibrillation/atrial flutter, 13.1% stroke/TIA. Nine
patients (6.2%) underwent PCI prior to TAVI, 5 of whom (3.4%) had stable
CAD. In the cohort with conservatively managed CAD, 19 (14%) had severe
CAD meeting the EAPCI criteria for intervention. In the conservatively
managed cohort, the incidence of MACE was 15.4%. There was no significant
difference in the primary or secondary outcomes in patients with severe
CAD, compared to patients without severe CAD (table 1). There was however
a numerically higher incidence of stroke and numerically lower incidence
of mortality, MI and revascularisation in the patients with severe CAD.
Conclusion This study found a low incidence of major adverse cardiac
events in patients with conservatively managed stable severe CAD at 1 year
post TAVI, and similar outcomes to patients without severe CAD. This
supports the safety of a heart team discussion guided conservative CAD
management strategy while randomised control trial data is awaited.

<60>
Accession Number
2026620147
Title
Effectiveness of Early Mobilization in Prevention and Rehabilitation of
Functional Impairment After Myocardial Revascularization Surgery: A
Systematic Review.
Source
International Journal of Cardiovascular Sciences. 36 (no pagination),
2023. Article Number: e20210166. Date of Publication: 2023.
Author
Das Judas M.C.L.; Fontes R.F.; de Moura R.; Dos Santos L.; de Almeida M.;
Gomes V.
Institution
(Das Judas) Centro Universitario Ruy Barbosa Wyden, BA, Salvador, Brazil
(Fontes) Faculdade Social da Bahia, BA, Salvador, Brazil
(de Moura) Unifacs, BA, Salvador, Brazil
(Dos Santos) Universidade Federal da Bahia (UFBA), BA, Salvador, Brazil
(de Almeida, Gomes) Escola Bahiana de Medicina e Saude Publica, BA,
Salvador, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Introduction: Myocardial revascularization surgery is associated with high
morbidity and mortality, due to factors like the general anesthesia and
the surgical procedure itself. Physiotherapy, combined with early
mobilization (EM), can provide the patient with better functional
parameters. Objective(s): To review, identify and describe the
effectiveness of EM in the prevention and rehabilitation of functional
parameters of coronary artery bypass graft surgery. Methodology: This is a
systematic review conducted between February 2020 and 2021 of randomized
clinical trials (RCTs) published in the Cochrane databases Library,
LILACS, Scielo and Medline / PubMed. The Physiotherapy Evidence Database
(PEDro) scale was used for assessment of the methodological quality of
studies included. Result(s): Four studies were reviewed. Two articles
assessed functional capacity, one using the cycle ergometer and one with
inspiratory muscle training (IMT) together with active exercises and early
walking. One article reported a reduction in the incidence of atelectasis
and pleural effusion with EM and one article reported improvements in the
alveolus-artery gradient and inspiratory muscle power using an inspiratory
muscle trainer combined with EM. Conclusion(s): EM is effective in
the prevention and rehabilitation of functional parameters after CABG
surgery, by improving functional capacity, respiratory muscle power,
quality of life and gas exchange, and reducing the incidence of
atelectasis and pleural effusion. Copyright © 2023, Sociedade
Brasileira de Cardiologia. All rights reserved.

<61>
Accession Number
2028318817
Title
Efficacy and safety of the serratus anterior block compared to thoracic
epidural analgesia in surgery: Systematic review and meta-analysis.
Source
Tzu Chi Medical Journal. 35(4) (pp 329-337), 2023. Date of Publication:
October 2023.
Author
Lusianawati; Suhardi C.J.; Sumartono C.; Wungu C.D.K.
Institution
(Lusianawati, Suhardi, Sumartono) Department of Anesthesiology and
Reanimation, Faculty of Medicine, Airlangga University/ Dr. Soetomo
Hospital, Surabaya, Indonesia
(Wungu) Department of Physiology and Medical Biochemistry, Faculty of
Medicine, Airlangga University, Surabaya, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objectives: The objective of this study was to compare the efficacy and
safety of serratus anterior plane block (SAPB) and thoracic epidural
analgesia (TEA) in thoracic region surgery. Material(s) and
Method(s): We implemented a systematic search of PubMed, ScienceDirect,
SCOPUS, and Web of Science and through gray literature for all randomized
controlled trials that compared SAPB, a novel thoracic wall nerve block,
and TEA in surgery. The evaluated outcomes included the Visual Analog
Scale (VAS), hypotension, and postoperative nausea and vomiting (PONV).
Review Manager, version 5.4.1, was implemented for the analysis of
statistics. Result(s): The pooled analysis included six trials that
fulfilled the inclusion criteria. In total 384, surgery had received
regional blocks (162 - SAPB and 163 - TEA). VAS did not differ
significantly between SAPB and TEA, with a mean difference of 0.71, P =
0.08. PONV incidence did not differ significantly between SAPB and TEA
(odds ratio = 0.25, P = 0.07). Hypotension incidence was lower in SAPB
compared to TEA (odds ratio = 0.10, P = 0.0001). Conclusion(s): SAPB
yielded comparable VAS with TEA in pain management of thoracic region
surgery. The incidence of hypotension was lower in SAPB than in TEA. No
difference in PONV incidence was observed. SAPB can be a viable
alternative to TEA in thoracic region surgery. Copyright © 2023
Tzu Chi Medical Journal Published by Wolters Kluwer - Medknow.

<62>
Accession Number
2028285085
Title
Literature Review of Handheld Articulating Instruments in Minimally
Invasive Surgery.
Source
Journal of Laparoendoscopic and Advanced Surgical Techniques. (no
pagination), 2023. Date of Publication: 2023.
Author
Mao R.; Gao L.; Gang W.; Wen L.
Institution
(Mao, Gao, Wen) Department of Medical Equipment, Sichuan Provincial
People's Hospital, School of Medicine, University of Electronic Science
and Technology of China, Chengdu, China
(Mao) School of Biological Science and Medical Engineering, Beihang
University, Beijing, China
(Gang) Hepatobiliary and Pancreatic Surgery Department, Sichuan Provincial
People's Hospital, Chengdu, China
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Minimally invasive surgery (MIS) using handheld articulating
instruments (HAIs) has emerged as an innovative approach, offering
enhanced dexterity and accessibility compared with conventional straight
tools. There has been a significant surge in market interest surrounding
HAIs. However, the question about the potential benefits of these devices
for surgeons and patients in clinical applications remains unclear.
 Method(s): We thoroughly searched relevant literature about the HAIs
with clinical applications. This article reviews the feasibility, safety,
outcomes, ergonomics, and learning curve associated with utilizing HAIs,
including notable commercial products FlexDex, ArtiSential, and HandX.
This study also investigates the comparisons of the use of HAIs with
traditional laparoscopy and the da Vinci robotic system in terms of
surgical outcomes and operational efficiency. Result(s): Early
clinical studies demonstrate the applicability of HAIs across
gastrointestinal, urologic, cardiothoracic, and general surgery, with
promising results and few complications reported. Comparisons with
conventional laparoscopy reveal no significant differences in surgical
outcomes. However, HAIs present a more prolonged learning curve than
robotic surgery for novice users. Combining three-dimensional
visualization techniques facilitate performance. Further research with
larger sample sizes is warranted to establish definitive superiority in
surgical efficiency and characterize optimal training methodology.
 Conclusion(s): Overall, the maneuverability and lower cost of HAIs
present new possibilities in MIS, potentially expanding accessibility for
smaller health care organizations and benefiting more
patients. Copyright © Mary Ann Liebert, Inc.

