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<1>
Accession Number
2026384210
Title
Effect of Esketamine Gargle on Postoperative Sore Throat in Patients
Undergoing Double-Lumen Endobronchial Intubation: A Randomised Controlled
Trial.
Source
Drug Design, Development and Therapy. 17 (pp 3139-3149), 2023. Date of
Publication: 2023.
Author
Liang J.; Liu J.; Qiu Z.; Sun G.; Xiang P.; Hei Z.; Li X.
Institution
(Liang, Liu, Qiu, Sun, Hei, Li) Department of Anesthesiology, The Third
Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
(Xiang) Department of Medical Quality Management, Nanfang Hospital,
Southern Medical University, Guangzhou 510630, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Postoperative sore throat is a frequent adverse event after
double-lumen endobronchial tube (DLT) intubation. The aim of this study
was to investigate whether esketamine gargle has a preventive effect on
the incidence of postoperative sore throat in patients undergoing DLT
intubation. Method(s): This trial included 140 patients undergoing
elective thoracic surgery at the third affiliated hospital of Sun Yat-Sen
University. Patients were randomly allocated into the following two groups
of 70 patients each: the control group, gargling with saline of 30 mL, and
the esketamine group, gargling with an esketamine solution of 30 mL (2
mL/50 mg esketamine in 28 mL saline), 5 min prior to anaesthesia
induction. The primary outcome was the incidence of sore throat 24 h after
surgery. The main secondary outcomes included the incidence of sore throat
and hoarseness at 1 h and 48 h after surgery, as well as the
intraoperative haemodynamic responses. Result(s): The incidence of
sore throat was significantly higher in the control group (47.1%, 33/70
patients) compared with the esketamine group (12.9%, 9/70 patients) at 24
h after surgery (RD, 0.41; 95% confidence interval, 0.26-0.57; p < 0.001).
Furthermore, the incidence of sore throat at 1 h (p = 0.027), 24 h (p =
0.019), and seventh day (p = 0.031) as well as hoarseness at 1 h (p =
0.027), 24 h (p = 0.019), and 48 h (p = 0.031) after surgery were reduced
in the esketamine group. Significant differences were seen in the peak
levels of systolic blood pressure, mean arterial blood pressure, and heart
rate between the groups during the intubation (p < 0.05). Besides, no
patient developed an adverse reaction to esketamine. Conclusion(s):
Preoperative gargling of esketamine can provide an effect against sore
throat after DLT intubation without adverse side effects and effectively
inhibit sharp elevations in heart rate and blood pressure during
double-lumen intubation procedures. Copyright © 2023 Liang et al.

<2>
Accession Number
2025551143
Title
Topical vancomycin for sternal wound infection prophylaxis. A systematic
review and updated meta-analysis of over 40,000 cardiac surgery patients.
Source
Surgery (United States). 174(5) (pp 1102-1112), 2023. Date of Publication:
November 2023.
Author
Kowalewski M.; Pasierski M.; Makhoul M.; Comanici M.; Dabrowski E.J.;
Matteucci M.; Litwinowicz R.; Kowalowka A.; Wanha W.; Jiritano F.; Fina
D.; Martucci G.; Raffa G.M.; Malvindi P.G.; Kuzma; Suwalski P.; Lorusso
R.; Meani P.; Lazar H.
Institution
(Kowalewski, Pasierski, Suwalski) Department of Cardiac Surgery and
Transplantology, National Medical Institute of the Ministry of Interior,
Warsaw, Poland
(Kowalewski, Lorusso) Cardio-Thoracic Surgery Department, Heart and
Vascular Centre, Maastricht University Medical Centre and Cardiovascular
Research Institute Maastricht, Netherlands
(Kowalewski, Pasierski, Makhoul, Matteucci, Litwinowicz, Kowalowka, Wanha,
Jiritano, Fina, Martucci, Raffa, Malvindi, Suwalski, Meani) Thoracic
Research Centre, Collegium Medicum Nicolaus Copernicus University,
Innovative Medical Forum, Bydgoszcz, Poland
(Makhoul, Comanici) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
(Matteucci) Cardiac Surgery Unit, Azienda Socio Sanitaria Territoriale dei
Sette Laghi, Department of Medicine and Surgery, University of Insubria,
Varese, Italy
(Dabrowski, Kuzma) Department of Invasive Cardiology, Medical University
of Bialystok, Poland
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Upper-Silesian Heart Center,
Medical University of Silesia, Faculty of Medical Sciences, Katowice,
Poland
(Wanha) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, School of Medicine in Katowice, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
(Fina, Meani) Department of Cardiothoracic and Vascular Anesthesia and
Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientific
Policlinico, San Donato Milanese, Milan, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo per i trapianti e Terapie ad alta specializzazione, Palermo,
Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Istituto Mediterraneo per i trapianti
e Terapie ad alta specializzazione, Palermo, Italy
(Malvindi) Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali
Riuniti delle Marche, Polytechnic University of Marche, Ancona, Italy
(Lazar) Boston University School of Medicine, MA
Publisher
Elsevier Inc.
Abstract
Background: Despite guideline recommendations, routine application of
topical antibiotic agents to sternal edges after cardiac surgery is seldom
done. Recent randomized controlled trials have also questioned the
effectiveness of topical vancomycin in sternal wound infection
prophylaxis. Method(s): We screened multiple databases for
observational studies and randomized controlled trials assessing the
effectiveness of topical vancomycin. Random effects meta-analysis and
risk-profile regression were performed, and randomized controlled trials
and observational studies were analyzed separately. The primary endpoint
was sternal wound infection; other wound complications were also analyzed.
Risk ratios served as primary statistics. Result(s): Twenty studies
(N = 40,871) were included, of which 7 were randomized controlled trials
(N = 2,187). The risk of sternal wound infection was significantly reduced
by almost 70% in the topical vancomycin group (risk ratios [95% confidence
intervals]: 0.31 (0.23-0.43); P <.00001) and was comparable between
randomized controlled trials (0.37 [0.21-0.64]; P <.0001) and
observational studies (0.30 [0.20-0.45]; P <.00001; P<inf>subgroup</inf>
=.57). Topical vancomycin significantly reduced the risk of superficial
sternal wound infections (0.29 [0.15-0.53]; P <.00001) and deep sternal
wound infections (0.29 [0.19-0.44]; P <.00001). A reduction in the risk of
mediastinitis and sternal dehiscence risks was also demonstrated. Risk
profile meta-regression showed a significant relationship between a higher
risk of sternal wound infection and a higher benefit accrued with topical
vancomycin (s-coeff. = -0.00837; P <.0001). The number needed to treat was
58.2. A significant benefit was observed in patients with diabetes
mellitus (risk ratios 0.21 [0.11-0.39]; P <.00001). There was no evidence
of vancomycin or methicillin resistance; on the contrary, the risk of
gram-negative cultures was reduced by over 60% (risk ratios 0.38
[0.22-0.66]; P =.0006). Conclusion(s): Topical vancomycin effectively
reduces the risk of sternal wound infection in cardiac surgery
patients. Copyright © 2023 Elsevier Inc.

<3>
Accession Number
2024482927
Title
Prognostic role of CA-125 in patients undergoing transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Clinical Cardiology. 46(10) (pp 1129-1136), 2023. Date of Publication:
October 2023.
Author
Diaz-Arocutipa C.; Saucedo-Chinchay J.; Mamas M.A.
Institution
(Diaz-Arocutipa) Vicerrectorado de Investigacion, Universidad San Ignacio
de Loyola, Lima, Peru
(Saucedo-Chinchay) Department of Cardiology, Hospital Nacional Edgardo
Rebagliati Martins, Lima, Peru
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Keele, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) has become a widely used
therapy for patients with severe aortic stenosis. Carbohydrate antigen 125
(CA-125) is a promising biomarker in some cardiovascular diseases. This
systematic review aims to assess the prognostic role of CA-125 in patients
undergoing TAVR. We searched electronic databases from inception to March
2023 to include cohort studies evaluating the association between
preprocedural CA-125 levels and mortality or heart failure (HF)
readmission at 12 months in patients undergoing TAVR. We pooled crude
(cHR) and adjusted hazard ratios (aHR) with their 95% confidence interval
(CI) using a random-effects model. The risk of bias was evaluated using
the QUIPS tool. The certainty of the evidence was assessed using the GRADE
approach. We included five cohort studies involving 1594 patients. Higher
levels of CA-125 were significantly associated with an increased risk of
mortality or HF readmission using crude (cHR 2.79, 95% CI 1.45-5.36,
I2 = 72%) and adjusted (aHR 3.27, 95% CI 2.07-5.18,
I2 = 0%, high certainty) effect estimates compared with lower
levels. Similarly, there was also associated with increased mortality
using crude (cHR 2.68, 95% CI 1.99-3.60, I2 = 0%) and adjusted
(aHR 2.17, 95% CI 1.54-3.07, I2 = 0%, high certainty) effect
estimates. The risk of bias varied between low to moderate across studies.
Our meta-analysis suggests that CA-125 has incremental prognostic value in
patients undergoing TAVR. Further studies are needed to determine the
clinical utility of CA-125 in guiding treatment decisions in this
population. Copyright © 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<4>
Accession Number
2027995967
Title
Methylene Blue Reduces Mortality in Critically Ill and Perioperative
Patients: A Meta-Analysis of Randomized Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Pruna A.; Bonaccorso A.; Belletti A.; Turi S.; Di Prima A.L.; D'amico F.;
Zangrillo A.; Kotani Y.; Landoni G.
Institution
(Pruna, Bonaccorso, Belletti, Turi, Di Prima, D'amico, Zangrillo, Kotani,
Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Zangrillo, Kotani, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
Publisher
W.B. Saunders
Abstract
Vasodilatory hypotension is common in critically ill and perioperative
patients, and is associated with adverse outcomes. As a nitric oxide
production inhibitor, methylene blue (MB) exerts its vasoconstrictor
property and is an adjuvant for catecholamine-refractory vasodilatory
shock. However, the effects of MB on clinically relevant outcomes remain
unclear. Therefore, the authors performed a meta-analysis of randomized
trials on MB in critically ill and perioperative patients. The authors
searched through databases for randomized trials on MB in critically ill
and perioperative patients, which yielded 11 studies consisting of 556
patients. The primary outcome was mortality at the longest follow-up.
Secondary outcomes included hemodynamic parameters and organ dysfunction
(PROSPERO: CRD42023409243). Nine out of the 11 included randomized trials
reported mortality, which was significantly lower in the MB group (risk
ratio, 0.60 [95% CI 0.43-0.84] p = 0.003), with findings confirmed in
septic shock and cardiac surgery subgroups. The authors found reduced
lengths of stay in the intensive care unit (mean difference [MD], -0.9
days [95% CI -1.06 to -0.77] p < 0.001) and in the hospital (MD, -2.2 days
[95% CI, -2.68 to -1.70] p < 0.001) in the MB group. MB was associated
with increased mean arterial pressure (MD, 8.4 mmHg [95% CI 5.01-11.75] p
< 0.001) and systemic vascular resistance (MD, 94.5 dyn/s/cm5
[95% CI 17.73-171.15] p = 0.02), with no difference in cardiac output
(standardized MD, 0.16 [95% CI, -0.25 to 0.57] p = 0.45). This
meta-analysis showed that MB reverses vasodilation in critically ill and
perioperative patients and might improve survival. Further adequately
powered randomized trials are needed to confirm these
findings. Copyright © 2023 Elsevier Inc.

<5>
Accession Number
2027964753
Title
Late Survival After Valve-in-Valve Transcatheter Aortic Valve Implantation
With Balloon- Versus Self-Expandable Valves: Meta-Analysis of
Reconstructed Time-to-Event Data.
Source
American Journal of Cardiology. 209 (pp 120-127), 2023. Date of
Publication: 15 Dec 2023.
Author
Sa M.P.; Jacquemyn X.; Simonato M.; Brown J.A.; Ahmad D.; Serna-Gallegos
D.; Clavel M.-A.; Pibarot P.; Dvir D.; Sultan I.
Institution
(Sa, Brown, Ahmad, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Brown, Ahmad, Serna-Gallegos, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Simonato) Yale School of Medicine, New Haven, Connecticut, United States
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
(Dvir) Department of Cardiology, Shaare Zedek Medical Center and Faculty
of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
Publisher
Elsevier Inc.
Abstract
Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) in
patients with failed bioprostheses arose as an alternative to redo
surgical aortic valve replacement. There is an increasing interest in
exploring the differences between self-expanding valves (SEVs) and
balloon-expandable valves (BEVs). Our study aimed to evaluate the
all-cause mortality in ViV-TAVI with SEV versus BEV in patients with
failed bioprostheses. We performed a study-level meta-analysis of
reconstructed time-to-event data from Kaplan-Meier curves of studies
published by March 30, 2023. A total of 5 studies met our eligibility
criteria and included 1,454 patients who underwent ViV-TAVI (862 with SEV
and 592 with BEV). Almost all BEVs were iterations of the Edwards BEVs
(SAPIEN, SAPIEN XT, and SAPIEN 3) and almost all SEVs were iterations of
the Medtronic SEVs (CoreValve/Evolut). During the first year after
ViV-TAVI, 67 deaths (11.8%) occurred in patients treated with BEV compared
with 92 deaths (11.1%) in patients treated with SEV (hazard ratio 0.92,
95% confidence interval 0.66 to 1.27, p = 0.632). At 8 years of follow-up,
the all-cause death was not statistically significantly different between
the groups, with mortality rates of 65.4% in the group treated BEV and
58.8% in the group treated with SEV (hazard ratio 0.91, 95% confidence
interval 0.75 to 1.09, p = 0.302). The restricted mean survival time was
overall 0.25 years greater with SEV than BEV, but this difference was not
statistically significant (p = 0.278), which indicates no lifetime gain or
loss with SEV in comparison with BEV. There seems to be no difference in
terms of all-cause death in ViV-TAVI with SEV versus BEV. Randomized
controlled trials are warranted to validate our results. Copyright
© 2023 Elsevier Inc.

<6>
Accession Number
2026287795
Title
Transcatheter aortic valve implantation versus sutureless aortic valve
replacement: a single-centre cost analysis.
Source
Acta Cardiologica. (no pagination), 2023. Date of Publication: 2023.
Author
De Paepe J.; Lamberigts M.; Meuris B.; Jacobs S.; Adriaenssens T.; Dubois
C.; Verbrugghe P.
Institution
(De Paepe, Adriaenssens, Dubois) Department of Cardiology, UZ Leuven,
Leuven, Belgium
(Lamberigts, Meuris, Jacobs, Verbrugghe) Department of Cardiac Surgery, UZ
Leuven, Leuven, Belgium
Publisher
Taylor and Francis Ltd.
Abstract
Aims: Sutureless aortic valve replacement (SU-AVR) and transcatheter
aortic valve implantation (TAVI) are both viable therapeutic interventions
for aortic stenosis in elderly patients. Meta-analyses show similar
all-cause mortality for both techniques albeit with a different pattern of
adverse effects. This study means to compare costs and, to a lesser
extent, clinical outcomes of both techniques. Method(s): A
retrospective single-centre analysis was performed for patients receiving
SU-AVR or TAVI from 2008 to 2019. Perioperative clinical data were
collected from patient files. Costs were assessed by a cost allocation
tool. In an attempt to avoid confounding, propensity score matching was
carried out. Result(s): A total of 368 patients underwent either TAVI
(n = 100) or SU-AVR (n = 268). After matching, there were 61 patients per
treatment group. Length of stay was significantly longer in the SU-AVR
group. Excluding device costs, total expenses for SU-AVR (median: 11,630)
were significantly higher than TAVI (median: 9240). For both groups, these
costs were mostly incurred on intensive care units, followed by nursing
units. Non-medical staff was the largest contributor to expenses.
Including device costs, SU-AVR (median: 14,683) was shown to be
cost-saving compared to TAVI (median: 24,057). Conclusion(s): To
conclude, we found SU-AVR to be cost-saving compared to TAVI, largely due
to higher device costs associated with the latter. Excluding device costs,
TAVI was associated with lower expenses and shorter length of stay.
Non-medical staff was the largest source of costs, suggesting length of
stay to be a major financial determinant. Copyright © 2023
Belgian Society of Cardiology.

<7>
Accession Number
2026287299
Title
Bilateral versus single internal mammary artery in diabetic patients:
systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2023. Date of
Publication: 2023.
Author
Parissis H.; Ahmed S.; Al Nasir J.; Khan J.; Ferwana M.
Institution
(Parissis, Khan) Royal Victoria Hospital, Belfast, United Kingdom
(Ahmed, Al Nasir) Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
(Ferwana) King Abdullah International Medical Research Center, King Saud
bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Publisher
SAGE Publications Inc.
Abstract
Objectives: Data on bilateral internal mammary artery (BIMA) versus single
internal mammary artery (SIMA) on diabetics were analyzed; This is the
only meta-analysis, the last 7 years. Method(s): Medline through
PubMed/EMBASE/CINHAL and the Cochrane Central Register of Controlled
Trials; 179 articles were studied; 19 studies deemed suitable and were
included in the analysis. Result(s): The mortality was 2.41% for BIMA
versus 1.71% for SIMA (odds ratio [OR] = 0.95; 95% confidence interval
[CI]: 0.74-1.22). Postoperative reopening for bleeding was higher at 3.75%
for BIMA versus 2.91% for SIMA (OR = 1.49; 95% CI: 1.15-1.93). The
incidence of MI was 0.87% for BIMA versus 0.83% for SIMA (OR = 0.73; 95%
CI: 0.37-1.44). Deep sternal wound infection was 3.02% for BIMA and 1.95%
for SIMA (OR = 1.57; 95% CI: 1.26-1.95). When skeletonized, the incidence
of DSWI was 2.5% for BIMA versus 2.41% for SIMA. There was a significant
difference at 5-year survival favoring the BIMA, 85.15% BIMA versus 80.77%
SIMA (OR = 1.79; 95% CI: 1.60-2.01). The 10-year overall survival was
74.04% BIMA versus 61.57% SIMA (OR = 1.79; 95% CI: 1.61-1.98). The 15-year
survival was 47.08% for BIMA versus 37.06% for SIMA (OR = 1.69; 95% CI:
1.52-1.88). Conclusion(s): Postoperative bleeding was higher in BIMA
group. Bilateral internal mammary artery in diabetic patients should be
carried out in a skeletonize fashion, to reduce DSWI. There is a survival
benefit of using BIMA in diabetics within 5 years of surgery; it remains
significant up to 15 years. Copyright © The Author(s) 2023.

<8>
Accession Number
2026269487
Title
Comparing functional and quality of life outcomes in transcatheter aortic
valve implantation and surgical aortic valve replacement for aortic
stenosis: a systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
519. Date of Publication: December 2023.
Author
Duffy M.; Lynch A.; Reddin C.; Judge C.; O'Donnell M.; Murphy R.
Institution
(Duffy, Lynch, Reddin, Judge, O'Donnell, Murphy) HRB-Clinical Research
Facility, University of Galway, Galway, Ireland
(Duffy, Lynch, Reddin, Judge, O'Donnell) Galway University Hospital,
Newcastle Road, Galway, Ireland
(Reddin) Welcome Trust - HRB, Irish Clinical Academic Training, Galway,
Ireland
(Murphy) Division of Neurology, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Murphy) Division of Neurology, Department of Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: To compare functional and health related quality of life
outcomes post-transcatheter aortic valve implantation (TAVI) and surgical
aortic valve replacement (SAVR) in patients with critical aortic stenosis
(AS) across low to high-risk surgical candidates. These patient-centred
factors will be compared between both groups in the short to medium term
time frames and will aid in shared decision making between patients and
healthcare workers. Material(s) and Method(s): We conducted a
systematic review and meta-analysis of randomised controlled trials which
compared TAVI with SAVR and reported on quality of life (QoL) and
functional scores. The scores used were the Kansas City Cardiomyopathy
Questionnaire (KCCQ), Euroqol-5DL (EQ5DL), the short form-36/12 (SF-36/12)
and the NYHA. Result(s): We identified eight trials with a total of
8898 participants. Both groups showed improvements from baseline at one
month. At one month there was a statistically significant difference in
standardised mean difference (SMD) in favour of TAVI for EQ5DL (SMD 0.37,
95% CI 0.26,0.49), KCCQ (SMD 0.53,95% CI 0.48, 0.58), SF physical summary
(SMD 0.55, 95% CI 0.31 - 0.78) and SF mental summary (SMD 0.34, 95% CI
0.27 - 0.40). At one year there was no statistically significant
difference between any of these QoL metrics. For NYHA, no significant
difference in odds ratio of class III/IV was observed at one month between
TAVI and SAVR (OR 0.94, 95% CI 0.83, 1.07), however, TAVI was associated
with reduced odds ratio of NYHA class I/II at one year (OR 0.87, 95% CI
0.78, 0.98). Conclusion(s): Both groups were associated with
improvements in QoL and functional outcomes with TAVI reporting more
significant improvements in QoL at one-month post-procedures. No
significant improvements between groups were seen at one year. This is the
largest meta-analysis comparing post-operative health-related quality of
life outcomes post SAVR and TAVI and has major implications in shared
decision making for the treatment of aortic stenosis. Copyright ©
2023, BioMed Central Ltd., part of Springer Nature.

<9>
Accession Number
2026268503
Title
Pulmonary atresia and ventricular septal defect: How accurate is the fetal
echocardiography, and do the major aortopulmonary collateral arteries
matter?.
Source
Echocardiography. (no pagination), 2023. Date of Publication: 2023.
Author
Uygur L.; Demirci O.; Yucel I.K.
Institution
(Uygur, Demirci) Department of Perinatology, Zeynep Kamil Gynecologic and
Pediatric Training Research Hospital, Health Sciences University,
Istanbul, Turkey
(Yucel) Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and
Cardiovascular Surgery Training and Research Hospital, Health Sciences
University, Istanbul, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Objective: To assess the accuracy of prenatal echocardiography in defining
pulmonary vasculature in pulmonary atresia with VSD (PAVSD). The second
aim is to compare the perinatal and postnatal outcomes of different
pulmonary blood supply types. Study design: The cases prenatally diagnosed
with PAVSD between 2017 and 2022 in a single tertiary fetal medicine
center were identified on the electronic database. Fetal echocardiography
reports and images were reviewed retrospectively. Postnatal outcomes were
acquired from the hospital records of relevant pediatric cardiology and
cardiovascular surgery clinics. Fetal echocardiography results were
compared with postnatal results. Perinatal and postnatal outcomes were
compared between the different pulmonary vascular supply types.
 Result(s): Among the 24 PAVSD cases, six were diagnosed with major
aortopulmonary collateral arteries (MAPCA) dependent, eleven were
diagnosed with ductus arteriosus (DA) dependent pulmonary supply, and
seven were diagnosed with double pulmonary supply (MAPCA + DA) on prenatal
echocardiography. Seventeen cases were live-born and have undergone
postnatal investigations. Fetal echocardiography was 88.2% accurate about
the type of pulmonary supply. The accuracy of fetal echocardiography
regarding pulmonary vascular anatomy was 82.3%. Postoperative survival was
69.2%. Mortality before surgery and postoperative survival did not differ
between pulmonary supply groups. Survival was impaired by the extracardiac
anomalies. The need for early interventions was significantly higher in
the DA group. Conclusion(s): Pulmonary vascularization in PAVSD can
be defined precisely on fetal echocardiography. The source of pulmonary
blood supply does not impact postnatal short-term outcomes significantly
but it impacts the management. The associated anomalies highly contribute
to postnatal mortality. Copyright © 2023 Wiley Periodicals LLC.

<10>
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.

<11>
Accession Number
2025280078
Title
Minimally Invasive Versus Transcatheter Aortic Valve Replacement: An
Updated Meta-Analysis and Systematic Review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 18(5) (pp 424-434), 2023. Date of Publication: September/October
2023.
Author
Ahmed A.; Varghese K.S.; Mathew J.; Huda S.; George J.; Mathew S.;
Abdelnasser O.A.; Awad A.K.; Mathew D.M.
Institution
(Ahmed, Varghese, Mathew, Huda, George, Mathew, Mathew) City University of
New York School of Medicine, NY, United States
(Awad, Abdelnasser) Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Awad) Faculty of Medicine, El-Galala University, Suez, Egypt
Publisher
SAGE Publications Ltd
Abstract
Objective: Transcatheter aortic valve replacement (TAVR) has arisen as a
viable alternative to surgery. Similarly, minimally invasive surgical
aortic valve replacement (mini-SAVR), such as ministernotomy and
minithoracotomy, have also gained interest. We conducted a pairwise
meta-analysis to further investigate the efficacy of TAVR versus
mini-SAVR. Method(s): Medical databases were comprehensively searched
for studies comparing TAVR with a mini-SAVR modality, defined as minimally
invasive aortic surgery, ministernotomy, minithoracotomy, or
rapid-deployment or sutureless SAVR. Random-effects meta-analysis was
conducted using the generic inverse variance method. Primary outcomes
included 30-day mortality, midterm mortality, 30-day stroke, acute kidney
injury (AKI), paravalvular leak (PVL), new permanent pacemaker (PPM),
new-onset atrial fibrillation, and postintervention mean and peak valve
pressure gradients and were pooled as risk ratio (RR), mean difference
(MD), or hazard ratio (HR) with 95% confidence interval (CI).
 Result(s): A total of 5,071 patients (2,505 mini-SAVR vs 2,566 TAVR)
from 12 studies were pooled. Compared with TAVR, mini-SAVR showed
significantly lower rates of both 30-day (RR = 0.63, 95% CI: 0.42 to 0.96,
P = 0.03) and midterm mortality at 4 years of follow-up (HR = 0.76, 95%
CI: 0.67 to 0.87, P < 0.001). Furthermore, mini-SAVR was protective
against 30-day PVL (RR = 0.07, 95% CI: 0.04 to 0.13, P < 0.001) and new
PPM (RR = 0.25, 95% CI: 0.11 to 0.57, P < 0.001). Conversely, TAVR was
protective against 30-day AKI (RR = 1.67, 95% CI: 1.20 to 2.32, P = 0.002)
and postinterventional mean gradients (MD = 1.65, 95% CI: 0.25 to 3.05, P
= 0.02). No difference was observed for 30-day stroke (RR = 0.84, 95% CI:
0.56 to 1.24, P = 0.38), new-onset atrial fibrillation (RR = 1.79, 95% CI:
0.93 to 3.44, P = 0.08), or postinterventional peak gradients (MD = 3.24,
95% CI: -1.10 to 7.59, P = 0.14). Conclusion(s): Compared with TAVR,
mini-SAVR was protective against 30-day and midterm mortality, 30-day PVL,
and new permanent pacemaker, while TAVR patients had lower 30-day AKI.
Future randomized trials comparing the efficacy of mini-SAVR approaches
with TAVR are needed. Copyright © The Author(s) 2023.

<12>
Accession Number
2023961323
Title
Platelet-rich plasma influence on the sternal wounds healing: A
meta-analysis.
Source
International Wound Journal. 20(9) (pp 3794-3801), 2023. Date of
Publication: November 2023.
Author
Zhu S.; Gao J.; Yu W.; Xiong J.
Institution
(Zhu) Department of Thoracic Surgery, The First Affiliated Hospital of
Gannan Medical University, Ganzhou, China
(Zhu) Ganzhou Key Lab of Brain Injury & Brain Protection, Ganzhou, China
(Gao, Yu) The First Clinical Medical College, Gannan Medical University,
Ganzhou, China
(Xiong) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Gannan Medical University, Ganzhou, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis research was executed to appraise the effect of
platelet-rich plasma (PRP) on sternal wound healing (SWH). Inclusive
literature research till April 2023 was done and 1098 interconnected
researches were revised. The 11 picked researches, enclosed 8961 cardiac
surgery (CS) persons were in the utilised researchers' starting point,
3663 of them were utilising PRP, and 5298 were control. Odds ratio (OR)
and 95% confidence intervals (CIs) were utilised to appraise the effect of
PRP on the SWH by the dichotomous approach and a fixed or random model.
PRP had significantly lower sternal wound infection (SWI) (OR, 0.11; 95%
CI, 0.03-0.34, p < 0.001), deep SWI (OR, 0.29; 95% CI, 0.16-0.51, p <
0.001), and superficial SWI (OR, 0.20; 95% CI, 0.13-0.33, p < 0.001),
compared to control in CS persons. PRP had significantly lower SWI, deep
SWI, and superficial SWI, compared to control in CS persons. However,
caution must be taken when interacting with its values since there was a
low sample size of some of the nominated research found for the
comparisons in the meta-analysis. Copyright © 2023 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<13>
Accession Number
2023155071
Title
Wound complications frequency in heart transplant recipients on mammalian
target of rapamycin inhibitors: A meta-analysis.
Source
International Wound Journal. 20(9) (pp 3491-3497), 2023. Date of
Publication: November 2023.
Author
Zhu S.; Yu W.; Gao J.; Xiong J.
Institution
(Zhu) Department of Thoracic Surgery, First Affiliated Hospital of Gannan
Medical University, Ganzhou, China
(Zhu) Ganzhou Key Lab of Brain Injury & Brain Protection, Ganzhou, China
(Yu, Gao) The First Clinical Medical College, Gannan Medical University,
Ganzhou, China
(Xiong) Department of Cardiovascular Surgery, First Affiliated Hospital of
Gannan Medical University, Ganzhou, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation was executed to measure the wound
complications (WCs) frequency in heart transplant (HT) recipients on
mammalian target of rapamycin inhibitors (MTRIs). A comprehensive
literature investigation till February 2023 was applied and 978
interrelated investigations were reviewed. The 10 chosen investigations
enclosed 2173 individuals with HT were in the chosen investigations'
starting point, 1164 of them were utilising MTRIs, and 1009 were utilising
control. Odds ratio (OR) in addition to 95% confidence intervals (CIs)
were utilised to compute the value of the WCs frequency in HT recipients
on MTRIs by the dichotomous approaches and a fixed or random model. MTRIs
had significantly higher WCs (OR, 1.53; 95% CI, 1.19-1.98, P =.001)
compared with those with control in individuals with HT. MTRIs had
significantly higher WCs compared with those with control in individuals
with HT. However, care must be exercised when dealing with its values
because of the low number of the nominated investigations and the low
sample size of some of the nominated investigations for the
meta-analysis. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<14>
Accession Number
2022677233
Title
The role of urinary Dickkopf-3 in the prediction of acute kidney injury: a
systematic review meta-analysis.
Source
International Urology and Nephrology. 55(12) (pp 3175-3188), 2023. Date of
Publication: December 2023.
Author
Xing H.; Jiang Z.; Wu Y.; Ou S.; Qin J.; Xue L.; Wu W.
Institution
(Xing, Jiang, Wu, Ou, Qin, Wu) Department of Nephrology, Affiliated
Hospital of Southwest Medical University, Luzhou, China
(Xue) Department of Urology, Affiliated Hospital of Southwest Medical
University, No. 25 Taiping Street, Jiangyang District, Sichuan, Luzhou
646000, China
(Xing, Jiang, Wu, Ou, Qin, Xue, Wu) Sichuan Clinical Research Center for
Nephropathy, Luzhou, China
(Xing, Jiang, Wu, Ou, Qin, Wu) Metabolic Vascular Disease Key Laboratory,
Luzhou, China
Publisher
Springer Science and Business Media B.V.
Abstract
Background: To systematically evaluate the diagnostic efficacy of urinary
Dickkopf-Related Protein 3 (DKK-3) in acute kidney injury and to explore
the clinical application value of urinary DKK-3. Method(s): English
databases (PubMed, Embase, Cochrane, and WOS) and Chinese databases (VIP,
WanFang data, and China National Knowledge Internet) were screened for
relevant papers published before March 12, 2023. After literature
screening and data extraction, quality assessment was performed according
to the QUADAS-2 scoring system. Then, the combined diagnostic and
predictive parameters were calculated using a bivariate mixed effect
meta-analysis model. Deek's funnel plot asymmetry test assessed
publication bias, and Fagan's nomogram plot was used to verify its
clinical utility. Result(s): A total of 5 studies involving 2787
patients were included in this meta-analysis, of which 4 focused on
contrast-induced acute kidney injury (CI-AKI) and 1 focused on AKI
associated with cardiac surgery. The analysis showed that urine Dickkopf-3
has high diagnostic accuracy for AKI, with a sensitivity of 0.55 (95% CI
[0.41, 0.68]), specificity of 0.80 (95% CI [0.70, 0.87]), positive
likelihood ratio (PLR) of 2.7 [1.8, 4.1], negative likelihood ratio (NLR)
of 0.56 [0.42, 0.75], diagnostic odds ratio (DOR) of 5 [3, 9], and AUC of
0.74 [0.70-0.77]. We did not perform subgroup analyses for predictive
value due to the small number of included studies. Conclusion(s):
Urinary DKK3 may have limited predictive ability for acute kidney injury,
especially for AKI associated with cardiac surgery. Therefore, urinary
DKK3 may serve as a potential predictor for AKI. However, clinical studies
with larger samples are still needed for validation. Copyright ©
2023, The Author(s), under exclusive licence to Springer Nature B.V.

<15>
Accession Number
641897516
Title
Confounding adjustment in observational studies on cardiothoracic
interventions: a systematic review of methodological practice.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 64(4) (no pagination),
2023. Date of Publication: 04 Oct 2023.
Author
Velders B.J.J.; Boltje J.W.T.; Vriesendorp M.D.; Klautz R.J.M.; Le Cessie
S.; Groenwold R.H.H.
Institution
(Velders, Vriesendorp, Klautz) Department of Cardiothoracic Surgery,
Leiden University Medical Center, Leiden, Netherlands
(Velders, Le Cessie, Groenwold) Department of Clinical Epidemiology,
Leiden University Medical Center, Leiden, Netherlands
(Boltje) Department of Cardiothoracic Surgery, Amsterdam University
Medical Center, Amsterdam, Netherlands
(Le Cessie, Groenwold) Department of Biomedical Data Science, Leiden
University Medical Center, Leiden, Netherlands
Abstract
OBJECTIVES: It is unknown which confounding adjustment methods are
currently used in the field of cardiothoracic surgery and whether these
are appropriately applied. The aim of this study was to systematically
evaluate the quality of conduct and reporting of confounding adjustment
methods in observational studies on cardiothoracic interventions.
 METHOD(S): A systematic review was performed, which included all
observational studies that compared different interventions and were
published between 1 January and 1 July 2022, in 3 European and American
cardiothoracic surgery journals. Detailed information on confounding
adjustment methods was extracted and subsequently described.
 RESULT(S): Ninety-two articles were included in the analysis. Outcome
regression (n=49, 53%) and propensity score (PS) matching (n=44, 48%) were
most popular (sometimes used in combination), whereas 11 (12%) studies
applied no method at all. The way of selecting confounders was not
reported in 42 (46%) of the studies, solely based on previous literature
or clinical knowledge in 14 (16%), and (partly) data-driven in 25 (27%).
For the studies that applied PS matching, the matched cohorts comprised on
average 46% of the entire study population (range 9-82%).
 CONCLUSION(S): Current reporting of confounding adjustment methods is
insufficient in a large part of observational studies on cardiothoracic
interventions, which makes quality judgement difficult. Appropriate
application of confounding adjustment methods is crucial for causal
inference on optimal treatment strategies for clinical practice. Reporting
on these methods is an important aspect of this, which can be
improved. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<16>
Accession Number
2028084701
Title
OA06.03 An International EORTC Survey on Resectability of Stage III
Non-small Cell Lung Cancer.
Source
Journal of Thoracic Oncology. Conference: 2023 World Conference on Lung
Cancer. Singapore Singapore. 18(11 Supplement) (pp S55-S56), 2023. Date of
Publication: November 2023.
Author
Houda I.; Bahce I.; Dickhoff C.; Kroese T.E.; Kroeze S.G.C.; Mariolo A.V.;
Tagliamento M.; Moliner L.; Brandao M.; Edwards J.; Opitz I.; Faivre-Finn
C.; de Ruysscher D.; Remon J.; Berghmans T.; Dingemans A.-M.C.; Besse B.;
Hendriks L.E.L.
Institution
(Houda, Bahce, Dickhoff) Amsterdam University Medical Centers, location VU
Medical Centers, Amsterdam, Netherlands
(Kroese, Opitz) Universitatsspital Zurich, Zurich, Switzerland
(Kroeze) Kantonsspital Aarau AG, CH, Aarau, Switzerland
(Mariolo) Curie-Montsouris Thoracic Institute, Paris, France
(Tagliamento, Besse) Gustave Roussy, FR, Villejuif, France
(Moliner) Institut Catala d'Oncologia, Barcelona, Spain
(Brandao, Berghmans) Institut Jules Bordet, BE, Bruxelles, Belgium
(Edwards) Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield,
United Kingdom
(Faivre-Finn) The Christie NHS Foundation Trust, Manchester, United
Kingdom
(de Ruysscher, Hendriks) Maastricht University Medical Center, NL,
Maastricht, Netherlands
(Remon) Centro Integral Oncologico Clara Campal HM Nou Delfos, Barcelona,
Spain
(Dingemans) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Introduction: The EORTC-Lung Cancer Group (LCG) is conducting a Delphi
consensus project to establish a consensual definition of resectability in
stage III NSCLC. This comprehensive project includes a systematic review,
survey, and clinical case discussions. The survey aimed to identify areas
of consensus and controversy. Here, we present the results of this survey.
 Method(s): The EORTC-LCG developed an online survey based on input
from a selected EORTC multidisciplinary team (MDT), including thoracic
surgeons, radiation oncologists, oncologists, and pulmonologists. The
13-item survey (9 single-answer questions, 3 check box questions, and 1
open question) was distributed among the members of 6 scientific societies
(EORTC, ESTS, ESTRO, ETOP, ERS, IASLC). Participants were interrogated on
the resectability of all possible stage III TNM-combinations (IASLC
8thed). Additionally, 4 N2-subdivisions were used (Table A).
Consensus was defined as 75% agreement among participants. Answers with
"yes" (upfront resectable) were considered resectable; "yes" and "maybe"
(borderline resectable) were grouped together and considered potentially
resectable. Answers with "no" were considered unresectable.
 Result(s): The specialties of the 558 respondents included thoracic
surgery (38%), radiation oncology (27%), medical oncology (16%),
pulmonology (13%), and others (6%). Most respondents worked in a
specialized cancer center (81%), had >5 years of experience (80%), were
European (72%), were male (73%), and treated >20 patients with stage III
NSCLC in their center annually (77%). Team members that were regularly
included in the MDT's were the thoracic surgeon (98%), radiation
oncologist (94%), medical oncologist (90%), pulmonologist (90%),
radiologist (90%), and pathologist (85%). Out of 37 possible
TNM-combinations, consensus was reached in 24 combinations (65%): 1 was
considered resectable (T3N1), 9 were considered potentially resectable and
15 were considered unresectable (Table A). N3-combinations were considered
unresectable. In T3 tumors, invasion of the parietal pleura, chest wall,
phrenic nerve, or parietal pericardium were considered potentially
resectable. T4 tumors invading the heart were considered unresectable. In
cases that were considered borderline resectable, most respondents (89%)
recommended surgery after downstaging with neoadjuvant chemoimmunotherapy,
assumed to be available in each country. Overall, thoracic surgeons
considered 4 more combinations to be potentially resectable compared to
other specialists. Conclusion(s): Substantial agreement as well as
disagreement on oncological resectability in the substages of stage III
NSCLC were observed in this survey. Thoracic surgeons were more likely to
consider some stage III TNM-combinations to be potentially resectable.
Keywords: Non-small Cell Lung Cancer, Resectability, Stage III NSCLC
[Formula presented] Copyright © 2023

<17>
[Use Link to view the full text]
Accession Number
2028073178
Title
Preoperative optimization and rapid discharge after coronary artery bypass
grafting.
Source
Current Opinion in Cardiology. 38(6) (pp 471-477), 2023. Date of
Publication: 01 Nov 2023.
Author
Ponnambalam M.; Alex R.M.
Institution
(Ponnambalam) University of Ottawa Heart Institute, Division of Cardiac
Surgery, Ottawa, ON, Canada
(Alex) University of Ottawa Heart Institute, Division of Cardiac
Rehabilitation and Prevention, Ottawa, ON, Canada
(Alex) The Ottawa Hospital, Department of Psychology, Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThis review discusses current guidelines and
evidence-based care for the preoperative optimization of patients who are
undergoing coronary artery bypass grafting (CABG) and for enabling rapid
discharge after surgery.Recent findingsSince the Enhanced Recovery After
Cardiac Surgery Society (ERAS Cardiac) issued guidelines for perioperative
care, in 2019, there has been a significant body of research that has
added to and provided further guidance regarding preoperative optimization
and accelerated recovery after CABG.SummaryA review of the current
literature provides a framework for a pragmatic approach to preoperative
optimization, utilizing the time from referral to surgery to mitigate
multiple aspects of the patient condition, leading to improved patient
outcomes and reduced length of stay and cost to the healthcare system.
 Copyright © 2023 Wolters Kluwer Health, Inc. All rights
reserved.

<18>
Accession Number
2028108119
Title
Risk Scores for Prediction of Postoperative Atrial Fibrillation After
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 209 (pp 232-240), 2023. Date of
Publication: 15 Dec 2023.
Author
Pandey A.; Okaj I.; Ichhpuniani S.; Tao B.; Kaur H.; Spence J.D.; Young
J.; Healey J.S.; Devereaux P.J.; Um K.J.; Benz A.P.; Conen D.; Whitlock
R.P.; Belley-Cote E.P.; McIntyre W.F.
Institution
(Pandey, Okaj, Ichhpuniani, Kaur) Michael G. DeGroote School of Medicine,
McMaster University, Hamilton, ON, Canada
(Tao) Faculty of Medicine, University of British Columbia, Vancouver, BC,
Canada
(Spence, Healey, Devereaux, Benz, Conen, Whitlock, Belley-Cote, McIntyre)
Population Health Research Institute, Hamilton, ON, Canada
(Young) Health Sciences Library, McMaster University, Hamilton, ON, Canada
(Healey, Devereaux, Um, Conen, Belley-Cote, McIntyre) Division of
Cardiology, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) is a common complication after
cardiac surgery and is associated with poor clinical outcomes. The
objective of this systematic review and meta-analysis was to assess the
performance of risk scores to predict POAF in cardiac surgery patients. We
searched MEDLINE, Embase, and Cochrane CENTRAL for studies that
developed/evaluated a POAF risk prediction model. Pairs of reviewers
independently screened studies and extracted data. We pooled area under
the receiver operating curves (AUCs), sensitivity and specificity, and
adjusted odds ratios from multivariable regression analyses using the
generic inverse variance method and random effects models. Forty-three
studies (n = 63,847) were included in the quantitative synthesis. Most
scores were originally developed for other purposes but evaluated for
predicting POAF. Pooled AUC revealed moderate POAF discrimination for the
EuroSCORE II (AUC 0.59, 95% confidence interval [CI] 0.54 to 0.65),
Society of Thoracic Surgeons (AUC 0.60, 95% CI 0.56 to 0.63), EuroSCORE
(AUC 0.63, 95% CI 0.58 to 0.68), CHADS<inf>2</inf> (AUC 0.66, 95% CI 0.57
to 0.75), POAF Score (AUC 0.66, 95% CI 0.63 to 0.68), HATCH (AUC 0.67, 95%
CI 0.57 to 0.75), CHA<inf>2</inf>DS<inf>2</inf>-VASc (AUC 0.68, 95% CI
0.60 to 0.75) and SYNTAX scores (AUC 0.74, 95% CI 0.71 to 0.78). Pooled
analyses at specific cutoffs of the CHA<inf>2</inf>DS<inf>2</inf>-VASc,
CHADS<inf>2</inf>, HATCH, and POAF scores demonstrated moderate-to-high
sensitivity (range 46% to 87%) and low-to-moderate specificity (range 31%
to 70%) for POAF prediction. In conclusion, existing clinical risk scores
offer at best moderate prediction for POAF after cardiac surgery. Better
models are needed to guide POAF risk stratification in cardiac surgery
patients. Copyright © 2023 Elsevier Inc.

<19>
Accession Number
2028073090
Title
Traditional Chinese Medicine Compound (Tongxinluo) and Clinical Outcomes
of Patients with Acute Myocardial Infarction: The CTS-AMI Randomized
Clinical Trial.
Source
JAMA. 330(16) (pp 1534-1545), 2023. Date of Publication: 24 Oct 2023.
Author
Li X.; Chen G.; Xian Y.; Zhang H.; Wu Y.; Yang Y.; Wu J.; Wang C.; He S.;
Wang Y.; Wang Z.; Liu H.; Wang X.; Zhang M.; Zhang J.; Li J.; An T.; Guan
H.; Li L.; Shang M.; Yao C.; Han Y.; Zhang B.; Gao R.; Peterson E.D.
Institution
(Yang, Li, Chen, Zhang, Wu, Zhang, Li, An, Guan, Li, Gao) State Key
Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Xian) Department of Neurology and Population and Data Science, University
of Texas Southwestern Medical Center, Dallas, United States
(Yang) Emergency Center, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
(Wu) Department of Cardiology, Xiuyan Manchu Autonomous County Central
People's Hospital, Liaoning, Anshan, China
(Wang) Department of Cardiology, Xihua County People's Hospital, Henan,
Zhoukou, China
(He) Department of Cardiology, Northern Jiangsu People's Hospital,
Jiangsu, Yangzhou, China
(Wang) Department of Cardiology, The First Affiliated Hospital of the
Medical College, Shihezi University, Xinjiang, Shihezi, China
(Wang) Department of Cardiology, Xiajin People's Hospital of Shandong
Province, Shandong, Xiajin, China
(Wang) Department of Cardiology, Xinxiang Central Hospital, Henan,
Xinxiang, China
(Liu) Department of Cardiology, Anyang District Hospital, Henan, Anyang,
China
(Wang) Department of Cardiology, Shihezi People's Hospital, Xinjiang,
Shihezi, China
(Zhang) Department of Cardiology, The Second Affiliated Hospital of
Guangzhou Medical University, Guangdong, Guangzhou, China
(Shang, Yao) Department of Biostatistics, Peking University Clinical
Research Institute, Peking University First Hospital, Beijing, China
(Han) Department of Cardiology, General Hospital of Northern Theater
Command, Liaoning, Shenyang, China
(Zhang) State Key Laboratory of Component-Based Chinese Medicine, Tianjin
University of Traditional Chinese Medicine, Tianjin, China
(Peterson) Department of Medicine, University of Texas Southwestern
Medical Center, Dallas, United States
Publisher
American Medical Association
Abstract
Importance: Tongxinluo, a traditional Chinese medicine compound, has shown
promise in in vitro, animal, and small human studies for myocardial
infarction, but has not been rigorously evaluated in large randomized
clinical trials. Objective(s): To investigate whether Tongxinluo
could improve clinical outcomes in patients with ST-segment elevation
myocardial infarction (STEMI). Design, Setting, and Participant(s):
Randomized, double-blind, placebo-controlled clinical trial was conducted
among patients with STEMI within 24 hours of symptom onset from 124
hospitals in China. Patients were enrolled from May 2019 to December 2020;
the last date of follow-up was December 15, 2021. Intervention(s):
Patients were randomized 1:1 to receive either Tongxinluo or placebo
orally for 12 months (a loading dose of 2.08 g after randomization,
followed by the maintenance dose of 1.04 g, 3 times a day), in addition to
STEMI guideline-directed treatments. Main Outcomes and Measures: The
primary end point was 30-day major adverse cardiac and cerebrovascular
events (MACCEs), a composite of cardiac death, myocardial reinfarction,
emergent coronary revascularization, and stroke. Follow-up for MACCEs
occurred every 3 months to 1 year. Result(s): Among 3797 patients who
were randomized, 3777 (Tongxinluo: 1889 and placebo: 1888; mean age, 61
years; 76.9% male) were included in the primary analysis. Thirty-day
MACCEs occurred in 64 patients (3.4%) in the Tongxinluo group vs 99
patients (5.2%) in the control group (relative risk [RR], 0.64 [95% CI,
0.47 to 0.88]; risk difference [RD], -1.8% [95% CI, -3.2% to -0.6%]).
Individual components of 30-day MACCEs, including cardiac death (56 [3.0%]
vs 80 [4.2%]; RR, 0.70 [95% CI, 0.50 to 0.99]; RD, -1.2% [95% CI, -2.5% to
-0.1%]), were also significantly lower in the Tongxinluo group than the
placebo group. By 1 year, the Tongxinluo group continued to have lower
rates of MACCEs (100 [5.3%] vs 157 [8.3%]; HR, 0.64 [95% CI, 0.49 to
0.82]; RD, -3.0% [95% CI, -4.6% to -1.4%]) and cardiac death (85 [4.5%] vs
116 [6.1%]; HR, 0.73 [95% CI, 0.55 to 0.97]; RD, -1.6% [95% CI, -3.1% to
-0.2%]). There were no significant differences in other secondary end
points including 30-day stroke; major bleeding at 30 days and 1 year;
1-year all-cause mortality; and in-stent thrombosis (<24 hours; 1-30 days;
1-12 months). More adverse drug reactions occurred in the Tongxinluo group
than the placebo group (40 [2.1%] vs 21 [1.1%]; P =.02), mainly driven by
gastrointestinal symptoms. Conclusions and Relevance: In patients
with STEMI, the Chinese patent medicine Tongxinluo, as an adjunctive
therapy in addition to STEMI guideline-directed treatments, significantly
improved both 30-day and 1-year clinical outcomes. Further research is
needed to determine the mechanism of action of Tongxinluo in STEMI. Trial
Registration: ClinicalTrials.gov Identifier: NCT03792035. Copyright
© 2023 American Medical Association. All rights reserved.

<20>
Accession Number
2028059813
Title
Systematic review of physiological and psychological outcomes of surgery
for pectus excavatum supporting commissioning of service in the UK.
Source
BMJ Open Respiratory Research. 10(1) (no pagination), 2023. Article
Number: e001665. Date of Publication: 12 Oct 2023.
Author
Walsh J.; Walsh R.; Redmond K.
Institution
(Walsh, Walsh) Department of Cardiothoracic Surgery, Fiona Stanley
Hospital, Murdoch, WA, Australia
(Redmond) Cardiothoracic Surgery, Mater Misericordiae University Hospital,
Dublin, Ireland
Publisher
BMJ Publishing Group
Abstract
Background Pectus excavatum (PEx) is the most common congenital chest wall
abnormality affecting 1 in 400 births in the UK. PEx is associated with
significant physiological and psychological impairment. While readily
surgically correctable, the benefits that surgery can bring have been
debated and proven difficult to objectively measure. In the UK, this has
led to the decommissioning of PEx surgery. The aim of this review is to
conduct a systematic search of the literature on PEx surgery to assess
physiological and psychological outcomes. Methods A systematic review of
the MEDLINE (PubMed), Embase and Cochrane databases was performed.
Articles were sought which included patients undergoing surgery for PEx
and reported on changes in cardiopulmonary measures, symptoms, quality of
life and psychological assessments before and after surgical repair. Last
search was performed in July 2022 and relevant findings were synthesised
by narrative review. Results Fifty-one articles were included in
qualitative synthesis, with 34 studies relating to physiological outcomes
and 17 studies relating to psychological and quality of life measures.
Twenty-one studies investigated pulmonary function at rest. There was no
change in forced vital capacity or forced expiratory volume in 1 second
following open repair and transient reductions followed closed repair. In
the 11 studies investigating echocardiography, transthoracic rarely
demonstrated cardiac compression; however, transoesophageal demonstrated
intraoperative relief in cardiac compression in severe cases. Sixteen
studies investigated exercise testing (cardiopulmonary exercise testing,
CPET), 12 of which demonstrated significant improvement following surgery,
both in maximal oxygen consumption and oxygen pulse. Seventeen studies
investigated quality of life, all but one of which showed improvement
following repair of PEx. All papers that reported on patient satisfaction
following surgery found high rates, between 80% and 97%. Discussion While
the majority of studies to date have been small and data heterogeneous,
the literature shows that for many patients with PEx, there exists a
cardiopulmonary limitation that while difficult to objectify, is likely to
improve with surgical repair. Resting parameters offer little yield in
aiding this except in the most severe cases. CPET therefore offers a
better option for dynamic assessment of this limitation and improvements
following repair. Surgery significantly improves psychological well-being
and quality of life for patients with PEx. Copyright © 2023 BMJ
Publishing Group. All rights reserved.

<21>
[Use Link to view the full text]
Accession Number
2028057309
Title
Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular
Support After Major Cardiac Surgery.
Source
Circulation. 148(17) (pp 1316-1329), 2023. Date of Publication: 24 Oct
2023.
Author
Ghadimi K.; Cappiello J.L.; Wright M.C.; Levy J.H.; Bryner B.S.; Devore
A.D.; Schroder J.N.; Patel C.B.; Rajagopal S.; Shah S.H.; Milano C.A.
Institution
(Ghadimi, Wright, Levy) Department of Anesthesiology, Divisions of
Cardiothoracic Anesthesiology and Critical Care Medicine, Clinical
Research Unit, Duke University School of Medicine, Durham, NC, United
States
(Levy, Bryner, Schroder, Milano) Department of Surgery, Adult Cardiac
Surgery Section, Duke University School of Medicine, Durham, NC, United
States
(Devore, Patel, Rajagopal, Shah) Department of Medicine, Division of
Cardiology, Duke University School of Medicine, Durham, NC, United States
(Cappiello) Department of Respiratory Therapy, Boise State University, ID,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Right ventricular failure (RVF) is a leading driver of
morbidity and death after major cardiac surgery for advanced heart
failure, including orthotopic heart transplantation and left ventricular
assist device implantation. Inhaled pulmonary-selective vasodilators, such
as inhaled epoprostenol (iEPO) and nitric oxide (iNO), are essential
therapeutics for the prevention and medical management of postoperative
RVF. However, there is limited evidence from clinical trials to guide
agent selection despite the significant cost considerations of iNO
therapy. METHOD(S): In this double-blind trial, participants were
stratified by assigned surgery and key preoperative prognostic features,
then randomized to continuously receive either iEPO or iNO beginning at
the time of separation from cardiopulmonary bypass with the continuation
of treatment into the intensive care unit stay. The primary outcome was
the composite RVF rate after both operations, defined after
transplantation by the initiation of mechanical circulatory support for
isolated RVF, and defined after left ventricular assist device
implantation by moderate or severe right heart failure according to
criteria from the Interagency Registry for Mechanically Assisted
Circulatory Support. An equivalence margin of 15 percentage points was
prespecified for between-group RVF risk difference. Secondary
postoperative outcomes were assessed for treatment differences and
included: mechanical ventilation duration; hospital and intensive care
unit length of stay during the index hospitalization; acute kidney injury
development including renal replacement therapy initiation; and death at
30 days, 90 days, and 1 year after surgery. RESULT(S): Of 231
randomized participants who met eligibility at the time of surgery, 120
received iEPO, and 111 received iNO. Primary outcome occurred in 30
participants (25.0%) in the iEPO group and 25 participants (22.5%) in the
iNO group, for a risk difference of 2.5 percentage points (two one-sided
test 90% CI, -6.6% to 11.6%) in support of equivalence. There were no
significant between-group differences for any of the measured
postoperative secondary outcomes. CONCLUSION(S): Among patients
undergoing major cardiac surgery for advanced heart failure, inhaled
pulmonary-selective vasodilator treatment using iEPO was associated with
similar risks for RVF development and development of other postoperative
secondary outcomes compared with treatment using iNO. Copyright
© 2023 American Heart Association, Inc.

<22>
[Use Link to view the full text]
Accession Number
2028057307
Title
Oral Anticoagulation Use and Left Atrial Appendage Occlusion in LAAOS III.
Source
Circulation. 148(17) (pp 1298-1304), 2023. Date of Publication: 24 Oct
2023.
Author
Connolly S.J.; Healey J.S.; Belley-Cote E.P.; Balasubramanian K.;
Paparella D.; Brady K.; Reents W.; Danner B.C.; Devereaux P.J.; Sharma M.;
Ramasundarahettige C.; Yusuf S.; Whitlock R.P.
Institution
(Connolly, Healey, Belley-Cote, Balasubramanian, Brady, Devereaux, Sharma,
Ramasundarahettige, Yusuf, Whitlock) Population Health Research Institute,
Hamilton Health Sciences, McMaster University, ON, Canada
(Paparella) University of Foggia, Italy
(Paparella) Santa Maria Hospital, Gvm Care & Research, Bari, Italy
(Reents) Rhon-Klinikum Campus Bad Neustadt, Germany
(Danner) Universitatsmedizin Gottingen, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: LAAOS III (Left Atrial Appendage Occlusion Study III) showed
that left atrial appendage (LAA) occlusion reduces the risk of ischemic
stroke or systemic embolism in patients with atrial fibrillation
undergoing cardiac surgery. This article examines the effect of LAA
occlusion on stroke reduction according to variation in the use of oral
anticoagulant (OAC) therapy. METHOD(S): Information regarding OAC use
was collected at every follow-up visit. Adjusted proportional hazards
modeling, including using landmarks of hospital discharge, 1 and 2 years
after randomization, evaluated the effect of LAA occlusion on the risk of
ischemic stroke or systemic embolism, according to OAC use. Adjusted
proportional hazard modeling, with OAC use as a time-dependent covariate,
was also performed to assess the effect of LAA occlusion, according to OAC
use throughout the study. RESULT(S): At hospital discharge, 3027
patients (63.5%) were receiving a vitamin K antagonist, and 879 (18.5%)
were receiving a non-vitamin K antagonist oral anticoagulant (direct OAC),
with no difference in OAC use between treatment arms. There were 2887
(60.5%) patients who received OACs at all follow-up visits, 1401 (29.4%)
who received OAC at some visits, and 472 (9.9%) who never received OACs.
The effect of LAA occlusion on the risk of ischemic stroke or systemic
embolism was consistent after discharge across all 3 groups: hazard ratios
of 0.70 (95% CI, 0.51-0.96), 0.63 (95% CI, 0.43-0.94), and 0.76 (95% CI,
0.32-1.79), respectively. An adjusted proportional hazards model with OAC
use as a time-dependent covariate showed that the reduction in stroke or
systemic embolism with LAA occlusion was similar whether patients were
receiving OACs or not. CONCLUSION(S): The benefit of LAA occlusion
was consistent whether patients were receiving OACs or not. LAA occlusion
provides thromboembolism reduction in patients independent of OAC use.
 Copyright © 2023 American Heart Association, Inc.

<23>
[Use Link to view the full text]
Accession Number
2028057289
Title
Effect of Glutamine Administration After Cardiac Surgery on Kidney Damage
in Patients at High Risk for Acute Kidney Injury: A Randomized Controlled
Trial.
Source
Anesthesia and Analgesia. 137(5) (pp 1029-1038), 2023. Date of
Publication: 01 Nov 2023.
Author
Weiss R.; Meersch M.; Gerke M.; Wempe C.; Schafers M.; Kellum J.A.;
Zarbock A.
Institution
(Weiss, Meersch, Gerke, Wempe, Zarbock) Department of Anesthesiology,
Intensive Care and Pain Medicine, University Hospital Munster, Munster,
Germany
(Schafers) Department of Nuclear Medicine, University Hospital Munster,
Munster, Germany
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Acute kidney injury (AKI) is a common complication after
cardiac surgery and is associated with increased morbidity and mortality.
However, no specific treatment options are available, emphasizing the need
for preventive measures. The aim of this study was to clarify the effect
of glutamine on [TIMP2]*[IGFBP7] levels at the end of the intervention
period. METHOD(S): In a randomized clinical, double-blind pilot
study, 64 eligible cardiac surgery patients at high risk for AKI
identified by high urinary [TIMP2]*[IGFBP7] were randomized, and body
weight-adapted intravenous glutamine or saline-control was administered
continuously for 12 hours postoperatively. The primary outcome was urinary
[TIMP2]*[IGFBP7] at the end of the 12-hour study period. Secondary
outcomes included kidney injury molecule-1 (KIM-1) and neutrophil
gelatinase-associated lipocalin (NGAL) at 12 hours, overall AKI rates at
72 hours, free days through day 28 of mechanical ventilation and
vasoactive medication, renal recovery at day 90, requirement of renal
replacement therapy and mortality each at days 30, 60, and 90, length of
intensive care unit (ICU) and hospital stay, and major adverse kidney
events consisting of mortality, dialysis dependency, and persistent renal
dysfunction (serum creatinine >=2x compared to baseline value) at day 90
(major adverse kidney event; MAKE<inf>90</inf>). RESULT(S):
Sixty-four patients (mean age, 68.38 [standard deviation {SD} +/- 10.48]
years; 10 of 64 women) were enrolled and randomized. Patients received
coronary artery bypass graft surgery (32/64), valve surgery (18/64),
coronary artery bypass graft and valve surgery (6/64), or other procedures
(8/64). Mean on-pump time was 68.38 (standard deviation +/- 10.48)
minutes. After glutamine administration, urinary [TIMP-2]*[IGFBP7] was
significantly lower in the glutamine compared to the control group
(primary end point, intervention: median, 0.18 [Q1, Q3; 0.09, 0.29],
controls: median, 0.44 [Q1, Q3; 0.14, 0.79]; P =.01). In addition, [KIM-1]
and [NGAL] were also significantly lower in the glutamine group. The
overall AKI rate within 72 hours was not different among groups:
(intervention 11/31 [35.5%] versus control 8/32 [25.0%]; P =.419; relative
risk [RR], 0.86% [95% confidence interval {CI}, 0.62-1.20]). There were no
differences regarding secondary end points. CONCLUSION(S): Glutamine
significantly decreased markers of kidney damage in cardiac surgery
patients at high risk for AKI. Future trials have to be performed to
investigate whether the administration of glutamine might be able to
reduce the occurrence of AKI after cardiac surgery. Copyright ©
2023 International Anesthesia Research Society.

<24>
Accession Number
642605707
Title
Assessment of cardiovascular alterations and catecholamines serum
concentration after oral surgery in patients receiving local anesthetics
with epinephrine: a randomized, blind, controlled clinical trial.
Source
Clinical oral investigations. (no pagination), 2023. Date of Publication:
26 Oct 2023.
Author
da Silveira M.L.M.; da Conceicao Coelho O.D.; Germano A.R.
Institution
(da Silveira) Program of Dental Science of the Federal University of Rio
Grande do Norte (UFRN), Natal, RN, Brazil
(da Conceicao Coelho) Januario Cicco Maternity School (MEJC) of the
Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
(Germano) Department of Oral and Maxillofacial Surgery, Onofre Lopes
University Hospital (HUOL), Av. Nilo Pecanha, 620 - Petropolis, Natal, RN,
59.012-300, Brazil
(Germano) Department of Dentistry of the Federal University of Rio Grande
do Norte (UFRN), Natal, RN, Brazil
Abstract
OBJECTIVES: A randomized controlled clinical trial was developed to
evaluate the cardiovascular effects of local anesthetics with
vasoconstrictors (LAVC) in healthy and hypertensive patients undergoing
teeth extraction with lidocaine 2% with epinephrine 1:100,000. MATERIALS
AND METHODS: Twenty patients were divided into control (CG - normotensive
patients) and experimental groups (EG - hypertensive patients). The
variables analyzed were heart rate (HR), oxygen saturation (SO2), systolic
and diastolic blood pressure (SBP and DBP), serum catecholamine
concentration (dopamine, epinephrine, and norepinephrine), ventricular and
supraventricular extrasystoles (VES and SVES respectively), and ST segment
depression. Data was obtained in three different moments (initial, trans,
and final). Blood samples were taken to measure the catecholamines, and a
Holter device was used to measure data from the electrocardiogram
including a 24-h postoperative evaluation period. The Mann-Whitney test
was used to identify differences between the two groups, and the Friedman
test with the adjusted Wilcoxon posttest was used for intragroup
evaluation for repeated measures. RESULT(S): The EG presented a lower
O2S in the initial period (p=0,001) while the sysBP showed a statistical
difference for the three evaluation periods with the EG presenting the
highest values. The VES was higher for the EG during the 24-h
postoperative evaluation period (p=0,041). The SVES and the serum
catecholamines showed were similar between the groups. The intragroup
analysis revealed significant statistical difference for the sysBP in the
EG with the trans period presenting the highest measurements. The
extrasystole evaluation showed that the 24-h postoperative period
presented most events with only the CG not presenting statistical
difference for the variable VES during this period (p=0,112). No ST
segment depression was noticed for both groups. CONCLUSION(S): Teeth
extraction with LAVC can be safely executed in hypertensive patients.
Blood pressure should be monitored in these patients since the sysBP
presented significant differences during the surgical procedures. Cardiac
arrhythmia and the serum catecholamines concentration levels seem not to
be altered by the surgical procedure. Also, serum catecholamines do not
influence cardiovascular changes in this type of surgery. CLINICAL
RELEVANCE: LAVC can be safely used in hypertensive patients and does not
increase the risk of arrhythmias or cardiac ischemia. Copyright ©
2023. The Author(s), under exclusive licence to Springer-Verlag GmbH
Germany, part of Springer Nature.

<25>
Accession Number
642605201
Title
Aortic Valve Replacement and Repair With or Without Concomitant Ascending
Aorta Replacement: Impact on Outcomes: A Systematic Review.
Source
Cardiology in review. (no pagination), 2023. Date of Publication: 26 Oct
2023.
Author
Zhang C.; Butt S.; Kashif H.; Rowe C.; Harky A.; Zeinah M.
Institution
(Zhang) From the Faculty of Medicine and Health, University of New South
Wales, Sydney, Australia
(Butt) Department of Plastic Surgery, Nottingham City Hospital,
Nottingham, United Kingdom
(Kashif) Department of Acute Medicine, King's College Hospital, London,
United Kingdom
(Rowe) Faculty of Medicine, Department of Medicine, Imperial College
London, London, United Kingdom
(Harky, Zeinah) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Zeinah) Faculty of Medicine, Ain Shams University, Egypt
Abstract
Aortic valve surgery is a common procedure used to treat significant
aortic valve stenosis or insufficiency. Some of these patients have
coexisting pathology affecting the ascending aorta requiring ascending
aorta replacement (AAR). Although the outcomes of these procedures are
independently positive, it is proposed that concomitant AAR improves
outcomes and minimizes the chances of future ascending aorta replacement.
A comprehensive literature search for relevant studies published since
2010 comparing outcomes of aortic valve repair and replacement with or
without concomitant ascending aorta replacement was undertaken using
electronic databases PubMed, Cochrane Library, Embase Ovid, and SCOPUS.
Major exclusion criteria were (1) conference posters, literature reviews,
editorials; (2) aortic root surgery, aortic arch surgery, or other
surgeries (3) case series with less than 5 participants. A total of 1189
patients from 6 retrospective cohort studies were included in the final
review, from which clinical outcomes such as mortality and complications
were compared. Mortality rates were similar in both intervention groups.
No significant differences were found between the 2 groups in
reexploration rates due to bleeding, stroke, postoperative dialysis, and
atrial fibrillation. Survival rates varied but had no significant
difference between interventions. Both isolated aortic valve surgery and
concomitant AAR procedures offer comparable favourable outcomes in terms
of mortality, survival rates, and complication risks. However, the
evidence is limited by the lack of randomized controlled trials. We
recommend that future studies should standardize reporting on
postoperative recovery, complications, long-term freedom from
reoperations, and long-term changes to aorta dimensions. Copyright
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

<26>
Accession Number
642602051
Title
Effectiveness of Surgeon-Performed Paravertebral Block Analgesia for
Minimally Invasive Thoracic Surgery: A Randomized Clinical Trial.
Source
JAMA surgery. (no pagination), 2023. Date of Publication: 25 Oct 2023.
Author
Chenesseau J.; Fourdrain A.; Pastene B.; Charvet A.; Rivory A.; Baumstarck
K.; Bouabdallah I.; Trousse D.; Boulate D.; Brioude G.; Gust L.; Vasse M.;
Braggio C.; Mora P.; Labarriere A.; Zieleskiewicz L.; Leone M.; Thomas
P.A.; D'Journo X.-B.
Institution
(Chenesseau, Fourdrain, Bouabdallah, Trousse, Boulate, Brioude, Gust,
Vasse, Braggio, Thomas, D'Journo) Department of Thoracic Surgery, Diseases
of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille
University, Assistance Publique-Hopitaux de Marseille, Marseille, France
(Pastene, Charvet, Rivory, Mora, Labarriere, Zieleskiewicz, Leone)
Department of Anesthesiology and Intensive Care Medicine, North Hospital,
Aix Marseille University, Assistance Publique-Hopitaux de Marseille,
Marseille, France
(Baumstarck) Departement of Biostatistics, Aix Marseille University,
Assistance Publique-Hopitaux de Marseille, Marseille, France
Abstract
Importance: In minimally invasive thoracic surgery, paravertebral block
(PVB) using ultrasound (US)-guided technique is an efficient postoperative
analgesia. However, it is an operator-dependent process depending on
experience and local resources. Because pain-control failure is highly
detrimental, surgeons may consider other locoregional analgesic options.
 Objective(s): To demonstrate the noninferiority of PVB performed by
surgeons under video-assisted thoracoscopic surgery (VATS), hereafter
referred to as PVB-VATS, as the experimental group compared with PVB
performed by anesthesiologists using US-guided technique (PVB-US) as the
control group. Design, Setting, and Participant(s): In this
single-center, noninferiority, patient-blinded, randomized clinical trial
conducted from September 8, 2020, to December 8, 2021, patients older than
18 years who were undergoing a scheduled minimally invasive thoracic
surgery with lung resection including video-assisted or robotic approaches
were included. Exclusion criteria included scheduled open surgery, any
antalgic World Health Organization level greater than 2 before surgery, or
a medical history of homolateral thoracic surgery. Patients were randomly
assigned (1:1) to an intervention group after general anesthesia. They
received single-injection PVB before the first incision was made in the
control group (PVB-US) or after 1 incision was made under thoracoscopic
vision in the experimental group (PVB-VATS). Intervention(s):
PVB-VATS or PVB-US. Main Outcomes and Measures: The primary end point
was mean 48-hour post-PVB opioid consumption considering a noninferiority
range of less than 7.5 mg of opioid consumption between groups. Secondary
outcomes included time of anesthesia, surgery, and operating room
occupancy; 48-hour pain visual analog scale score at rest and while
coughing; and 30-day postoperative complications. Result(s): A total
of 196 patients were randomly assigned to intervention groups: 98 in the
PVB-VATS group (mean [SD] age, 64.6[9.5] years; 53 female [54.1%]) and 98
in the PVB-US group (mean [SD] age, 65.8[11.5] years; 62 male [63.3%]).
The mean (SD) of 48-hour opioid consumption in the PVB-VATS group
(33.9[19.8] mg; 95% CI, 30.0-37.9 mg) was noninferior to that measured in
the PVB-US group (28.5[18.2] mg; 95% CI, 24.8-32.2 mg; difference: -5.4
mg; 95% CI, - to -0.93; noninferiority Welsh test, P<=.001). Pain score at
rest and while coughing after surgery, overall time, and postoperative
complications did not differ between groups. Conclusions and
Relevance: PVB placed by a surgeon during thoracoscopy was noninferior to
PVB placed by an anesthesiologist using ultrasonography before incision in
terms of opioid consumption during the first 48 hours. Trial Registration:
ClinicalTrials.gov Identifier: NCT04579276.

<27>
Accession Number
642600163
Title
Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve
Replacement Among Patients with Atrial Fibrillation.
Source
Circulation. (no pagination), 2023. Date of Publication: 24 Oct 2023.
Author
Kapadia S.R.; Krishnaswamy A.; Whisenant B.; Potluri S.; Iyer V.; Aragon
J.; Gideon P.; Strote J.; Leonardi R.; Agarwal H.; Larrain G.; Sanchez C.;
Panaich S.S.; Harvey J.; Vahl T.; Menon V.; Wolski K.; Wang Q.; Leon M.B.
Institution
(Kapadia, Krishnaswamy, Menon, Wolski, Wang) Cleveland Clinic, Cleveland,
OH, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Potluri) Baylor Scott and White The Heart Hospital, Plano, TX, United
States
(Iyer) University of Buffalo, Buffalo, NY, United States
(Aragon) Santa Barbara Cottage Hospital, Santa Barbara, CA
(Gideon) Banner University Medical Center, Phoenix, AZ, United States
(Strote) Medical Center of the Rockies, Loveland, CO, United States
(Leonardi) Lexington Medical Heart and Vascular Center, West Columbia, SC,
United States
(Agarwal) CHI Health Research Center, Omaha, NE, United States
(Larrain) Aspirus Research Institute, Wausau, WI, United States
(Sanchez) OhioHealth Research Institute, Columbus, OH, United States
(Panaich) University of Iowa Hospitals & Clinics, Iowa City, IA, United
States
(Harvey) WellSpan York Hospital, York, PA, United States
(Vahl, Leon) Columbia University Medical Center, New York, NY
Abstract
BACKGROUND: Atrial fibrillation (AF) is common in patients undergoing
transcatheter aortic valve replacement (TAVR) and is associated with
increased risk of bleeding and stroke. While left atrial appendage
occlusion (LAAO) is approved as an alternative to anticoagulants for
stroke prevention in patients with AF, placement of these devices neither
in patients with severe AS, nor at the same time as TAVR, has been
extensively studied. METHOD(S): WATCH-TAVR was a multicenter,
randomized trial evaluating the safety and effectiveness of concomitant
TAVR and LAAO with WATCHMAN in AF patients. Patients were randomized 1:1
to TAVR+LAAO or TAVR+medical therapy. WATCHMAN patients received
anticoagulation for 45 days followed by dual antiplatelet therapy until 6
months. Anticoagulation was per treating physician preference for patients
randomized to TAVR+medical therapy. The primary non-inferiority endpoint
was all-cause mortality, stroke, and major bleeding at 2-years between the
two strategies. RESULT(S): The study enrolled 349 patients, 177
TAVR+LAAO and 172 TAVR+medical therapy, between December-2017 and
November-2020 at 34 US centers. The mean age was 81 years, CHA2DS2-VASc
score was 4.9 and HAS-BLED score was 3.0. At baseline, 85.4% of patients
were taking anticoagulation and 71.3% patients were on antiplatelet
therapy. The cohorts were well-balanced for baseline characteristics. The
incremental LAAO procedure time was 38 minutes; the median contrast volume
was 119 mL for combined procedures versus 70 mL with TAVR alone. At 24
months follow-up, 82.5% compared to 50.8% of patients were on any
antiplatelet therapy, and 13.9% compared to 66.7% of patients were on any
anticoagulation therapy in TAVR+LAAO compared to TAVR+medical therapy
group respectively. For the composite primary endpoint, TAVR+.LAAO was
non-inferior to TAVR+ medical therapy (22.7 vs 27.3 events/100 patient
years for TAVR+LAAO and TAVR+medical therapy respectively; Hazard Ratio
0.86, 95% CI 0.60 -1.22, Pnoninferiority<0.001). CONCLUSION(S):
Concomitant WATCHMAN LAAO and TAVR is noninferior to TAVR with medical
therapy in severe aortic stenosis patients with AF. The increased
complexity and risks of the combined procedure should be considered when
concomitant LAAO is viewed as an alternative to medical therapy for
patients with AF undergoing TAVR.

<28>
Accession Number
2026097198
Title
Complement-activating donor-specific anti-HLA antibodies in solid organ
transplantation: systematic review, meta-analysis, and critical appraisal.
Source
Frontiers in Immunology. 14 (no pagination), 2023. Article Number:
1265796. Date of Publication: 2023.
Author
Al-Awadhi S.; Raynaud M.; Louis K.; Bouquegneau A.; Taupin J.-L.; Aubert
O.; Loupy A.; Lefaucheur C.
Institution
(Al-Awadhi, Raynaud, Louis, Bouquegneau, Aubert, Loupy, Lefaucheur)
Universite de Paris Cite, Institut National de la Sante et de la Recherche
Medicale (INSERM) Unite Mixte de Recherche (UMR)-S970, Paris
Cardiovascular Research Center (PARCC), Paris Translational Research
Centre for Organ Transplantation, Paris, France
(Louis, Lefaucheur) Kidney Transplant Department, Saint-Louis Hospital,
Assistance Publique - Hopitaux de Paris, Paris, France
(Bouquegneau) Department of Nephrology, Dialysis and Transplantation,
Centre Hospitalier Universitaire (CHU) de Liege, Liege, Belgium
(Taupin) Department of Immunology and Histocompatibility, Centre
Hospitalier Universitaire (CHU) Paris-GH St-Louis Lariboisiere, Paris,
France
(Aubert, Loupy) Kidney Transplant Department, Necker Hospital, Assistance
Publique - Hopitaux de Paris, Paris, France
Publisher
Frontiers Media SA
Abstract
Introduction: Several studies have investigated the impact of circulating
complement-activating anti-human leukocyte antigen donor-specific
antibodies (anti-HLA DSAs) on organ transplant outcomes. However, a
critical appraisal of these studies and a demonstration of the prognostic
value of complement-activating status over anti-HLA DSA mean fluorescence
intensity (MFI) level are lacking. Method(s): We conducted a
systematic review, meta-analysis and critical appraisal evaluating the
role of complement-activating anti-HLA DSAs on allograft outcomes in
different solid organ transplants. We included studies through Medline,
Cochrane, Scopus, and Embase since inception of databases till May 05,
2023. We evaluated allograft loss as the primary outcome, and allograft
rejection as the secondary outcome. We used the Newcastle-Ottawa Scale and
funnel plots to assess risk of bias and used bias adjustment methods when
appropriate. We performed multiple subgroup analyses to account for
sources of heterogeneity and studied the added value of complement assays
over anti-HLA DSA MFI level. Result(s): In total, 52 studies were
included in the final meta-analysis (11,035 patients).
Complement-activating anti-HLA DSAs were associated with an increased risk
of allograft loss (HR 2.77; 95% CI 2.33-3.29, p<0.001; I2=46.2%), and
allograft rejection (HR 4.98; 95% CI 2.96-8.36, p<0.01; I2=70.9%). These
results remained significant after adjustment for potential sources of
bias and across multiple subgroup analyses. After adjusting on pan-IgG
anti-HLA DSA defined by the MFI levels, complement-activating anti-HLA
DSAs were significantly and independently associated with an increased
risk of allograft loss. Discussion(s): We demonstrated in this
systematic review, meta-analysis and critical appraisal the significant
deleterious impact and the independent prognostic value of circulating
complement-activating anti-HLA DSAs on solid organ transplant risk of
allograft loss and rejection. Copyright © 2023 Al-Awadhi,
Raynaud, Louis, Bouquegneau, Taupin, Aubert, Loupy and Lefaucheur.

<29>
Accession Number
2027997590
Title
Preconditioning program reduces the incidence of prolonged hospital stay
after lung cancer surgery: Results from the Move For Surgery randomized
clinical trial.
Source
British Journal of Surgery. 110(11) (pp 1467-1472), 2023. Date of
Publication: 01 Nov 2023.
Author
Patel Y.S.; Sullivan K.A.; Churchill I.F.; Beauchamp M.K.; Wald J.;
Mbuagbaw L.; Fahim C.; Hanna W.C.
Institution
(Patel, Fahim, Hanna) Division of Thoracic Surgery, Department of Surgery,
McMaster University, Hamilton, ON, Canada
(Sullivan, Churchill, Mbuagbaw, Hanna) Department of Health Research
Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
(Beauchamp) School of Rehabilitation Science, McMaster University,
Hamilton, ON, Canada
(Wald) Firestone Institute for Respiratory Health, McMaster University,
Hamilton, ON, Canada
Publisher
Oxford University Press
Abstract
Background: Lung cancer resection is associated with high rates of
prolonged hospital stay. It is presumed that preconditioning with aerobic
exercise can shorten the postoperative duration of hospital stay, but this
has not yet been demonstrated in trials after lung cancer surgery. The aim
of this study was to perform a RCT to determine whether Move For Surgery
(MFS), a home-based and wearable technology-enhanced preconditioning
program before lung cancer surgery, is associated with a lower incidence
of prolonged hospital stay when compared to usual preoperative care.
 Method(s): Patients undergoing lung resection for early-stage
non-small cell lung cancer were enrolled before surgery into this blinded,
single-site RCT, and randomized to either the MFS or control group in a 1:
1 ratio. Patients in the MFS group were given a wearable activity tracker,
and education about deep breathing exercises, nutrition, sleep hygiene,
and smoking cessation. Participants were motivated/encouraged to reach
incrementally increasing fitness goals remotely. Patients in the control
group received usual preoperative care. The primary outcome was the
difference in proportion of patients with hospital stay lasting more than
5 days between the MFS and control groups. Result(s): Of 117 patients
screened, 102 (87.2 per cent) were eligible, enrolled, and randomized (51
per trial arm). The majority (95 of 102, 93.1 per cent) completed the
trial. Mean(s.d.) age was 67.2(8.8) years and there were 55 women (58 per
cent). Type of surgery and rates of thoracotomy were not different between
arms. The proportion of patients with duration of hospital stay over 5
days was 3 of 45 (7 per cent) in the MFS arm compared to 12 of 50 (24 per
cent) in the control arm (P = 0.021). Conclusion(s): MFS, a
home-based and wearable technology-enhanced preconditioning program before
lung cancer surgery, decreased the proportion of patients with a prolonged
hospital stay. Registration number: NCT03689634
(http://www.clinicaltrials.gov). Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of BJS Society Ltd. All
rights reserved.

<30>
Accession Number
2026287729
Title
The impact of preoperative malnutrition on postoperative delirium: a
systematic review and meta-analysis.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 55.
Date of Publication: December 2023.
Author
Dong B.; Wang J.; Li P.; Li J.; Liu M.; Zhang H.
Institution
(Dong, Wang, Li, Li, Liu, Zhang) Department of Anesthesiology, Hebei
General Hospital, Shijiazhuang 050051, China
(Dong) Graduate Faculty, Hebei North University, Zhangjiakou 075132, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative delirium (POD) is a common postoperative
complication, characterized by disturbance of attention, perception, and
consciousness within 1 week after surgery, and linked to cognitive
decline, increased mortality, and other serious surgical outcomes. Early
identification and treatment of risk factors for POD could reduce the
occurrence of delirium and the related poor outcomes. Malnutrition as a
possible precipitating factor, defined as the poor anthropometric,
functional, and clinical outcomes of nutrient deficiency, has been
investigated. However, the evidence is controversial. The goal of this
systematic review and meta-analysis was to comprehensively assess the
correlation between preoperative malnutrition and POD. Method(s):
PubMed, Embase, Cochrane Library, and Web of Science were used to search
prospective cohort articles that explored the correlation between
preoperative malnutrition and POD from inception until September 30, 2022.
Two researchers independently conducted the literature selection and data
extraction. The quality of the literature was evaluated according to the
Newcastle-Ottawa scale (NOS). Odds ratios (ORs) and 95% confidence
intervals (CIs) for POD associated with malnutrition relative to normal
nutritional status were calculated. Result(s): Seven prospective
cohort studies qualified for the meta-analysis, which included 2701
patients. The pooled prevalence of preoperative malnutrition was 15.1%
(408/2701), and POD occurred in 428 patients (15.8%). The NOS score was
above 7 points in all 7 studies. Our results demonstrated that the pooled
OR for malnutrition and POD was 2.32 (95% CI 1.62-3.32) based on a
random-effects model. Our subgroup analysis suggested that the
relationship between malnutrition and POD was significant in adults
following noncardiac surgery (OR = 3.04, 95% CI, 1.99-4.62, P < 0.001),
while there was no statistical significance in adults following cardiac
surgery (OR = 1.76, 95% CI, 0.96-3.22, P = 0.07). Additionally, in the
subgroup analysis based on different malnutrition assessment tools (MNA-SF
versus others), a significant association was found in the MNA-SF group
(OR = 3.04, 95% CI, 1.99-4.62, P < 0.001), but not in the others group (OR
= 1.76, 95% CI, 0.96-3.22, P = 0.07). Other subgroup analyses showed that
this association was not significantly affected by evaluation instruments
for POD, location of the study, or quality of the article (all P < 0.05).
 Conclusion(s): Based on the currently available evidence, our results
suggested that preoperative malnutrition was independently associated with
POD in adult surgical patients. Copyright © 2023, The Author(s).

<31>
Accession Number
2025995653
Title
OCOSO2: study protocol for a single-blinded, multicentre, randomised
controlled trial assessing a central venous oxygen saturation-based
goal-directed therapy to reduce postoperative complications in high-risk
patients after elective major surgery.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 659. Date of
Publication: December 2023.
Author
Pastene B.; Bernat M.; Baumstark K.; Bezulier K.; Gricourt Y.; De Guibert
J.-M.; Charvet A.; Colin M.; Leone M.; Zieleskiewicz L.
Institution
(Pastene, Bernat, Bezulier, Charvet, Colin, Leone, Zieleskiewicz)
Department of Anaesthesiology and Intensive Care Unit, Hopital Nord,
Hopitaux Universitaires de Marseille, Marseille, France
(Pastene, Leone, Zieleskiewicz) Centre for Cardiovascular and Nutrition
Research (C2VN), INRA, Aix Marseille University, INSERM, Marseille, France
(Baumstark) Department of Epidemiology and Health Economy, Hopitaux
Universitaires de Marseille, Marseille, France
(Gricourt) Department of Anaesthesiology and Pain Management, Centre
Hospitalo-Universitaire Caremeau, Nimes and Montpellier University 1,
Nimes, France
(De Guibert) Department of Anaesthesiology and Intensive Care Unit,
Institut Paoli Calmettes, Marseille, France
Publisher
BioMed Central Ltd
Abstract
Background: Fluid loading-based goal-directed therapy is a cornerstone of
anaesthesia management in major surgery. Its widespread application has
contributed to a significant improvement in perioperative morbidity and
mortality. In theory, only hypovolemic patients should receive fluid
therapy. However, to achieve such a diagnosis, a surrogate marker of
cardiac output adequacy must be used. Current methods of fluid
loading-based goal-directed therapy do not assess cardiac output adequacy.
Nowadays, new devices make it possible to continuously monitor central
venous oxygen saturation (ScvO<inf>2</inf>) and therefore, to assess the
adequacy of perioperative cardiac output during surgery. In major surgery,
ScvO<inf>2</inf>-based goal-directed therapy can be used to enhance fluid
therapy and improve patient outcomes. Method(s): We designed a
prospective, randomised, single-blinded, multicentre controlled
superiority study with a 1:1 allocation ratio. Patients to be included
will be high-risk major surgery patients (> 50 years old, ASA score > 2,
major intra-abdominal or intra-thoracic surgery > 90 min). Patients in the
control group will undergo standard fluid loading-based goal-directed
therapy, as recommended by the guidelines. Patients in the intervention
group will have ScvO<inf>2</inf>-based goal-directed therapy and receive
fluid loading only if fluid responsiveness and cardiac output inadequacy
are present. The primary outcome will be the Comprehensive Complication
Index on day five postoperatively. Discussion(s): This study is the
first to address the issue of cardiac output adequacy in goal-directed
therapy. Our hypothesis is that cardiac output optimisation during major
surgery achieved by continuous monitoring of the ScvO<inf>2</inf> to guide
fluid therapy will result in a reduction of postoperative complications as
compared with current goal-directed fluid therapy practices. Trial
registration: ClinicalTrials.gov. NCT03828565. Registered on February 4,
2019. Copyright © 2023, BioMed Central Ltd., part of Springer
Nature.

<32>
Accession Number
2024289518
Title
Incidence, risk factors, and clinical sequelae of incomplete stent
apposition after sirolimus-eluting stent.
Source
International Journal of Cardiovascular Imaging. 39(10) (pp 1921-1926),
2023. Date of Publication: October 2023.
Author
Liu P.; Qiu C.-G.; Huang Z.-W.; Zhou Y.
Institution
(Liu, Zhou) 1Department of Cardiology, People's Hospital of Hebi, School
of Medicine, Henan University, Henan, China
(Liu, Qiu, Huang) 2Department of Cardiology, First Affiliated Hospital of
Zhengzhou University, Henan, China
Publisher
Springer Science and Business Media B.V.
Abstract
Incomplete stent apposition has been documented after sirolimus-eluting
stent implantation. However, its clinical sequelae remain controversial.
To identify the incidence and its clinical consequences of ISA, IVUS was
performed on 78 patients. In spite of well apposition immediately after
the deployment, late stent malapposition occurred after 6-months
follow-up. A total of 7 patients who received SES showed ISA. There were
no significant differences in IVUS measurements between patients with or
without ISA. However, there was an increase in external elastic membrane
area in ISA group than non-ISA group (19.69 +/- 3.50 vs. 15.05 +/- 2.56
mm2, P<0.05). There were positive clinical events for ISA cases
at 6-months clinical follow-up. Univariate and multivariable analyses
indicated that hs-CRP, miR-21, and MMP-2 were risk factor for ISA. ISA was
observed in 9% of patients after SES implantation, which was related to
vessel positive remodeling. The incidence of MACEs in patients with ISA
was higher than those without ISA. However, careful long-term follow-up
remains to be clarified. Copyright © 2023, The Author(s), under
exclusive licence to Springer Nature B.V.

<33>
Accession Number
2027953782
Title
Outcomes of transcatheter aortic valve replacement in patients with mitral
annular calcification and concomitant mitral valve dysfunction: A
systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Ahmad S.; Yousaf A.; Ghumman G.M.; Dvalishvili M.; Ahsan M.J.; Dilibe A.;
Reis H.L.; Qavi A.H.; Szerlip M.; Goldsweig A.M.
Institution
(Ahmad, Goldsweig) Division of Cardiovascular Medicine, University of
Nebraska Medical Center, Omaha, NE, United States
(Yousaf) Department of Medicine, McLaren Flint-Michigan State University,
Flint, MI, United States
(Ghumman) Department of Cardiology, St. Vincent Mercy Medical Center,
Toledo, OH, United States
(Ahmad, Dvalishvili, Dilibe) Department of Medicine, East Carolina
University, Greenville, NC, United States
(Ahsan) Department of Cardiology, Iowa Heart Center, Des Moines, IA,
United States
(Reis) William E Laupus Health Sciences Library, East Carolina University,
Greenville, NC, United States
(Qavi) Division of Cardiovascular Medicine, East Carolina Heart Institute,
Greenville, NC, United States
(Szerlip) Department of Cardiology, Baylor Scott and White, The Heart
Hospital Plano, Plano, TX, United States
(Goldsweig) Department of Cardiology, Baystate Medical Center/UMass Chan
Medical School, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Calcific aortic stenosis is the principal indication for
transcatheter aortic valve replacement (TAVR). Comorbid mitral annular
calcification (MAC) is often present in patients undergoing TAVR. Limited
data exist on the impact of MAC on TAVR outcomes. We conducted a
systematic review and meta-analysis to explore the effects of MAC and
concomitant mitral valve dysfunction (MVD) on TAVR outcomes.
 Method(s): A comprehensive literature review was conducted using
PubMed, Embase, Google Scholar, ClinicalTrials.gov, Scopus, and OVID for
studies until March 20, 2023. Using the random-effects Mantel-Haenszel
method, we calculated pooled risk ratios (RRs) and their corresponding 95
% confidence intervals (CIs) for all dichotomous variables.
 Result(s): Six studies comprising 5822 patients (2541 with MAC
[severe MAC (>4 mm thickness) 583; non-severe MAC 1958; 400 with MVD; and
1071 without MVD], 3281 without MAC) met inclusion criteria. At 30 days
and 1 year, no significant differences were observed between the overall
MAC and no MAC groups in terms of mortality, stroke, and permanent
pacemaker implantation. However, MAC with MVD was associated with a higher
risk of all-cause mortality compared to MAC without MVD at 30 days (RR =
3.43, 95 % CI 2.04-5.76, P < 0.00001) and at 1 year (RR = 2.44, 95 % CI
1.85-3.20, P < 0.00001). Moreover, the risk of cardiovascular mortality
was higher in patients with MAC and MVD compared to those with MAC alone
(RR = 2.77, 95 % CI 1.89-4.06, P < 0.00001). Additionally, patients with
severe MAC had a higher risk of major bleeding at 30 days compared to the
non-severe MAC group (RR = 1.33, 95 % CI 1.04-1.69, P = 0.02).
 Conclusion(s): TAVR appears to be safe in patients with non-severe
MAC, but severe MAC is associated with a higher risk of major bleeding and
concomitant MVD increases the mortality risk in patients undergoing
TAVR. Copyright © 2023 Elsevier Inc.