<63>
Accession Number
2026641918
Title
The Use of Sodium-Glucose Cotransporter-2 Inhibitors in Coronary
Revascularization: Where Are We Now? A Systematic Review.
Source
American Journal of Cardiovascular Drugs. (no pagination), 2023. Date of
Publication: 2023.
Author
EL-Andari R.; Fialka N.M.; Kang J.; Bozso S.J.; Nagendran J.
Institution
(EL-Andari, Fialka, Kang, Bozso, Nagendran, Nagendran) Division of Cardiac
Surgery, Department of Surgery, University of Alberta, Mazankowski Alberta
Heart Institute, 4-108A Li Ka Shing Health Research Centre, 8602-112
Street, Edmonton, AB T6G 2E1, Canada
Publisher
Adis
Abstract
Introduction: Diabetes and coronary artery disease are two common
conditions that often co-exist. In recent years, sodium-glucose
cotransporter 2 inhibitors (SGLT2i) have been demonstrated to provide
significant cardioprotective benefits, especially among patients with
heart failure. Objective(s): In this systematic review, we look to
identify the outcomes SGLT2i use in patients undergoing coronary
revascularization. Method(s): Pubmed and Embase were systematically
searched for articles describing the outcomes of patients taking SGLT2i
and undergoing coronary revascularization. 834 titles and abstracts were
screened, 42 full texts were reviewed, and 18 studies were found to meet
the inclusion criteria and were included in this review. Result(s):
For patients undergoing coronary artery bypass grafting and percutaneous
coronary intervention, the use of SGLT2i resulted in reductions in
mortality, hospitalization for heart failure, and improved blood glucose;
however, these benefits were not consistently reported in the literature.
Reduced inflammatory markers and positive cardiac remodeling were
identified among patients taking SGLT2i. Conclusion(s):
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been demonstrated
to provide benefits for patients with heart failure along with a host of
positive modulatory effects on the cardiovascular system, including
reductions in inflammatory properties, hypertension, and left ventricular
volume load. Given the clear benefit provided by SGLT2i to patients with
cardiovascular disease and a host of positive properties that are expected
to be protective for patients with ischemic heart disease, future
investigation into the relationship between SGLT2i and outcomes for
patients undergoing revascularization is imperative. Copyright ©
2023, The Author(s), under exclusive licence to Springer Nature
Switzerland AG.

<64>
Accession Number
642738576
Title
Transcatheter valvular interventions after heart transplantation: a
systematic review.
Source
Trends in cardiovascular medicine. (no pagination), 2023. Date of
Publication: 09 Nov 2023.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Labrousse L.; Pernot M.; Leroux L.;
Modine T.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Labrousse, Pernot, Leroux,
Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Pessac,
France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy; Department of Cardiac Surgery,
University Hospitals Leuven, Leuven, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Abstract
An increasing number of patients experience late valvular disease after
heart transplantation (HTx). While mostly being primarily addressed
through surgical interventions, transcatheter valve procedures to treat
these conditions are rising, particularly for unsuitable surgical
candidates. This review aims at analyzing the outcomes of transcatheter
valvular procedures in this subset of patients. A systematic review was
conducted including studies reporting on adult patients requiring any form
of transcatheter valvular intervention after a previous HTx. Studies
involving a surgical approach, heterotopic heart transplants, or
concomitant procedures performed during the transplant itself were
excluded. Twenty-five articles with a total of 33 patients met the
inclusion criteria, 10 regarding the aortic valve (14 patients), 5 the
mitral valve (6 patients), and 6 the tricuspid valve (13 patients). In two
cases, the procedure was recommended to stabilize the valvular lesion
before re-transplantation, as both were very young patients. Overall, the
mean time from heart transplantation to reintervention was 14.7 +/- 9.5
years. The mean follow-up was 15.5 +/- 13.5 months, and only one patient
died 22.3 months after the intervention. There is a growing emergence of
transcatheter interventions for valvular disease after heart
transplantation, especially in cases where surgery is deemed high-risk or
prohibitive. A different strategy may also be considered in young patients
to permit longer allograft life before later re-transplantation. Although
encouraging outcomes have been documented, additional research is required
to establish the most appropriate approach within this specific subset of
patients. Copyright © 2023. Published by Elsevier Inc.

<65>
Accession Number
642723842
Title
Discontinuation vs. continuation of renin-angiotensin system inhibition
before non-cardiac surgery: the SPACE trial.
Source
European heart journal. (no pagination), 2023. Date of Publication: 07
Nov 2023.
Author
Ackland G.L.; Patel A.; Abbott T.E.F.; Begum S.; Dias P.; Crane D.R.;
Somanath S.; Middleditch A.; Cleland S.; Gutierrez Del Arroyo A.; Brealey
D.; Pearse R.M.
Institution
(Ackland, Patel, Abbott, Begum, Dias, Crane, Gutierrez Del Arroyo, Pearse)
Translational Medicine and Therapeutics, William Harvey Research
Institute, Queen Mary University of London, Charterhouse Square, London
EC1M 6BQ, United Kingdom
(Somanath) County Durham and Darlington NHS Foundation Trust, Darlington,
United Kingdom
(Middleditch) University Hospitals Bristol NHS Foundation Trust, United
Kingdom
(Cleland) University Hospitals Plymouth NHS Trust, United Kingdom
(Brealey) Bloomsbury Institute of Intensive Care Medicine, University
College London, London, United Kingdom
(Brealey) UCL Hospitals NHS Foundation Trust, London, United Kingdom
(Brealey) NIHR University College London Hospitals Biomedical Research
Centre, London, United Kingdom
Abstract
BACKGROUND AND AIMS: Haemodynamic instability is associated with
peri-operative myocardial injury, particularly in patients receiving
renin-angiotensin system (RAS) inhibitors (angiotensin-converting-enzyme
inhibitors/angiotensin II receptor blockers). Whether stopping RAS
inhibitors to minimise hypotension, or continuing RAS inhibitors to avoid
hypertension, reduces peri-operative myocardial injury remains unclear.
 METHOD(S): From 31 July 2017 to 1 October 2021, patients aged >=60
years undergoing elective non-cardiac surgery were randomly assigned to
either discontinue or continue RAS inhibitors prescribed for existing
medical conditions in six UK centres. Renin-angiotensin system inhibitors
were withheld for different durations (2-3 days) before surgery, according
to their pharmacokinetic profile. The primary outcome, masked to
investigators, clinicians, and patients, was myocardial injury [plasma
high-sensitivity troponin-T (hs-TnT) >= 15 ng/L within 48 h after surgery,
or >=5 ng/L increase when pre-operative hs-TnT >=15 ng/L]. Pre-specified
adverse haemodynamic events occurring within 48 h of surgery included
acute hypertension (>180 mmHg) and hypotension requiring vasoactive
therapy. RESULT(S): Two hundred and sixty-two participants were
randomized to continue (n = 132) or stop (n = 130) RAS inhibitors.
Myocardial injury occurred in 58 (48.3%) patients randomized to
discontinue, compared with 50 (41.3%) patients who continued, RAS
inhibitors [odds ratio (for continuing): 0.77; 95% confidence interval
(CI) 0.45-1.31]. Hypertensive adverse events were more frequent when RAS
inhibitors were stopped [16 (12.4%)], compared with 7 (5.3%) who continued
RAS inhibitors [odds ratio (for continuing): 0.4; 95% CI 0.16-1.00].
Hypotension rates were similar when RAS inhibitors were stopped [12
(9.3%)] or continued [11 (8.4%)]. CONCLUSION(S): Discontinuing RAS
inhibitors before non-cardiac surgery did not reduce myocardial injury,
and could increase the risk of clinically significant acute hypertension.
These findings require confirmation in future studies. Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<66>
Accession Number
2028272522
Title
erector spinae plane block versus paravertebral block for postoperative
pain management in thoracic surgery: a systematic review and
meta-analysis.
Source
Minerva Anestesiologica. 89(11) (pp 1042-1050), 2023. Date of Publication:
November 2023.
Author
Capuano P.; Hileman B.A.; Martucci G.; Raffa G.M.; Toscano A.; Burgio G.;
Arcadipane A.; Kowalewski M.
Institution
(Capuano, Martucci, Burgio, Arcadipane) Department of Anesthesia and
Intensive Care, Irccs-isMett (Istituto Mediterraneo per i Trapianti e
Terapie ad Alta Specializzazione), Palermo, Italy
(Hileman) University of Pittsburgh, School of Medicine, Pittsburgh, Pa,
United States
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Irccs-isMett, Palermo, Italy
(Toscano) Department of Anesthesia, Critical Care and Emergency, Citta
Della Salute e Della Scienza, University of Turin, Turin, Italy
(Kowalewski) Department of Cardiac Surgery and Transplantology, Central
Clinical Hospital of the Ministry of Interior, Center of Postgraduate
Medical Education, Warsaw, Poland
(Kowalewski) Department of Cardiothoracic Surgery, Heart and Vascular
Center, Maastricht University Medical Center, Maastricht, Netherlands
(Kowalewski) Cardiovascular Research Institute Maastricht (CariM),
Maastricht, Netherlands
(Kowalewski) Thoracic Research Center, Collegium Medicum, Innovative
Medical Forum, Nicolaus Copernicus University, Bydgoszcz, Poland
Publisher
Edizioni Minerva Medica
Abstract
introDUction: the 2018 guidelines for enhanced recovery in thoracic
surgery recommend paravertebral block (PvB) for postoperative pain
management. However, recent studies demonstrate that erector spinae plane
block (esPB) achieves similar postoperative pain control with reduced
block-related complications. eviDence acQUisition: We conducted a
meta-analysis of randomized controlled trials to evaluate the analgesic
efficacy and safety of ESPB versus PvB for pain management after thoracic
surgery. PubMed, embase, and scopus were searched through December 2022
(ProsPero registration - crD42023395593). Primary outcomes were
postoperative pain scores, resting at 6, 12, 24, and 48 hours, and at
movement at 24 and 48 hours. secondary outcomes included opioid
consumption at 24 and 48 hours, and incidence of postoperative nausea and
vomiting or block-related complications in the first 48 hours. eviDence
sYntHesis: ten randomized control trials enrolling a total of 624 total
patients were included. there were no significant differences in pain
scores, resting or at movement, at any time points except reduced resting
pain scores at 12 hours with PVB (mean difference [MD]) 0.60, 95%
confidence interval [CI] 0.32 to 0.88). Opioid consumption demonstrated no
significant differences at 24 hours; PVB reduced opioid consumption at 48
hours (MD 0.40, 95% CI -0.09 to 0.89). There were no significant
differences in postoperative nausea or vomiting. ESPB exhibited a
nonsignificant trend toward reduced cumulative block-related complications
(risk difference [RD] 0.05, 95% CI -0.10 to 0.00). CONCLUSION(S):
Compared with PVB, ESPB is safe and demonstrates no clinically significant
differences in pain management after thoracic surgery. Copyright
© 2023 eDiZioni Minerva MeDica.

<67>
Accession Number
2028271009
Title
Outcomes of Ozaki Procedure/Aortic Valve Neocuspidization for Aortic Valve
Diseases: A Systematic Review.
Source
Anatolian Journal of Cardiology. 27(11) (pp 619-627), 2023. Date of
Publication: November 2023.
Author
Badalyan S.S.; Markosyan S.V.; Ismailbaev A.M.; Asghar A.; Rehman A.U.
Institution
(Badalyan) Department of Cardiology, I.M. Sechenov University Hospital
First Moscow State Medical University, Moscow, Russian Federation
(Markosyan) Department of Cardiology, Yerevan State Medical University
after Mkhitar Heratsi, Yerevan, Armenia
(Ismailbaev) Department of Cardiovascular Surgery, I.M. Sechenov
University Hospital First Moscow State Medical University, Moscow, Russian
Federation
(Asghar) Institute of Pharmaceutical Sciences, University of Veterinary
and Animal Sciences, Lahore, Pakistan
(Rehman) Department of Food Science and Human Nutrition, University of
Veterinary and Animal Sciences, Lahore, Pakistan
Publisher
Turkish Society of Cardiology
Abstract
Background: Perfect heart valve prostheses have optimized hemodynamics,
reduced surgical morbidity, long-lasting durability, and extended patient
survival with greater quality of life. Mechanical valves are recommended;
however, young children may need anticoagulant medication for life. In
this study, we looked at the success rate and viability of aortic valve
neocuspidization (AVNeo) surgery for a variety of aortic disorders.
 Method(s): A methodical search strategy was used to fully evaluate
the AVNeo results. Boolean operators were used to combine important words
like "Ozaki Procedure," "Aortic Valve Neocuspidization," "AVNeo," and
associated terms. Reputable databases such as PubMed, MEDLINE, Embase, Web
of Science, and Scopus were the focus of our search. Study quality was
assessed using a critical evaluation created with the Critical Appraisal
Skills Programme tool. Result(s): The findings are summarized in
the"Results" section that contains descriptive and critical analysis,
ramifications, and explanations. According to research, AVNeo improved
valve function and had few side effects. Aortic valve neocuspidization has
a lower mean pressure gradient and a larger mean efficient orifice area
than Trifecta. Aortic valve neocuspidization surgery reduces aortic valve
regurgitation and pressure gradients. Postoperative echocardiograms
indicated a decrease in peak and a rise in mean pressure gradient.
 Conclusion(s): The Ozaki method restores a healthy laminar flow
pattern while preventing bivalvular disease. Ozaki procedure should be
explored for valve repair in infants with truncal valve and congenital
aortic disease. Aortic valve tricuspidization with glutaraldehyde-treated
autologous pericardium results in considerable effective orifice area,
modest pressure gradients, and little
regurgitation. Copyright@Author(s) - Available online at
anatoljcardiol.com.

<68>
Accession Number
2026579080
Title
Incidence and Factors Related to Prolonged Postoperative Cognitive Decline
(POCD) in Elderly Patients Following Surgery and Anaesthesia: A Systematic
Review.
Source
Journal of Multidisciplinary Healthcare. 16 (pp 3405-3413), 2023. Date of
Publication: 2023.
Author
Arefayne N.R.; Berhe Y.W.; van Zundert A.A.
Institution
(Arefayne, Berhe) Department of Anaesthesia, College of Medicine and
Health Sciences, University of Gondar, Gondar, Ethiopia
(van Zundert) The University of Queensland & Royal Brisbane and Women's
Hospital, Department of Anaesthesia and Perioperative Medicine, Brisbane,
QLD, Australia
Publisher
Dove Medical Press Ltd
Abstract
Aim: The aim of this systematic review is to explore the current
literature to provide evidence regarding the incidence and risk factors of
prolonged POCD in elderly patients following cardiac and non-cardiac
surgical interventions. Method(s): The PubMed and Google Scholar
databases were searched using appropriate keywords and search engines for
adequate evidence from studies meeting the inclusion criteria so as to
reveal the end-point, which was the presence of prolonged POCD in elderly
patients following surgery and anaesthesia. The incidence of POCD at
different time intervals and the variables predicting the occurrence of
POCD were analysed. Result(s): The results of 23 articles covering
5077 patients (3694 non cardiac and 1383 cardiac surgeries) were carefully
analysed. POCD occurs from the first postoperative day and lasts for
potentially long periods. The incidence of POCD in this review ranged from
2.2% to 35.7%. More specifically, it ranged from 2.2% to 31.5% in
non-cardiac surgeries and 11.8% to 35.7% in patients who had undergone
cardiac surgeries. Some of the independent risk factors (predictors) for
the development of POCD were advanced age, high concentration of
neuroinflammatory mediators detectable in plasma, low SpO<inf>2</inf>,
longer anaesthetic and surgical duration, and depth of anaesthesia.
 Conclusion(s): This review can only provide limited evidence of
prolonged POCD (more than a year) and further research that involves
better study designs, larger samples, involving longer follow-up, and at
different sites (multicentre) is highly advised. This in turn may help
researchers and clinicians to discover the actual causes and risk factors
and develop appropriate preventive and treatment protocols to tackle POCD
in the ageing surgical population. Copyright © 2023 Arefayne et
al.