<34>
Accession Number
2027923442
Title
Machine Learning for Predicting Postoperative Atrial Fibrillation After
Cardiac Surgery: A Scoping Review of Current Literature.
Source
American Journal of Cardiology. 209 (pp 66-75), 2023. Date of Publication:
15 Dec 2023.
Author
El-Sherbini A.H.; Shah A.; Cheng R.; Elsebaie A.; Harby A.A.; Redfearn D.;
El-Diasty M.
Institution
(El-Sherbini, Elsebaie) Faculty of Health Sciences, Queen's University,
Kingston, ON, Canada
(Shah, Cheng) School of Medicine, Queen's University, Kingston, ON, Canada
(Harby) The School of Computing, Queen's University, Kingston, ON, Canada
(Redfearn) Division of Cardiology, Department of Medicine, Queen's
University, Kingston, ON, Canada
(El-Diasty) Division of Cardiac Surgery, University Hospitals Cleveland
Medical Center, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) occurs in up to 20% to 55% of
patients who underwent cardiac surgery. Machine learning (ML) has been
increasingly employed in monitoring, screening, and identifying different
cardiovascular clinical conditions. It was proposed that ML may be a
useful tool for predicting POAF after cardiac surgery. An electronic
database search was conducted on Medline, EMBASE, Cochrane, Google
Scholar, and ClinicalTrials.gov to identify primary studies that
investigated the role of ML in predicting POAF after cardiac surgery. A
total of 5,955 citations were subjected to title and abstract screening,
and ultimately 5 studies were included. The reported incidence of POAF
ranged from 21.5% to 37.1%. The studied ML models included: deep learning,
decision trees, logistic regression, support vector machines, gradient
boosting decision tree, gradient-boosted machine, K-nearest neighbors,
neural network, and random forest models. The sensitivity of the reported
ML models ranged from 0.22 to 0.91, the specificity from 0.64 to 0.84, and
the area under the receiver operating characteristic curve from 0.67 to
0.94. Age, gender, left atrial diameter, glomerular filtration rate, and
duration of mechanical ventilation were significant clinical risk factors
for POAF. Limited evidence suggest that machine learning models may play a
role in predicting atrial fibrillation after cardiac surgery because of
their ability to detect different patterns of correlations and the
incorporation of several demographic and clinical variables. However, the
heterogeneity of the included studies and the lack of external validation
are the most important limitations against the routine incorporation of
these models in routine practice. Artificial intelligence, cardiac
surgery, decision tree, deep learning, gradient-boosted machine, gradient
boosting decision tree, k-nearest neighbors, logistic regression, machine
learning, neural network, postoperative atrial fibrillation, postoperative
complications, random forest, risk scores, scoping review, support vector
machine. Copyright © 2023 Elsevier Inc.

<35>
Accession Number
2026236255
Title
Proportional troponin changes and risk for outcomes with intervention
strategies in non-ST-elevation acute coronary syndrome across kidney
function.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Mathew R.O.; Rangaswami J.; Abramov D.; Mahalwar G.; Vellanki S.; Abuazzam
F.; Fraser G.E.; Butler F.M.; Lo K.B.; Herzog C.A.; Shroff G.R.; Sidhu
M.S.; Bangalore S.
Institution
(Mathew) Division of Nephrology, Department of Medicine, Loma Linda VA
Healthcare System, Loma Linda, CA, United States
(Mathew, Abuazzam) Division of Nephrology, Department of Medicine, Loma
Linda University School of Medicine, Loma Linda, CA, United States
(Rangaswami) Division of Nephrology, Department of Medicine, Washington DC
VA Medical Center, Washington, DC, United States
(Rangaswami, Vellanki) Department of Medicine, George Washington
University School of Medicine, Washington, DC, United States
(Abramov, Fraser) Division of Cardiology, Department of Medicine, Loma
Linda University School of Medicine, Loma Linda, CA, United States
(Mahalwar) Department of Medicine, Cleveland Clinic Foundation, Cleveland,
OH, United States
(Fraser, Butler) Center for Nutrition, Healthy Lifestyle, and Disease
Prevention, School of Public Health, Loma Linda University, Loma Linda,
CA, United States
(Fraser, Butler) Adventist Health Study, Loma Linda University, Loma
Linda, CA, United States
(Fraser, Butler) Department of Preventive Medicine, School of Medicine,
Loma Linda University, Loma Linda, CA, United States
(Lo) Department of Medicine, Einstein Medical Center, Philadelphia, PA,
United States
(Lo) Department of Medicine, Sydney Kimmel College of Thomas Jefferson
University, Philadelphia, PA, United States
(Herzog, Shroff) Cardiology Division, Department of Internal Medicine,
Hennepin Healthcare, University of Minnesota, Minneapolis, MN, United
States
(Sidhu) Division of Cardiology, Department of Medicine, Albany Medical
College, Albany, NY, United States
(Bangalore) Division of Cardiology, New York University Grossman School of
Medicine, New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Aims: This analysis evaluates whether proportional serial cardiac troponin
(cTn) change predicts benefit from an early versus delayed invasive, or
conservative treatment strategies across kidney function in
non-ST-elevation acute coronary syndrome (NSTE-ACS). Method(s):
Patients diagnosed with NSTE-ACS in the Veterans Health Administration
between 1999 and 2022 were categorized into terciles (<20%, 20 to <=80%,
>80%) of proportional change in serial cTn. Primary outcome included
mortality or rehospitalization for myocardial infarction at 6 and 12
months, in survivors of index admission. Adjusted hazard ratio (HR) with
95% confidence Intervals (95% confidence interval [CI]) were calculated
for the primary outcome for an early invasive (<=24 h of the index
admission), delayed invasive (>24 h of index admission to 90-days
postdischarge), or a conservative management. Result(s): Chronic
kidney disease (CKD) was more prevalent (45.3%) in the lowest versus 42.2%
and 43% in middle and highest terciles, respectively (p < 0.001). Primary
outcome is more likely for conservative versus early invasive strategy at
6 (HR: 1.44, 95% CI: 1.37-1.50) and 12 months (HR: 1.44, 95% CI:
1.39-1.50). A >80% proportional change demonstrated HR (95% CI): 0.90
(0.83-0.97) and 0.93 (0.88-1.00; p = 0.041) for primary outcome at 6 and
12 months, respectively, when an early versus delayed invasive strategy
was used, across CKD stages. Conclusion(s): Overall, the invasive
strategy was safe and associated with improved outcomes across kidney
function in NSTE-ACS. Additionally, >80% proportional change in serial
troponin in NSTE-ACS is associated with benefit from an early versus a
delayed invasive strategy regardless of kidney function. These findings
deserve confirmation in randomized controlled trials. Copyright ©
2023 The Authors. Catheterization and Cardiovascular Interventions
published by Wiley Periodicals LLC.

<36>
Accession Number
2026076146
Title
Cold-stored platelets for acute bleeding in cardiac surgical patients: a
narrative review.
Source
Canadian Journal of Anesthesia. 70(10) (pp 1682-1700), 2023. Date of
Publication: October 2023.
Author
Lu J.; Karkouti K.; Peer M.; Englesakis M.; Spinella P.C.; Apelseth T.O.;
Scorer T.G.; Kahr W.H.A.; McVey M.; Rao V.; Abrahamyan L.; Lieberman L.;
Mewhort H.; Devine D.V.; Callum J.; Bartoszko J.
Institution
(Lu) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Karkouti, Peer) Department of Anesthesia and Pain Management, Sinai
Health System, Women's College Hospital, University Health Network,
Toronto General Hospital, Toronto, ON, Canada
(Karkouti, McVey, Bartoszko) Department of Anesthesiology and Pain
Medicine, University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(Karkouti) Interdepartmental Division of Critical Care Medicine,
University of Toronto, Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(Spinella) Department of Critical Care Medicine, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
(Spinella) Department of Surgery, University of Pittsburgh, Pittsburgh,
PA, United States
(Apelseth) Department of Immunology and Transfusion Medicine, Haukeland
University Hospital, University of Bergen, Bergen, Norway
(Apelseth) Norwegian Armed Forces Joint Medical Services, Norwegian Armed
Forces, Oslo, Norway
(Scorer) Centre of Defence Pathology, Royal Centre for Defence Medicine,
Birmingham, United Kingdom
(Scorer) School of Cellular and Molecular Medicine, University of Bristol,
Bristol, United Kingdom
(Kahr) Division of Haematology/Oncology, The Hospital for Sick Children
(SickKids), Toronto, ON, Canada
(Kahr) Cell Biology Program, SickKids Research Institute, Toronto, ON,
Canada
(Kahr) Departments of Paediatrics and Biochemistry, University of Toronto,
Toronto, ON, Canada
(McVey) Department of Anesthesia and Pain Medicine, The Hospital for Sick
Children (SickKids), Toronto, ON, Canada
(McVey) Department of Physics, Toronto Metropolitan University, Toronto,
ON, Canada
(Rao) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University of Toronto, Toronto, ON, Canada
(Abrahamyan) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Abrahamyan) Toronto Health Economics and Technology Assessment (THETA)
Collaborative, Toronto General Research Institute, Toronto, ON, Canada
(Lieberman) Department of Laboratory Medicine and Pathobiology, University
of Toronto, Toronto, ON, Canada
(Mewhort) Department of Surgery, School of Medicine, Queen's University,
Kingston, ON, Canada
(Devine) Canadian Blood Services, Vancouver, BC, Canada
(Devine) Department of Pathology and Laboratory Medicine, The University
of British Columbia, Vancouver, BC, Canada
(Callum) Quality in Utilization, Education and Safety in Transfusion
Research Program, University of Toronto, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, School of
Medicine, Queen's University, Kingston, ON, Canada
(Callum) Kingston Health Sciences Centre, Kingston General Hospital,
Kingston, ON, Canada
(Bartoszko) Department of Anesthesia and Pain Management, Sinai Health
System, Women's College Hospital, University Health Network, Toronto
General Hospital, 200 Elizabeth Street, 3EN-464, Toronto, ON M5G 2C4,
Canada
Publisher
Springer
Abstract
Purpose: Cold-stored platelets (CSP) are an increasingly active topic of
international research. They are maintained at 1-6 degreeC, in contrast to
standard room-temperature platelets (RTP) kept at 20-24 degreeC. Recent
evidence suggests that CSP have superior hemostatic properties compared
with RTP. This narrative review explores the application of CSP in adult
cardiac surgery, summarizes the preclinical and clinical evidence for
their use, and highlights recent research. Source: A targeted search of
MEDLINE and other databases up to 24 February 2022 was conducted. Search
terms combined concepts such as cardiac surgery, blood, platelet, and
cold-stored. Searches of trial registries ClinicalTrials.gov and WHO
International Clinical Trials Registry Platform were included. Articles
were included if they described adult surgical patients as their
population of interest and an association between CSP and clinical
outcomes. References of included articles were hand searched. Principal
findings: When platelets are stored at 1-6 degreeC, their metabolic rate
is slowed, preserving hemostatic function for increased storage duration.
Cold-stored platelets have superior adhesion characteristics under
physiologic shear conditions, and similar or superior aggregation
responses to physiologic agonists. Cold-stored platelets undergo
structural, metabolic, and molecular changes which appear to "prime" them
for hemostatic activity. While preliminary, clinical evidence supports the
conduct of trials comparing CSP with RTP for patients with
platelet-related bleeding, such as those undergoing cardiac surgery.
 Conclusion(s): Cold-stored platelets may have several advantages over
RTP, including increased hemostatic capacity, extended shelf-life, and
reduced risk of bacterial contamination. Large clinical trials are needed
to establish their potential role in the treatment of acutely bleeding
patients. Copyright © 2023, Canadian Anesthesiologists' Society.

<37>
Accession Number
2024235558
Title
Influenza vaccination and cardiovascular events in patients with ischaemic
heart disease and heart failure: A meta-analysis.
Source
European Journal of Heart Failure. 25(9) (pp 1685-1692), 2023. Date of
Publication: September 2023.
Author
Modin D.; Lassen M.C.H.; Claggett B.; Johansen N.D.; Keshtkar-Jahromi M.;
Skaarup K.G.; Nealon J.; Udell J.A.; Vardeny O.; Solomon S.D.; Gislason
G.; Biering-Sorensen T.
Institution
(Modin, Lassen, Johansen, Skaarup, Gislason, Biering-Sorensen) Department
of Cardiology, Copenhagen University Hospital - Herlev & Gentofte,
Copenhagen, Denmark
(Claggett, Solomon) Cardiovascular Medicine Division, Department of
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Keshtkar-Jahromi) Division of Infectious Diseases, Department of
Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Nealon) School of Public Health, Li Ka Shing Faculty of Medicine, The
University of Hong Kong, Hong Kong
(Udell) Cardiovascular Division, Department of Medicine, Women's College
Hospital, Toronto, ON, Canada
(Vardeny) Department of Medicine, University of Minnesota, Minneapolis,
MN, United States
(Gislason) Institute of Clinical Medicine, Faculty of Health Sciences,
University of Copenhagen, Copenhagen, Denmark
(Biering-Sorensen) Department of Biomedical Sciences, Faculty of Health
and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Randomized controlled trials (RCTs) enrolling patients at high
cardiovascular risk have found that influenza vaccination may reduce the
incidence of cardiovascular events. We performed an updated meta-analysis
assessing the effect of influenza vaccination on the incidence of
cardiovascular events in patients with ischaemic heart disease or heart
failure. Methods and Results: We searched PubMed, EMBASE and other
sources to identify RCTs examining the effect of influenza vaccination on
the incidence of cardiovascular events assessed as efficacy outcomes in
patients with ischaemic heart disease or heart failure. Eligible studies
followed patients for at least one influenza season, defined as a minimum
duration of 6 months. The primary endpoint was a composite of
cardiovascular death, acute coronary syndrome, stent thrombosis or
coronary revascularization, stroke or heart failure hospitalization. The
secondary endpoints were cardiovascular death and all-cause death. Two
investigators independently identified and extracted data from studies.
Results were compared using hazard ratios (HRs) in both random effects and
fixed effects models. We included five peer-reviewed and one non
peer-reviewed RCTs for a total of 9340 patients. Five trials included
patients with ischaemic heart disease (n = 4211) and one trial included
patients with heart failure (n = 5129). Influenza vaccination was
associated with a reduced incidence of the primary composite endpoint
(random effects HR [rHR] 0.74, 95% confidence interval [CI] 0.63-0.88, p <
0.001, I2 = 52%), cardiovascular death (rHR 0.63, 95% CI
0.42-0.95, p = 0.028, I2 = 58%) and all-cause death (rHR 0.72,
95% CI 0.54-0.95, p = 0.0227, I2 = 52%). Results were similar
when non peer-reviewed data were excluded. Conclusion(s): In this
meta-analysis of available RCTs in patients at high cardiovascular risk,
influenza vaccination was associated with a reduced incidence of
cardiovascular events, cardiovascular death and all-cause death as
compared to placebo or no treatment. Copyright © 2023 European
Society of Cardiology.

<38>
[Use Link to view the full text]
Accession Number
642559609
Title
Enhanced CT-guided adrenal venous sampling versus traditional X-ray-guided
adrenal venous sampling in patients with primary aldosteronism.
Source
Medicine. 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, First Affiliated Hospital, Fujian
Medical University, Fuzhou, China
(Chen) Department of Clinical Nutrition, National Regional Medical Center,
Fujian Medical University, Binhai Campus of The First Affiliated Hospital,
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, First Affiliated Hospital, Fujian
Medical University, Fuzhou, China
(Chen) Department of Endocrinology, National Regional Medical Center,
Fujian Medical University, Binhai Campus of The First Affiliated Hospital,
Fuzhou, China
(Chen) Diabetes Research Institute of Fujian Province, First Affiliated
Hospital, Fujian Medical University, Fuzhou, China
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 the Author(s). Published by Wolters Kluwer Health, Inc.

<39>
Accession Number
642550537
Title
Effects of interventions targeting the systemic inflammatory response to
cardiac surgery on clinical outcomes in adults.
Source
Cochrane Database of Systematic Reviews. 2023(10) (no pagination), 2023.
Article Number: CD013584. Date of Publication: 24 Oct 2023.
Author
Abbasciano R.G.; Tomassini S.; Roman M.A.; Rizzello A.; Pathak S.; Ramzi
J.; Lucarelli C.; Layton G.; Butt A.; Lai F.; Kumar T.; Wozniak M.J.;
Murphy G.J.
Institution
(Abbasciano, Roman, Rizzello, Pathak, Butt, Lai, Wozniak, Murphy)
Department of Cardiovascular Sciences, University of Leicester, Leicester,
United Kingdom
(Tomassini) University of Warwick, Warwick, United Kingdom
(Ramzi) Leicester Medical School, University of Leicester, Leicester,
United Kingdom
(Lucarelli) Department of Cardiac Surgery, University of Verona, Verona,
Italy
(Layton) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Kumar) Leicester Clinical Trials Unit, University of Leicester,
Leicester, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Organ injury is a common and severe complication of cardiac
surgery that contributes to the majority of deaths. There are no effective
treatment or prevention strategies. It has been suggested that innate
immune system activation may have a causal role in organ injury. A wide
range of organ protection interventions targeting the innate immune
response have been evaluated in randomised controlled trials (RCTs) in
adult cardiac surgery patients, with inconsistent results in terms of
effectiveness. Objective(s): The aim of the review was to summarise
the results of RCTs of organ protection interventions targeting the innate
immune response in adult cardiac surgery. The review considered whether
the interventions had a treatment effect on inflammation, important
clinical outcomes, or both. Search Method(s): CENTRAL, MEDLINE,
Embase, conference proceedings and two trial registers were searched on
October 2022 together with reference checking to identify additional
studies. Selection Criteria: RCTs comparing organ protection
interventions targeting the innate immune response versus placebo or no
treatment in adult patients undergoing cardiac surgery where the treatment
effect on innate immune activation and on clinical outcomes of interest
were reported. Data Collection and Analysis: Searches, study
selection, quality assessment, and data extractions were performed
independently by pairs of authors. The primary inflammation outcomes were
peak IL-6 and IL-8 concentrations in blood post-surgery. The primary
clinical outcome was in-hospital or 30-day mortality. Treatment effects
were expressed as risk ratios (RR) and standardised mean difference (SMD)
with 95% confidence intervals (CI). Meta-analyses were performed using
random effects models, and heterogeneity was assessed using I2.
 Main Result(s): A total of 40,255 participants from 328 RCTs were
included in the synthesis. The effects of treatments on IL-6 (SMD -0.77,
95% CI -0.97 to -0.58, I2 = 92%) and IL-8 (SMD -0.92, 95% CI
-1.20 to -0.65, I2 = 91%) were unclear due to heterogeneity.
Heterogeneity for inflammation outcomes persisted across multiple
sensitivity and moderator analyses. The pooled treatment effect for
in-hospital or 30-day mortality was RR 0.78, 95% CI 0.68 to 0.91,
I2 = 0%, suggesting a significant clinical benefit. There was
little or no treatment effect on mortality when analyses were restricted
to studies at low risk of bias. Post hoc analyses failed to demonstrate
consistent treatment effects on inflammation and clinical outcomes. Levels
of certainty for pooled treatment effects on the primary outcomes were
very low. Authors' conclusions: A systematic review of RCTs of organ
protection interventions targeting innate immune system activation did not
resolve uncertainty as to the effectiveness of these treatments, or the
role of innate immunity in organ injury following cardiac
surgery. Copyright © 2023 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<40>
Accession Number
642535357
Title
Effect of remote ischemic preconditioning on lung function after surgery
under general anesthesia: a systematic review and meta-analysis.
Source
Scientific reports. 13(1) (pp 17720), 2023. Date of Publication: 18 Oct
2023.
Author
Kashiwagi S.; Mihara T.; Yokoi A.; Yokoyama C.; Nakajima D.; Goto T.
Institution
(Kashiwagi, Goto) Department of Anesthesiology, Yokohama City University
Graduate School of Medicine, Yokohama, Japan
(Kashiwagi) Department of Anesthesiology, Yokohama City University
Hospital, Kanazawa-Ku, 3-9 Fukuura 236-0004, Japan
(Mihara) Department of Health Data Science, Yokohama City University
Graduate School of Data Science, Yokohama, Japan
(Yokoi) Department of Anesthesiology and Intensive Care Medicine, Nagoya
City University Graduate School of Medical Sciences, Nagoya, Japan
(Yokoyama) Department of Anesthesia, Chiba Children's Hospital, Chiba,
Japan
(Nakajima) Department of Anesthesiology, Yokohama City University Medical
Center, Japan
Abstract
Remote ischemic preconditioning (RIPC) protects organs from
ischemia-reperfusion injury. Recent trials showed that RIPC improved gas
exchange in patients undergoing lung or cardiac surgery. We performed a
systematic search to identify randomized controlled trials involving RIPC
in surgery under general anesthesia. The primary outcome was the PaO2/FIO2
(P/F) ratio at 24 h after surgery. Secondary outcomes were A-a DO2, the
respiratory index, duration of postoperative mechanical ventilation (MV),
incidence of acute respiratory distress syndrome (ARDS), and serum
cytokine levels. The analyses included 71 trials comprising 7854 patients.
Patients with RIPC showed higher P/F ratio than controls (mean difference
[MD] 36.6, 95% confidence interval (CI) 12.8 to 60.4, I2=69%). The cause
of heterogeneity was not identified by the subgroup analysis. Similarly,
A-a DO2 (MD 15.2, 95% CI - 29.7 to - 0.6, I2=87%) and respiratory index
(MD - 0.17, 95% CI - 0.34 to - 0.01, I2=94%) were lower in the RIPC group.
Additionally, the RIPC group was weaned from MV earlier (MD - 0.9 h, 95%
CI - 1.4 to - 0.4, I2=78%). Furthermore, the incidence of ARDS was lower
in the RIPC group (relative risk 0.73, 95% CI 0.60 to 0.89, I2=0%). Serum
TNFalpha was lower in the RIPC group (SMD - 0.6, 95%CI - 1.0 to - 0.3
I2=87%). No significant difference was observed in interleukin-6, 8 and
10. Our meta-analysis suggested that RIPC improved oxygenation after
surgery under general anesthesia.Clinical trial number: This study
protocol was registered in the University Hospital Medical Information
Network (registration number: UMIN000030918),
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000035
305. Copyright © 2023. Springer Nature Limited.

<41>
Accession Number
642533873
Title
Systematic review and meta-analysis of topical tranexamic acid in spine
surgery.
Source
Neurosurgical focus. 55(4) (pp E18), 2023. Date of Publication: 01 Oct
2023.
Author
Izima C.; Sampath S.G.; Tang A.J.; Ambati V.S.; Chou D.; Chan A.K.
Institution
(Izima, Sampath, Tang, Chou, Chan) Department of Neurological Surgery,
Columbia University Vagelos College of Physicians and Surgeons, NY, United
States
(Ambati) 2School of Medicine, University of California, San Francisco,
California; and
(Chou, Chan) 3The Och Spine Hospital at NewYork-Presbyterian, NY, United
States
Abstract
OBJECTIVE: Tranexamic acid (TXA) is an antifibrinolytic drug associated
with reduced blood loss in a range of surgical specialties, including
neurosurgery, orthopedic surgery, and cardiac surgery. Concerns about
venous thromboembolism and seizures from intravenous (IV) TXA have led to
increased use of topical TXA. Given the relative scarcity of the
literature on topical TXA compared with that on IV TXA within
neurosurgery, the authors aimed to conduct a systematic review and
meta-analysis on the safety, efficacy, and optimal administration of
topical TXA in a wide range of spinal procedures and pathologies.
 METHOD(S): The PRISMA guidelines, Cochrane risk of bias tool, and
Newcastle-Ottawa Scale were used to extract randomized controlled trials
and high-quality case-control and cross-sectional/cohort studies (adult
studies only) from PubMed, Web of Science, Cochrane Library, and Embase
published between 2016 and 2023. Studies were analyzed by two independent
reviewers for variables including dosage, TXA administration route, type
of spine procedure, blood loss, adverse events including thromboembolism
and infection, postoperative hemoglobin level, and hospitalization length.
Pooled analysis comparing intraoperative and postoperative blood loss,
postoperative hemoglobin levels, and hospitalization length of stay on the
basis of route of TXA administration was conducted. RESULT(S): Four
cohort studies, 1 cross-sectional study, 1 case-control study, and 12
randomized controlled trials, together involving 2045 patients, were
included. The most common route of topical TXA administration was via TXA
in saline solution. Other routes of topical TXA included retrograde
injection and TXA-soaked Gelfoam. In pooled analysis, topical TXA
significantly reduced visible blood loss (standardized mean difference
[SMD] -0.22, 95% CI -0.45 to -0.00001), postoperative blood loss (SMD
-1.63, 95% CI -2.03 to -1.22), and length of hospital stay (SMD -1.02, 95%
CI -1.42 to -0.61), as well as higher postoperative hemoglobin (SMD 0.59,
95% CI 0.34-0.83), compared with non-TXA controls. No significant
differences in outcomes were found between topical and IV TXA or between
combined (topical and IV) and IV TXA. Thromboembolism and infection rates
did not significantly differ between any TXA administration group and
non-TXA controls. CONCLUSION(S): In pooled analyses, topical TXA was
associated with decreased perioperative blood loss in a wide range of
scenarios, including cervical spine surgery and thoracolumbar trauma, as
well as in patients with a thromboembolic history.

<42>
[Use Link to view the full text]
Accession Number
642501067
Title
Comparing the effectiveness of single-lumen high-frequency positive
pressure ventilation with double-lumen endobronchial tube for the
anesthesia management of endoscopic thoracic sympathetic blockade surgery.
Source
Medicine. 102(41) (pp e35315), 2023. Date of Publication: 13 Oct 2023.
Author
Akaslan I.; Koc S.
Institution
(Akaslan) Department of Thoracic Surgery, Biruni University, Istanbul,
Turkey
(Koc) Department of Anesthesiology and Reanimation, Biruni University,
Istanbul, Turkey
Abstract
OBJECTIVES: In this trial, we aimed to compare anesthetic effectiveness of
single lumen tube (SLT) for tracheal intubation with high-frequency
positive pressure ventilation (HFPPV) versus classic double lumen tube
(DLT) for tracheal intubation in endoscopic thoracic sympathetic blockade
surgery. DESIGN: This was a prospective randomized controlled clinical
study. SETTING: The study was single-centered and conducted in a
university hospital. PARTICIPANTS: There were 135 endoscopic thoracic
sympathetic blockade patients in this study. INTERVENTIONS: The patients
were randomly allocated either to DLT (n = 67) or SLT (n = 68) groups. In
SLT group, the ventilator setting was kept with frequencies that range
from 1 to 1.8 Hz (60-110/min). Data regarding anesthesia duration, surgery
duration, difficult intraoperative lung deflation, postoperative
atelectasis, postoperative pain, postoperative pneumothorax were recorded
and compared. All patients were operated by a single experienced surgeon
under general anesthesia provided by the same anesthesia team.
MEASUREMENTS AND MAIN RESULTS: Both groups were age and gender matched.
Among all recorded variables, only anesthesia time was found to be close
to statistical significance (P = .059, favoring single lumen). All other
parameters were found to be similar between groups. (P < .05).
 CONCLUSION(S): We reported that DLT and single lumen tracheal
intubation were equally effective for lung deflation during surgery, and
SLT with HFPPV ventilation mode during endoscopic thoracic sympathetic
blockade surgery provided the surgeon with an adequate and clean workspace
with shorter onset of anesthesia. We may suggest the HFPPV technique for
uncomplicated surgery groups or where sufficient conditions for DLT cannot
be provided in the operating room. Copyright © 2023 the
Author(s). Published by Wolters Kluwer Health, Inc.

<43>
Accession Number
642500711
Title
Hemolysis and cardiopulmonary bypass: meta-analysis and systematic review
of contributing factors.
Source
Journal of cardiothoracic surgery. 18(1) (pp 291), 2023. Date of
Publication: 13 Oct 2023.
Author
Bhirowo Y.P.; Raksawardana Y.K.; Setianto B.Y.; Sudadi S.; Tandean T.N.;
Zaharo A.F.; Ramsi I.F.; Kusumawardani H.T.; Triyono T.
Institution
(Bhirowo, Sudadi) Department of Anesthesiology and Intensive Care, Faculty
of Medicine, Public Health and Nursing, Dr. Sardjito General Hospital,
Universitas Gadjah MadaJl. Kesehatan No. 1 ,Sekip Utara, Yogyakarta 55281,
Indonesia
(Raksawardana, Tandean, Ramsi, Kusumawardani) Faculty of Medicine, Public
Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(Setianto) Department of Cardiology, Faculty of Medicine, Public Health
and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada,
Yogyakarta, Indonesia
(Zaharo) Department of Ophthalmology, Faculty of Medicine, Public Health
and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada,
Yogyakarta, Indonesia
(Triyono) Department of Clinical Pathology and Laboratory Medicine,
Faculty of Medicine, Public Health and Nursing, Dr. Sardjito General
Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
Abstract
BACKGROUND: The use of cardiopulmonary bypass (CPB) is almost inevitable
in cardiac surgery. However, it can cause complications, including
hemolysis. Until now, there have not been any standards for reducing
hemolysis from CPB. Therefore, this systematic review was conducted to
determine the factors that increase or reduce hemolysis in the use of CPB.
 METHOD(S): Keywords Earches (cardiac surgery AND cardiopulmonary
bypass AND hemolysis) were done on PubMed databases and Cochrane CENTRAL
from 1990-2021 for published randomized controlled trials (RCTs) that
studied interventions on CPB, in cardiac surgery patients, and measured
hemolysis as one of the outcomes. Studies involving patients with
preoperative hematological disorders, prosthetic valves, preoperative use
of intra-aortic balloon pumps and extracorporeal circulation, emergency
and minimally invasive surgery are excluded RESULTS: The search yielded 64
studies that met the inclusion criteria, which involved a total of 3,434
patients. The most common surgery was coronary revascularization (75%).
Out of 64 studies, 33 divided into 7 analyses. Remaining 31 studies were
synthesized qualitatively. Significant decreases were found in centrifugal
vs roller pumps for PFHb (p=0.0006) and Hp (p<0.0001) outcomes, separated
vs combined suctioned blood (p=0.003), CPB alternatives vs conventional
CPB (p<0.0001), and mini extracorporeal circulation (MiniECC) vs
conventional CPB for LDH (p=0.0008). Significant increases were found in
pulsatility (p=0.03) and vacuum-assisted venous drainage (VAVD) vs
gravity-assisted venous drainage (GAVD) (p=0.002). CONCLUSION(S): The
review shows that hemolysis could be caused by several factors and efforts
have been made to reduce it, combining significant efforts could be
beneficial. However, this review has limitations, such as heterogeneity
due to no standards available for conducting CPB. Therefore, further
research with standardized guidelines for CPB is needed to yield more
comparable studies. Meta-analyses with more specific parameters should be
done to minimize heterogeneity. Copyright © 2023. BioMed Central
Ltd., part of Springer Nature.

<44>
Accession Number
642127931
Title
Cardiac Magnetic Resonance Imaging Versus Computed Tomography to Guide
Transcatheter Aortic Valve Replacement: A Randomized, Open-Label,
Noninferiority Trial.
Source
Circulation. 148(16) (pp 1220-1230), 2023. Date of Publication: 17 Oct
2023.
Author
Reindl M.; Lechner I.; Holzknecht M.; Tiller C.; Fink P.; Oberhollenzer
F.; von der Emde S.; Pamminger M.; Troger F.; Kremser C.; Lassnig E.;
Danninger K.; Binder R.K.; Ulmer H.; Brenner C.; Klug G.; Bauer A.;
Metzler B.; Mayr A.; Reinstadler S.J.
Institution
(Reindl, Lechner, Holzknecht, Tiller, Fink, Oberhollenzer, von der Emde,
Brenner, Klug, Bauer, Metzler, Reinstadler) University Clinic of Internal
Medicine III, Cardiology and Angiology (M.R., I.L., M.H., C.T., P.F.,
F.O., S.v.d.E., C.B., G.K., A.B., B.M., S.J.R.), Medical University of
Innsbruck, Austria
(Pamminger, Troger, Kremser, Mayr) University Clinic of Radiology (M.P.,
F.T., C.K., Medical University of Innsbruck, Austria
(Lasnig, Danninger, Binder) Department of Cardiology and Intensive Care
(E.L., University Teaching Hospital Klinikum Wels-Grieskrichen, Wels,
Austria
(Ulmer) Institute of Medical Statistics and Informatics (H.U.), Medical
University of Innsbruck, Austria
Abstract
BACKGROUND: Computed tomography (CT) is recommended for guiding
transcatheter aortic valve replacement (TAVR). However, a sizable
proportion of TAVR candidates have chronic kidney disease, in whom the use
of iodinated contrast media is a limitation. Cardiac magnetic resonance
imaging (CMR) is a promising alternative, but randomized data comparing
the effectiveness of CMR-guided versus CT-guided TAVR are lacking.
 METHOD(S): An investigator-initiated, prospective, randomized,
open-label, noninferiority trial was conducted at 2 Austrian heart
centers. Patients evaluated for TAVR according to the inclusion criteria
(severe symptomatic aortic stenosis) and exclusion criteria
(contraindication to CMR, CT, or TAVR, a life expectancy <1 year, or
chronic kidney disease level 4 or 5) were randomized (1:1) to undergo CMR
or CT guiding. The primary outcome was defined according to the Valve
Academic Research Consortium-2 definition of implantation success at
discharge, including absence of procedural mortality, correct positioning
of a single prosthetic valve, and proper prosthetic valve performance.
Noninferiority was assessed using a hybrid modified
intention-to-treat/per-protocol approach on the basis of an absolute risk
difference margin of 9%. RESULT(S): Between September 11, 2017, and
December 16, 2022, 380 candidates for TAVR were randomized to CMR-guided
(191 patients) or CT-guided (189 patients) TAVR planning. Of these, 138
patients (72.3%) in the CMR-guided group and 129 patients (68.3%) in the
CT-guided group eventually underwent TAVR (modified intention-to-treat
cohort). Of these 267, 19 patients had protocol deviations, resulting in a
per-protocol cohort of 248 patients (121 CMR-guided, 127 CT-guided). In
the modified intention-to-treat cohort, implantation success was achieved
in 129 patients (93.5%) in the CMR group and in 117 patients (90.7%) in
the CT group (between-group difference, 2.8% [90% CI, -2.7% to 8.2%];
P<0.01 for noninferiority). In the per-protocol cohort (n=248), the
between-group difference was 2.0% (90% CI, -3.8% to 7.8%; P<0.01 for
noninferiority). CONCLUSION(S): CMR-guided TAVR was noninferior to
CT-guided TAVR in terms of device implantation success. CMR can therefore
be considered as an alternative for TAVR planning. REGISTRATION: URL:
https://www. CLINICALTRIALS: gov; Unique identifier: NCT03831087.

<45>
Accession Number
2026423207
Title
Endothelial Microparticles: Markers of Inflammatory Response After
Sutureless Valve Implantation.
Source
Brazilian Journal of Cardiovascular Surgery. 39(1) (no pagination), 2024.
Article Number: e20230111. Date of Publication: 2024.
Author
de Oliveira J.L.R.; Dos Santos M.A.; Timerman A.
Institution
(de Oliveira, Dos Santos) Department of Cardiovascular Surgery, Instituto
Dante Pazzanese de Cardiologia, Universidade de Sao Paulo, Sao Paulo, Sao
Paulo, Brazil
(Dos Santos) Department of Cardiovascular Surgery, Hospital do Coracao,
Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
(Timerman) Department of Clinical Division, Instituto Dante Pazzanese de
Cardiologia, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Systemic inflammatory response syndrome (SIRS) is related to
increased circulating endothelial microparticles (EMP). Objective(s):
The aim of this study was to compare the plasma concentration of EMP
between patients undergoing aortic valve replacement with conventional
bioprosthesis implantation and PercevalTM S (LivaNova) and to evaluate its
impact on the inflammatory response in the short-term follow-up.
 Method(s): This is a randomized clinical trial with 24 patients
submitted to isolated aortic valve replacement divided into two groups:
PercevalTM S (Group P) and conventional bioprostheses (Group C). Incidence
of severe SIRS (three or more criteria) in the first 48 hours
postoperatively, EMP release profile, interleukins (IL) 6 and 8,
C-reactive protein, and procalcitonin were analyzed pre-and
postoperatively at 24 hours and three months. Result(s): There were
24 patients (12 in each group), mean age was 69.92+/-5.17 years, 83.33%
were female, the incidence of severe SIRS was 66.7% and 50% in groups C
and P, respectively (P=0.68), and EMP showed a significant increase in the
24-hour postoperative period (P<=0.001) and subsequent decrease in the
three-month postoperative period (P<=0.001), returning to baseline levels.
For IL-6 and IL-8, there was a greater increase in group C at 24 hours
postoperatively (P=.0.02 and P<0.001). Conclusion(s): The incidence
of severe SIRS was similar in both groups, with significantly higher
levels of IL-6 and IL-8, at the 24-hour postoperative period, in group C,
however with higher levels of EMP in group P, and subsequent return to
baseline levels at the three-month postoperative period in both
groups. Copyright © 2024, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<46>
Accession Number
2028060102
Title
Comparisons of procedural characteristics and clinical outcomes between
SMARTTOUCH SURROUNDFLOW catheter and other catheters for atrial
fibrillation radiofrequency catheter ablation: A systematic literature
review.
Source
BMJ Open. 13(10) (no pagination), 2023. Article Number: e075579. Date of
Publication: 17 Oct 2023.
Author
Li J.; Zhou G.; Li X.; Huang S.; Lin H.; Lin S.; Tan L.; Chen W.; Huang
X.; Wang Y.
Institution
(Li, Zhou, Li, Huang, Lin, Lin, Huang, Wang) Department of Cardioloqy,
Southern Medical University Nanfang Hospital, Guangdong, Guangzhou, China
(Tan) Changsha Normin Health Technology Ltd, Changsha, China
(Chen) Normin Health Consulting Ltd, Mississauga, ON, Canada
(Chen) THETA Collaborative, University of Toronto, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Background SMARTTOUCH SURROUNDFLOW (STSF) catheter is the new generation
of SMARTTOUCH (ST) catheter with an upgraded irrigation system for
radiofrequency catheter ablation (RFCA) in patients with atrial
fibrillation (AF). Methods This systematic literature review searched the
major English and Chinese bibliographic databases from 2016 to 2022 for
any original clinical studies assessing the STSF catheter for RFCA in AF
patients. Meta-analysis with a random effects model was used for evidence
synthesis. Results Pooled outcomes from 19 included studies indicated that
STSF catheter was associated with a significantly shorter procedure time
(weighted mean difference (WMD): -17.4 min, p<0.001), shorter ablation
time (WMD: -6.6 min, p<0.001) and lower catheter irrigation fluid volume
(WMD: -492.7 mL, p<0.001) than ST catheter. Pooled outcomes from four
included studies with paroxysmal AF patients reported that using the STSF
catheter for RFCA was associated with a significantly shorter ablation
time (WMD: -5.7 min, p<0.001) and a lower risk of 1-year postablation
arrhythmia recurrence (rate ratio: 0.504, p<0.001) than the SURROUNDFLOW
(SF) catheter. Significant reductions in procedure time and ablation time
associated with the STSF catheter were also reported in the other four
studies using non-ST/SF catheters as the control. Overall complications of
STSF catheter and control catheters were comparable. Conclusions Using the
STSF catheter was superior to using the ST catheter to conduct RFCA for AF
by significantly reducing procedure time, ablation time, fluoroscopy time
and irrigation fluid volume. The superiority of the STSF catheter over the
SF catheter and other non-ST/SF catheters for RFCA needs further
confirmation. Copyright © Author(s) (or their employer(s)) 2023.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<47>
Accession Number
2026410231
Title
Survival of Heart Transplant Patients with Chagas' Disease Under Different
Antiproliferative Immunosuppressive Regimens.
Source
Arquivos Brasileiros de Cardiologia. 120(10) (no pagination), 2023.
Article Number: e20230133. Date of Publication: 2023.
Author
Furquim S.R.; Galbiati L.C.; Avila M.S.; Marcondes-Braga F.G.; Fukushima
J.; Mangini S.; Seguro L.F.B.D.C.; de Campos I.W.; Strabelli T.M.V.;
Barone F.; de Paulo A.R.S.A.; Ohe L.A.; Galante M.C.; Gaiotto F.A.; Bacal
F.
Institution
(Furquim, Galbiati, Avila, Marcondes-Braga, Fukushima, Mangini, Seguro, de
Campos, Strabelli, Barone, de Paulo, Ohe, Galante, Gaiotto, Bacal)
Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, SP, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: Chagas' disease (CD) is an important cause of heart
transplantation (HT). The main obstacle is Chagas' disease reactivation
(CDR), usually associated to high doses of immunosuppressants. Previous
studies have suggested an association of mycophenolate mofetil with
increased CDR. However, mortality predictors are unknown.
 Objective(s): To identify mortality risk factors in heart transplant
patients with CD and the impact of antiproliferative regimen on survival.
 Method(s): Retrospective study with CD patients who underwent HT
between January 2004 and September 2020, under immunosuppression protocol
that prioritized azathioprine and change to mycophenolate mofetil in case
of rejection. We performed univariate regression to identify mortality
predictors; and compared survival, rejection and evidence of CDR between
who received azathioprine, mycophenolate mofetil and those who changed
from azathioprine to mycophenolate mofetil after discharge ("Change"
group). A p-value < 0.05 was considered statistically significant.
 Result(s): Eighty-five patients were included, 54.1% men, median age
49 (39-57) years, and 91.8% were given priority in waiting list. Nineteen
(22.4%) used azathioprine, 37 (43.5%) mycophenolate mofetil and 29 (34.1%)
switched therapy; survival was not different between groups, 2.9 (1.6-5.0)
x 2.9 (1.8-4.8) x 4.2 (2.0-5.0) years, respectively; p=0.4. There was no
difference in rejection (42%, 73% and 59% respectively; p=0.08) or in CDR
(T. cruzi positive by endomyocardial biopsy 5% x 11% x 7%; p=0.7;
benznidazole use 58% x 65% x 69%; p=0.8; positive PCR for T. cruzi 20% x
68% x 42% respectively; p=0.1) rates. Conclusion(s): This
retrospective study did not show difference in survival in heart
transplant patients with CD receiving different antiproliferative
regimens. Mycophenolate mofetil was not associated with statistically
higher rates of CDR or graft rejection in this cohort. New randomized
clinical trials are necessary to address this issue. Copyright ©
2023, Sociedade Brasileira de Cardiologia. All rights reserved.