<69>
Accession Number
2026558238
Title
COMPARISON OF AMIODARONE VERSUS MAGNESIUM SULPHATE IN PREVENTION OF POST
OPERATIVE ARRHYTHMIAS IN OPEN HEART SURGERY: A RANDOMIZED CONTROLLED TRIAL
AT LADY READING HOSPITAL PESHAWAR.
Source
Journal of Postgraduate Medical Institute. 37(4) (pp 238-243), 2023. Date
of Publication: 06 Nov 2023.
Author
Ali A.; Moin Ud Din M.H.; Hassanain S.S.; Izaz M.; Ahmad M.A.
Institution
(Ali, Moin Ud Din, Hassanain, Izaz, Ahmad) Department of Anesthesia, Lady
Reading Hospital Peshawar, Pakistan
Publisher
Postgraduate Medical Institute
Abstract
Objective: To compare the frequency of postoperative arrhythmias with
amiodarone versus magnesium sulphate in patients undergoing open heart
surgery Methodology: This randomized Controlled trial was done at
Department of Anethesia Lady Reading Hospital, Peshawar. Eighty patients
of age 40-70 years, either gender undergoing open heart surgery under
general anesthesia were enrolled via Non-probability, consecutive sampling
technique. Then they were divided in two groups by using lottery method.
In group A, patients were given loading dose of amiodarone 5mg/Kg and in
group B, patients were given 2g of MgSO4 in 100ml of isotonic 0.9%
solution intravenously. After surgery, patients were followed-up there for
3 days. Patients were monitored through ECG monitor for postoperative
arrhythmias. Result(s): The mean age of patients was 49.93+/-7.38
years in amiodarone group while 51.45+/-7.31yeas in MgSO4 group. There
were 26 (65%) males and 14 (35%) females in group A while 15 males (37.5%)
and 25 females (62.5%) in group B. Postoperative arrhythmias were observed
in 10 (25%) cases with amiodarone while in 16 (40%) cases with MgSO4,
although the difference was insignificant (p>0.05). Conclusion(s):
The frequency of postoperative arrhythmias is reduced with using
amiodarone than MgSO4. Copyright © 2023, Postgraduate Medical
Institute. All rights reserved.

<70>
Accession Number
2025401623
Title
Effect of valve leaflet surface patterning on valve hydrodynamic
performance.
Source
International Journal of Artificial Organs. 46(10-11) (pp 569-573), 2023.
Date of Publication: October-November 2023.
Author
Wang A.; Wang Y.; Liu W.; Liu L.; Zhou J.
Institution
(Wang, Wang, Zhou) State Key Laboratory of Cardiovascular Disease, FuWai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Liu) Beijing Star Medical Devices Co., Ltd, Beijing, China
(Liu) Center for Medical Devices Testing, National Institutes for Food and
Drug Control, Beijing, China
Publisher
SAGE Publications Ltd
Abstract
Objective: We aimed to elucidate the effects of the micro-structure of the
pyrolytic carbon for artificial heart valves on its hydrodynamic
performance. Method(s): Bileaflet mechanical valves of GKS 23 and 29
A were randomly selected. According to ISO5840, mean transvalvular
pressure (MPG), regurgitation fraction (RF), and effective orifice area
(EOA) of valve were assessed. Then, parallel-groove pattern was
constructed by laser etching on leaflet surface, and the valves were
subjected again to the same test. Result(s): Compared with before
patterning at 2, 3.5, 5, and 7 L/min, the MPG of the valves in two
specifications were higher, the EOA was larger in 23 A, but smaller in 29
A, and the RF was contrary to EOA. At 5 L/min, the RF in both
specifications was lower after etching at 45 bpm. At 70 bpm however, the
RF in 23 A decreased, in 29 A increased. Conclusion(s): The
parallel-groove pattern on leaflet surface affected the hemodynamic
performance of the valve prostheses. Copyright © The Author(s)
2023.

<71>
Accession Number
2024861337
Title
DOACs in the Anticoagulation of Mechanical Valves: A Systematic Review and
Future Perspectives.
Source
Journal of Clinical Medicine. 12(15) (no pagination), 2023. Article
Number: 4984. Date of Publication: August 2023.
Author
Langenaeken T.; Vanoppen A.; Janssens F.; Tanghe L.; Verbrugghe P.; Rega
F.; Meuris B.
Institution
(Langenaeken, Vanoppen, Janssens, Tanghe, Verbrugghe, Rega, Meuris)
Department of Cardiac Surgery, University Hospitals Leuven, Herestraat 49,
Leuven 3000, Belgium
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Valvular heart disease is a common disease often necessitating valve
replacement. Mechanical heart valves (MHVs) are often used in younger
patients because of their longer durability. Their main disadvantage is
the need for lifelong anticoagulation. Warfarin is considered a standard
treatment, but it is far from perfect. Direct oral anticoagulants (DOACs)
are a new and more patient-friendly alternative to warfarin when
anticoagulation is required, but have not yet been approved for the
indication of mechanical valves. Evidence Acquisition: A literature
search of Pubmed, Embase, Web of Science (Core Collection), and Cochrane
Library (from inception to May 2023) was performed using a search string
that was well defined and not modified during the study. An extensive
overview of the search terms used in each database can be found in the
Appendix. Only prospective clinical trials were included in this review. A
total of 10 publications were included in this review. Relevance to
clinical practice: This systematic review summarizes the different types
of DOACs and their possible use in the anticoagulation of mechanical
valves. We aim to propose future directions in anticoagulation research
for mechanical valves. Conclusion(s): DOAC use in MHVs has been
halted due to the failure of both dabigatran and apixaban in two major
clinical trials. However, rivaroxaban was successful in two small clinical
trials. Ample research is still needed to explore new valve designs as
well as new anticoagulation targets. Copyright © 2023 by the
authors.