<48>
Accession Number
2028023949
Title
Bicuspid Aortic Valve Disease: Classifications, Treatments, and Emerging
Transcatheter Paradigms.
Source
Structural Heart. (no pagination), 2023. Article Number: 100227. Date of
Publication: 2023.
Author
Kalra A.; Das R.; Alkhalil M.; Dykun I.; Candreva A.; Jarral O.; Rehman
S.M.; Majmundar M.; Patel K.N.; Rodes-Cabau J.; Reardon M.J.; Puri R.
Institution
(Kalra) Department of Cardiology, Franciscan Health, Lafayette, IN, United
States
(Das, Alkhalil) Department of Cardiothoracic Services, Freeman Hospital,
Newcastle-upon-Tyne, United Kingdom
(Dykun, Puri) Department of Cardiovascular Medicine, Heart, Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Candreva) Department of Cardiology, University Heart Centre, University
Hospital Zurich, Zurich, Switzerland
(Jarral) Department of Cardiothoracic Surgery, St. Thomas Hospital,
London, United Kingdom
(Rehman) Department of Cardiothoracic Surgery, OLV Hospital, Aalst,
Belgium
(Majmundar) Department of Cardiology, University of Kansas Medical Center,
Kansas City, KS, United States
(Patel) Department of Cardiology, West Virginia University Hospital,
Morgantown, WV, United States
(Rodes-Cabau) Department of Interventional Cardiology, Quebec Heart & Lung
Institute, Quebec City, Canada
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist
Hospital, Houston, TX, United States
Publisher
Cardiovascular Research Foundation
Abstract
Bicuspid aortic valve (BAV) is a common congenital valvular malformation,
which may lead to early aortic valve disease and bicuspid-associated
aortopathy. A novel BAV classification system was recently proposed to
coincide with transcatheter aortic valve replacement being increasingly
considered in younger patients with symptomatic BAV, with good clinical
results, yet without randomized trial evidence. Procedural technique,
along with clinical outcomes, have considerably improved in BAV patients
compared with tricuspid aortic stenosis patients undergoing transcatheter
aortic valve replacement. The present review summarizes the novel BAV
classification systems and examines contemporary surgical and
transcatheter approaches. Copyright © 2023 The Author(s)

<49>
Accession Number
642596093
Title
Surgical management of atrial fibrillation in patients undergoing cardiac
surgery: a systematic review of clinical practice guidelines and
recommendations.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2023. Date of Publication: 23 Oct 2023.
Author
Kumar N.S.; Khanji M.Y.; Patel K.P.; Ricci F.; Providencia R.; Chahal A.;
Sohaib A.; Awad W.I.
Institution
(Kumar, Khanji, Patel, Awad) Barts Heart Centre, St. Bartholomew's
Hospital, London, United Kingdom
(Kumar) National Medical Research Association, London, United Kingdom
(Khanji) Newham University Hospital, Barts Health NHS Trust, London,
United Kingdom
(Khanji) NIHR Barts Biomedical Research Centre, William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
(Patel) Institute of Cardiovascular Sciences, University College London,
United Kingdom
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
G.d'Annunzio University of Chieti-Pescara, Chieti, Italy
(Providencia) Department of Cardiac Electrophysiology, Barts Heart Centre,
Barts Health NHS Trust, St. Bartholomew's Hospital, London, United Kingdom
(Chahal) Division of Cardiology, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Sohaib) NHLI, Imperial College London, London, United Kingdom
(Awad) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London, London, United
Kingdom
(Awad) University of South Wales, Cardiff, United Kingdom
Abstract
AIMS: Surgical ablation of atrial fibrillation (AF) has been demonstrated
to be a safe procedure conducted concomitantly alongside cardiac surgery.
However, there are conflicting guideline recommendations surrounding
indications for surgical ablation. We conducted a systematic review of
current recommendations on concomitant surgical AF ablation. METHODS AND
RESULTS: We identified publications from MEDLINE and EMBASE between
January 2011 and December 2022 and additionally searched Guideline
libraries and websites of relevant organisations in accordance with PRISMA
guidelines. Of 895 studies screened, 4 were rigorously developed (AGREE-II
> 50%) and included. All guidelines agreed on the definitions of
paroxysmal, persistent, and longstanding AF based on duration and
refraction to current treatment modalities. In the Australia-New Zealand
(CSANZ) and European (EACTS) guidelines, opportunistic screening for
patients > 65 years is recommended. The EACTS recommends systematic
screening for those aged > 75 or at high stroke risk (Class IIa, Level B).
However, this was not recommended by AHA or STS guidelines. All guidelines
identified surgical AF ablation during concomitant cardiac surgery as safe
and recommended for consideration by a Heart Team with notable variation
in recommendation strength and the specific indication (3 guidelines fail
to specify any indication for surgery). Only the STS recommended left
atrial appendage occlusion (LAAO) alongside surgical ablation (Class IIA,
Level C). CONCLUSION(S): Disagreements exist in recommendations for
specific indications for concomitant AF ablation and LAAO, with the
decision subject to Heart Team assessment. Further evidence is needed to
develop recommendations for specific indications for concomitant AF
procedures and guidelines need to be made congruent. Copyright ©
The Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<50>
Accession Number
642595838
Title
Sensorineural hearing loss after cardiac surgery: a systematic review.
Source
ANZ journal of surgery. (no pagination), 2023. Date of Publication: 23
Oct 2023.
Author
Daniel J.; Glynatsis J.M.; Kovoor J.G.; Stretton B.; Bacchi S.; Ovenden
C.D.; To M.-S.; Goh R.; Hewitt J.N.; Sahota R.S.; Chan J.C.Y.; Ramponi F.;
Krishnan G.; Gupta A.K.
Institution
(Daniel, Glynatsis, Kovoor, Stretton, Bacchi, Ovenden, Chan, Krishnan,
Gupta) Discipline of Surgery, University of Adelaide, Adelaide, SA,
Australia
(Daniel, Kovoor, Stretton, Ovenden, Goh, Hewitt, Sahota, Ramponi) Royal
Adelaide Hospital, Adelaide, SA, Australia
(Glynatsis, Bacchi, To) Flinders Medical Centre, Adelaide, SA, Australia
(Kovoor) Queen Elizabeth Hospital, Adelaide, SA, Australia
(Chan) NYU Langone, New York City, NY, United States
(Gupta) Gold Coast University Hospital, Southport, QLD, Australia
Abstract
BACKGROUND: Sensorineural hearing loss (SNHL) may occur following cardiac
surgery. Although preventing post-operative complications is vitally
important in cardiac surgery, there are few guidelines regarding this
issue. This review aimed to characterize SNHL after cardiac surgery.
 METHOD(S): This systematic review was registered on PROSPERO and
conducted in accordance with PRISMA guidelines. A systematic search of the
PubMed, Embase and Cochrane Library were conducted from inception.
Eligibility determination, data extraction and methodological quality
analysis were conducted in duplicate. RESULT(S): There were 23
studies included in the review. In the adult population, there were six
cohort studies, which included 36 cases of hearing loss in a total of 7135
patients (5.05 cases per 1000 operations). In seven cohort studies
including paediatric patients, there were 88 cases of hearing loss in a
total of 1342 operations. The majority of cases of hearing loss were mild
in the adult population (56.6%). In the paediatric population 59.2% of
hearing loss cases had moderate or worse hearing loss. The hearing loss
most often affected the higher frequencies, over 6000Hz. There have been
studies indicating an association between hearing loss and extracorporeal
circulation, but cases have also occurred without this intervention.
 CONCLUSION(S): SNHL is a rare but potentially serious complication
after cardiac surgery. This hearing loss affects both paediatric and adult
populations and may have significant long-term impacts. Further research
is required, particularly with respect to the consideration of screening
for SNHL in children after cardiac surgery. Copyright © 2023 The
Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia,
Ltd on behalf of Royal Australasian College of Surgeons.

<51>
Accession Number
642595418
Title
Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years.
Source
The New England journal of medicine. (no pagination), 2023. Date of
Publication: 24 Oct 2023.
Author
Mack M.J.; Leon M.B.; Thourani V.H.; Pibarot P.; Hahn R.T.; Genereux P.;
Kodali S.K.; Kapadia S.R.; Cohen D.J.; Pocock S.J.; Lu M.; White R.;
Szerlip M.; Ternacle J.; Malaisrie S.C.; Herrmann H.C.; Szeto W.Y.; Russo
M.J.; Babaliaros V.; Smith C.R.; Blanke P.; Webb J.G.; Makkar R.
Institution
(Mack, Leon, Thourani, Pibarot, Hahn, Genereux, Kodali, Kapadia, Cohen,
Pocock, Lu, White, Szerlip, Ternacle, Malaisrie, Herrmann, Szeto, Russo,
Babaliaros, Smith, Blanke, Webb, Makkar) From Baylor Scott and White
Health, Plano, TX (M.J.M., M.S.); Columbia University (M.B.L., R.T.H.,
S.H.K., C.R.S.) and the Cardiovascular Research Foundation (M.B.L.,
R.T.H., S.H.K., D.J.C., C.R.S.), New York, and St. Francis Hospital and
Heart Center, Roslyn (D.J.C.) - all in New York; Marcus Heart Valve
Center, Piedmont Heart Institute (V.H.T.), and Emory University (V.B.) -
both in Atlanta; Laval University, Quebec, QC (P.P.), and St. Paul's
Hospital, University of British Columbia, Vancouver (P.B., J.G.W.) - both
in Canada; Morristown Medical Center, Morristown (P.G.), and Robert Wood
Johnson University Hospital, New Brunswick (M.J.R.) - both in New Jersey;
Cleveland Clinic, Cleveland (S.R.K.); London School of Hygiene and
Tropical Medicine, London (S.J.P.); Edwards Lifesciences, Irvine (M.L.,
R.W.), and Cedars-Sinai Medical Center, Los Angeles (R.M.) - both in
California; Heart Valve Unit, Haut-Leveque Cardiological Hospital,
Bordeaux University, Pessac, France (J.T.); Northwestern University,
Chicago (S.C.M.); and the University of Pennsylvania, Philadelphia
(H.C.H., W.Y.S.)
Abstract
BACKGROUND: A previous analysis in this trial showed that among patients
with severe, symptomatic aortic stenosis who were at low surgical risk,
the rate of the composite end point of death, stroke, or rehospitalization
at 1 year was significantly lower with transcatheter aortic-valve
replacement (TAVR) than with surgical aortic-valve replacement.
Longer-term outcomes are unknown. METHOD(S): We randomly assigned
patients with severe, symptomatic aortic stenosis and low surgical risk to
undergo either TAVR or surgery. The first primary end point was a
composite of death, stroke, or rehospitalization related to the valve, the
procedure, or heart failure. The second primary end point was a
hierarchical composite that included death, disabling stroke, nondisabling
stroke, and the number of rehospitalization days, analyzed with the use of
a win ratio analysis. Clinical, echocardiographic, and health-status
outcomes were assessed through 5 years. RESULT(S): A total of 1000
patients underwent randomization: 503 patients were assigned to undergo
TAVR, and 497 to undergo surgery. A component of the first primary end
point occurred in 111 of 496 patients in the TAVR group and in 117 of 454
patients in the surgery group (Kaplan-Meier estimates, 22.8% in the TAVR
group and 27.2% in the surgery group; difference, -4.3 percentage points;
95% confidence interval [CI], -9.9 to 1.3; P=0.07). The win ratio for the
second primary end point was 1.17 (95% CI, 0.90 to 1.51; P=0.25). The
Kaplan-Meier estimates for the components of the first primary end point
were as follows: death, 10.0% in the TAVR group and 8.2% in the surgery
group; stroke, 5.8% and 6.4%, respectively; and rehospitalization, 13.7%
and 17.4%. The hemodynamic performance of the valve, assessed according to
the mean (+/-SD) valve gradient, was 12.8+/-6.5 mm Hg in the TAVR group
and 11.7+/-5.6 mm Hg in the surgery group. Bioprosthetic-valve failure
occurred in 3.3% of the patients in the TAVR group and in 3.8% of those in
the surgery group. CONCLUSION(S): Among low-risk patients with
severe, symptomatic aortic stenosis who underwent TAVR or surgery, there
was no significant between-group difference in the two primary composite
outcomes. (Funded by Edwards Lifesciences; PARTNER 3 ClinicalTrials.gov
number, NCT02675114.). Copyright © 2023 Massachusetts Medical
Society.

<52>
Accession Number
642594251
Title
Skeletonized Versus Pedicled Harvesting of Internal Mammary Artery: A
Systematic Review and Meta-Analysis.
Source
Current problems in cardiology. (pp 102160), 2023. Date of Publication:
21 Oct 2023.
Author
Shafiq A.; Maniya M.T.; Duhan S.; Jamil A.; Hirji S.A.
Institution
(Shafiq, Jamil) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Maniya) Department of Medicine, Ziauddin Medical University, Karachi,
Pakistan
(Duhan) Department of Medicine, Sinai Hospital of Baltimore, MD, United
States
(Hirji) Division of Thoracic and Cardiac Surgery, Department of Surgery,
Brigham and Women's Hospital, Harvard Medical School, Mass, Boston, United
States
Abstract
There are two recognized internal mammary artery (IMA) harvesting
techniques during coronary artery bypass grafting (CABG): pedicled and
skeletonized. This systematic review and meta-analysis sought to compare
the clinical outcomes of the two harvesting techniques. A comprehensive
electronic literature search of PubMed, Scopus, and Embase was conducted
from inception till June 2023. Thirty-one studies with a total of 13005
patients met our inclusion criteria. The results from the included studies
were presented as weighted mean difference (WMD) with its relevant
standard deviation (SD) for continuous variables, while Odds Ratio (OR)
was used for dichotomous variables. A 95% confidence interval (CI) was
used, and the results were pooled using a random effects model. The
skeletonized IMA demonstrated a significantly reduced risk of sternal
wound infection (SWI) compared to the pedicled IMA (OR=0.45 [95% CI,
0.32-0.66]; p=0.0001). The conduit length used was significantly longer in
the skeletonized IMA (WMD -2.48, 95% CI, [-3.75, -1.20], P=0.0001) and a
significantly higher postoperative flow rate was observed while using
skeletonization compared to the pedicled harvesting (WMD -13.11, 95% CI,
[-22.52, -3.70], P=0.006). However, no significant difference was seen in
mortality between the two techniques (OR=1.19 [95% CI, 1.00-1.41];
p=0.05). Pedicled harvesting demonstrated significantly reduced incidents
of MI (OR=1.38 [95% CI, 1.13-1.69]; p=0.002), while significant results in
graft patency were observed favoring pedicled harvesting over
skeletonization (OR=0.63 [95% CI, 0.40-0.98]; p=0.04). Copyright
© 2023. Published by Elsevier Inc.

<53>
Accession Number
642593530
Title
Literature Review of Handheld Articulating Instruments in Minimally
Invasive Surgery.
Source
Journal of laparoendoscopic & advanced surgical techniques. Part A. (no
pagination), 2023. Date of Publication: 23 Oct 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
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.

<54>
Accession Number
642591465
Title
Delirium in older patients given propofol or sevoflurane anaesthesia for
major cancer surgery: a multicentre randomised trial. Comment on Br J
Anaesth 2023; 131: 253-65.
Source
British journal of anaesthesia. (no pagination), 2023. Date of
Publication: 20 Oct 2023.
Author
O'Reilly D.; Naughton R.; Lavelle A.
Institution
(O'Reilly, Naughton, Lavelle) Department of Anaesthesiology, St. James's
Hospital, Dublin, Ireland

<55>
Accession Number
2027915763
Title
Perioperative prophylactic corticosteroids for cardiac surgery in
children: A systematic review and meta-analysis.
Source
American Heart Journal. 266 (pp 159-167), 2023. Date of Publication:
December 2023.
Author
Cheema H.A.; Ahmad A.H.; Khan A.A.; Khalid A.; Shahid A.; Hermis A.H.;
Syed A.; Bansal N.; Yuki K.; Ghelani S.J.; Dani S.S.
Institution
(Cheema, Shahid) Department of Cardiology, King Edward Medical University,
Lahore, Pakistan
(Cheema, Khalid, Shahid) Department of Medicine, King Edward Medical
University, Lahore, Pakistan
(Khan, Ahmad, Khan) Department of Surgery, King Edward Medical University,
Lahore, Pakistan
(Hermis) Al-Mustaqbal University College, Babylon, Hillah, Iraq
(Syed) Medical College of Wisconsin, Milwaukee, WI, United States
(Bansal) Division of Pediatric Cardiology, Mount Sinai Kravis Children's
Hospital, New York, NY, United States
(Yuki) Cardiac Anesthesia Division, Department of Anesthesiology, Critical
Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United
States
(Yuki) Department of Anaesthesia and Immunology, Harvard Medical School,
Boston, MA, United States
(Ghelani) Department of Cardiology, Boston Children's Hospital, Boston,
MA, United States
(Ghelani) Department of Pediatrics, Harvard Medical School, Boston, MA,
United States
(Dani) Division of Cardiovascular Medicine, Beth Israel Lahey Health,
Lahey Hospital and Medical Center, Burlington, MA, United States
Publisher
Elsevier Inc.
Abstract
Objective: Perioperative corticosteroids have been used for pediatric
cardiac surgery for decades, but the underlying evidence is conflicting.
We aimed to investigate the efficacy and safety of perioperative
prophylactic corticosteroids in pediatric heart surgeries. Method(s):
We searched electronic databases until March 2023 to retrieve all
randomized controlled trials (RCTs) that administered perioperative
prophylactic corticosteroids to children undergoing heart surgery. We used
RevMan 5.4 to pool risk ratios (RRs) and mean differences (MDs).
 Result(s): A total of 12 RCTs (2,209 patients) were included in our
review. Corticosteroids administration was associated with a
nonsignificant reduction in all-cause mortality (RR 0.62; 95% CI:
0.37-1.02, I2 = 0%; moderate certainty); however, it was
associated with a lower duration of mechanical ventilation (MV) (MD -0.63
days; 95% CI: -1.16 to -0.09 days, I2 = 41%; high certainty).
Corticosteroids did not affect the length of ICU and hospital stay but
significantly reduced the incidence of postoperative low cardiac output
syndrome (LCOS) (RR 0.76; 95% CI: 0.60-0.96, I2 = 0%; moderate
certainty) and reoperation (RR 0.37; 95% CI: 0.19-0.74, I2 =
0%; moderate certainty). There was no increase in adverse events except a
higher risk of hyperglycemia and postoperative insulin use.
 Conclusion(s): The use of perioperative corticosteroids in pediatric
heart surgeries is associated with a trend toward reduced all-cause
mortality without attaining statistical significance. Corticosteroids
reduced MV duration, and probably decrease the incidence of LCOS, and
reoperations. The choice of corticosteroid agent and dose is highly
variable and further larger studies may help determine the ideal agent,
dose, and patient population for this prophylactic therapy. Copyright
© 2023 Elsevier Inc.

<56>
Accession Number
2027912493
Title
Rationale and design of non-antithrombotic therapy after transcatheter
aortic valve implantation (NAPT) trial.
Source
Contemporary Clinical Trials. 134 (no pagination), 2023. Article Number:
107358. Date of Publication: November 2023.
Author
Inohara T.; Otsuka T.; Watanabe Y.; Shirai S.; Tada N.; Yamanaka F.; Ueno
H.; Ohno Y.; Tabata M.; Suzuyama H.; Asami M.; Yamawaki M.; Izumo M.;
Yamasaki K.; Nishina H.; Fuku Y.; Mizutani K.; Yashima F.; Yamamoto M.;
Hayashida K.
Institution
(Inohara, Hayashida) Department of Cardiology, Keio University of School
of Medicine, Tokyo, Japan
(Otsuka) Department of Hygiene and Public Health, Nippon Medical School,
Tokyo, Japan
(Otsuka) Center for Clinical Research, Nippon Medical School Hospital,
Tokyo, Japan
(Watanabe) Department of Cardiology, Teikyo University School of Medicine,
Tokyo, Japan
(Shirai) Department of Cardiology, Kokura Memorial Hospital, Kitakyushu,
Japan
(Tada) Department of Cardiology, Sendai Kosei Hospital, Miyagi, Japan
(Yamanaka) Department of Cardiology, Shonan Kamakura General Hospital,
Kanagawa, Japan
(Ueno) Second Department of Internal Medicine, Toyama University Hospital,
Toyama, Japan
(Ohno) Department of Cardiology, Tokai University, Isehara, Japan
(Tabata) Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa
Medical Center, Chiba, Japan
(Suzuyama) Department of Cardiology, Saiseikai Kumamoto Hospital,
Kumamoto, Japan
(Asami) Department of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
(Yamawaki) Department of Cardiology, Saiseikai Yokohamashi City Eastern
Hospital, Kanagawa, Japan
(Izumo) Department of Cardiology, St. Marianna University Hospital,
Kanagawa, Japan
(Yamasaki) Department of Cardiology, Sapporo Higashi Tokushukai Hospital,
Hokkaido, Japan
(Nishina) Department of Cardiology, Tsukuba Medical Center, Ibaraki, Japan
(Fuku) Department of Cardiology, Kurashiki Central Hospital, Okayama,
Japan
(Mizutani) Department of Cardiology, Kindai University Hospital, Osaka,
Japan
(Yashima) Department of Cardiology, Saiseikai Utsunomiya Hospital,
Tochigi, Japan
(Yamamoto) Department of Cardiology, Toyohashi Heart Center, Toyohashi,
Japan
(Yamamoto) Department of Cardiology, Gifu Heart Center, Gifu, Japan
(Yamamoto) Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
Publisher
Elsevier Inc.
Abstract
Background: Despite the wide implementation of transcatheter aortic valve
implantation (TAVI), the optimal antithrombotic therapy after TAVI has not
been established yet. Owing to the accumulating evidence supporting the
efficacy and safety of single antiplatelet therapy (SAPT) over dual
antiplatelet therapy, the latest guideline recommends life-long SAPT.
However, there is scarce evidence supporting SAPT compared with
non-antithrombotic therapy. Given the vulnerability of patients undergoing
TAVI in terms of high bleeding risk, the benefit of SAPT may be canceled
out by its potential increased bleeding risk. Study design and objectives:
Non-antithrombotic Therapy After Transcatheter Aortic Valve Implantation
(NAPT) Trial is a prospective, randomized controlled, open-label blinded
endpoint multicenter trial conducted in Japan, testing the non-inferiority
of non-antithrombotic therapy compared with aspirin monotherapy in
patients who underwent TAVI and had no indications for long-term oral
anticoagulation therapy (OAC). Patients who successfully underwent
trans-femoral TAVI for severe aortic stenosis with either
balloon-expandable or self-expandable valves are eligible for inclusion.
Key exclusion criteria are (i) occurrence of perioperative complications
(ii) indications of taking antithrombotic drugs for other reasons; (iii)
eGFR <30 ml/min/1.73 m2 or hemodialysis or peritoneal dialysis. A total of
360 patients will be randomized (1:1) to aspirin monotherapy vs.
non-antithrombotic therapy. The primary outcome is a composite of
all-cause mortality, myocardial infarction, stroke, and bleeding. All
bleeding events based on the Valve Academic Research Consortium 3 are
included as a component of the primary outcome. Conclusion(s): The
NAPT trial will determine the non-inferiority of a non-antithrombotic
therapy compared with aspirin monotherapy after TAVI. Copyright ©
2023

<57>
Accession Number
2025730612
Title
Clinical Outcomes Following Bifurcation Techniques for Percutaneous
Coronary Intervention.
Source
Journal of Clinical Medicine. 12(18) (no pagination), 2023. Article
Number: 5916. Date of Publication: September 2023.
Author
Krittanawong C.; Virk H.U.H.; Qadeer Y.K.; Irshad U.; Wang Z.; Alam M.;
Sharma S.
Institution
(Krittanawong) Cardiology Division, NYU Langone Health and NYU School of
Medicine, New York, NY 10016, United States
(Virk) Harrington Heart & Vascular Institute, University Hospitals
Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
44195, United States
(Qadeer, Alam) Section of Cardiology, Baylor College of Medicine, Texas
Heart Institute, Houston, TX 77030, United States
(Irshad) Department of Medicine, Rawalpindi Medical University, Rawalpindi
46000, Pakistan
(Wang) Robert D. and Patricia E. Kern Center for the Science of Health
Care Delivery, Mayo Clinic, Rochester, MN 55905, United States
(Wang) Division of Health Care Policy and Research, Department of Health
Sciences Research, Mayo Clinic, Rochester, MN 55905, United States
(Sharma) Cardiac Catheterization Laboratory of the Cardiovascular
Institute, Mount Sinai Hospital, New York, NY 10029, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)

<58>
Accession Number
2025248170
Title
Efficacy and Safety of Moderate-Intensity Continuous Training on the
Improvement of Cardiopulmonary Function in Patients After Transcatheter
Aortic Valve Replacement (ENERGY): A Randomized Controlled Trial.
Source
Journal of the American Medical Directors Association. 24(11) (pp
1783-1790.e2), 2023. Date of Publication: November 2023.
Author
Hu Q.; Li Y.-S.; Ren Q.; Liang Y.-C.; Zhang J.; Wang Y.-X.; Wang C.-L.;
Hong T.-L.; Wang S.-Y.; Zhang Y.; Zhang Q.-Y.; Han Y.-L.
Institution
(Hu, Li, Ren, Liang, Zhang, Wang, Wang, Hong, Wang, Zhang, Zhang, Han)
Department of Cardiology, General Hospital of Northern Theater Command,
Shenyang, China
(Hu) Department of Cardiology, Air Force Hospital of Western Theater
Command, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Objectives: To investigate the effect of moderate-intensity continuous
training (MICT) on the improvement of cardiopulmonary function for
patients undergoing transcatheter aortic valve replacement (TAVR).
 Design(s): Randomized controlled study. Setting and Participants:
Between August 20, 2021, and February 28, 2022, a total of 66 patients
after TAVR were screened for inclusion and randomly divided into the MICT
and control groups at a ratio of 1:1. MICT was scheduled 3 times per week
for 3 months in the intervention group. Patients in the control group
received one-time advice on physical activity according to the current
guideline. Method(s): The primary endpoint was the 3-month change in
peak oxygen consumption (peak VO<inf>2</inf>) assessed by cardiopulmonary
exercise testing. The secondary endpoints included the 3-month change in
6-minute walk test (6MWT), the 12-Item Short Form Health Survey (SF-12),
New York Heart Association (NYHA) class, echocardiographic parameters, and
laboratory parameters. Result(s): After 3 months, the change in peak
VO<inf>2</inf> was higher in the MICT group than that in the control group
(1.63 mL/kg/min, 95% CI 0.58-2.67, P = .003). Change in 6MWT (21.55 m, 95%
CI 0.38-42.71, P = .046) was higher in the MICT group compared with the
control group. A significant change in favor of MICT was also observed for
low-density lipoprotein cholesterol (-0.62 mmol/L, 95% CI -1.00 to -0.23,
P = .002). However, there were no significant changes in other
echocardiographic indices, laboratory parameters, and SF-12 between the 2
groups (all P > .05). Conclusions and Implications: MICT had a positive
effect on the cardiopulmonary function and physical capacity of patients
after TAVR. Copyright © 2023 AMDA - The Society for Post-Acute
and Long-Term Care Medicine

<59>
Accession Number
2024862259
Title
Infective Endocarditis Risk with Melody versus Sapien Valves Following
Transcatheter Pulmonary Valve Implantation: A Systematic Review and
Meta-Analysis of Prospective Cohort Studies.
Source
Journal of Clinical Medicine. 12(15) (no pagination), 2023. Article
Number: 4886. Date of Publication: August 2023.
Author
Machanahalli Balakrishna A.; Dilsaver D.B.; Aboeata A.; Gowda R.M.;
Goldsweig A.M.; Vallabhajosyula S.; Anderson J.H.; Simard T.; Jhand A.
Institution
(Machanahalli Balakrishna) Department of Internal Medicine, Creighton
University School of Medicine, Omaha, NE 68124, United States
(Dilsaver) Department of Medicine, Division of Clinical Research and
Public Health, Creighton University School of Medicine, Omaha, NE 68124,
United States
(Aboeata) Division of Cardiovascular Medicine, Department of Medicine,
Creighton University School of Medicine, Omaha, NE 68124, United States
(Gowda) Department of Interventional Cardiology, Icahn School of Medicine
at Mount Sinai Morningside and Beth Israel, New York, NY 10029, United
States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical
Center, Springfield, MA 01199, United States
(Goldsweig) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE 68105, United States
(Vallabhajosyula) Section of Cardiovascular Medicine, Department of
Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
27101, United States
(Anderson, Simard, Jhand) Department of Cardiovascular Medicine, Mayo
Clinic, Rochester, MN 55905, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Transcatheter pulmonary valve implantation (TPVI) is an
effective non-surgical treatment method for patients with right ventricle
outflow tract dysfunction. The Medtronic Melody and the Edwards Sapien are
the two valves approved for use in TPVI. Since TPVI patients are typically
younger, even a modest annual incidence of infective endocarditis (IE) is
significant. Several previous studies have shown a growing risk of IE
after TPVI. There is uncertainty regarding the overall incidence of IE and
differences in the risk of IE between the valves. Method(s): A
systematic search was conducted in the MEDLINE, EMBASE, PubMed, and
Cochrane databases from inception to 1 January 2023 using the search terms
'pulmonary valve implantation', 'TPVI', or 'PPVI'. The primary outcome was
the pooled incidence of IE following TPVI in Melody and Sapien valves and
the difference in incidence between Sapien and Melody valves. Fixed effect
and random effect models were used depending on the valve. Meta-regression
with random effects was conducted to test the difference in the incidence
of IE between the two valves. Result(s): A total of 22 studies
(including 10 Melody valve studies, 8 Sapien valve studies, and 4 studies
that included both valves (572 patients that used the Sapien valve and
1395 patients that used the Melody valve)) were used for the final
analysis. Zero IE incidence following TPVI was reported by eight studies
(66.7%) that utilized Sapien valves compared to two studies (14.3%) that
utilized Melody valves. The pooled incidence of IE following TPVI with
Sapien valves was 2.1% (95% CI: 0.9% to 5.13%) compared to 8.5% (95% CI:
4.8% to 15.2%) following TPVI with Melody valves. Results of
meta-regression indicated that the Sapien valve had a 79.6% (95% CI: 24.2%
to 94.4%, p = 0.019; R2 = 34.4) lower risk of IE incidence
compared to the Melody valve. Conclusion(s): The risk of IE following
TPVI differs significantly. A prudent valve choice in favor of Sapien
valves to lower the risk of post-TPVI endocarditis may be
beneficial. Copyright © 2023 by the authors.

<60>
Accession Number
2022207793
Title
A prospective randomized controlled study to assess the effectiveness of
super FIXSORB WAVE for sternal stabilization after sternotomy.
Source
General Thoracic and Cardiovascular Surgery. 71(11) (pp 665-673), 2023.
Date of Publication: November 2023.
Author
Oishi K.; Arai H.; Kuroki H.; Fujioka T.; Tomita M.; Tasaki D.; Oi K.;
Nagaoka E.; Fujiwara T.; Takeshita M.; Yoshizaki T.; Someya T.; Mizuno T.
Institution
(Oishi, Arai, Oi, Nagaoka, Fujiwara, Takeshita, Mizuno) Department of
Cardiovascular Surgery, Graduate School of Medical and Dental Science,
Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo
113-8519, Japan
(Kuroki, Someya) Department of Thoracic Surgery, Ome Municipal General
Hospital, Tokyo, Japan
(Fujioka) Department of Diagnostic Radiology, Tokyo Medical and Dental
University, Tokyo, Japan
(Tomita) School of Data Science, Yokohama City University, Kanagawa, Japan
(Tasaki, Yoshizaki) Department of Cardiovascular Surgery, Musashino Red
Cross Hospital, Tokyo, Japan
Publisher
Springer
Abstract
Background: We developed a new sternal fixation device, Super FIXSORB
WAVE, a corrugated plate made of u-HA/PLLA, to improve sternal
stability after sternotomy. This present study aimed to evaluate the new
device clinically. Method(s): This prospective, single-blinded,
multicenter trial randomized 69 patients to either wire cerclage only
(group C, n = 30) or wire cerclage plus Super FIXSORB WAVE
(group W, n = 39). The primary endpoint was a degree of sternal
displacement at six months. Displacement of the sternal halves in the
anteroposterior and lateral directions was measured using computed
tomography horizontal section images at the third costal and fourth
intercostal levels. The secondary endpoints were sternal pain and
quality-of-life over 6 months. Result(s): Group W showed
significantly reduced sternal anteroposterior displacement at both the
third costal (0 [0-1.9] mm vs. 1.1 [0-2.1] mm; P = 0.014) and fourth
intercostal (0 [0-1.0] mm) vs. 1.0 [0-1.8] mm; P = 0.015) levels than
group C. In group W, lateral displacement was suppressed without a
significant increase from 2 weeks to 6 months, while it increased in group
C. There was no significant difference in postoperative sternal pain and
quality-of-life between the two groups. No adverse events, such as
infection, inflammation, or foreign body reaction, were observed with this
device. Conclusion(s): Using Super FIXSORB WAVE, sternal
displacement was significantly suppressed in both the anteroposterior and
lateral directions. The use of this device results in safe and easy
sternal reinforcement without any adverse events, and sternal healing can
be accelerated. Clinical trial registry number: This study was registered
in the Japan Registry of Clinical Trials (February 21, 2019;
jRCTs032180146). Copyright © 2023, The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<61>
Accession Number
2018282158
Title
Remote ischemic preconditioning in patients undergoing cardiac surgery
with six ischemic cycles.
Source
Perfusion (United Kingdom). 38(7) (pp 1418-1427), 2023. Date of
Publication: October 2023.
Author
Boning A.; Flicker L.; Rodriguez-Montesinos J.; Cabrera-Fuentes H.;
Preissner K.T.; Niemann B.; Taghiyev Z.T.
Institution
(Boning, Flicker, Niemann, Taghiyev) Department of Cardiovascular Surgery,
University Hospital Giessen, Giessen, Germany
(Rodriguez-Montesinos, Cabrera-Fuentes) Department of Biochemistry, Justus
Liebig University, Giessen, Germany
(Preissner) Department of Cardiology, Medical Faculty, Kerckhoff Heart
Research Institute, Justus Liebig University, Giessen, Germany
Publisher
SAGE Publications Ltd
Abstract
Background: We have previously shown that remote ischemic preconditioning
(RIP), which utilizes in part the extracellular RNA (eRNA)/RNase1 pathway,
can induce ischemic tolerance in humans. Because RIP has thus far been
tested only with four cycles of extremity ischemia/reperfusion, we
investigated the influence of six cycles of ischemia on the eRNA/RNase1
pathway in cardiac patients. Method(s): Six cycles of RIP were
carried out in 14 patients undergoing cardiac surgery. Blood samples were
taken at 13 timepoints during surgery and at three timepoints after
surgery for determining serum levels of RNase1, eRNA, and TNF-alpha.
Trans-cardiac gradients between the myocardial blood inflow and outflow
were calculated. Result(s): Between the fourth and the sixth RIP
cycles, a noticeable increase in the levels of eRNA (fourth: 151.6 (SD:
44.2) ng/ml vs sixth: 181.8 (SD: 87.5) ng/ml, p =.071), and a significant
increase in RNase1 (fourth: 151.1 (SD: 42.6) U/ml vs sixth: 175.3 (SD:
41.2) U/ml, p =.001), were noted. The trans-cardiac gradients of RNase1
and eRNA before and after ischemia were not significantly different (p
=.158 and p =.221; p =.397 and p =.683, respectively). Likewise, the
trans-cardiac gradient of TNF-alpha was similar before and after ischemia.
During the first 48 h after the surgery, RNase1 activity rose
significantly and exceeded baseline values (135.7 (SD: 40.6) U/ml before
and 279.2 (SD: 85.6) U/ml after surgery, p =.001) as did eRNA levels
(148,6 (SD: 35.4) ng/ml before and 396.5 (SD: 154.5) ng/ml after surgery,
p =.005), whereas TNF-alpha levels decreased significantly (91.7 (SD:
47.7) pg/ml before and 35.7 (SD: 36.9) pg/ml after surgery, p =.001).
 Conclusion(s): Six RIP cycles increased the RNase1 levels
significantly above those observed with four cycles. More clinical data
are required to show whether this translates into a benefit for
patients. Copyright © The Author(s) 2022.

<62>
Accession Number
2026316864
Title
An Unusual Case of a Double Tricuspid and Mitral Valves Infective
Endocarditis Complicated by Multiple Septic Embolisms Secondary to an
Atrial Septal Defect: A Case Report and Review of Literature.
Source
Infectious Disease Reports. 15(5) (pp 494-503), 2023. Date of Publication:
October 2023.
Author
Monari C.; Molinari D.; Cornelli A.; Alessio L.; Coppolino F.; Barbareschi
C.; De Pascalis S.; Torella M.; Cimmino G.; De Feo M.; Coppola N.;
Formisano T.
Institution
(Monari, Cornelli, Alessio, De Pascalis, Coppola) Infectious Diseases
Unit, Department of Mental Health and Public Medicine, Section of
Infectious Diseases, University of Campania Luigi Vanvitelli, Via L.
Armanni 5, Naples 80131, Italy
(Molinari, Barbareschi, Cimmino, Formisano) Cardiology Unit, Azienda
Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, Naples
80138, Italy
(Coppolino) Department of Women, Child and General and Specialized
Surgery, Section of Anaesthesiology, University of Campania Luigi
Vanvitelli, Piazza Miraglia 2, Naples 80138, Italy
(Torella, De Feo) Department of Translational Medical Sciences, Section of
Cardiac Surgery and Heart Transplant, University of Campania Luigi
Vanvitelli, via L. Bianchi c/o Ospedale Monaldi, Naples 80131, Italy
(Cimmino) Department of Translational Medical Sciences, Section of
Cardiology, University of Campania Luigi Vanvitelli, via L. Bianchi c/o
Ospedale Monaldi, Naples 80131, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Multivalvular endocarditis (MVE) is an uncommon infection that mostly
involves mitral and aortic valves, and it is related to a higher risk of
congestive heart failure and a higher mortality. We described a case of a
bilateral MVE and performed a review of the literature on similar clinical
cases. We reported an unusual case of a 68-year-old male patient with a
tricuspid and mitral infective endocarditis due to a methicillin-resistant
Staphylococcus aureus complicated by multiple right- and left-sided septic
embolization (lungs, brain, spleen, L2-L3 vertebral bones) due to an
unknown atrial septal defect identified and repaired during cardiac
surgery. Despite the severity of the clinical case, the patient
experienced a good clinical outcome also thanks to a multidisciplinary
approach. We identified 21 case reports describing bilateral MVE. A
multidisciplinary approach is essential in the management of valve
diseases to improve the prognosis of patients, especially in bilateral
MVE. Copyright © 2023 by the authors.

<63>
Accession Number
2026316777
Title
Contingent Mother's Voice Intervention Targeting Feeding in Hospitalized
Infants with Critical Congenital Heart Defects.
Source
Children. 10(10) (no pagination), 2023. Article Number: 1642. Date of
Publication: October 2023.
Author
Kjeldsen C.P.; Emery L.; Simsic J.; He Z.; Stark A.R.; Neel M.L.; Maitre
N.L.
Institution
(Kjeldsen) Department of Speech and Hearing Science, The Ohio State
University, Columbus, OH 43210, United States
(Kjeldsen, He, Neel, Maitre) School of Medicine and Children's Healthcare
of Atlanta, Emory University, Atlanta, GA 30306, United States
(Emery, Simsic) Nationwide Children's Hospital, Columbus, OH 43205, United
States
(Stark) Beth Israel Deaconess Medical Center, Department of Neonatology,
Boston, MA 02215, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Infants with critical congenital heart defects (CCHD) are at high risk for
feeding challenges and neurodevelopmental delays; however, few
interventions promoting the neurodevelopmental progression of feeding have
been studied with this population. Contingent mother's voice has been
successfully used as positive reinforcement for non-nutritive suck (NNS)
in studies with preterm infants, leading to improved weight gain and more
rapid cessation of tube feedings; however, this type of intervention has
not been studied in infants with CCHD. This study aimed to determine
whether an NNS-training protocol using the mother's voice as positive
reinforcement and validated in preterm infants could improve oral feeding
outcomes in hospitalized infants with CCHD undergoing cardiac surgical
procedures. Infants were randomized to receive the contingent mother's
voice intervention before or after cardiac surgery, with a control
comparison group receiving passive exposure to the mother's voice after
surgery. There were no significant differences in discharge weight, PO
intake, length of stay, time to full feeds, or feeding status at 1-month
post-discharge between infants who received contingent mother's voice
compared to those who did not. There were significant differences in PO
intake and time to full feeds following surgery based on infants'
pre-enrollment PO status and severity of illness. At 1-month
post-discharge, parents of infants in the intervention group expressed a
higher rate of positive feelings and fewer concerns regarding their
infant's feeding compared to parents of infants in the control group.
While the current protocol of 5 sessions was not associated with improved
feeding outcomes in infants with CCHD, it empowered parents to contribute
to their infant's care and demonstrated the feasibility of using the
mother's voice as positive reinforcement for infants with CCHD. Further
study of timing, intensity, and duration of interventions leveraging the
mother's voice in this population is needed. ClinicalTrials.gov
Identifier: NCT03035552. Copyright © 2023 by the authors.

<64>
Accession Number
2026296540
Title
Impact of New Cardiovascular Events on Quality of Life and Hospital Costs
in People With Cardiovascular Disease in the United Kingdom and United
States.
Source
Journal of the American Heart Association. 12(19) (no pagination), 2023.
Article Number: e030766. Date of Publication: 2023.
Author
Lui J.N.M.; Williams C.; Keng M.J.; Hopewell J.C.; Sammons E.; Chen F.;
Gray A.; Bowman L.; Landray S.M.J.; Mihaylova B.
Institution
(Lui, Williams, Keng, Gray, Mihaylova) Health Economics Research Centre,
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Hopewell, Sammons, Chen, Bowman, Landray) Clinical Trial Service Unit and
Epidemiological Studies Unit, Nuffield Department of Population Health,
University of Oxford, Oxford, United Kingdom
(Bowman) Medical Research Council Population Health Research Unit,
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Mihaylova) Health Economics and Policy Research Unit, Wolfson Institute
of Population Health, Queen Mary University of London, London, United
Kingdom
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Despite optimized risk factor control, people with prior
cardiovascular disease remain at high cardiovascular disease risk. We
assess the immediate-and longer-term impacts of new vascular and
nonvascular events on quality of life (QoL) and hospital costs among
participants in the REVEAL (Randomized Evaluation of the Effects of
Anacetrapib Through Lipid Modification) trial in secondary prevention.
METHODS AND RESULTS: Data on demographic and clinical characteristics,
health-related quality of life (QoL: EuroQoL 5-Dimension-5-Level), adverse
events, and hospital admissions during the 4-year follow-up of the 21 820
participants recruited in Europe and North America informed assessments of
the impacts of new adverse events on QoL and hospital costs from the UK
and US health systems' perspectives using generalized linear regression
models. Reductions in QoL were estimated in the years of event occurrence
for nonhemorrhagic stroke (-0.067 [United Kingdom], -0.069 [US]), heart
failure admission (-0.072 [United Kingdom], -0.103 [US]), incident cancer
(-0.064 [United Kingdom], -0.068 [US]), and noncoronary revascularization
(-0.071 [United Kingdom], -0.061 [US]), as well as in subsequent years
following these events. Myocardial infarction and coronary
revascularization (CRV) procedures were not found to affect QoL. All
adverse events were associated with additional hospital costs in the years
of events and in subsequent years, with the highest additional costs in
the years of noncoronary revascularization (5830 [United Kingdom], $14 133
[US Medicare]), of myocardial infarction with urgent CRV procedure (5614,
$24722), and of urgent/nonurgent CRV procedure without myocardial
infarction (4674/4651 and $15 251/$17 539). CONCLUSION(S): Stroke,
heart failure, and noncoronary revascularization procedures substantially
reduce QoL, and all cardiovascular disease events increase hospital costs.
These estimates are useful in informing cost-effectiveness of
interventions to reduce cardiovascular disease risk in secondary
prevention. Copyright © 2023 The Authors.

<65>
Accession Number
2026296535
Title
Differences in Postoperative Atrial Fibrillation Incidence and Outcomes
After Cardiac Surgery According to Assessment Method and Definition: A
Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 12(19) (no pagination), 2023.
Article Number: e030907. Date of Publication: 03 Oct 2023.
Author
Perezgrovas-Olaria R.; Alzghari T.; Rahouma M.; Dimagli A.; Harik L.;
Soletti G.J.; An K.R.; Caldonazo T.; Kirov H.; Cancelli G.; Audisio K.;
Yaghmour M.; Polk H.; Toor R.; Sathi S.; Demetres M.; Girardi L.N.;
Biondi-Zoccai G.; Gaudino M.
Institution
(Perezgrovas-Olaria, Alzghari, Rahouma, Dimagli, Harik, Soletti, An,
Cancelli, Audisio, Yaghmour, Polk, Toor, Sathi, Girardi, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(An) Division of Cardiac Surgery, Department of Surgery, University of
Toronto, ON, Canada
(Caldonazo, Kirov) Department of Cardiothoracic Surgery, Friedrich
Schiller University Jena, Jena, Germany
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Naples, Italy
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is the most frequent
complication of cardiac surgery. Despite clinical and economic
implications, ample variability in POAF assessment method and definition
exist across studies. We performed a study-level meta-analysis to evaluate
the influence of POAF assessment method and definition on its incidence
and association with clinical outcomes. METHODS AND RESULTS: A systematic
literature search was conducted to identify studies comparing the outcomes
of patients with and without POAF after cardiac surgery that also reported
POAF assessment method. The primary outcome was POAF incidence. The
secondary outcomes were in-hospital mortality, stroke, intensive care unit
length of stay, and postoperative length of stay. Fifty-nine studies
totaling 197 774 patients were included. POAF cumulative incidence was 26%
(range: 7.3%- 53.1%). There were no differences in POAF incidence among
assessment methods (27%, [range: 7.3%- 53.1%] for continuous telemetry,
27% [range: 7.9%- 50%] for telemetry plus daily ECG, and 19% [range: 7.8%-
42.4%] for daily ECG only; P>0.05 for all comparisons). No differences in
in-hospital mortality, stroke, intensive care unit length of stay, and
postoperative length of stay were found between assessment methods. No
differences in POAF incidence or any other outcomes were found between
POAF definitions. Continuous telemetry and telemetry plus daily ECG were
associated with higher POAF incidence compared with daily ECG in studies
including only patients undergoing isolated coronary artery bypass
grafting. CONCLUSION(S): POAF incidence after cardiac surgery remains
high, and detection rates are variable among studies. POAF incidence and
its association with adverse outcomes are not influenced by the assessment
method and definition used, except in patients undergoing isolated
coronary artery bypass grafting. Copyright © 2023 The Authors.
Published on behalf of the American Heart Association, Inc., by Wiley.