<72>
Accession Number
2026523543
Title
The effect of resistance training on PCSK9 levels in patients undergoing
cardiac rehabilitation after coronary artery bypass grafting: a randomized
study.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
549. Date of Publication: December 2023.
Author
Dwiputra B.; Santoso A.; Purwowiyoto B.S.; Radi B.; Ambari A.M.
Institution
(Dwiputra, Santoso, Purwowiyoto, Radi, Ambari) Department of Cardiology
and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ Harapan
Kita National Cardiovascular Center, Jl Letjen S Parman Kav 87, Palmerah,
Jakarta Barat 11420, Indonesia
Publisher
BioMed Central Ltd
Abstract
Background: Resistance training is commonly recommended as part of
secondary prevention for post-coronary artery bypass graft (CABG) patients
in conjunction with aerobic exercise. Despite its potential benefits,
there is currently a lack of studies investigating the impact of
resistance training on proprotein convertase subtilisin kexin 9 (PCSK9).
 Aim(s): To evaluate the effect of intensive resistance training on
proprotein convertase subtilisin kexin 9 (PCSK9) levels among post-CABG
patients undergoing cardiac rehabilitation (CR). Method(s): In this
prospective, open-label, randomized trial, 87 post-coronary artery bypass
graft (CABG) patients were randomly assigned into two groups: moderate to
high intensity resistance training and aerobic training (n = 44) or
aerobic training alone (n = 43) for a total of 12 sessions. Changes in
PCSK9 levels was determined as a primary endpoint, while secondary
endpoints included changes in the six-minute walk test (6-MWT) results,
aerobic capacity, WHO-5 well-being index, fasting blood glucose, and lipid
profile. Both groups underwent intention-to-treat analysis.
 Result(s): Following completion of cardiac rehabilitation program,
the intervention group demonstrated a significant decrease in mean PCSK9
levels when compared to the control group (beta = -55 ng/ml, 95% CI -6.7
to -103.3, p = 0.026), as well as significant improvements in the 6-MWT
result (beta = 28.2 m, 95% CI 2.4-53.9, p = 0.033), aerobic capacity (beta
= 0.9 Mets, 95% CI 0.1-1.7, p = 0.021), and WHO-5 well-being index (beta =
8.1, 95% CI 2.0-14.4, p = 0.011) in patients who received resistance and
aerobic training. No statistically significant changes were observed in
fasting blood glucose, cholesterol, LDL-C, HDL-C, and triglyceride levels.
 Conclusion(s): Resistance training in CR significantly reduced PCSK-9
levels and increases patient's functional capacity and quality of life.
(NCT02674659 04/02/2016). Copyright © 2023, The Author(s).

<73>
Accession Number
2026487266
Title
Balancing anticoagulation and hemostasis in an infant with severe
hemophilia A during cardiac transplantation: Review of the literature and
development of a surgical protocol.
Source
Pediatric Blood and Cancer. (no pagination), 2023. Date of Publication:
2023.
Author
Regling K.; Sehgal S.; Hollon W.; Rayner P.; Stricker L.; Sarnaik A.;
Sassalos P.; Al-Ahmadi M.; Rajpurkar M.; Chitlur M.B.
Institution
(Regling, Rajpurkar, Chitlur) Division of Hematology Oncology, Department
of Pediatrics, Children's Hospital of Michigan, Central Michigan
University College of Medicine, Detroit, MI, United States
(Sehgal) Division of Cardiology, Department of Pediatrics, Children's
Hospital of Michigan, Central Michigan University College of Medicine,
Detroit, MI, United States
(Hollon, Rayner) Detroit Medical Center, Children's Hospital of Michigan,
Detroit, MI, United States
(Stricker) Department of Anesthesia, Children's Hospital of Michigan,
Wayne State University School of Medicine, Detroit, MI, United States
(Sarnaik) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, Children's Hospital of Michigan, Central Michigan University
College of Medicine, Detroit, MI, United States
(Sassalos, Al-Ahmadi) Department of Pediatric Cardiovascular Surgery,
Children's Hospital of Michigan, Detroit, MI, United States
Publisher
John Wiley and Sons Inc
Abstract
Hemophilia A is a disorder resulting in a deficiency of clotting factor
VIII that can lead to life-threatening bleeding. Evidence-based guidelines
for surgical interventions like cardiac surgery are limited.
Anticoagulation is necessary for cardiac bypass, thus risk of bleeding in
a patient with hemophilia is increased and requires careful attention to
maintain hemostasis. We report the first infant with severe hemophilia A
and dilated cardiomyopathy who underwent successful cardiac
transplantation, and review the literature on previous cardiac transplant
cases in congenital hemophilia. To ensure safe and effective management, a
multidisciplinary approach was used to develop the surgical protocol for
transplant. Copyright © 2023 Wiley Periodicals LLC.

<74>
Accession Number
2026433344
Title
Midterm Outcomes of Endovascular vs. Medical Therapy for Uncomplicated
Type B Aortic Dissection: Meta-Analysis of Reconstructed Time to Event
Data.
Source
European Journal of Vascular and Endovascular Surgery. 66(5) (pp 609-619),
2023. Date of Publication: November 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Chu D.; Serna-Gallegos D.; Singh
M.J.; Chaer R.A.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Singh, Chaer, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Centre, Pittsburgh, PA, United
States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Singh, Chaer) Division of Vascular Surgery, University of Pittsburgh
Medical Centre, Pittsburgh, PA, United States
Publisher
W.B. Saunders Ltd
Abstract
Objective: To evaluate outcomes of thoracic endovascular aortic repair
(TEVAR) vs. medical therapy in uncomplicated type B aortic dissections
(TBAD). Data sources: PubMed/MEDLINE, EMBASE, SciELO, LILACS,
CENTRAL/CCTR, Google Scholar, and reference lists of relevant articles.
Review methods: This was a pooled meta-analysis of time to event data
extracted from studies published by December 2022 for the following
outcomes: all cause mortality, aortic related mortality, and late aortic
interventions. Certainty of evidence was evaluated through the Grading of
Recommendations, Assessment, Development and Evaluations (GRADE) tool.
 Result(s): Ten studies met the eligibility criteria (eight
observational; two randomised trials), comprising 17 906 patients (2 332
patients in the TEVAR groups and 15 574 patients in the medical therapy
group). Compared with patients who received medical therapy, patients who
underwent TEVAR had a statistically significantly lower risk of all cause
death (HR 0.79, 95% CI 0.72 - 0.87, p < .001; GRADE certainty: low) and
lower risk of aortic related death (HR 0.43, 95% CI 0.30 - 0.62, p < .001;
GRADE certainty: low) without statistically significant difference in the
risk of late aortic interventions (HR 1.05, 95% CI 0.88 - 1.26, p = .56;
GRADE certainty: low). In the subgroup analyses, TEVAR was associated with
lower risk of all cause death when randomised controlled trials only were
pooled (HR 0.44, 95% CI 0.23 - 0.83, p = .012; GRADE certainty: moderate),
younger patients only (HR 0.56, 95% CI 0.47 - 0.67, p < .001; GRADE
certainty: low), Western populations only (HR 0.85, 95% CI 0.77 - 0.93, p
= .001; GRADE certainty: low) and non-Western populations only (HR 0.47,
95% CI 0.35 - 0.62, p < .001; GRADE certainty: low). For all cause
mortality and aortic related mortality, restricted mean survival time was
overall 396 days and 398 days longer with TEVAR (p < .001), respectively,
which means that TEVAR was associated with lifetime gain.
 Conclusion(s): TEVAR may be associated with better midterm survival
and lower risk of aortic related death in the follow up of patients
treated for uncomplicated TBAD compared with medical therapy; however,
randomised controlled trials with larger sample sizes and longer follow up
are still warranted. Copyright © 2023 European Society for
Vascular Surgery

<75>
[Use Link to view the full text]
Accession Number
642696524
Title
Effects of music therapy on pain relief during fundus screening in
infants: Randomized controlled clinical trial.
Source
Medicine. 102(44) (pp e35878), 2023. Date of Publication: 03 Nov 2023.
Author
Chen R.; Duan S.; Wang Y.; He F.; Ren L.; Peng W.
Institution
(Chen, Duan, Wang, He, Ren, Peng) Department of Nursing, West China Second
University Hospital, Sichuan University, Key Laboratory of Birth Defects
and Related Diseases of Women and Children (Sichuan University), Ministry
of Education, Chengdu, Sichuan, China
(Chen, Peng) West China School of Nursing, Sichuan University, Chengdu,
Sichuan, China
Abstract
BACKGROUND: To determine the efficacy of music therapy on pain relief
during fundus screening in infants. METHOD(S): The sample consisted
of infants aged 0 to 3 months who required fundus screening. Infants were
randomized to fast music, slow music, and control groups. All groups
underwent fundus screening under topical anesthesia. Music therapy was
provided to the music groups prior to, during, and after the operation.
The patient's heart rate (HR), transcutaneous oxygen saturation, and
crying decibel were measured. The Face, Legs, Activity, Cry, Consolability
scale was used for pain measurement. RESULT(S): A total of 300
subjects' data were collected. The quantitative analysis revealed that in
both music groups, peripheral capillary oxygen saturation and satisfaction
levels increased while pain scores decreased (P < .05). The slow music
group's HR was shown to have significantly decreased (P < .05).
 CONCLUSION(S): Music therapy can effectively reduce pain and crying,
and increase blood oxygen saturation during fundus examination of infants.
Music with a rhythm of 60 to 80 beats per minute can decrease HR. Music
therapy must be remembered to increase infants' comfort during fundus
examination. Copyright © 2023 the Author(s). Published by Wolters
Kluwer Health, Inc.

<76>
[Use Link to view the full text]
Accession Number
641972978
Title
Robotic Lobectomy Is Cost-effective and Provides Comparable Health Utility
Scores to Video-assisted Lobectomy: Early Results of the RAVAL Trial.
Source
Annals of surgery. 278(6) (pp 841-849), 2023. Date of Publication: 01 Dec
2023.
Author
Patel Y.S.; Baste J.-M.; Shargall Y.; Waddell T.K.; Yasufuku K.; Machuca
T.N.; Xie F.; Thabane L.; Hanna W.C.
Institution
(Patel, Shargall, Hanna) Department of Surgery, Division of Thoracic
Surgery, McMaster University, Hamilton, ON, Canada
(Baste) Department of Surgery, Division of Thoracic Surgery, Rouen
Normandy University, France
(Waddell, Yasufuku) Department of Surgery, Division of Thoracic Surgery,
University of Toronto, Toronto, ON, Canada
(Machuca) Department of Surgery, Division of Thoracic and Cardiovascular
Surgery, University of Florida, Gainesville, FL, Puerto Rico
(Xie, Thabane) Department of Epidemiology and Biostatistics, McMaster
University, Hamilton, ON, Canada
Abstract
OBJECTIVE: The aim of this study was to determine if robotic-assisted
lobectomy (RPL-4) is cost-effective and offers improved patient-reported
health utility for patients with early-stage non-small cell lung cancer
when compared with video-assisted thoracic surgery lobectomy
(VATS-lobectomy). BACKGROUND: Barriers against the adoption of RPL-4 in
publicly funded health care include the paucity of high-quality
prospective trials and the perceived high cost of robotic surgery.
 METHOD(S): Patients were enrolled in a blinded, multicentered,
randomized controlled trial in Canada, the United States, and France, and
were randomized 1:1 to either RPL-4 or VATS-lobectomy. EuroQol 5 Dimension
5 Level (EQ-5D-5L) was administered at baseline and postoperative day 1;
weeks 3, 7, 12; and months 6 and 12. Direct and indirect costs were
tracked using standard methods. Seemingly Unrelated Regression was applied
to estimate the cost effect, adjusting for baseline health utility. The
incremental cost-effectiveness ratio was generated by 10,000 bootstrap
samples with multivariate imputation by chained equations. RESULT(S):
Of 406 patients screened, 186 were randomized, and 164 analyzed after the
final eligibility review (RPL-4: n=81; VATS-lobectomy: n=83). Twelve-month
follow-up was completed by 94.51% (155/164) of participants. The median
age was 68 (60-74). There were no significant differences in body mass
index, comorbidity, pulmonary function, smoking status, baseline health
utility, or tumor characteristics between arms. The mean 12-week health
utility score was 0.85 (0.10) for RPL-4 and 0.80 (0.19) for VATS-lobectomy
( P =0.02). Significantly more lymph nodes were sampled [10 (8-13) vs 8
(5-10); P =0.003] in the RPL-4 arm. The incremental cost/quality-adjusted
life year of RPL-4 was $14,925.62 (95% CI: $6843.69, $23,007.56) at 12
months. CONCLUSION(S): Early results of the RAVAL trial suggest that
RPL-4 is cost-effective and associated with comparable short-term
patient-reported health utility scores when compared with
VATS-lobectomy. Copyright © 2023 Wolters Kluwer Health, Inc. All
rights reserved.

<77>
Accession Number
642712189
Title
Assessment of Individualized Mean Perfusion Pressure Target for Cardiac
Surgery-Associated AKI: PrevHemAKI Trial.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2023 Annual Meeting. Philadelphia, PA United States. 34 (pp 435), 2023.
Date of Publication: 2023.
Author
Andujar A.M.; Rios J.; Pineiro G.J.; Poch E.
Institution
(Andujar, Rios, Pineiro, Poch) Hospital Clinic de Barcelona, Barcelona,
Spain
Publisher
Wolters Kluwer Health
Abstract
Background: Retrospective studies support that mean perfusion pressure
(MPP) deficit in cardiac surgery patients is associated with a higher
incidence of post-operative acute kidney injury. The aim of our study was
to apply an algorithm based on MPP = mean arterial pressure (MAP)-central
venous pressure (CVP) in the postoperative period of cardiac surgery
patients to determine whether management with an individualized target
compared to standard treatment reduces the incidence of acute kidney
injury (CC-AKI). Method(s): Randomized controlled trial of patients
undergoing cardiac surgery with extracorporeal circulation between October
2019 and September 2022. Inclusion criteria were: adults with valve
replacement and/or bypass surgery intervention with Leicester score >30.
Patients were randomized to follow target of MPP >75% baseline vs standard
follow-up during the first 24h. Result(s): 98 patients were
recruited, 82.7% male with mean age 72.96 +- 7.25 years and eGFR of 55.3
+/-16.6 ml/min. 49 were randomized to the intervention arm and 49 to the
standard treatment arm. Mean MAP during the intervention was higher in the
intervention group (73.6/75.9 p=0.008), with no differences in mean MAP
and MPP of the first 24h (75.5 vs 76.7, p=0.32 and 66.5 vs 67.5, p= 0.375
respectively) although a higher use of noradrenaline was found in the
intervention arm (38.78 vs 63.27, p= 0.026). The percentage of time with
MPP<75% baseline was similar in both groups (21.5/21.4%, p=0.811). Mean
24h fluid balance was similar (331 [-384-1206] vs 26 [-984-999], p=0.154).
The incidence of CC-AKI was 36.7% (72.2% of them stage 1), with no
differences between both groups but with a tendency to a higher incidence
of AKI in the presence of PPM deficit of >20% (p=0.064).
 Conclusion(s): There was a tendency to a higher incidence of AKI if
MPP deficit >20% but individualized hemodynamic management based on MPP
compared to standard treatment did not reduce the incidence of AKI
associated to cardiac surgery in our study. Larger cohorts are needed in
order to confirm these findings.