<66>
Accession Number
2028041609
Title
Comparison of Figure-of-Eight Suture and Perclose ProGlide Suture-Mediated
Closure in Large Bore Venous Access Hemostasis: A Randomized Controlled
Trial.
Source
American Journal of Cardiology. 209 (pp 181-183), 2023. Date of
Publication: 15 Dec 2023.
Author
Lodhi H.; Shaukat S.; Mathews A.; Maini B.; Khalili H.
Institution
(Lodhi, Shaukat, Mathews, Maini, Khalili) Florida Atlantic University,
Boca Raton, FL, United States
(Khalili) Memorial Health Cardiovascular Institute, Hollywood, Florida,
United States
Publisher
Elsevier Inc.
Abstract
Suture-mediated closure device and Figure-of-Eight suture are commonly
used to achieve hemostasis after use of large bore venous access. Although
both methods of closure are commonly used in clinical practice, a
head-to-head comparison in a controlled setting has not been performed.
Patients presenting to a single center for elective left atrial appendage
occlusion or transcatheter edge-to-edge mitral valve repair were
randomized to large bore venous closure using the Perclose ProGlide
suture-based closure or a Figure-of-Eight suture closure. The patients
were followed for 1 month after the procedure. Primary outcome, a
composite of access site large ecchymosis, hematoma, infection, pain, need
for unscheduled venous ultrasound and need for transfusion, was compared
between the 2 arms. A total of 40 patients were randomized in a 1:1
fashion to the 2 venous closure strategies. Baseline characteristics were
similar between the 2 groups. Perclose ProGlide arm required use of more
devices for hemostasis (1.5 +/- 0.5 vs 1 +/- 0 respectively, p <0.0001),
and there was a significant difference in the cost of closure device
($367.00 +/- 122.00 vs $1.00 +/- 0 respectively, p <0.001). At 1 month
post-procedure, the primary outcome occurred in 4 patients (20%) in the
Perclose arm and 7 (35%) patients in the Figure-of-Eight arm, a difference
that was not statistically significant (p = 0.48). Time to hemostasis
between Figure-of-Eight and Perclose arms did not reach statistical
significance (2.5 +/- 2.1 vs 3.7 +/- 2.3, p = 0.09). In conclusion, both
Perclose ProGlide suture-based device and Figure-of-Eight closure are
equally feasible and safe for patients who underwent large bore venous
access. Figure-of-Eight-based closure is more cost
effective. Copyright © 2023

<67>
Accession Number
2026392898
Title
The Effect of Bariatric Surgery on Patients with Heart Failure: a
Systematic Review and Meta-analysis.
Source
Obesity Surgery. (no pagination), 2023. Date of Publication: 2023.
Author
Esparham A.; Mehri A.; Hadian H.; Taheri M.; Anari Moghadam H.; Kalantari
A.; Fogli M.J.; Khorgami Z.
Institution
(Esparham, Anari Moghadam) School of Medicine, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Mehri) Endoscopic and Minimally Invasive Surgery Research Center, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Hadian) Heshmatieh Hospital, Naieen City, Iran, Islamic Republic of
(Taheri, Fogli) Department of Cardiology, Ascension St. John Medical
Center, Tulsa, OK, United States
(Kalantari, Khorgami) Department of Surgery, University of Oklahoma School
of Community Medicine, Tulsa, OK, United States
(Khorgami) Harold Hamm Diabetes Center, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Fogli) Department of Internal Medicine, University of Oklahoma School of
Community Medicine, Tulsa, Oklahoma, United States
Publisher
Springer
Abstract
The current study aims to evaluate the effect of bariatric metabolic
surgery (BMS) on the New York Heart Association (NYHA) class and left
ventricular ejection fraction (LVEF) in patients with diagnosed heart
failure (HF). Fourteen related articles with 217 patients were included in
the final analysis. LVEF significantly improved after BMS in patients with
HF with a mean difference of 7.78% (CI 95%: 3.72, 11.84, I 2 =
83.75, p-value < 0.001). Also, the NYHA class significantly decreased
after BMS with a mean difference of - 0.40 (CI 95%: - 0.62, - 0.19, I
2: 47.03, p-value < 0.001). A total of 27 patients with obesity
and HF were listed for cardiac transplantation after BMS. Of those, 20
patients successfully underwent heart transplantation after
BMS. Copyright © 2023, The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature.

<68>
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. (no pagination), 2023.
Date of Publication: 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.

<69>
Accession Number
2026316967
Title
Long-term outcomes after transcatheter aortic valve replacement:
Meta-analysis of Kaplan-Meier-derived data.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Shimamura J.; Takemoto S.; Fukuhara S.; Miyamoto Y.; Yokoyama Y.; Takagi
H.; Kampaktsis P.N.; Kolte D.; Grubb K.J.; Kuno T.; Latib A.
Institution
(Shimamura, Grubb) Department of Surgery, Division of Cardiothoracic
Surgery, Emory University School of Medicine, Atlanta, GA, United States
(Takemoto) Department of Cardiovascular Surgery, Kyushu University
Hospital, Fukuoka, Japan
(Fukuhara, Yokoyama) Department of Cardiac Surgery, University of
Michigan, Ann Arbor, MI, United States
(Miyamoto) Division of Nephrology and Endocrinology, University of Tokyo,
Tokyo, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, NY, United States
(Kolte) Division of Cardiology, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical center, Albert
Einstein Medical College, New York City, NY, United States
(Kuno) Division of Cardiology, Jacobi Medical center, Albert Einstein
Medical College, New York, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is as an
alternative treatment to surgical AVR, but the long-term outcomes of TAVR
remain unclear. Aim(s): This study aimed to analyze long-term
outcomes following TAVR using meta-analysis. Method(s): A literature
search was performed with MEDLINE, EMBASE, Cochrane Library, Web of
Science, and Google Scholar through November 2022; studies reporting
clinical outcomes of TAVR with follow-up periods of >=8 years were
included. The outcomes of interest were overall survival and/or freedom
from structural valve deterioration (SVD). Surgical risk was assessed with
the Society of Thoracic Surgeons (STS) predicted risk of mortality (PROM)
score. A subgroup analysis was conducted for intermediate-/high-surgical
risk patients only. Result(s): Eleven studies including 5458 patients
were identified and analyzed. The mean age was 82.0 +/- 6.5 years, and
mean STS PROM score ranged from 2.9 to 10.6%. Survival rate at 5 and 10
years was 47.7% +/- 1.4% and 12.1 +/- 2.0%. Five studies including 1509
patients were analyzed for SVD. Freedom from SVD at 5 and 8 years was 95.5
+/- 0.7% and 85.1 +/- 3.1%. Similar results for survival and SVD were
noted in the subgroup analysis of intermediate-/high-risk patients.
 Conclusion(s): Following TAVR, approximately 88% of patients died
within 10 years, whereas 85% were free from SVD at 8 years. These date
suggest that baseline patient demographic have the greatest impact on
survival, and SVD does not seem to have a prognostic impact in this
population. Further investigations on longer-term outcomes of younger and
lower-risk patients are warranted. Copyright © 2023 Wiley
Periodicals LLC.

<70>
Accession Number
2028009485
Title
Dynamic changes of serum trace elements following cardiac surgery: A
systematic review and meta-analysis.
Source
Journal of Trace Elements in Medicine and Biology. 81 (no pagination),
2024. Article Number: 127331. Date of Publication: January 2024.
Author
Mazaheri-Tehrani S.; Haghighatpanah M.A.; Abhari A.P.; Fakhrolmobasheri
M.; Shekarian A.; Kieliszek M.
Institution
(Mazaheri-Tehrani) Child Growth and Development Research Center, Research
Institute for Primordial Prevention of Non-communicable Disease, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Mazaheri-Tehrani) Student Research Committee, School of Medicine, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Haghighatpanah) Department of Cardiovascular Surgery, Chamran Heart
Center, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Abhari, Fakhrolmobasheri) Heart Failure Research Center, Isfahan
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Shekarian) Isfahan Endocrine and Metabolism Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Kieliszek) Department of Food Biotechnology and Microbiology, Institute
of Food Sciences, Warsaw University of Life Sciences -SGGW, Nowoursynowska
159C, Warsaw 02-776, Poland
Publisher
Elsevier GmbH
Abstract
Background: Cardiac surgeries are known to induce an inflammatory
response. Besides, dietary factors such as trace elements contribute to
promoting cardiovascular health by maintaining oxidative balance. Here we
systematically review the literature about alterations in serum
concentrations of zinc (Zn), copper (Cu), and selenium (Se) in response to
cardiac surgeries. Method(s): A systematic search was performed on
databases until the end of December 2022. Studies assessing the changes of
mentioned elements in adult patients undergoing cardiac surgery were
included. Changes in the means and standard deviations of the elements
before and after the cardiac surgery were utilized as desired effect
sizes. Result(s): Among 1252 records found in the primary search, 23
and 21 articles were included in the systematic review and meta-analysis
respectively. Seventeen studies evaluated the changes in serum Zn and Cu
levels, and fifteen studies assessed Se levels. According to the results
of quantitative analysis, Zn, Cu, and Se concentrations, one day after the
surgery were significantly lower than preoperative values (WMD for Zn:
4.64 micromol/L [3.57-5.72], WMD for Cu: 1.62 micromol/L [0.52-2.72], and
WMD for Se: 0.1 micromol/L [0.03-0.16]). The concentration of trace
elements recovered gradually during the first-week post-operation and
reached preoperative levels or even higher. Conclusion(s): Serum
trace elements dropped significantly soon after the cardiac surgery, but
they reached their baseline levels mostly during the first week after the
surgery. Future studies are warranted to elucidate the impact of
alterations in serum concentration of trace elements on the outcomes and
complications of open-heart surgeries. Copyright © 2023 The
Authors

<71>
Accession Number
2027996985
Title
Nasal decolonization: What antimicrobials and antiseptics are most
effective before surgery and in the ICU.
Source
American Journal of Infection Control. 51(11 Supplement) (pp A64-A71),
2023. Date of Publication: November 2023.
Author
Smith M.; Herwaldt L.
Institution
(Smith, Herwaldt) Division of Infectious Diseases, Department of Internal
Medicine, University of Iowa Carver College of Medicine, Iowa City, IA,
United States
(Smith) Center for Access & Delivery Research and Evaluation (CADRE), Iowa
City VA Health Care System, Iowa City, IA, United States
(Herwaldt) Department of Epidemiology, University of Iowa College of
Public Health, Iowa City, IA, United States
Publisher
Elsevier Inc.
Abstract
Background: Staphylococcus aureus colonization is a key risk factor for S.
aureus infections in surgical patients and in hospitalized patients. Many
studies have assessed various decolonization agents, protocols, and
settings. This review summarizes key findings about nasal decolonization
for 2 different patient populations: patients undergoing surgery and
patients hospitalized in intensive care units. Method(s): We reviewed
major studies related to decolonization of patients colonized with S.
aureus and who were either undergoing surgical procedures or were
hospitalized in intensive care units. We focused on recent studies,
particularly randomized controlled trials and robust quasi-experimental
trials. We also reviewed select non-randomized trials when more rigorous
trials were limited. Discussion/Conclusions: Mupirocin is the best-studied
agent for decolonization. Its use reduces the risk of surgical site
infection following orthopedic surgery (strongest data) and cardiac
surgery. Mupirocin decolonization also reduces the incidence of S. aureus
clinical cultures in the intensive care unit. Povidone-iodine is less
well-studied. Current data suggest that it decreases the risk of surgical
site infections after orthopedic surgical procedures. In contrast,
povidone-iodine is less effective than mupirocin for reducing the
incidence of S aureus clinical cultures in the intensive care unit. Both
mupirocin and povidone-iodine have important limitations, highlighting the
need for future decolonization research. Copyright © 2023

<72>
Accession Number
2027982823
Title
Incidental finding of left-sided superior vena cava: A case report and
comprehensive literature review.
Source
International Journal of Surgery Case Reports. 112 (no pagination), 2023.
Article Number: 108968. Date of Publication: November 2023.
Author
Nunez-Rocha R.E.; Gomez-Carrillo D.E.; Mahecha-Carvajal M.E.; Perez-Ariza
V.; Ochoa D.L.; Herrera-Almario G.
Institution
(Nunez-Rocha, Gomez-Carrillo, Mahecha-Carvajal, Perez-Ariza,
Herrera-Almario) School of Medicine, Universidad de los Andes, Bogota,
Colombia
(Ochoa) Department of Diagnostic Imaging, Fundacion Santa Fe de Bogota,
Colombia
(Herrera-Almario) Department of Surgery, Fundacion Santa Fe de Bogota,
Colombia
Publisher
Elsevier Ltd
Abstract
Introduction and importance: Persistent left superior vena cava (PLSVC) is
a rare vascular anomaly that affects systemic venous circulation. PLSVC
typically is asymptomatic as the return of venous blood to the right
atrium occurs through the coronary sinus. It is important to possess a
comprehensive understanding of drainage as it can present challenges in
catheter placement on the right side of the heart, aiming to prevent
potential complications. Case presentation: A 59-year-old female patient
presented at the medical service with abdominal distention. During the
examination, the presence of ascites was observed. Subsequent studies
revealed peritoneal carcinomatosis of unknown origin. The patient
underwent staging laparoscopy with biopsy sampling. Consequently, the
placement of a catheter for chemotherapy was performed. A portable chest
X-ray was obtained revealing the catheter extending along the left
subclavian vein and progressing through the left paramediastinal regionThe
presence of persistent left superior vena cava was confirmed after
reviewing prior studies. Clinical discussion: The most common abnormality
in the venous drainage system is PLSVC. Approximately 40 % of PLSVC cases
have associated significant cardiovascular anomalies, with septal defects
being the most common. Recognizing anomalies and anatomical variants with
the involvement of a multidisciplinary team is critical to prevent
vascular complications during endovascular procedures and to tailor
techniques for patients in need of cardiac endovascular procedures or
cardiac devices. Conclusion(s): PLSVC is often asymptomatic and
discovered incidentally, it is essential to have a comprehensive
understanding of this anomaly and perform meticulous imaging workup to
prevent potential complications. Copyright © 2023 The Authors

<73>
Accession Number
2028023573
Title
Mollicutes-related infections in thoracic surgery including lung and heart
transplantation: A systematic review.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2023. Date of
Publication: 2023.
Author
Farfour E.; Vasse M.; Vallee A.
Institution
(Farfour, Vasse) Service de Biologie Clinique, Hopital Foch, Suresnes,
France
(Vasse) Universite Paris-Saclay, INSERM Hemostase Inflammation Thrombose
HITH U1176, Le Kremlin-Bicetre, France
(Vallee) Departement d'Epidemiologie et de Sante Publique, Hopital Foch,
Suresnes, France
Publisher
Elsevier Inc.
Abstract
Background: Urogenital Mollicutes, that is, Mycoplasma hominis and
Ureaplasma spp., can colonize the urogenital tract. While urogenital
colonization is frequent, infections are rare but should not be missed.
Furthermore, extragenital infections are even rarer. Over the past years,
they have been increasingly documented as a cause of hyperammonemia
syndrome (HS) and post-surgical infections. We review the literature on
studies focused on post-surgical infections and HS involving urogenital
Mollicutes after thoracic surgery including lung (LTR) and heart (HTR)
transplantation. Method(s): A systematic review was performed by
searching PubMed/Medline case reports, case series, cohort studies, and
clinical trials. Cases of infections and HS by urogenital Mollicutes after
HTR and LTR transplantations were reported. Result(s): Overall,
urogenital Mollicutes were associated with 15 HS, 31 infections in HTR and
LTR, and 18 post-thoracic surgical infections in another context.
Post-surgical infections were reported in all contexts. They were mainly
due to M hominis, the only species that could cultivate on standard
enriched agar forming pinpoint colonies after 3-5 days of incubation.
Microbiologists should be prompted to pinpoint colonies even if the
examination of Gram-staining is negative. The patients' management
required surgical treatment and antimicrobials, almost always
tetracyclines and/or fluoroquinolones. Conversely, HS occurred almost
exclusively in bilateral LTR and is more likely due to Ureaplasma spp. As
Ureaplasma spp. do not cultivate on standard media, the microbiological
diagnosis was performed using molecular methods. Conclusion(s):
Infections involving urogenital Mollicute should be considered in LTR with
HS. The overall rate of mortality is high and might be due in part to
delay in etiologic diagnosis. Post-surgical infections were reported in
all contexts. The route of contamination with Mollicutes remains unknown
in HTR and non-transplant surgery, but evidence of transmission from
donors has been documented for LTR. Copyright © 2023

<74>
Accession Number
2028023449
Title
Albumin and Cardioprotection in On-Pump Cardiac Surgery-A Post Hoc
Analysis of a Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Vlasov H.; Talvasto A.; Hiippala S.; Suojaranta R.; Wilkman E.; Rautamo
M.; Helve O.; Petaja L.; Raivio P.; Juvonen T.; Pesonen E.
Institution
(Vlasov, Talvasto, Hiippala, Suojaranta, Wilkman, Petaja, Pesonen)
Department of Anesthesiology and Intensive Care Medicine, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland
(Rautamo) HUS Pharmacy, University of Helsinki and Helsinki University
Hospital, Helsinki, Finland
(Helve) Children's Hospital, Pediatric Research Center, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland
(Helve) Department of Health Security, Finnish Institute for Health and
Welfare, Helsinki, Finland
(Raivio, Juvonen) Department of Cardiac Surgery, Heart, and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objectives: To study the quantitative potency of plasma albumin on
cardioprotection in terms of creatinine kinase-myocardial band mass
(CK-MBm) in on-pump cardiac surgery. Design(s): Post hoc analysis of
a double-blinded randomized clinical trial. Setting(s): Single-center
study in the Helsinki University Hospital. Participant(s): A total of
1,386 adult on-pump cardiac surgical patients. Intervention(s):
Administration of 4% albumin (n = 693) or Ringers acetate (n = 693) for
cardiopulmonary bypass priming and volume replacement intraoperatively and
postoperatively during the first 24 hours. Measurements and Main
Results: Albumin concentration was measured preoperatively and
intraoperatively (after protamine administration), and CK-MBm on the first
postoperative morning. Multivariate linear regression analyses were
measured in the whole cohort and the Ringer group. Plasma albumin
concentration did not differ between the groups preoperatively (Ringer v
albumin: 38.3 +/- 5.0 g/L v 38.6 +/- 4.5 g/L; p = 0.171) but differed
intraoperatively (29.5 +/- 5.2 g/L v 41.5 +/- 6.0 g/L; p < 0.001).
Creatinine kinase-myocardial band mass was higher in the Ringer (32.0 +/-
34.8 mug/L) than in the albumin group (24.3 +/- 33.0 mug/L) (p < 0.001).
Aortic cross-clamping time associated with CK-MBm in the whole cohort
(standardized beta = 0.376 [95% CI 0.315-0.437], p < 0.001) and the Ringer
group (beta = 0.363 [0.273-0.452]; p < 0.001). Albumin administration in
the whole cohort (beta = -0.156 [-0.201 to -0.111]; p < 0.001) and high
intraoperative albumin concentration in the Ringer group (beta = -0.07
[-0.140 to -0.003]; p = 0.04) associated with reduced CK-MBm. Compared
with ischemia-induced increase in CK-MBm, albumin's potency to reduce
CK-MBm was 41% in the whole cohort (beta-value ratio of -0.156/0.376) and
19% in the Ringer group (beta-value ratio of -0.07/0.363).
 Conclusion(s): Both endogenous and exogenous albumin appear to be
cardioprotective regarding CK-MBm release in on-pump cardiac
surgery. Copyright © 2023 The Authors

<75>
Accession Number
2026283743
Title
THE ROLE OF CARDIAC REHABILITATION IN IMPROVING POSTOPERATIVE RECOVERY AND
LONG-TERM OUTCOMES AFTER CARDIAC SURGERY: A SYSTEMATIC REVIEW.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 30(18) (pp
151-159), 2023. Date of Publication: 30 Sep 2023.
Author
Tahir T.; Shah J.Z.; Mukhtar H.; Attia F.; Ahmad S.; Khalid A.; Ashraf
S.R.; Ali N.; Shahzad K.
Institution
(Tahir) Kuwait Teaching Hospital, Department of Surgery, Pakistan
(Shah) Heart Hospital, HMC, Doha, Qatar
(Mukhtar) Pakistan Nursing Council and Nursing and Midwifery Council UK,
Pakistan
(Attia) FMO Haveli DHQ, Netherlands
(Ahmad) Rawalpindi Institute of Cardiology Rawalpindi, Pakistan
(Khalid) District Kotli AJK, Tehsil khuiretta, Pakistan
(Ashraf) Department of Biochemistry, University of Gujrat, Pakistan
(Ali) Department of Physiotherapy, The Sahara College Narowal, Pakistan
(Shahzad) HIESS, Hamdard University, Karachi, Pakistan
Publisher
Codon Publications
Abstract
Aim: This study aims to assess the efficacy of cardiac rehabilitation
programs in enhancing postoperative recovery following cardiac surgery.
 Background(s): The background of the study underscores the increasing
prevalence of cardiac surgeries and the importance of effective recovery
strategies to optimize patient outcomes. Cardiac rehabilitation programs
have emerged as integral interventions for postoperative recovery,
encompassing exercise, education, and psychosocial support.
 Method(s): The methodology involves a systematic review of relevant
literature to gather and analyze data on the impact of cardiac
rehabilitation programs on postoperative recovery metrics such as physical
function, quality of life, and cardiac-related morbidity. Result(s):
The results reveal a significant positive correlation between
participation in cardiac rehabilitation programs and improved
postoperative recovery outcomes. These outcomes encompass enhanced
physical function, reduced hospital readmissions, and improved overall
quality of life. Conclusion(s): In conclusion, cardiac rehabilitation
programs demonstrate substantial efficacy in enhancing postoperative
recovery following cardiac surgery. Incorporating these programs into
standard care can lead to better patient outcomes and contribute to the
broader goal of improving cardiovascular health. Copyright ©
2023, Codon Publications. All rights reserved.

<76>
Accession Number
2027890230
Title
Comparison between preoperative hook-wire and liquid material localization
for pulmonary nodules: a meta-analysis.
Source
Wideochirurgia I Inne Techniki Maloinwazyjne. 18(3) (pp 401-409), 2023.
Date of Publication: 2023.
Author
Wang S.-J.; Gao X.-X.; Hui H.; Li N.; Zhou Y.; Yin H.-T.
Institution
(Wang, Yin) Department of Radiotherapy, Xuzhou Clinical School, Xuzhou
Medical University, Xuzhou, China
(Gao, Hui, Li, Zhou) Department of Radiotherapy, First Clinical School,
Xuzhou Medical University, Xuzhou, China
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Computed tomography (CT)-guided liquid material (LM) and
hook-wire (HW) are usually localized for pulmonary nodules (PNs) before
video-assisted thoracic surgery (VATS) resection, but the relative
advantages of these 2 techniques remain uncertain. Aim(s): This
meta-analysis was conceived to juxtapose the efficacy and safety of HW
localization (HWL) and LM localization (LML), both guided by CT, for the
preoperative localization of PNs. Material(s) and Method(s): The
PubMed, Web of Science, and Wanfang databases were searched to identify
relevant studies published as of March 2023, after which pooled analyses
of study outcomes were conducted. Result(s): A total of 7 studies
were included in this meta-analysis from 142 relevant studies. These 7
studies included 551 patients (583 PNs) with CT-guided HWL and 551
patients (612 PNs) with LML. The successful localization rate was
significantly higher in the LM group (LMG) than in the HW group (HWG) (p =
0.002). The LMG also exhibited significantly lower pooled total
complication and lung haemorrhage rates than the HWG (p = 0.007 and
0.00001, respectively). Pooled localization duration, pneumothorax rates,
and VATS procedure duration were comparable in both groups (p = 0.45,
0.15, and 0.74, respectively). Furthermore, the pooled postoperative
hospital stay was significantly shorter in the LMG than in the HWG (p =
0.009). Significant heterogeneity was detected in the endpoints of
localization duration and pneumothorax rate (I2 = 93% and 66%,
respectively). Conclusion(s): CT-guided LML is safer and more
successful than HWL for patients with PNs before VATS
resection. Copyright © 2023 Termedia Publishing House Ltd.. All
rights reserved.

<77>
Accession Number
2027964754
Title
Surgical Ablation for Atrial Fibrillation During Mitral Valve Surgery: A
Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Source
American Journal of Cardiology. 209 (pp 104-113), 2023. Date of
Publication: 15 Dec 2023.
Author
Gemelli M.; Gallo M.; Addonizio M.; Van den Eynde J.; Pradegan N.; Danesi
T.H.; Pahwa S.; Dixon L.K.; Slaughter M.S.; Gerosa G.
Institution
(Gemelli, Addonizio, Pradegan, Gerosa) Department of Cardiac, Thoracic,
Vascular Sciences and Public Health, Cardiac Surgery Unit, University of
Padua, Padua, Italy
(Gallo, Pahwa, Slaughter) Department of Cardiothoracic Surgery, University
of Louisville, Louisville, Kentucky, United States
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Danesi) Cardiac Surgery Unit, San Bortolo Hospital, Vicenza, Italy
(Danesi) Division of Cardiac Surgery, University of Cincinnati College of
Medicine, Cincinnati, Ohio, United States
(Dixon) Clinical Effectiveness Unit, The Royal College of Surgeons of
England, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Although surgical ablation has been shown to produce excellent outcomes at
follow-up for patients with atrial fibrillation who underwent mitral valve
replacement/repair (MVR), this procedure is not commonly performed. Our
objective was to conduct a systematic review and meta-analysis to evaluate
the outcomes of concomitant surgical ablation during MVR. Three databases
were systematically reviewed for randomized clinical trials published by
August 2022. The primary outcome was sinus rhythm (SR) at 12 months.
Secondary outcomes included SR at discharge and 6 months, all-cause
mortality, permanent pacemaker implantation, and stroke and thromboembolic
events. A random-effects meta-analysis was performed, calculating odds
ratios (ORs) for each outcome. Thirteen studies were included, involving
1,089 patients comparing patients who underwent either isolated MVR
("MVR-only") or concomitant surgical ablation during MVR ("MVR+Ablation").
The odds of SR were significantly higher in the MVR+Ablation group at
discharge (OR 9.62, 95% confidence interval [CI] 4.87 to 19.02,
I2 = 55%), at 6-month follow-up (OR 7.21, 95% CI 4.30 to 12.11,
I2 = 34%), and at 1-year follow-up (OR 8.41, 95% CI 5.14 to
13.77, I2 = 48%). All-cause mortality was not different in the
groups, as were stroke and thromboembolic events, whereas the odds of
permanent pacemaker implantation were slightly higher in the MVR+Ablation
group (OR 1.87, 95% CI 1.11 to 3.17, I2 = 0%). Concomitant
surgical ablation during MVR showed excellent outcomes at short-term
follow-up, despite a slightly higher rate of permanent pacemaker
implantation. Further studies with longer follow-ups are needed to assess
if the SR is maintained over the years. Copyright © 2023 Elsevier
Inc.

<78>
Accession Number
2027963528
Title
Effects of acupressure on intestinal function in patients with coronary
artery bypass graft surgery: A randomized clinical trial.
Source
Gastroenterology and Hepatology from Bed to Bench. 16(3) (pp 282-291),
2023. Date of Publication: June 2023.
Author
Khan-Mohammadi F.; Jafari H.; Bagheri-Nesami M.; Moosazadeh M.; Kamali M.;
Esmaeili-Ahangarkelai N.; Quds K.
Institution
(Khan-Mohammadi) School of Nursing Midwifery, Mazandaran University of
Medical Sciences, Sari, Iran, Islamic Republic of
(Jafari, Bagheri-Nesami) Traditional and Complementary Medicine Research
Center, Addiction Institute, Mazandaran University of Medical Sciences,
Sari, Iran, Islamic Republic of
(Bagheri-Nesami, Esmaeili-Ahangarkelai) World Federation of
Acupuncture-Moxibustion Societies (WFAS), Beijing, China
(Moosazadeh) Gastrointestinal Cancer Research Center, Non-communicable
Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,
Islamic Republic of
(Moosazadeh) Health Sciences Research Center, Addiction Institute,
Mazandaran University of Medical Science, Sari, Iran, Islamic Republic of
(Kamali) Cardiovascular Research Center, Mazandaran University of Medical
Sciences, Sari, Iran, Islamic Republic of
(Quds) Department of Cardiac Surgery, Semnan University of Medical
Sciences, Semnan, Iran, Islamic Republic of
Publisher
Research Institute for Gastroenterology and Liver Diseases
Abstract
Aim: This study aimed to determine the effects of acupressure on the
intestinal function of patients undergoing Coronary Artery Bypass Graft
(CABG) surgery. Background(s): Studies indicated that cardiovascular
patients are prone to constipation. Acupressure is one of the therapeutic
and palliative approaches that can be used by doctors, nurses, and even
patients themselves. Method(s): The present three-group randomized
clinical trial study was conducted on 90 patients undergoing CABG surgery.
In the intervention group, 48 hours after surgery the patients received
acupressure points LI4 and ST25 twice a day (10 am and 6 pm) for three
sequential days. In the sham group, the patients received acupressure at a
1.5 cm distance from the LI4-ST25 points, and the patients in the control
group received only the usual care. This research used a demographic and
medical information questionnaire, Rome IV scale, Bristol stool scale,
symptom registration checklist, and daily excretion assessment checklist.
The intestinal function indices were completed 24 hours after surgery
(before intervention), 48, 72, 96, and 120 hours after surgery.
 Result(s): All three intervention, sham, and control groups were
without defecation in 24 hours (before intervention) and 48 hours after
surgery. There was a significant difference between the three
intervention, sham, and control groups in the number of stools after 72
hours, 96 hours, and 120 hours after the intervention (p<0.001). Also, a
significant difference was observed among the three groups in terms of
stool consistency 96 hours after the start of the intervention (p=0.032)
and 120 hours after the start of the intervention (p<0.001).
 Conclusion(s): The results showed that patients had a significant
improvement in the number of bowel movements and stool consistency in the
intervention group. In acute conditions, acupressure on LI4-ST25 points
can positively affect intestinal function when patients are hospitalized
in the intensive care unit. Copyright © 2023 Research Institute
for Gastroenterology and Liver Diseases. All rights reserved.

<79>
Accession Number
2027557657
Title
COMPARISON OF INHALATIONAL INDUCTION USING SEVOFLURANE WITH INTRAVENOUS
INDUCTION USING PROPOFOL IN ADULTS UNDERGOING CORONARY ARTERY BYPASS
GRAFTING SURGERY IN TERMS OF HEMODYNAMIC STABILITY - A PROSPECTIVE
RANDOMIZED, COMPARATIVE STUDY.
Source
International Journal of Academic Medicine and Pharmacy. 5(3) (pp
1997-2002), 2023. Date of Publication: 2023.
Author
Shalini A.; Sivashankari K.; Meena S.; Kumar D.A.
Institution
(Shalini, Sivashankari, Meena) Department of Anaesthesiology, Tamilnadu
Government Multi Super Speciality Hospital Omandurar Estate, Tamilnadu,
Chennai, India
(Kumar) Department of Anaesthesiology, Tamilnadu Government Multi Super
Speciality Hospital Omandurar Estate, Tamilnadu, Chennai, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Anaesthetic induction techniques in patients with coronary
artery disease undergoing coronary artery bypass grafting surgery are
based on considerations for hemodynamic stability, optimising myocardial
oxygen supply demand and minimizing intubation stress response. This study
compares the hemodynamic stability of induction between intravenous agent
propofol and inhalational agent sevoflurane in patients with coronary
artery disease posted for coronary artery bypass grafting surgery (CABG).
 Material(s) and Method(s): This prospective randomized comparative
study was conducted at Apollo Hospital, Chennai, from Nov 2017 to Nov
2018. All the patients were informed and consented before entry into the
study. All 60 patients in the study were randomized equally in group A
sevoflurane and group B propofol. The patient's detailed history, general
physical and systemic examination and all necessary investigations were
examined thoroughly for anaesthesia. Result(s): The study found no
significant difference in age, gender, and BMI between groups, with no
significant difference in hypertension, diabetes, or ejection fraction.
Propofol had a greater fall in SBP than sevoflurane, with a statistically
significant difference at T2 and T3. Propofol had a statistically
significant fall in DBP at time points T2 and T3. MAP decreased in both
groups, with sevoflurane having statistically more MAP values at T2 and
T3. Phenylephrine requirement for hypotension was significantly less in
sevoflurane group.Time taken for induction was also shorter in the
sevoflurane group than the propofol group. Propofol and sevoflurane
induction techniques were satisfactory for 26.7% of patients, but no
adverse effects were observed. Conclusion(s): Inhalational induction
with sevoflurane is a better alternative for IV induction with propofol
due to its quicker and better hemodynamic stability. Copyright ©
2023 Society for Healthcare and Research Development. All rights reserved.

<80>
Accession Number
2027557650
Title
THE EFFICACY OF INCENTIVE SPIROMETRY IN RESTORING BASELINE LUNG CAPACITY
AFTER UPPER ABDOMINAL AND MIDLINE LAPAROTOMY: A RANDOMISED CASE CONTROL
STUDY.
Source
International Journal of Academic Medicine and Pharmacy. 5(3) (pp
1961-1966), 2023. Date of Publication: 2023.
Author
Maity B.; Choudhury A.; Banerjee C.
Institution
(Maity, Choudhury, Banerjee) Department of General Surgery, Burdwan
Medical College & Hospital, West Bengal, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Changes in pulmonary dynamics following laparotomy are well
documented. Deep breathing exercises, with or without incentive
spirometry, may help counteract postoperative decreased vital capacity.
This study aims to determine the effect of the use of incentive spirometry
on pulmonary function following elective abdominal surgery as measured by
peak expiratory flow rate(PEFR). Material(s) and Method(s): It was
institution based randomized case control study. Study conducted in the
department of General Surgery at Burdwan Medical College and Hospital, A
total 80 cases were enrolled for the study, during the period March 2021
to August 2022. Result(s): Patients were then divided into a control
group and a study group using computer generated randomization tables. The
Control Group (CS) (n=40) received Chest Physiotherapy thrice a day
starting from post-operative day 01 for a total duration of 5 days. The
study group (IS) (n=40) received Incentive Spirometry every
4thhourly (6 times a day) following training by a
physiotherapist in addition to Chest Physiotherapy thrice a day starting
from post-operative day 01 for a total duration of 5 days. Above analysis
we found that on POD1 the values of PFT in chest physiotherapy group (FVC
=1.22+/-0.19 litre, FEV1 = 1.14 +/-0.27 litre and PEFR = 1.53+/-0.32
litre/sec) was lower in comparison with incentive spirometry group (FVC
=1.29+/-0.21 litre, FEV1 = 1.18 +/-0.19 litre and PEFR = 1.62+/-0.40
litre/sec) however the difference was not statistically significant (p
value = >0.05). Conclusion(s): The effectiveness of
best-physiotherapy techniques such as deep breathing exercises and
coughing and huffing techniques as well as spirometry in addition to early
mobilization have been proved in the prevention and treatment of depressed
cardiopulmonary function and post-operative pulmonary complications after
thoracic or abdominal surgery. Copyright © 2023 Society for
Healthcare and Research Development. All rights reserved.

<81>
Accession Number
2026288382
Title
The effect of postoperative intravenous iron in anaemic, older cardiac
surgery patients on disability-free survival (AGE ANEMIA study): study
protocol for a multi-centre, double-blind, randomized, placebo-controlled
trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 693. Date of
Publication: December 2023.
Author
Smoor R.M.; Rettig T.C.D.; Vernooij L.M.; Groenewegen E.M.; van Dongen
H.P.A.; Noordzij P.G.
Institution
(Smoor, Vernooij, Groenewegen, van Dongen, Noordzij) Department of
Anaesthesiology, Intensive Care and Pain Medicine, St. Antonius Hospital,
Nieuwegein, Netherlands
(Rettig) Department of Anaesthesiology, Intensive Care and Pain Medicine,
Amphia Hospital, Breda, Netherlands
(Vernooij, Groenewegen, Noordzij) Department of Intensive Care Medicine,
University Medical Centre Utrecht, Utrecht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative anaemia is common in older cardiac surgery
patients and often caused by iron deficiency. Anaemia may negatively
affect recovery after cardiac surgery. This study aims to determine the
efficacy of treatment of postoperative iron deficiency anaemia (IDA) with
intravenous iron (IVI) on disability 90 days after cardiac surgery in
older patients. Method(s): This is a randomized placebo-controlled
double-blind multi-centre trial. In total, 310 patients aged >= 70 years
with moderate IDA on postoperative day 1 (haemoglobin 85-110 g/L and
ferritin concentration < 100 mug/L or iron saturation < 20%) after
uncomplicated elective cardiac surgery (aortic valve repair or coronary
artery bypass graft surgery) will be included. Patients will be randomly
allocated to receive either IVI (ferric derisomaltose) or placebo (sodium
chloride 0.9%) on postoperative day 1 in a 1:1 ratio, stratified by centre
and type of cardiac surgery. The primary outcome is disability measured by
the 12-item World Health Organization Disability Assessment score 2.0
after 90 days. Secondary outcome measures are the number of postoperative
red blood cell (RBC) transfusions, change in reticulocyte haemoglobin
content (pg) from randomization to hospital discharge, Hb levels at
discharge, hospital complications, dyspnoea (assessed with the Rose
Dyspnoea Scale) and health-related quality of life (HRQL) (assessed with
The Older Persons and Informal Caregivers-Short Form (TOPICS-SF)
questionnaire) after 90 days and days alive and out of hospital after 90
days. Lastly, the functional outcomes (e.g. steep ramp or 6-min walk test)
and Hb level after 90 days will be assessed as an exploratory endpoint.
 Discussion(s): The results of this study will demonstrate whether
early treatment of postoperative IDA with IVI improves disability at 90
days in older cardiac surgery patients. Trial registration:
ClinicalTrials.gov NCT04913649. Registered on June 4, 2021. Copyright
© 2023, The Author(s).

<82>
Accession Number
2027938368
Title
Catheter-based serratus anterior plane block vs. continuous wound
infiltration for postoperative pain control following minimally invasive
atrioventricular valve surgery: a randomized, prospective trial.
Source
Acta Anaesthesiologica Belgica. 74(3) (pp 145-154), 2023. Date of
Publication: September 2023.
Author
Bussche B.V.; Vandenheuvel M.; Moerman A.
Institution
(Bussche, Vandenheuvel, Moerman) Department of Anaesthesiology and
Perioperative Medicine, Ghent University Hospital, Ghent, Belgium
Publisher
BeSARPP
Abstract
Background: Minimally invasive cardiac surgery via mini-thoracotomy
reduces surgical trauma compared to full sternotomy. However, thoracotomy
can cause severe postoperative pain. Managing postoperative pain is
challenging but critical for fast rehabilitation and avoidance of chronic
pain. Our objective was to compare the efficacy of analgesia of a bolus in
combination with continuous local anaesthetics using a serratus anterior
plane block (SAPB) catheter versus a wound infiltration catheter (CWI) in
patients after minimally invasive cardiac surgery. Design and setting: We
conducted a monocentric, prospective, randomized controlled trial between
January 2021 and August 2022. The study was performed at Ghent University
Hospital, Belgium. Method(s): Patients scheduled for minimally
invasive cardiac surgery via thoracoscopy and mini-thoracotomy were
randomized to receive either a SABP or a CWI catheter. Postoperatively,
continuous ropivacaine 0.2% was started at 10ml/h, and a supplementary
bolus of 30ml ropivacaine 0.5% was administered one hour before
detubation. The catheter remained in place for at least 24 hours. The
primary endpoint was opioid consumption during the first 48 hours
postdetubation. Secondary endpoints were anti-emetic consumption,
Numerical Analogue Score for 48 hours, length of stay in the Intensive
Care Unit and hospital, and incidence of chronic pain. Qualitative data
were compared using the Chi - Square test, quantitative data were analyzed
with the Student's t-test. Result(s): During the study period, a
total of 21 patients received a SAPB catheter and 26 patients received a
CWI catheter. No statistical significant differences were seen in baseline
characteristics. In the first 48 hours postdetubation, morphine equivalent
consumption was similar in both groups (p= 0.52), with no differences
observed in the early, mid- or late postoperative phases. The total
morphine equivalent dose was 21.8 mg in the SAPB and 18.6 mg in the CWI
group. There were no significant differences in postoperative vomiting and
nausea, length of stay in the Intensive Care Unit and in the hospital and
chronic thoracic pain (23% and 33% for the SAPB and CWI group,
respectively, p=0.54). Conclusion(s): This prospective study found no
significant difference in postoperative opioid consumption between
patients who received a serratus anterior plane block catheter and those
who received a wound catheter with bolus and continuous ropivacaine,
following minimally invasive cardiac surgery via right thoracoscopy and
mini-thoracotomy. Copyright © 2023 ARSMB-KVBMG. All rights
reserved.

<83>
Accession Number
2027752482
Title
The Effect of Preoperative Oral Chlorhexidine Rinse on Ventilator
Associated Pneumonia and ICU Mortality After Open Heart Surgery.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 27(4) (pp
241-246), 2021. Date of Publication: 2021.
Author
Ugur I.; Yurtseven N.; Polat S.; Ferhatoglu S.Y.; Ocalmaz S.
Institution
(Yurtseven, Ferhatoglu, Ocalmaz) SBU. Dr. Siyami Ersek Gogus Kalp ve Damar
Cerrahisi Egitim Arastirma Hastanesi, Anesteziyoloji ve Reanimasyon
Klinigi, Istanbul, Turkey
(Ugur) Medigunes Hastanesi, Manisa, Turkey
(Polat) Bahcesehir Universitesi, Anesteziyoloji ve Reanimasyon Klinigi,
Istanbul, Turkey
Publisher
Turkish Anaesthesiology and Intensive Care Society
Abstract
Objective: Ventilator-associated pneumonia (VAP) is the most frequent
nosocomial infection in the intensive care unit (ICU). VAP develops 10-20%
of patients in 48 hours of mechanical ventilation. In this study, it was
aimed to determine the effect of preoperative oral chlorhexidine rinse on
VAP and mortality in patients undergoing open cardiac surgery.
 Method(s): 300 patients who were planned to undergo elective open
cardiac surgery were included in this study. Patients were prospectively
randomized into two groups by a computer software. Group 1: Patients
brushing their teeth and then gargling with 0.12% chlorhexidine before
bedtime at the last night before surgery and 15 minutes before going to
the operating room. Group 2, It consisted of patients only brushing their
teeth. Result(s): VAP was seen in 3 patients (2.12%) in Group 1 and
in 12 (8.10%) patients in Group 2 (p<0.02). Duration of intubation was
15+/-7.40 hours for Group 1 and 23 32.01 for Group 2. These differences
were statistically significant (p <0.01). Although duration of ICU stay
and hospital stay in Group 1 are shorter than in Group 2 but it was not
statistically significant (p>0.05). There was no difference in mortality
(p>0.05). Conclusion(s): Consequently, chlorhexidine gluconate rinse
before elective cardiac surgery reduced the VAP rate and duration of
intubation but did not change the mortality rate and the length of ICU and
hospital stay. On the other hand we think these results would be change in
large multicentric studies. © Copyright The Society of Thoracic
Cardio-Vascular Anaesthesia and Intensive Care.

<84>
Accession Number
2027752477
Title
The Effect of Low- Flow Anesthesia on Hemodynamic Parameters and Gas
Consumption in Single Lung Ventilation.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 27(3) (pp
192-200), 2021. Date of Publication: 2021.
Author
Geyik F.D.; Yuce Y.; Erkal K.H.; Cevik B.; Saracoglu K.T.
Institution
(Geyik, Yuce, Erkal, Cevik, Saracoglu) Kartal Dr. Lutfi Kirdar City
Hospital, Istanbul, Turkey
Publisher
Turkish Anaesthesiology and Intensive Care Society
Abstract
Objective: We aimed to compare the effects of low and medium high- flow
anesthesia on hemodynamic parameters, blood gas values and gas consumption
in patients undergoing single lung ventilation. Method(s): We studied
40 patients over 18 years of age in ASA I-III group who underwent elective
thoracic surgery by single lung ventilation. The patients were intubated
with double-lumen tube (DLT) following induction of anesthesia. We
randomly divided the patients into two groups. In Group 1, 1L/min (80%
oxygen+20% air) 4-6% desflurane; in Group 2, 2L/min (80% oxygen+20% air)
was applied. Peripheral oxygen saturation, end-tidal carbon dioxide
levels, heart rate, invasive blood pressure values, tidal volume,
respiration rate, FiO2, fresh gas flow rate values during single lung
ventilation in both groups were recorded. Arterial Blood Gas analysis was
performed at 1 hour intervals. The amount of desflurane used at the end of
single lung ventilation was monitored by anesthesia device.
 Result(s): Desflurane consumption was significantly lower in Group 1
(55.3+/-18.4 vs. 84.9+/-37.6,p=0.003). EtCO2 was found to be statistically
significantly lower in Group 2, especially between 30 and 75 minutes, and
systolic, diastolic, and mean arterial pressure between 45 and 120
minutes. There was no significant difference between the groups in terms
of NIRS. Only in both left and right NIRS there was a significant
elevation in Group 1 at 120 minutes (p=0.08 and p=0.06, respectively).
 Conclusion(s): Low flow with desflurane using appropriate equipment
and close monitoring can be safely applied without side
effects. © Copyright The Society of Thoracic Cardio-Vascular
Anaesthesia and Intensive Care.

<85>
Accession Number
2027752434
Title
Comparison of Standard Endotracheal Tube and Endotracheal Tube with
Subglottic Secretion Drainage in Patients Undergoing Open Heart Surgery;
Risk of Developing Postoperative Nosocomial Pneumonia.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 27(1) (pp
21-29), 2021. Date of Publication: 2021.
Author
Talas Z.; Cardakozu T.; Azak E.; Gur S.
Institution
(Talas) Kocaeli Universitesi, Tip Fakultesi, Hastanesi Kalp Damar
Cerrrahisi Anabilim Dali, Kocaeli 41001, Turkey
(Cardakozu, Gur) Kocaeli Universitesi, Tip Fakultesi, Anestezi ve
Reaniamsyon Anabilim Dali, Kocaeli, Turkey
(Azak) Kocaeli Universitesi, Tip Fakultesi, Enfeksiyon Hastaliklari
Anabilim Dali, Kocaeli, Turkey
Publisher
Turkish Anaesthesiology and Intensive Care Society
Abstract
Objective: Postoperative nasocomial pneumonia (PoNP) is the pneumonia that
develops 48 hours after the surgery. The risk of PoNP is 3-20 times higher
when endotracheal tube (ET) was used. Therefore ETs with drainage lumens
allowing subglottic secretion were produced (SSD-ET). The risk of PoNP has
increased in cardiac surgery. There are limited number of studies on
SSD-ET and VAP in the literature on patients under going fast-track
cardiac anesthesia protocol. The aim of our study is to compare the
protective effect of the SSD-ET on the extubation time and the development
of PoNP in the patients having open heart surgery under going fast-track
cardiac anesthesia protocols. Method(s): A prospective, non-blind,
randomized trial was conducted. Patients scheduled for cardiac surgery
were randomly assigned to receive Standart Tube Group (Group 1) or
Subglottic Aspiration Tube Group (Group 2). 60 patients were included in
the study. The diagnosis of PoNP is determined according to the diagnostic
criteria of 2015 "Centersfor Disease Control and Prevention (CDC)"(1). A
two-sided p-value <0.05 was considered as statistically significant.
 Result(s): Extubation time was 12.65 h in group SSD-ET, it was
revealed as 16.88 h in the S-ET group. Hence, the extubation time was
significantly shorter in the SSD-ET group (<0.027) Conclusion(s): Our
study has showed that SSD-ETs decreased the extubation time in patients
who underwent open heart surgery, although they did not directly affect
the development of PoNP. Copyright © 2021 Turkish Anaesthesiology
and Intensive Care Society. All rights reserved.

<86>
Accession Number
2026392508
Title
Postoperative outcomes of pediatric patients with perioperative COVID-19
infection: a systematic review and meta-analysis of observational studies.
Source
Journal of Anesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Gong T.; Huang Q.; Zhang Q.; Cui Y.
Institution
(Gong, Huang, Zhang, Cui) Department of Anesthesiology, Chengdu Women's
and Children's Central Hospital, School of Medicine, University of
Electronic Science and Technology of China, No. 1617, Riyue Avenue,
Qingyang District, Chengdu 611731, China
Publisher
Springer
Abstract
Objective: To quantify the risk of adverse postoperative outcomes in
pediatric patients with COVID-19 infection. Method(s): We searched
PubMed, Embase, Cochrane Library from December 2019 to 21 April 2023.
Observational cohort studies that reported postoperative early mortality
and pulmonary complications of pediatric patients with confirmed
COVID-19-positive compared with COVID-19-negative were eligible for
inclusion. We excluded pediatric patients underwent organ transplantation
or cardiac surgery. Reviews, case reports, letters, and editorials were
also excluded. We used the Newcastle-Ottawa Scale to assess the
methodological quality and risk of bias for each included study. The
primary outcome was postoperative early mortality, defined as mortality
within 30 days after surgery or during hospitalization. The random-effects
model was performed to assess the pooled estimates, which were expressed
as risk ratio (RR) or mean difference (MD) with 95% confidence intervals
(CI). Result(s): 9 studies involving 23,031 pediatric patients were
included, and all studies were rated as high quality. Compared with
pediatric patients without COVID-19, pediatric patients with COVID-19
showed a significantly increased risk of postoperative pulmonary
complications (PPCs) (RR = 4.24; 95% CI 2.08-8.64). No clear evidence was
found for differences in postoperative early mortality (RR = 0.84; 95% CI
0.34-2.06), postoperative intensive care unit (ICU) admission (RR = 0.80;
95% CI 0.39-1.68), and length of hospital stay (MD = 0.35, 95% CI
-1.81-2.51) between pediatric patients with and without COVID-19.
 Conclusion(s): Perioperative COVID-19 infection was strongly
associated with increased risk of PPCs, but it did not increase the risk
of postoperative early mortality, the rate of postoperative ICU admission,
and the length of hospital stay in pediatric patients. Our preplanned
sensitivity analyses confirmed the robustness of our study
findings. Copyright © 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<87>
Accession Number
2026333633
Title
Effects of perioperative vitamin E and zinc co-supplementation on systemic
inflammation and length of stay following coronary artery bypass graft
surgery: a randomized controlled trial.
Source
European Journal of Clinical Nutrition. (no pagination), 2023. Date of
Publication: 2023.
Author
Makiabadi E.; Nakhaeizadeh R.; Soleimani M.; Nasrollahzadeh J.
Institution
(Makiabadi, Nasrollahzadeh) Department of Clinical Nutrition & Dietetics,
Faculty of Nutrition Sciences and Food Technology, National Nutrition and
Food Technology Research Institute, Shahid Beheshti University of Medical
Sciences, No. 7, Hafezi St., Farahzadi Blvd., Qods Town, Tehran, Iran,
Islamic Republic of
(Nakhaeizadeh) Department of Surgery, School of Medicine, Shafa Hospital,
Kerman University of Medical Sciences, Kerman, Iran, Islamic Republic of
(Soleimani) Department of Cardiac Intensive Care Unit, School of Medicine,
Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran,
Islamic Republic of
Publisher
Springer Nature
Abstract
Objectives: Coronary artery bypass graft (CABG) surgery has been reported
to be associated with lower postoperative plasma antioxidant and zinc
levels. We hypothesized that perioperative supplementation of vitamin E
and zinc might improve short-term postoperative outcomes. Method(s):
In this placebo-controlled double-blind, randomized study, patients
undergoing CABG performed with cardiopulmonary bypass were recruited. The
intervention group received zinc and vitamin E supplementation (1200 IU
vitamin E and 120 mg elemental zinc) the day before surgery, followed by
postoperative daily supplementation of 30 mg zinc and 200 IU vitamin E
from the 2nd day after surgery to 3 weeks. The control group received
placebos. Length of stay (LOS) in the intensive care unit and hospital,
sequential organ failure assessment score on 3rd day after surgery, and
plasma inflammatory markers on days 3 and 21 post-surgery were evaluated.
 Result(s): Seventy-eight patients completed the study (40 in the
intervention group and 38 in the placebo group). The hospital LOS was
significantly shorter (p < 0.05) in the intervention group. Postoperative
changes in plasma albumin levels were not different between the two
groups. The plasma zinc level was higher (p < 0.0001), but plasma
C-reactive protein (p = 0.01), pentraxin 3 (p < 0.0001), interferon gamma
(p < 0.05), malondialdehyde (p < 0.05), and aspartate aminotransferase (p
< 0.01) were lower in the intervention group compared to the placebo
group. Conclusion(s): Perioperative vitamin E and zinc
supplementation significantly reduced hospital LOS and the inflammatory
response in CABG surgery patients. In these patients, the optimal
combination and dose of micronutrients need further study but could
include zinc and vitamin E. Clinical trial registry: This trial was
registered at ClinicalTrials.gov website (NCT05402826). Copyright
© 2023, The Author(s), under exclusive licence to Springer Nature
Limited.

<88>
Accession Number
2027939251
Title
Focus on heart failure and cardiomyopathies: new ESC Guidelines and key
meta-analyses.
Source
European Heart Journal. 44(37) (pp 3487-3491), 2023. Date of Publication:
01 Oct 2023.
Author
Crea F.
Institution
(Crea) Department of Cardiovascular Medicine, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Rome, Italy
(Crea) Department of Cardiovascular and Pulmonary Sciences, Catholic
University of the Sacred Heart, Rome, Italy
Publisher
Oxford University Press

<89>
Accession Number
2027939235
Title
Efficacy of pulmonary artery pressure monitoring in patients with chronic
heart failure: a meta-analysis of three randomized controlled trials.
Source
European Heart Journal. 44(37) (pp 3658-3668), 2023. Date of Publication:
01 Oct 2023.
Author
Clephas P.R.D.; Radhoe S.P.; Boersma E.; Gregson J.; Jhund P.S.; Abraham
W.T.; McMurray J.J.V.; de Boer R.A.; Brugts J.J.
Institution
(Clephas, Radhoe, Boersma, de Boer, Brugts) Department of Cardiology,
Erasmus MC University Medical Centre, Dr. Molewaterplein 40, Rotterdam
3015 GD, Netherlands
(Gregson) Department of Medical Statistics, London School of Hygiene &
Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
(Jhund, McMurray) British Heart Foundation Cardiovascular Research Centre,
School of Cardiovascular and Metabolic Health, University of Glasgow, 126
University Place, Glasgow G12 8TA, United Kingdom
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
410 W 10th Ave, Columbus, OH 43210, United States
Publisher
Oxford University Press
Abstract
Aims Adjustment of treatment based on remote monitoring of pulmonary
artery (PA) pressure may reduce the risk of hospital admission for heart
failure (HF). We have conducted a meta-analysis of large randomized trials
investigating this question. Methods A systematic literature search was
performed for randomized clinical trials with PA pressure monitoring
devices in patients and results with HF. The primary outcome of interest
was the total number of HF hospitalizations. Other outcomes assessed were
urgent visits leading to treatment with intravenous diuretics, all-cause
mortality, and composites. Treatment effects are expressed as hazard
ratios, and pooled effect estimates were obtained applying random effects
meta-analyses. Three eligible randomized clinical trials were identified
that included 1898 outpatients in New York Heart Association functional
classes II-IV, either hospitalized for HF in the prior 12 months or with
elevated plasma NT-proBNP concentrations. The mean followup was 14.7
months, 67.8% of the patients were men, and 65.8% had an ejection fraction
<=40%. Compared to patients in the control group, the hazard ratio (95%
confidence interval) for total HF hospitalizations in those randomized to
PA pressure monitoring was 0.70 (0.58-0.86) (P = .0005). The corresponding
hazard ratio for the composite of total HF hospitalizations, urgent visits
and all-cause mortality was 0.75 (0.61-0.91; P = .0037) and for all-cause
mortality 0.92 (0.73-1.16). Subgroup analyses, including ejection fraction
phenotype, revealed no evidence of heterogeneity in the treatment effect.
Conclusion The use of remote PA pressure monitoring to guide treatment of
patients with HF reduces episodes of worsening HF and subsequent
hospitalizations. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<90>
Accession Number
2027937374
Title
An Overview and Implication of High Intensity Laser Therapy in Neck Pain:
A Narrative Review.
Source
Journal of Clinical and Diagnostic Research. 17(9) (pp YE01-YE05), 2023.
Date of Publication: September 2023.
Author
Shrestha D.; Hussain M.A.; Barbhuiya N.N.B.; Rahman Y.; Kalita M.; Sharma
S.
Institution
(Shrestha, Kalita) Department of Musculoskeletal Physiotherapy, Maharishi
Markandeshwar Institute of Physiotherapy and Rehabilitation, Haryana,
Ambala, India
(Hussain) Department of Cardiopulmonary Physiotherapy, Maharishi
Markandeshwar Institute of Physiotherapy and Rehabilitation, Haryana,
Ambala, India
(Barbhuiya) Department of Paediatric Physiotherapy, Maharishi
Markandeshwar Institute of Physiotherapy and Rehabilitation, Haryana,
Ambala, India
(Rahman) Department of Neurological Physiotherapy, School of Allied Health
Sciences, Sharda University, Uttar Pradesh, Greater Noida, India
(Sharma) Department of Musculoskeletal Physiotherapy, Maharishi
Markandeshwar Institute of Physiotherapy and Rehabilitation (MMIPR),
Maharishi Markandeshwar (Deemed to be University), Haryana, Mullana, India
Publisher
Journal of Clinical and Diagnostic Research
Abstract
High-Intensity Laser Therapy (HILT), also known as Class IV laser, is a
relatively modern type of non invasive physical electrotherapy that has
been used to treat a variety of conditions. However, there has been little
research conducted on this equipment. HILT can be highly beneficial for
treating painful neck-related disorders, as it offers various effects
including bio stimulation, regeneration, analgesia, anti-inflammatory
properties, and anti-oedema properties. Many disorders that cause neck
pain can be effectively treated with HILT in combination with exercise. To
gather essential information on the subject, electronic databases such as
PubMed, Scopus, and Google Scholar were searched. The conclusions of the
review indicate that HILT is highly efficient, affordable, and innovative.
However, it has received minimal academic research attention and has not
been widely used in Indian clinical settings. The evidence suggests that
HILT is a highly effective physical treatment technique that significantly
improves pain, Range of Motion (ROM), functional status, and Quality of
Life (QoL) in patients with neck pain. Copyright © 2023 Journal
of Clinical and Diagnostic Research. All rights reserved.

<91>
Accession Number
2027926553
Title
BR vs. R-miniCHOP in unfit patients with B-cell non-Hodgkin lymphoma: A
randomized, two-center, cohort study.
Source
Oncology Letters. 26(4) (no pagination), 2023. Article Number: 440. Date
of Publication: October 2023.
Author
Zhang D.; Lin Y.; Dong Y.; Zhang L.
Institution
(Zhang, Dong) Department of Oncology, Xiangyang No. 1 People's Hospital,
Hubei University of Medicine, Xiangyang, Hubei 441000, China
(Zhang, Zhang) Cancer Center, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, Hubei 430071, China
(Lin) Department of Gastroenterology, Xiangyang No. 1 People's Hospital,
Hubei University of Medicine, Xiangyang, Hubei 441000, China
Publisher
Spandidos Publications
Abstract
The aim of the present study was to compare the efficacy and safety
between the bendamustine plus rituximab (BR) regimen and rituximab
combined with low-dose doxorubicin, cyclophosphamide, vincristine and
prednisone (R-miniCHOP) in the treatment of 'unfit' patients with diffuse
large B-cell lymphoma (DLBCL) and follicular lymphoma grade 3B (FL3B).
Patients, >70 years of age with DLBCL or FL3B, defined as unfit according
to Comprehensive Geriatric Assessment, were included in the present study.
All patients received 4-6 cycles of a BR or R-miniCHOP regimen at a
three-week interval. The objective remission rate (ORR) and adverse
reactions were evaluated between the two groups. A total of 35 patients,
recruited between January 2020 and December 2021, were included in this
prospective study. The median age was 74 years (range, 70-82 years). The
ORR in the BR group was similar to that in the R-miniCHOP group (73.3 vs.
75.0%; P=0.606). However, the BR group exhibited a lower incidence of
leukopenia than the R-miniCHOP group (20.0 vs. 60.0%; P=0.037). The
univariate analysis revealed that the ORR was influenced by the serum
beta2 microglobulin level. The BR regimen showed equivalent efficacy but
more improved safety compared with R-miniCHOP in unfit patients with DLBCL
and FL3B. The BR regimen may be considered as an alternative treatment in
these subgroups of patients. Copyright © 2023 Spandidos
Publications. All rights reserved.

<92>
Accession Number
2027925505
Title
Heparin-induced thrombocytopenia in newborns: experience at a pediatric
hospital and a literature review.
Source
Research and Practice in Thrombosis and Haemostasis. 7(7) (no pagination),
2023. Article Number: 102214. Date of Publication: October 2023.
Author
Gay J.; Le Beller C.; Asgari R.; Chocron R.; Bajolle F.; Auger L.; Mimoun
A.; Borgel D.; Lillo-Le-Louet A.; Lasne D.
Institution
(Gay, Auger, Borgel, Lasne) Laboratoire d'Hematologie, Hopital
Universitaire Necker-Enfants Malades, AP-HP, Paris F-75015, France
(Le Beller, Asgari, Lillo-Le-Louet) Centre Regional de Pharmacovigilance,
Hopital Europeen Georges Pompidou, AP-HP, F-75015 Paris, France;,
Innovative Therapies in Haemostasis, INSERM, Paris, France
(Chocron) Service d'Accueil des Urgences, Hopital Europeen Georges
Pompidou, AP-HP, Paris F-75015, France
(Bajolle) Unite Medico-Chirurgicale de Cardiologie Congenitale et
Pediatrique, Centre de Reference M3C-Necker, Hopital Universitaire
Necker-Enfants Malades, AP-HP, Paris F-75015, France
(Mimoun) Centre de Recherche des Cordeliers, INSERM, Sorbonne Universite,
Universite De Paris - F-75015 Paris, France
Publisher
Elsevier B.V.
Abstract
Background: Heparin-induced thrombocytopenia (HIT) is a rare,
difficult-to-diagnose, and potentially serious adverse drug reaction with
thrombotic complications. Even though the immune system is still immature
during the neonatal period, HIT has been described in newborns with
reporting rates ranging from 0% to 2.3%. Therefore, it is important to
clarify the risk of HIT in newborns because it can affect the management
and monitoring of heparin treatment. Objective(s): The objectives of
the present study were to review the literature and determine the
incidence of HIT after cardiac surgery in newborns in our pediatric
hospital. Method(s): We searched the literature from 1992 to 2021 for
reports of HIT in newborns. Four raters then analyzed all the literature
reports on HIT and classified them as "likely," "uncertain," or
"unlikely." We also determined the incidence of HIT among newborns having
undergone cardiac surgery in our pediatric hospital. Result(s):
Eleven population-based studies and 12 case reports on suspected HIT in 17
newborns were reviewed. One study reported HIT in 14 out of 930 (1.5%)
heparin-treated newborns, but the other studies (n = 467 newborns) did not
mention HIT at all. None of the cases described in the literature was
classified as "likely" by the raters. In our center, none of the 2997
newborns that had undergone cardiac surgery in the previous 16 years was
diagnosed with HIT. Conclusion(s): We conclude that the incidence of
HIT in newborns has been overestimated in the literature. Copyright
© 2023 The Authors

<93>
Accession Number
2027905931
Title
Association of Malnutrition with Risk of Acute Kidney Injury: A Systematic
Review and Meta-Analysis.
Source
International Journal of Clinical Practice. 2023 (no pagination), 2023.
Article Number: 9910718. Date of Publication: 2023.
Author
Xiang X.; Zhu X.; Zhang L.
Institution
(Xiang, Zhang) Geriatric Diseases Institute of Chengdu/Cancer Prevention
and Treatment Institute of Chengdu, Department of Critical Care Medicine,
Chengdu Fifth People's Hospital, The Second Clinical Medical College,
Affiliated Fifth People's Hospital, Chengdu University of Traditional
Chinese Medicine, Chengdu 611137, China
(Zhu) Department of Internal Medicine, Traditional Chinese Medicine
Hospital, Wenjiang District, Chengdu 611130, China
Publisher
Hindawi Limited
Abstract
Background. Acute kidney injury (AKI) is a complex clinical syndrome of
hospitalization that may be affected by undernutrition and metabolic
changes. The aim of this meta-analysis was to systematically assess the
association between malnutrition and the risk of prevalent AKI. Materials
and Methods. We searched PubMed, Embase, Ovid MEDLINE, Web of Science, and
Chinese databases (WANFANG, VIP, and CKI) from database inception until
May 1, 2023, for studies evaluating the association of malnutrition with
the risk of AKI. Summary odds ratios (ORs) were estimated using a
random-effects model. Results. We identified 17 observational studies,
which included 273,315 individuals. Compared with patients with normal
nutritional status, those with malnutrition had a 125% increased risk of
prevalent AKI (pooled ORs, 2.25; 95% confidence interval, 1.80-2.82).
Malnutrition was also significantly associated with prevalent AKI across
all subgroups when subgroup analyses were performed on covariates such as
region, study design, age, sample size, malnutrition assessment method,
patient characteristics, covariate adjustment degree, and risk of bias.
Meta-regression models demonstrated no significant differences in AKI risk
between patients with malnutrition and without malnutrition. Conclusions.
Our results suggest that malnutrition may be a potential target for AKI
prevention. However, well-designed studies with ethnically or
geographically diverse populations are needed to evaluate strategies and
interventions to prevent or slow the development and progression of AKI in
malnourished individuals. Copyright © 2023 Xiang Xiang et al.

<94>
Accession Number
2027810182
Title
The Effect Of Passive Leg-Raising Maneuver On Hemodynamic Stability During
Anesthesia Induction For Adult Cardiac Surgery.
Source
Journal of Cardiovascular Disease Research. 14(9) (pp 1014-1023), 2023.
Date of Publication: 2023.
Author
Vali L.F.; Khoja A.; Kujur A.; Vali R.
Institution
(Vali, Vali) Department of Anaesthesia, Government Medical College,
Superspeciality Hospital, Nagpur, India
(Khoja) Department of Anaesthesia, Government Medical College, Trauma Care
Center, Nagpur, India
(Kujur) Department of Anaesthesia, Government Medical College, Gondia,
India
Publisher
EManuscript Technologies
Abstract
Background: Anesthesia-induced hypotension is a common complication among
patients who undergo cardiac surgery. This study investigates/aims to
investigate The present study investigated the efficacy of passive leg
raising maneuver (PLMR) to prevent or modify the severity of
post-anesthesia-induced hypotension during adult cardiac surgery. Method
and sample: A total of 146 subjects were equally randomized into to two
groups. Group 1 (n=73): PLRM group [where PLRM was performed] and Group 2
(n=73): Control group [where PLRM was not performed]. Heart rate, invasive
mean arterial blood pressure (MAP), and central venous pressure (CVP) was
were recorded before PLRM, before anesthetic induction, before
laryngoscopy, and at 5, 10, and 20 minutes after tracheal intubation. The
hypotension episode rate (MAP <70 mmHg) and CVP changes were compared
between the 2 groups. Result(s): Out of total sample size of 146
patients, CAD was found in majority in PLRM group (52.1%) and control
group (57.5%). The mean LVEF was found to be 49.72+/-5.73 in PLRM group
while 48.17+/-5.83 in control group, (p>0.05). The mean hemodynamic
parameters (HR, SBP, DBP and MAP) and CVP of patients from PLRM group was
more stable as compared to that of the control group at different time
intervals after laryngoscopy with statistically significant difference in
SBP, DBP and MAP (P<0.05). Patients in the control group (51) showed
significantly increased requirement of IVD (Inj Noradrenaline) compared to
PRLM group (31). Conclusion(s): This study concludes that PLRM is a
simple, rapid, safe, and effective method of preventing anesthesia-induced
hypotension and helps induce anesthesia in a more stable hemodynamic state
during cardiac operations with simple monitoring of MAP and
CVP. Copyright © 2023 EManuscript Technologies. All rights
reserved.

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

<96>
Accession Number
2027750816
Title
Septal Myectomy and Subvalvular Repair in Hypertrophic Cardiomyopathy, a
Systematic Review and Pooled Analysis.
Source
Reviews in Cardiovascular Medicine. 24(9) (no pagination), 2023. Article
Number: rcm2409268. Date of Publication: September 2023.
Author
Song M.-Y.; Wei X.; Li C.-H.; Li R.
Institution
(Song, Wei, Li, Li) Division of Cardiothoracic and Vascular Surgery,
Tongji Hospital, Tongji Medical College, Huazhong University of Science
and Technology, Hubei, Wuhan 430030, China
(Wei, Li) Key Laboratory of Organ Transplantation, Ministry of Education,
Hubei, Wuhan 430010, China
(Wei, Li) NHC Key Laboratory of Organ Transplantation, Hubei, Wuhan
430073, China
(Wei, Li) Key Laboratory of Organ Transplantation, Chinese Academy of
Medical Sciences, Hubei, Wuhan 430010, China
Publisher
IMR Press Limited
Abstract
Background: Some patients with hypertrophic obstructive cardiomyopathy
(HOCM) still exhibit systolic anterior motion (SAM) and mitral
regurgitation (MR) even after undergoing an isolated ventricular
septectomy. Currently, there are disputes regarding whether to perform a
mitral valve intervention and which type of operation is more effective.
 Method(s): By searching PubMed, Cochrane, Embase, Web of Science,
FDA.gov, and ClinicalTrials.gov, as well as other resource databases, we
obtained all articles published before December 2022 on ventricular septal
myectomy combined with mitral valve intervention for hypertrophic
cardiomyopathy. Demographic information and outcome variable data were
extracted from 10 screened studies on ventricular septal resection
combined with mitral valve repair. The risk of bias was assessed using
methodological index for non-randomized studies (MINORS). Student's t-test
was used for comparisons of continuous variables, and the chi-square or
Fisher's exact test was used for dichotomous variables. A total of 692
patients across 10 studies were analyzed. Result(s): There were 5
(0.7%) deaths in the perioperative period. The average cardiopulmonary
bypass time was 64.7+/-22.2 minutes, and the average follow-up time was
39.6+/-36.3 months. Compared with baseline levels, the left ventricular
outflow tract gradient (83.6 +/- 32.2 mmHg vs. 11.0 +/- 7.8 mmHg, p <
0.01), maximum interventricular septal thickness (22.5 +/- 5.1 mm vs. 14.7
+/- 5.5 mm, p < 0.01), III/IV mitral regurgitation (351/692 vs. 17/675, p
< 0.01), anterior mitral leaflet (AML)-annulus ratio (0.49 +/- 0.14 vs.
0.60 +/- 0.12, p < 0.01), tenting area (2.72 +/- 0.60 cm2 vs. 1.95 +/-
0.60 cm2, p < 0.01), and SAM (181/194 vs. 11/215, p < 0.01) were
significantly improved. 14 (2.1%) patients were in New York Heart
Association functional class III/IV, which was significantly improved
compared with the preoperative state (541/692 vs. 14/682, p < 0.01).
 Conclusion(s): Ventricular septectomy combined with mitral valve
repair can be a safe and effective treatment option for patients suffering
from HOCM with SAM and severe MR. Copyright © 2023 The Author(s).

<97>
Accession Number
2027744694
Title
Frequency of Stroke in Intermediate-Risk Patients in the Long-Term
Undergoing TAVR vs SAVR: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. Part B. 49(1) (no pagination), 2024.
Article Number: 102099. Date of Publication: January 2024.
Author
Llerena-Velastegui J.; Navarrete-Cadena C.; Delgado-Quijano F.;
Trujillo-Delgado M.; Aguayo-Zambrano J.; Villacis-Lopez C.; Marcalla-Rocha
M.; Benitez-Acosta K.; Vega-Zapata J.
Institution
(Llerena-Velastegui, Navarrete-Cadena) Pontifical Catholic University of
Ecuador, Medical School, Quito, Ecuador
(Delgado-Quijano) Vantage Healthcare, Rehabilitation Center, MA, United
States
(Trujillo-Delgado, Aguayo-Zambrano) Catholic University of Santiago de
Guayaquil, Medical School, Guayaquil, Ecuador
(Villacis-Lopez) Central University of Ecuador, Medical School, Quito,
Ecuador
(Marcalla-Rocha) National University of Chimborazo, Medical School,
Riobamba, Ecuador
(Benitez-Acosta) La Sabana University, Medical School, Bogota, Colombia
(Vega-Zapata) Regional Autonomous University of Los Andes, Medical School,
Ambato, Ecuador
Publisher
Elsevier Inc.
Abstract
The aim of this research is to compare the long-term incidence of stroke
in intermediate-risk patients who have undergone either transcatheter
aortic valve replacement (TAVR) or surgical aortic valve replacement
(SAVR) procedures. The objective is to identify which method exhibits a
higher propensity for stroke occurrence, potentially contributing to
disability or stroke-related mortality. We conducted a systematic review
and meta-analysis to evaluate the frequency of stroke post-TAVR and SAVR
procedures. Data were compiled from a diverse array of research articles,
retrieved from the Embase, Cochrane Library, and PubMed databases.
Conclusions were derived from the comprehensive analysis of forest plots.
The analysis indicates no significant reduction in stroke incidence among
patients undergoing TAVR compared to those receiving SAVR. This
conclusion, underscored by a P-value of 0.76 and a 95% confidence interval
(CI) ranging from 0.80 to 1.17, arises from a careful review of multiple
pertinent studies. The meta-analysis of pooled data does not reveal a
significant decrease in stroke frequency associated with TAVR. For
intermediate-risk patients, both TAVR and SAVR present similar stroke
risks, indicating no procedure is inherently safer. Healthcare providers
must take this into account when counseling patients, considering each
procedure's benefits and drawbacks. This study focuses specifically on
intermediate-risk individuals, so results may not apply universally.
Further research across different risk categories is needed. This study
emphasizes the need for individualized patient care and informed
decision-making in aortic stenosis management. Copyright © 2023
Elsevier Inc.

<98>
Accession Number
2027738235
Title
Venoarterial extracorporeal membrane oxygenation in patients with
infarct-related cardiogenic shock: an individual patient data
meta-analysis of randomised trials.
Source
The Lancet. 402(10410) (pp 1338-1346), 2023. Date of Publication: 14 Oct
2023.
Author
Zeymer U.; Freund A.; Hochadel M.; Ostadal P.; Belohlavek J.; Rokyta R.;
Massberg S.; Brunner S.; Lusebrink E.; Flather M.; Adlam D.; Bogaerts K.;
Banning A.; Sabate M.; Akin I.; Jobs A.; Schneider S.; Desch S.; Thiele H.
Institution
(Zeymer) Institut fur Herzinfarktforschung, Ludwigshafen, Germany
(Zeymer, Hochadel, Schneider) Klinikum Ludwigshafen, Ludwigshafen, Germany
(Freund, Jobs, Desch, Thiele) Heart Center Leipzig at University of
Leipzig and Leipzig Heart Science, Leipzig, Germany
(Ostadal) Department of Cardiology, Na Homolce Hospital, Department of
Cardiology and University Hospital Motol and 2nd Faculty of Medicine,
Charles University, Prague, Czechia
(Belohlavek) Department of Medicine II, General University Hospital and
1st Medical School, Charles University, Prague, Czechia
(Rokyta) Cardiology Department, University Hospital and Faculty of
Medicine Pilsen, Charles University, Czechia
(Massberg, Brunner, Lusebrink) Medizinische Klinik und Poliklinik I,
Klinikum der Universitat Munchen, Munich, Germany
(Massberg, Brunner, Lusebrink) German Center for Cardiovascular Research
(DZHK), Munich Heart Alliance, Munich, Germany
(Flather) Norwich Medical School, University of East Anglia, Norwich,
United Kingdom
(Adlam) Department of Cardiovascular Sciences, University of Leicester and
NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
(Bogaerts) KU Leuven, Department of Public Health and Primary Care,
I-BioStat, Leuven and UHasselt, Hasselt, Belgium
(Banning) Glenfield Hospital, University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
(Sabate) Consorci Institut D'Investigacions Biomediques August Pi I
Sunyer, Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
(Akin) University Medical Centre Mannheim, Medical Faculty Mannheim,
Heidelberg University, Mannheim, Germany
Publisher
Elsevier B.V.
Abstract
Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is
increasingly used in patients with cardiogenic shock despite the lack of
evidence from adequately powered randomised clinical trials. Three trials
reported so far were underpowered to detect a survival benefit; we
therefore conducted an individual patient-based meta-analysis to assess
the effect of VA-ECMO on 30-day death rate. Method(s): Randomised
clinical trials comparing early routine use of VA-ECMO versus optimal
medical therapy alone in patients presenting with infarct-related
cardiogenic shock were identified by searching MEDLINE, Cochrane Central
Register of Controlled Trials, Embase, and trial registries until June 12,
2023. Trials were included if at least all-cause death rate 30 days after
in-hospital randomisation was reported and trial investigators agreed to
collaborate (ie, providing individual patient data). Odds ratios (ORs) as
primary outcome measure were pooled using logistic regression models. This
study is registered with PROSPERO (CRD42023431258). Finding(s): Four
trials (n=567 patients; 284 VA-ECMO, 283 control) were identified and
included. Overall, there was no significant reduction of 30-day death rate
with the early use of VA-ECMO (OR 0.93; 95% CI 0.66-1.29). Complication
rates were higher with VA-ECMO for major bleeding (OR 2.44; 95% CI
1.55-3.84) and peripheral ischaemic vascular complications (OR 3.53; 95%
CI 1.70-7.34). Prespecified subgroup analyses were consistent and did not
show any benefit for VA-ECMO (p<inf>interaction</inf> >=0.079).
 Interpretation(s): VA-ECMO did not reduce 30-day death rate compared
with medical therapy alone in patients with infarct-related cardiogenic
shock, and an increase in major bleeding and vascular complications was
observed. A careful review of the indication for VA-ECMO in this setting
is warranted. Funding(s): Foundation Institut fur
Herzinfarktforschung. Copyright © 2023 Elsevier Ltd

<99>
Accession Number
2027733144
Title
ST Elevation Myocardial Infarction Complicated by Cardiogenic Shock:
Systematic Review of Survival Predictors.
Source
American Journal of Medicine Open. 10 (no pagination), 2023. Article
Number: 100057. Date of Publication: December 2023.
Author
Khoo J.K.; Trewin B.P.; Adji A.; Wong Y.W.; Hungerford S.
Institution
(Khoo) Department of Cardiology, Liverpool Hospital, Sydney, Australia
(Trewin) The Children's Hospital at Westmead, Sydney, Australia; The
University of Sydney, Australia
(Adji) Victor Chang Cardiac Research Institute, Sydney, Australia; St
Vincent's Hospital Clinical School, The University of New South Wales,
Sydney, Australia; Macquarie University, Sydney, Australia
(Wong) Department of Cardiology, The Prince Charles Hospital, Brisbane,
Australia, University of Queensland, Brisbane, Australia
(Hungerford) St Vincent's Hospital Clinical School, The University of New
South Wales, Sydney Australia, Department of Cardiology, Royal North Shore
Hospital, Sydney, Australia; The CardioVascular Center, Tufts, Boston,
Mass, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiogenic shock complicating acute myocardial infarction is
associated with reduced survival despite advancements in the treatment of
acute coronary syndromes. Characterizing predictors of morbidity and
mortality in this setting is crucial to improving risk stratification and
management. Notwithstanding, the interplay of factors determining survival
in this condition remains poorly studied. Method(s): Embase, MEDLINE,
and CINAHL databases were searched for original studies evaluating
predictors of short-term (30-day or in-hospital) survival in ST elevation
myocardial infarction with cardiogenic shock (STEMI-CS). Included studies
were analyzed by way of vote counting, identifying variables that
predicted mortality or survival. Result(s): Twenty-four studies,
consisting of 14,735 patients (5649 nonsurvivors and 9086 survivors) were
included. All studies were observational by design (17 retrospective and 7
prospective) with clinical and statistical heterogeneity. Unsuccessful
revascularization, reduced left ventricular ejection fraction, renal
impairment, and other variables were identified as key independent
predictors of mortality. Conclusion(s): Several key variables have
been shown to independently increase mortality in STEMI-CS populations.
Future prospective studies examining the prognostic role of multivariate
scoring systems incorporating these domains are required. Copyright
© 2023 The Author(s)

<100>
Accession Number
2027145770
Title
Intraoperative hypotension and postoperative outcomes: a meta-analysis of
randomised trials.
Source
British Journal of Anaesthesia. 131(5) (pp 823-831), 2023. Date of
Publication: November 2023.
Author
D'Amico F.; Fominskiy E.V.; Turi S.; Pruna A.; Fresilli S.; Triulzi M.;
Zangrillo A.; Landoni G.
Institution
(D'Amico, Fominskiy, Turi, Pruna, Fresilli, Triulzi, Zangrillo, Landoni)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
Publisher
Elsevier Ltd
Abstract
Introduction: Intraoperative hypotension is associated with adverse
postoperative outcomes; however these findings are supported only by
observational studies. The aim of this meta-analysis of randomised trials
was to compare the postoperative effects permissive management with
targeted management of intraoperative blood pressure. Method(s): We
searched PubMed, Cochrane, and Embase up to June 2023 for studies
comparing permissive (mean arterial pressure <=60 mm Hg) with targeted
(mean arterial pressure >60 mm Hg) intraoperative blood pressure
management. Primary outcome was all-cause mortality at the longest
follow-up available. Secondary outcomes were atrial fibrillation,
myocardial infarction, acute kidney injury, delirium, stroke, number of
patients requiring transfusion, time on mechanical ventilation, and length
of hospital stay. Result(s): We included 10 randomised trials
including a total of 9359 patients. Mortality was similar between
permissive and targeted blood pressure management groups (89/4644 [1.9%]
vs 99/4643 [2.1%], odds ratio 0.88, 95% confidence interval [CI],
0.65-1.18, P=0.38, I2=0% with nine studies included). Atrial
fibrillation (102/3896 [2.6%] vs 130/3887 [3.3%] odds ratio 0.71, 95% CI
0.53-0.96, P=0.03, I2=0%), and length of hospital stay (mean
difference -0.20 days, 95% CI -0.26 to -0.13, P<0.001, I2=0%)
were reduced in the permissive management group. No significant
differences were found in subgroup analysis for cardiac and noncardiac
surgery. Conclusion(s): Pooled randomised evidence shows that a
target intraoperative mean arterial pressure <=60 mm Hg is not associated
with increased mortality; nevertheless it is surprisingly associated with
a reduced rate of atrial fibrillation and of length of hospital stay.
Systematic review protocol: PROSPERO CRD42023393725. Copyright ©
2023 British Journal of Anaesthesia

<101>
Accession Number
2026852444
Title
Science mapping analysis of computed tomography-derived fractional flow
reverse: a bibliometric review from 2012 to 2022.
Source
Quantitative Imaging in Medicine and Surgery. 13(9) (pp 5605-5621), 2023.
Date of Publication: 01 Sep 2023.
Author
Zhang X.; Zhu X.; Jiang Y.; Wang H.; Guo Z.; Du B.; Hu Y.
Institution
(Zhang, Zhu, Jiang, Wang, Du, Hu) Department of Cardiovascular Diseases,
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing,
China
(Guo) Faculty of Medicine Health and Human Sciences, Macquarie University,
Sydney, Australia
Publisher
AME Publishing Company
Abstract
Background: Computed tomography-derived fractional flow reserve (CT-FFR)
is a non-invasive imagological examination used for diagnosing suspected
coronary atherosclerotic heart disease, providing the morphological and
functional value on a three-dimensional (3D) coronary artery model. This
article aimed to collate the existing knowledge and predict this novel
technology's future research hotspots. Method(s): To collect data,
1,712 articles were retrieved from the Web of Science Core Collection
(WoSCC) database from 2012-2022. CiteSpace5.8.R3 was used to visually
analyze the research status and predict future research hotspots.
 Result(s): Firstly, the United States, China, and the Netherlands
were identified as the countries having published the most articles about
CT-FFR. Jonathan Leipsic's group ranked first for the highest number of
published articles. Secondly, the visualized analysis indicated that the
exploration of CT-FFR is multidisciplinary and involves cardiology,
radiology, engineering, and computer science. Thirdly, the hotspots in
this field, which were inferred from the keyword distribution and
clustering, included the following: "diagnostic performance", "accuracy",
and the "prognostic value" of CT-FFR, and comparison of CT-FFR and other
imaging methods sharing similarities. The research frontiers included
technologies utilized to obtain more accurate CT-FFR values, such as
artificial intelligence (AI) and deep learning. Conclusion(s): As the
first visualized bibliometric analysis on CT-FFR, this study captured the
current accumulated information in this field and offer more insight and
guidance for future research. Copyright © 2023 AME Publishing
Company. All rights reserved.

<102>
Accession Number
2026288767
Title
Editorial: Challenges in the contemporary assessment of coronary
physiology.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1305913. Date of Publication: 2023.
Author
Aleksandric S.; Tesic M.; Orlic D.
Institution
(Aleksandric, Tesic, Orlic) Cardiology Clinic, University Clinical Center
of Serbia, Belgrade, Serbia
(Aleksandric, Tesic, Orlic) Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
Publisher
Frontiers Media SA

<103>
Accession Number
2026221451
Title
Furosemide continuous infusion versus repeated injection in the management
of acute decompensated heart failure in infants with left to right shunt:
a randomized trial.
Source
Egyptian Pediatric Association Gazette. 71(1) (no pagination), 2023.
Article Number: 77. Date of Publication: December 2023.
Author
Zarzor M.; Hasaneen B.; Abouelkheir M.M.; El-Halaby H.
Institution
(Zarzor, Abouelkheir) Pediatric Cardiology Unit, Mansoura University
Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura,
Egypt
(Hasaneen, Abouelkheir, El-Halaby) Department of Pediatrics, Faculty of
Medicine, Mansoura University, Mansoura, Egypt
(El-Halaby) Pediatric Intensive Care Unit, Mansoura University Children's
Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Furosemide is the foremost drug used in the management of
acute decompensated heart failure (ADHF). By tradition, it was
administered as repeated intravenous boluses but fluctuations in
intravascular volume and blood pressure were noticed in addition to the
possibility of toxicity. Hence, continuous intravenous infusion was
thought of as an alternative route of administration. In searching the
literature, all previously published data concerning the pediatric age
group was for infants and children following cardiac surgery. This study
aims to compare the efficacy and safety of furosemide repeated injection
versus continuous infusion during the management of ADHF in infants with
left to right shunt. Method(s): A prospective parallel-design
randomized study was conducted on 54 infants with ADHF, Ross class IV,
secondary to left to right shunt. Twenty-seven infants received repeated
injections of furosemide and 27 infants had furosemide continuous
infusion. Patients were followed clinically for weight, urine output,
hours required for resolution of failure symptoms, serum creatinine,
sodium and potassium, and length of hospital stay. Result(s):
Non-significant differences were observed between both groups regarding
preadmission oral furosemide dose and serum creatinine level. A lower
daily dose of furosemide was observed in the continuous infusion arm (3.5
+/- 0.6 vs 4.7 +/- 1.0, p = 0.001) with less fluctuation in urine output
and significantly fewer hours required for resolution of failure symptoms
(42.1 +/- 9 vs 56 +/- 18.5, p = 0.001). At the end of furosemide infusion,
serum creatinine was significantly higher in the continuous infusion group
(0.39 +/- 0.06 vs 0.34 +/- 0.1, p = 0.030). However, before hospital
discharge, non-significant differences were noticed (0.32 +/- 0.05 vs 0.33
+/- 0.06, p = 0.584). Non-significant differences between both groups
regarding serum sodium and potassium levels at the end of furosemide
injection were detected (p = 0.289, 0.890, respectively).
 Conclusion(s): Continuous infusion of furosemide can be safely
administered to infants with ADHF, Ross class IV, secondary to left to
right shunt with clinical gradual alleviation of fluid overload symptoms
and less hemodynamic instability than repeated injections. Trial
registration: The study was approved by the Mansoura Faculty of Medicine
institutional research board (MS/16.02.41) on August 3rd,
2016. Copyright © 2023, Egyptian Pediatric Association.

<104>
Accession Number
2026207932
Title
Colchicine and diabetes in patients with chronic coronary artery disease:
insights from the LoDoCo2 randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1244529. Date of Publication: 2023.
Author
Mohammadnia N.; Los J.; Opstal T.S.J.; Fiolet A.T.L.; Eikelboom J.W.;
Mosterd A.; Nidorf S.M.; Budgeon C.A.; Tijssen J.G.P.; Thompson P.L.; Tack
C.J.; Simsek S.; Bax W.A.; Cornel J.H.; El Messaoudi S.
Institution
(Mohammadnia, Los, Opstal, Cornel, El Messaoudi) Department of Cardiology,
Nijmegen, Radboudumc, Netherlands
(Opstal, Cornel) Department of Cardiology, Northwest Clinics, Alkmaar,
Netherlands
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Fiolet, Mosterd, Cornel) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Eikelboom) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Mosterd) Department of Cardiology, Meander Medical Center, Amersfoort,
Netherlands
(Nidorf, Thompson) Heart and Vascular Research Institute of Western
Australia, Perth, WA, Australia
(Nidorf) GenesisCare Western Australia, Perth, WA, Australia
(Budgeon, Thompson) School of Medicine, University of Western Australia,
Perth, WA, Australia
(Tijssen) Department of Cardiology, Amsterdam University Medical Centers,
Amsterdam, Netherlands
(Tijssen) Cardialysis BV, Rotterdam, Netherlands
(Thompson) Sir Charles Gairdner Hospital, Perth, WA, Australia
(Tack) Department of Internal Medicine, Nijmegen, Radboudumc, Netherlands
(Simsek, Bax) Department of Internal Medicine, Northwest Clinics, Alkmaar,
Netherlands
(Simsek) Department of Internal Medicine, Amsterdam University Medical
Centers, Amsterdam, Netherlands
Publisher
Frontiers Media SA
Abstract
Introduction: Despite optimal treatment, patients with chronic coronary
artery disease (CAD) and diabetes mellitus (DM) are at high risk of
cardiovascular events, emphasizing the need for new treatment options. The
Low-Dose Colchicine 2 (LoDoCo2) trial demonstrated that colchicine reduces
cardiovascular risk in patients with chronic CAD. This analysis determines
the efficacy of colchicine in patients with chronic CAD and DM as well as
the effect of colchicine on the development of new-onset type 2 diabetes
mellitus (T2DM). Method(s): The LoDoCo2 trial randomized 5,522
patients to placebo or colchicine 0.5 mg once daily, with a median
follow-up of 28.6 months. The primary composite endpoint was
cardiovascular death, spontaneous myocardial infarction, ischemic stroke,
or ischemia-driven revascularization. The effect of its treatment in
patients with and without DM was evaluated by including an interaction
term in the model. Result(s): A total of 1,007 participants (18.2%)
had T2DM at baseline. The adjusted hazard ratio (HR) [(95% confidence
interval (CI)] for the primary endpoint in the T2DM group was 1.52
(1.15-2.01, p < 0.01) compared with the group without T2DM. The HR for the
treatment effect on the primary endpoint was 0.87 (0.61-1.25) in
participants with T2DM and 0.64 (0.51-0.80) in participants without
diabetes (p<inf>interaction</inf>= 0.14). The incidence of new-onset T2DM
was 1.5% (34 out of 2,270) in the colchicine group and 2.2% (49 out of
2,245) in the placebo group (p = 0.10). Discussion(s): In conclusion,
based on the current evidence, the beneficial effects of colchicine on
cardiovascular endpoints are consistent regardless of DM status. The
potential benefits of colchicine in preventing new-onset DM need further
investigation. These findings are only hypothesis-generating and require
larger prospective trials to confirm the results. Copyright 2023
Mohammadnia, Los, Opstal, Fiolet, Eikelboom, Mosterd, Nidorf, Budgeon,
Tijssen, Thompson, Tack, Simsek, Bax, Cornel and El Messaoudi.