<78>
Accession Number
642708188
Title
Effect Of SGLT2 Inhibition On Metabolic, Cardiac And Renal Outcomes In
Heart Transplant Recipients (EMPA-HTx study): Protocol And Study Design.
Source
Journal of the Endocrine Society. Conference: Endocrine Society's Annual
Meeting, ENDO 2023. Chicago, IL United States. 7(Supplement 1) (pp A396),
2023. Date of Publication: October - November 2023.
Author
Raven L.M.; Muir C.A.; Iglesias C.K.; Kotlyar E.; Muthiah K.; Bart N.K.;
Macdonald P.S.; Hayward C.S.; Jabbour A.; Greenfield J.R.
Institution
(Raven, Greenfield) Garvan Institute of Medical Research, Sydney,
Australia
(Muir, Iglesias, Kotlyar, Muthiah, Bart, Macdonald, Hayward, Jabbour) St
Vincent's Hospital, Darlinghurst, Australia
Publisher
Endocrine Society
Abstract
Background: Heart transplantation (HTx) is standard of care for treatment
of end-stage heart failure. Immunosuppression medication, required to
prevent rejection, can result in adverse metabolic and renal effects.
Clinically significant post-transplant complications include metabolic
(diabetes, weight gain), renal impairment and cardiac disease, such as
allograft vasculopathy and myocardial fibrosis. Sodium glucose
co-transporter 2 inhibitors (SGLT2i) may have positive effects on all of
these posttransplant complications. SGLT2i have been observed to improve
metabolic parameters in patients with type 2 diabetes following cardiac
and renal transplantation, but their benefit and safety in HTx has not
been evaluated in randomised prospective studies. Aim(s): The overall
aim of this project is to study the safety and efficacy of empagliflozin
in HTx recipients. The primary end point will be improvement in glycaemic
control assessed by change in glycosylated hemoglobin (HbA1c) and/or
fructosamine, with secondary endpoints of cardiac fibrosis assessed by
cardiac magnetic resonance, and renal function assessed by serum
creatinine. Method(s): Randomised, placebo-controlled trial of
empagliflozin 10 mg daily versus placebo in recent HTx recipients. One
hundred participants will be randomised 1:1. They will commence the study
medication within 6-8 weeks of transplantation. Follow up will be 12
months after transplantation. Results from routine pre-HTx assessment will
be reviewed to assess for pre-HTx diagnosis of diabetes. Routine
laboratory tests, including full blood count, biochemistry, glucose,
lipids and liver function as well as HbA1c, fructosamine,
beta-hydroxybutyrate and urine albumin creatinine ratio, will be measured
at baseline prior to receipt of study drug or placebo. Patients will be
reviewed monthly during the study until 12 months post-HTx and data will
be collected for each patient at each study visit. Cardiovascular magnetic
resonance will be measured at baseline and 12 months after HTx.

<79>
Accession Number
2028318345
Title
Effect of intravenous levosimendan or milrinone on left atrial pressure in
patients undergoing off-pump coronary artery bypass grafting - A
prospective double-blind, randomized controlled trial.
Source
Annals of Cardiac Anaesthesia. 26(4) (pp 411-417), 2023. Date of
Publication: October 2023.
Author
Mondal A.; Ghosh K.; Kar S.K.; Dammalapati P.K.; Dasgupta C.S.
Institution
(Mondal, Ghosh, Kar, Dammalapati, Dasgupta) Department of Cardio Thoracic
Vascular Anaesthesiology, Institute of Post Graduate Medical Education and
Research (IPGME&R), West Bengal, Kolkata, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Maintaining a low left atrial pressure (LAP) in off-pump
coronary artery bypass grafting (OPCAB) is desirable. This study was done
to compare the effects of intravenous levosimendan or milrinone on LAP at
different stages of OPCAB. Material(s) and Method(s): After
institutional ethics committee clearance, this two-arm double-blind
randomized control trial was done in 44 adult patients with triple vessel
coronary artery disease undergoing OPCAB at cardiac OT of IPGME&R,
Kolkata. The patients were randomly allocated into two groups receiving
intraoperative either levosimendan or milrinone. Pulmonary capillary wedge
pressure (PCWP) was compared as the primary outcome parameter, whereas
other echocardiographic and hemodynamic parameters were also assessed
during six stages of OPCAB, that is, after sternotomy, proximal(s), left
anterior descending artery (LAD), obtuse marginal (OM), posterior
descending artery (PDA) grafting, and before sternal closure. Numerical
parameters were compared using Student's unpaired two-tailed t-test.
 Result(s): PCWP was found to be significantly lower (P < 0.05) in the
levosimendan group during proximal (P = 0.047), LAD (P = 0.018), OM (P <
0.0001), PDA grafting (P = 0.028), and before sternal closure (P = 0.015).
Other parameters indicate LAP, that is, from mitral early diastolic inflow
velocity to mitral annular early diastolic velocity ratio (E/e'), which
indicated significantly lower LAP in levosimendan group during LAD, OM,
and PDA grafting and before sternal closure. Conclusion(s):
Levosimendan may be used as a primary inotrope in terms of better
reduction in left atrial pressure during different stages of OPCAB,
translating to a decrease in left ventricular end-diastolic pressure,
therefore maintaining optimum coronary perfusion pressure, which is the
primary goal of the surgery. Copyright © 2023 Wolters Kluwer
Medknow Publications. All rights reserved.

<80>
Accession Number
2028318341
Title
Effects of a forced-air warming system and warmed intravenous fluids on
hemodynamic parameters, shivering, and time to awakening in elderly
patients undergoing open cardiac surgery.
Source
Annals of Cardiac Anaesthesia. 26(4) (pp 386-392), 2023. Date of
Publication: October 2023.
Author
Akbarpour Roshan M.; Jafarpoor H.; Shamsalinia A.; Fotokian Z.; Hamidi S.
Institution
(Akbarpour Roshan, Shamsalinia, Fotokian) Nursing Care Research Center,
Health Research Institute, Babol University of Medical Sciences, Babol,
Iran, Islamic Republic of
(Jafarpoor) Department of Anesthesiology and Operating Room, School of
Allied Medical Sciences and Social Determinants of Health Research Center,
Health Research Institute, Babol University of Medical Sciences, Babol,
Iran, Islamic Republic of
(Hamidi) Department of Anesthesiology, School of Medicine, Babol
University of Medical Sciences, Babol, Iran, Islamic Republic of
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: As one of the most common postoperative complications,
hypothermia is the main cause of numerous problems during treatment,
especially in elderly patients with decreased cardiac reserves.
 Objective(s): The aim of the present study was to compare the effects
of forced-air warming system (FAWS), warmed intravenous fluids (WIVFs) and
routine method on hemodynamic parameters, arterial blood gases (ABGs),
shivering, and time to awakening in elderly patients undergoing open
cardiac surgery (OCS). Method(s): This clinical randomized controlled
trial was conducted on 94 elderly patients who underwent OCS at Ayatollah
Rouhani Hospital, Babol, Iran. They were divided into three groups, namely
FAWS (n=31), WIVFs (n=31) and routine rewarming method (RRWM, with a
blanket) (n=32). The data were then recorded in a checklist. Descriptive
and inferential statistics were performed using SPSS 26 at a significance
level of less than 0.05. Result(s): The findings demonstrated that
the degree of hypothermia had a significant decreasing trend in the groups
receiving FAWS and WIVFs (P=0.002). Additionally, increased respiratory
rate (P=0.013), higher bicarbonate (HCO3-) levels on arrival up to 4 hours
after surgery (P=0.045), reduced lactate level (P=0.005), normal base
excess (BE) and accelerated time to awakening (P=0.004) were observed in
patients receiving FAWS. There was no significant difference in the study
groups regarding shivering. Conclusion(s): The results revealed that
FAWS could mitigate the degree of hypothermia, increase body temperature
and decrease the postoperative serum lactate levels. Moreover, BE as one
of the most important parameters for ABGs, could remain at a normal level.
Besides, the use of FAWS could lead to early awakening, and thus
facilitate weaning and extubation of these patients. Copyright ©
2023 Wolters Kluwer Medknow Publications. All rights reserved.