<105>
Accession Number
2026179777
Title
Effect of optimized thrombus aspiration on myocardial perfusion and
prognosis in acute ST-segment elevation myocardial infarction patients
with primary percutaneous coronary intervention.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1249924. Date of Publication: 2023.
Author
Xu B.; Zhang C.; Wei W.; Zhan Y.; Yang M.; Wang Y.; Zhao J.; Lin G.; zhang
W.-W.; Huo X.; Shi B.; Fan L.
Institution
(Xu, Zhang, Zhan, Yang, Wang, Zhao, Lin, zhang, Huo, Shi) Cardiovascular
Department, The Fifth Clinical College of China Medical University,
Bengang General Hospital of China Resources Medical Group, Benxi, China
(Wei, Fan) Cath Lab, The Fifth Clinical College of China Medical
University, Bengang General Hospital of China Resources Medical Group,
Benxi, China
Publisher
Frontiers Media SA
Abstract
Objective: To investigate the impact of optimized thrombus aspiration on
myocardial perfusion, prognosis, and safety in patients with acute
ST-segment elevation myocardial infarction (STEMI) undergoing primary
percutaneous coronary intervention(primary PCI). Method(s): A total
of 129 patients with STEMI were randomly allocated into control group
(Subgroup A and B) and experimental group(Subgroup C and D). Control group
received percutaneous transluminal coronary angioplasty (PTCA),thrombus
aspiration and primary PCI. Experimental group received optimized thrombus
aspiration and primary PCI. The number of thrombus aspiration was less
than 4 times in Subgroup A and C. The number of thrombus aspiration was
performed more than 4 times in Subgroups B and D. The classification of
thrombi extracted, the TIMI flow grade, the incidence of no-reflow and
slow flow, cTFC, TPI and CK-MB at 12 h and 24 h after stenting, ST segment
resolution of ECG after stenting, NT-proBNP, LVEFat 24 h, 30 days and 180
days after stenting were compared between groups. The incidence of
intraoperative and postoperative bleeding complications, stroke events and
major cardiovascular events (MACE) were recorded and compared between
groups. Result(s): The classification of thrombi extracted in the
experimental group was higher than that in the control group. The TIMI
flow grade of the experimental group was better than the control group
after thrombus aspiration. After stenting, the advantage still existed,
but the difference was not statistically significant. On cTFC, the
experimental group was lower than the control group, but the difference
was not statistically significant; After stenting the experimental group
was significantly lower than the control group. The CK-MB at 12 h and 24 h
of the experimental group was lower than the control group. After thrombus
aspiration the incidence of no-reflow in the experimental group was
significantly lower than that in the control group; after stenting the
incidence of no-reflow in the experimental group was still lower than the
control group, but no statistically difference. After thrombus aspiration
and stenting the incidence of slow flow in the experimental group were
lower than that in the control group. After stenting, NT-proBNP at 24 h
was lower in the experimental group than that in the control group,
However, there was no statistical difference; after stenting, The
NT-proBNP in the experimental group was lower than that in the control
group at 30 days and 180 days. After stenting, LVEF of the experimental
group was significantly higher than the control group at 24 h and 30 days;
superiority remained after 180 days but no statistical difference. There
was no statistical difference between two groups for intraoperative and
postoperative bleeding complications, stroke events, and MACE events. In
Subgroup analysis,there was no significant difference in the
classification of thrombi extracted, TIMI flow grade, cTFC,
CK-MB,NT-proBNP and LVEF between group C and D, but group A was better
than group B. Analysis of variance showed that the optimal number of
suction was 4-5 times. Conclusion(s): Optimized thrombus aspiration
can significantly improve myocardial perfusion and short-term and
medium-term prognosis of STEMI patients after PCI, and reduce the
incidence of slow flow and no-reflow. The optimal suction times were 4-5
times. Traditional aspiration method with more aspiration times is harmful
to cardiac prognosis. Thrombus aspiration does not increase the incidence
of stroke events and is safe. Clinical Trial Registration: identifier,
ChiCTR2300073410. Copyright 2023 Xu, Zhang, Wei, Zhan, Yang, Wang,
Zhao, Lin, zhang, Huo, Shi and Fan.

<106>
Accession Number
2026177466
Title
Cervical aortic arch in the pediatric population: a meta-analysis of
individual patient's data.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1266956. Date of Publication: 2023.
Author
Baudo M.; Varrica A.; Reali M.; Saracino A.; Carminati M.; Frigiola A.;
Giamberti A.; Lo Rito M.
Institution
(Baudo, Varrica, Reali, Frigiola, Giamberti, Lo Rito) Department of
Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato
Milanese, Italy
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Saracino, Carminati) Department of Pediatric and Adult Congenital
Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
Publisher
Frontiers Media SA
Abstract
Background: This is the first meta-analysis to analyze all reports of
published pediatric cases of cervical aortic arch (CAA) by highlighting
the clinical characteristics and treatment outcomes using the reported
individual data of the patients. The aim of the study is to investigate
the clinical features and surgical outcomes of such a rare disease in the
pediatric population. Method(s): A comprehensive search was conducted
in various academic databases, including PubMed, ScienceDirect, SciELO,
DOAJ, and Cochrane Library, until June 2022 for case reports describing
the presence of cervical aortic arch in the pediatric age. Case reports
and series were included if the following criteria were met: (1)
description of the cervical aortic arch; (2) patient of pediatric age; and
(3) published in the English language. All other types of publications
that lacked patient-specific information were excluded from the analysis.
This systematic review was conducted in accordance with the PRISMA
guidelines. The primary outcome measure of the analysis was early and late
mortality. Result(s): The literature search identified 2,272
potentially eligible articles, 72 of which met our inclusion criteria with
96 patients including the author's institutional case. At a median of 365
(90-730) days, the overall cohort registered a 7.3% (7/96) mortality rate.
In the subset of patients who underwent surgery, the mortality rate was
also 7.3% (4/55), and the mortality rate following surgery to treat only
CAA was 2.4% (1/42). Dyspnea was identified as an independent determinant
of mortality by employing the univariable Firth bias-reduced logistic
regression method. Conclusion(s): Cervical aortic arch is a rare
congenital heart disease that poses treatment challenges due to the high
anatomical variability, diverse clinical presentations, and the presence
of other concomitant diseases. The surgical treatment appears to be a safe
and effective approach for resolving the symptoms, although it needs to be
tailored individually for each patient. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346826,
Identifier: CRD42022346826. Copyright 2023 Baudo, Varrica, Reali,
Saracino, Carminati, Frigiola, Giamberti and Lo Rito.

<107>
Accession Number
2023337193
Title
Brain injury and long-term outcome after neonatal surgery for non-cardiac
congenital anomalies.
Source
Pediatric Research. 94(4) (pp 1265-1272), 2023. Date of Publication:
October 2023.
Author
Aalten M.; Tataranno M.L.; Dudink J.; Lemmers P.M.A.; Lindeboom M.Y.A.;
Benders M.J.N.L.
Institution
(Aalten, Tataranno, Dudink, Lemmers, Benders) Department of Neonatology,
University Medical Center, Utrecht Brain Center and Wilhelmina Children's
Hospital, University Utrecht, Utrecht, Netherlands
(Lindeboom) Department of Pediatric Surgery, Wilhelmina Children's
Hospital, University Medical Center Utrecht, Utrecht, Netherlands
Publisher
Springer Nature
Abstract
Background: There is growing evidence that neonatal surgery for
non-cardiac congenital anomalies (NCCAs) in the neonatal period adversely
affects long-term neurodevelopmental outcome. However, less is known about
acquired brain injury after surgery for NCCA and abnormal brain maturation
leading to these impairments. Method(s): A systematic search was
performed in PubMed, Embase, and The Cochrane Library on May 6, 2022 on
brain injury and maturation abnormalities seen on magnetic resonance
imaging (MRI) and its associations with neurodevelopment in neonates
undergoing NCCA surgery the first month postpartum. Rayyan was used for
article screening and ROBINS-I for risk of bias assessment. Data on the
studies, infants, surgery, MRI, and outcome were extracted.
 Result(s): Three eligible studies were included, reporting 197
infants. Brain injury was found in n = 120 (50%) patients after NCCA
surgery. Sixty (30%) were diagnosed with white matter injury. Cortical
folding was delayed in the majority of cases. Brain injury and delayed
brain maturation was associated with a decrease in neurodevelopmental
outcome at 2 years of age. Conclusion(s): Surgery for NCCA was
associated with high risk of brain injury and delay in maturation leading
to delay in neurocognitive and motor development. However, more research
is recommended for strong conclusions in this group of patients. Impact:
Brain injury was found in 50% of neonates who underwent NCCA surgery.NCCA
surgery is associated with a delay in cortical folding.There is an
important research gap regarding perioperative brain injury and NCCA
surgery. Copyright © 2023, The Author(s), under exclusive licence
to the International Pediatric Research Foundation, Inc.

<108>
Accession Number
2027142959
Title
Glutamate Infusion Reduces Myocardial Dysfunction after Coronary Artery
Bypass Grafting According to NT-proBNP: Summary of 2 Randomized Controlled
Trials (GLUTAmate for Metabolic Intervention in Coronary Surgery
[GLUTAMICS I-II]).
Source
American Journal of Clinical Nutrition. 118(5) (pp 930-937), 2023. Date of
Publication: November 2023.
Author
Holm J.; Vanky F.; Svedjeholm R.
Institution
(Holm, Vanky, Svedjeholm) Department of Thoracic and Vascular Surgery,
Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular
Medicine, Linkoping University, Sweden
Publisher
Elsevier B.V.
Abstract
Background: Glutamate is reported to enhance the recovery of oxidative
metabolism and contractile function of the heart after ischemia. The
effect appears to be blunted in diabetic hearts. Elevated plasma
N-terminal pro-brain natriuretic peptide (NT-proBNP) reflects myocardial
dysfunction. In the GLUTAmate for Metabolic Intervention in Coronary
Surgery (GLUTAMICS) II trial, the proportion of patients with diabetes had
nearly doubled to 47% compared with the cohort used for sample size
estimation, and a significant effect on the postoperative rise in
NT-proBNP was only observed in patients without diabetes.
 Objective(s): We aimed to summarize the pooled NT-proBNP results from
both GLUTAMICS trials and address the impact of diabetes. Method(s):
Data from 2 prospective, randomized, double-blind multicenter trials with
similar inclusion criteria and endpoints were pooled. Patients underwent a
coronary artery bypass grafting (CABG) +/- valve procedure and had a
left-ventricular ejection fraction of <=0.30 or a European System for
Cardiac Operative Risk Evaluation II (EuroSCORE II) of >=3.0 with at least
1 cardiac risk factor. Intravenous infusion of 0.125 M L-glutamic acid or
saline at 1.65 mL/kg/h was started 10-20 min before reperfusion and
continued for 150 min. The primary endpoint was the difference between
preoperative and day 3 postoperative NT-proBNP levels. Result(s): A
total of 451 patients, 224 receiving glutamate and 227 controls, fulfilled
the inclusion criteria. Glutamate was associated with a reduced primary
endpoint (5344 +/- 5104 ng/L and 6662 +/- 5606 ng/L in glutamate and
control groups, respectively; P = 0.01). Postoperative mortality at <=30 d
was 0.9% and 3.5% (P = 0.11), whereas stroke at <=24 h was 0.4% and 2.6%
in glutamate and control groups, respectively (P = 0.12). No adverse
events related to glutamate were observed. A significant interaction
regarding the primary endpoint was only detected between glutamate and
insulin-treated diabetes groups (P = 0.04). Among patients without
insulin-treated diabetes, the primary endpoint was 5047 +/- 4705 ng/L and
7001 +/- 5830 ng/L in the glutamate and control groups, respectively (P =
0.001). Conclusion(s): Infusion of glutamate reduced the
postoperative rise in NT-proBNP after CABG in medium- to high-risk
patients. A significantly blunted effect was observed only in
insulin-treated patients with diabetes. Clinical trial details: This trial
was registered at www.clinicaltrials.gov as NCT02592824. Copyright
© 2023 The Author(s)

<109>
Accession Number
2025418653
Title
2022 ACC/AHA guideline for the diagnosis and management of aortic disease:
A report of the American Heart Association/American College of Cardiology
Joint Committee on Clinical Practice Guidelines.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(5) (pp e182-e331),
2023. Date of Publication: November 2023.
Author
Isselbacher E.M.; Preventza O.; Hamilton Black J.; Augoustides J.G.; Beck
A.W.; Bolen M.A.; Braverman A.C.; Bray B.E.; Brown-Zimmerman M.M.; Chen
E.P.; Collins T.J.; DeAnda A.; Fanola C.L.; Girardi L.N.; Hicks C.W.; Hui
D.S.; Schuyler Jones W.; Kalahasti V.; Kim K.M.; Milewicz D.M.; Oderich
G.S.; Ogbechie L.; Promes S.B.; Ross E.G.; Schermerhorn M.L.; Singleton
Times S.; Tseng E.E.; Wang G.J.; Woo Y.J.; Faxon D.P.; Upchurch G.R.; Aday
A.W.; Azizzadeh A.; Boisen M.; Hawkins B.; Kramer C.M.; Luc J.G.Y.;
MacGillivray T.E.; Malaisrie S.C.; Osteen K.; Patel H.J.; Patel P.J.;
Popescu W.M.; Rodriguez E.; Sorber R.; Tsao P.S.; Santos Volgman A.;
Beckman J.A.; Otto C.M.; O'Gara P.T.; Armbruster A.; Birtcher K.K.; de las
Fuentes L.; Deswal A.; Dixon D.L.; Gorenek B.; Haynes N.; Hernandez A.F.;
Joglar J.A.; Jones W.S.; Mark D.; Mukherjee D.; Palaniappan L.; Piano
M.R.; Rab T.; Spatz E.S.; Tamis-Holland J.E.
Publisher
Elsevier Inc.
Abstract
Aim: The "2022 ACC/AHA Guideline for the Diagnosis and Management of
Aortic Disease" provides recommendations to guide clinicians in the
diagnosis, genetic evaluation and family screening, medical therapy,
endovascular and surgical treatment, and long-term surveillance of
patients with aortic disease across its multiple clinical presentation
subsets (ie, asymptomatic, stable symptomatic, and acute aortic
syndromes). Method(s): A comprehensive literature search was
conducted from January 2021 to April 2021, encompassing studies, reviews,
and other evidence conducted on human subjects that were published in
English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and
other selected databases relevant to this guideline. Additional relevant
studies, published through June 2022 during the guideline writing process,
were also considered by the writing committee, where appropriate.
Structure: Recommendations from previously published AHA/ACC guidelines on
thoracic aortic disease, peripheral artery disease, and bicuspid aortic
valve disease have been updated with new evidence to guide clinicians. In
addition, new recommendations addressing comprehensive care for patients
with aortic disease have been developed. There is added emphasis on the
role of shared decision making, especially in the management of patients
with aortic disease both before and during pregnancy. The is also an
increased emphasis on the importance of institutional interventional
volume and multidisciplinary aortic team expertise in the care of patients
with aortic disease. Copyright © 2022 American College of
Cardiology Foundation and the American Heart Association, Inc. Published
by Elsevier

<110>
Accession Number
2016503839
Title
Multiple arterial coronary bypass grafting is associated with better
survival compared with second-generation drug-eluting stents in patients
with stable multivessel coronary artery disease.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(3) (pp 782-790.e7),
2023. Date of Publication: September 2023.
Author
Rocha R.V.; Fang J.; Tam D.Y.; Elbatarny M.; Austin P.C.; Gaudino M.F.L.;
Lee D.S.; Fremes S.E.
Institution
(Rocha, Tam, Elbatarny, Fremes) Division of Cardiac Surgery, Schulich
Heart Centre, Department of Surgery, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Fang, Austin, Lee) Cardiovascular Program, ICES, Toronto, ON, Canada
(Austin, Fremes) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Gaudino) Department of Cardio-Thoracic Surgery, Weill Cornell Medicine,
New York, NY
(Lee) Division of Cardiology, Peter Munk Cardiac Centre, University Health
Network, University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objective: We sought to compare the long-term outcomes of multiarterial
graft (MAG) coronary artery bypass grafting (CABG) versus percutaneous
coronary intervention (PCI) with second-generation drug-eluting stents
(DES) to treat stable multivessel coronary artery disease. Method(s):
This study was a multicenter population-based retrospective analysis of
all residents of Ontario, Canada, from January 1, 2011, to December 31,
2019. We identified 3600 cases of elective primary isolated CABG with MAG
and 2187 cases of PCI with second-generation DES. Result(s): After
the application of propensity score-weighting using overlap weights, MAG
was associated with better survival over 5 years compared with DES (96.8%
vs 94.5%; hazard ratio [HR], 0.56; 95% CI, 0.37-0.85). MAG was also
associated with better secondary outcomes including a composite of death,
myocardial infarction, and stroke (94.3% vs 88.5%; HR, 0.49; 95% CI,
0.36-0.65). The rate of death, stroke, myocardial infarction, and repeat
revascularization (91.2% vs 70.7%; HR, 0.24; 95% CI, 0.20-0.30), and the
individual end points of myocardial infarction (1.4% vs 6.9%; HR, 0.22;
95% CI, 0.13-0.35), and repeat revascularization (4.1% vs 24.2%; HR, 0.14;
95% CI, 0.10-0.18) were lower with MAG. PCI with second-generation DES was
associated with a lower rate of stroke up to 5 years (0.6% vs 1.8%; HR,
3.97; 95% CI, 1.45-10.88). Conclusion(s): CABG with MAG was
associated with better survival and fewer major cardiac adverse events
compared with second-generation DES and might be considered the treatment
of choice for patients with stable multivessel coronary artery disease.
Further randomized controlled trials are needed to confirm this
hypothesis. Copyright © 2021 The American Association for
Thoracic Surgery

<111>
Accession Number
642560538
Title
Examining the Association Between Preoperative Cognitive Impairment and
Intraoperative Cerebral Desaturation in Elderly Patients Undergoing
Cardiac Surgery.
Source
Journal of Neurosurgical Anesthesiology. Conference: 51st Annual Meeting
of the Society for Neuroscience in Anesthesiology and Critical Care, SNACC
2023. Alexandria, VA United States. 35(4) (pp e60-e61), 2023. Date of
Publication: October 2023.
Author
Behera A.; Vladimir R.; Orui H.; Hussain Z.; Peck J.; Ananthakrishnan A.;
Mathur P.; Kveraga K.; Subramaniam B.
Institution
(Behera, Vladimir, Orui, Hussain, Peck, Ananthakrishnan, Mathur, Kveraga,
Subramaniam) Beth Isreal Deaconess Medical Center, Boston, MA, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Older cardiac surgery patients are at increased risk for
preexisting cognitive impairment and perioperative neurocognitive
disorders (PND), both associated with adverse postoperative outcomes.
Neuromonitoring using cerebral oximetry (CO), a surrogate marker for
cerebral blood flow, may predict PND (1). However, preoperative,
predisposing factors for cerebral desaturation intraoperatively are not
clearly delineated. We investigated the relationship between preoperative
cognitive impairment and intraoperative cerebral desaturation to
potentially link a risk factor with neuromonitoring used for PND
prediction. We hypothesized that patients with vulnerable brains
preoperatively will undergo greater cerebral desaturations during surgery.
 Method(s): This is a secondary analysis of an ongoing, multi-center,
triple-blinded, randomized trial (2) assessing the efficacy of
postoperative intravenous acetaminophen in preventing postoperative
delirium (POD) in elderly cardiac surgery patients. Baseline
characteristics of 110 patients aged > 60 years undergoing CABG and/ or
valve surgery from a single academic center were collected, including
preoperative cognitive status assessed with the Montreal Cognitive
Assessment (MoCA) and its telephone version (t-MoCA). Participants were
categorized as having normal cognition if their MoCA score was > =26 or
t-MoCA was > =19. Those with scores below these cutoffs were deemed to be
cognitively impaired. Intraoperative cerebral oxygenation from the right
and left cerebral hemispheres using Masimo's O3 regional oximetry module
was recorded, and cerebral desaturations were defined as CO values < 60%.
Data extracted from the monitors were read as excel files. The baseline CO
value around anesthesia induction and lowest value intraoperatively in
both groups were compared using the Wilcoxon rank sum test. Average CO
values for the right and left hemispheres for the total duration of the
surgery were computed for each patient and compared between the two
groups. Range of CO values (maximum-minimum) denoting the maximum
fluctuation in cerebral oxygenation status as well as the total time spent
in cerebral desaturations (in minutes) was calculated for all patients and
compared using non-parametric tests. Multiple linear regression was used
to assess the association between the intraoperative CO values and the
baseline cognitive assessment while adjusting for age, gender, race, BMI,
mean end-tidal anesthesia concentration, and total surgery time.
 Result(s): The baseline characteristics of the study participants are
presented in Table 1. Cognitively impaired patients had first CO value
around induction time that was 1.9 % and 2.8% lower on the left and right
sides, respectively. which wasn't statistically different from the normal
cognition group after adjustment. Lowest CO value recorded during the
entire surgery in the cognitively impaired group was 1.9 % and 1.1% lower
in left and right sides respectively which didn't reach statistical
significance when compared to the normal group after adjusting for
confounders. The average intraoperative CO value was not found to be
associated with preoperative cognition status (63.8 [59.4, 67.1] in
abnormal vs 63.3 [60.6,67.1] in normal group; P = 0.7, adjusted analysis
provides P = 0.32). The cognitively impaired group didn't suffer greater
fluctuations in cerebral oxygenation (22 [17.5, 29.5] vs 22.5 [19,28.8]; P
= 0.6 after adjusting). Patients in the abnormal cognition group spent
greater time intraoperatively with CO values < 60 % but this difference
was not statistically significant in comparison to the normal cognition
group (55.4 [12.4, 119] vs 46.3 [19.2, 81.9]; P = 0.6, adjusted analysis
showed that patients in the abnormal group spent 4.2 minutes longer (P =
0.8) in cerebral desaturation compared to the normal group).
 Conclusion(s): Our study revealed no evidence of a link between
preoperative cognitive impairment and intraoperative cerebral
desaturations. However, it is worth noting that a shared vascular
abnormality related to cerebral atherosclerosis among both groups in our
cardiac surgery cohort may have influenced these findings. Hence, future
investigations focusing on non-cardiac surgery patients may uncover
intriguing insights (Figure Presented).

<112>
Accession Number
642560450
Title
AACVPR 38th Annual Meeting Scientific Abstract Presentations.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. Conference: 38th
American Association of Cardiovascular and Pulmonary Rehabilitation Annual
Meeting, AACVPR 2023. Milwaukee, WI United States. 43(5) (no pagination),
2023. Date of Publication: September 2023.
Author
Anonymous
Publisher
Lippincott Williams and Wilkins
Abstract
The proceedings contain 44 papers. The topics discussed include:
identifying and prioritizing barriers to cardiac rehabilitation
participation among patients with heart failure: a modified Delphi study;
lower socioeconomic status patient characteristics entering phase 2
cardiac rehabilitation; county-level analysis of cardiac rehabilitation
facilities and broadband access to support virtual/ hybrid models;
cost-effectiveness of cardiac rehabilitation for older adults with
coronary heart disease in the united states; the compounding
vulnerabilities of sex and socioeconomic status in those entering cardiac
rehabilitation; examining associations between baseline health-related
quality of life and depression and physical functioning improvement
following pulmonary rehabilitation; CR completion and outcomes of
participants with English versus non-English preferred language;
interhospital variability in cardiac rehabilitation participation after
cardiac surgery among Medicare beneficiaries; can staff members accurately
predict outpatient cardiac rehabilitation enrollment?; anxiety levels in
individuals of lower-socioeconomic status during cardiac rehabilitation;
and a systematic review of educational interventions aiming to increase
enrollment and participation in cardiac rehabilitation.

<113>
Accession Number
642560215
Title
Optimising Exercise Prescription Within Cardiac Rehabilitation: A Network
Meta-analysis.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. Conference: 38th
American Association of Cardiovascular and Pulmonary Rehabilitation Annual
Meeting, AACVPR 2023. Milwaukee, WI United States. 43(5) (pp E9-E10),
2023. Date of Publication: September 2023.
Author
Gordon B.A.; Collins B.; Wundersitz D.; Kingsley M.
Institution
(Gordon, Collins, Wundersitz, Kingsley) Holsworth Research Initiative, La
Trobe University, Bendigo, Australia
(Kingsley) University of Auckland, Newmarket, New Zealand
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Exercise-based cardiac rehabilitation is an important
component of recovery from an acute cardiovascular event. There is no
internationally agreed guideline for the delivery of aerobic-based
exercise in cardiac rehabilitation, with substantial implementation
variation within rehabilitation centers. Advancement in medical management
for acute cardiovascular events has led to improved survival rates,
although rates of secondary cardiovascular events are increasing.
Therefore, it is important to consider how exercise can be prescribed most
effectively to increase cardiorespiratory fitness, which is highly
associated with reduced risk of subsequent cardiac events.
 Purpose(s): To identify the most effective method to deliver
aerobic-based exercise as part of cardiac rehabilitation to improve
cardiorespiratory fitness. Design(s): Systematic review with
meta-analyses. Method(s): MEDLINE, CINAHL, Cochrane, Scopus, and
SPORTDiscus databases were systematically searched from January 1, 2000,
to January 13, 2023, using constructs of "coronary heart disease,"
"cardiac rehabilitation," and "cardiorespiratory fitness." Studies were
excluded if they were not randomized trials, did not conduct a 4-week (or
longer) aerobic-based exercise intervention where the exercise dose could
be quantified, did not report an outcome of cardiorespiratory fitness
measured in mL kg-1 min-1, or included individuals
with a diagnosis of stroke, heart failure, heart transplant, or
hypertrophic cardiomyopathy as the primary condition. Duplicate studies
were identified and removed by a single reviewer. Studies were uploaded
into Covidence for completion of abstract, then full-text review, by two
independent reviewers. Conflicts were resolved through discussion. Risk of
bias was completed using the TESTEX tool, as this was developed
specifically for exercise interventions by two independent reviewers, with
conflicts resolved through discussion. Data were extracted from included
articles into an Excel spreadsheet. Interventions were considered as
supervised if any component of exercise was actively supervised (ie,
completed within a clinic) and intensity classified in accordance with the
ACSM. Random-effects meta-analyses were conducted using MetaXL (version
5.3; Epigear International, Australia). Result(s): Fifty-five studies
were included in the review with an average TESTEX score of 10.3 +/- 1.7
out of a possible 15. Aerobic-based exercise increased cardiorespiratory
fitness when directly compared to no-exercise (WMD: 3.38 (95% CI:
2.89-3.88) mL kg-1 min-1, n = 33 studies). Network
meta-analysis combining direct and indirect comparisons (55 studies, 63
comparisons) determined that versus no-exercise, supervised very
high-intensity training (HIT) had the greatest effect of cardiorespiratory
fitness (WMD: 8.20 (5.79-10.62) mL kg-1 min-1).
There was no apparent difference between supervised (WMD: 3.14 (1.34-4.93)
mL kg-1 min-1) and unsupervised (WMD: 3.10
(1.20-5.01) mL kg-1 min-1) moderate-intensity
exercise. Supervised HIT (WMD: 4.41 (2.68-6.13) mL kg-1
min-1) tended to produce greater cardiorespiratory fitness
changes than supervised moderate-intensity exercise. Conclusion(s):
Aerobic-based cardiac rehabilitation increases cardiorespiratory fitness
in individuals recovering from coronary heart disease. Although there are
indications that supervised and high-intensity exercise provides larger
effects than unsupervised and moderate-intensity exercise respectively,
there is limited statistical support for this. From these data,
aerobic-based cardiac rehabilitation should be conducted in a supervised
setting at an intensity as high as possible for the individual.

<114>
Accession Number
642560102
Title
SEECMO 2023.
Source
Cardiology in the Young. Conference: Specialists Educational
Extracorporeal Membrane Oxygenation Conference, SEECMO 2023. Gainesville,
FL United States. 33(8) (no pagination), 2023. Date of Publication: August
2023.
Author
Anonymous
Publisher
Cambridge University Press
Abstract
The proceedings contain 23 papers. The topics discussed include: exploring
preoperative factors in 19 patients undergoing cardiac transplantation
requiring extracorporeal membrane oxygenation; extracorporeal membrane
oxygenation use in patients with bronchopulmonary dysplasia: a single
center review; taking from toddlers: transcatheter atrial stent removal
following extracorporeal membrane oxygenation support; novel hypothesis
for decreasing hemolysis and prolonging oxygenator life whilst on
extracorporeal membrane oxygenation utilizing inhaled nitric oxide to the
oxygenator; creating a culture of resiliency in an extracorporeal life
support program; a novel approach to using negative pressure wound therapy
to manage extracorporeal membrane oxygenation site deterioration; what is
the weakest point of a secured aortic cannula in central extracorporeal
membrane oxygenation?; and extracorporeal membrane oxygenation and
molecular adsorbent recirculating system in acute liver failure: a
systematic review.

<115>
Accession Number
642560024
Title
The Safe Addition of Nitric Oxide to the Sweep Gas of the Extracorporeal
Membrane Oxygenation Circuit.
Source
Cardiology in the Young. Conference: Specialists Educational
Extracorporeal Membrane Oxygenation Conference, SEECMO 2023. Gainesville,
FL United States. 33(8) (pp 1487), 2023. Date of Publication: August 2023.
Author
Brock M.A.; Narasimhulu S.S.; Bleweis M.S.; Jacobs J.P.; Philip J.;
Sullivan K.; Hernandez-Rivera J.; Vazquez-Colon Z.; Peek G.J.
Publisher
Cambridge University Press
Abstract
Extracorporeal life support has become a widely-accepted technology
provide short-term mechanical circulatory support for the heart, lungs, or
both. However, there is a high morbidity associated with extracorporeal
life support, in large part due to the systemic inflammatory response
caused by the blood-circuit interaction. Studies have demonstrated the
beneficial effects of adding nitric oxide to the cardiopulmonary bypass
circuits of children undergoing cardiac surgery. The addition of nitric
oxide to the sweep gas of the extracorporeal life support circuit has been
proposed as a method to reduce the systemic inflammatory response. Here,
we describe our single-centre experience of adding nitric oxide to the
sweep gas for the extracorporeal life support circuit in 19 patients in a
paediatric cardiac intensive care unit. The outcomes of this cohort were
then compared, retrospectively, to 30 patients who underwent
extracorporeal life support without the addition of nitric oxide to the
sweep gas. There were no incidences of clinically significant
methemoglobinemia in either group. There were no differences in the
frequency of adverse bleeding events between the groups. Using a cutoff of
2% the use of nitric oxide in the sweep gas did not increase the
probability of having an elevated methaemoglobin level The addition of
nitric oxide to the sweep gas appears safe. A multicentre randomized
control trial is needed to determine the efficacy of this seemingly
beneficial therapy.

<116>
Accession Number
642559897
Title
Improvement in Enrollment Among Women Since the COVID-19 Pandemic.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. Conference:
Canadian Association of Cardiovascular Prevention and Rehabilitation
Annual Meeting, CACPR 2023. Oxford, QC Canada. 43(4) (pp E2), 2023. Date
of Publication: July 2023.
Author
Harris J.; Sawyer J.; Lafreniere T.; Faleri F.; Quinlan B.; Coutinho T.
Institution
(Harris, Sawyer, Lafreniere, Faleri, Quinlan, Coutinho) University of
Ottawa, Heart Institute, Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Participation in an outpatient cardiovascular rehabilitation
(CR) program is essential within guideline-driven best practice for
cardiovascular disease and has been shown to improve quality of life and
reduce death and hospitalization by >20%. Despite the known benefits,
participation among women has traditionally been lower than among men,
both as cited in the literature and as evidenced by enrollment rate data
at our tertiary institution (46% enrollment among women from 2018-2020
compared with 44% for men). From 2020-2022, our CR program underwent
several significant changes, all intending to meet patient needs. Some of
the changes were specifically due to the mandated shutdowns related to the
COVID-19 pandemic, while others resulted from ongoing quality improvement
initiatives. These adaptations not only allowed patients continued access
to CR programming throughout the pandemic but also had the added benefit
of better access for women. Method(s): Between March 2020 and
December 2021, adaptations to the CR program included the following: (1)
automatic referral (AR) process changes including systematic review of all
discharged charts using the electronic medical record, implementation of a
referral liaison (a member of the participant care team who engages with
the patient regarding the role of CR and initiates the CR referral), and
providing the intake appointment date prior to discharge for surgical
patients on the patient after-visit summary; (2) addition of supervised
virtual exercise (VEx) sessions in October 2021; and (3) implementation of
a tailored pre-habilitation (prehab) intervention by CR multidisciplinary
team members for elective cardiac surgery patients. Result(s):
Changes to the AR process resulted in an absolute 5% improvement in
enrollment rates overall, with a particular effect among women (9%
improvement). The VEx class attendance for 2022 reflected more women (62%
in the moderate-intensity virtual aerobics and 56% in the low-intensity
chair class) than on-site options (the usual on-site proportion of women
was 30%). Prehab programming improved CR enrollment rates for the targeted
surgical population from 50% (49% among women) prior to program
implementation to 80% (77% among women) since program implementation (May
2021-December 2022). Conclusion(s): Having health care providers act
as a referral liaison and provide a CR appointment before discharge,
offering VEx options, and engaging with surgical patients before surgery
all have had an added benefit of increasing CR enrollment rates, including
among women.

<117>
Accession Number
2027910100
Title
Safety and Immunogenicity of the Live-Attenuated Varicella Vaccine in
Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis.
Source
American Journal of Transplantation. Conference: American Transplant
Congress 2023. San Diego United States. 23(6 Supplement 1) (pp S1102),
2023. Date of Publication: June 2023.
Author
Hinson D.; Piche-Renaud P.; Lee E.Y.; Ji C.; Huang J.Y.; Uleryk E.; Teoh
C.; Morris S.K.; Top K.; Upton J.E.; Vyas M.V.; Allen U.
Institution
(Piche-Renaud, Teoh, Morris, Upton, Allen) The Hospital for Sick Children,
Toronto, ON, Canada
(Lee) St. Michael's Hospital, Toronto, ON, Canada
(Ji, Huang, Vyas) University of Toronto, Toronto, ON, Canada
(Uleryk) E.M. Uleryk Consulting, Mississauga, ON, Canada
(Top) Dalhousie University, Halifax, NS, Canada
Publisher
Elsevier B.V.
Abstract
Purpose: Recent recommendations in solid organ transplant (SOT) recipients
have been more permissible on the use of the live-attenuated varicella
vaccine (LAVV), if certain criteria are respected, such as being at least
one-year post-transplant, two months post-rejection and on low-dose
steroids or tacrolimus. The purpose of this study was to synthesize the
available evidence on the immunogenicity, safety and effectiveness of the
LAVV in the post-transplant period. Method(s): We conducted a
systematic review and meta-analysis. Electronic databases (OvidSP Medline
and EMBASE) were searched using predefined terms to identify articles
published in English that reported on the use of the LAVV in the
post-transplant period. Case series and reports were also considered for
inclusion, as they can provide important insight on rare cases of
vaccine-strain varicella (vOka) that may occur after vaccination. Pooled
proportions of SOT recipients who seroconverted, who developed vOka and
varicella disease (vaccine failure) were generated (excluding case
reports), with inverse-variance weights obtained from a random-effects
model. Analyses were performed using Stata and R. Result(s): After
screening and full-text review, nineteen articles (15 studies and 4 case
reports) were included. The articles reported on 715 SOT recipients who
received the LAVV in the post-transplant period, with 330 (46.2%) having
immunological investigations performed after vaccination. The pooled
proportion of vaccinees who seroconverted was 88.2% (95% confidence
interval 78.0%-96.0%) and was comparable between liver, kidney and heart
transplant recipients (Figure). The pooled proportion of vaccinees who
developed vOka was 0% (0%-1.2%) and the pooled proportion of vaccinees who
experienced vaccine failure was 0.8% (0%- 4.9%). There was substantial
heterogeneity for most outcomes (I2of 76.2%, 45.3% and 54.2%,
respectively). Conclusion(s): Live-attenuated varicella vaccination
in select transplant recipients was found to be safe, with a low
proportion having developed vOka. While it was found to be immunogenic,
the proportion of transplant recipients who seroconverted was lower than
that seen in the general population. Our data supports the use of
varicella vaccination in select solid organ transplant recipients.
CITATION INFORMATION: Piche-Renaud P., Lee E., Ji C., Huang J., Uleryk E.,
Teoh C., Morris S., Top K., Upton J., Vyas M., Allen U. Safety and
Immunogenicity of the Live-Attenuated Varicella Vaccine in Solid Organ
Transplant Recipients: A Systematic Review and Meta-Analysis AJT, Volume
23, Issue 6, Supplement 1. DISCLOSURES: P.Piche-renaud: None. M.V.Vyas:
n/a. U.Allen: n/a. E.Y.Lee: n/a. C.Ji: n/a. J.Y.Huang: n/a. E.Uleryk: n/a.
C.Teoh: n/a. S.K.Morris: n/a. K.Top: n/a. J.E.Upton: n/a. [Figure
presented] Copyright © 2023

<118>
Accession Number
2027909582
Title
Custodiol-N versus Custodiol: Results from a Prospective Randomised Single
Blind, Multicenter Phase III Trial in Patients Undergoing Heart
Transplantation.
Source
American Journal of Transplantation. Conference: American Transplant
Congress 2023. San Diego United States. 23(6 Supplement 1) (pp S880),
2023. Date of Publication: June 2023.
Author
Shakoor H.I.; Aliabadi-Zuckermann A.; Osorio-Jaramillo E.; Knosalla C.;
Gummert J.; Szabo G.; Wittmann F.; Yeter R.; Schramm R.; Gokler J.; Hennig
F.; Morshuis M.; Zuckermann A.
Institution
(Aliabadi-Zuckermann) Dept of Cardiac Surgery, Medical University of
Vienna, Vienna, Austria
(Osorio-Jaramillo, Wittmann, Gokler) Medical University of Vienna, Vienna,
Austria
(Knosalla, Yeter, Hennig) Deutsches Herzzentrum Berlin, Berlin, Germany
(Gummert, Schramm, Morshuis) Herz und Diabeteszentrum NRW, Bad Oeynhausen,
Germany
(Szabo) Universitatsklinikum Halle, Halle, Germany
(Zuckermann) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
Publisher
Elsevier B.V.
Abstract
Purpose: Custodiol solution (HTK) is a well-established preservation
solution in organ transplantation. Custodiol-N (HTK-N), is a novel
HTK-based solution, which includes iron chelators to reduce oxidative
injury, as well as L-arginine, to improve endothelial cell function.
Earlier results in coronary artery bypass surgery, showed good cardiac
protection without any safety concerns. The aim of this study was to
evaluate the safety and ability of Custodiol-N to preserve cardiac grafts
for heart transplantation Methods: This prospective randomised, single
blind multicenter non-inferiority trial was performed at three centers in
Austria and Germany. 105 patients were randomized to HTK N (n=53) or HTK
(n=52) as preservation solution for their donor hearts. The primary
endpoint was creatine kinase (CK-MB) peak value from 4-168 hours after
opening of the aortic cross clamp, with a 30% non-inferiority margin.
Secondary efficacy endpoints were patient and graft survival, incidence of
primary graft failure, length of intensive care unit stay. The primary
endpoint was analysed in per-protocol (PP) population, whereas other
endpoints were analysed in both as treated and PP populations.
 Result(s): Average donor age (39.42+/-12.73 vs. 45.05+/-11.62;
p=n.s.) and ischemic times (206.33+/-49.42 vs. 220.6+/-65.63; p=n.s.) were
comparable between HTK-N and HTK groups. For the PP data set, 19 patients
(HTK-N n=12, HTK n=7) were excluded due to missing CK-MB values. Average
CK-MB peak values 178.17+/-202.41 U/L in the HTK group compared to
136.29+/-70,72 U/L in the HTK-N Group (p-value for non-inferiority of
HTK-N by 30% <.0001). Patient and graft survival were comparable between
groups at 30 days and 1-year post transplantation (HTK-N: 100%, 88,7%;
HTK: 98.1%, 90,4%, p=0.83). The incidence of primary graft failure was
21.5% in the HTK and 11.3% in HTK-N group (p=0.19). Median length of
intensive care unit stay was 8 days (25%-75%: 5-11 days) in the HTK-N
group compared to 11 days in the HTK group (25%-75%: 6-19 days; p=0.13).
Safety assessment showed even distributed adverse events with only 7
(HTK:n=4, HTK-N:n=3) possibly related to the preservation solutions.
 Conclusion(s): This study shows that HTK-N is safe and provides
similar cardiac protection as the established HTK solution. Both solutions
were safe to use in clinical heart transplantation. CITATION INFORMATION:
Aliabadi-Zuckermann A., Osorio-Jaramillo E., Knosalla C., Gummert J.,
Szabo G., Wittmann F., Yeter R., Schramm R., Gokler J., Hennig F.,
Morshuis M., Zuckermann A. Custodiol-N versus Custodiol: Results from a
Prospective Randomised Single Blind, Multicenter Phase III Trial in
Patients Undergoing Heart Transplantation AJT, Volume 23, Issue 6,
Supplement 1. DISCLOSURES: A.Aliabadi-zuckermann: n/a. F.Hennig: n/a.
M.Morshuis: n/a. A.Zuckermann: Speakers Bureau;; Kohler Chemie.
E.Osorio-jaramillo: n/a. C.Knosalla: n/a. J.Gummert: n/a. G.Szabo: n/a.
F.Wittmann: n/a. R.Yeter: n/a. R.Schramm: n/a. J.Gokler:
n/a. Copyright © 2023

<119>
Accession Number
642580311
Title
Exercise-based cardiac rehabilitation for one or three montsh after
surgical aortic valve replacement, a feasibility study of a randomized
controlled trial.
Source
European Journal of Cardiovascular Nursing. Conference: EuroHeartCare -
Annual Meeting of the Association of Cardiovascular Nursing and Allied
Professions, ACNAP 2022. Madrid Spain. 21(Supplement 1) (pp i133), 2022.
Date of Publication: July 2022.
Author
Schlyter M.
Institution
(Schlyter) Skane University Hospital, Lund, Sweden
Publisher
Oxford University Press
Abstract
Background: Aortic stenosis (AS) is a common disease. Many patients on the
waiting list for surgery cut down on their physical activity resulting in
anxiety and reduced physical function. It is important to offer this group
exercise-based training in the shape of cardiac rehabilitation (CR) after
surgery. Aim(s): The primary aim was to study the feasibility of a
randomized controlled trial studying if there was any differences in
change of level of physical activity and functional exercise capacity
after one month of training compared to three months of training. Method A
feasibility study of a randomized controlled trial (RCT) with one group
receiving one month of CR (group A) versus one group receiving three
months of CR (group B). Feasibility was measured in terms of recruitment
rate, adherence rate, retention rate, adverse events and the ability to
collect primary and secondary outcome measurements. Primary outcome
measure was 6-minute walk test (6MWT) and secondary outcome measures were
heel-lift, 30-second chair stand test (CST), self-perceived physical
activity, level of physical activity, factors limiting functional exercise
capacity in daily life and current state of self-perceived health. Thirty
patients were included in the result. Result(s): Regarding
feasibility in this study the recruitment rate was low, but the adherence
and retention rates were good. The ability to collect outcome assessment
was good and there was only one adverse event. Significant differences
were found regarding physical activity and self-perceived health in favor
of the three-months training group (group B). There were no differences in
6MWT, heel-lift, CST or physical capacity between the two groups.
 Conclusion(s): This feasibility study showed that recruitment rate
was low but other measures of feasibility was satisfactory. Results
indicate that a shorter supervised program may be sufficient and may
facilitate effective use of resouces.

<120>
Accession Number
2027907957
Title
Incidence and Effects of Posttransplant Herpes Zoster in Adult Solid Organ
Transplant Recipients : A Meta-Analysis.
Source
American Journal of Transplantation. Conference: 2020 American Transplant
Congress. Virtual. 20(Supplement 3) (pp 790-791), 2020. Date of
Publication: April 2020.
Author
Han S.H.; Kwon D.
Institution
(Han, Kwon) Yonsei University Health System, Seoul, South Korea
Publisher
Elsevier B.V.
Abstract
Purpose: Recently, non-live recombinant subunit HZ vaccine showed highly
effective for herpes zoster (HZ) in hematopoietic stem cell
transplantation. Several observational studies reported various features
of HZ among heterogeneous subjects of solid organ transplantation (SOT)
recipients. We performed a meta-analysis to clarify clinical aspects of HZ
in SOT recipients. Method(s): We collected the articles using
keywords of "herpes zoster" or "human herpesvirus 3" or "varicella zoster"
and "transplant" in Pubmed and EMBASE database. Among total 3671 papers,
739 overlapping and 1406 irrelevant studies were removed by abstract
review. The full text review deleted 1512 studies (301 in pediatrics, 956
in hematopoietic stem cell transplantation, 23 of laboratory studies, 217
of case report, and 15 of non-English). Because two studies were not
eligible due to insufficient data, we finally included 12 observational
studies in meta-analysis. In addition, we retrospectively collected the
data for 329 HZ in 3498 SOT recipients from January 2001 to December 2018
of Yonsei University Health System at South Korea to include this
meta-analysis. We systemically analyzed given data according to sex and
transplant organs with R package. Result(s): Total 873 HZ cases
occurred in 10058 SOT recipients. Total pooled proportion (PP) of HZ was
0.091 (95% confidence interval [CI], 0.076-0.108) in random effects model.
The PP was significantly different between four transplant organs (overall
P < 0.001). The PP of HZ in heart transplant (HT) recipients (N=644,
0.152, 95% CI; 0.126-0.182) was highest, followed by lung transplant (LTx)
(N=780, 0.110, 95% CI; 0.083-0.144) and liver transplant recipients (LT)
(3199, 0.086, 95% CI; 0.072-0.102). The kidney transplant (KT) recipients
had the lowest HZ PP (N=5435, 0.067, 95% CI; 0.051-0.088) (Figure 1).
Meta-regression revealed that higher PP of HZ was significantly associated
with higher proportion of graft rejection (P = 0.024) (Figure 2).
 Conclusion(s): The HT and LTx recipients had higher PP of HZ than LT
and KT recipients. The HZ development in SOT recipient had significantly
association with the higher risk of graft rejection. The active program
for HZ vaccination should be implemented in high risk SOT recipients
CITATION INFORMATION: Han S., Kwon D. Incidence And Effects Of
Posttransplant Herpes Zoster In Adult Solid Organ Transplant Recipients :
A Metaanalysis Am J Transplant. 2020;20(suppl 3). DISCLOSURE: S.H. Han:
None. D. Kwon: None. [Figure presented] Copyright © 2020 American
Society of Transplantation & American Society of Transplant Surgeons.
Published by Elsevier Inc. All rights reserved.