<81>
Accession Number
2028241060
Title
The Effect of Liver Cirrhosis on Patients Undergoing Cardiac Surgery.
Source
Global Heart. 18(1) (no pagination), 2023. Article Number: 54. Date of
Publication: 05 Oct 2023.
Author
Liu F.; Li Z.-W.; Liu X.-R.; Liu X.-Y.; Yang J.
Institution
(Liu, Li, Liu, Liu) Department of Gastrointestinal Surgery, The First
Affiliated Hospital, Chongqing Medical University, Chongqing, China
(Yang) Department of Anesthesiology, The First Affiliated Hospital,
Chongqing Medical University, Chongqing, China
Publisher
Ubiquity Press
Abstract
The aim of this study was to investigate the impact of liver cirrhosis
(LC) on postoperative complications and long-term outcomes in patients who
underwent cardiac surgery. Three databases, including PubMed, Embase, and
the Cochrane Library, were searched on July 24, 2022. A total of 1,535,129
patients were enrolled in the seven included studies for analysis.
According to our analysis, LC was a risk factor for postoperative overall
complications (OR = 1.48, 95% CI = 1.21 to 1.81, I2 = 90.35%, P
= 0.00 < 0.1). For various complications, more patients developed
pulmonary (OR = 1.86, 95% CI = 1.21 to 2.87, I2 = 90.79%, P =
0.00 < 0.1), gastrointestinal (OR = 2.03, 95% CI = 1.32 to 3.11,
I2 = 0.00%, P = 0.00 < 0.05), renal (OR = 2.20, 95% CI = 1.41
to 3.45, I2 = 91.60%, P = 0.00 < 0.1), neurological (OR = 1.14,
95% CI = 1.03 to 1.26, I2 = 7.35%, P = 0.01 < 0.05), and
infectious (OR = 2.02, 95% CI = 1.17 to 3.50, I2 = 92.37%, P =
0.01 < 0.1) complications after surgery in the LC group. As for
cardiovascular (OR = 1.07, 95% CI = 0.85 to 1.35, I2 = 75.23%,
P = 0.58 > 0.1) complications, there was no statistical significance
between the 2 groups. As for long-term outcomes, we found that in-hospital
death (OR = 2.53, 95% CI = 1.86 to 3.20, I2 = 44.58%, P = 0.00
< 0.05) and death (OR = 3.31, 95% CI = 1.54 to 5.07, I2 =
93.81%, P = 0.00 < 0.1) in the LC group were higher than the non-LC group.
LC was a risk factor for cardiac surgery. Patients with LC who would
undergo cardiac surgery should be fully assessed for the risks of cardiac
surgery. Similarly, the surgeon should assess the patient's liver function
before surgery. BACKGROUND Liver cirrhosis (LC) is a common disease that
kills about 1.03 million people each year [1-2]. Patients with LC often
suffered from nutritional damage, immune system dysfunction, coagulation
disorders, acute kidney injury, etc. [3-5]. These issues cause surgeons to
be hesitant to operate on patients with LC. Surgery on patients with LC
remains a challenge for surgeons and anaesthetists. This challenge depends
on the type of liver disease and its severity, the surgical procedure, and
the type of anaesthesia [6-7]. As for cardiothoracic surgery, especially
cardiac surgery requiring cardiopulmonary bypass, LC remains a tricky
problem [8-10]. Liver disease remains a major risk factor in the
perioperative period of cardiac surgery [11]. Cardiac disease could be a
fatal condition. Surgery was an excellent treatment. As for LC patients,
the surgeon should assess the patient's liver function before surgery. The
underlying physiological conditions caused by LC make these patients
vulnerable to coagulation dysfunction and major organ dysfunction after
direct cardiac surgery with extracorporeal circulation [12]. Figuring out
the impact and mechanism of LC on cardiac surgery could help surgeons find
preventive measures. However, according to our review of previous studies,
the effects of LC on the postoperative outcomes of cardiac surgery
continued to be controversial. Some studies suggest a poor effect of LC on
postoperative outcomes in cardiac surgery [13-17]. Other studies
demonstrated that there was no association between LC and postoperative
cardiac surgery outcomes [18-19]. Therefore, this pooling-up analysis
aimed to investigate the impact of LC on postoperative complications and
long-term outcomes in patients who underwent cardiac surgery. METHODS Our
meta-analysis was produced in accordance with the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [20].
Three databases were searched, including PubMed, Embase, and the Cochrane
Library, on July 24, 2022. The key words of the search strategy were LC
and cardiac surgery. The search strategy for LC was as follows: "liver
cirrhosis" OR "cirrhosis" OR "cirrhotic", and as for cardiac surgery, we
searched "cardiac surgery" OR "cardiac operation" OR "heart surgery" OR
"heart operation" OR "thoracic surgery" OR "cardiac surgical procedures"
OR "cardiopulmonary bypass" OR "CPB" OR "congenital heart disease". Then,
the two search strategies were combined by "AND". The search was limited
to titles and abstracts, and the language was limited to English. The
inclusion criteria for eligible studies were as follows: 1) all patients
were diagnosed with cardiac disease and underwent cardiac surgery; 2) both
the LC group and the non-LC group were reported; 3) at least 1 of the
following complications (cardiovascular, pulmonary, gastrointestinal,
renal, neurological, infectious) was reported; and 4) as for long-term
outcomes, in-hospital death or death should be reported. The exclusion
criteria were as follows: 1) case reports, case series, comments, letters
to the editor, conference abstracts, and nonoriginal articles; 2) data was
repeated or overlapped; and 3) incomplete information. Two authors
searched the databases and identified eligible studies separately. First,
duplicate studies were excluded. Then, the two authors scanned the titles
and abstracts to find eligible studies. Finally, the full text would be
read to identify studies that could be included. Any disagreements were
settled by a third author. Patients were divided into the LC group and the
non-LC group according to whether they were diagnosed with LC. The cardiac
surgery types included coronary artery bypass graft, surgery with
cardiopulmonary bypass, cardiac surgery, and aortic valve replacement. The
complication was defined as a cardiovascular, pulmonary, gastrointestinal,
renal, neurological, or infectious disease that occurred after surgery.
Overall complication was the sum of all complications reported in the
included studies that were not directly reported. In-hospital death was
defined as a patient's cause of death when they died in the hospital after
surgery. Death was defined as a patient's cause of death after they left
the hospital. The information included characteristics of the studies,
baseline information on patients, medical history, postoperative
complications, and long-term outcomes. The characteristics of the studies
were as follows: the first author, published year, published country,
study date, sample size of the LC group and the non-LC group, and
Newcastle-Ottawa Scale (NOS) score. The baseline information for patients
included age, gender, and race. For medical history, hypertension,
diabetes, chronic obstructive pulmonary disease (COPD), heart failure,
prior myocardial infarction (MI), and malignancy were collected. For
complications, cardiovascular, pulmonary, gastrointestinal, renal,
neurological, and infectious diseases were collected. As for long-term
outcomes, in-hospital death and death were collected. In-hospital death
was defined as a death that occurred during hospitalization, regardless of
cause. Death was defined as a death that occurred after discharge from the
hospital due to cardiac failure or liver cirrhosis. If the cause of death
during this period was unknown, it was also considered related. The NOS
was used to assess the quality of the included studies [21]. High-quality
studies would be scored at nine points. Median quality had scores ranging
from 7 to 8 points. Low-quality studies were indicated by a score of less
than 7 points. The mean difference (MD) and 95% confidence interval (CI)
were calculated for age. The odds ratio (OR) and 95% CI were calculated
for gender, medical history, complications, and long-term outcomes.
I2 values were used to assess the statistical heterogeneity of
the included studies [22-23]. When I2 > 50%, which was
considered to be high heterogeneity, the random effects model was used,
and P < 0.1 was considered statistically significant. Otherwise, the fixed
effects model would be used, and p < 0.05 meant statistically significant.
We performed data analysis with Stata V16.0 software. RESULTS A total of
1,158 studies were searched from the three databases (353 studies in
PubMed, 778 studies in Embase, and 27 studies in the Cochrane Library).
359 duplicate studies were eliminated. After the remaining 799 studies
were viewed for titles and abstracts, 21 studies were left for full-text
screening. Then, there were 13 studies left for qualitative synthesis.
Finally, seven eligible studies were included in this analysis [13-19].
(Figure 1) Copyright © 2023 The Author(s).

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