<121>
Accession Number
2027907907
Title
Effect of Intravenous Ferric Gluconate on Post Heart Transplant Outcomes
in Patients Bridged with Left Ventricular Assist Devices.
Source
American Journal of Transplantation. Conference: 2020 American Transplant
Congress. Virtual. 20(Supplement 3) (pp 771-772), 2020. Date of
Publication: April 2020.
Author
Krepostman N.; Kim D.; Masic D.; Kuhrau S.; Negrelli J.; Liebo M.;
Raichlin E.; Heroux A.; Basha H.
Institution
(Krepostman, Kim, Masic, Kuhrau, Negrelli, Liebo, Raichlin, Heroux, Basha)
Internal Medicine, Loyola University Medical Center, Maywood, IL, United
States
Publisher
Elsevier B.V.
Abstract
Purpose: Our study examined the effect of intravenous (IV) ferric
gluconate compared to oral iron repletion in reducing 30-day hospital
readmissions and all-cause mortality in patients with left ventricular
assist devices (LVAD) who received orthotopic heart transplants (OHT).
 Method(s): This was a retrospective cohort study of patients bridged
with LVAD (n=32) who received OHT at our institution from 2014 to 2019.
LVAD patients with iron deficiency treated with IV ferric gluconate were
compared to those receiving oral ferrous sulfate for one year following
OHT or until death. Primary outcomes included one-year all-cause mortality
and 30-day readmissions following OHT. Secondary outcomes included treated
rejection, allograft dysfunction, cardiac allograft vasculopathy (CAV),
CMV viremia, and gastrointestinal (GI) bleeding. Result(s): Prior to
OHT, 5 LVAD patients received IV ferric gluconate compared to 27 patients
who received oral iron. Baseline demographics were mostly similar between
both groups (Table 1). One patient receiving IV iron therapy had higher
requirement of blood product transfusions both pre and post OHT for GI
bleeding. There was no difference in one-year survival, 30-day
readmissions, treated rejection episodes, allograft dysfunction, CAV, CMV
viremia and GI bleeding between the 2 groups. Conclusion(s):
Intravenous ferric gluconate does not improve post heart transplant
outcomes compared to oral iron therapy in LVAD patients. Prospective
randomized controlled trials with larger sample sizes using other
intravenous iron formulations such as ferric carboxymaltose may help
clarify the role of intravenous iron therapy on post OHT outcomes in
patients bridged with LVADs. CITATION INFORMATION: Krepostman N., Kim D.,
Masic D., Kuhrau S., Negrelli J., Liebo M., Raichlin E., Heroux A., Basha
H. Effect Of Intravenous Ferric Gluconate On Post Heart Transplant
Outcomes In Patients Bridged With Left Ventricular Assist Devices Am J
Transplant. 2020;20(suppl 3). DISCLOSURE: N. Krepostman: None. D. Kim:
None. D. Masic: None. S. Kuhrau: None. J. Negrelli: None. M. Liebo: None.
E. Raichlin: None. A. Heroux: None. H. Basha: None. [Figure
presented] Copyright © 2020 American Society of Transplantation &
American Society of Transplant Surgeons. Published by Elsevier Inc. All
rights reserved.

<122>
Accession Number
2027907883
Title
Recruitment in the Pediatric Heart Transplant TEAMMATE Trial: Observed vs.
Expected.
Source
American Journal of Transplantation. Conference: 2020 American Transplant
Congress. Virtual. 20(Supplement 3) (pp 762), 2020. Date of Publication:
April 2020.
Author
Daly K.P.; Sleeper L.A.; Addonizio L.J.; Alejos J.C.; Auerbach S.; Bock
M.J.; Butto A.; Carlo W.F.; Castleberry C.; Dreyer W.J.; Feingold B.;
Lamour J.M.; Albers E.L.; Hollander S.A.; Klein G.L.; Lal A.; Pahl E.;
Peng D.; Punnoose A.R.; Rossano J.W.; Ryan T.D.; Su J.; Sutcliffe D.L.;
Zangwill S.; Almond C.S.
Institution
(Daly, Sleeper, Addonizio, Alejos, Auerbach, Bock, Butto, Carlo,
Castleberry, Dreyer, Feingold, Lamour, Albers, Hollander, Klein, Lal,
Pahl, Peng, Punnoose, Rossano, Ryan, Su, Sutcliffe, Zangwill, Almond)
TEAMMATE Trial Investigators, Boston, MA, United States
Publisher
Elsevier B.V.
Abstract
Purpose: The TEAMMATE (Tacrolimus/Everolimus vs. Tacrolimus/MMF in
Pediatric Heart Transplant Recipients using the MATE Score) Trial is the
first multicenter effort to address key scientific questions in pediatric
heart transplant using a randomized trial design. Given that pediatric
trials present unique challenges with respect to enrollment, we sought to
examine our screening patterns, recruitment performance, and the
characteristics of the randomized cohort. Method(s): TEAMMATE has 26
participating US study sites. Six-month heart transplant survivors are
randomized in a 1:1 ratio to everolimus/low-dose tacrolimus (EVL/LDTAC) or
tacrolimus/mycophenolate mofetil (TAC/MMF) and are followed for 30 months.
Patient screening and recruitment began in Feb 2018 and will be completed
by spring 2020. The TEAMMATE Trial Coordinating Centers (Clinical:
Stanford/Lucile Packard Hospital; Data: Harvard/Boston Children's
Hospital) developed several tools including a public website
(http://med.stanford.edu/teammate. html) and an informed consent video in
two languages, approved by a central IRB. The target sample size is 210
patients. Original design assumptions were 85% eligibility and 80%
consent, for a yield of 68% of total screened. Result(s): As of
12/05/19, a total of 504 patients were screened for trial eligibility. Of
these, 56% were potentially eligible and approached for consent. The
consent rate was 63% and 162 were randomized (32% of total screened). The
most common reasons (not mutually exclusive) for the 214 screen failures
were a) inability to return to study site for study visits (n=52, 24%); b)
prior qualifying rejection (n=34, 16%); c) past reaction to MMF (n=32,
15%); d) history of non-adherence to immunosuppression regimen (n=30,
14%); and e) participation in a concurrent pediatric heart transplant
trial (n=18, 8%). The randomized cohort (n=81 EVL/LDTAC, n=81 TAC/MMF to
date) is age 7.9+/-6.2 years (17% infants). One-half (48%) had a
cardiomyopathy diagnosis and 47% had congenital heart disease (n=64 single
ventricle and n=11 two ventricle). Nearly half (49%) are insured by
Medicare/Medicaid/CHIP. One quarter (24%) experienced rejection prior to
trial enrollment (15% grade 1R and 7% grade 2R acute cellular rejection;
1% grade 1 and 2% grades 2-3 antibody-mediated rejection).
 Conclusion(s): Actual eligibility and informed consent rates for the
TEAMMATE Trial were lower than expected for multiple reasons; but
innovative trial tools and close collaboration have led to successful,
albeit longer duration of, recruitment in this medically complex
population. The randomized cohort will provide unique information on the
safety and relative efficacy of EVL/LDTAC with respect to long-term
complications of heart transplant in children. CITATION INFORMATION: Daly
K., Sleeper L., Addonizio L., Alejos J., Auerbach S., Bock M., Butto A.,
Carlo W., Castleberry C., Dreyer W., Feingold B., Lamour J., Albers E.,
Hollander S., Klein G., Lal A., Pahl E., Peng D., Punnoose A., Rossano J.,
Ryan T., Su J., Sutcliffe D., Zangwill S., Almond C. Recruitment In The
Pediatric Heart Transplant TEAMMATE Trial: Observed Vs. Expected Am J
Transplant. 2020;20(suppl 3). DISCLOSURE: K.P. Daly: Grant/Research
Support; Name of Commercial Interest; Novartis. Grant/Research Support;
Nature of Relationship; Site PI on Clinical Trial. L.A. Sleeper: None.
L.J. Addonizio: None. J.C. Alejos: None. S. Auerbach: None. M.J. Bock:
None. A. Butto: None. W.F. Carlo: None. C. Castleberry: None. W.J. Dreyer:
None. B. Feingold: None. J.M. Lamour: None. E.L. Albers: None. S.A.
Hollander: None. G.L. Klein: None. A. Lal: None. E. Pahl: None. D. Peng:
None. A.R. Punnoose: None. J.W. Rossano: None. T.D. Ryan: None. J. Su:
None. D.L. Sutcliffe: None. S. Zangwill: None. C.S. Almond:
None. Copyright © 2020 American Society of Transplantation &
American Society of Transplant Surgeons. Published by Elsevier Inc. All
rights reserved.

<123>
Accession Number
2027907877
Title
Bariatric Surgery to Achieve Sufficient Weight Loss for Heart Transplant
Candidacy: Results of a Systematic Review and Meta-Analysis.
Source
American Journal of Transplantation. Conference: 2020 American Transplant
Congress. Virtual. 20(Supplement 3) (pp 759-760), 2020. Date of
Publication: April 2020.
Author
Orandi B.; Purvis J.; Mehta S.; Gray M.; Pamboukian S.; Tallaj J.; Hoopes
C.; Lewis C.; Terrault N.; Locke J.
Institution
(Orandi, Purvis, Mehta, Gray, Pamboukian, Tallaj, Hoopes, Lewis, Locke)
UAB, Birmingham, AL, United States
(Terrault) USC, Los Angeles, CA, United States
Publisher
Elsevier B.V.
Abstract
Purpose: As the obesity epidemic grows, it can be expected that an
increasing number of heart failure patients will be precluded from heart
transplant based on BMI. Method(s): A PubMed search strategy was used
to identify studies of bariatric surgery to help patients achieve heart
transplant. When possible, individual level data were aggregated to create
summary statistics. Result(s): We identified 19 studies (761 were
excluded), which included 82 patients who were ineligible for heart
transplant because of their high BMI and subsequently underwent bariatric
surgery (Table 1). 41.5% were female, mean age was 42.9, and 74.4% had
non-ischemic cardiomyopathy as the etiology of their heart failure.
Rouxen-Y gastric bypass, sleeve gastrectomy, adjustable gastric band, and
biliopancreatic diversion were performed in 50.0%, 36.6%, 12.2%, and 1.2%,
respectively. 37.8% had a left ventricular assist device in place prior to
bariatric surgery and 9.7% had it placed simultaneous with bariatric
surgery. Patients had a decrease in BMI from 47.3
kg/m2pre-bariatric surgery to 34.8 kg/m2over an
average of 20.7 months of follow-up (P<0.0001). Of the 22 patients with
ejection fraction (EF) reported both pre- and post-bariatric surgery, the
mean EF increased from 20.5% (SD 4.8) to 33.2% (SD 14.4) (P<0.0001) over
an average of 23.9 months of follow-up. Patients also had improvement in
New York Heart Association Heart Failure Classification (Figure 1). Mean
hospital length of stay was 8.0 (SD 5.7) days and no perioperative deaths
were reported. 40.2% of patients were able to be listed and 72.7% of
listed patients were able to be transplanted over a mean of 13.9 months
(SD 5.4). Overall, 46.3% of the group was able to be listed or no longer
required transplant (n=7) due to clinical improvement. Conclusion(s):
Small sample size and publication bias in the identified studies are major
limitations; however, the aggregated data suggest that with appropriate
operative and perioperative care, bariatric surgery in heart failure
patients with obesity that precludes transplant candidacy may benefit
carefully selected patients. CITATION INFORMATION: Orandi B., Purvis J.,
Mehta S., Gray M., Pamboukian S., Tallaj J., Hoopes C., Lewis C., Terrault
N., Locke J. Bariatric Surgery To Achieve Sufficient Weight Loss For Heart
Transplant Candidacy: Results Of A Systematic Review And Meta-analysis Am
J Transplant. 2020;20(suppl 3). DISCLOSURE: B. Orandi: None. J. Purvis:
None. S. Mehta: None. M. Gray: None. S. Pamboukian: None. J. Tallaj: None.
C. Hoopes: None. C. Lewis: None. N. Terrault: None. J. Locke: None.
[Figure presented] Copyright © 2020 American Society of
Transplantation & American Society of Transplant Surgeons. Published by
Elsevier Inc. All rights reserved.

<124>
Accession Number
2026267647
Title
Benefits of using digital thoracic drainage systems for post-operative
treatment in pediatric populations: personal experience and review of
literature.
Source
Frontiers in Pediatrics. 11 (no pagination), 2023. Article Number:
1280834. Date of Publication: 2023.
Author
Frediani S.; Romano G.; Pardi V.; Aloi I.P.; Bertocchini A.; Accinni A.;
Zarfati A.; Inserra A.
Institution
(Frediani, Romano, Pardi, Aloi, Bertocchini, Accinni, Zarfati, Inserra)
General and Thoracic Pediatric Surgery Unit, Bambino Gesu Children's
Hospital, IRCCS, Rome, Italy
Publisher
Frontiers Media SA
Abstract
Introduction: The digital chest drainage monitoring system (Medela
Thopaz+), unlike analogical systems, reliably regulates the pressure
applied to the patient's chest and digitally and silently monitors
critical therapeutic indicators (volume of fluid and/or drained air). Its
use in adulthood has been widely described, but there is still little
experience in the pediatric field. The aim of this study is to test this
new device in the pediatric population. Material(s) and Method(s): We
conducted a retrospective study of 160 patients undergoing chest surgery
at our Hospital. These patients were divided into 82 treated with the
Thopaz system in the period from January 2021 to April 2023 and 78 in whom
Pleurevac, had been used in the time period from January 2020 to April
2023. Result(s): The average age of patients was 10.45 years (range:
3.1-17.2) for the Thopaz Group and 10.71 years for Pleurevac Group. The
groups were homogeneus also by weight and type of intervention. The device
was held in place for 10.64 days (mean) for Thopaz Group, compared to
16.87 days (mean) for Pleurevac Group (p < 0.05). The median number of
postoperative x-rays before the closure of the chest tube was 4.29 in the
digital drainage group compared to 8.41 in the traditional draining group
(p < 0.05). Conclusion(s): The digital chest monitoring device
provides objective measurement, allows for rapid patient mobilization
(with good pain control and increased compliance). In addition, the use of
Thopaz in the paediatric population seems to be safe (there is no
statistically significant difference in terms of complications such as
prolonged air leaks and pneumothorax after the chest tube closure) and
potentially beneficial. Copyright 2023 Frediani, Romano, Pardi, Aloi,
Bertocchini, Accinni, Zarfati and Inserra.

<125>
Accession Number
2026261306
Title
Concurrent coronary artery disease and immune thrombocytopenia: a
systematic review.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1213275.
Date of Publication: 2023.
Author
Rahhal A.; Provan D.; Shunnar K.; Najim M.; Ahmed A.O.; Rozi W.;
Al-Khabori M.; Marashi M.; AlRasheed M.; Osman H.; Yassin M.
Institution
(Rahhal) Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
(Provan) Barts and The London School of Medicine, Queen Mary University of
London, London, United Kingdom
(Shunnar) Cardiology Department, Hamad Medical Corporation, Doha, Qatar
(Najim) Internal Medicine Department, Rochester Regional Health-Unity
Hospital, New York, NY, United States
(Ahmed, Rozi) Internal Medicine Department, Hamad Medical Corporation,
Doha, Qatar
(Al-Khabori) Hematology Department, Sultan Qaboos University, Muscat, Oman
(Marashi) Dubai Academic Health Corporation and Mediclinic Hospital,
Dubai, United Arab Emirates
(AlRasheed) Hematology Department, AlAdan Hospital, Hadiya, Kuwait
(Osman) Hematology and Oncology Department, Tawam Hospital, Abu-Dhabi,
United Arab Emirates
(Yassin) Hematology Department, National Centre for Cancer Care and
Research, Hamad Medical Corporation, Doha, Qatar
Publisher
Frontiers Media SA
Abstract
Introduction: Coronary artery disease (CAD) management in the setting of
immune thrombocytopenia (ITP) remains very challenging to clinicians as a
reasonable balance between bleeding and thrombosis risks needs to be
achieved, and the evidence guiding such management is scarce.
 Method(s): We conducted a systematic review following the PRISMA
guidelines to summarize the available literature on the management and
outcomes of CAD coexisting with ITP. We searched PubMed and Embase for
studies published in English exploring CAD and ITP management until 05
October 2022. Two independent reviewers screened and assessed the articles
for inclusion. Patients' characteristics, CAD treatment modalities, ITP
treatment, and complications were reported. Result(s): We identified
32 CAD cases, among which 18 cases were revascularized with percutaneous
coronary intervention (PCI), 12 cases underwent coronary artery bypass
graft surgery (CABG), and two cases were managed conservatively. More than
50% were men, with a mean age of 61 +/- 13 years and a mean baseline
platelet count of 52 +/- 59 x 109/L. Irrespective of the
revascularization modality, most patients were treated with either
corticosteroids alone, intravenous immunoglobulins (IVIG) alone, or in
combination. Among those who underwent PCI, two patients had bleeding
events, and one patient died. Similarly, among those with CABG, one
patient developed bleeding, and one patient died. Conclusion(s): We
found that revascularization with either PCI or CABG with the concurrent
use of corticosteroids and/or IVIG for ITP was feasible, with an existing
non-negligible risk of bleeding and mortality. Copyright © 2023
Rahhal, Provan, Shunnar, Najim, Ahmed, Rozi, Al-Khabori, Marashi,
AlRasheed, Osman and Yassin.

<126>
Accession Number
2026244773
Title
Cost-effectiveness of left atrial appendage closure for stroke prevention
in atrial fibrillation: a systematic review appraising the methodological
quality.
Source
Cost Effectiveness and Resource Allocation. 21(1) (no pagination), 2023.
Article Number: 76. Date of Publication: December 2023.
Author
Hewage S.A.; Noviyani R.; Brain D.; Sharma P.; Parsonage W.; McPhail S.M.;
Barnett A.; Kularatna S.
Institution
(Hewage, Brain, Sharma, Parsonage, McPhail, Barnett, Kularatna) Australian
Centre for Health Services Innovation and Centre for Healthcare
Transformation, Queensland University of Technology, No.61, Musk Avenue,
Kelvin Grove, QLD 4059, Australia
(Noviyani) Department of Pharmacy, Udayana University, Bali, Indonesia
(Parsonage) Cardiology department, Royal Brisbane and Women's Hospital,
Herston, QLD, Australia
(McPhail) Digital Health and Informatics Directorate, Metro South Health,
Brisbane, QLD, Australia
Publisher
BioMed Central Ltd
Abstract
Background: The increasing global prevalence of atrial fibrillation (AF)
has led to a growing demand for stroke prevention strategies, resulting in
higher healthcare costs. High-quality economic evaluations of stroke
prevention strategies can play a crucial role in maximising efficient
allocation of resources. In this systematic review, we assessed the
methodological quality of such economic evaluations. Method(s): We
searched electronic databases of PubMed, EMBASE, CINAHL, Cochrane Central
Register of Controlled Trials, and Econ Lit to identify model-based
economic evaluations comparing the left atrial appendage closure procedure
(LAAC) and oral anticoagulants published in English since 2000. Data on
study characteristics, model-based details, and analyses were collected.
The methodological quality was evaluated using the modified Economic
Evaluations Bias (ECOBIAS) checklist. For each of the 22 biases listed in
this checklist, studies were categorised into one of four groups: low
risk, partial risk, high risk due to inadequate reporting, or high risk.
To gauge the overall quality of each study, we computed a composite score
by assigning + 2, 0, - 1 and - 2 to each risk category, respectively.
 Result(s): In our analysis of 12 studies, majority adopted a
healthcare provider or payer perspective and employed Markov Models with
the number of health states varying from 6 to 16. Cost-effectiveness
results varied across studies. LAAC displayed a probability exceeding 50%
of being the cost-effective option in six out of nine evaluations compared
to warfarin, six out of eight evaluations when compared to dabigatran, in
three out of five evaluations against apixaban, and in two out of three
studies compared to rivaroxaban. The methodological quality scores for
individual studies ranged from 10 to - 12 out of a possible 24. Most
high-risk ratings were due to inadequate reporting, which was prevalent
across various biases, including those related to data identification,
baseline data, treatment effects, and data incorporation. Cost measurement
omission bias and inefficient comparator bias were also common.
 Conclusion(s): While most studies concluded LAAC to be the
cost-effective strategy for stroke prevention in AF, shortcomings in
methodological quality raise concerns about reliability and validity of
results. Future evaluations, free of these shortcomings, can yield
stronger policy evidence. Copyright © 2023, BioMed Central Ltd.,
part of Springer Nature.

<127>
Accession Number
642571625
Title
Outcomes of Transcatheter Mitral Valve Repair Using the MitraClip System
in Patients With Atrial Fibrillation. A Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 18 Oct 2023.
Author
Halboni A.; Hamza M.; Dayco J.; Al-Abcha A.; Alhalbouni A.; Zghouzi M.;
Alhusain R.; Sattar Y.; Alraies M.C.
Institution
(Halboni, Dayco, Alhusain) Department of Internal Medicine, Wayne State
University/Detroit Medical Center, Detroit, MI, United States
(Hamza) Department of Medicine, Albany Medical Center, Albany, NY, United
States
(Al-Abcha) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Alhalbouni) School of Medicine, University of Jordan, Amman, Jordan
(Zghouzi) Division of Vascular Medicine, University of Michigan, Ann
Arbor, MI, United States
(Sattar) Division of Cardiology, West Virginia University, Morgantown, WV,
United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Abstract
Transcatheter mitral valve repair (TMVR) with the MitraClip system is now
approved for degenerative and functional mitral regurgitation (MR). Atrial
fibrillation (AF) is commonly seen in MR. In our study, we perform a
pooled analysis of the existing data to investigate the outcomes of
MitraClip in patients with versus without AF. We conducted a systematic
search of PubMed, Google Scholar, and SCOPUS databases through December,
2022 for studies comparing the outcomes of TMVR using the MitraClip in
patients with preexisting AF versus those without AF. A meta-analysis was
performed to investigate the primary outcomes of all-cause mortality and
heart failure (HF) hospitalization. Secondary outcomes were cardiovascular
mortality, in-hospital mortality, stroke, New York Heart Association class
I or II at follow-up, length of hospital stay, and procedural time. A
total of 10 studies (n=24,111; AF=12,789; no AF=11,322) were included in
the final analysis. Preexisting AF was associated with higher overall
all-cause mortality (odds ratio 1.55, 95% confidence interval 1.32 to
1.83, p <0.0002) and higher overall HF hospitalization rate (odds ratio
1.3, 95% confidence interval 1.08 to 1.56, p <0.0154). There was no
statistically significant difference in cardiovascular mortality,
in-hospital mortality, stroke, length of hospital stay, procedural time,
or New York Heart Association class I/II at follow-up comparing AF versus
no AF. The presence of AF in patients who underwent TMVR with MitraClip is
associated with higher all-cause mortality and HF hospitalization. This
should be taken into consideration in the management of MR
patients. Copyright © 2023. Published by Elsevier Inc.

<128>
Accession Number
642571557
Title
Trimethoprim-Sulfamethoxazole Significantly Reduces the Risk of
Nocardiosis in Solid Organ Transplant Recipients: Systematic review and
Individual Patient Data Meta-Analysis.
Source
Clinical microbiology and infection : the official publication of the
European Society of Clinical Microbiology and Infectious Diseases. (no
pagination), 2023. Date of Publication: 19 Oct 2023.
Author
Passerini M.; Nayfeh T.; Yetmar Z.A.; Coussement J.; Goodlet K.J.; Lebeaux
D.; Gori A.; Mahmood M.; Temesgen Z.; Murad M.H.
Institution
(Passerini) Department of Pathophysiology and Transplantation, University
of Milano, Milan, Italy; Department of Infectious Disease, ASST FBF SACCO
Fatebenefratelli, Milano, Lombardia, Italy
(Nayfeh, Mahmood, Temesgen, Murad) Division of Public Health, Infectious
Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic,
Rochester, MN, United States
(Yetmar) Division of Public Health, Infectious Diseases and Occupational
Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA;
Department of Infectious Diseases, Respiratory Institute, Cleveland Clinic
Foundation, Cleveland, Ohio, USA
(Coussement) Sir Peter MacCallum Department of Oncology, The University of
Melbourne, Melbourne, VIC, Australia; Service de Maladies Infectieuses et
Tropicales, Centre Hospitalier Universitaire de Guadeloupe, Les Abymes,
Guadeloupe, France
(Goodlet) Department of Pharmacy Practice, Midwestern University,
Glendale, Arizona, USA; Norton Thoracic Institute, Dignity Health - St.
Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
(Lebeaux) Institut Pasteur, Universite Paris Cite, CNRS UMR 6047, Genetics
of Biofilms Laboratory, 75015 Paris, France; Departement de Maladies
Infectieuses et Tropicales, AP-HP, Hopital Saint-Louis, Lariboisiere,
F-75010 Paris, France
(Gori) Department of Pathophysiology and Transplantation, University of
Milano, Milan, Italy; Department of Infectious Disease, ASST FBF SACCO
Fatebenefratelli, Milano, Lombardia, Italy; Centre for Multidisciplinary
Research in Health Science (MACH), University of Milan, Milan, Italy
Abstract
BACKGROUND: Whether trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis
prevents nocardiosis in solid organ transplant recipients (SOT) is
controversial. OBJECTIVE(S): To assess the effect of TMP-SMX in the
prevention of nocardiosis after SOT, its dose-response relationship, its
effect on preventing disseminated nocardiosis, and the risk of TMP-SMX
resistance in case of breakthrough infection. METHOD(S): A systematic
review and individual patient data meta-analysis. DATA SOURCES: MEDLINE,
Embase, Cochrane Central Register of Controlled Trials, Cochrane Database
of Systematic Reviews, Web of Science Core Collection, and Scopus up to 19
September 2023. STUDY ELIGIBILITY CRITERIA: (i) risk of nocardiosis
between SOT recipients with and without TMP-SMX prophylaxis, or (ii)
sufficient details to determine the rate of TMP-SMX resistance in
breakthrough nocardiosis. PARTICIPANTS: SOT recipients. EXPOSURE: TMP-SMX
prophylaxis versus no prophylaxis. ASSESSMENT OF RISK OF BIAS: ROBINS-E
for comparative studies; dedicated tool for non-comparative studies.
METHODS OF DATA SYNTHESIS: For our primary outcome (i.e., to determine the
effect of TMP-SMX on the risk of nocardiosis), a one-step mixed-effects
regression model was used to estimate the association between the outcome
and the exposure. Univariate and multivariable unconditional regression
models were used to adjust for the potential confounding effects.
Certainty of evidence was assessed using the GRADE approach.
 RESULT(S): Individual data from three case-control studies were
obtained (260 SOT recipients with nocardiosis, 519 uninfected controls).
TMP-SMX prophylaxis was independently associated with a significantly
decreased risk of nocardiosis (adjusted OR=0.3, 95% CI 0.18-0.52, moderate
certainty of evidence). Variables independently associated with an
increased risk of nocardiosis were older age, current use of
corticosteroids, high calcineurin inhibitor concentration, recent acute
rejection, lower lymphocyte count, and heart transplant. Breakthrough
infections (66/260, 25%) were generally susceptible to TMP-SMX (pooled
proportion 98%, 95% CI 92-100). CONCLUSION(S): In SOT recipients,
TMP-SMX prophylaxis likely reduces the risk of nocardiosis. Resistance
appears uncommon in case of breakthrough infection. Copyright ©
2023. Published by Elsevier Ltd.

<129>
Accession Number
642559689
Title
Impact of Mobile Apps in Conjunction With Percutaneous Endoscopic
Gastrostomy on Patients' Complications, Quality of Life, and
Health-Related Self-Care Behaviors: Randomized Clinical Trial.
Source
JMIR mHealth and uHealth. 11 (pp e48970), 2023. Date of Publication: 20
Oct 2023.
Author
Chen B.-L.; Lien H.-C.; Yang S.-S.; Wu S.-C.; Chiang H.-H.; Lin L.-C.
Institution
(Chen, Chiang) Department of Nursing, National Yang Ming Chiao Tung
University, Taipei City, Taiwan (Republic of China)
(Chen) Department of Nursing, Taichung Veterans General Hospital,
Taichung, Taiwan (Republic of China)
(Lien) Division of Gastroenterology, Taichung Veterans General Hospital,
Taichung, Taiwan (Republic of China)
(Yang) Division of Thoracic Surgery, Taichung Veterans General Hospital,
Taichung, Taiwan (Republic of China)
(Wu) Institute of Health and Welfare Policy, National Yang Ming Chiao Tung
University, Taipei City, Taiwan (Republic of China)
(Lin) Department of Nursing, Asia University, Taichung, Taiwan (Republic
of China)
Abstract
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is commonly chosen
for long-term enteral nutrition support. However, common complications of
PEG include wound infection, leakage, obstruction, bleeding, dislodgement,
pneumonia, peritonitis, and more. The anticipation of these complications
by both patients and their family caregivers underscores the essential
requirement of ongoing technical guidance for the daily care of PEG and
the adoption of preventative strategies. OBJECTIVE(S): This study
aimed to establish and compare a health education program utilizing a
tracking system for PEG using a mobile app (PEG app) and instant messaging
software versus a paper-based health education program with instant
messaging software. Their effectiveness in preventing complications,
avoiding hospital readmissions, improving self-care practices, and
enhancing quality of life outcomes was assessed. METHOD(S): A
randomized controlled trial design was used, and the study sample
consisted of patients from a medical center in central Taiwan who
underwent thoracic surgery or gastroenterology procedures. Inclusion
criteria were being a new case undergoing his or her first gastric tube
insertion and having the ability to operate a smartphone. Exclusion
criteria were cases requiring tube replacement or nasogastric tubes. A
total of 74 participants were enrolled, with 37 participants in the
experimental group and 37 participants in the control group. Data
collection took place from hospitalization until 1 month after discharge.
The experimental group received care using the gastric tube tracking
system (PEG app) and the Line app that included phone, text, and photo
capture capabilities, while the control group received routine nursing
care and used the Line app. RESULT(S): The experimental group
demonstrated a significant reduction in the occurrence of complications
compared with the control group (chi21=12.087, P=.001). Specifically, the
occurrence of leakage events was significantly lower in the experimental
group than in the control group (chi21=12.906, P=.001). However, the
experimental group exhibited superior self-care ability compared with the
control group (t72=2.203, P=.03). There was no significant difference in
overall quality of life scores between the experimental and control groups
(t72=1.603, P=.11). However, the experimental group showed better social
aspects of quality of life than the control group (t72=2.164, P=.03).
 CONCLUSION(S): Integration of the PEG app with instant messaging can
enhance self-care ability, improve social aspects of quality of life, and
reduce complications. The study results suggest that the PEG app could be
used as an adjunct tool to promote patients' self-directed management of
their gastric tube at home, particularly for patients who have undergone
their first PEG placement and are being discharged from the hospital.
TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2300071271;
https://tinyurl.com/4vvy584e. Copyright ©Bi-Lian Chen, Han-Chung
Lien, Shyh-Sheng Yang, Shiao-Chi Wu, Hsien-Hsien Chiang, Li-Chan Lin.
Originally published in JMIR mHealth and uHealth
(https://mhealth.jmir.org), 20.10.2023.

<130>
Accession Number
642559368
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: 01 Oct 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), Kolkata, West Bengal, India
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.

<131>
Accession Number
642559232
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: 01 Oct 2023.
Author
Akbarpour Roshan M.B.; Jafarpoor H.; Shamsalinia A.; Fotokian Z.; Hamidi
S.H.
Institution
(Akbarpour Roshan) Student Research Committee, 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
(Shamsalinia, Fotokian) Nursing Care 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
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.

<132>
Accession Number
642557817
Title
Survival Following Surgical Aortic Valve Replacement in Low-Risk Patients:
A Contemporary Trial Benchmark.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 16 Oct 2023.
Author
Thourani V.H.; Habib R.; Szeto W.Y.; Sabik J.F.; Romano J.C.; MacGillivray
T.E.; Badhwar V.
Institution
(Thourani) Department of Cardiothoracic Surgery, Piedmont Healthcare,
Atlanta, GA, United States
(Habib) Society of Thoracic Surgeons Research and Analytic Center,
Chicago, IL, United States
(Szeto) Division of Cardiovascular Surgery, University of Pennsylvania,
Philadelphia, PA, United States
(Sabik) Department of Surgery, University Hospitals, Cleveland, OH, United
States
(Romano) Department of Cardiac Surgery, University of Michigan, Ann Arbor,
MI, United States
(MacGillivray) Department of Cardiac Surgery, MedStar Health, WA, United
States
(Badhwar) Department of Cardiovascular and Thoracic Surgery, West Virginia
University, Morgantown, WV, United States
Abstract
BACKGROUND: The use of transcatheter aortic valve replacement (TAVR) for
severe aortic stenosis in low-risk patients necessitates an evaluation of
contemporary long-term, real-world outcomes of similar patients undergoing
surgical aortic valve replacement (SAVR) in a national cohort.
 METHOD(S): All patients undergoing primary, isolated SAVR in the STS
database between 2011-2019 were examined. The study population of 42,586
adhered to the inclusion/exclusion criteria of the PARTNER 3 and Evolut
Low Risk randomized trials. Patients were further stratified by STS
predicted risk of mortality (PROM), age, and left ventricular ejection
fraction (LVEF). The primary end-point was all-cause National Death Index
mortality. Unadjusted survival to 8 years was estimated using the
Kaplan-Meier method. RESULT(S): The mean age was 74.3+/-5.7 years and
mean STS PROM was 1.9%+/-0.8%. The overall Kaplan-Meier time to event
analysis for all-cause mortality at 1-, 3-, 5-, and 8-years was 2.6%,
4.5%, 7.1% and 12.4%, respectively. In subset analyses, survival was
significantly better for 1) lower STS PROM (p<0.001), 2) younger versus
older age (p<0.001), and 3) higher versus lower LVEF (p<0.001). When STS
PROM was below 1% or the patient age was below age 75 years, the 8-year
survival following SAVR was 95%. CONCLUSION(S): The results of this
national study confirm that the long-term survival following SAVR remains
excellent, at 92.9% at 5 years. These contemporary longitudinal data serve
to aid in the balanced interpretation of current and future trials
comparing SAVR and TAVR and may assist in the clinical decision-making
process for patients of lower surgical risk. Copyright © 2023.
Published by Elsevier Inc.

<133>
[Use Link to view the full text]
Accession Number
2027782829
Title
The Time to Initiate Anti-Inflammatory Therapy for Patients With Chronic
Coronary Atherosclerosis Has Arrived.
Source
Circulation. 148(14) (pp 1071-1073), 2023. Date of Publication: 03 Oct
2023.
Author
Ridker P.M.
Institution
(Ridker) Center for Cardiovascular Disease Prevention, Division of
Preventive Medicine, Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins

<134>
Accession Number
2027042532
Title
Effects of Remote Ischemic Preconditioning on Delirium and Neurological
Function in Patients Undergoing Cardiac Surgery: A Multicenter Randomized
Controlled Trial.
Source
Heart Surgery Forum. 26(4) (pp E408-E416), 2023. Date of Publication:
2023.
Author
Liu T.; Liu X.; Wan R.
Institution
(Liu, Liu, Wan) Department of Quality Management, The 904th Hospital of
Joint Logistic Support Force, Jiangsu, Wuxi 214044, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Postoperative delirium (POD) and neurological dysfunction are
very common following cardiac surgery and deteriorate the patient's
prognosis and the outcome of surgical procedures. A clinically effective
management strategy or drug is not yet available for POD. Additionally, it
is unknown whether remote ischemic preconditioning (PJPC) has
neuroprotective and anti-delirium benefits in patients who undergo cardiac
surgery. Method(s): This study examined whether PJPC can improve POD
and neurological function in cardiac surgery patients. We screened 510
consecutive adult patients aged 18 and older who underwent cardiac surgery
between January 2018 and December 2022. Then. 448 of these patients were
recruited in the trial as the intention to treat (ITT) group, who were
then randomly assigned to receive either a control (n = 223) or PJPC
treatment (n = 225). The primary outcome measures were hospitalization
postoperative delirium, six-month modified Rankins scale (mRS), hospital
cerebral infarction, 30-day overall mortality, neuron-specific enolase
(NSE) and S-lOOb levels, related adverse effects, hospital costs, and
hospital stay. Result(s): A statistically significant variation was
not observed between the two groups in terms of the baseline clinical
data, hi contrast to the control group, the POD in the PJPC group was
considerably alleviated. PJPC treatment also decreased the levels of NSE
and S-lOOb. which alleviated nerve injury. The adverse impacts of
PJPC-induced objective indicators of tissue or neurovascular damage were
similar in both groups, showing no significant variations between the two.
The hospital stays and hospitalization costs also decreased significantly
in the PJPC-treated patients. Conclusion(s): The study findings
suggested that PJPC may benefit cardiac surgery patients by reducing POD,
alleviating injury, and lowering hospital expendinires and length of stay.
Cardiac surgery patients can be treated with PJPC, which is an effective
and safe technique. Copyright © 2023 Forum Multimedia Publishing
LLC. All rights reserved.

<135>
Accession Number
2025259787
Title
The impact of PECS II blockade in patients undergoing minimally invasive
cardiac surgery-a prospective, randomized, controlled, and triple-blinded
trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 570. Date of
Publication: December 2023.
Author
Hoerner E.; Stundner O.; Naegele F.; Fiala A.; Bonaros N.; Mair P.;
Holfeld J.; Gasteiger L.
Institution
(Hoerner, Stundner, Fiala, Mair, Gasteiger) Department of Anaesthesiology
and Intensive Care Medicine, Medical University of Innsbruck, Anichstrasse
35, Innsbruck 6020, Austria
(Naegele, Bonaros, Holfeld) Department of Cardiac Surgery, Medical
University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
Publisher
BioMed Central Ltd
Abstract
Background: Classic neuraxial techniques, such as thoracic epidural
anesthesia, or alternative approaches like the paravertebral block, are
not indicated in cardiac surgery due to increased bleeding risk. To
provide satisfactory analgesia without the need for excessive opioid use,
novel ultrasound techniques gained popularity and are of growing interest.
The pectoralis nerve block II (PECS II) has been shown to provide good
postoperative analgesia in modified radical mastectomy and might also be
suitable for minimally invasive cardiac surgery. Method(s): In a
single center, prospective, triple-blinded, two-group randomized trial, 60
patients undergoing elective, unilateral minimal invasive cardiac surgery
will be randomized to receive a PECS II with 30 ml of ropivacaine 0.5%
(intervention group) or sodium chloride 0.9% (placebo group). The primary
outcome parameter is the overall opioid demand given as intravenous
morphine milligram equivalents (MME) during the first 24 h after
extubation. Secondary endpoints are the visual analog scale (VAS) 2, 4, 6,
8, 12, and 24 h after extubation, the Overall Benefit of Analgesia Score
(OBAS) after 24 h, the interval until extubation, and intensive care unit
(ICU) discharge within 24 h, as well as the length of hospital stay (LOS).
 Discussion(s): This prospective randomized, controlled, and
triple-blinded trial aims to assess if a PECS II with ropivacaine 0.5%
helps to decrease the opioid demand in the first 24 h and increases
postoperative pain control after minimally invasive cardiac surgery. Trial
registration: www.clinicaltrialsregister.eu ; EudraCT Nr: 2021-005452-11;
Lukas Gasteiger MD, November 18, 2021. Copyright © 2023, BioMed
Central Ltd., part of Springer Nature.

<136>
Accession Number
2027902180
Title
Extracorporeal cardiopulmonary resuscitation-based approach to refractory
out-of-hospital cardiac arrest: A focus on organ donation, a secondary
analysis of a Prague OHCA randomized study.
Source
Resuscitation. (no pagination), 2023. Article Number: 109993. Date of
Publication: 2023.
Author
Smalcova J.; Havranek S.; Pokorna E.; Franek O.; Huptych M.; Kavalkova P.;
Pudil J.; Rob D.; Dusik M.; Belohlavek J.
Institution
(Smalcova, Havranek, Kavalkova, Pudil, Rob, Dusik, Belohlavek) 2nd
Department of Cardiovascular Medicine, General University Hospital in
Prague, First Faculty of Medicine, Charles University in Prague, Prague,
Czechia
(Pokorna) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Smalcova, Franek) Emergency Medical Service Prague, Prague, Czechia
(Huptych) Czech Institute of Informatics, Robotics and Cybernetics
(CIIRC), Czech Technical University in Prague, Prague, Czechia
Publisher
Elsevier Ireland Ltd
Abstract
Background: Refractory out-of-hospital cardiac arrest (OHCA) has a poor
outcome. In patients, who cannot be rescued despite using advanced
techniques like extracorporeal cardiopulmonary resuscitation (ECPR), organ
donation may be considered. This study aims to evaluate, in refractory
OHCA, how ECPR versus a standard-based approach allows organ donorship.
 Method(s): The Prague OHCA trial randomized adults with a witnessed
refractory OHCA of presumed cardiac origin to either an ECPR-based or
standard approach. Patients who died of brain death or those who died of
primary circulatory reasons and were not candidates for cardiac
transplantation or durable ventricle assist device were evaluated as
potential organ donors by a transplant center. In this post-hoc analysis,
the effect on organ donation rates and one-year organ survival in
recipients was examined. Result(s): Out of 256 enrolled patients, 75
(29%) died prehospitally or within 1 hour after admission and 107 (42%)
during the hospital stay. From a total of 24 considered donors, 21 and 3
(p = 0.01) were recruited from the ECPR vs standard approach arm,
respectively. Fifteen brain-dead and none cardiac-dead subjects were
ultimately accepted, 13 from the ECPR and two from the standard strategy
group. A total of 36 organs were harvested. The organs were successfully
transplanted into 34 recipients. All transplanted organs were fully
functional, and none of the recipients died due to graft failure within
the one-year period post-transplant. Conclusion(s): The ECPR-based
approach in the refractory OHCA trial is associated with increased organ
donorship and an excellent outcome of transplanted organs. Trial
registration: ClinicalTrials.gov Identifier: NCT 01511666. Registered
January 19, 2012. Copyright © 2023 The Authors

<137>
Accession Number
2026207153
Title
Intravenous Diltiazem Versus Metoprolol in Acute Rate Control of Atrial
Fibrillation/Flutter and Rapid Ventricular Response: A Meta-Analysis of
Randomized and Observational Studies.
Source
American Journal of Cardiovascular Drugs. (no pagination), 2023. Date of
Publication: 2023.
Author
Bolton A.; Paudel B.; Adhaduk M.; Alsuhaibani M.; Samuelson R.; Schweizer
M.L.; Hodgson-Zingman D.
Institution
(Bolton) Department of Epidemiology, College of Public Health, University
of Iowa, Iowa City, IA 52242, United States
(Paudel, Adhaduk) Department of General Internal Medicine, University of
Iowa Hospitals and Clinics, Iowa City, IA, United States
(Alsuhaibani) Department of Pediatrics, King Faisal Specialist Hospital
and Research Centre, Riyadh, Saudi Arabia
(Alsuhaibani) College of Medicine, Alfaisal University, Riyadh, Saudi
Arabia
(Samuelson) Hardin Library for the Health Sciences, University of Iowa,
Iowa City, IA, United States
(Schweizer) Division of Infectious Disease, University of Wisconsin School
of Medicine and Public Health, Madison, WI, United States
(Hodgson-Zingman) Department of Cardiology, University of Iowa Hospitals
and Clinics, Iowa City, IA, United States
Publisher
Adis
Abstract
Background: Atrial fibrillation (AF) and/or atrial flutter (AFL) with
rapid ventricular response (RVR) is a condition that often requires urgent
treatment. Although guidelines have recommendations regarding chronic rate
control therapy, recommendations on the best choice for acute heart rate
(HR) control in RVR are unclear. Method(s): A systematic search
across multiple databases was performed for studies evaluating the outcome
of HR control (defined as HR less than 110 bpm and/or 20% decrease from
baseline HR). Included studies evaluated AF and/or AFL with RVR in a
hospital setting, with direct comparison between intravenous (IV)
diltiazem and metoprolol and excluded cardiac surgery and catheter
ablation patients. Hypotension (defined as systolic blood pressure less
than 90 mmHg) was measured as a secondary outcome. Two authors performed
full-text article review and extracted data, with a third author mediating
disagreements. Random effects models utilizing inverse variance weighting
were used to calculate odds ratios (OR) and 95% confidence intervals (CI).
Heterogeneity was assessed using the I 2 test. Result(s):
A total of 563 unique titles were identified through the systematic
search, of which 16 studies (7 randomized and 9 observational) were
included. In our primary analysis of HR control by study type, IV
diltiazem was found to be more effective than IV metoprolol for HR control
in randomized trials (OR 4.75, 95% CI 2.50-9.04 with I 2 =
14%); however, this was not found for observational studies (OR 1.26, 95%
CI 0.89-1.80 with I 2 = 55%). In an analysis of observational
studies, there were no significant differences between the two drugs in
odds of hypotension (OR 1.12, 95% CI 0.51-2.45 with I 2 = 18%).
 Conclusion(s): While there was a trend toward improved HR control
with IV diltiazem compared with IV metoprolol in randomized trials, this
was not seen in observational studies, and there was no observed
difference in hypotension between the two drugs. Copyright ©
2023, The Author(s), under exclusive licence to Springer Nature
Switzerland AG.

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